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Home My WebLink About2852 DRAKE AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�.�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, GA 92626 ,lob Address: 2852 DRAKE AV Suite: Viciniry: Parcel Number: 14154504 Applicanr. LIM, CORAZON C Address: 2852 DRAKE AVE COSTA MESA, CA Owner. LIM, CORAZON C Address 2852 DRAKE AVE COSTA MESA, CA Contractor: OWNER-BU ILDER Address: Zip: Arch : Address: Phone: Zoning: Phone: 714-751-1365 Zip: 92626 Phone: 714-751-1365 Zip: 92626 Phone: License: 000000 Eng: Address: ISSUED BY: Stalus: ISSUED Applied: 10/22/2003 Issued: 11/07/2003 Phone: Zip: License: License: SCOPE OF PERMIT ADD 278SF MASTER BEDROOM AND BATHROOM AT THE REAR OF SFD. � ADDITION IS 12' HIGH. 64% OPEN SPACE IS PROPOSED. � Plan Check: $261.20 Permit: $401.85 SMIP Res: $2.57 SMIP Com: $0.00 Other. $0.00 Inspection: $0.00 Total: $665.62 SETBACKS MAINSTRUCTURE Fronl 0-0 ACCESSORY Front 0-0 PARKING Existinq: a Rear 20- 0 Rear 0- 0 Re uired: 4 FEE SUMMARY PLANNING & ZONING Left 46- 0 Left 0- 0 Praposetl: 4 Calc Valuation: Claim Valuation: Right 5- 0 Right 0- 0 $25,687.20 So.aO NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-g2) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlona and (inel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ?aaaafi le�oo) WOHKERS' COMPENSATION DECLARATION: I hereby ettlrm under penalry of perjury one of the following tleclaretlons: ❑ I heve end wlll meimein a cenificate of consent to self-Insure lor workers' compensetion, as provided for �y section 3700 of the Lahor Code, for the pertormance ot the work for whlch thi9 Dermit is issued. ❑ I heve end will malntaln workers' compenSaGon insurance, as requiretl by section 3700 of ihe Lebor Code, tor the pertortnance oi the work fa which ihis pertnit is issued. My workers' compensetion Insurance carner and policy number are: Cerrier. Poliry Number. (This section neetl nof be comp/eted i/ the permit is velued af one huntlretl dollers ($100J or /ess.) ❑ I certity that in the PeAormance of the work for which t�is permit is issuotl, I shall not employ eny person in any manner so as �o become suDject to ihe workers' compensatlan laws ot Calitomia, end agree t�at tl I shoultl become sub�ect to the workero' compensation provisions oi Section 3700 of [he Lebor Cade, I shall forthwlth comply with these p�ovisions. Applican� Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SW1LL SUBIECT AN EMPLOVER TO CRIMINAL PENALilES AND GVIL FlNES UP TOONE HUNORED TFKKISAND DOIIARE (5100.0001� IN A�DITION TO iHE WST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECiION 3]OB OF THE UBOR COOE, IMEREST, AND ATTORNEI^S FEES. LICENSED CON7RACYORS DECIARATION: I hareby aHirm thet I em licensad under provisions of Chepter 9(commencing wit� Section 7000) of Division 3 of the Business end Professlons Code, and my license is in lutl forCe and eHect Llc. a Cless N ConVecrofs Signeture: Dete: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn the� there is e canstruction lending egency br ihe peAormence of the work for which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: Lender's Address: SignaWre: Da�e: OWNER•BUILDER DEC�NATIONS: I hereby eHirm ihet und6� penalry of perjury that I em EXEMPT FROM THE CONTRAC70R5 LICENSE LAW for the lollowing reason (Sec. 7031.5, Business end Prolessions Code: Any ciry or counry whic� requires a pertnii to construc6 elter, improve, demalish, or repair any structure, pnor to its issuance, also requires the applicam Por such pertnit to file e signetl statement Ihet he or she is licensed pursuent to the provislons of ihe Contractors License Lew (Chapter 9(commencing with Section 7000) ot Divislon 3 0l the e�siness and Proisssions Gade) or thst he or she is exempt theretrom sntl the basis tor ihe allegatl exempiion. Am/ violetfon ot Section 703t.5 by any applicant for e pertnit suDjects ihe epplicem to e civil penaliy ol not more than five hundrea tlollars ($500).): ❑ I, es owner of the properry, or my employees with wages es ihelr sole compensation, WILL DO THE WORK, and Ihe siructure Is not intentled or offeretl for sele (Sec. 7044, Business and Professions Code: The Contractors License Law doas not apply to an owner of property who builds or improves thereon, and who tloes such work himself or herself or through his or her own employees, pwvided that suc� improvemenis are not Intended or aHered for sale. If, however, Iha building ar Improvement is sold within one yeAr of completioq Ihe owner-builder will have iho burden of proving ihat he or sha did not builtl or impiove lor puryose of sale.). ' ❑ I, es owner ot Ihe pmperty, am EXCWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7040, Business ana Pmfessions Cada: The conirac�ors License Lew does not epply to en owner of property who builds or Improves thereon, entl w�o contraGiS for such project with e coNrector(S) �license pursuant to �he Comreaors License LawsJ. ID vedtled by ❑ No Business and Professions Code for ihis reason: Verifkallon ot Ownership by (type oi document, i.e. - property tan bi6 or tleed): DIVISION OF INDUSTRIAL SAFEN PEHMI7 CERTIFICATON: ❑ I hereby cenity t�e� �o excevetion fiva (5) or more feet in depth inio which a person is required to descenq will ba mede in connection wiih work authonzetl by t�is permit, end that no builCing siructure, scaHoltling, falsework, or tlemolition or dismantling thereof, wlll De more than �hirty-six (36) taet high. (Chap. 3.2, Grp 2, ArI 2, Sec. 341, 71I1e 8, Califo/nia Atlminisirative Code). ❑ As ownerbuilder, I will not employ enyane to tlo wo�k which would require e permit irom the Division of Industnal Safery, es noted above, unless such person hes e permil �o do such work Irom �he tlivision. Signature: Date: Divisian of Indusirial Salety Permit Number: CERTIFlCATE OP COMPLIANCE AND AUTHORVA710N OF ENTRV: I certify under penalry ot perjury ihe� I heve read this application and stafa Ihat Ihe infortnation given is correct. I egree to comply with all s[ate laws end ciry ordinences releting to 6uilding construction, end authonze representatives o� Ihe qry of Costa Mesa to enter upon the ebove-described D�operty for inspection purposes. I agree ol to ocCupy or allow occupancy ot any building authorized by this pe it un/QI final inspection. O ':�'1t �' � �/�7/�� Signat f L Owner(s) Date An r Authonzed Applican� Date CQDE 1. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 7266 Pool Spe Final 200 Finel Re-Roat 201 Flnal Block/Reta��8 �'�'e�� 202 Final Factary Fife Place 203 Final Sign 204 Finef DemotifiQn �� COUE 1 INSPELTIONTYYE 206 Final Mechanicel 208 Final Plumbing 210 Finel Eleciricel 212 Finel Fire Prevention 220 Final Planning Approval 222 FinelSite 250 Final Building/Occupency � 1[� (714) 754-5273 • Fau {714) 754-4856 • www.ci.costa-mesa��SCTRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: 2852 DRAKE AV 14154504 npplicant: LIM, CORAZON C Address: 2852 DRAKE AVE COSTA MESA, CA Owner: LIM, CORAZON C Address 2852 DRAKE AVE COSTA MESA, CA Contracror: OWNER-BUILDER Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 uniLs) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 7000a Motors l0 1 hp Molors to 10hp Motors to SOhp Molors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Phone: 714-751-1365 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 SCOPE OF PERMIT B03-01840 10 LIGHTS, 15 OUTLETS, 5 SWITCHES, 1 BATHROOM FANS. 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 $11.00 $16.50 $5.50 $0.00 $0.00 $0.00 $0.00 50.00 $4.75 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 10 15 5 0 0 0 0 0 7 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist Syslem / Lightin9 Busway /100 ft 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 ntle) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other ElecUical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 11/26/2003 Issued: 11/26/2003 ISSUED BV: C- � Quantiry 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 So.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 � 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92•28, § 1, 1241-92) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 1 BO days. / INSPECTIONS: In order for ihe work authonzed under this permit to be considered legal, such work must comply with all� applicable codes, and all requlred Inspectlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the,expiration of ihis permit. FOH INSPECTIONS CALL: (714) 754-5626 2aasee �sma� WORKERS'COMPENSAnON DECLARAnON: I hereby ettirm under panalry of perjury one of the following declaretions: ❑ I heve and will maintain e certificete ol wnsent to selbinsure for workers' compensatlon, es proviCed for by section 3700 of ihe Lebor Cotle, for the peAormence of the work tor which Ihis pertnit is issuetl. ❑ I heve antl will rhaintain workers' compensatlon insurence, as requiretl by section 3700 of Ihe Labor Code, for the peAonnance of the work for which Ihis permit is issuetl. My workers' compensation Insurance certier antl polity number are: . Cerrier: Policy Number. (This secNon neetl not be completed i! the permifls velued et one hundred dollers ($ f00) or Iess.J ❑ I ceRity Ihet in the performance of the work lor which ihis pertnit is issued, I shell not employ any person in any manner so as to become subject to ihe workers' compensetlon laws ot California, end egree that II I should become subJect to ihe workers' compensation provisions of Sactlon 3700 oi Ihe Labor Code, I shall lorthwlih comply with the5e provisions. Appllcent Signeture: Date: WARNING FAIIURE TO SECURE WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL ANO SHALL SUBJECT AN EMMOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNORED THOUSAND DOIJ.AqE (5��.�I. IN ADDITION TO TNE COST OP COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O60F TME IABOR CODE, IMEREST, ANO ATTORNEV'S FEES. LICENSEO CONTRACTORS DECLARATON: I �ereDy ettirm that I am licensed under provislons af Chapter 9(commencing with Saction 7000) of Division 3 of ihe Business and Professions Cotle, and my license is in full force entl eHecL Lic. q qass # Conireaofs Signature: Date: CONSTRUCTON LENDING AGENCY: ❑ I hereby ettirm tnat there is a construction lending egency for the pedormance ol �he work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Nema: . Lentler's Address: Signeture: Oete: OWNER-BUILDER DECLARATIONS: I hereby efllrm that under penalry of perjury t�et I em E%EMPT FROM THE CONTHACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Professlons Code: Any ciry or couniy which requires a pertnil lo conshuct, aller, improve, demolish, or repair any siructure, prior to its issuance, also requires Ihe epplicant for such permit to tile a signetl statemem Ihat he or she is licensetl pursuant to ihe provisions ol the Contrectors License Law (Chepter 9(commencing with Section 7000) oi Divislon 3 of the Business entl Professions Code) or thet he or she Is exempt therefrom and the Easis tor Ihe ellagetl e:emption. Any violation of Sectlon 7031.5 by any apDlicant tor e pertnit subjects Ihe applicaN �o e civil penelry of noI more than tive huntlred dollars (5500).): ❑ I, es owner of ihe properry, or my employees with wages as their sole compensatlon, WILL DO 7}1E WORK, entl t�e siructure is not intended or otteraa for ule (Sec. 7044, Business dnd Professions Cotle: The Contractors License Law does not apD�Y �o an owner of property who builtls or improves thereon, and who does such work �imselt or hersep or through his or �er own employees, provided that such improvements ere not intended or otteretl for sale. It, however, the building or improvement is sold within one year of complation, the owner-builder will heve tha burden of proving thel he or she did not build or improve for purpose of sale.). I, as owner of t�a Propeny, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRAGTORS to consiruct the ptojeti (Sec. 7044, Business and Professions Code: The coniractors Ucense Law tloes not apply to en owner of propeny who builtls or Improves thereon, and who conirects for such pro�ect with e contractor(s) license pursuant to the Con�rectors License LewsJ. ❑ I am exempt undAr sec. and Pwfessions Coda tor this reason: Date: ¢v�enfietl by d��ers Ilebnse. � Venilcation of Ownership by (type oi daumem, � No DriveYs Licens No. properry tan bill or deetl): DIVISION OF INDUSYRIAL SAFETV PEHMIT CERTIFICATION: ❑ I hereby certify tnat no excavetion tive (5) or more teet in tlepth into which e person is requlred to descen0, will be made in connecllon with work authorized by Ihis permil, antl ihat Po building strudure, scaHoltling, lalsework, or demolition or dismantling ihereof, will be more than thirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celifomia Adminisirative Cotle). ❑ As owner-builtler, I will not employ enyone to do work which would require e pertnit from the Division af Industnal Sefery, es noted ebove, unless suc� person hes e permlt to da sucn work from ihe divlsion. Signature: pate: Division of Indusirial Safery Permit Number. CEHi1FlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I certify untler penalry oi perjury that I have read t�is epplicetion end state that ihe infortnation given is correc�. I agree �o comp�Y wi�h ell stete lews end city ordinances relating to 6uiltling conslruc�ion, entl euthodze representaUves of Ihe Ciry ot Casta Mesa Io enter upon the above-descrihed property �or inspecUon puLir// (6-(r�7Nee not tQ occupy or allow acupancy of any huilding authorized hy this Dermit upUl fma�0.3 on. �a �_ �./� Signature Leg Owner D AnNOr Authonzed Applicani Date COOE 1. INSVECTIONTYPE Q9IE lC�k$ �616 Fixetl System Final Fire Preventlon 1266 Pool Spa Fina� 200 Finel Re-RooF 201 Flnel BIxWRelaining wall 202 Final Factory F�re Place 203 Final Sign 204 Final Demolitian COOE I INSVECTION TYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Electrical 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Si�e 250 Final Building/Occupancy P�TE It�EL� ,�-1�'� � (714) 754-5273 • Fax (714) 754-4856 • www.Cl.cOsta-me98.ca.us 77 FAIR DRIVE, GOSTA MESA, CA 92626 Job Address: 2852 DRqKE AV Suite No Viciniry: Parcel Number: 14154504 Applicane LIM, CORAZON C Address: 2852 DRAKE AVE COSTA MESq, CA owner: LIM, CORAZON C Address: 2852 DRAKE AVE COSTA MESq, CA Contractor. Address: OWNER-BUILDER 803-01840 1 ALT. DUCT SYSTEM. ISSUE FEE Insl FAU <700 k BTU Insl FAU >700 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Hlr Refng Sys <700 k BTU Refng Sys >100 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 Fumace floor or Suspend Heater $23.50 $0.00 $0.00 513.70 so.00 30.00 50.00 $0.00 $0.00 30.00 $0.00 30.00 50.00 $0.00 50.00 30.00 50.00 50.00 50.00 $0.00 Quantity MECHANICAL PERMIT Status: ISSUED Applied: 71/26/2003 Issued: 11I26I2003 ISSUEDBY: v`�- Phone: 714-751-1365 Zip: 92626 Phone: Zip: 92626 Phone: 2ip: License: 000000 SCOPE OF PERMIT FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I n cinerator DomesUc Incinerator Compressors / Absorption Svstems Uplo3hp/100kBTU 3 To 15 hp I 500 k BTU 15 To 30 hp I 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15 l0 30 hp 30 l0 50 hp . . Over 50 hp Other Mechanical Fee Investlgation Fee Plan Check Fee Reinspection Fee Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 ao.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 $0.00 0 50.00 0 ao.00 0 50.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 537.20 NOTICE: The work authorized by thig permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12•27•g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all required Inspeatlons and (Inal epproval must be obtained. Fallure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 2aeae Ierool WORKERS'COMPENSATON DECLARAnON: I hereby ettirm untler penalry of perjury one ol the following declaratlons: ❑ I have and wiil maintain e cetlificate oi wnsent to self-Insure lor workers' compansatlon, es provided for by section 3700 of the Lebor Code, lor the pertortnence ot the work for which this permit is issuetl. ❑ I have entl wlll maintain workero' mmpensatbn insurance, az requiretl by SecUon 3700 of Iha Lebor Cotle, for Ihe peAortnanca ot the wark lor whkh this pertnit is issuetl. My workers' compensation Insurance cartier antl policy number are: Carder. Policy Number. (This sectiar need no� be completetl il the pemtitls ve/ued a( one hundred tlW/ers (S f00) or /eu.J ❑ I cotlity Ihat in tPe pedormance of l�e work tor which Ihis permit is Issued, I s�all not employ any parson In eny manner so as ta become subject to the workers' compensation laws af Calitomia, entl egree Ihet il I should becane sub�ed to Ihe workers' compensetian proWsions oi Section 3700 ot t�e Lebor Cade, I shail fonhwith comply with these provisions. Applicant Signature: Date; WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIdJ COVEMGE IS UNLAW FUL AND SHALL SUBJECT Ml EMVLOVER TO CRIMINAL PENALTIES AND CM� FlNES UP TO ONE HUNDRED THOUSAND OO�IARE ($��1. IN ADDITION TO TME COST OF COMPENSATIIXJ, DAM4GES AS PROVIDED FOR IN SECTION 3]08 OF THE LABOR COOE.IfJrEREST, AN� ATTOFNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm thal I am licensed under provislons ot Chapter 9(commendng with Sectlon 7000) of DMsion 3 of ihe Busineu and Professlons Cade, anE my Iicense is in lull torce end eHecL Lic. Y Cless x ComrectoYs Slqnamre: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby eNirtn tpat there is e construction lentlinp egenty lar the pertormance ol the work br whiU I�is permll is issuetl. (Sec. 3097, CiWI Catle). � Lontler'e Namo: Lendefs Atltlr855: Slgne�uro: Da�e: OWNER-BUILDER DECLARA710NS: I hereby aHirtn thet under penalry ol per�ury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl ProFessiwu Cotle: Any ciry or counry which raquires e permii to consiruct, aitar, impmve, demolish, or repair any strucNre, priar to Its iuuance, elso requires Ihe epPlicant lor such permit ta tile a signed statemem that �e or she Is Iicensetl pursuant to the provisions at Ihe Contrectors License Lew (Chapter 9(commendng with SecUon 7000) ot Division 3 ot Ne Business end Professions Cotle) or that he or sha is exempt therelrom entl lhe besis tor the alleged e:emption. Any violatian of SecUon 7031.5 �y any applicant tor e pertnit sub�ects the epplicant to a civil penalry of not more Ihan frve huntlred ddlars (5500)J: ❑ I, es owner of ihe property, or my employees with wages as their sde wmpenutlon, WILL DO 7ME WORK, entl ihe sWcture is not Iniended or oHered tor sale (Sec. 7044, Business and Professions Code: The Coniractors License Law dces not apply to an owner of properry who builds or improves thereon, anC who does such work �Imself or hersetl or t�rough hIs or her own employees, pmvided thet such improvements are not intendetl or oflered tor sale. If, however, the building or improvement is sold within one year oi completion, the owner�Duilder will heve the burden ot proving ihat ha or sha did not build or improve for purpose ot sale.). � I, es owner ot the pmperty, am E%CLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS ro conslruct the prqect (Sec. 7044, Busineu and Pmfessions Cotle: The camracbrs License Law does not epply to en owner of propeny who builds or Improves Ihereon, antl who contracis for such pm�ect wlih e contractor(s) license pursuant to the Contractors License Lews.). sec. O�verifiad by d��eYs license Verificatlon ol Ownership by (rype of Business antl Pmfessions Code for �his reason: �s ❑ No Dnvels License i.e. - property ta: bill or de DIVISION OF INDUSYAIAL SAFETY VERMIT CERTIFICATION: Expir85: � I �ereby certtly tqat no excavation Ilve (5) or more �eet in depth into which a person Is required to tlescend, wlll be matle in connectlon wlth work euthodzeC by this permit, antl ihat no 6uilding sirudure, scaflolding, talsework, or demolition or tlismantling thereof. will be more then ihirty-six (38) feet high, (Chap. 3.2, Grp 2, Art 2, Sec. 341, Titla B, Celi�ornia Atlminlsiretive Code). ❑ As owner-builtle�. � wlll not employ enyone to Co work which woultl require e permit tmm the DiWsion ot Indusirial Sefery, es noted ebove, unless such person has e permil Io tlo sucn work irom the division. Signature: Date: DiviSion ot Industnal Setery Permit Numbor: CERTIPICATE OF COMPIIANCE AND AUTNORIZATION OF EMRY: I certity undor penalty of perjury that I hnve reatl this epplication and state that the information given is correct. I egree to comp�y wlth ell stete laws entl ciry ordinances releting to builtling construc�ion, anC euthodze represeniatives of the CIIy ol CoSte Mesa to enter upon �ha ahove-dexribed praperty lor inspection purposes. I a�ee not to acupY ar ellow occupency of any huilding authorized by this permit un I linal ins ection. /�,�� - /�%�� .� sie a� o+�e98i s> � o Ana/Or Aut�onzetl Appliwnt Date cooe �. �sie 1288 Fixetl System Finel Fire Prevenilon Poal Spe Fine� 200 Finel Re-Rool 201 FIneI Block/Ra�eining Well 202 Finel Fattory Fire Plece 203 Final Sign 20a Final Demolition � It� COOE 1 INSPELTION TYPE 208 Final Mechenlcal 20B Flnel Plumbing 210 Finel Eloctticel 212 Finel Fire Prevention 220 Finel Plenning Appraval 222 Final Site 250 FinalBuilding/Occupency ��I3m � (714) 754-5273 • Fax (714) 754-a856 • www,ci.costa-mesa.ca.us Job Address: 2852 DRAKE AV Suite No Vicinity: Parcel Nunmber: 14154504 Applicanc: LIM, COR,4ZON C Address: 2852 DR4KE AVE COSTA MESA, CA Owner: LIM, CORAZON C Address 2852 DRAKE qVE COSTA MESA, CA Contractor: OWNER-BUILDER Address: Arch / Eng : Address: ISSUE FEE Backflow irrigaEon BackFlow Preventer Bathtub Clarifier System Connecl Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Dnnking Fountain Expansion Tank PLUMBING PERMIT Phone: 714-751-1365 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT 803-01B40 10 1 FLOOR DRqiN, 1 SHOWER, 1 WASH BASIN AND 1 TOILET. AMT $23.50 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 59.80 $0.00 50.00 50.00 so.00 QTY FEESUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irtigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $9.80 Sink, bar $0.00 Sink, commercial $0.00 77 FAIR DRIVE, GOSTA MESA, CA 92626 Status: ISSUED Applied: 11l26/2003 Issued: 11I26I2003 ISSUED BY: � QTY AMT 0 Sump Pump $0.00 0 Swimming Pool 50.00 0 Trap Primer $0.00 0 Urinal $0.00 0 Vacuum Brkr BkOow(1-4) $0.00 0 Vacuum_BrkrBkFlow(5+) $0.00 0 � Wasti Basin $9.80 0 Wash Basin Set $0.00 0 Waste and Vent System 50.00 0 Water Closet (Toilet) $9.80 1 Water Heater / vent $0:00 0 Water Piping (Inst or Rep.) $0:00 0 Water Re-pipe SU.00 i/ on 0 0 0 0 0 0 1 0 0 7 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calilomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241•92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or ii work fs suspended or abandoned tor a pedod of 180 days. INSPECTIONS: in order for the work authorized under this permit to be considered legal, such work must comply with all applicabla codes, and all requlred Inspeetiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 75M5626 244&IB (fl/00) WORKERS' COMPENSATION DECLARA710N: I hereby eHirtn under penaly of perjury one oi the lollawing declarations: ❑ I heve end wiil maintain e certilicate of consent to self-Insure for workers' compensetlon, e5 Drovidetl tor by section 3700 of tha Lebor Cotle, lor Ihe pertormence ol the work lar whic� t�is partnit Is issuad. ❑ I have antl wiil ma��Wln wwkers' compensation Inwr6�ce, as required by section 3700 of the Lebor Cotle, lor the peAortnance of the work for which t�is pertnit is issued. My workers' compensation Insurence wrrier entl policy number are: Cartier: Policy Num6er: (Thls secfion need not be comp/efed7f (he permit Is vefued et one hundred tlollers (5700) or /ess.J ❑ I certity that in thB peAormence of the work lor whic� thls pertnit is issued, I shell not omploy eny person in any manner so es to became subject to the workers' compensation laws of Celifomia, entl agree that It I shoultl Decome subject to Ihe workers' compensetion provlsions of Sectlon 3700 ot Ihe Lebor Code, I shall forthwith comply with t�es9 P�ovislons. Applicant Signeture: Date: WAPNINO: FAILURE TO SECURE WORNERS' CO!APENSATION GOVEMOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRE� THOUSAND OOLURE (51 W.000). IN ADDRION TO TME COST OF COA/PENSATION, DAMAGES AS PqOVIDED FOR IN SECTION 3]OB OF THE IABOR CODE, INrEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I ert� �kensed untler proWSions of C�apter 8(commencing with Section 7000) ot Division 3 of Ihe Buslness and Profeulons Cotle, end my license Is In full force entl eMact. Lic. a Class a Contrectofs SignaWre: Dete: CONSTRUCTIOH'LENDING AGENCV: . ❑ I hereby aNirm th8� there Is e consiruction lending agency tor the pertormance ot ihe work tor which ihis permi� Is issued. (Sec. 3097, CiWI Cotle). Londers Name: Lender's Adtlress: SignaWre: Date: OWNER-BUILDER DECLARATONS: I hereby eMirtn t�a� under penelry of per'ryry thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires e permit lo construct, elter, improve, tlemolish, or repair any structure, prior to its issuanCe, elso reQuires ihe epplicant for Such permit to file e slgnetl stateme�� ihat he or she is licensed pursuent to t�e O�ohsions of Ihe Contrectors lJcense Lew (Chepter 8(commencing wit� Sectlon 7000) of Divisian 3 of the Business and Pmteuio�s Code) or Net he or she is exempt therefrom and tha basis tor the slleged exemptfon. Any violatlon W Seclion 7031.5 hy any applicant tor e pertnfl sublecis the applicant to a civil penelly of not more than Ilve hundretl tlollars ($500).): ❑ I, es awner oi the propeny, or my employees wlih wages es their sole compensetion, WILL DO THE WORK, end the structure is not Intended or aHered for sale (Sec. 7044, Business antl Professlons Cade: The Contractors License Law tloes not appty to an owner of property who builds or improves Ihereon, and who tloes such work himself or herselt or through his or her own employees, proviaed that such impmvements ere not Intended or oNeretl br sale. II, however, ihe building or improvemeni Is �///��old within one year of completion, Ihe ownerDuilder will have the burden of proving that he or she did not builtl or improve tor purpose oi saleJ. es owner of the p�operry, am EXCLUSIVELY CONTRACTING WIiH LICENSED CONTRACTORS to consiruct the projact (Sec. 7044, Business and Prolessions Cotle: The contraCtors License Lew does not appy to an awner ol pro0erty who builtls or impmves lhereon, end who contrects for suc� prqect with e contractor(s) licanse pursuant to the Contraaors License Laws.). ❑ I eaempt untle� sec. Business and Professions Cotle for Ihis reason: gn e: Dat . . � Owner ID venfietl by dd�ers li nse. ❑ No riv rs Lic se No. �r� S �a� Vedlketlon ot Ownership by (rype ot document, i.e. - property tex hill or tleed): ( DIVISION OF INDUS7qIAL SAFETV PERMR CERTIFICATION: ❑ I hereby cenify ih9� �o exwvation five (5) ar more leet in depth into which e person Is required to descentl, wlll be made in cronnection with work euthorized Dy this pertnil, and that nP building struciure, scafldding, falsework, or demolition or disman�ling �hereot, will ba more ihen thirty-six (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Calilornle Atlministretive Code). ❑ As owner-bulltler, I will not employ enyone to do work whic� would requlre e pormll irom ihe Divislon ol Intlustrial Sefety, es notetl ebove, unless such person hes e permii �o do such work irom the division. Signature: Date: Division ol Industrial Selery Permil Number: CERTIFlCATE OF COMPV4�NCE ANO AUTHORPJITION OF EMRY: I certiry under penalry ot perjury that I have reatl Ihis epplication end stete ihat ihe iniortnation given Is correct I egree lo comp�y with all state laws and ciry ordinances releting to building conswction, entl authodze represeniatives of the Clry of Costa Mesa to enter upon Ihe ebova-descnbed properry tor inspection purposes. I egree no� lqpccupy r ellow occupency ot eny building authonzetl by t�is pert/nit un fl linel in pection. �� 1� o � Slg re Ot. ega mer(s) Dat " Antll r Au�honzBA ApD��teN Dele COOE �. INSVEGfIONTYPE f 818 Fixed System F�nel Fire Preventlon � 1268 Pool Spe Final 200 Finel Re-Rool 201 Finel BIacWRetelning Well 202 203 204 Final Fectory Fire Place Final Sign Finfll OemoliUon PdIE Itf�ELS COOE� INSPECTIONTYPE 206 Final Mec�enicel 20B Finel Plumbing 210 Finel Elactricel 2�2 Finel Fire Pravontlon 220 Finel Planning Approval 222 Final Slte 250 Final Building/Occupanry PLg IIf�At� � - � �� . CdS7A MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 C08TA MHBA. CALIPORNIA For Applicant to Fill In Complefely TYPE OR PRINT � BUILDING Z852 DFake Avenue A�ORESS COSTA MESA. CALIFORNIA ADORE66 38�� . C088t ��T,. Corona del Mar FEE�, RECE eVED FINANCE DEPT. CI1M OF COSTA MESA APPLtCATION FOR PERMIT BUILDING For Oifice Use Only R6G81VT NO. �iKRNlT�f1 /Xt ➢'Tt RCCHIVBO BY I DATB HBCe�V60 I f..P.wra IBlUI 34220 BUILDING ADDRE88 34220 riRe zoNe APPROVED c�n Corona del Mar, Calif. �icTrEio. 98808-$B-1 No: OR 34220 SIZE No. M BtDO OF LOT 620� SQ . Ft • � NOW ON LOT�Oae use oF None CENTCR OPNBiAlBTM 4�' REAfi YARD 36 SIDE YARD LEFf S� IRIGHT 5� DESCRIPTION OF WORK NEW I X IIALTERATION I IIADDITION I REPAIR I IIMOVING I IIDEMOLISH I BUILDING, NO. OF SIZB bQ�X�i2�^4�� ROOMS % 6TORIES 1 EXTERIOR WAL ROOF COVERING�`100��SGUCC COVHRINGWOOd ehinglea USE OF BUILDING AND WORK TO BH PERFORMED attached 1 H8R80Y ACKNOWL80G¢ TMAT 1 X�VB IiGAD TH�9 AWLIWTION AND 6TAT6 THAT THE ABOVB 18 CARAGCT AND AGpGL TO COM� PLY WITH ALL CIlY O��NANCHB AN� 8TAT8 UWO RIOVIATINO BUILDINO CONBTIiUCT10N. aicNnrups.pF�SA DEL MAR DEVELOPlfENT C0. ZONB �.ao�� CASTA MESA. CALIFORNIA ZONING NO. OP Y08 OF N PLANB � BUILDINO I YL � `� �,F �'f J YARD6 EVES APPROVED ALLO �¢xr¢n uxa eT.� (� FRONT ��'� FT. � � H. SIDE FT. L. SIDE `S/ F7. ..�... /1 J % .._ Area - 1361 SF Aeea - 410 SF �ov. ror¢n itio �a TNB �MOUNT 6XOWN UNO6p VALUATION IC POP TX8 �UIiPOBB OF 69TABL16MIN0 A vBRMIT I88 ONLY. VALUATION � PERMIT PEE $ �o $ L�i,446.�� PLAN CHECK $ _ . . .. _ . G�/ I�