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Home My WebLink About2040 CONTINENTAL AVE - Building Permits(774) 754-5273 • Fau (714) 754-4856 Job Address: Suite No Vicinity: . CITY OF COSTA MESA BUILD/NG DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT 2040 CONTINENTAL AV CARPORT ENCLOSURE TO GARAGE Parcel Nunmber: 42250325 npp�icant: REYNOLDS, GARY W Address: 204000NTINENTALAVE � i' � " COSTAMESA;,�CA'- -. - � �, ��. �-� �. . ir/` �' Owner: 'REYNOLDS, GARY W' /�N.' t Address �-2040�CONTINENTALAVE"-" / �j/� A `-' _ . , �l%i � ; � . � �COSTA MESA -CA--�"� ��;�� . � �� , /. / � "' �-',%. � � Confractor �. !�� % ;� � ,�Addressr, ; ��j�:;!� � � �.�: / ��. , � _ � �� . . •�' . ' ��.' , , , , . . . � . .. , . . !�� - . ._. . _ ,� _ �Phone: (949)646-4387 � ' Zip: 92627 �; /� Phone: Zip: 92627 Phone: /. � . . . i Zip: �License: PERMIT NUMBER E99-00730 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08/OS/7999 Issued: 08/OS/1999 ISSUED BY: � . � �--� \ _ V -� �' �� ;\ \ �//�\ \. ,�_ , , . � �, .� � _ ,�t , � '�� . ; ' �� , - ��' \ '� , . � , �� i �' '� 'f� a' � ,' �- ' SCOPE OF PERMIT � � � � ^, �� , UPGRADE EXISTING 40 AMP ELECTRICAL SERVICE TO NEW 100 AMP SERVICE METER. � � �� " �, . . .- _ . . . ;. , , � ^ . , . _- . . _ � .. _ � � ., Quantity �'.�ISSUE.FEE � $6.50 � t ��Temp service te's6,, � $0.00 . , �,Res)�a/cpackage . $0.00 N�ew Res.(1-2�units)''.,�,..,� $0.00 0 New'Res (3+units) $0.00 -- 0 Pool'/�Spa $0.00 " 0 Ligliting Fixts� '� `; 1:��,.��, $0_00 0 �.,,, Recept�0utlets � � `. $0.00 0 Switcfies�', � �, $0.00 ' 0 Non Res,Appl '� " �,; $0.00 0 ResAppl.��,��`��, . � ',�$0.00 0 Service to�200a, $2725 1 .�. Service to t000a � , $0.00 � . 0' `" Service over 1000a� ��% $0.00 ; 0 - Motorstolhp �A`', � . $0.00 - 0 -, Motors to 10hp ` $0.00 0 Motors to 50hp � � - _ $0.00 � 0 Motors to 100hp � � - $0.00 0 Motors over 100hp � � $0.00 . 0 , Communication drops - $0.00 0 Sub panel to 200a $0.00 - 0 Pole Light Pkg $0.00 0 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 FEE SUMMARY quentity ' � - � -Temp, Dist System / Lighting - $0.00 0 � ' . � � __ 1." Busway/100,ft�'.-. .-- -� - $0.00 0 � - __ .- Standing_Section' - � $0.00 0 `� � . Misc Electrical Equipment $0.00 0 % Transforrriers up to 1 kva/kw $0.00 0/-;�. ,� ...............�.up to 10�kva/kw . $0.00 0 . ; .. ... .................upto50kva/kw - 1 $0.00 ;0 �- �` -'. .. . ............._..up to 100 kva/kw -, $0.00 �'� Oi ., �� - . � .......:..........over 100 kva/kw ' $0.00 �' 0 � ` � ' � _ - Low Voltage Equipment , $0.00= �. 0 " Low Volt Wiring System / Ckt ' � � $0.00 %' 0 � � . � - �Misa Conduit � , , �- -$0.00 0 �� , , � , . Misc. Conductor �'_. � $0.00 � 0 �� . �Cirws�(genorride) .� . $0.00'�.�'�0 L•�';' " - Circus (mech ride or hghte) �- $0.00� ; -� 0 !� %�� , Christmas Tree�Stand' $0.00 � � 0 . � " ' � • Fireworks Stand $0.00 0 " Other Eledrical Fee $0.00 , " ' Investigation Fee $0.00 , Plan Check Fee �$0.00 Reinspection Fee , $0.00 TOTAL CALCULATED FEES 533.75 COMMENTS / SPECIAL CONDITIONS \. 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 I 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 � requlr=d inspeetlone entl fina=approv-1 must be obtained. Failure=o obtain inspections and final approval w-11 result in the expiration of this permit. � FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: � I hereby aHirtn untler penalry of perjury one o1 the lollowing declarations: . ' ❑ I have antl wlll meintein a Getlificate of consent to sel4lnsure for workers' compensation, as provided for by section 3700 of ihe Labor Cotle, lor tha pertormance of the work for which ihis permit ie issued. ❑ 1 hava end will maintain wo�kers' compensation insurence, as required by section 3700 of the Labor Code, Por Iha perfortnanca of Ihe work for which this permit is issuetl. My workers' compensation Insurence cerner and policy numbar ere: Cerner: Policy Number: (Thts sectfon need nof be comp/9�etl i! the permit is veluetl et one huntlred dollars ($100) or less.) " ❑ I certiy ihat in the pertormance of the work for which this permit is issued, I shall not employ eny pereon in any manner so as to become subjeci to the workers' compensation laws of Celitomia, end agree that if I should become subject to ihe workers' compensation provisions of Section 3700 of Ihe Labor Cotle, I shall forihwith camply with these provisions. Applicant Signature: Date: WARNING FAILURE TO SECURE WORKERS' WMPENSATION CAVERAGE IS UNI.AWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANO OOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES PS PROVIDEO FOR IN SEGTION 3706 OF THE LABOR CODE, IM1f�EREST, AN� ATTOFNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihal I am licensetl untler provislons ot Chapter 9(commencing with Section 7000) ot Division 3 of the Business and Protessions Coda, and my license is in full I fo�ce and eHect. Lic. # Class N ContrectoYs SignaWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm Ihet ihere is a consiruction lentling agency for the performance ot the work for which ihis permit is issuatl. (Sec. 3097, Civil Code). Lender's Name: . Lenders Adtlress: Signature: Date�. OWNER-BUILDER DECLARATIONS: I here6y ettirtn ihat untler penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for iha following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which rsquires a permit to construct, alter, improve, demolish, or repeir any structure, prior to its issuance, also requires the applicaM for such permit to file e signed statement Ihal he or she is licansetl pursuant to the provisions of �he Contractors Licanse Law (Chapter 9(commencing wlth Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt Iheretrom antl the basis tor Ihe alleged exemption. Any violation of Section 7031.5 by any epplicant for e permit subJecis the applicant to a civil penalry of not more than five hundred dollars ($500).): �, as owner of ihe p�openy, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, antl ihe stmcture is not intendetl or otteretl for sale (Sec. 7044, Businass and Professions Code: Tha Conirectors License Law does not appiy to en owner oi property who builtls or improves thereon, and who tloes such work himseN or hersetl or througn his or her own employees, providetl that such improvemenis are not intended or oHered for sale. If, however, the building or improvement is sold within one year of completioq the owner-builder will have the burden ot proving that he or she ditl not build or improve tor purpose of sale.). ❑ I, as owner of tha properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the prolect (Sec. 7044, Business antl Protessions Cotla: The conirectors License Law tloes not appty m an owner of property who builtls or improves theraon, and who contracts for such projec� with a contractor(s) license pursuant to the Coniractors License Laws.). ❑ 1 am exe ntler sec. Signa�ure: Owner I venfietl by tlr s license. Venfication of Ownership by (rype ot and Professions Cotle for ihis reason: Ves ❑ No Dnver's License No. rt, i.e. - properry tex 6ill or deetl): DIVISION OF INDUSTRIAL SAFE7V PERMI7 CER7IPICATION: Date: Expires: ❑ I hereby certl(y ihat no excavation tive (5) or mora feet in depth into which a person Is required to descend, will be mada in connection with work authorized by this parmit, and that no builtling siructure, scattolding, falsework, or demolition or tlismantling thereot, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Administrative Code). ❑ As ownerbuiltler, I will not employ anyone to tlo work which would require e permit irom the Division of Indusirial Safery, as noted ebove, unless such person has a permit to do such work from the tlivision. Signature: Data: Division oi Indusidal Safety Permit Numbar: CERTIFICATE OF COMPLIANCE AND AU7HORVATON OF ENTRY: I certify undar penelty of perjury that I have read this application and state that tha information given is correct. I agree ro comply with all stela laws and ciry ordinances relating to 6uilding construction, end authorize representatives ot the Ciry ot Costa Mesa m en�er upon ihe above-desc' d property for inspectlon pu ses. I aqree t to occupy a ellow occupancy of any builtling authorized by lhi pertnit until fin n ection. ,�. ` a✓ �—.�— �,� ^ SignaNre OI L Owner(s) Date And/Or Authorized Applicant Date �OUE �. 1616 1266 Fiaed System Finel Fire P�evention Pool Spa Finel 200 Final Re-Roof 201 Final BIocWRetaining WW�I 202 Finel Fflctory Fire Place 203 Finel Sign 204 Final Demolition Z�fa .. 2AIE 1��3 CQDEt INSPECTIONTYGE ' 206 Finel Mechanical 208 Final Plumbing 210 Finel Elecincal 212 Final Flre Prevention 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy Q�E 'Z(o OC� �m, : �_,�—� � � M ' 4` o � J "' �' � (714) 754-5273 • Fax (774) 754-4856 CITY OF COSTA MESA BUILDING DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT , PERMIT JobAddress: 2040 CONTINENTALAV Suite: Vicinity: Parcel Nunmber: 42250325 Applicant: REYNOLDS, GARY W Address: REYNOLDS, OLGA COSTA MESA,CA , 2040 CONTINENTAL AVE � Owner: REYNOLDS, GARY W Address REYNOLDS, OLGA COSTA MESA,CA �. 2040 CONTINENTAL AVE Contractoc Address: Zip: Arch : Address: Phone: Zip: License: BUILDING PERMIT Zoning: Phone: 949-646-0387 Zip: 92627 Phone: Zip: 92627 ' \ . Phone: License: Eng: Address: 77 FAIR DRIVE, I MBER 39-00022 MESA, CA'92626 Status: ISSUED Applied: 01/04/1999 ISSued: 01/19/7999 Phone: License: , SCOPE OF PERMIT 126.5 SQ. FT. ADDITION TO EXISTING CARPORT AND CONVERSION TO A 360 SQ. FT. ONE-CAR GARAGE FEE SUMMARY Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $48.59 $74.75 $0.50 $0.00 $0.00 $0.00 $123.84 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 47-9 PARKING Existina: � NOTES: Rear 0- 0 Rear 45- 6 Re uired: t PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 5-0 $2,730.50 $o.00 EXPIRATION: This permit shall automatically 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. . INSPEC710NS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will resWt in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: � . I hereby ettirtn under penalty of perjury one of ihe followinq declarations: ❑ I heve antl will maintain a certificate of consent to salf-Insure tor workers' compensation, as provitletl tor by section 3700 01 the Labor Code, br Ihe pertortnance ot ihe wark fOr which ihis permit i5 i5suetl. ❑ I have end will maintain workers' compensetion insurance, es requiretl by sedion 3700 ot the Labor Code, for the pedortnance of ihe work for which this permit is is5ue0. My workers' compensatlon Insurance wrtier and policy number ere: Cartiec Policy Number: (TT/s secfion neetl not be comp/efed il the permit is va/ued af one huntlretl dollars ($100) or less.) ❑ 1 certify ihat in ihe peAormance ot the work tor which ihis pertnit is issued, I shflll not employ any person in any mannar so as to become subject to the workers' compensation laws ol Celifornia, end egree ihet if 1 should become subject to the workers' compensetion provisions of Section 3700 of Ihe Labor Cotle, 1 shall forthwith comply with t�ese provi5ion5. Applicent Signature: Dete: WARNING FAILURE TO SECURE WORKERS' �dPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVI� FINES UP TO ONE HUNDRED hKK1SAND DOLLARE (E100.OW), IN ADOITIQV TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3]OB OF THE LABOR COOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRAC70R5 DECLARATION: I hereby aflirtn ihat I em Ilcensad under provisions ot Chapter 9(commencing wiM Section 7000) oi Division 3 of Ihe Business and Protessions Cotle, end my license is in tull force end ettect. Lic. # Glass A Contractor's Signature: Date: CONSTRUCTION LENDING pGENCY: ❑ I hereby aKrm ihet �here is a constmction IenGing agency for ihe perfortnance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLAppTIONS: I hereby aHirtn Ihet untler penatly of perjury that I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7037.5, Business antl Professlons Code: Any ciry or counry which reQuires e pertnit to consirucL alter, improve, demolish, or repeir any structure, pnor to iis issuanca, elso requires the applicent tor such permit to file a signed statement that he or she Is Ilcensed pursuent to tha provisions of the Contrectors License Law (C�epter 9(wmmancing with Section 7000) of Division 3 oi Ihe Business and Professions Code) or ihet he or she is ezempt iherefmm and the basis for the alleged exemption. Any violation of Section 7031.5 by any epplicant tor a permit subjects Ihe applicant to a clml penalry of not more ihan fve hundred dollars ($500).): ❑ I, as owner of iha property, or my employees with wages as their sole compensation, WILL DO THE WORK, and �he structure is not intendad or ottered for sale (Sec. 7044, Business flnd Professions Code: TOe Conirectors License Law does not epply to an owner of property who builds or improves thareon, and who does such work hlmselt or herself w Ibrough his o� he� own employees, provitled that such improvements are not intended a ofreretl for sale. It, however, the building or improvemenf is soltl within one year of completlon, the owner-builder wlll have the burtlen of proving Ihat he or she tlid not build or improve for purpose oi sale.). ❑ I, es owner of ihe prOperty, em E%CLUSIVELV CONTRACTING WITH LICENSED CON7RAC70RS to construct Ihe project (Sec. 7044, Business ana Prafessions Code: The comrectorg License Lew does not apply to en owner of property who builds or improves ihereon, end who contrecis tor such project with a conlracior(s) �license pursuant b the Gontrectors License Wws.). I am exempjqqder sec. �rL:� � L1 LA Businass and Prolessions Code for this reason: _ Sionature: /, �� ./.c. _ �'7 _ _ _ Date: Owner ID veriil�by c�r'g license. �s ❑ No Dnver's license Na. Venfication ol Ownerehip by (rype oi doc ent, I.e. - property tex bill or deetl): DIVISION OF INUUSTRIAL SAFE7V PERMR CER7IFICATON: ❑ I here�y cartify that no excavatlon five (5) or mora feet in depth Into w�ich a person is requiretl to tlescantl, will ba mede in connection with work authonzed by this permit, and ihet no hullaing structure, scaHolding, (elsework, or tlemolition or dismantling thereof, will ba more than Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Ttle 8, Califomla Atlministrative Cotle). ❑ As owner�builder, I will not employ enyone to do work which would require a pertnit from the Division of Indusinal Satery, as noted above, unless such person hes a permit to do such work from the division. SignaNre: Date: Division o1 Industnal Sefery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTFIORIZATON OF ENTRY: I certify untler penelry of perjury Ihat I heve read this applicetion entl state that ihe information given is correc�. I agree to comply With all state laws and ciry ordinances relating to building cons�ruction, and authonze representetives of the Ciry ot Costa Mesa to enter upon the above-descnb d property tor in/sp�ection urp ses. I agree not to occupy or allow occupancy of any building authorized by this permit until finel inspe —a b �, '�l, ��.L,—�� /— /� — �� Signeture Of Leg� ner(s) Date � AnNOr Autho ed Applicant Date COOE I. INSGECTIONTYVE QOjj 1616 Fixetl System Fin�l Fire Prevention 1266 200 207 202 203 204 2d46-46 Pool Spe Final Final Re-Roof Final BIocWRetaining Wall Final Factory Fire Plece Final Sign Final Demolition ��$ QQjj� INSGECTIONTYPE 206 Final Mechanical 20B Final Plumbing � 270 Final Electncel 212 Finel Fire Prevention 220 Final Plenning Approval 222 FinalSite 250 Final Building/Occupancy 09IE UISIDdLS 4:49 pm Costa Mesa, CA-City Of Requested Inspect Date: Tuesday, August 15, 2000 Site Address: 2040 CONTINENTAL AV CM AIPID Information Activity: 699-00022 Type: BLD_SUB Sub Type: ALT_SFR Status: ISSUED ConsiType: V-N Occupancy: 17 Use: Insp Area: Owner: REYNOLDS, GARY W Plan check: CAC Applicant: REYNOLDS, GARY W Phone: 949-646-4387 Description: 126.5 SQ. FT. ADDITION TO EXISTING CARPORT AND CONVERSION TO A 360 SQ. FT. ONE-CAR GARAGE Requestedlnspection(s) Item: 250 FINAL BUILDING / OCCUPANCY Requestor: Assigned To: *"'""««.... Aclion: Time Exp: _ Item Comments: Inspection Historv Item: 4 FOOTINGS (Optional) "Approved" 03/02/99 Inspector: EP 03/09/99 Inspector: EP Item: 150 MISCELLANEOUS INSPECTION (Optional) Item: 250 FINAL BUILDING / OCCUPANCY (Required) Item: 12 ROOF SHEATHING (Required) "Approved *' 04/20/99 Inspector: EP Item: 16 EXTERIOR SHEAR PANEL (Required) REPT131 Requested Time: 08:00 AM Phone: Entered By: FURLO_K K Action: DN DENIED Action: AP APPROVED Action: AP APPROVED �— �/�lC� � � ✓� �U� l � Ce� �� OG� " G%�f� /�C•9-s/�y GJl�d r.� „�� /{��- �/�� s� - � �� Run Id: 9774 r�M S CITY OF COSTA MESA � - ' BUILDING DIVISION � . � DEVELOPMENT SERVICES DEPARTMENT �*� - � PERMIT � . RMIT NUMBER �"+roamce `� ... . . .. . . , E99-00036 (714) 754-5273 • Fax (714) 754-4856 77 FAIR ORIVE, COSTA MESA, CA 92626 JobAddress: 2040 CONTINENTALAV Suite No Vicinity: Parcel Nunmber: 42250325 Applicant: REYNOLDS, GARY W Address: REYNOLDS, OLGA COSTA MESA,CA 2040 CONTINENTAL AVE owner: REYNOLDS, GARY W Address REYNOLDS, OLGA . COSTA MESA,CA � 2040 CONTINENTAL AVE Contractor. Address: - ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa. Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermetl Pole ''� ELECTRICAL PERMIT Phone: 949-646-0387 Zip: 92627 Phone: Zip: 92627 Phone: Zip: ��License: SCOPE OF PERMIT 3 OUTLETS, 2 SWITCHES & 3 LIGHTS REFB99-22. $22.00 $0.00 so.ao $0.00 $0.00 $0.00 $3.00 $3.00 $2.00 $0.00 $0.00 $0.00 30.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 3 3 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY � Temp Dist System / Lighling Busway/t00ft . Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ...............:up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit'� Misa Conductor . Circus ( gen or nde) - - Cirws (mech ride or lights) Christmas Tree Stand Fireworks-Stand Other Electrical Fee Investigation Fee Plan Check Fee . Reinspection Fee . TOTAI CALCULATED FEES Status: ISSUED Applied: 01/19/1999 Issued: 01/19/1999 Quantity $0.00 0 $0.00 0 $o.00 0 $0.00 D $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 , 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 E30.00 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot ihis permit. FOR INSPECTIONS CALL: (714) 7545626 ' WORKERS' COMPENSA710N DECLARA710N: 1 horeby aHirtn under penalry ot perjury one ot the following declarations: ❑ I have antl will maintain a cenificate oi consent to self-Insure br workers' compensation, es provided tor by section 3700 of the Labor Cotle, for the paAormance oi Ihe work tor which �his pertnit is issued. ❑ I have end will maintain workers' compensation insurance, es required Dy sedion 3700 ot ihe Labor Code, Por the pedortnence oi Ihe work for which Ihis pertnit is issuetl. My workers' compensation Insurance cartier end policy number are: Cartier. Policy Numbec (This section need nof be complered il tbe perm/t is velued et one hundred dallars ($ f 00) or less.) ❑ I certiy thet in ihe pertortnance of the work for which ihis permit is issued, I shall not employ any person in any manner so as to become sublect to Ihe workers' compensation laws pf Celifomle, antl egree ihet if I shoultl become subject to the workers' compensetion provisions of Section 3700 oi Ihe Labor Code, I shall fotlhwith comply with Ihese provisions. . Applicam Signeture: Date: WFFNING: FAIIURE TO SECURE WORKERS' GYMIPENSATIIXJ COVEMGE IS UNLAWFUL AND SHlLLL SU6IECT AN EMPLOYER TO CRIMINAL PENALTIE& AND CIVIL FINES UP TOONE HUNDRED TKKISAND DOLLARE (5100,000), IN ADDITION TO THE COST OF fAMPENSATION, DAMAGES AS PROVI�ED FOR IN SECTION 310fi OF THE LABOR WDE, IMEREST. M1D ATTORNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby eNirm that I em liCensetl undar provisions oi Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professiuns Code, and my Ilcense is in full torce antl eNed. Lic. p Class # Contredars SignaNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn ��at there is a consiruction lending agency for Ihe pertortnance of Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lenders Address: Signeture: Date: OWNER•BUILOER DECLpqAT10N5: I hereby eHirtn Ihet under penalry at perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tar ihe tollowing reason (Sec. 7031.5, 8usiness and Prafessions Cotle: Any ciry or counry Which requires e pertnit to consWd, altar, improve, demolis�, or repeir any siructure, pnor to its issuance, elso requires the applicant tor such permit to file a signetl statement Ihet he or she is licensetl pursuam b the provisions oi the Contrectors License Law (Chepter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code) or �hat he or she is e:empt theretrom and ihe 6asis for the alleged exemp�ion. Any violation of Section 7031.5 by any applicant for a pertnit sublects the epplicant to a civ�l penalry of not more than five hundred dollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as t�eir sole compensation, WILL DO THE WORK, entl ihe slmcNre is not Intended or oflered for sale (Sec. 7044, Business antl professions Code: The Contractors �cense Law does not aOPly 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, provitled that such improvements are not intended or ottered for sale. If, however, the bullding or improvement is solC wiihin one year oi completion, Ihe owner-builder will have the burden ot proving thet ha or she tlitl not build or improve for purpose of sale.). ❑ I, es owner of the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTHACTORS to construct ihe project (Sec. 7044, Business antl Professions Code: The cantrectOrs License Lew does not apply ta en owner of praperty who bullds or improves thereon, and who cantracts for such project with e contractor(S) Jicense pursuant to the CONrec�t jrs License WwsJ. [� I em eaempt u r sec. fZ� L u i ss and Professions Code for this reason: Siqnature: �l�/ � Date�. � Owner ID venfied by dnver's� �e. 0'7es ❑ No Drivers License No. . �� Espiras: Vedtication of Ownarship by (rype ot document, i.e. - property tau bill or deed): �— 3 " DIVISION OF INDUSTRIqL SAFETY PERMR CERTIFICATION: ❑ I hereby certity ihet no ezcavatlon five (5) or mora feet in tlepth into which a person Is required to descend, will be metle In connection with work authodzetl by this pertnit, and Ihet no 4uilding structure, scafloltling, felsework, or tlemolition or dismantling thereof, will be more then ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, lltle 8, Celitomia Atlminisiretive Code). ' ❑ As owner-builder, I Will not employ enyone to do work which would require a permit from the Division af Indusirial Sefety, es note0 above, unless such person has e pertnit to do such wprk trom Ihe tlivision. Signature: Division of Indus�nal Satety permlt Number: Date: CERTIFlCATE OF COMPLIpNCE AND AllTT10RIZATON OF ENTRY: I certify under penalty ot perjury thet I have read �his epplication and state that ihe intormation given is corred. I agree to comply with all state laws and ciry ordinances relating to building construction, and authodze representatives of the Ciry of Coste Mesa to enter upon the ebove-desc' e0 property for inspection puryoses. I agree not occupy or allow occupency oi any building authonzetl by ihis permit until final inspection. t✓ /- / �' - S' S SlgnaWre OI Le wner(s) � ata And/Or Authonzetl Applicant Date COOE I. INSVELiIONttVE �QS¢ �lS 1676 Fixetl System Final Fire Prevention 7266 Pool Spa Final 200 Final Re-Rool 201 Final BIocWRetaining Wall 202 Final Factory fire Place 203 Final Sign 204 Finel Demolition 24a6<6 LOOE II INSFECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electncal 212 Final Fire Prevention 220 Final Planning ApO�oval 222 Final Site 250 Final Builtling/Occupancy OAg JIII. . q:71��ii]`�11 Y' GAS 1 WATER ROUGH PLUMBING PROP. SWR. LINE � HOUSE CON. � SPRINKLING SVSTEM MISCELLANEOUS POUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNOERGROUNO � POWER � ROUGH WIRING FORMS � � STEEL REINF. BOND BEAM � STEEL REINFORCE � SHEATHING FRAME ANo FLASHING LATHING — IN n OUT ❑ PLASTER, 9ROWN COAT STRUCTIIRPL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST I� DATE 5-31-72 BUILDING PERMIT N0. 34784 FIRE ZONE VALUE $ 500.00 GROUP J TYPE V SUBCONTRACTOR _ : ,�� 347�4 � • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 12pp COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUII.DING „ .. „ _ ,n i OWNER � MAIL , Z -- ADDRESS p � ' W W dU pTV G�G�T,J JJA Zz Q CONSTRUCTION O N LENDER am J � BRANCH J N m J ADDRESS" J Q ARCHITECT N OR ENGINEER / I� U Q _ w2 ADDRESS ZLi'�Q (�p� aw W Z CONTRACTOF SqM Z J � m Z J � ADDRESS W w �= GTV Z � w � STATE � � LIC. NO. 70 F z Q U J a a Q 0 H N z 0 F U � � H Z SIZE OF LOT USE OF EXISfING BLDG. SIZE OF NEW BLDG. I S� �X �S � EXTERIOR WALL ' COVERING USE OF BUILDING AND WI ` ADDRESS TEI. TRP No. (ey�-37 W A ✓ OWNER NEL.GS�G�J s ..' i FIRE� / TEL. NO. CITV LIC. NO. INO.O BF L�DGS. NOW ON LOT NO.OF / ROOMS / 5' ROOF- COVERING K TO BE PERFORM _ �.r,�,�r , 4'Alll '+" 3n-?;'�,,�,;001276��s ...`rt�'�*5.04 :ATIO FOR BUILDING PERMIT BV DATEy RECEIVED DATE ISSUI `� 'JO' % S " 3O . . �� PER IT .�lJ �D C��nT/n/�it/TA/, � NO.OF — PViN$ DS APPROVED V AR. # F V.P. #` G. /Svnr/S �""'$ 500 °s' GFiOUP / L� DATES �3� � —b USE OF NEw �/d BUILDING P� JE�� YAFDSAPPqOVED ACCESSORV BUILDING i s �r BET. MAIN & ACCESS.BLD DATE APPROVED I hereby-acknow�etlge that I have reatl ffiis application antl state that tha above informatian is wrrect antl a8ree to complywith all laws regulating builtling consvuction, and I shall not'employ any person in viq�ation of the workman's compensation laws of the State�ot Califomia. � �� / � / m (L� � I hereby certify that I am properly licensed as a contractor under SQ. FT. o the State ot California Business antl Professions Code, Divisicn 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR �� Chapter 9,'antl that such licenzes are in full torce and effect, or I THE PURP�E OF ESTABLISHING A PERMIT FEE ONLV: .m am exempt from t�e piovisions of the State of California B�siness ¢ VALUATION �-� y antl Professions Cotle, Division 3, Chapter 9. � ' C � ' PERMIT FEE $ V � � Sig^ature of � � - fJ- d '. . � m Permittee ��1�'�� "� $ SD O P�N CHECK $-. E `o Auihorized Agent � � . ` ��-� LL TOTAIFEE $ `� ORANGE COUNTY 6UILDING DEPARTMENT APPLICATION FOR PERMIT . -1 636 Norfh Broodway . � � 1 � � � � p p fAVTA ALIA I`M�vnnu�♦ � . m0170�e . .. W - - ? - -w J Z \ t, 1 � '. ._ � J ..a. .�� . �rc ��' ' `• . ' "L` , o �a e a �•t , . � _ l_'. � � � • , � : c , . �• `.- :>'; - . ; :;�,.. ... . . -; � 4�� _ � f: 4�'! � . . �,•. : �� STREET PLOT PLAN - Show location and distances from property line and between buildings. • „ 1 � t, ; • � . _. �.J:.�..._........ �_. . - . � ...,, �? . .�'._ .. .. o�i .. , - � = - --�--. ..._.. :1" . � ;, � ':: � .. .. ' ". - .'� . r � �_ . � .. � . .� . . .�!.�'r . _ l � — _ ��. . .^ J ♦.C, - �... . . . . . . � _ • .� . -j f f • 1 � I' r " . �. , t":. �, t '�""' �"' ' . J `. _. . ' � - , � � �, _ _ _-_- ` . J ' L ' ' b �. . . . � 1 t. �v - `�. 1 � 'U . _ L � . ._. �C>� u �r � ., r . ;� . • .:7 . .iw�•'C,.. I�' \ '\\'..-,�,� . . .�i; y._=,;.._. . . . . 1 ��'� , .. . � _