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Home My WebLink About1427 DEAUVILLE PL - Building PermitsL (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 1427 DEAUVILLE PL Suite No Vicinity: Status: ISSUED Applied: 12/20/2002 Issued: 12/20/2002 Parcel Nunmber: 41814637 ISSUED BY: Applicant: PAUL KAMINSKY'�- Address: 11612 KNOTT ST X`, Phone: (714) 895-1246;; GARDEN GROVE CA Zip: 92841 - - -A Owner"' MORAD,-KAREN V ,A AA Address 1427 DEAUVILLE,PL i Phone: Ate: �•,A� ,�,,� COSTA MESA, CA Zip: 92626-262 l V Contractor: "NOCK PLUMBING y- � \ 4 1 1 Address .1.1612 KNOTT ST I •" -. •` _ Phone: (714) 895-1241!" n • ti. GARDEN GROVE, CA Zip: 92841 si License: 707775 J- 'Arch Eng Address: ' Address: - _ .. Phone: Zip:, License: SCOPE OF PERMIT INSTALL NEW WATER HEATER - -� s �r FEE.SUMMARY AMT-\�, ., QTY . ' - AMT -'; QTY -a -_ �� ti AMT QTY ISSUE FEE $23.50 - <- Laundry Tub / Washer $0 00• `-0 '- ?e Surnp,Pump 0 Backflow Irrigation '0_, �0 Landscape Irrigation ' $0.00 0 -Swimming Pool � ,$0.00 "$0,00 0 Backflow Preventers j$0.00„ �- 'P -Trap •, _,-- '^ $0.00 0 .ii Trap Prime��, �i J $0.00 0 Bathtub �. $0.00 0 Pressure Regulator, $0.00 `0 - ! ' Unnal� '- • - ,�', $0.00 0 Clarifier System . �� $01.001, -" 0 ProcessPiping(per' 10 ftj $0.00- 0 Vacuum Brkr Bkflow(0=4) $0.00 0 Connect (Ice,Soda,etc); .,y$0.00, 0 Receptors. ` - $0.00 - 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 1__$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' 1, 0 - Sewer Private Line - $0.00 .0 - 'j.Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 �0 Shower - $0.00 0. - `, '-.Water Heater/ vent $12.30 1 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 f Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 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 244646 (6/00) 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. `g- I 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 carder and policy number are: Carder: (7191,D of N, V Policy Number: Z�70ocL3Z92 ci7 (This sect/on need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensa li, and agree that If should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wi t(n hese.provf ns. Applicant Signature: , Date: /2 Z o - o L WARNING: FAILURE TO SECURE WOR RS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($/00,000), IN ADD THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION WOa OF 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 Division 3 of the Busi ass and Professions Code, and my license is in full farce and effect. Lic..tl—��7r Class N 0.3F ///%/ Contractor's Signature: Date: y 2 � 2 0• oz CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affiml that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lendees Name: Lander'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 following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constmct, 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 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 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 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 appty to an owner of property who builds or improves thereon, and who contracts tot 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: )� `.-'/'c Data: Owner ID verified by drivels license. ❑ Yes Ji ❑ 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 pernit, 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 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 hazartlous 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 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 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 thisa plication aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? M Yes 8 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? ❑Yes ❑ 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 Cade Section 42303 been made? ❑ Yes ❑ No . ....._....................._............................................................................................................................................................................................................................................................................................................................................................ 6 (It 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: CEPPI ATE OF OMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is /cyr(act. agree} 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-desc d property fyr inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date rz 20 -Ol-i And/Or Authonzed Applicant Date CODE f. ifispiibpofrylk QST INTRIAL$ CODE INSPECTION TYPE QA3 lNTITIALS 1616 Fixed System Final Fite Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing Nr\ 200 Final Re -Roof 210 Final Electrical J 201 Final Block/Retaining Wall 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 2274. COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 217 COSTA MESA. CALIFORNIA �� 1 .�pplicq t fo F' 1 I Completely P R PRINT COSTA MESA, CALI B MAIL BOX .�s 3432 Via Oporto, Npt Bch Lifetime Residential Bldg Cor none LINE FROM NO. OP BLOCS. EFT 0 I RIGHT 0 DESCRIPTION OF WORK lOOH NO-OFROOMS r iLL„i_ _ I ROOF USE OF BUILDING AND WORK TO BE PERFOF Construction of "III occupanc with nJn construction garage 2 I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PLY WITHALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. E AUTHORIZED FEE RECEIVED Lot# 5- Plan# 2�AUG - 3 1964 TINnAFNC�E��TDEPT. APPLICATION POR`PERNIITMESA BUILDING For Office Use Only ' RHCEIPT NO. PF,p%1fL.q � RECHI BY OyTCE D""ACCJJT•."ELL}jI8/I8UEO Alm i R 1QR8R 1 BUIL ING ADDRESS / FIRE 20HE TYPE ✓ GROUP APPROVED BY DATE ZONING 7 ZON NO. O USE OF N PLAN BUN.Drn Ck LEGAL L P DESCBIPTION 1 O 11 " D A. P. NO. NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 90' TO SIDE 9 REAR P. L. , EAVES ALLOWED (U. S. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM-C/L TREET) _ FRONT FT. FT. I" R. SIDE FT. FT. L. SIDE . FT. FT. REAR FT. ) FT. DISTANCE BET. BET. MAIN 8 MAIN BLDGS. ACCESS. BLDGS. CC RR . CAU.P.* _J APPROVED'I`I" APPROV ,. BY DATE SQ. FT: 3 7� a• THE'AMOUNT SHOIWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION _ /� PERMIT FEE $ '7 y� TOTAL FEE S J E/ '✓ 89500 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 32820 For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA OF WORK A 1 HERESY ACKNOWLEDGE THAT.1 AND STATE THAT TNR ASOVK.IS PLY WITH ALL CITY ORDINANCES BUILDING CONSTRUCTION. /� A SIGNATURE OF/",, // // AUTHORIZED DEC 19-68C11PA;00 819 0 APPLICATION FOR PERMIT BUILDING For Office Use Only I v R[Ci1PT k0. �hpBY �C/•�-/YO0 R[CRI Y D KC[I 6Bypo BUILDI G ADDRt FIRE ZONE TYPE GROUP r APPROVED n2 / �O DATA/2 ZONING zon xo. or u[[ or NEW U runs � ByuolN DR ECRIPTION �4 A. P.NO. NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 90• TO BIDE a REAR P. L. EAVES ALLOWED (U. S. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN ACCEMSC^RY BUILDING LBUILDING OM CLW�Re�WO FRONT � W"U'"— �L� .1 SANV' 0�'JN�R- R. ID FT. L. SID FT. REAR Fr. DISTANCE BET. BET. MAIN e MAIN SLOGS. ACCESS. 9L398. VAR.* DATE C. APPROVED APPROVED )Z K - UJ DATE SQ. PT. THE AMOUNT KNOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEZ ONLY. VALUATION z PERMIT FEE ✓ III PLAN CHECK 2 TOTALPEE 4 I v OWNER WILSON, EVA DATE 12-19-6 JOB ADDRESS TL5)7 n..,,,PIIIP viBUILDING PERMIT NO. Pomo GAS WATER ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDIT[ TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING TRENCHES I!] FORMS ❑ STE FLOOR SYSTEM BOND BEAM ❑ STEEL REINFC SHEATHING FRAME AND FLASHING LATHING - IN n OUT [� PLASTER, BROWN COAT G' TURAL, FINAL H, ,G, VENT., REFRIG. AND A. SUBCONTRACTOR