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Home My WebLink About1103 CORONA LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa."MBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1103 CORONALN Suite No FEE SUMMARY Vicinity: Parcel Nunmber: 14161420 Applicant: BROWN, KHALIF Address: 1117 S PEARL ST :: AMT COMPTON, CA Owner: DENMAN, RICHARD Address 1103 CORONA LN $23.50 ,COSTA MESA, CA - Phone: 310-604-9598 Zip: 90221 Phone:. 949-929.85.32-- - Zip: 92626 Contractor: A AND J CONTRACTOR AND PLUMBING Address: 1117 S PEARL ST - Phone: '310-604-9598 COMPTON, CA Zip: 90221 License: 456822 - SCOPE OF PERMIT COPPER RE -PIPE FOR S.F.D. Status: ISSUED Applied: 08/09/2005 Issued: 08/09/2005 -- NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 FEE SUMMARY AMT QTY _. -. - - - :: AMT QTY_, .., AMT (QTY ISSUE FEE $23.50 Laundry Tub /Washer $0.00 ..0 - Sump Pump $0.00 0 Backflow irrigation $0.00 0 _ Landscape Irrigation $0.00.0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P -Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 SO Urinal $0.00 0 Clarifier System - $0.00 0 Process Piping (per 10 fl) $0.00 0 - Vacuum Brkr Bkflow(1-4) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors -Woo -0 - - Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 - Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo , $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect " $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 `. 0 Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/ vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar - $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial' - - $0.00 0 Water Re -pipe $9.80 1 Gas Earthquake Valve $0.00 0 Sink, Floor - $0.00„ ,0 Water Service $0.00 0 Gas (1-4 outlets) $0.00 0 Sink; kitchen - $0.00 ! 0 . , Water Softener $0.00 0 Gas (Over 4 outlets) $0.00 0 - Sink, service/mop . " - . $0.00'-- -0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 • 0 VIOLATION _ $0.00 Gas Service $0.00 0 - Spa (public) - $0.00 .. 0. PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 - a.`,- --..�. REINSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 :.- 0 1' 'TOTAL CALCULATED FEES: $33.30 -- NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carder: Policy Number: section need not be completed it the permit Is valued at one hundred dollars ($100) or less.) ,7 celtify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' –compensatlon laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with these provi_ Applicant Signature: 7 6 Deter- %//0r WARNING:. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL LAWFUL AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED -THOUSAND DOUARE ($100.000), IN ADDMON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby.affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divlslop 3 of the Business and Professlons Code, and my license Is In full force and effect. Llc. N 6"& 2'i ^ LClass,g- �r_i.� (/ r ont�g� nat�re: � r--Deter–.6�9��.5� CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o1 not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight o1 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................._..........................__........._.................................___......._............_............................._........................................................................................... __........... .._..__.___._._.......__. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Ves ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .. ............................ .................................................................. ........................................................... .................. .................................... ............ ....... ................................ ....................................... ...................... -......................................................... 3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Cade provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .......................................................................................................................34of_..................._._.__....................__..................................................................it................ ..a.. .............. .... ..0 ..... _................_.........__........__.. 4 If an RMPP is presently required, hes Section 25534. the California Health end Safety Code been fully complied with? ❑Yes ❑ No 5 Does or will the applicant or present or future building Occupant require for the work which Is the subject this application ao for such construction or modification Irom the South Coast Air Quality Management District or from any other air pollution control district or agency? UNy? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .............................................._............................ .._....._.........................................__........................_.........................._............................................................................. ........__............................____........_._..............__. 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............-.............................................................. _____............................................. _._...................... ___ ........................ _.... _.................................................... __..................................... __..... __............. _......... __........... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ........._ ...................... ......................... -.......... __.... ..__._... _.._................................ __................... __............................. .............................. .......................... ...... _............................... _.._....___._............ _........ —........... B (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: 1 certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. S' na we at Own D O?-AufffixizecI AppIIcant - – � Date CODE 1. INSPECTION TYPE pA1€ ISS CODE INSPECTION TYPE 216M INTITALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical -73 1266 Pool Spa Final 208 Final Plumbing,C fir 200 Final Re -Roof 210 Final Electrical 201 Final BIocWRetaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 08/09/2005 09:39 310-9001-0684 POPULAR CASH EXPRESS PAGE 01 PACIFIC ..;- 9Y // M. B✓n9T - P3EBi. MIO MOST E i NNl BONG NDEED awE /o ' . A 8 J C�ITRAC'FO�.$.pg,{Qj cI� wsBlRraoNl81 w„. C36 . a tkyo w moo A BOND PEI ¢. 0 aQp9 a 0 a 0•. PACIFIC ..;- 9Y // M. B✓n9T - P3EBi. MIO MOST E RY �11D7EO (. I6NCE0 '. NNl BONG NDEED awE ' cI� wsBlRraoNl81 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa. BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 1103 CORONA LN Suite: Vicinity: ROOF Parcel Number: 14161420 Zoning: Applicant: SKIRZYNSKI, JOHN Address: 10782 S MEADS AV Phone: (714) 771-0118 ORANGE, CA Zip: 92869 Owner: AGUILAR, LOUIS PHELIPPE Address 1103 CORONA LN Issued: Phone: COSTA MESA, CA Zip: 92626 Contractor: SHARP ROOFING Address: 10782 S. MEADS AV Arch : Address: Phone: (714) 771-0118 ORANGE,CA Zip: 92869 License: 571575 Phone: Eng: Address: Status: ISSUED Applied: 10/14/2002 Issued: 10/14/2002 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16" OSB OVER SPACED SHEATHING. INSTALL ELK, 30 YEAR, COMPOSITION SHINGLES, 15 # FELT. 2,900 S.F. INCLUDES ATTACHED GARAGE. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244&46(6=) FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,400.00 Permit: $139.25 Claim Valuation: $6,400.00 SMIP Res: $0.64 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.89 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244&46(6=) DECLARATIONS L WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the _ work for which this permit Is issued. IAEA I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. '<J My workers' co pensa��f44 Ins ance carrier and policy number are: Carrier: 5�'4Q itJwPolic';Number;, 2SS OUO Z3 w 'U Z Y(ThlssacNon need not be completed if the per#rch a hundred dollars ($100) or less.) ❑ I certify that in the perfortnence of Ih oermit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensation laws of Callfor ' rbecome subject to the workers' compensation provisions of Section x700 of he Labor Code, I shall forthwith rnmply ,wifliffine provision$ /J 1 `�ApplI66hi SignBWre: ';Date: /D /`/ 0 WARNING: FAILURE TO SECURE WO ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOULARE ($10DO0o), INA DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/013OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I ereby,affirnbhat I am licensed under provisions f Chapter 9 (commencing with Section 7000) of Division 3 of�6 ass and Profe Bions Cada, and my license Is in full rTvc. „ usy lC)ass.p! Contractor's Signature!'- Date D Z. CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby allirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 70315, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 o1 the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): ❑ I, as owner of the property, Or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feel in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building Structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Cade). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................................................................................................................................................................................................................................._.._..........__._. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Masa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................ .......................... ........................... .................. .... ................ ..................................................................... ...................... ....................................................... ....................... ....................................... ... .................. 3 Does or will the appplicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ........................................................................................................................................................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ......................................................... .....................-........................ ........................................__........................... __-_.... _.............................. ___._............................................_........................_.................... _............................ ....... _._... 5 DOeS or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermlt for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Coda requires that the requested information be furnished on applications for non-residential building permits). ........._-_._................................................................_......................................._...._.................................................................................._._...................................................................._._.........._........................................_.................. 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..........................................................................................................................___ .........................._._......................................................_._............................. .......... .........................................._..... ....................... .............................—.......... 7 II a permit from the South Coast Air Quality Management Distinct or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _......._..........__.......................__._.......................... .._...__._._..._..__.._.._............__—__..__............_.................._........_.._...._—___._____................._......._..._......___--._..__.._..___ 8 (If yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes. 1 agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. oture Of Legal Owner(s) Date -M-�^ -> ��. / `l. , (And/ P:ulhdrizedApplicant CODE 1. INSPECTION TYPE 2AM INTME6S CODE I INSPECTION TYPE RAM INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root YO—ZS'OZ. _S,.rGL 2XCc 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill in all f CITY OF COSTA MESA - - PER IT NO. CONSTRUCTION PERMIT .S" within heavy border lines and sign all appropriate declaration TRACT NO. I LOT NO. I BLDG. NO: "°"e'MR' -P4TF4 Cf1M rpon�/,O-/,7cp l Address Arch/Eng. _ Address Contracts r_ e _ a nrc• O License No. ' I i TYPE OF CONSTRUCTION ❑ NEW -❑ ADD- ❑ ALTERATION - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER 'WATER HEATER _ lYl;A1C:K ' ' EATINGPhone 530-244( TYPE OF PERMIT - ❑ GRADING, -❑ FOUNDATI N ❑ STRUCTURAL ;I hereby affirm that I am licensed under provisions ovisions of Charter /9 co .TENANT. O'ELECTRICAL. PLUMBING ❑MECHAL.-. mencing with section 7000) of'Divislory, 3'3J the, d ❑-OTH_ER" ' Professions Code, and my license is/n f II force an ect APROJECT DESCRIPTION License-Class- Datehxi--iCFgym_ __ SQ. F.T. __-- - - WORKERS'COMPENSATION EBLARAT, - TM .'OCCUPANCY CONSTRUCTION_ TYPE_ I hereby affirm that I have d certificate of.p nsent t0 self -insure or a r.VALUATION ZONE .certificate of. Workers'I''Compensation Insurance, or a certified' copy; - __ _4 - thereof (Se rr$d80064T9C.). f FREMONT GRADING CU. YOS. ^ ACRES Policy No. LV r Company-- El ompany- ❑ Certified copy is hereby furnished. _ - REMARKS: ❑ Certified copy is filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred - ($100)orless - --_ ' __ — - - - 1 certify that In the performance of the work for which this permit is Issued, -I -shall note mplay any -person in any manner so as to become Subject to the Workers' Compensation Laws of California. PLUMBING" PLAN CHECK -BATHTUBS- -' - - SHOWERS ' Date 1 Slgnature NOTICE: If after making this declaration, you should become subject .}TOILETS URINALS - to the Workers' Compensation provisions of the Labor Code, you must .forthwith comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE L -AVS -- revoked. -KIT. SINKS -- - DISHWASHERS CONSTRUCTION LENDING P.GENCY - -' I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 Civ. -C.).._ _ _.__--- _ __ _ .-- - - Lender's Name SERVICE SINKS ...r ,.SUMPS - FLOOR SINKSFLOOR DRAINS Ledder'S Address - - - - - - -DRINKING' FOUNTAINS - - - -- - - OWNER BUILDER.DECEARATION-.-_.. I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS' - the.following reason .(Section, 7031.5_ Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish.or repair -any Structure, prior to its issuance, also re-. quires the apt-licant for such permit to file a signed statement that he S 71MMING-POOL - PTRAP - WATER SERVICE ALTERATION ' Is licensed pursuant totheprovisions of -the Contractor's -License Law. Chapter 9 (commencing With Section 7000) of Division 3 of the GASSERVICE - OUTLETS" �- siness and. Professions Code).or that he is exempt therefrom and the.. basis for the alleged exemption. Any violation of Section 7031.5 by any. applicant for a.permil subjects the applicant to a.civil penalty of not more than five hundred dollars ($500). ❑ I, as -Owner of the -property, or my employees with wages as their Sole compensation, will do the work, and the structure is not intended ..WATER HEATERS - BTU OUTPUT- - - SEWER -CONNECTIONS - - SOLAR TANK COLLECTORS - or offered -for sale. (Section 7044, Business -and Professions Code: -The Contractor's License Law tloes not apply to an owner Of a property SOLAR PIPING SYS. -ISSUE FEE who 'builds or improves' thereon, and who does Such work himself or through his own employees, provided that such improvements are not I mended or offered for sale. If, however', the building Or improvement' is sold within one year of completion, the owner will have the burden MECHANICAL PLAN CHECK Of proving he did not build or improve for the purpose of sale). ❑ 1, -as owner of the Property, am exclusively contracting with licensetl contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law.does not apply to HEATING SYSTEM 0-100,000 BTU AND DUCTING - - 100,000 +BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such project5..with a contractor(s). Ilcesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU reason Date Owner SYSTEM REPAI R, ALTERATION I hereby certif at I hav read this ap ica on and state that the above EXHAUST SYSTEM MULTIPLE informatio is correct.- agre m y with all city an cpunty- ordinanc a state la s rela ng to n ruction, and here y uthoriz0 repres Rhin -City to n -u the abo prop t or i ection Our - Signa or ISSUE FEE - Drivers' Licens SS � CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1332 12/OGl& 7.00 TI. - " ZONING REGULATIONS", ZONE - PLNTG..,REF:'P LINE SET ACK C LST. 'PROPEIRTV - SIDE SIDE VA --- ---- --- - RIGHT ' REAR YARD (TO P/L) -- -- - ' PKG. SPACE REQ. -• P,ROV IOED. - -' -STREET WIDTH '- PARK_ FEE$ ,ZONING APPROVED -6V- --" - DATE-' '.SPECIAL CONDITIONS: - - - • q - I ELECTRICAL - - -PLAN CHECK ; - -- -SO. FT. - --qQ FT - .GENERATOR - '0.1 KW=1=30 TRANSFORMER APPLIANCE 10-50 KW_50+KW 'MOTORS - -'0-1-HP_1-10 HP JINC.SOLAR)_ 10 -50 -HP 50+HP _ -FIXTURES OUTLETS -"SWITCHES -' ---- -GAS TUBE SIGNS-- - - - -- POLE LIGHTS - - - - - - - - - - - 'POLES -" ME!<E ED - SUB PANELS-` - MAIN - SUB - I 'SERVICE-- - - -AMP -ISSUE FEE - - - - - -APPLICATION APPROVED BY ---- -- - - DATE SUMMARY OF FEES - BUILDING-- - - - - - PERMIT $ SMTP PLAN CHECK $ PERMIT � _ -ISSUANCE- $ - ,PLUMBING $ - - RADING $' _.G" PLAN CHECK $ �� ELECTRICAL $ $ i" - PLAN CHECK -$ - � MICROFILM $ , TOTAL FEE $.7r OO MECHANICAL $ - PLAN CHECK -•$- - - -` LESS AD- - VANCEPC $-, /'� FINAL FEE $ CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL & SNS.x APPROVALS- Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test_ 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap-❑ Undrarn _ 10. Structural Floor System 52. APPROVAL TO DECK" 11. Property Sewer Line & House Connection - 53. Backwash & Receptor -Final - 2. Street Sewer Connection - 54. Heater & Vent -Final 3. Rough Plumbing 55, Plumbina Syqem _ Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning - encing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough &Test 20. Roof Framing 21: Roof Sheathing NOTES: 22. Frame and Flashing- 23. Insulation - - - 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat ' 27. Electrical Power Meter -Final 28. Final Electric - 3. Final Heating & Air Conditioning 30. Final Gas Pipe -Test - 31. Final Plumbing 32. Water Service -Final - 33. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Ga; Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date 2024-7 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. Box 317 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT nooaEss 1103 Corona lane COSTA MESA, CALIFORNIA MAIL ADDRESS 38QO E Coast H•phw v TEL. Oriole CITY CalifNO. ARCHITECT TEL.0r10le ORENGINEERMacco Realty CO NO. ADDRESS Same as above CONTRACTOR MaCCO Realty CO ADDRESS Same as atIove CITY Same as above STATE__.._, _ . __ _ TEL. _ . SIZE NO. OF BLOOS. OF LOT 21 X t NOW ON LOT N USE OF EXISTING BLDG. None BE BACK LI NH PBOM CENTER OF BTRER 1 REAR ARO 1611 SIDE YARD.I LEFT 101 I RIGHT 8t DESCRIPTION OF WORK IOU USE OFBUILDING AND WORK TO BE PERFORMED Si le farm dwellin w attached garage. Plan 500-E I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. 12ERMITTE SIGNATUREOF Macc Realty CO• _..-By - FEE RECEIVED JU L 2 8 1983 Afl(VN V,T ` I_{- ,PERMIT CIT'�o�FO' 4JAE&ly 155UED 2 9 190 ZONING ZONENO. OF USE OF NEWSSng R-1 PLANS 2 BUILDINW / LEGAL . nn m__. _i t'_On 7E: NO EAVE OVERHANG SHALL BE LESS THAN TO SIDE @ REAR P. L. 'ES .OWED 1 (U. B. C. REQUIREMENT) YARDSAPPROVED YARDS APPROVED MAIN BUILDING - ACCESSORY BUILDING IOM C/L STREET) pDISTANCE BET. ( BET. MAIN MAIN SLOGS. ACCESS. SLOGS. VAR.* - DATE AByrRVYGV W.L.D. DATE -22-6 Dwelling 2266 Garage 460 s A N SQ. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION ry PERMIT FEE $ j ti 23)925600 PLAN CHECK D 0 4