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Home My WebLink About3040 CLEVELAND AVE - Building Permits� (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: $O4O CLEVELANDAV Suite No Vicinity: Parcel Nunmber: 14114145 App�icant: PHILIP PIOTROWSKI Address: PLUMBING PERMIT Phone: 562-924-1002 Zip: owner: BISBEE, ROBERT J Address 3040 CLEVELAND AVE � Phone: COSTA MESA, CA Zip'. 92626 Contractor: PHIL'S PLUMBING ADVANCED MOBILE SHOPS Address: 79902 JERSEY AV Arch / Eng : Address: LAKEWOOD,CA Phone: 562-924-1002 Zip: 90715 License: 506677 Phone: Zip: License: SCOPE OF PERMIT GASLINE FOR 86Q PIT, NO OTHER WORK AUTHORIZED BY THIS PERMIT. ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 50.00 $0.00 $0.00 $0.00 Q7Y FEESUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: O6112/2000 Issued: 06/72/2000 ISSUED BY: � / SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin � Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $29.65 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this parmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 day5. INSNECTIONS: In order for �he work aNhorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inepectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (774) 754-5626 WORKERS'COMPENSAnON DECLARAnON: I hereby attirm untler penalty of perjury one of Ihe following declarations: ❑ I heve end will maintain a certificate oi ionsent to selt-Insure for workers' cnmpensetion, as provitletl for by section 3700 of the Labor Cotle, for the pertormance of the work for which this permit is iuued. . � I have and will maintain workers' compensaGon insurance, as required by section 3700 ot Ihe Labor Cotle, tor ihe Dedortnance of the work for which ihis pertnit is issuetl. Carrier. nof be ve/uetl or Iess.J Palicy ❑ I certity that in iha peAorma F� Fe work for which '4 pe t is issued, 1 shall not employ any person in eny manner so es to become subject to the workers' compensation laws of Calii if d agree ihal if I s d 6 ome subject to the workers' compensation provisions oi Section 3700 of Ihe LaDor Code, I shall torihwith comply with lhese provisi �^/� ^ O J / �y Applicent Signatura: Date: � WARNING: FAILURE TO SEC WORKER$' WMPENSATI N COVERAGE IS UNLAWFUL ANO SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GIVIL FINES UP TO ONE HtINDRED THOUSANDDOLLARE($100. ),INADDfTIONTOTHECO$TOFCOMPENSATION,OAMAGESASPROVIDEDFORINSECTION3]O60FTHElABORWOE,IMEFEST,MIDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm �hat I am license�llntler provisions ot Chapter 9(wmmencing with Sectio 7000) of Division 3 of the Business and Professions Code, antl my license is in full brce and ettect. ua n � Class u G^—' � 6 � ` n Con�rac�orsSigna�ure: j Date: 7 CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirtn that there is a construction lending agency for Ihe performance of ihe work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Atldress: � Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm Ihat under penalry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires a pertnit �o construq, alter, improve, tlemolish, or repair any swcwre, pnor to its issuance, also requires ihe applicant tor such permit ro file a signed statement that he or sha is licensed pursuant to ihe provisions of Ihe Contractors License Lew (Ghapter 9(commencing with Section 7000) of Division 3 of ihe Business end Profeuions Code) or Ihat he or she is exempt therefrom antl Ihe basis for the allagetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appliwnt to a civll penalry of not more than five huntlred tlollars ($500).): ❑ I, as owner oi the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intentled or otteretl for sale (Sec. 7044, Business antl Professions Code: The Conirectors License Law dces not apply to an owner of property who builds or improves ihereon, antl who does such work himsetl or herself or through his or her own employees, provided ihat such improvements are no� intended or otteretl tor sale. If, however, the builtling or improvement is sold within one year of completion, the owner-6uilder will have the burden of proving ihat he or she tlid not build or improve for purpose of sale.). ❑ I, as owner ot Ihe pmperry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consimct tha project (Sec. 7044, Business and Professions Cotle: The conirectors License Law does not epply lo an owner of property who 6uilds or improves thereon, end who contrects tor such project with a contractor(s) license pursuanl to ihe Contractors License Laws.). ❑ I am exempt under sec. Business antl Professions Cotle for this reason: Signature: Date: Owner ID venfied Dy tlrivefs license. ❑ Yes ❑ No Driver's License No. Venfica�ion ot Ownership by (type of document, i.e. - property tax bili or deed): Ezpires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certity ihat no ezcavation tive (5) or more feet in depth into which a person is required to descend, will be matle in connec�ion with work auihorized by this permit, and that no building structure, scaHWding, fal5ework, or demolition or tlismantling Ihereot, will be more than ihirty-sis (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 347, Title 0, California Administrative Code). ❑ As owner-huiltler, I will not employ anyone to tlo work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit ta do such work fwm the division. Signature: Date: Division ol Indusirial Satery Permit Number: CERTIFICA OF MPLIANCE D AIfT}IORIZATION OF ENTRV: I certity under penalty of perjury that I have read Ihis epplication and stata that the information given is correct. I�e comply with state laws and ciry ordinances relating to building constmction, and authorize representatives of the City of Costa Mesa to enter upon the above-tl r propeny for � ction purposes. I agree not to occupy or allow occupancy of any building authonzed by th' ermit until linal inspection. � � �� `� �-�- CO�E L INSPECTIONTYPE 1616 Fixod System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2446-46 DpTE i ia� CODE� INSPECTIONTYGE 206 Final Mechanical 208 Final Plumbinq 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DpTE INTRIALS � fl LOT 2. ' TRACT �395_� � ' �' - �s2�. _ COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA-MEBA. CALIFORNIA ! Fo� Applieanf fo Fill ln Completely COSTA MESA. GALIFORNIA ■ STATE , TEL. � I NO. OR 96'lBACK lIN6 PROM ( / G[MER OF 8Tit6HT REAR YARDo / C/ SIDE YARO LEFT � RIGHT 'J DESCRIPTIOId OF WORK WALC ' ROOF WVVV ' iTllf.f COVERING .ine.� IILDING AND WORK TO BE PERFORMED � f`E'E RECEIUED 1�Y JAN 3 1 ig82 �' fINANCE DEPt. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only aece�rr xo. re r lJ er o�re rsecerveg DATE iesueo � � � 9 � —/ 2I� .... .. _ .nen COSTA MESA. CALIFORNIA APPROVE� ZONING ZONE / NO.OP ^J U8E OF NEW Sq�(. R PtANB [� BUILOINO WIR��/ �eaw� �ot z j� y 3 9s oescxirrion /� ICEMHR LJNC BT.) PLAN � xeneer �cKHow�eoae rx�r � n�ve na�c rHie MPLIWTION ANO BTAT6 THAT TXE ABOVE i8 COFIRECT AND AGREE TO COM- PLY WITX ALL GIlY OROINANCEB AND BTAT¢ UWB R86ULATNG BUILDINO GON6TRUGTON. SIGNATURE OF � �.,/ `�� - PERMITTE%� AUTFIORIZED AGENT S U FT. �� s— FT. 3 FT. Za F7 z APPROVE� THE AMO�INT 9HOWN UNDEq VqLUAT10N �8 FOR THE PURP066 OP, EBTABLI6HING A PERMIT FEE ONLY. VALUATION 7y PEftMIT FEE $ J /�. )— $ /%a3� � PLAN CHECK S /V /J d