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HomeMy WebLinkAbout238 FAIRWAY PL - Building Permits(774) 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 Vicinity: Parcel Nunmber. Applicant Address: Owner: Address Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recepl Outlels Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to thp Motors to tOhp Molors to 50hp Motors to 100hp Motors over 100hp Communication drops 238 FAIRWAY PL REAR SFD 43921308 GREGORY, JpHN S 238 FAIRWAY PL COSTA MESA, CA GREGORY, JOHN S 238 FAIRWAY PL COSTA MESA, CA OWNER-BUILbER Phone: 949-722-8146 Zip 92627-4612 Phone: 909393-8655 Zip: 92627-0612 Phone: Zip: License: 000000 Staws: ISSUED Applied: 02/17/2005 Issued: 02/17/2005 ISSUED BY: .' " • Mti J, - � - � {'yy, ,.( .�,�ry�� � SCOPE OF PERMIT CONSTRUCT A 332 SF IN-GROUND GUNITE POOL 8 38 SF SPA. AT THE REAR OF AN EXISTING SFD. 1POOUSPA REF:BOS-00296 $23.50 50.00 30.00 30.00 $0.00 $49.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 t 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / �ighling Busway/100 k Standing Section Misc Electncal Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Qaantity 50.00 0 50.00 0 30.00 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 $0.00 0 $0.00 0 $0.00 $0.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 72-21-92) EXPIRATION: This permit shall automatic811y expire and become void it 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 Inapectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aa646 (6/W) WORKERS'COMPENSAnONDECLARAnON: I �ereby aHirm under penalry of perjury one of ihe following daclarations: ❑ I have antl will maintein e certificeta ol consent to self-Insure for workers' compensetlon, as provided for by section 3700 0l the Labor Code, for the pertormence of tne work tor which this permi� is issuetl. ❑ I have and will maintain workers' compensatlon insurance, as required by section 3700 ot the Lebor Code, Por t�e pedortnance ol tha work for which this pertnit is issued. My workers' compensatlon Insurence carda� entl policy number are: Carder. veluetl af one or/ess.) Policy Number: �;% I certily that in the peAortnence oi the wark tor w�ich this pertnit is issuetl, I shell not emplay eny person in any menner sa es to 6ecome su6ject to the workers' �' compensation laws ol G' omia, entl egree thet il I shoulC bewme sub�ect b the workers' compensation pmvisions oi SecUon 3700 of Ihe Labor Code, I s�all forthwith compry wiN these pr isio s. Z�/ �/O � � re: D�1» WA NING:FAILURETOS (ERS'COMPENSATIONOJVERAGEISUNLAWFULANDSMALLSUBJECTANEMPLOVERTOCR� PENPLT SAN�GVILFlNESUPTOONEHUNORED THOUSANDDOLLARE($1 ,000),INADDITIdJTOTHEC0.STOFCOMPENSATION,�AMAGESNSPROVIDEDFORINSECTIIXJ31060FiHELABORCODE,IIJrEREffi,ANDATTORNEYSFEES. LICENSED CON7RACTORS DECLARATION: I horeby eNirm ihat I am licensed under provisions of Chapter 9(commencing with Sectlon 7000) of Divislon 3 of ihe Business antl Professions Code, end my Ilcense Is in full tome end aflect. Lic. q Class a Conirector's Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aMirtn that there is a construction le�ding egency for Ihe pertormance ol ihe work for w�ich Ihis pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signeture: Date: i OWNER-BUILDER OECLARATIONS: I hereby eflirtn Ihat under penalry ot perjury thet I em E%EMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or counry which requires e pertnit to construc6 alter, improve, demolish, or repeir eny structure, prior to its issuence, also requires the epplicant lor such pertnit to file e slgne tatement that he or she is Ilcensed pursuant to the provisions of the Coniredors License Lew (Chapter 9(commencing with Section 7000) of DlNslon 3 of the Busine Professions Catle) or t�et he or she is exempt therefrom and the 6asis br the ellegetl e:emption. Any violetlon ol Section 7031.5 by eny epPlicant for a permit subj the epplicantlo a civil penalry of not more ihan tive hundred dollers (5500).): I, es owner of the property, or my employees with weges es their sole compensetion, WILL DO THE WORK, antl ihe sirucWre Is not intentled or otteretl tor sala (Sec. 7044, Business and Protesslons Code: The Contractore License Law dces not epply lo en owner ot properry who builds or improves thareon, and who does such work himself or herself br thmu'gh his or her own employees, proviaetl that such improvements are not intended or oHered for sala. H, however, ihe building or improvement is soltl within one year oi comple6on, ihe ownB�-buildar will heve Ihe bwden ol proving that he or she did not build or improve lor purpose of sale.). � ❑ I, as owner af the property, am EXCLUSIVHLV CONTRACTING WITM LICENSED CONTpACTORS to construct tha proJect (Sec. 7044, Business end Professlons Code: The comractors License Law does no� epply to en owner ot propeny who bullds or Improves Ihereon, and who comracts for such project with e contractor(s) liten5e pur5uant to lhe Contrector5 Lltense �ews.). ❑ I em exe der sec. Business end Prolessions Code for lhis reason: lure: Owner ID verifi vers license. Ves ❑ No D: ,er�s'�._L' e se No. `' Verificetlon ol nership by (type ol documem, i.a. - properry Iax 6ill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CBA7�FICA710N: ❑ I hereby cenify that no excavation tive (5) or more teet in tlepth into which e person Is requlred to descend, will De made In connectlon with work authorized by ihis permil, and that no building structure, scaMolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Califomia AtlmlNstretive CoOe). � ❑ As ownerv6uilder, I will not employ anyone to do work which would require a permit imm the Division ot Industriel Selery, as noted ebava, unleu such person hes a permit lo do such work from the division. Signature: Dete: Division ot Indusirial Satery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AU7HORWITON OF ENfHV: I cenity under penalty of perjury that I have read this application and state ihat ihe infortnation given is wrrect. I egree Io comply wi�h ell state lews end city ordinances rela�ing to building consWction, end authonze representetives ol the Ciry of Cosia Mesa to enter upon Ihe abova-desc' r pa y for inspection Ourposes, � egree not to occupy or ellow occupency ol eny building authorized by this per il until final inspec�ion. 2 i;�/�s_ namr�eJiOrv�ner(s) ° "sate'�" And/Or Authonzed ApPlicant Date COQE 1. INSPECTIONTYPE 161G Fized System Final Fire Prevention 126G Pool Spa Final 200 Finel Re-Roof 201 Finel BlwklRetaini� W all 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition PAIE lt�dl@ 400E� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electricel 212 Final Fire Preve�tW� 220 Final Planning Approval 222 Final Site 250 Final Building/Occupenry PL� U�LS r 1 ��t� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 Job Address: 238 FAIRWAY PL Suite No Vicinity: REAR SFD Parcel Number: 43921306 npp�icant: GREGORY, JOHN S Address: 238 FAIRWAY PL COSTq MESA, CA Owner: GREGORY, JOHN S Address: 238 FqIRWAY PL COSTq MESA, CA Contracror: O W N E R-B U I L D E R Address: MECHANICAL PERMIT Phone: 949-722-8146 Zip: 92627-0672 Phone: 909393-8655 Zip: 92627-4612 Phone: Zip: License: 000000 Status: ISSUED Applied: 02/17/2005 Issued: 02/17/ 005 ISSUED BY: SCOPE OF PERMIT CONSTRUCT A 332 SF IN-GROUND GUNITE POOL & 38 SF SPA. AT THE REAR OF AN EXISTING SFD. 1 INST FAU > t00K BTU REF: BOS00296 ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heal Inst / Rep. Recess Wall Htr Refng Sys <100 k BTU Refng Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $0.00 $18.20 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 50.00 $0.00 S0.00 $0.00 $0.00 $0.00 $0.00 50.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeralion Unit Ventillation System Evaporative Cooler � Commercial I ncinerator Domestic Incinerator Compressors / Absorotion Systems Upto3hp/.t00kBTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp I 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Uplo3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Imestigalion Fee - Plan Check Fee - ,. O. �. ?'.. .n� ' � ��.� .+-�...' . � ' . ..c-.�-.. �..ri" i 1 „ , Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 N0710E: The work authorizetl by Ihis permit shall comply with a!1 applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-g2) ' EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1 BO days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 . / 2446-bfi(fl/00) WORKERS' COMPENSA710N DECLARATION: I hereby ettirm untler penalty ol perjury one ot the tollowing tleclarations: ❑ I heve end will maintein e certiticete of consent to sell-Insure tor workers' compensetion, es pmvided tor by section 3700 0l the Lebor Code, lar the pertortnance of Ihe work for w�ic� this permit is issuetl. ❑ I have entl will maintaln workers' mmpensation insurance, as requlrad by section 3700 0l the Labor Cotle, for Ihe pertortnance ot the work for which this permit is issuetl. My workers' compensatlon Insurance wrner antl policy num6er ere: Carriar: Policy Numbec (This tlon need nof be camp/efetl i! the permit is va/ued et one hundred dollers ($ f00) or less.) � I certity that in the Dertormance ol ihe work for which Ihis permit is issued, I shell not employ any person in eny manner so as to become sublect ro the workere' compensetlon laws ol Iitomia, end egree that It I should become sub�ect to the workers' compensation provlsions ot Section 3700 of the Lebor Code, I shali torthwith coinplywit�these ovi '_ eanl'SignaWre: �; �// �%/C%S WARNINO: FAILURE TO WOFKERS' WMPENSATION CqVERAGE IS UNLAWFUL AND SMP1L SUBJECi AN EMP OYER TO C�NAL PE ilES ANO CIVIL FlNES UP TOONE HUNDRED TFIOUSAND OOILARE � .00O�, IN ADDRION TO iHE COST OF CAMPENSATION, OAMAGES AS PROVIDED FOR IN SECf10N 3'!OB OF THE UBOR CODE, IMEREST, AN� ATTOFNEV'S FEES. LICENSED CON7RAC70RS DECLARATION: I hereby eflirm that I em licensetl untler provisions of Chapter 9(commencing with Sealon 7000) ot Division 3 of ihe Business and Professlons Code, entl my license is in full force and ettect. Lic. a Class a Comractors Signeture: Date: CONSTRUCTON LENDING AGENCV: ❑ I hareby aNirtn that Ihere is a construction landing egency for �he pedormanca ol the work br which Ihis pertnit is issued. (Sec. 3097, Civil Code). , Lentler'S Neme: Lentlels Adtlress: Signaturo: Date: OWNER-BUILOER DECLARATIONS: I hereby effirtn Ihet under penalry ot perjury that I am EXEMPT FqOM THE CONTRACTORS LICENSE LAW tor the lollowing reeson (Sec. 7031.5, Busineu end Professions Cotle: Any ciry or counry which requires e parmit ro construc�, alter, Improve, demolish, or repair any strucWre, pnor to its issuanca, also requires the applicaN for such pertnit lo file e signed statement ihat he or sha is licensed pursuant to the provisions ot ihe Contractors License Law (CheO�er 9(commancing with Sectlon 7000) oF Dlvision 3 oi ihe Business en Brofesslons Code) or that he or she is exempt therehom entl tha 6esi5 lor the elleged exemption. Any vloletion ol Sectlon 7031.5 6y any applicent tor e permit subject epplicant to e civil penalry of not more t�en tive �undred dollers (5500).): � I es owner oi Ihe properry, or my employaes with weqes as ihelr sole compensatlon, WILL DO THE WORK, antl ihe structure Is not intentled or oHered for sale (Sec. 7044, Business and Professions Cotle: The Contrac�ors License Lew does not apply to an owner of property who builds or Improves thereon, end who does such work hlmself or he�s^;; c• �hrough his or her own employees, provided ihat such improvements are not Intended or oHeretl for sele. If, however, Ihe building or improvameM is sold'within one yeer o; .:ornpletion, ihe owner-builder will have the burden of proving �hat he or she did not build or improve for purpose of sale.). � ❑ I, as owner of the�pmDerty, am EXC WSIVELV CONTRACTING WITH LICENSED CONTRACTORS b construct the prolect (Sec. 7044, Business and Protessions Code: The conirectors Llcense Lew does not apply to en owner ol property who Oulltls or improves thereon, entl who wntracis lor such pmjeq with a contrecror(s) license pursuant to the Conirectors License Laws.). ❑ I am axe pt r sec. Business antl Professions Code for this reason: 9�� rgr Owner 10 ve' atl tlnve s icense. ❑ Yes ❑ No DriV�e"�'j .�i7"c �cnsa�No.. � Venfication t nership by (rype ot document, i.e. - properry tau bill or daed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity t�et no excavation five (5) or more feet in depih into which e person is required to descentl, will De made in connection with work authorized by this permit, end that no builtling sirucNre, scalloltling, lelsework, or demolition or dismantling theraoi, will he more than thirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Callfomia Atlministrative Code). . ❑ As owner�builder, I wlll not employ enyone to do work which would require e permit irom the Division of Indusidel Safety, es noted ebove, unless such persan has a pennit to do such work from ihe division. Signature: Date: _ _ Division ot Industnal Satety Permit Numbec CER7IFlCATE OF COMPLIANCE AND AIffHORVA710N OF ENTRY: I cenity under penalry ot perjury that I have read this epplicetion and state Ihat the information given is correct. I ogree to comply wiih all state laws antl city ordinances relating to building construction, and auihorize representatives of ihe Ciry of Goste Mesa to amer upon the ebove-described prop r ins ection purposes. I agree not to occupy or ellow acupancy of any building authonzed by �h' permity ntil final inspection. 2%i7/b � gnallu�pq4Dufien�l- � 1:5 • ata AndiOr Authorized Applicant Date CODE 1. INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spe Finel 200 Finel Ra-Rool 201 FIneI BIocWReteining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demolition Qdjf, f�¢ 1C�U� INSPECTIONTYPE 206 Finel Mechanical 208 Finel Plumbing 210 Finel ElecMcal 212 Finel Fire Prevenilon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy (714) 754-5273 • Fa�c (714) 754-4866 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 238 FAIRWAY PL Suite No Vicinity: REAR SFp Parcel Nunmber: 43921308 Applicant: GREGORY, JOHN S Address: 238 FAIRWAY PL COSTA MESA, CA Owner: GREGORY, JOHN S Address 238 FAIRWAY PL COSTA MESA, CA Contractoc Address: ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service OWNER-BUILDER PLUMBING PERMIT Phone: 949-722-8146 Zip: 92627-4612 Phone: 909393-8655 Zip: 92627-4612 Phone: Zip: License: 000000 Staius: ISSUED Applied: 02/17/2005 Issued: 02/17/2005 ISSUED BY: .. t � _.gY. _ . r �r ;y"b- SCOPE OF PERMIT CONSTRUCT A 332 SF IN-GROUND GUNITE POOL & 38 SF SPA. AT THE REAR OF AN EXISTING SFD. 1 SWIMMING POOL, 1 PRIVATE SPA REF: BOS•00296 . _ AMT $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEESUMMARY QTY AMT -QTY Laundry Tub / Washer $0.00 0 0 Landscape Irrigation $0.00 0 0 P-Trap $0.00 0 0 Pressure Regulator $0.00-.- 0 0 Process Piping (per 10 ft) $0.00 ' 0 0 Receptars $0.00 0 ' 0 Septic Tank $0.00 0 0 Sewer Cap for Demo $0.00 0 0 Sewer Connect $0.00 0 0 Sewer Private Line $0.00 0 0 �Shower $0.00 0 0 Sink, bar $0.00 0 0 Sink, commercial $0.00 0 0 Sink, Floor $0.00 0 0 Sink, kitchen $0.00 0 0 Sink, service/mop $0.00 0 0 Spa(private) $3025 �-.1 0 �Spa (public) $0.00 0 SumpPump Swimming Pool Trap Pnmer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK AMT $0.00 $60.75 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall aUtomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final approval must be obtainetl. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 , / 24a6-46(6/00) WORKERS' COMPENSATION DECLARA710N: ' I hereby attirtn undar penalty of perjury one of Ihe following declarations: ❑ I have and will maintaln e ceniticete ot consent to self�lnsure for workers' wmpensation, as providetl tor by section 3700 of the Lebor Code, lor the pedormance of the work for which this pertnit is issueA. ❑ I have and will maintain workers' compensation insurance, as raquired by section 3700 of the Labor Catle, for Ne pertortnance of tha work Por whiU Nis pertnit is issued. My workers' compensation Insurance carner and policy numher are: Carrier: (This s� ane Policy Number: or less.) �'4 I certify that in the pertortnenca of the work for which Ihis permit is issued, I shall not employ any person in eny manner so as lo become subl� �o �he workers' l compensation laws ol C fomia, end agree that if I should bacome subject to Ihe warkers' compensation provi5ions of Sectlon 3700 oi Ihe Labor Code, I shall forthwith comply with these pr isi s. / � Ap�i�aa�igne70r`e: _- oat.� 2/ ! i /OS u WARNI G FAILURE TO S E�N R�f S' C616� ATION CAVERAGE IS UNLAW FUL AND SHALL SUBJECT AN EMPLOVER TO CRIMI AL PENAL ES FNO CM� FWES UP i0 qJE HUNDRED THOUSAND DOLLARE (5100,000�, �F77�DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3]O60F THE L4BOF CODE, INTEREST, AND AiTORNEI"S FEES. IICENSED CONTRACTORS DECLARATION: I here6y aNirm that I em licensetl untler provislons of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, antl my license is in full force end ettect. Lic. # Cless N Contrector's Signemre: Dete: CONSTRUCTION LENUING AGENCY: ❑ I hereby aNirm thet fhere is a constmction lentling agency for ihe peAormance of the work br which this permit is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: 1 �ereby aHirtn thet under penalry of perjury Ihat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any city or county which requires e permit fo construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such pertnit to file a �Igned statement that he or she is Ilcensed pursuant to the pmvisions of the Contractors License Lew (C�epter 9(commencing with Section 7000) ot Division 3 of the Business and Professions Cade) or that he or she is eaempt theretrom and the basis tor the allegad exemption. Any violetion of Section 7031.5 by any applicant for a pertnit subjecis ihe epplicant to a civil penalry of not more ihan five hundred dollars ($500).): �][�" � as owner of Ihe properry, or my employees with wages as iheir sole compensation, WILL DO THE WORK, end the strucWre is not intentled or ottered for sale (Sec. "-7044, Businass and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work himsalf or herselt or through his or her own employees, provided that such improvements are not intended or oHered for sale. If, howevar, ihe building or improvement is sold within one year ot completion; the owner-builder will have ihe burden of proving that �e or she did not build or improve for purpose of sale.). � ❑ I, es owner of the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the projact (Sec. 7044, Business and Professions Code: Tha contractors License Law tloes not apply to an owner of property who builds or Improves ihereon, and who contracis for such project with a contractor(s) liconse pursuant b the Comractors License Laws.). ❑ I am e�mAt undet sec. Business and Professions Code for this reeson: �rivefs licens� ❑ ves ❑ No Ownership by (type of daument, I.e. - property tac 6ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cehity ihat no excavetion five (5) or more teet in depih into which a person is required to descend, will be mede in connec�ion with work authorized by ihis permit, and that no building stmcture, scaflolding, talsework, or demolition or dismantling ihereof, will be more then ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, CeliPornia Adminlsirative Code). � ❑ As owner-builder, I will not employ anyone to do work which would require a permit fmm the Division of Indusiriel Sefety, es noted ebove, unless such person has e permit �o tlo such work from tha division. Siqnawre: Date: Division oF Intlustrial Safety Permit Number. CERTIFlCATE OF COMPLIANCE AND AU7HORVATON OF EN7RY: I certiry under penalry of perjury that I have reatl this application and state that the iniormation given is correct. I egree to comply with ell stete laws and ciry ordinances relating to builtling consiruction, and authorize representatives of t�e City of Costa Mesa to enter upon the above-described prop ection ur oses. I agree noi to ocwpy or allow occupancy of any building authonzed by this yermit u I final inspection. 2//��d� ignatur LegelOwner(s) � dDate, i� And/Or Authonzed Applicanl Date COpE t. INSPECTONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Finel Slgn 204 Finel Demolition u�rE ixrm�� cooe� wsvecnoxnre 206 Final Mechanical 208 Final Plumbing 210 Final Eleciricel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency o�re �� I�AC.l1�� �� ISS p�a� �sa-sz�s • Fax (714) 754-4856 • www.c�.cos�a-mesa.���LDING PERMIT ,labAddress: 238 FAIRWAYPL Suite: Vicinily: SIDE OF PROPERTY LINE Parcel Number: 43921308 Applicant: GREGORY, JOHN S Address: 238 FAIRWAY PL COSTA MESA, CA Owner: GREGORY, JOHN S Adtlress 238 FAIRWAY PL COSTA MESA, CA Contractor: OWN ER-BUILDER Address: Zip: Arch : Address: Zoning: Phone: 949.722.8146 Zip: 92627-4612 Phone: 909-393-8655 2ip: 92627-4672 Phone: License: 000000 Eng: Address: 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 10/17I2002 Issued: 10I18/2002 ISSUED BY: � Phone: Phone: Zip: License: � License: SCOPE OF PERMIT CONSTRUCT SOLF, 6' HIGH BLOCK WALL ON THE RIGHT SIDE PROPERTY LINE SETBACK 20' FROM THE FRONT PER CITY STANDARDS. Plan Check: $25.19 Permit: $38.75 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 inspection: $0.00 Total: $64.44 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0. 0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0. 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0. 0 Lefl 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 s�,000.00 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (OM. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shali automatically exp(re and become void if work is not commenced within 1 BO 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 inepectlons and final approvel must be obtained. Failure to obtaln inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALI: (714) 7545626 2aaaael�oo) WORKERS'COMPENSAnON OECLARAnON: � I hereby aHirm under penalry ol perjury one of the following declaratlons: ❑ I heve end will meintain e c9h���cate of consent to self-Insure br workers' compensation, es O�o�tled lor by section 3700 oi Ihe Lebor Cotle, for the peAormance of the work lor whlch this permlt i5 Lssued. ❑ I have entl wlll maintein wwNers' compensation insurer�ce, ss requiretl by SecUon 3700 oi ihe lahor Code, for Ihe peAortnance ol Ihe wwk lor which tftls pemtit Is issuetl. My workers' compensatlon Insu2nce cartier arM polity num�er ere: Carrier. no! or less.) Policy NumDer. _� ( cenily t�el In Ihe pertortnance ol tha work tor which Ihis pertnit Is issued, I shall not employ any person in eny manner sa es to becwne suD�ect to Na workers' compensatlon laws ol Celifomia, and agrae that il I should become sub�ect Io the workero' compensetion provlslons oi Sectlon 3700 0l ihe Lebor Code, I sha111oMwlth comptywiththese visions. � � F �p�p,��lkam�5lgneN.�ra:� Dele: �� �� O�. ARNINW G: FAILUqE TO O�ERS' COAV�I ATION COVEMOE IS UMAWFUL AND SWLLL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAN�DOLLARE( ,OO�,INAPDIiIqJTOiHEWSTOFCOAIPEN5AT10N,DAMAGESASPROVIDEOFORINSECTION3]OBOFTHEUBORCOOE,IMEREST,ANDAITORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm ihat I em licensed under provisions of Chapter B(commencing wlth Section 7000) ot Division 3 of ihe Business ond Professlons Code, and my license is In full iOfCB 0fld BHBCI. UC. M CIB39 N Gomrectofs Signawre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eflirm thet ihere Is a cwistrucGon lentling agency br Ihe pedormanco of the work br which this permit Is issued. (Sec. 3097, Civil Cotle). Lentler's Neme: Lentlefs AAdress: Sipnature: Oate: OWNER•BUILDER DEGLARA710N5: I hereby eflirm t�et untler penalry ot perjury thet I am EXEMP7 FROM THE CON7RAC70R5 LICENSE LAW for t�e tollowing reason (Sec. 7031.5, Business end Professlons Code: Any city or counry which reGuires e pertnit to consWct, fllter, imprwe, demdish, or repair eny sirucWre, pdor to its issuence, elso requires ihe appliwnt tor such permit to ille e signetl stetement thet he or she is licensetl pursuent to the provisions ol the Contrectors License Lew (Chepter 9(commenUng with Section 7000) of D'Msion 3 of the Business and Professions COAe) or lhat he or sha is axempt tharefrom enC Ihe besis for the elleged exemption. Any violetlon ol Sectlon 7031.5 by any epPlicant for a permit sublecis ihe epplicant lo e dvil penalry af not more than live hundred tlollers (5500�.): ❑ I, es owner af Ihe propeny, or my employees wilh weges es lhelr sole compensatlon, WILI DO TME WORK, and the structure is not Intendetl or ottere0 for sele (Sec. 7044, Business and Professions Cotle: The Coniractors License Lew does noi epply �o an owner of propehy who builds or improves ihereon, and who does such work hlmself or herself or lhrough his or her own employees, provided ihat such impmvemenis are not intended or oMered tor sele. If, �owever, Ihe building or Imprwement Is soltl wi�hln one year ot completion, the owner-builtler will have the burden of proving that he or she did no� builtl or imD�o�e for purpose ol sale.). ❑ I, es owner ot the pmperty, Am EXCLUSIVELY CONTRACTiNG WITH LICENSED CONTAACTORS to construct ihe project (Sec. 7044, Business and Professions Cotle: coniractors Llcense Lew does not appy to an owner ol proparty w�o builCs or impmves Ihereon, entl who contrects br such project wi[h a contractor(s) _ li se.pursuent to the CoNrectors License Lews.). Busine55 Bnd Professians Code for �hi5 reeson: Owner ID ve ' ie� drivers licens� Yes ❑ No VedllcaHon a ersNp Dy (type ot Oaum �.e. - property tax hlll or tleetl): DIVISION OF INDUSTRIAL SAFET' PERMI7 CER7IFICATION: ❑ I hereby certlty that no excevetion Me (5) or more teet in tleD�h Imo which e parson is requireA to descend, wlll be matle In connecUon with work authodzeE by thLn permlt, and that no bullding 5��ucture, sceilolding, lalsework, or tlemolition or tlismantling thereot, will be more than Ihirry•six (38) teet �Ig�. (C�ep. 32, Grp 2, AM1 2, SeC. 337, Title B, Celllomia Atlmin�stretive Code). ❑ As owner-bullder, I will nol employ enyrone to da wark which woultl requlre a pormil Irom Ihe Division ot Intlusinel Safery, es notetl ebove, unless such person hes e pormll lo do such work Irom �ha divislon. Signature: Dato: Dlvision o� Industrlal Solaty Permil Number. CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF ENTAY: I cenity under penalry of perjury thet I heve reed this epplication antl state that Ihe Informatlon given is correct. I agree to compty wlth ell state laws end dry ordinences relatlng to builGing construction, entl eNhodze representatives af tha Clry of Costa Mesa to enter upon the abave•described pro erty br insp�ctlon Quryases. I agree not to occupY or ellow occupency ol eny �uilding euthorized hy�� pprmit u til line�pection. 'SignB)'uF" CegalOwnerSb) ����lpate ' " AnNOr Authonzed Applicent Oata COOE �. INSPECTIONTYPE 1816 Flxetl System Final Fira Prevenilon 1286 Pool Spe Finel 200 Final Re-Root 201 FInaI8locWRetaining Well 202 Final Fectory Fira Place 203 Finaf Sign 20d Final Demolition P� I[{�l@ �7'�/' �QQE2 INSPECTION TYPE 206 Final Mec�enical 208 Finel Plumbing 210 Finel Elocirical 212 Finel Fire Prevention 220 Final Planning Appro�al 222 Finfll Slte � 250 Finel BulldindOccuoern PAIF ItlD�dlffi • T}flS SI�TQi LS FOR INFORMATfONAL WRPQS6 ONLY. APPIJGM LS RFSPONSIBLE FOR PROVIDIIJG AN ACCURATE REPRESFNI'ATION OF 1}�Qt PROPERTY QJ CASE 7HE Sl-lAPE AND SIZE DO N07 ODRRFSPOND WIfH THE INFORMA170N PROVIDID ON 7}ffS SFffiEl'. i � T C 16 1 ��� —d� %U 7 • SOLD WALLS/FFNCFS BEIWEIN 2'�6• k 6' QJ FIDGtfI' SHALL BE SEI'BAIX AT IFASf 10' FROM FRONf' PROPFRIY LINE. • 90LID WALiS/FFNQ�S SFIALL N07' S%�D 2' 6' IIJ k�IC}fC WII}�I10 OF'It� FROM PROPFRTY IlNE �10T NRB IINE7. • VERffY DLSTAN� FROM NRB TO PROPEfC�Y LINE AND SfiOW ON P[AN. VERIF7Gl10N FROM li� Q7Y5 ENCINFFRNIG DIV6fON S REQU6tED. ULL (711) 754Si�3 POR IIJFORMATfON. �.tttt`L.Y tl 1li� (•�f �..' ,' � nr rrcT ,.-.. _ Ti�'„ -o��r'.,...,. _ ' - �IIVIW PLANNING DIV. E APPRv'Fil R.V L;. BLDG. DEPT, REG ...s,j� fJ ,.! � �P.�/�7 2 CA 0 n�sse 4���� --- -- � ����. ' ditisYts�sNi� d ��i� RE90ExfF �1.�.LJ � �i J ' i �(� I" M9IFNQ N� � 1 1 lU f� OVE 8 Co4� � t �� RC90EMCC � """"'""""'" I _ � _ �3� �'U��STREET �Q(.�-GQ. BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION �6 �� ,r I '� I TYPICAL 6�� CONCRETE BLOCK FENCE Cemem Coping Optianal � C�annel8bck With 1�3/8� Hori:onul Top ol all Fencn For Fence� 5' ar less Ven. Bars 3/8"¢ at 4' �0" O.C. For Fences HigAer Than 5' Vert. Ban 3/8"Q at 32" O.C. � Fill Cells Solid With Grou1 Where $Ieel OCcun Rnninrcing Sleel $hall Cunlorm �o Sec.A�15�39 A.S.7.M. All S�eel to be Lapped 24" or to Code NATUHALGRADE TWO 7/8"d BARS �-1 CONTINUOUS TOV I 6 BOTTOM y_� HOQIZSTEEI MUST BE T1E01N PLACE AT TIME OF TRENGH INSVECTION. a 0 a z V '- � Y W R I a > z e i � .� yA 'U ry _ en - - �-►— W IDT F � SEE CN� L BE�OW o ^ I �+—•--� '�', � ^ � _ �• WIOTH THICKNES$ . OEPiH OF EARTHTOOTH SPACING OF EARTHTOOTH 14 10" 24" 12' .. [' � �- , a: ; =00TING�'RE�UIREMENTS CHART ' 5 �" :' � . 14" . :i " 10" 20" - 14� . �U��D��l� DI 7 �.7I�� 12" 9` 16" 16' GENERAL- NOTES MORTAR: p�e part Plastic Cement, and Three Parts Sond GROUT: One Port Cemenf Three ana One Holf Ports �and COPING: One Part Ctmeot, Three Parfs Sond CO!vCRETE: Wen Mned C2-I/2:3-I/2 Mar of 7- I/2 Gal;cns of Watar Per Sack ol Cemenl GROUT MAV BE POUREU FROM THE TOV OF TME FENCE IN CELlS WHERE STEEL OCCURS. CELLS AND AREASOF NOHIZONTAL REIN FOHCEMENT SHALI BE CIEAR, CLEAN 6 FREE OF ALL MORTAR DEBR15, ETC. 11,.�' [4RTHTCOTH V. fHE ME�GTN Of �ENCE �IOW BOTTOM O� iOGT�NG SCALE: I/2�� = I 12" 8" 12� 16' (714) 754-5273 • Fa�c (714) 754-4856 • www.Ci.Costa-mesa.Ca.uS 77 FAIR DRIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job Address: 238 FAIRWAY PL Suite: Vicinity: NEW FRONT PORCH & NEW PATIO @ REAR Parce� Number: 43921308 App�icant: GREGORY, JOHN Address: 238 FAIRWAY PL COSTA MESA, Cq Owner: GREGORY, JOHN Address . -238 FAIRWAY PL COSTA MESA, Cq Contracror: OWN ER-BU I Lb ER Address: Zip: Arch : Address: Phone: Zoning: ISSUED BY: Phone: (949) 548-8828 Zip: 92627 Phone: (949) 548-8828 Zip: 92627 Phone: License: 0 Eng: Address: Status: ISSUED Applied: 04/23/2001 Issued: 04/23I2001 Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 99 SQ FT PATIO COVER ATTACHED TO REAR OF EXISTING SINGLE FAMILY RESIDENCE AND 65 SQ , FT FRONT PORCH. ' � Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $137.86 �. � ;� � SETBACKS� � �. MAINSTRUCTURE Front 20-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 11- 0 Rear 0- 0 ReQuired: 0 FEE SUMMARY PLANNING & ZONING Left 74-6 Left , 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuafion: i � ��'. � � %�/ i Right` 10-0 . % Right 0- 0 $2,643.68 so.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92•2B, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void iF work is not commenced within 180 days, or il work is suspended or abandoned for a periotl of 780 tlays. INSPECTIONS: In order tor fhe work authonzed under this permit to be considered Iegai, such work must compty with all applicable codes, and all required Inapectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration.of this permit. FOR INSPECTIONS CALL: (714) 7545626 244W8(fi/00) WORKERS'COMPENSAnON DECLARATON: � I hereby aXirtn under penalry o� perjury one of ihe following tleUarations: � ❑ I have end will meintain a certlliwta ot consent to sell-Insure for workers' compensetion, es proWtled tor by section 3700 of the Lebor Coda, br the pertortnance o1 the work for which this Dertnit is issuatl. ❑ I have entl will maintain workers' compensaGon Insurance, as required by sectlon 3700 ot Ue Lebor Cade, tor tha padortnance of the woAc for which Ihis permit is Issued. My workers' compensation Insurence wrrier entl policy number are: Cerner. Policy Number. (Th/s sec(ion neetl not be canpleted i/ the permit is valuetl at one hundred dollars (5700) or less.) ❑ I certily Ihat in the perlormance ot ihe work for which Ihis permit is issued, I shall not employ eny person In any manner so as to become su6ject to the workers' compensetion laws of CB�Ifomla, antl agrea Ihat if I s�ould become subjact to the workers' compensation provisions of Section 3700 oi ihe Labor Cotle, I shell forthwith comply with these Dmvisions. Applicnnt SlgneNre: Data: WARNRICv FAILURE TO SECURE WORKERS' COMPENSATION CAVERApE IS UNLAWFl/L AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND dVIL FWES UP TOONE HUNDRED THOUSAND DOLLAqE (5100,000�, IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE IABOF CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aftirm that I am licensdd untler provisions oi Chapter 9(commencing wlth Section 7000) ol Divislon 3 ot che eusiness and Professions Cotle, antl my license is In full force and eHecL Lic, a Class N Contractors Signature: Dete: CONSTRUCTION LENDING PGENCY: ❑ I hereby aHirtn thal there is a consiruction lending agency for ihe peAormance of ihe work lor which ihis parmit is issuetl. (Sec. 3097, Civil Code). Lentlels Name: Lendefs Adtlress: SignaNre: _ OWNER-BUILDER DECLARATIONS: Date: I hereby etfirm t�et under penalry oi perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Busine5s end Proleulons Code: Any ciry or county which requires e pertnit to construct, alter, improve, tlemolish, or repair eny strucWre, pnor to its issuance, also requires ihe epplicaN for such permit to tile a signa statement that he or sha Is licensed pursuant to the provisions of the Comracrore License Lew (Chepter 9(commencing with Saclion 7000) ot Divislon 3 of t�e Business Protesslons Coda) or that he or she is eaempt therefrom and the basis for the alleged exemption. Any Wolation oi Section 7031.5 by eny applicant tor a pertnit subje he eppllwnl to a civil penalry ot not more ihan five hundred tlollars ($500).): I, ias dwner of the properiy. ar my employaes with wages as iheir soie compensation, WILL DO 7HE WORK, and Ihe simcNre is no� intended or oNered for sale (Sec. ---7044; Business and Pmf�ssions Code: The Contractors License Law does not apply to en owner ol property who builds or improves thereon, antl who does such work himself or herself or IhroUgh his or her own employees, provided ihat such improvements are not In�ended or oHered for sale. tl, howaver, the 6uilding or improvement is sold within one year ot completion, the owner-builder will have the burtlen of proving ihat ho or she did not build or improve for purpose of sale.). 0 I, es owner ol ihe property, am EXCWSIVELV CONTRACTING WIiH LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business and Pmfessions Coae: ihe contractors LiCanse Law tloes not eppiy �o an owner o1 property who bullds or improves Ihereon, antl who coniracis tor such project with a conhectorjs) liconse pursuant to ihe Coniractors License Laws.). ❑ lem Owner ID ven Verifl[etlon of Business and Protessions Code br this reeson: license. ❑ ves ❑ No by (type of document, i.e. - pmperty �ax blll or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIGICATION: �ers Licanse No. _� ❑ I horeby certify Me� no ex��ation five (5) or more taet in depih into which e person is requlre0 to descend, will be made in wnnection with work authodzed by this permit, antl t�at no builtling sirucNre, swftolding, talsework, or demolition or dismentling �hereot, will ba more �han ihirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 34i, Ttle B, Calitomia Atlministrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permil irom ihe Division ol Industnel Safety, as noted above, unless such person hes a permit to do such work trOm ihe division. Signature: Date: Division ot Induslnal Sefe�y Permit Number: CERTIFICATE OF COMPLIANCE AND AU7HORIZATIONOF ENTRV: I certify under Oenelty of perlury ihat I have �ead this application antl state �hat the inlormetion given is correct. I agree to comply with all s�ate laws end ciry ordinances relating to building consiruction, and euthodze representatives of ihe City of Costa Mesa to enter upon Ihe above�describ tl property for inspe ie pases. I agree not to occuDY or ellow occupency of eny building authorized by this permit until finel inspection. � Signature Ot Lega. wner Date } qnNOr Authorizad Applicam Date CO�E I, INSPEtnoNiYVE 1616 Fixed System Final Fire Pravention 1266 Pool Spe Final 200 Final Re-Roof 201 Finel BIocWReteining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Final Damolition o"re' ItIIID�LS �� � //���J• / ���' 7/ y00E� INSPECiIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electrical 212 Final Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final BuiV IIdIE � �im. 6 S�,w� �, ��Y 1 � m �►Rw�Y �c� rOi � ji� 'P �.� � 9cM-� = �I6 = i -o , '• "= ;. . - �. . �. �� n �a 71�11��� CITY OF COSTA MESA PLANNING DIV. SUB ECT TO BLD . DEPT. REG. 6YG�4��G�G�'ZI� I/neTr 1� �22 NOTE � ADDITIONS, DELETI�NS, OR CORRECTIONS SHALL BE APPROVEDi13Y THE PLANfVIN� DIVISiON `^— -._. - - _ _ Mc 8 Mrs. John Gregory 238 Fairway Place Costa Mesa, CA 92627 '; � �tion i �an+ ��cY1 23`d �cz'�rvx� YI. � p.G • �}�r 1 ��i a G. i�� �Q . M Q�'� � 't`l1�. �PScJ S "T�{. ! '� � ��� 23� �"2u'P�1 �L DNISION OF BUiLDING SAFE7'Y C1TY OF COSTA MESA APPROVED �r f/►� c o�e 4_I� I � ;xis sel ot plens 8nd spedtkalion.s MUST be kept on Nis job al all times and fl is w �{.l(7Tf�� �r^keanyd�angesaallereliononsamewAlbWwriltenpem�ssiaifromlheDNisanoi �d Salery, C)ty of Costa Mesa. he stert�ping af this plan and spa!tifiratiau SHAII NOTba held to permil orto be an, _ . fthe'{' .. � vw atron ot any provisions of any Ciry oi Cost2 Mesa OMmance anNor , *ese c�ar:: and permit sheli e�ire bp f'unila�ron and bscome nu� and void if the 1 l5 OC? CQ!f!fqP�-(?r�?�� moi+f.fnnA?,.1=�n u� I.IPn �o�� IA1 Wlth�r} 1Q� (�c�'F 0� � S,T 22 2� c� p�+�� � i�o�C a �� 2.�@2 �1 I}� 4�t2 2-i�Ur 2�TiE5 1 �1L� ��Q.�+D.L .�� I (eXt¢ �� � t3 +- 44'�✓y 4x�2 � (4Xt¢.t"�"� i lar. nc � "I 201t�s,R00F CONNECTION DETAILS CONT, LEDGER CONT. LEDI ID BLOCK i/2�� DIA. X 5�� LAG SCR AT 32��� O.C. DETAIL I CR B CL ��TECO�� �RIPS OR JOIST �#ANGER rfR 3Ig° DIA. X 5�� LAG SCR. nT �g" o.c. DETAIL 2 ,Ot�OR LIGHT WEIGHT ROOFS ONLY CONNECTION DETAILS 2��X FACIA-MIN.REQ. RAFTER APPROVED METPL HANGER DETAIL 3 ��r.,�Pn�tar . sm�rrcFs n�.urir�tar BUILDI�IG Sl1FEPY DIVISION OWNER: �To}'�n G��� AODRESS� 234, ��rwc�� PL CONTRACTOR: �N�bUi�o�2. AODRESS� RAFTERS CARPORT, PORCH OR PATIO NOT SUPPORTING CEILING SIZF. SPACING SPAN 2"x4" 12"O.C. 9'-6" 16" S'-0" 24" 6'-6" 32" 6'-0" 48" 5'-0" 2"x6" 12" 16'-6" 16" 14'-6" 24" 12'-0" 32" 10'-6" 48" .8'-0" 2"x8" 24" 15'-6" 32" 13'-6" 48" 11'-6" 4"x6" 24" 17'-0" 32" 15'-0" 36" 14'-0" 4"x8" 24" 21'-0" 32" 19'-0" 36" 18'-0" 48" 16'-0" 4"x10" 32" 22'-0" 36" 21'-0„ 48" 20'-0" 72�� 1��_0�� PATIO COVER TYP. PLANS DATE � `�/'��J�� PHONE � �`�'����gz$ LIC. N0. PHONE: RAFfERS APPROVED FOR LIGHT WEIGHT AOOF COVER OF gUILDINC PERMIT LATH, FIBERGI,ASS, ALUM, By Da[e SIZE SPACING SPAN 2"x4" 16"O.C. 9'-6" 24�� 8�_��� 32" 6'-6" 48" 5'-6" 2"x6" 16" 16'-6" 24" 14'-6" 32". 12'_0" _ i.on ,n�_nu 24" 19'-0" 32" 15'-6" 48'S 13'-6" HEADERS LIGHT WEIGHT ROOF ONLY � POST SPACING 6 � -0�� 4x6 9'-0" 4x8 12'-0" 4x10 15'-0" CARPORT, 4x6 PORCH OR PATIO POST SPACING $ � _0'� 8' -0�� 10'-0" 12'-6" GENERAI. NafES: 1. These plans must be kept on [he job at all time during constructian. 2. All feaming [o be Douglas Fir N� � grade minimum. 3. Raf[ers may not a[tach to facia ex- cept for l0�roofs as shown on details; 2Qlysroofs mus[ use a cantinuous ledger attached as shown on details Jilt�r`2. 4. LLght weigh[ roofs may attach to facia for 14' span max., spans over 14 must use a continuo�s ledger as shown in detail 1�3. � �UU �19�U NOTE� SHOW AND DIMENSION PROPOSED PATIO COVER AND YARD AREAS r� � � a . I 1 I STREET N 0 � r � c� 2 0 J � m F � X SEE DETAILS ON REVEFSE SIDE- ROOF SHEATMING OVERHANG _X_RAFTERS AT_ O.C. _X� BEAM T- STRAP EA. SIDE FOR POST- BEAM CONNECTION. o � a F U a Z = � W a � F H N 4 f/1 a p __ ¢ Q O � =� � O N Z U O W x J Z 2 � O V ��� � m Q J N U Z J � U � DROP PATIO W LL = fLOOR 2' p o � d N d SLOPE TO DRAIN � o: :o: . a...�.. �_ 26 GA. G. I. FLASMING � WOOD FLOOR CONSTRUCTION SIDE ELEVATION � -i � � N � � --LL _ _ J PIERS 12�� SaJ� PLOT PLAN I CONSTRUCTION DETAILS W � Q ¢ l7 2 � W O m Q w 0 a a c� z � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DfiIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job Address: 238 FAIRWAY PL Suite: Vicinity: NEW SWIMMING POOL & SPA Parcel Number: 43921308 Applicant: GREGORY, JOHN S Address: 238 FAIRWAY PL COSTA MESA, CA Owner: GREGORY, JOHN S Address 238 FAIRWAY PL COSTA MESA, CA Contractor: O W N E R-BU I LD ER Address: :'�' Arch : Address: Phone: Zoning: Phone: 949-722-8146 Zip: 92627-4612 Phone: 949-722-8146 Zip: 92627-4612 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 02/17/2005 Issued: 02/17/2005 ISSUED BY: �- �'; " a S � �, :� � bL` 6L� 9•e—= ��� -:� �`,.�—"'��.`�-T Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT A 332 SF IN-GROUND GUNITE POOL & 38 SF SPA. AT THE REAR OF AN EXISTING SFD. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $320.29 $492.75 $3.50 $0.00 $0.00 $0.00 $816.54 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0-0 $35,000.00 $35,000.00 NOTICE: 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 780 days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order for Ihe 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 ot this permit. FOR INSPECTIONS CALL: (714) 7545626 / 2aasas (sroo) ( _ WORKERS'COMPENSAnON DECLARAnON: � I hereby attirm under penalty ot perjury one of the following declarations: ❑ I have and will meintain a certificate of consent m self-Insure for workars' compensation, as provided for by section 3700 of ihe Lebor Code, tor ihe pertormence of the work for w�ich this permit is issuetl. ❑ I have antl vnll meintain workers' compensation insurance, as requiretl by seIXion 3700 ot the Lehor Cade, for ��e perfortnance of the work for which this pertnit is issuetl. My workers' compansation Insurance carrier antl policy number are: Carner: Policy Numbar: (This�Soction need not be completed il the permit is velued at one hundred dollars ($100) or /ess.) !� I cetlify ihat in the pedormence of the work tor w�ich this percnit is issuetl, I shall not employ any parson in any manner so as to bacome subject ro the workers' compensetion laws of Califomia, and egree ihat If I should 6ecome sublect to the workers' compensation provisions oi Section 37 0 of the Lebor Code, I shell totlhwith camply wi�h ihese v' n5. A�,-,r�,�s� �„re: ��- 2�i 7 o S WARNING: FAILURE SE WOFKERS' CAMPENSATI DVERAGE IS UNLAWFUL FND SHALL SU&IECi AN EMPLOYER TO CRIMINQ PE LTIES AND CIVIL FINES UP TOONE HUNDRED THOUSANDDOLLA ($1 , f,�NA�DITIONTOTHE. TOF('qN,PENSATION,DAMAGESASPROVIDEDFORINSECTION310fiOFTHEL4BOqCODE,IMEREST,ANDATTOflNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat I am licensed under provisions of Chapter 9(commancing with Section 7000) of Division 3 ot �he Business and Professions Code, and my license is in full fome and effecL Lic. # Cless N Comracbr's SignaNre: Date: CONSTRUCTION LENOING AGENCY: ❑ I hereby aHirm that there is a constmction Iending agency for the pedormance of the work for which ihis permit is issue0. (Sec. 3097, Civil Code). Lenders Name: Lendefs Adtlress: Signeture: Date: OWNER-BUILDER DECLARATONS: I hereby aHirm ihat under penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Protessions Code: Any city or county which requires a permit to constmct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe epplicant for such permit to tile a signed statementlhat he or she is licensed pursuent to the provislons of the Contractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 of the Busineu endp� ofessloris.Code) or Ihat ha or she is exempt theretrom end the basis for the alleged e:emption. Any violetion oi Section 7037.5 by any epplicant for a parmit suhj t�pplicant to e cl�ll penzliy of ribt more than five hundred dollars ($500).): �� I, as owner of the pmperty, or my employees with wages es their sole compensetion, WILL DO THE WORK, and the simcture Is not intende0 or oHered for sale (Sec. 7044, Business and Protessions Code: The Contractors License law does not apply to an owner ot propeny who builtls or improves thereon, and who does such work himself or herself or through his or her own employaes, pmvided ihat such improvemems ere not intended or oHered for sale. If, however, the building or impmvement is sold within one year ot completion, the ownerv6uiltler will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, as owner of t�e property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the proleci (Sec. 7044, Business and Professions Code: The coniracmrs License Law Aoes not apply to en owner ol property who builds or Impmves Nereon, end who coNracts lor such project with e contractor(s) license pursuant to the Comractors License Lews.). ❑ I am e under sec. 8usiness end Protessions Code for this reason: iuie: Owner ID ve fied ver's license. Ves ❑ No Dn�sL'fCBn567No:�-� Vedfication o ership 6y (type of tlocumen6 i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � I hereby certify that no excavetion five (5) or more feet in depih into which a parson is requlred to descend, will be matle in connection with work authonzetl by �his pertnit, antl that no building sirucNre, scaHolding, falsework, or demolition or dismantling thereoi, will be more than thirty-six (36) teet high. (Chap. 32, Gry 2, Ah 2, Sec. 341, Title B, Californie Administrative Code). � ❑ As owner-builder, I will not employ enyone to do work which would require e permit irom the Division oi Industrial Safery, as noted above, unless such person hes e pertnit to do such work from the division. Signature: Date: Division of Industdal Safery Permit Numbec CERTFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I cenity under penalry of perjury ihat I have read ihis application and state that the informa�ion given is correct. I agree to comply with all state laws and city ortlinances relating to building consWction, and authonze representatives of the Ciry of Costa Mesa to enter upon the ebove-descnbed y �or inspection purposes. I egree not to occupy or allow occupancy of eny 6uilding authorizetl by this ermit u� I fi�al��pection. 2 l -7 (�S Signature • a:Owne g1 • le, AnNOr Authonzetl Applicant Date COOE �. INSPECTIONTYVE I616 Fixed System Final Fire Prevention 7266 Pool Spa Final 200 Final Re-Roof 201 Finel Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition RTE 11L1RIAL5 . (� 1 � %i. E 1 INSPECTION TYPE 20fi Final Mechanical 208 210 212 220 Final Plumbing Final Electrical Final Fire Prevention Final Planning Approval 222 Final Site 250 Final Building/Occupancy onre IIR�LdLS � � � 5ar� c�. �orion Specinl /nspectron Sernices 6232 Kiowa Road • Westminster, CA 92683 Joint Cettified ICBO Rc�inforced Concrete ACI Concrete Field Tech I.icen�e #0_S�Rfii Ph 714-895-1344 Fax 714-899-5684 Mobile 714-309-7304 L-maingnAiowaQa verizon.net Insured REGISTERED INSPECTOR'S DAILY REPORT �ob No. Da(e._ 8 DS rme TYPE OF ❑ Reinforced concrete ❑ Structural Steel Assembly ❑ Quality ConVol INSPECTION ❑ Post Tensioned Concrete fr.l Gunite ❑ Epoxy REpUIRED ❑ Reinforced Masonry ❑ Shot crete ❑ Other o ress „8�, !��-� - � City /1 '�.:' = M rT �._----� C...O JoD Name " Permit�Na I sueG By _ I ,.�;c�1.%3o,s.; 2 �—" � . _ .. _ .,,, 7ype af SirucNre Arc iTi �i"��� Ma[enal Descnption (rype. gratle, soume) Ergineer G � Contractor O /� � Inspec�Or(s) Name Subcontractor � � TESTS PERFORMED TYPE OF SAMPLE SLUMP �UANTITY IN SET ADDITIONAL REMARKS ON SAMPLES 5 / INSPECTION SUMMARY -LOCATIONS OF WORK INSPECTED, 7EST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROCaRESS, REMAqKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WOqK PERFORMED, NUMBER, TVPE 8 1DENT. NO'S OP 7ES7 SAMPLES TAKEN: STRUCT, CONNECTIONS (WELD MADE H.L BOLTS TOROUED) CHECKED; ETC. 'y - � — 5 r J O�Svi¢.5 , � � CONTINUED ON NE%T PAGE � PAGE � OF_� OF TIME IN I TIME OUT I pEG. HOURS I O.T. MOUflS I SAMPLES All inspections basetl on a minimum of 4 hours antl over a hours - 8 hour minimum. � � � -r � _ _ — � qpprwe0 Cy NO AGENCV Prqect SuperintenEent WHITE - CITY'S COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY �� .. 'v .. . ` Job Address_ Name_�� Residence Address Laboratory � Address � �e =CIAL INSPECTOR REGISTRATIOh Number tY Jt�et („Fl�s �,.�� �'A S?�81 City State Zip All ticenses listed below must be currently valid and legible copy(s) and must be attached to this registration. DISCIPLINE CONCRETE DUCTILE MOMENT RESISTING FRAMp REINF00.CING STEQL PRESTRESSING STEEI WELDING HIGH STRENGTH BOLTING STRUCTVRAI MASONRV REINFORCED GVPS4M CONCRETE INSULATING CONCqETE SPRAVE� ON FIRE GROOFING PILINGS, DRILLED PIERS, CAISSONS SPECIAL GRApING, E%CAVATION OR PI�LING SPECIAL CASES UNUSVALNA2Aq05 L.A. COUNTV �!� L.A. CITV I ORANGE COUNTY I OTHER �! I hereby certify that I am qualified by training and experience to perform the inspections for which I hold the above Iisted Sp�cial Inspectors licenses, and will provide all certifications required by the City of Cosia Mesa. I will inspect and c�rtify the following procedures: I will certify not only to the job conditions but that they are in conformance with the approved plans. If at any time, progress occurs on the above mentioned job relating to my area�s) of responsibility, without my knowl- edge or approval, 1 Will stop the jobs progress immediately with notification in writing to the job superintendent and notify the Bui�ding Division of the situation. A record of my tests and/or inspections as agreed to above will be available upon request by the Building Division. Upon request I will submit a complete package of testing and inspection results. A letter certifying satisfactory completion wil�e pr�ovide�yy-me�pon completion. This registration is accepted and approved by: (Plan Check Engineer) Official) (Date) CMF1068�46 W�Ite-BuiltlinqDivision; Canary-SOeclallnspectar; Vink•Oeveloper �s:� � , . � t . � y R� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c��ILDING PERMIT n FAIR DRIVE, COS7A MESA, CA 92626 Jobnddress: 238 FAIRWAY PL Suite: Vicini[y: DETACHED Parcel Number: 43921308 App�icant: GREGORY, JOHN S Address: 238 FAIRWAY PL COSTA MESA, CA Owner: GREGORY, JOHN S Address 238 FAIRWAY PL COSTA MESA, CA Con tractor: O W N E R-B U I LD E R Address: Zip: Arch : Address: Zoning: Phone: 949-722-8146 2ip: 92627-4612 Phone: 90&393-8655 Zip: 92627�612 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 12/15/2003 Issued: 12I15I2003 �� �� i •- r/ EXTENSION ALLO D PER_� � EXPIRES 9/o a Phone: Y� !� � � J,�� Phone: ��V� . Zip: License: �A License: SCOPE OF PERMIT REPLACE GARAGE SIDING AND STUCCO. ADD NEW PLYWOOD SHEAR P,SNELS TO EXISTING WALLS AND REPAIR EXISTING FRAMING. Plan Check: Permil: SMIP Res: SMIP Com: Other. Inspection: $0.00 $125.25 $0.60 $0.00 $0.00 $0.00 Total: $125.85 SETBACKS ACCESSORY PARKING NOTES: Front 0- 0 Front 0- 0 Existinq: 0 Rear 0- 0 Rear 0- 0 Re uired: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 ss,000.00 36,000.00 NOTICE: The work authorized by thig permit shall comply with all applicable handicap access requiremenis undar Califomia statutes and related regulalions. (Ord. No. 92-28, § 1, 12-21•g2) EXPIRATION: Thls permit shall automgtically expire and become vold it work Is not commenced within 780 days, or if work is suspended or abandoned lor a period of 180 days. INSPECTIONS: In ordar tor the work aulhorfzed under this permit to be considered legal, such work must comply with all epplicable codes, and all requlred Inepeetiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the axpiration of ihls permit. FOR INSPECTIONS CALL: (714) 7545628 zaaa+e �eroo� WOHKERS'COMPENSAnON DECLARAnON: � � ' I hereby eHirm under penalry of perjury one ol Ihe fWlowing declarations: ❑ I heve entl will meintain e cenificete of wnsem lo selbinsure tor workers' compensatlan, es provitletl for 6y section 3700 0l Ihe Labor Cotle, tor the peAortnance ot the work tor which this permi� is issuetl. ❑ I liave antl will malntain workers' compensaUon insurance, es required by section 3700 of tha Lebor Code, tor Ihe peAortnance of Ne work for whkh this pertnit is iswed. My workers' compensation Insurence wrtier end palicy number are: Carrior. . policy Number: (This tlon need no( be corqp�eted i! the permil ls valued e( one hundred dollers ($100) or /ess.J 1 certity thet in Ihe peAoimance of tha work br which this pormil is issuetl, I shell not employ eny person in any manner so as to bocome subjact to Ihe workers' compensation laws ol Califomia, entl apree Ihet If 1 should bewme sub�ect to the workers' compensation provislons of Sectlon 3700 0l t�e Lebor Cade, I shell forthwith comply with these pro�iJj90 �2 j/� �03 Applicant Slpneture: %�% Dete: � WARNINO: FAILURE TO S ORKER$' IPENSI1T10N COVEMGE IS UNL4WFUL AND SHALL SU&IECT PN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE HUNDRED THOUSAND DOLIARE (51 . 0�, �N ADDRION TO THE COST OF COMPENSATION, UMAqGES AS PROVIDED FOii IN SECiION 3"lOfi OF THE UBOR CODE, IMEREST, FND ATTORNEI"5 FEES. LICENSEDCONTAACTORS DECIARATION: I hereby eMirm ihat I am licensed under proNsions ot Chepter 9(cammencing wlt� Sectlon 7000) of DlNslon 3 of Iha Business entl Profossions Cotle, end my license Is in lull force end eHect. LJc. p Cless k Contrector's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eflirtn thet Nere I5 a constructlon lentling egency for lhe peAormance of the work for wNch �his permil is issuetl. (Sec. 3097, Civil Coda). Lontlefa Name�. lsntlefs Atltlress: SignaWra: Date: OWNER•BUILDER DECLAHATIONS: I herehy eilirtn thet untler pena�ry ot perjury that I flm EXEMP7 FROM THE CONTFiAC70R5 LICENSE LAW for the Iollowing reason (Sec. 7031.5, Business entl Professions Coda: Any clry or wunry whicp requires e permit to construct, alter, improve, tlemolis�, ar re0eir eny swcture, prior to its issuance, elso requires Ne appllcaN tor such pertNt to file a signed statement t�at he or she Is licensetl pursuant to Ihe provisions of the Cantrectors License Law (Chapter 9(commencing wit� Section 7000) 01 Divisian 3 of t�e Business end Professions Code) or that ha or she is exempt Itieretrom anA the basis for t�e elleped e:emption. Any violetlon of Section 7031.5 by any epplicant tor a pertnit subjects the applicant to e civil penalry of not more than tive �untlred dallers ($500).): ❑ I, es owner ol ihe pmperry. or my amployees with wages es Iheir sole compensatlon, WILL DO 7HE WORK, antl ihe sWcture is not Intentled or oHeretl tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law tloes not appty to en owner of propeny who builtls or improves thereon, antl who does such work himself or hersetl or ihrough his or her awn employees, provided Ihai such improvemenis ere not intended or oflered for sale. If, however, lhe building or improvament Is sold within one year of cPmpletion, the owneo-builtler will hava the burden of proving ihat he or she tlitl not build or improve for puryose of sale.). � ❑ I, as owner of the O�operry. am EXCLUSIVELV CONTRAC7INC W17H LICENSED CONTRACTORS to constmct ihe project (SecJ044, Business and Prolessions C e: The coniractors Licensa Lew Aoes noi appty to en owner oi pmperry who bulltls or Impmves thereon, antl who contracts lor suc� project wilh a contractor(5) nse pursuant to the Goniractors License Laws.). I am exe der sea� �^ r Business antl Pmlessions Cotle for ihis reason: Signature: `_��-"� �� %� Expires: L� Oy3 Venflcation ot Ownership by (rype o( documeni, I.ex�Properry ta�c bill or dee�: w DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION: i ❑ I hereDy certlty thet no e%��etion five (5) or more feet in depth into w�ich e person is required to descend, will be mede in connectlon with work euthodzed by this portni�, enA thai no building structure, scaHolding, telsework, ar demdition or tlismantling thereol, wiil De more ihan ihirry-six (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title e, Celifomla Adminlstrative Code). ❑ Aa owner-bulltler, I wlll not emplay enyone lo tlo work which would requlre e permlt from the Divislon of Industrlel Setety, as notetl ebove, unleu such person has e permit ta do such work from ihe divislon. SignaNre: Date: Divislon ol Industnal Satery Pe�it Number: CERTIFlCAIE OF COMPLIANCE AND Al7THORIZA710N OF EMAY: I certiy under penalry of perjury ihat I have reatl this epplication antl stete that the infarmation given is conect I egree lo compty with all state laws antl dry orAlnances releting to Guiltling constructlon, entl authonze represematives ol the Ciry ot Casta Mesa to emer upon t�e ebova-tlescrlbetl p rry for ins ection puryoses. I egree not to occupy or allow occu0ency of eny building authonzed by this rmil un final inspeclion. ���;�'7 /2%i S �3 $I�aWre�hti.egalOwner(s) � Da�e qnd/Or Authonzed Applicam Date cooe �. �pecnoNivve �6t6 Fiaotl System Final Fl�e Preventlon 1268 Pool Spe Finel 200 Finel Re-Rool 201 Flnel BIocWRetaining'Nall 202 Finel Fectory Fira PIaCe 203 Finel Slgn 204 Finnl Demolition PAIE Itl�LS CODE� INSPECTIONTVPE 206 finel Mechanical 20B Finel Plumb��g 210 Final Electdcal 212 Finel Fire P�eventlon 220 Finel Planning Apprwal 222 250 Finel Site Finel Building/Occupancy � I�� (714) 754-5273 • Fax (714) 754-4856 � CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 238 FAIRWAY PL Suite: Vicinify: REAR OF EXIST. SFD. Parcel Number: 43921308 npp�icant: GREGORY, JOHN Address: 238 FAIRWAY PL CA COSTA MESA , , � Owner: GREGORY, JOHN Address 238 FAIRWAV PL CA ', - � �. �. COSTA MESA- � ' _ � . � \ � � Contractor: � �I/�Ju��-�.; Address: � �-" - - �' Arch : Address: BUILDING PERMVT Zoning: -Phone: (909)393-8655 � Zip: 92627 NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Slatus: ISSUED Applied: 08/24/1999 Issued: 09/22/1999 ISSUED BY: ��`� l i ' - Phone; (909) 393-8655 � � , - Zip: 92627- ` • � � ' � ` �; �� Phone: � Zip: . , License: Zip: , _� � � Phone: � � � , License: � Eng: Address: Phone: � �.�License: + SCOPE OF PERMIT � ADD 686 SF MASTER BEDROOM , BATHROOM, AND LAUNDRY. , , FEE SUMMARY Plan Check:. $459.39 Calc Valuation: ' Permit: . . $706.75 , „ - ,'.' � , i.,, - Claim Valuation: SMIP Res: � $5.87 -� ' �� SMIP Com: ',� $0.00 ' � � � Other. $0.00 � Inspection; � $0.00 - _ t Total: $7,172.01 SETBACKS MAIN STRUCTURE Front 20. 0 ACCESSORY Front 0-0 PARKING ��existinq: 2 NOTES: PLANNING 8 ZONING Rear 20- 0 Lefl 14- 6 Rear 0- 0 Left 0. 0 Reauired: 0 Proposed: 0 Right 10- 0 Right 0-0 558,653.00 � - $o.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Orcl. 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 it work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetions end flnal epprovel must be obtained. Failure to obtain inspections and final approval will resufl in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION OECLARATION: 1 hereby altirm untler penalry of perjury one oi ihe following declarations: ❑ I have and will maintain a certificate of consent to selt-Insure for workere' compensation, as provided tor by section 3700 ot the Lebor Code, for ihe peAormance ot the work for whiCh �his permi� is issuetl. ❑ I have antl wiil maintain workers' compensation insurance, as required by section 3700 oi t�e Labor Code, tor ihe peAortnanca of tha work for which ihis pertnit is issuatl. My workers' compensation Insurance carrier and policy num6er ere: Cerrier: Policy Number: (This section need nof be cromple(ed il the permit Is valued et one bundred dollars ($100J ar less.) ❑ I certify that In the pertormance of Ihe work for which this pertnit is issued, I shall not employ eny person in any manner so es to become subject to the workers' compensation laws of California, and agree that ii I should bacome subject to the workers' compensation provisions of Section 3700 oi the Labor Cotle, I shall fotlhwith comply with ihese pravisions. Applicant SignaWre: Date: WARNING: FAILUFE TO SECURE WORKEFS' COMPENSATION COVERAGE IS UNL4WFUL PND SHALL SUBJECT AN EMPLOYER TO CRIMINPL PENALTIES AND GVIL FINES UP TO ONE HUNORED iHOUSAND DOLLARE ($100,000). IN ADDfTION TO iHE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECiION 31O60F THE LABOR CODE. IMEREST, AND ATTORNEYS FEES. LICENSEO CONTRACTORS DECLARATION: I hereby attirm ihat I am licensed under provisions ot Chapter 9(commencing with Sectlon 7000) of Division 3 of �he Business and Professions Code, and my license is in full force and eHect. Lic. # Class # Contrectors SignaWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a constmction lending agency for ihe performance oi �he work br which ihis parmit is issued. (Sec. 3097, Civil Coda). Lendefs Name: Lentler's Adtlress: SignaWre: Date: OWNER•BUILDER DECLARATIONS: I hereby eNirm that untler penalry of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business and Professions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any sWcture, prior to ils issuance, also requires t�e appliwnt br such permit Io file a signed statement thet he or she is licansed pursuan� to the provisions of the Coniractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 oi Ihe Business antl Professions Cotle) or ihat he or she is exempt therefrom and ihe basis for iha alleged exemption. Any violatlon oi Section 7031.5 by eny epplicant for a permit suD' cts the applicant to a civil penalry oi not more than five huntlred dollars (5500).): � I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe siructure is not intended or ottered for sale (Sac. 7044, Business and Professions Code: The Conirectors License Law does not epply to an owner of property who 6uilds or improves thereon, and who does such work himself or herself or through his ar her own employees, provided that such improvemenis are not intentletl or oHered for sale. If, howaver, ihe building or improvement is sold within one year of completion, tha owner�builtler will have Ihe burden of proving that he or sha did not build or improve for purposa of sale.). ❑ I, as owner oi the property, am E%CLUSNELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professians Code: The contractors License law does not apply to an owner of property who builds or improves ihereon, end who contrects tor such project with a coniractor(s) license pursuant to lhe Comractors License Laws.). ❑ I am ez�pt untler Owner ID ver�e/1 by dnver'S ❑ Ves ❑ No Business and Professions Code for this reason: oate: e'-7 Q�l DnvefS Licen58 No. Expires: %J Z3 O� Venfication ofbwnership by (rype bf documenL i.e. - property ten bill or deetl): OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation tive (5) or more feet in tlepih into which a person Is required to tlescend, will be made in connection with work authorizetl by t�is permit, antl ihat no building sWctura, scaflolding, talsework, or demolition or dismantling ihereof, will be mora than thirry-six (36) teet high. (Chap. 32, Grp 2, Ar12, Sec. 347, Ttle B, Californla Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit from the Division of Intlustrial Safety, as noted above, unless such person has a permit to do such work irom the division. SignaWre: Date: Division of IndusMal Safety Permit Number. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EMAY: I certify under penalty ot perjury that 1 have read this application and state that Ihe information given is correct. I agree to comply with all state laws and ciry ordinances relating to 6uilding construction, and auihorize representatives of the Ciry ot Costa Mesa to enter upon the ebove-descnbed property tor inspaction purposes. I agree not to occupy or allow occupancy of any building authorized by thisp ertnit until tinal inspection. �I/ Z z��i9 SigneNre Ot Lega m � Date And/Or Authonzed Applicant Date COOE �, INSPECTIONTYPE 1616 1266 Fixed System Finel Fire Prevention Pool Spa Final 200 Final RB-Roof 201 Final BIocWRetaining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolitian 2a46-d6 F�F INTIf1AL5 CODEt INSPECTIONTYGE 206 Final Mechanical 20B Final Plum6inq 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupancy A�TF, INTRIRLS VALUE AP.No.119-12i—OB LOT THACT FIRE ZONE INSPECTIONS I DATE I GROUP �T SUBCON7RACTOR � PERMITSISSUED . OCCUPANCY Form 410—SM-11-59 5•B P � • 11653 11�'053 COSTA MfSA BUILDIN6-SAFETY DEPARTMENT P, p. BOX 917 C08TA MEBA. CALIFORNIA For Applieanfi fo Fill In Complefely TYPE OR PRINT BUILDING • ���� � ADDRE68 COSTA MESA. CALIFORNIA � MAIL ■ 81ZE NG � USE T FROM TEL. NOy. THL. NO. OP ltDG6. DESCRIPTION OF WORK ��� / I ROOF (( COVERiI AND WORK TO BE C��� ■A1 ; i E �ECI�i�lv� FINANCE DEPT. CiTY OF COSTA 69ESA APPLICATION FOR PERMIT BUILDING For Office Use Only neceirr No. ne� COSTA FIRE Y� � �ONING ' — I NO. OP I UBE OF NEW PLAN6 BU�LOING ��.� 3 S oescairTiorv A. P. NO. //_�_� 3 �� YARDS EVES APPROVED ALLOWED ICeNreP LINe er.> . /� � _ �; o 1 HLR89Y ACNNOWIPDGe lXAT 1 HAVB RGAD THIB APPLIGTION THg AMOUM 9HOWN UNOER VpLUATION �8 POq TMH AND HTATB THAT TX8 /�BOY6 19 CORACCT AND AORE6 TO COM• pUFP086 OF 88TABLIBHING A nERMIT P¢8 ONLY. PLY WITM ALL CITY OIiDINANCEB Ml� BiATB UWB R60ULATINO Bu1tDtNa CONeTRu N. VALUATION 81GNATUR6 OF �� G�� PERMIT PEE B PERMITTE %J �{f j� S/ �/� � PLAN CHECK $ AUTHORIZED ACENT � � � TOTAL FEE