The URL can be used to link to this page

Home My WebLink About1149 DANIELLE DR - Building Permits u ' 'its. CITY OF COSTA MESA BUILDING DIVISION >:r•„r..ki.- DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER t ) PERMIT °• ' P06-00869 (714)754-5273 • Fax(714)754-4856 • .ci.costa•mesa ftL MBING PERMIT, • ,77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1149 DANIELLE DR ' Status: ISSUED Suite No Applied: 10/23/2006 Issued: 10/23/2006 Vicinity: - Parcel Nunmber: 41207164 N. - r' Applicant ELLIS, JOE - ISSUED R . Address: Phone: 310-838-0408 Zip: B4301779 SS Owner: DANIELLO, PETER TR Address 1149 DANIELLE DR a! s ,t.y�. Phone: 714-545-5718 -14' y':. S COSTA MESA,CA Zip: 92626-1634 ?t' Contractor: ORANGE COUNTY SERVICES INC DBA GEOR BRILLU Address: 3801 LENAWEE AVE Phone: 310-253-5229 CULVER CITY,CA Zip: 90232 License: 679898 SCOPE OF PERMIT REPLACE HOT WATER PIPING FROM WATER HEATER TO MASTER BATHROOM IN SFD. WORK TO INCLUDE: 1 WATER REPIPE 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 0 Urinal • $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $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 $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 $0.000 • 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 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.30 COMMENTS/SPECIAL CONDITIONS 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 shaft automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora 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 2446-46 WOO) DECLARATIONS • WORKERS'COMPENSATION DECLARATION: ' hereby affirm under penalty of perjury one of the following declarations: ❑ I hive 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. 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 Issu . My workers'co o once el r and policy number are: _ -- Carder: 8 �7/ V Nt) [Policy Number: y6"-WOW-Zoo L� (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) - -- ❑ I certify that in the performance of the w• h -rmit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califo • ,and a :// •eco e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply wh sa ith-1provisi s. s �'3 Applicant Signature: WARNING: Date: /v FAILURE TO SECURE WORKER COMPENSATION��/RAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100.004 IN ADDITI TO THE COST OF > PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am liEenAsktn of Chapter 9(comm ' g with Section 7000)of Division 3 of the Business,and r f P es3ians Code,and my license is in full force end effect.Lk'Ii EClass A ! Ci f0 till,,,, \Contractor's Signature: y ( Da Ie: f� 7----°3 —O(4 _ CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 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.). ❑ I,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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I 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,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 hazardous material? 0 Yes j]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 le 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this as plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes L-I No (Section 65850.2 of the California Government Code 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? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 It a permit from the South Coast Alr 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? 0 Yes 0 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. r– -gee �� /&�7,r-a--°x-An Or ulhorizant (`Date • COD1616 I, INFixed yN TYPIIIIIII�LS CODE(06Final ec TanPATE /,/ 1616 System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing // G • 200 Final Re-Roof 210 Final Electrical • 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 W'/- CITY OF COSTA MESA BUILDING DIVISION :j � 4• DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER 1.1 Tori PERMIT 11101141 B05-02354 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.stLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1149 DANIELLE DR Status: ISSUED Suite: Applied: 12/21/2005 Vicinity: SIDE OF PROPERTY Issued: 12/23/2005 Primary Occ: R Type of Construction: V-N Parcel Number 41207164 Zoning: R1 Applicant: PATRICK MCCOURT Address: 13202 SUSSEX PL Phone: 714-345-5847 ISSUED BY: SANTA ANA,CA Zip: 92705 Owner: DANIELLO, PETER TR Address 1149 DANIELLE DR '+ , Phone: 5 COSTA MESA,CA Zip: 92626-1634 ft Contractor PATRICK MCCOURT Address: 13202 SUSSEX PL Phone: 714-345-5847 3r' E SANTA ANA,CA 5 Zip: 92705 License: 774960 Arch : Eng: Address: - Address: �1",j* Phone: ,*� �"a Phone: Zip: License: License: SCOPE OF PERMIT ADD 119.25 S.F.TO EXISTING S.F.D.WORK TO INCLUDE:CREATE A NEW OFFICE. EXISTING 2 BEDROOM,2 BATH S.F.D.TO REMAIN THE SAME. FEE SUMMARY Plan Check: $126.91 Calc Valuation: $10,995.60 Permit: $195.25 Claim Valuation: $0.00 SMIP Res: $1.10 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $323.26 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY N 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 susspendedabandoned 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 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: . ❑ I 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. �❑ t.haya r or•will maintain w ricers'cam r'eo insurance,doli as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 'M_y_worke�ompe do I uranof3 Carrd policy number are: Gamer: �� • Pahcy Numbery— (Thi:'_cllon need not be completed if the permit is valued at one hundred dollars($100)or less.) Ut I certify that ip.the pSi or/ a•ce the work for hich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensatlonlaw• • t$i la nd agree t7d�+if I s d become Aubject 10 the workers'compensation provisions of Section 700 of the Labor Code,I shall forthwith Comply with'these bov, t� Apelic nt.8lgnJature: l V G c 1( 'V/Pt-, • (Daffy—, kat 3105- • WARNING:FARURE TO ECURE WORKERS'COMPENSATION COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLuARE($100000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under•r•v-io• • Co•%r 9(commencing with Secti• 7000)of Division 3.o1 the Business an rofessions Code,and mylicense is in full farce end effecf,Llcl i a 0 - . ; / L Class'A, ^� r E7t��.I�E Date: Contractor55' nature: � CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 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 owne,o1 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.). ❑ I,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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 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: ❑ I 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)feel 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 hazardous material? 0 Yes 0 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? 0 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L-I No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 0 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 0 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 stale 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 ebov cribe property for i pec' purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until ,i. uthfinal inspection. �Si net Of a ner(s) /2 �. nn An r Aonzec Applicant 'r��'r. 1 C -Date— gen A IN$pigIIWLBPE PAIS 1ffTRIAI$ CODE; INSPECTIONTYPE PALE INIM&15 1616 Fixed System Final Fire Prevention 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof - 210 Final Electrical 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 11L! CITY OF COSTA MESA 4 . ►, BUILDING DIVISION }it vii ..�i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F . j01414 ." ' i PERMIT E05-01353 wan (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite No Applied: 12/23/2005 Vicinity: ADDITION Issued: 12/23/2005 Parcel Nunmber: 41207164 Applicant: PATRICK MCCOURT Address: 13202 SUSSEX PL ISSUED BY: 140 Phone: 714-345-5847 SANTA ANA,CA Zip 92705 • • Owner: DANIELLO, PETER TR Address 1149 DANIELLE DR Phone: A COSTA MESA,CA Zip: 92626-1634 yG+ Contractor: PATRICK MCCOURT ^sY Address: 13202 SUSSEX PL Phone: 714-345-5847 SANTA ANA,CA Zip: 92705 License:774960 SCOPE OF PERMIT ELECTRICAL PERMIT 119.25 S.F.ADDITION TO EXISTING S.F.D. REF#:B05-02354 WORK TO INCLUDE:8 LIGHTING FIXTS,8 RECEPT OUTLETS AND 2 SWITCHES. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3-1-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $8.80 8 up to 50 kva/kw $0.00 0 Recept Outlets $8.80 8 up to 100 kva/kw $0.00 0 Switches $2.20 2 . over 100 kva/kw $0.00 0 Non Res Appl . $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 . 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 . 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee . $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $43.30 Intermed Pole $0.00 0 nfSARAzurc r encnI A l nnurwrinuo 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-fs su sp- ended or abandoned fora 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 2446-46(6/00) WORKERS'COMPENSATION DECLARATIO I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. I]—Hhaworkicler c m compensation Insurance ante ca carrier compensation insurance,oli as required red by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ��My wworkers'compensation Insurance carrier antl policy number are: Carrie • PollcyNumber: (777L: ction need not be completed it the permit is valued t e hundred dollars($100)or loss.) ---'-- I certify that in th rfor ancepf ie work for i is permit is' tied,I shall not employ any person in any manner so as to become subject to the workers' compensation la of lifom a, d agre th f s ould becom bject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith ply,with ov' • Appitcant Signature: Date:" WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPCOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I•he[eby-affirm.thallam licensed er r vi-0 - h/0e0commencing with Section 7000)of Division 3 of the Business and of ssion Code,and my license is in full lforaeffect. e i Lic. CaS3'p„_ a � / Dete:Contractor's Signature: •••-• / CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 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.). • ❑ I,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.). ,❑ I am.exempt.under sec. Business an• 'rofessions Code for this reason: ` Sytg te:--`k. — _ _ D. l -Owner ID v, died by drive. 0 Yes ■ o Drivers-License-No. L---� r, :' Verification of Ownership by(type of document,i.e.-property tax bill or deed): L---k DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I 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,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 hazardous material? 0 Yes 0 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 0 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 Calif omia Health and Safely 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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Application a ermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? l�Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). B 'Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 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(Duality 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 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: CERTIFIC• - 0 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. :free o comply 'th all state laws and cit •r'inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-d f s•ribe• property t' inspection pure ses.I -gr::not to mato. or allow occupancy of any building authorized by this permit until final inspection. Signatur: •e f:dl• •e ,.) / rj�•� -1� f G (J \.. And/Or uuthonzed Applicant •Kr._.-....-_-1-5t. £DgLL INSPECTION MI 12d1E MAO CODE( INSPECTIONTYPF DATE INiRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof - 210 Final Electrical - int 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 1! CITY OF COSTA MESA 4 BUILDING DIVISION > :r • DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER onrgaiden.t. PERMITiftok05-00762 roErnin 04* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite No Applied: 12/23/2005 Issued: 12/23/2005 Vicinity: ADDITION Parcel Number: 41207164 ISSUED BY: Applicant: PATRICK MCCOURT Address: 13202 SUSSEX PL Phone: 714-345-5847 SANTA ANA,CA Zip: 92705 Owner: DANIELLO, PETER TR Address: 1149 DANIELLE DR Phone: COSTA MESA,CA Zip: 92626-1634 Contractor: PATRICK MCCOURT Address: 13202 SUSSEX PL Phone: 714-345-5847 SANTA ANA,CA Zip: 92705 License:774960 SCOPE OF PERMIT �:, „/, jZM(PERMIT FOR 119.25 S.F.ADDITION TO EXISTING S.vusa REF#:805-02354 WORK TO INCLUDE: 1 LESS THAN 100 K BTU(WALL FURNACE). FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $14.80 1 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU• $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES 538.30 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California s 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 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 2446-46 16/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O I have.and.will maintain a certificate of consent to sell-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. LI ❑.irha end 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. . Myworkers'compensation Insurance carrier and policy number are: C r: Poli r (This ction need not be completed it the permit is valued et one hundred dollars($100)or less.) _ "1 certify that In the r'arman of the wor or whic i' permit is -sued,I shall not employ any person in any manner so as to become subject to the workers' compensation la lifor i ,and ag e hat If I .ho d bec• C sub'ect to the workers'compensation provisions of ecti 3700 1 the Labor Code,I shall forthwith f _...compensation comply with then o � t wa (2 23() YApplicentSignaDa WARNING..FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($103,C00),IN ADMIX/kJ TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereb,affkmihati r visions f ter 9 co encin with Section 7000)of Division 3 olghe.Buyness and Pr e---- Bions Code,and my license Is in full ry v_^ � � � ( g C�ass.p-.3 1. force and a f4Lic.b Contractors Signature. x Oa CONSTRUCTION LENDING AGENCY: ❑ I 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: $Ignature: 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 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 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 properly,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.). O I,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.). j] I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 I 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,Art 2,Sec. 341,Title 8,California Administrative Code). a 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? 0 Yes 0 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? 0 Yes ❑No (Section 25533 of the California Health end 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 then 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 tiling 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Govemment Code 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? 0 Yes 0 No (If'ryes",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 0 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. Ie to comply with all state laws and ci rdinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-d c b prop fly for ins cti purposes. tee not t occupy or allow occupancy of any building authorized by this permit until final inspection. C Sig &Legal w (Andl0 r Wheezed Applicant > Date 'Mt gglF L INSPECTION TYPE PAIL IfNTTDALS CODES INSPECTIONTYPE gra y1N IpsIT SLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical At--20-6,4 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof • 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 5`1L! CITY OF COSTA MESA . BUILDING DIVISION }:i.�,,,ralarlir• DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER In 1. 1 PERMIT � . P05-00980 , s* • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite No Applied: 12/23/2005 Issued: 12/23/2005 Vicinity: Parcel Nunmber: 41207164 Applicant: PATRICK MCCOURT ISSUED BY:_ Address: 13202 SUSSEX PL Phone: 714-345-5847 SANTA ANA,CA Zip: 92705 Owner: D PETER TRSib ilk I Address 114949 DANIELLE LE DR' Phone: COSTA MESA,CA Zip: 92626-1634 Contractor PATRICK MCCOURT Address: 13202 SUSSEX PL Phone: 714-345-5847 SANTA ANA,CA Zip: 92705 License: 774960 SCOPE OF PERMIT PLUMBING PERMIT FOR 119.25 S.F.ADDITION TO EXISTING S.F.D. REF#:605-02354 WORK TO INCLUDE: 1 WATER HEATER CHANGE OUT 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 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $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 $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 $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 Water Re-pipe $0.00 0 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 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS 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 applicablg.Eodes, 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 V 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION. I hereby affirm under penalty of perjury one of the following declarations: • ❑ I 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. _ ❑�l.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: Carnet: cameo. Policy Numbe c'-"-'?7 �is Dn need not be complete.,it the permit is valued at hundred dollars($100)or less.) Me I certify that in the pert n•:of theA•rk for hi is ermit is is ued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of a or d :• ee th if oul becom9 s4ject to the workers'compensation provisions of S tion 37 of the Labor Code,I shall forthwith c omply-with.these•pro ' s. /IyV/(w I ^ Applicant Signature: I� � �j� /�" Date: /��1ep 3b5-` WARNIWARNING: NG:FAILURE TO SECUR WORKERS'•. PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL RENAL AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTloeta7 OFTHEIABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS ECLARATION: I hereby affirm that I am lice d and qhy-- Ch�a��Oar/9(commencing with Section 7000)of Division 3 of the.Buainess an7n,rRrofessi s Code,and my license is in full forc ract is Signature: W%-'"'Y- Date: J 1. Contractor's Signature. ,.lh Date: ' CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 theprovisions 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(5500).): ❑ 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 sate.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.). ❑ I,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 en 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 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: ❑ I 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,Art 2,Sec. 341,Title B,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: I 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 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled 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? 0 Yes 0 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 Califomia Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this implication a permit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? lYes IJ No (Section 65850.2 of the Califomia Government Code 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 0 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 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 at state aNs and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the obey: es ribed pro :rty for insp cti pyrposes.I agree not to occupy or allow occupancy of any building authorized by this permit until finalfiinninspection. Ill j _ nre JU e al ne [ I tett3 - Oc o_ze.APplicant �i ar• J c00E t INSPECT10I TYPE PAM INnTlALS y00E k INSPECTION TYPE PAIS INTu1ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical Y1 1268 Pool Spa Final 208 Final Plumbing 4 'AO-O!o .�_ 200 Final Re-Roof 210 Final Electrical 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 ci ft 42 , ( ,___________, 41r7 \ ill /' ' `. ( , -1kCX ------i ' 7 s:. /, Enclasee( /iTr.-4)41 i 1 1 ililn� e!C(e Eos - 0 i3s3 MSN Hotmail - Message Page 2 of 2 ©2006 Microsoft TERMS OF USE Advertise TRUSTe Approved Privacy Statement GetNetWise Anti-Spam Policy • • t ; http://by 101 fd.bay 101.hotmail.msn.com/cgi-bin/getmsg?msg=37D5C6C6-9DE4-4DF 1-A3... 4/10/2006 CITY OF COSTA MESA , 4 ►afl BUILDING DIVISION .:f,,,,,,1 1 DEVELOPMENT SERVICES DEPARTMENT PERM T NUMBER :: ria . PERMIT aPIiNwonmco a+�' B04-00359 • (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite: Applied: 02/13/2004 Vicinity: Issued: 02/13/2004 Parcel Number: 41207164 Zoning: R1 R1 e. Applicant: SANCHEZ, AL ISSUED BY: �� Address: Phone: 714-991-7773 Zip: Owner: DANIELLO, PETER TR I I/ 11 o Address 1149 DANIELLE DR Phone: COSTA MESA,CA Zip: 92626-1634 llieg Contractor: ORANGE COUNTY FENCE ifl r Address: 534 S ATCHISON ST i Phone: 714-991-7773 ANAHEIM,CA 0 Zip: 90601 License: 820512 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 7 FT.HIGH BLOCK WALL OF 30 LINEAL FT.AT REAR PROPERTY AND 16 LINEAL FT(TOTAL 46 SF)AT LEFT PROPERTY PER CITY STANDARDS.SEE MINOR MODIFICATION MM-04-07 • FEE SUMMARY • Plan Check: $25.19 Calc Valuation: $920.00 Permit: $38.75 Claim Valuation: $o.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $64.44 • PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 96-0 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)7545626 2446-48(6/00) DECLARATIONS , WORKERS'COMPENSATION DECLARATION: - ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. 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. y work compensation Insurancens� carrier and policy nuglber are �+� I Carrier: yp7J4 /j-i._ .aA_. _ '7tGeLk� r../.4;\__ 7 Policy Number: (This section fleeAA not be camel it In ermif is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of t work for which this pe it is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, d a re at if I sh I ecome subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions Applicant Signature: Date: 9 —73 -Q WARNING:FAILURE TO SECURE ORKE MPENS COVERAGE IS UN AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100, ,IN AD TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: ' I hereby affirm that I am licensed der prA vis s of Chapter 9(commencing with Section 7000)of Division 3 of the Business ann Professions C ,and my license is in full 2 V 5 force and effect.Lice# / C- Class# . C Z Contractors Signature: Date: — / Ar ��_ CONSTRUCTION LENDING ENCY: r — \ ❑ I 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 following 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 thatfie 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 Coderorzthat 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'eriployees,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.). ' ❑ I,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 en 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I 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,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 hazardous material? 0 Yes 0 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 0 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). . .. .. .. t.. .... ..... .cute.. 3 Does or will the applicant or presentt or future building occupant need to prepare a 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 epartment 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apgermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li 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). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 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? 0 Yes 0 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 at 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. Sign: .•': Of -gal OwnerDate tfir':A . . leant (--) Da PORE II INSPECTION TYPE ' PATE 1{111W4 CODES INSPECTION TYPE PATE IMAIP 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof `/ • 210 Final Electrical 201 Final Block/Retaining Wall i/a7/Qy 4 212 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 \ 1 •THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN Pa•&6'IN HEIGHT SHALL ONLY. APPLICANT ISRESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10' FROM FRONT F ROMM LINE AN ACCURATE REPRESENTATION OF THEIR PROPERTY IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WALLS/FENCES SHALL NOT IDR®2'6*N HEIGHT WITH THE INFORMATION PROVIDED ON THIS Stint WITHIN 10 OF THE FRONT PROPERTY UNE(NOT CURB LINE). •VERIFY DISTANCE FROM CURB TO PROPERTY LINE AND SHOW ON PLAN. VERIFICATION FROM THE CITY'S ThIGNEERINC DIVIMON 6 REQUIRED. CALL IIIA 754-5343 OKAY TO PROCEED OR INFORMATION. WITH PLAN CHECK.THIS DOES NOT CONSTITUTE FINAL PLANNING APPROVAL. BY: DATE: rliccal K p i RESIDENCEI�oEICE 1 :411 •}I Nev✓i'tic h KCw 11 101, {I � r>�Ifi at. Ii • FAF411 )' hlh1-- y . - - . qq `` Lia_k:d(( J r NM-oy-OV _ NM-Oy-01 I:nSl(elf) - SLI wc.iltcu LL..- MM-0 —• `{-05 = = -.: s • .' z z : " J L L C I ,I .. a BLbDEMQ RtsxNLT 11L90OIfI 1 W .4- .i+-I14 f �' f1145 11 Ilya Xo W `N . e 11%1• SnwrY /HI ,60 - •e S y UIV SI NITY - GOSTA•1N A B' poi /toot MIA SU Blot WC.�5 -toA 362 o t,3R A I'r-R-H�'' I: A V I -Wail oto �� 0'inns MI IST be kept on bat all Times and o is unlaoful to .7011r (�n C/ Aerafionsonsame wiVtoulvmtlenpermasionfrom ftv:0iisnnotPvild�g CITY OF COSTA A e' ¢ancd cSa7fety,Goy of Costa Mesa. �jflLl 00 —MANNING-DIVISION 4 $TmlrKannn 4of this clan and spew cat ons SHALL NOT he hceld tuppenceor a doa Slot eroval SUBJECT TO BLDG. DEPT. REG. of the violation of any proviswl s�t a v h ;I f '' These plans and permit shall eryire by limitation and become null and void t the burl�tng or NO . ' work rs not commenced and mlamtained active per UBG§303(d(wdhin 170 r at of r•uance o �YN YOUT FOR BUILDING PERMIT APPROVED BY THE PLANNING DIV. • • LI �- y BY:/ DATE: /3 ,SL, -!/L,i - OV,-os -a, PLANNING DIVISION ?J ff I r \ TYPICAL 8" CONCRETE BLOCK FENCE - a Cement Coping Optional Xvip � GENERAL - NOTES Channel block with one 5/8 •. •i'I� I Mortar. One Part Plastic Cement, Horizontal Top of all Fences 0 / I 1 and Three Ports Sand 2 2 2 2 Grout: One Port Cement,Three 'dip For Fences 8'high I I and One Half Ports Sand Vert.Bars 5/8'0 atl6'O.C. / `c All Cells Solid Graouted % % .Q' l I Coping: One Part Cement,and i Three Parts Sand Reinforcing Steel Shall m m o / / Concrete: Well Mixed 1:2- 1/2:3-1/2 Conform to Sec.A-15-39 A.S.i.M. LT Max of 7-1/2 Gallons of / �%I Water Per Sack of Cement All Steel to be Lapped ,Its 24'or to Code / / . •Grout may be poured from the 101 topI of the fence.NATURAL GRADE Cells-47 01I0 and areas of horizontal I reinforcement shot be clear. �' S' • clean and free of all mortar - debris,etc. „RI � Q 1i Two 5/8'0 Bars Continuous Top —►I II I4-- 1 8'O C MAX and Bottom VV1dih • ► NOTE Horiz.Steel must be tied In place See Chart wall In excess of 6 feet In height at time of trench Inspection Below ♦ 136' require discretionary review and • approval process through the Planning DMslon and are not • 3 —'� automatically approved. Please Il 2 I I ►I } 2-,1--71- 1-411-- consult wtth the Planning DMsian. FOOTINGIREQUIREMENTS CHART Wall Height 6'TO 8' Width 16' Thickness 12' 10E 1 Depth of Earthtooth 36' Spacing of EarihTooth 8' Diameter of Earthtooth 12' BUILDING DIVISION 2105.46 • ., - CITY OF COSTA MESA P O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 -...w . y (d:' DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION November 10, 2005 Peter Daniello 1149 Danielle Dr Costa Mesa, CA 92626-1634 PERMIT NUMBERS: B04-00359 FOR: Block Wall PROJECT ADDRESS: 1149 Danielle Dr., Costa Mesa _• Our records indicate the above listed permits were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project and additional fees will be required to finalize expired permits. According to our records, the permits listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contact this office so we may correct our records. If you need to request an inspection please call our Inspection Request Line at 714-754-5626. If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you do not have an approved final inspection, your permits will expire on November 29, 2005. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, 5)1‘7)Zji:La-1-tt-ti "1—(--id Macy Jane Weidenkeller Office Specialist II cc: Orange County Fence 534 S. Atchison St Anaheim CA 92805-4749 Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754.5244 • www.ci costa-mesa.ca.us 12-05-2005 Inspection Request Reporting Page 27 1 :24 pm osta Meca 1'A - City Of Requested Inspect Date: Thursday, March 30,2006 Site Address: 1149 DANIELLE DR CM A/P/D Information Activity B04-00359 Type: BLD_SUB2 Sub Type: BLKWALL Status: EXPIRED Const Type Occupancy: 31 Use: Insp Area: Owner DANIELLO, PETER TR Applicant SANCHEZ AL Phone: 714-991-7773 Contractor ORANGE COUNTY FENCE Phone: 714-991-7773 Description CONSTRUCT TTSF)WAT LEFT PROPERTY PER CITY STANDARDS SEE MINOR MODIFICATION MM 04-07 Notice: PERMIT IS EXPIRED BY LIMITATION -WEIDE MJ Notice: 10 DAY NOTICE SENT. PERMIT WILL EXPIRE1/29/05.-WEIDE_MJ Requested Inspection(s), Item 150 MISCELLANEOUS INSPECTION Requested Time 08:00 AM Requestor Phone Assigned To Entered By WEIDE_MJ K Action Time Exp: Inspection History Item: 4 FOOTINGS/UFER GROUND **Approved** 02/19/04 Inspector: GWH Action: AP APPROVED Comment: Item 30 PRE-GROUT Item 150 MISCELLANEOUS INSPECTION Item 201 FINAL BLOCK/RETAINING WALL 12/02/05 Inspector: MJW Action: EXP Expired Comment: iy) tiX d(/ /62- REPT131 Run Id: 1148 ■■■■ M = MIME . ... _ ■ ■w� ■■■■■ ` Ell MOM S■■ rj ■1111111■111111� _.1 .1 YJ ■ I ■ 1_ A ..1 _�_ J els/ .1111/_.= , __ .- ' 41 1 . . 1 1 • 11 , a I 11 1■ . 1 -M ■ 1 Ir , 1 e ,. - J 1■ 1 -1 / 1 -1 F -l. 1 a ■ T A ■ 1 I \ —■mow_ , yon TEST SPECIMEN AND COMPRESSIVE STRENGTH DATA SHEET /i).. r j3 �" 'O �o/'��°sT (00, PROJECT NAME: Danielle INSPECTOR'S NAME: Richard Luiz O/`//O n AI PROJECT ADDRESS: t1.149 Danielle Drive INSPECTOR'S LICENSE NO.: N/A �- N Costa Mesa,CA INSPECTOR'S SIGNATURE: N/A --_ PERMIT NUMBER: 004/00562 SET IDENTIFICATION NUMBER: N/A CAST DATA(ATTACH DATA SHEET OF OTHERS WHEN AVAILABLE) CAST DATE 4/12/04 DESCRIPTION Concrete Grout Mortar Shotcrete Masonry Prism Olner GUNITE CONTRACTOR Owner/Builder SPECIFIED F's.PSI 2,000 CEMENT TYPE V SUBCONTRACTOR Arco CAST BY Juan ADMIXTURE N/A ENGINEER Lacher NO.OF SAMPLES 1 WATER ADDED N/A CONC.SUPPLIER N/A TOTAL YDS.PLACED N/A SLUMP N/A PLANT N/A TICKET NUMBER N/A AIR CONTENT N/A MIX DESIGN NO. 41/2-1 CAST TIME N/A AIRICONC.TEMP. N/A LOCATION IN BLDG.: Wall of the Swimming Spa NOTES: NR =Not Reported . Samples cast using wire mesh(no mold used). Test specimens were sawcut into 3-in.x 3-in.x 3-in.shapes for compression . testing. _ i t COMPRESSIVE STRENGTH DATA DATE SPECIMENS RECVD. 4/21/04 EQUIPMENT USED Forney DR2000 REPORT DATE 4/26/04 SN OF EQUIPMENT 99108 TECHNICIAN NAME C. Henrique2-Supervisor CALIB./RECAL.DATE 2-04/2-05 SPECIMEN AGE AT TEST TEST I SPECIMEN DIMENSIONS4N.' AREA LOAD Pc BREAK IDENTIFICATION TEST DATE TIME I 2 3 4 SQ.IN. LBS. I PSI TYPE' NUMBER DAYS 5 6 ] 8 (hit) 0004228A I 14 4/26/04 5:15am 3.063 3.053 3.066 3.050 9.35 18,808 2,011 c 3.080 3.080 3.080 3.080 11.01) Soecimen dimensions 1 -4=width and length of each face at midheight,4 through 8=specimen height at midwidlh. 'Break type designation per ASTM C39 Figure 2:a=Cone,b=Cone and Split.c=Cone and Shear,d=Shear,erColumnar COMPLIANCE WITH SPECIFIED STRENGTH/COMMEN Complies l %-// AUTHOR 0 SIGNATURE 7 9/0]V2 10600 Pioneer Boulevard, Suite G • Santa Fe Springs, California 90670 • (562)903-0032 Fax (562)903-3534 • 9GYpA'p2 � ,c. RICHARD LUIZ • QOM�cp 2e0 `o 5071 LOYOLA AVENUE 1c S�. 00 WESTMINSTER, CA 92683 0/p. • Report of Special Inspection • `/s� �s9 ?:eject Name & Address Did -0 — Imo° hneNsLU.1.-L DO--NV`s–� Co v nn&k.,sA ?- Nniiber `b04-0064oL I n.spection Typc(s) C-unite inspection Date(s) 2-- ] Periodic [ xxx ] Continuous Describe Inspeclu�Madc, including Locations: Inspection of the Swimming @ the above address on 14 —I2, —c4 _:s, Tess Made: CACI— 41:04dV" Lt^1b`12— 1 1 'rC TD'.aI Inspection 'lime Each Day: Date 114 tz Hours ?j _ s'. !'.c^s Requiring Correction, include uncorrected items previously listed or...... s: `o ,he best of my knowledge, the work inspected was in accordance with the Building Dcpartmen. :nprosee design drawings, speci. Icatio and applicable workmanship provisions of the U,B C as noicd above Signed: Date 1 — t� I .C. B .O . # F--,J!! Fame: Richard T. Luiz Registration No. 1075691-49 Concrete FORM 28 IU CITY OF COSTA MESA - •` 4�i _ BUILDING DIVISION • • Forf _ , DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER i m.: i 1 �• PERMIT lOPq,,� B04-00562 -ORroaarco (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite: Applied: 03/18/2004 Vicinity: Issued: 03/26/2004 Parcel Number: 41207164 Zoning: R1 R1 Applicant: NICKEL, JERRY ISSUED BY: Address: P 0 BOX 875 Phone: 714-998-2715 ORANGE,CA Zip: 92856 Owner: DANIELLO, PETER TR Address 1149 DANIELLE DR Phone: COSTA MESA,CA Zip: 92626-1634 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT IN-GROUND SPA. FEE SUMMARY Plan Check: $163.31 Calc Valuation: $15,000.00 Permit: $251.25 Claim Valuation: $16,000.00 SMIP Res: $1.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $416.06 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 NOTES: 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 I/ 2446-46(6/00) DECLARATIONS G ., WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-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. ❑ 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I 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' compensation 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT Ni EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 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 Business and Professions Code,and my license is in full force and effect.Lie.* Class A Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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 following reason(Sec.7031.5,Business end 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 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 Coda: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.). ❑ I,as owner of the property : LUSIVELY'CQNTRACTIN WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contracto ense Law •:snot appy to aril/of property who builds or Improves thereon,and who contracts for such project witscontractor(s) license purs nt.t•' -Contrac ��'' censei:...), 0_,....1-a exe pt •ar,;:c. //4 a B .ness and Professions Code for this reason: 9,•-• _---- -_5�___s? Signet.re' e 1 . /.e/laa—- , .. Expires: Verif . ion of 0 er�ype• ment,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I 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 authortzed 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,Gm 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: I Will the applicant or present or future building occupant need to tile and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia 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? 0 Yes 0 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 then 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Govemment Code 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? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safely 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 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penally 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 •• yer• •• is.p • purposes.I a•-e not to occupy or allow occupancy of any building authorized by this permit until final inspection. .77, ..., 0. ..,• 8, L , "A• Oryllfori Applicant ate CODE F 'I sPFonoN DM MAU CODE! INSPECTION TYPE DATE INDTULS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 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 "` il.-C Peter & Jan Daniello 1149 Danielle Drive Costa Mesa, CA 92626 March 15, 2004 To Whom It May Concern: Jerry Nichols of Nickel Wright Architects is hereby authorized to act as our agent in connection with the construction of the in-ground spa and decking which is being installed at our home at the above address. Peter Daniello i Janice Daniello eetei 0/ en& Neat Vaddiuuy2D rz t111 FFA444OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An 'owner-builder building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will he issued until this verification is received. I. I personally plan to provide the major labor and materials for construction of the proposed property improvement. ❑ Yes ❑ No 2. I (have/have not) SB /for signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the Wowing person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type 'ork JaY Al )(Kg_ Pobo 697s cepiNl 7/ r27/SC — i J 1042 06 (REV 959) 4`d4tU ME 9 CITY OF COSTA MESA BUILDING DIVISION e y DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER iir:4 PERMIT �aQrPe'`ppRC� . M04-00134 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1149 DANIELLE DR Status: PENDING Suite No Applied: 03/18/2004 Issued: Vicinity: Parcel Number: 41207164 ISSUED BY: Applicant: NICKEL, JERRY Address: P 0 BOX 875 Phone: 714-998-2715 ORANGE,CA Zip: 92856 Owner: DANIELLO, PETER TR Address: 1149 DANIELLE DR Phone: COSTA MESA,CA Zip: 92626-1634 Contractor: OWNER BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT IN-GROUND SPA. REF:B04-00562.HEATER FOR SPA.LESS THAN 100K BTU. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Fumace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $38.30 J� 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 2446.46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of con5ent 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. ❑ 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I 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' compensation 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDrTION TO THE C/KT OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 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 Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 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.). ❑ I,as owner of the property,am CC LY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors Lic:• L�.does net appt to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license.pursuantfq>e✓:fj!. •rs L' ense La 071-am roe. •t u r - '# i Business and Professions Code for this reaso ,Signature _ /dY/Ld'Ilif�W,�r�_ er Expires: /y Vert . Ion of Ow ership by( •:of docu •.nt,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I 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(38)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: I 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 9 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 lime 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 9 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 Califomia Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a kerrnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code 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? 0 Yes 0 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? 0 Yes 0 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 ws=rd city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described•roperty for inspect". pot oses. agre: of to occupy or allow occupancy of any building authorized by this permit until final inspection. 4., --kir !St .47 6'ODE 4,44SPECTION TYPE faKE )NTmALS CODE( INSPECTION TYPE PATE 1616 Fixed System Final Fire Prevention 206 Final Mechanical /'7/17/ 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 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 4`�4TB Ilk, CITY OF COSTA MESA qg BUILDING DIVISION Fq _ _7 Ai DEVELOPMENT SERVICES DEPARTMENT PER NUMBER 4. PERMIT 04-00265 4le04. prom (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite No Applied: 03/18/2004 Vicinity: Issued: 03/26/2004 Parcel Nunmber: 41207164 Applicant: NICKEL, JERRY ISSUED BY: Address: P 0 BOX 875 Phone: 714-998-2715 ORANGE,CA Zip: 92856 Owner DANIELLO, PETER TR Address 1149 DANIELLE DR Phone: COSTA MESA, CA Zip: 92626-1634 Contractor: OWNER BUILDER Address: Phone: Zip: License: 000000 SCOPE OF PERMIT IN-GROUND SPA.REF: B04-00562. ELECTRICAL FOR SPA FEE SUMMARY Quantity - Quantity ISSUE FEE $23.50 • Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment 50.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $49.50 1 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 - up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 . Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 , Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 ' • / J 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 I 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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: (This section need not be completed ll the permit is valued of one hundred dollars($100)or less.) ❑ I 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' compensation 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COGARE(5100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 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 Business and Professions Code,and my license is in full force and effect.Lie.# Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY; ❑ I 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 following 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 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.). ❑ I,as owner of the property,am EXCLUSI ELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractor •,••.5 n• appl .'•a . ner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) lice •pursu' _'i exp✓ •!sr -.). / / Ar ❑�am e •p =r S.V�� // Business and Professions Code for this reason: �fF� / /� / 'Signature /1_.aieracle .c.../L=✓ // ..l,Il�<3 G- Expires: , Vo'cation of•. ne33 a •f d�m- ,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation live(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,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 hazardous material? 0 Yes 0 No (Section 25505 of the California Health end 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? 0 Yes 0 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 end 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 en 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 application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes D No (Section 65850.2 of the California Government Code 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? 0 Yes 0 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? 0 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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection•..•• - . •• e•not to occupy or allow occupancy of any building authorized by this permit until final inspection. 021 c mac.—, ..ru�•rizredd,••j' _ .,.-.. _ •-te i CODEL , r•• s •:. .�%-" OAS MOMS CODEI • a•, s- Prig lamina 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical f]"Z/"oy 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 • 'F CITY OF COSTA MESA BUILDING DIVISION > DEVELOPMENT SERVICES DEPARTMENT PER NUMBER - f�r° PERMIT + a PO4-00193 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite No Applied: 03/18/2004 Issued: 03/26/2004 Vicinity: Parcel Nunmber: 41207164 ISSUED BY: Applicant: NICKEL, JERRY Address: P 0 BOX 875 Phone: 714-998-2715 ORANGE,CA Zip: 92856 Owner: DANIELLO, PETER TR Address 1149 DANIELLE DR Phone: COSTA MESA,CA Zip: 92626-1634 Contractor: OWNER BUILDER Address: Phone: Zip: License: 000000 Arch / Eng : • Address: Phone: • Zip: License: SCOPE OF PERMIT IN-GROUND SPA. REF B04-00562 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 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $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 $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 $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 i 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 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less) ❑ I 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' compensation 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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 Business and Professions Code,end my license is in full force and effect.LIc.M Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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 following 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 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 sate.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractor;Lic• ._ .w•doe5' .t apply to a •w.: of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuan oth: or . ors Licen :ws.). :m. Q I am e . 'nth / i Business and Processions Code for this reason: /� Signatu . !//�c ar 7'- _Ownm.venfie• r �- M Yes 9 No Drivers License No. . - Expires: Coe' Ve-ication o •wnership b•e• document,'e-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)of 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,Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder, I will not empby 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? 0 Yes 0 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? 0 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit 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 Code 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 ole school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end 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? 0 Yes 0 No 8 (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 ANDAUTHORIZATION OF ENTRY: 1 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 proper for ins. .,,• •urposes )agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. .4.----70,04 ---7 %/j / : et Lx al ner(s)ner(s) /� / — D. / -.r iriOr Au r.,t 9.nn•,•ma:m.. .. C PATE INTRUL$ CODE( INSPECTION TYPE PATE URRIAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing a) —zhat at 200 Final Re-Roof 210 Final Electrical 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 MINOR MODIFICATION Reference No.: Status: APPLIED Applied Date: 02-13-2004 Approved Date: 02/13/2004 Denied Date: MINOR MODIFICATION NO.: MM-04-07 Project Address: 1149 DANIELLE DR Suite: Parcel Number: 41207164 Project Applicant: DANIELLO, PETER TR PROPOSED MINOR MODIFICATION: NEW 7 FT. HIGH BLOCK WALL OF 16 LINEAL FT. AT LEFT PROPERTY LINE AND 30 LINEAL FT. AT REAR PROPERTY TO TIE IN WITH NEIGHBORS 7' BLOCK WALL. REQUIRED FINDINGS:Y The improvement will not be materially detrimental to the health, safety and general welfare of persons residing or working within the immediate vicinity of the project or to property and improvements within the neighborhood. Y The improvement is compatible and enhances the architecture and design of the existing and anticipated development in the vicinity. This includes the site planning, land coverage, landscaping, appearance, scale of structures, open space and any other applicable features relative to a compatible and attractive development. PROJECT PLANNER: NOTES: �'"`* CITY OF COSTA MESA - °tri• BUILDING DIVISION ��y , t' ""'7' ' DEVELOPMENT SERVICES DEPARTMENT F�J ' PERMIT PERMIT NUMBER B98-01573 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1149 DANIELLE DR Status: ISSUED Suite: Applied: 08/31/1998 Vicinity: Issued: 08/31/1998 Parcel Nunmber: 41207164 Zoning: R1 R1 Applicant: JONES, CRISTAL Address: Zip .. -. Owner DANIELL'O(PETER' - f Address DANIELLO,-JANICE . . ' _ N COSTA MESA,CA v\ - Phone: .545-57.11k; l\-y N 1149 DANIELLE DR - ' Zip: 92626 ••' '- v: `� N ,, i / Contractor:/ CAL-PAC-ROOFING Address: 4091 C LA PALMA N' -7 ,i ? ANAHEIM(CA/ Phone: 714-978-9274 ii- ,-1 UNIT D„! Zip:', 92807 License:%-.719716 , _ • /Arch/Eng ' _ - �'-' , • Address^ - ' - l -.^ , 1 V 'Phone:_ - . •, /. I Zip: - - • ” - , ' License:• License: - SCOPE OF PERMIT ' . . / ,REROOF OVER EXIST.WOOD SHAKE WITH LIGHTWEIGHT STEEL TILE•ICBO NR ER.3409 i -r is - ..e - ` FEE SUMMARY ,ij • Plan Check: .--$0.00 A ,• 4 ,:- „:4�-_ - „ , -Calc Valuation: - $14,000.00 Permit: '$212.25 _ 2-- ,e1111,:712,:/ ,' ' Claim Valuation: $14,000.00 SMIP Res: ' ',$1.40 SMIP Com: $0.00 - ' Other: ' . $0.00 Inspection: '$0�.00 .Total: ,$213:65 -PLANNING &`ZONING,.' SETBACKS ' '_ ' MAIN STRUCTURE Front -0-o' .' - - Rear 0-0' - • Left 0-0 Right 0-0 . �/ ACCESSORY Front -0-.0 - Rear 0-0 Left 0-0 Right 0,0 , PARKINGExisting: 0 - Required: 0 Proposed: 0 • NOTES: , • . EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora 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: O I 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. cps 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) O I 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' compensation laws of California,and agree that it I ould become subject to the workers'corn e satlon provisionsSection 370 of the Labor Code,I shall forthwith CO y.'•^"—' '• OVI``510n.e.^�,�e y� (� (� /o/�L� � 4 {.� Ap.'.:nt Signature: Date: C/ IVtC/ •:. . • • .- 0 SECURE WORKERS'COMPENSATION E GE IS UNLAWFUL AND SHALL SU MI EMPLOYER TO IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(slco,0C0),IN ADDITION TO THE COST OF SATION,DAMAGES AS PROVIDED FOR IN stt,'n 378 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSE• • -. •-S.DECLARATION: I ..y affirm that I am licensed 'or provisio of Che tel 9 Lcommencing with Section 7000)of.Di .- • -. •:-s -n• Prof; .'o;uy ode,and my license is in full orce and effect.Lic.a z t Class a 4 _ is Contractor's Signature: 1 N Date: �� i , CONSTRUCTION LENDING AGENCY: ❑ I 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 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 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 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.). ❑ I, 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 t0 the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • ❑ I 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,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 hazardous material? 0 Yes 0 No (Section 25505 of the Califomia 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 0 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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L.1 No (Section 85850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 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 0 No e (N 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 COMPUANCE 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. ign re Of egal O illD: • (1 �J ta ndlOr ulhorized Alia ` Date CODF L INSPFCTION TY � MEALS CODE f INSPECTION TYPF DATE IM➢DEL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �/ � ��/ 208 Final Plumbing q 200 Final Re-Roof [ "9•'9D (ffes- 210 Final Electrical 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 Bullding/Occupancy 2446-46 CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION ` Permit No. 73q " /57 Property Address \\y q 1 t1�\aN e l l e D r Owner � i (' \Rn\ e l l ° Contractor l ,Q,` - Q C, IT/1 State Contractor License Number 1 '9-11 (. Classification \ r 39 I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company D Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. q \O0, I E.Company or Co f A Inn t. N 1krx ` e cL q 2-X07 Received by Building Division V �Y l P k CY1 f By: S��Q �Q A -a Signature Date Initial 3 \51Cris �-a I Sones D e Printed or Typed Name 0990<6 MW 9/97 White-Building Div.:Canary-Contractor:Pink-Owner 3789 2/21%79 283.94 it COSTA MESA BUILDING-SAFETY DEPARTMENT 6%3789 '2/21/79. 283.94CKTU P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 01 UK L ia APP ICATION FO RU 0 A 7P IIT I'Q For Applicant to Fill in Completely - Use Ink Only - R El D s D TE RECEI DATE ISSUED BUILDING ADDRESS Tract 10277, Lot 44 ' - -�_ - t. PERMIT NO. OWNER McLain Development Co. A.P.NO. 4/2- 07/- C hit MAIL BUIDDIEGADDRESS 1470 Jamboree Road ADDRESS // y9 TEL. TRACT frac 1. LOT 44 BL277 CITY Newport Beach NO. 640-6800CONSTRUCTIONNEW ADD ALTER REPAIR MOVING DEM LENDER ` , // BRANCH VN 1/`I 1�i� . OWNER !Y L ..A1/1,, Cli ADDRESS UE //,. ,p/� • ARCHITECT TEL. US £5 AY*7—thrk S Zi ) OR ENGINEER Corbin/xamafuji NO. 752-5567 �{ FIRE ADDRESS 3661 Spruce St., Newport Beach ZONE TYPE GROUPr�J APPROVED CONTRACTOR McLain Development Co. By DATE ADDRESS 1470 Jamboree Road TEL. ZONE NO.OF USE OF NEW CITY Newport Beach NO. 640-6800 PDR-nip PLANS BUILDING RES STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. 273875 LIC. NO. MAIN BUILDING ACCESSORY BUILDING Lu SIZE NO.OF BLDGS. (FROM C/L STREET) 0.. OF LOT 60 x 112 I NOW ON LOT FRONT 2D FT. 0 FT. Q USE OF Lel EXISTING BLDG. R.SIDE /2 FT, 0 FT. Eh 1-1 I—. Separate permits are required for L.SIDE . FT. a FT. - electric,plumbing and heating work. W REAR /7 FT. O FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED .DISTANCE BET. BET.MAIN& CMAIN BLDGS. ACCESS.BLOCS. DATE MI Single family residence, C U.P VAR.# 2f-ie-3$/ APPROVED .2h-7/71 New House APPROVEDC.fe / ff _DATE nom//..517, 12 HOLD FOR SPECIAL REOUIREMFNT, 0 I hereby acknowledge that I have read this application and state N C that the above information is correct and agree to comply with 4m ell laws regulating building construction, and I shall not employ House 1561 a Z any person In violation of tho workman's compensation laws of E Lra the State of California. 3 I hereby certify that I am properly licensed as a contractor under SO. FT. Garage 434 N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the provisions of the State of California Business /p� N and Professions C de, Division 3,Chapter 9 VALUATION PERMIT FEE $ a Z^ '//� PLAN CHECK $ Q 50 co Signature of /t /W-l- U �s _v F�� 0 /� 7�e LL Permittee l U $ TAX $ .3 0‘ / e Authorized A tU .- r. TOTALPAID $ ni