The URL can be used to link to this page

Home My WebLink About3180 Pullman St - Building PermitsJobAddress: 3180 PULLMANST Status: ISSUED Suite: Applied: 09/12/2006 Vicinity: Issued: 04RSY2007 Primary Occ: B Eat<SOI OKceI Bar<50 Type of Construction: V-N Parcel Number: 42707101 Zoning: Applicant: YOUNG, JEFF Address: 7 CORpORATE PLAZA Phone: 949-719-7225 ISSUED BY: �l � NEWPORT BEACH, CA � _ • Zip: 92660� Owner: OCRC FUNDING CORP � ` - Address 7 CORPORATE PLAZA � � ' ' ' ' ' ' . . � . � Phone: . , . , , � NEWPORT BEACH, CA . . - Zip: 92660-7904 � " - , � Contractoc " � - � . � ' � � �. . � ' � � .. Address: � � . � � . i � , Phone: - , � � , ' . � � .�: �. . . Zip: - � License: „ , . � � Arch : OKEEFE, WILLIAM J K Eng: Address: 4937 BIRCH ST Address: -� • - � Phone: 949-261-9000 � , . - . �Phone: NEWPORT 9EACH, CA � � . - � � • � � . � - Zip: 92660 License: C12798` - - License: " SCOPE OF PERMIT - CONSTRUCTION OF 1 NON-LOAD BEARING WALL AND INSTALLATION OF ILLUMINATED EXITING SIGNS FOR COMMERCIAL BLDG. �� •'1�GALIZATION OF NON-P MITTED INTERIOR PARTITION WAL�L . e� 't 5.e �i.. � Lo�2q � o� _ t,lno oma �to_ rtr `sVwo»ir�.. c�i.sa�le ��,.. cyo,� 1�� "— � ," FEE SUMMARY _ Plan Check: $90.51 Calc Valuation: s�,000.00 Permit: $139.25 - Claim Valuation: s�,000.00 SMIP Res: 50.00 -. � - ' SMIPCorrc $1.47 � — -� -------> ._` _ � ' Other: $139.25 -' � � Inspection: $0.00 ' � _ � Total: 5370.48 � � � `�� ''� PIANNWG B�ZONING � _ SETBACKS � � � -.` . ' � =�; � �::., t;..: �>;�,_.�.,,,� MAINSTRUCTURE Front �`0=0\ _Rear � 0-0 ` � Left 0-0 �"�< "�Right i0-0 . " ACCESSORY Front 0- 0� ', Rear - 0- 0, Lefl 0- 0 , Right � 0-, 0;, ; �� PARKING Existn f 0� �_��Reauired: o Pr000sed: 0= �� , , . � � � �� . � � � � _ ; � � _ , ` . . �; . J , . � �i .i: . . � \ . . .. � . NOTIC TE h oe w�.�rk authorizetl by this permit shall comply with all applicable handicap access requiremeNs under Calitomia statutas and related regula[ions. (Ord. No. 92-28, § 1, 7241-92) EXPIRATION: This perm0 shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned tor a penod of 180 days. � INSPECTIONS: In ordar for the work euthorized under this permit to be considered legal, such work must comply with ell eppllceble codes, and all required Inapeetiona end final epproval mus� �e obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOfl INSPECTIONS CALL: (714) 754-5626 ns<s (srool WORKERS' COMPENSATION DECLARATION: I �ereby attirtn under penelry ot per�ury one o1 the following deGareUons: ❑ I heve end will maintein a certlficate of consent to self-Insure br workers' compensation, es pmvitletl for by sectlon 3700 ot the Lebor Code, lor the perlormence of the work for whith Ihis pBrmli is ISSUBtl. ❑ I heve arW will maintain workere' compensa0on insure�ue, as requlretl by secUon 3700 of the Labor Cotle, for the pertortnance of tha work tor whid� Nis permlt Is Iswed. My workers' compensatlon Insurence ceMer entl poliq number ere: Certier: Palicy Number. (This sectian neeC not be completed I! fhe permit Is ve/ue0 af one huntlred dollars ($100) or Iess.J , ❑ I cerlity Ihat in Ihe peAormance oi I�e work far which Ihis pertnit Is issued, I shall not employ any person in any menner so es to become suh�ect to the workers' wmpensetion laws of Cqptom�e, end epree that if I shoultl become subjad �o [he warkers' compensetion Orovlslons ot SecUon 3700 01 Ne Lebor Cotle, t sbell foMwith comply vnth these proWsions. Applicant Signature: Date: WARNING: FNLURE TO SECURE WORI(ERS' COMPENSATION CWEMOE IS UNLAWFUL AND SHPi1 SUBIECT AN EMPLOVER TO CRIMINAL PENFLTIES AND pVIL FlNES UP TO ONE HUNDRED TIqU$AND DOLIARE (S/OO,OOO�.IN ADDITION TO THE CQ"iT OF COAIPENSATION. DAAMGES AS PHOVIOED FOR IN SECiION 31O80F TME LABOF COOE, INTEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATON: I �ereby aflirm that I am Ilcens0d under provlsions of Chepter 9(commencing with Section 7000) oi Divislon 3 of the Business end Professlons Cade, end my Ilcense Is In full lorce entl ettecL LiC. N Class p Conirectofs Signeture: Date: CONSTRUCTION LENDING qGENCY: . � ❑ I hereby eMirm Ihat there is e constructlon lending egency for tha peAormance oi ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendels Neme: Lenders Addreu: Signeture: Dele: OWNER-BUILDER DECLARqT10NS: 1 hereby eHirtn ihel untler penalry ol pe�ury ihat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the tollawing reasan (Sec. 7037.5, Business anA Pratesslons Cotle: Any ciry or county which requlres e permit �o consiruct, alter, improve, demolish, or repair eny structure, pnor to Its issuance, also requires the epplicant for such pertnit ro file e slgneC slatement that he or she Is Ilcensetl pursuent ro the provislons of the Contrecrors License Lew (Chepter 9(commencing with Sectlon 7000) of Dlvislon 3 oi the Busineu end Professions Coqe) or Ihat he or she is exempt therefrom and Ihe basls for the allegeA asemption. Any vloletion of Section 7031.5 by eny eppllcant for a pertnit suh�ads Ihe applicant to e civll penalty of no1 mora than five hundred tlollers ($500).): ❑ I, as owner oi Ihe property, or my employees with wages as their sole compensetion, WILL DO THE WORK, and the structure is not intended or oHered for sale (Sec. 7044, Business and Protessions Code: The Contradoro License Lew does not apply to an owner oi property who builds or improves thereon, end who does such work himselt or harsetl or ihroUph his ar har own employees, provitled Ihat such Improvements ere not intendetl or o8eretl for sale. If, however, the building or improvement is soltl within one year oi cpmpletion, the owner-Dullder will heve the burden of proving ihat he or she did not build or improve lor purpose ot sele.). ' ❑ I, as owner of ihe prapeqy, em E%CLUSIVELY GONTRACTNG WITH LICENSED CONTRACTORS to conslruci Ihe prqecl (SeC. 7044. BuSinBss entl Professions Code: 71ie cantrectors Ucense Lew does not ep0�1' �o en awner ol pmperty who builCs or Improves thereon, entl who coniracts for such pro�ect with e concrecror(s) license pursuant to ��e Contractor9 Litense Lews.). ❑ I am exe un er sect.,. Business end Professions Code tor this reason: �Signatura: —y l � Data: Owner ID venlieC driver's IiCense. ❑ Ves ❑ No Drivefs License No. VedNcetian o1 Ownershlp by (rype of tlocument, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SqFETY 7ERMIT CERTIFICATION: Expires: ❑ � hereby certily thet no excevation fNe (5) or more feet in depth into which e person is required to descend, wlll be made in connectlon with work euthonzeO by t�is permit, end thet no building sWdure, scaNdtling, talsawork, or demolition or dismantling thereot, will be more than thirty-six (36) laet high. (Chap. 32, Gry 2, An 2, Sec. 341, Ttle B, Celitomla Atlministretiva Code). ❑ As owner-bulider, I will not employ enyone to do work whic� would require e permit trom the Division of Industrial Safery, es noted ebove, unleu such peraon has e permit to do suU work trpm ihe dlvislon. Signature: Date: Division ot Industnel Safery Permit Number: ICERTIFlCATE OF COMPLIANCE AND AIJTHORQATON OF ENTRY: I certiy under penalty of perjury Ihat I have read this eppllcalion and state that t�e intormatlon gNen is I cortecL I egree to wmply with all stete lews end Ury ordinances relating to buil0ing consWctlon, and euihodze representalives ot the Clty oi Costa Mesa to enter upon the ebove-descnbed praperry for Inspection purposes. I agree not to occupy or ellow occupancy ot any building euthorized by this pertnit until finel inspection. � I AnNOr Aulhoriz Applicant • COOE1. MSPECIIONTYPE QS¢, INfiilALS 1618 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Root 201 FIneI8lock/Retelning Well 202 Final Fedory Fira Plece 203 Final Sign 204 Finel Demolltion ! cooe� n+svernoxirae 206 Final Mechanicel 208 Flnel Plumbing 210 Finel EIeclHcal 212 Finel Fire Prevention 220 Final Planning Approval 222 Flnal Site 250 Finel Building/Occupency PAIF. It�L CITY OF COSTA MESA BYILDING DIVISION i � 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754•5273 • Fax (714) 754-4856 • www. '.costa-m sa. u � " FOR INSPEGTIONS CALI: (714) 754-5628 .�� PERMIT NUMBER. E07-00642 PERMIT TYPE ELEC STATUS: ISSUED DATE ISSUED: 0612912007 - -- ISSUED BY: ''��/� ' �• ( '-. _ - - JOB AODRESS: 3180 PULLMAN��ST CM- �� -� $uite%Unit:� -;`.�. vicinity: ; :�.. . _ . . _ . .' - _ _ ' ". . . '��,-� � ...,.i.. � � •" ��."' `.- ..�� . . �. SCOPE OF WORK: INSTALL 10FIXTURES 700UTCETS AND 4SWITCHES FOR BATHROOM�REMODEIS.�RE:806-01512 � _ ,..<Y l . �� . pl'� i ' \ .:i,�?4. � �� " '�" ;;�;; � - OWNER: OCRC FUNDING CORP:' �,� Address: 7 CORPORATE PLAZA "Unit: PHONE: � �; -' �'%:�V ' - � � City/State/Zip: � NEWPORT BEACH, CA ;• �� ., , , .. . . . . APPLICANT: YOUNG, JEFf � � , " . ' . ' � Address: . �� Unit: -. � � , . PHONE: 949-719-7225 ' i � � �" City/State/zZip: . . CONTRACTOR: - � � � � . . . . . License No. - - Address: Unit: � . PHONE: - � - � � . - -- ' Ciry/Siale: � . . , ZipCode: - � � - " CELL: � , ELECTRICAL PERMIT FEES = - � - . Electrical Plan Check Fee: $0.00 ' Electrical Permit Fee: � $49.90 � . Reinspectian Fee '. ,$0.00 � TOTAL FEES •;r . .$49.90 0 �`; _, � , _ ; , _. , . . � , . . - _ � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulaUons. (Ord. No. 92-28, § 1, 12-21-92) E%PIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order (or the vrork authorized under this permit to be co�sidered legal, such work must comply with all applipble codes, and all required inspections and final approval must be obtained. Failure to obtain inspec0ons and final approval will result in the expiration of this permit. SODE/. INSpECTIONTYPE Qj�Jf, I 1L COUEI INSPECTIONTYPE QejE IN R 1878 Fixed System Final Fire Prevention 20B Final Mechanical 1266 Pool Spa Final ' 208 Final PlumOing �� 200 Final Re-Roof 270 Final ElectnWl 201 Final Block/Retaining Wall 272 Final Fire Prevention 202 Final Faaory Fire Place � 220 Final Planning Approval 203 Final Sign 222 Final Sita 204 Final Demolition 250 Final Building/Occupanc/ � WORKERS' COMPENSA710N DECLARATION: 1 hereby aKrm under penalry of perjury one of the lo��wing dedaration's: �� ❑ I have and vrill maintain a certifcate o( consent lo sel4lnsure (or warkers' compensation, as Drovidetl br by section 3700 of the Labor Code, for Ihe perfortnance of the work for which t�is permit is issuetl. � ❑ I have arM vrill maintain warkers' compensation insurance, as required by sectbn 3700 of ttre Labor Code, for Ihe peAortnance o( lhe�work fa vfiich this permit is issued. My vrorkers' compensation Insurance carrier and policy number are: Carrier. (TNs SMian neM rpl pp mmpkfeC I Ne pmril6 valuatl at wrB �urMiMN9ars (f ]00) a ku ) Policy Number: ❑ I certify that in the peAortnance of the vrork for which lhis pertnit is issuetl, I shall not employ any person in any manner so as to bewme subject to ihe workers' compensation laws of Califomia, and agree that if I should become subject to the workers' compensalion provisions of Section 3700 ot the Labor CoCe. I shall torthwith comply with these provisions. Md�m�Ps SB^a�ure Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensetl untler provisions of Chapler 9(commencing wilh Section 7000) ol Division J of the Business anC Profassions Cotle. and my license is in lull lorce and eflect. Lic. # Class p Contraclor's SipnaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that there is a construction lending a9ency fa the peAortnance of Ihe v.ork fa wfiich this pertnit is issuetl. (Sec. 3097. Civil Code). Lender's Name: LendersA0dres5: _ Date OW NER-BUILDER DECLARATIONS: I hereby aKrtn lhat under penalty of perjury lhal I am E%EMPT FROM THE CONTRACTORS LICENSE LAW lor Ihe following re250n (Sec. 7031.5, Business and Professions Code: Any city or Gounry which requires a permit ro consWct, alter, improve. demolis�, or repair any strucWre, prior to its issuance, also requires the applicant for such permit lo file a signed statement ihat he or she is licensed pureuant to tha provisions of Ihe CanVactors License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business and Professions Coda) or ihal ha or she is exempt therefrom and the basis (or the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit subjects the applicant to a civil penalry of not more than 6ve hundretl dollars ($500).�: ❑ I, as ovmer of the propeAy, or my employees with vlages as t�eir sole compensation, WILL DO THE WORK, and the stmcNre is not intendetl or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply lo an owner ot property who builds or improves thereon, and who dces such vrork himself or herself or through his or her ovm employees, provitleE that such improvements are noYintended or offered for sale. If, hovrever, the builtling or improvement is sold wilhin one year of completion, the ownervbuilder will have the burden of proving that he or she did not build or improve for purpose of sale.�. � �� I, as ovmer o( the propehy, am �EXClU51VELY�CONTRAC7ING WITH LICENSED CONTRAC70RS ro conswct the projecl (Sec. 7644, 8usiness and Pro(essions Code: The comractas License Law does not apply to an ovmer of property who Duiltls or improves thereon, and who contracts Iw such prqect with a contracta(s) license pursuant lo tha Cont2clors License Laws.). Owner ID verified by drive ise. ❑ Ves ❑ No S� l� Driver's License No. � ' Expires: ' Venfication ot Ownership by (lype of document, i.e. - property lax Dill or deed): 'DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: - ❑ I hereby certily that no excavation frve (5) or mwe feet in depth into whic� a pereon is reQuired to descend, will be made in connection with wvrk authorized by lhis pertnit, and thal no building swcNre, scalfdding, falsewurk, p demolition w tlismantling thereof, vrill be more lhan ihirty-s& (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, Title 8, Calilomia AOminisirative Code). ❑ As owner-builtler, I will not employ anyone to do work which vrould require a permil !rom the Division of Industrial Safery, as noted above, unless such person has a pertnit to tlo such work (rom the division. Apdipnfs SignaWre 6a�e Division of Induslrial Sa(e[y Pertnit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future builtlinq occupant neeC to fle antl certify a Business Plan for emergency response to release or threatened release of a hazarAous matenal7 ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Cotle requires. wim some exceptions, Ihat a Business Plan be filed wilh the Costa Mesa Fire Deparimenl by every busin855 whiCh ha5 at any one time during a reported year a quantity ot hazardous materials equal to or greater than a vreight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet ol compressed gas at standard temperature and pressure). 2. Does or will the applicant or presenl or future building occupant neetl to fle a registration form for acutely �azartlous materials? ❑ Yes ❑ No (Section 25533 of the California Health antl Safety Code, wilh some exceptions, requires registration with the Costa Mesa Fire Department �y each business which at any one time has on hand a quanlity of awtely hazartlous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of wmpressed gas al standard temperaNre and pressure). 3. Does or will Ihe appliwnt or present a future building occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazartlous malenals)? ❑ Ves ❑ No (Section 25534 0l the Califomia Health and Safety Code provides that the Costa Mesa Fire Depariment may require the preparation, certification and fling vrith the Fire Department of an RMPP by businesses whic� are required to register acutely hazartlous materials with Ne Fire Department. 4. If an RMPP is piesently requiretl, has Section 25534 of lhe Calilornia Health and Safety Code been fully complieC wil�? ❑ Yes ❑ No 5. Dces or vrill the applicant or present or future builtling occupant require for the work whic� is the subject of this application a permit for suc� consiruction or modifcation (rom the SOuN Coast Air Qualily Managemenl DisMct or trom any other air pollution control tlisiric� or agency7 ❑ Ves ❑ No (Section 658502 of the Calilomia Govemment Code requi25 that lha requestetl infortnation be fumished on appliWti0n5 fa noo-resitlential building permits). 6. Will any paA of the (aciliry to be constructed under this permit be within 1000 feet from the outer boundanes of a school7 ❑ Yes ❑ No (II yes", Ihe facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safery Cotle�. 7. If a permit from the South Coast Air �ualiry Management DisMct or other air polWtion control dis[rict or agency is requireC fOr Ihe work vfiich is the subjecl of this application, have all o! lhe disclosures prescri6ed by California Heallh and Salety Cotle Section 42303 been matle'! ❑ Ves ❑ No, 8. p(yes", atlach certiflcate of compliance from the appropnale air pollution control oKcer). . . CER7IFICATE OF COMPLIANCE: I certify Ihat undar penalty ol perjury Ihe infortnation given above is cortecl. I agree to comply�with all state laws and city ordinances regarding HazarOous Materials antl Emissions. � � � SignaWre CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I . cetlify untler penalry ol perjury that I have read this aODlicalion antl stale that ❑ I am exempt under sec: the infortnation given is correcl. I agree lo comply vnth all stata laws and city , ordinances relating to building consWction, and authorize representatives of Business and Professions Codelor this reason: the City of Costa Mesa to enter upon the above-descrihed property for � inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit untit final inspection. , � n ��0 �i � SignaWre ol Legal Ormer�s) Dal< �_y SiBnxWm Da�e F� CC r, -�,�,� � � ' 305]< 1Y01) ' � . . . � —� , r ul�wzetl ppiont Date CITY OF COSTA MESA � BYILDING DIVISION i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us ".�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBERYP07-00439 PERMIT TYPE PLUM STATUS: ISSUED _ DATE ISSUED: 0612912007 '- - � " ISSUED BY: SHA _ S , �� . .. �• � ' . ' . ��` J08 ADDRESS: 3180 PULLMAN�ST CM , � Suite/Unit: .'.= Vicinity: / .` � ' : ; - ' � �j '';-. r ; ;�' SCOPE OF WORK: INSTALL 2URINACS; 2N%ASH BASINS, 2VENTS, 4WATER CLOSETS, 2WATEFj REPIPE FOR BATHROOM REMODELS. RE:806-01512 ' • %� �:-: ` � �,`-, -' � � .��_ -r�," ' `y�,�, , ., � . {> _ . � .. . . . . .�� . , , _ ; : � �.;� , .'-. . , . i i. ,. OWNER: OCRC FUNOING CORP , . � - ; : pddress: �' ' � - '7 CORPORATE PI:A7A ' � ' PHONE: ' �' . �' . � ... ' City/Slate/Zip: � � NEWPORT BEACH, CA APPLICANT: YOUNG, JEFF � , � � Address: . , . - PHONE: 949-719-7225 - � � � � City/State/zZip: � � � � - . � . .� _ _._. . u . . ... .. . CONTRACTOR: �. _ � � License No. � " Address: � �, . -"" � =r PHONE: . , �. City/State: .� . �� . ZipCod'e: " ..� --r.-�_,.��:� -.�.... CELL: . . ,� � -- - ' _ ' �., � . PLUMBING PERMIT FEE SUMMARY ' ' ' ' .' . � � ; "' PLAN CHECK FEE: `$0.00 .� ' . • PERMIT FEE: $141.10 ' � . . - % . . TOTAL FEES: $141.10 � �- " ; `� , .. � - �.✓r� i � _.`� -_ , T. ;.� , , . NOTICE: The work authorized by this pertnil Shall comply with all applicable handicap access requirements under Cali(omia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � • EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and Tinal approval must be oblained. Failure to obtain inspections and final approval will result in the expiretion o( lhis permit. CODE/, iNsrecnoxirre pyg �� CODEI ixsrecnoHrme pdg �i 1818 Fixed Syslem Final Fire Prevention 208 Final MeUanical ' 1266 Pool Spa Final ' 208 Final Plumbing �$ Z00 Final Re-Roof 210 Final Electrical ZOt Final Block/ReWining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Fina15ite 204 Final Demolition 250 Final Building/Occupanq WORKERS' COMPENSATION DECLARATION: I hereDy aRrm under penally of perjury one of the lo��wing declaretions: � ❑ I have and will maintain a certifcate of wnsent to self-Insure �(or`viorkers' compensalion, as provided for by seclion 3700 of the Labor Code, !or Ihe peAormance of Ihe vrork for which Ihis pertnit is issued. ❑ I have and will maintain v.orkers' compensation insu2nce, as required by . section 3700 of the Labor Code, fw the peAwmance of the'work (a which this pertnit is issued. My workers' compensation Insurance carner and policy number are: Carrier: (Tfris sectim neetl not Ge oompletetl /Ne pemml a vah+ed al ma frwMied tlotlars (5�00) w less ) Policy Number: ❑ 1 certify that in the peRormance of the v+ork tor which this permit is issuetl, I shall not employ any person in any manner so as lo �ecome subject lo the workers' wmpensation laws of Califomia, and aqree thal il I shoultl hecome subject to the workers' wmpensation provisions of Section 3700 of the La6or Cotle, I shall lorthvrith comply with these provisions. Ap0lionfs Si9nmure Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, INTEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm Ihat I am licensed untler provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force antl eflect. Lic. # Class # Contrector's SignaWre Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affum that there is a construction lending agency for Ihe peAortnance of the v.ork fa wfiich this permit is issued. (Sec. 3097. Civil Cotle�. Lender's Name: Lenders Address: SignaWre Da�e OWNER-BUILDER DECLARATIONS: _� I hereby affirm Ihat under penalty of perjury t�at I am EXEMPT FROM TME CONTRACTORS LICENSE LAW (or Ne (ollowing rea50n (Sec. 7031.5, Business and Professions Code: Any ci�y or county v.hich requires a permit to construc[, alter, improve. demolish, or repair any sWcture, prior to its issuance, also reduires Ihe applicant (or suGh permit to file a signed statemen� Ihat he or she is licensed pursuant lo lhe provisions of the Contractors License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business antl Prolessions Cotle) or that he or she is exempl therefrom antl the basis for ihe alleged exemption. Any violation of Seclion 7031.5 by any applicant for a permit subjects t�e applicant lo a civil penalry ot not more Ihan five hundred dollars ($500�.�: � I, as ovmer of I�e property, or my employees with v2ges as Iheir sole compensalion, WILL DO THE WORK, and ihe structure is not intendetl or o%ered lor sale (Sec. 7044, Business and Professions Code: The Contraclors License Law does not apply to an owner of properly v+ho builtls or improves Ihereon, and who does such woAc himsell or herself or lhrough his or her ovm employees, provided that such improvements are not intended�or oHeretl for sale. If, however, tha builCing or improvement is sold within one year ot completion, the ovmer-builtler will have lhe burtlen of proving that hg or she �, did not build or improve for purpose of sale.). � [.� I, as owner of the property. am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to crostruct Ihe project (Sec. 7044, Business and Professbns Code: 7he contractas License Law dces rrot apply to an ovmer of property who Duilds or improves theraon, and wfio conl2cts fw such pmjecl with a contracta(s) license pursuant to the Contractors License Laws.). „ Owner ID verifed by drivt ?se. ❑ Yes ❑ N ' Dnvers�LicenseNo. Expires: - ,j-11� Verifcalion of Ovmership by (type of document, i.e. - property tax bill or deed�: DIVISION-OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certi(y that no excavation Me (5) or more fcet in depth inro which a person is required to descend, will be made in connectbn with work author¢ed by this permit, and Ihat no building struclure, scaffdtling, falsev.ork, or demolition or dismantling thereof, will be more [han thirty-six (36) feet high. (Chap. 3.2, Grp 2. M 2, Sec. 341, Tlle 8, Califomia Administrative CoGe). ❑ As ovmer-Duiltler, I will not employ anyone lo do work which woultl require a permit (mm the Division of IndusMal Safety, as noted above, unless such person has a permit to tlo such work from the division. Apollwnl's Sipnawre Oate Division of Indust�ial Safety Permit Number: HAZARDOUS MATERIAIS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or future building occupant neetl to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 01 the Califomia Health and Safery Code requires, with some exceptions, that a Business Plan be filed with the CasW 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 feel of compressed gas at standard temperature antl pressure�. 2. Does or will the applicant or present or tuture building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Cotle, with some exceptions, requires registration wilh lhe Costa Mesa Fire Department Dy each business which at any one time has on hantl a quantily of acutely hazardous matenals equal to or greater than a weight of 500 pountls. or a volume of 55 gallons, or 200 cubic feet ot compressed gas at standard lemperature and pressure). 3. Does or will lhe applicant or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acu[ely ilaZ2fdou5 mateflals)? ❑ Ve5 ❑ No (Section 25534 0! the Califomia Health and Satety Code pmvides that the Costa Mesa Fire Departmenl may require the preparalion, certification antl filing with ihe Fire Department of an RMPP by businesses which are required lo register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of Ihe Califomia Health and Safely Code been (ully complie0 with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or lulure building occupant require tor Ihe vrork whic� is the subject of Ihis application a pertnit for such conslruction or modifcation from Ihe Soulh Coast Air �uality Management District or (rom any other air polWtion control tlistrict or agency7 ❑ Ves ❑ No (Sectbn 65850.2 of the Califomia Govemment Code fequi25 thal thC reduested infortnation De fumished on applications fa non-resitlential builAing pertnits). 6. Will any part of tha lacility �o be constructe0 un0er Nis permit be vnthin 1000 feel from the ouler boundaries ol a school? ❑ Ves ❑ No (I! yes", the laciliry must meet the requirement of Sections 25534 and 42303 of lhe Calilomia Health and Satery Code). 7. II a permit from the South Coasl Air Quality Management Dislrict or oNer air pollution control distnct or agency is requiretl (or the v+ork which is the subject o( this application, have all of the disclosuras prescriDetl by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _ 8. Qf'yes', attach certificate of compliance from the appropriate air pollutlon coMrol officer�. � , CERTIFICATE �OF COMPLIANCE: I certify that untler penalry of perjury ihe information given above is correct. I agree to comply with all state laws antl ciry ordinances regartling Hazardous Materials and Emissions. � SignoWre Qa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I . certify under penalry ot perjury that I have reatl this application antl state Nat ❑ I am exempt undei sec. �he information given is correct I agree to wmply vrith all state taws antl ciry ordinances relatinq to building conswction, antl authorize representatives of Business antl Professions Cotle for this reason: the Ciry o! Costa Mesa to enter upon lhe above-0escribed pmperty for � inspection purposes. I agree not to occupy or allow occupancy o( any building / authorized by ihis permit until final inspection. 0 �� ' �� U� � SignaWre ot Legal Owner(s� Dale —7 1 -�/ .y / Si. m , Date � b^ ^ /�(�l�l�/� 305]<6(3 )) /-�C--� � AnObrAul�onieGApq'on� Dd1E (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ELECTRICAL PERMIT n FAIR DRIVE, COS7A MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicanl: Address: Owner: Address 3180 PULLMAN ST DMX 42707101 CURRENT ELECTRIC / SANDY BOYD 27 SPECTRUM POINTE DR STE 309 ' , ../'' i- LAKE FOREST; CA'.-� ' ' �, , � _ _ , �-. OCRC FONDING CORP 7 CORPORATE PLAZA " ' ! \. � �i, �NEWPORTBEACH,CA i/ii; Phone: (949) 588-3777 Zip 92630 Phane: Zip: 92660-7904 Contractor. - CURRENT ELECTRIC / SANDY BOYD Address: 27 SPECTRUM POINTE DR - ``'"� STE 309 � • 'Phone: (949) 5883777 LAKE FOREST, CA ' " �Zip: � 92630 � - _ , � -� - - License:488263 ISSUE FEE Temp service test Res. a/c package New Res (1-2 uni45) New Res (3+units) Pool / Spa Lighting Fixts � Recept Outlets Switches Non Res Appl � � Res Appl Service to 200a Service to t000a Service over 1000a Motors to 1hp Motors to tOhp Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Status: ISSUED Applied: 03/29/2005 Issued: 04/19I2005 ISSUED BY: i i , , �, � . .. , �, . `�. i SCOPE OF PERMIT UPGRADE UPS FROM EXISTING 400A TO NEW 800A WITH 1,EXISTING 400A AND 1 NEW 400A SUBPANEL AND 2 NEW METERS WITH SWITCHES.-TENANT: DMX -.�� NO OTHER WORK AUTHORIZED WITH THIS PERMIT. Duantity $23.50 50.00 50.00 50.00 0 50.00 0 50.00 0 � _ , 30.00 0 , 50.00 0 � 50.00 . -' - 0 � $0:00 � 0 - 50.00 " � 0 . " - $0.00 � -0-�, � 362.15 ' �' 1 � 50.00 0 � � 50.00 " :,�0 � . �� 30.00 : - � 0 , � $0.00 �� 0 � 50.00�- � , 0- - 50.00 �--; - � 0 -_ 50.00 � 0 ss�.00 z FEE SUMMARY - - - . �uantity � Temp Dist System / Lighting $0.00 0� Busway /100 f6 $0.00 0 - Standing Section $0.00 0 Misc ElecMcal Equipment $0.00 0 , . +; Trensformers up l0 1 kva/kw - $0.00 0� , � " .......:........up to 10 kva/kw $0.00 0 - � � � .............:...up to,50 kva/kw $0.00' � ' � 0 .................up to �OO,kva/kw 50.00' ' p , � ..................over 100:kva/kw'-- 30.00 � 0 ' , � Low Voltage Equipment ;30.00 : 0 Low Volt Wiring System / Ckt $0.00 �� 0 Misc: CondWt -- � $0.00 j 0 �� Misc. Conductor � . $O.W ' 0 - � Circus ( gen or ride)' � � 50.00 �,�0 Circus (mech nde or IighLs) � -50.00 ; 0� Christmas Tree S(and � � � $0.00 � 0 � � Fireworks Stand . � � .$0.00 , 0 ' � Other ElecMral Fee- �� , 50.00 \ , InvestlgatiomFee, v ='.�,�-- $0.00 Plan Check Fee - 50.00 NOTICE: The work authorized by this permit shall comply with all applicable hantlicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work Is not commenced within 180 days, or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authoAzed under this permit to be considered legal, such work must comply with ali applicable codes, end all requlred Inapectione and final approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 [OC6-06(6�p0) WORKERS'COMPENSArON DECLAAArON: ' I hereby effirm under penalry oi perjury one ot the tollowing declawtions: � I heve end will meintein e cenificaie of consent to self-Insure lor workers' compensation, es provided for by section 3700 of ihe Lebor Coda, lor the pertortnanca of the work for which this Oe�� is issued. —� 1 heve end will meintain workers' Wmpensetion insurence, es requlred by sectlon 3700 of tha Lebor Code, for the pedormance of the work fo� which [his pertnit is issued. My wo ers' compens/e�tion Insurence certier end policy number ere: p Ca� �TEi'T�.l b?y��5�-T101J �e F�n QS1icr��mLer, o�i (p ' � � ��i 0�zQ`F) �(7fi/s sec0on need not be cromp/eted il the pem�it is velued et one huntlred dollars ($ �00) or less.) ❑ I certity that in the pertortnence of the work for whlch Ihis Oe�it is issued, I shall not employ eny peroon in any manner so as to becroma su6�ect to the workers' compensetion lews of CeliFomla, B�d ree Ihat il I should become sub�ecl to ihe workers' compensatlon provislons of Section 3700 01 tha Lebor Gode, 1 shall forthwit� comply with ihese provisions. ` L/ /� ��nt�Si9neNre: �y ��ata'-�_ ? ��-7 �� WARNING: FAILURE TO SECURE WORNEP$' COMPENSATION COVERAOE IS UNLAWFUL AND SHALL SUBJECT qN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TqUSAND DOLLARE (5100,000), IN ADDITIO�'1 TOTNE CO5T OF COMPENSATION, DAMFpES AS PRpVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATfORNEI"S FEES. LICENSED CONTRqCTORS DECLARA710N: I hereby eRirtn Ihatl.am licensed der provisions ot Chepter 9(commencing wllh Section 7000) oi Division 3 01 t e.Busines� ntl Professions Cotle, antl my license is in lull iarce entl eBect. Lic Y..%� % �g.p d(J / Q ContrectoCS.SignaLtore: � � D�?- 4-19-dS � CONSTAUCTION LENDING AGENCV: ❑ I here6y aXirm ihet there is a construction lentling egency for the DeAormence ot Ihe work br which Ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Atltlress: Signature: OWNER-BUILDER DECLARATONS: Date: I �ereby aRirtn thel undar penelry ot parjury Ihat I em E%EMPT FROM TME CON7RACTORS LICENSE LAW lor Ihe lollowing reason (SecJ031.5, Business antl Professlons Code: Any ciry or county which requires a pertnit to construct, elter, improve, demolish, or repeir eny strucNre, Drior to its issuance, also requires ihe appliwrrt for such permit to file e signed statement that he or she is Iicensad pursuant ro the provisions ol the Contrecbrs License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of ihe Busin85s end Profeuions Code) or thal �e or s�e is exempt Iheretrom end Ihe besis tor the ellaged axemption. Any violation of Section 7031.5 by any applicant lor a partnit su6jecis the epplicent to e civil penelty o� nol more Ihen five hundred dollers ($500).): ❑ I, as owner oi the properry, or my Bmployeas wlih wegas es Ihelr sole compensetlon, WILL DO THE WORK, and Ihe strucWre is not interMeE or oflered for sale (Sec. 7044, Business and Professlons Gada: The Contractors License Lew does not apply to an owner of properry who builtls or improves thereon, and w�o does such work himselt or herself or Ihrough his or her own employees, provided ihet such improvements ere not intentled or offered for sale. If, however, the builtling or improvement is sold within ona year of completion, the owner-builder will have fhe burden oi proving �hat he or she ditl not 6uild or improve for purpose of sale.). ❑ I, as owner of the properry, am E%CLUSIVELY CONTRACTING WRH LICENSED CONTRACTORS to constmct the project (Sec. 7044, 8usiness antl Protessions Gotle: The contrectors License Lew tloes not eppty �o an owner ol property who builtls or improves thereon, antl w0o contracis lor such p�oject wi�h a conlracior(s) license pursuaM to t�e Contractor5 License Laws.). ❑ I em exempt under sec. Signaiure: Owner ID venfied by drivers licanse. ❑ Ves ❑ No Business antl Professions Coda br this reason: Venficetion oi Ownarship by (rype oi tlacument, i.e. - pmpeM �a: bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION: Driver's License No. Date: Expires: ❑ I �ereby canify that no ascavation five (5) or more teet in tlept� into which e person Is requlretl to tlescend, will be made in connectian with work authonzed by this pertnit, end I�at no building siructu�e, scaHolding, talsework, or tlemolition or dlsmantling thereof, will Oe mo�e than thirty-six (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitomia Administratrve Code). ❑ As owner-builder, 1 will not employ enyone to do wark which would requlre e permit Irom the Division ot Indusirial Safery, as noted above, unless such person has a pertnit to do such wark trom t�e tlihsion. ' SignaWre: Date: Division ot Industnal Safery Pertnit Number. CER7IFlCATE OF COMPLIANCE AND AlliMORVA710N OF ENTAY: I cenity un0er penalry ol porjury ihal I have read this epplication and state t�at tha inlortnation given is corred. I egree to comply with all stete lews entl ciry ordn�nGes�relating to bullding constmclion, end authorize rep�esen�atives ot Ihe City ol Costa Mesa to enter upon lhe above-described Oropeny lor i spection puryoses.�prae'not to wcupy or allow occupency of eny building aulhorizod by this permit until linal inspemion. � j: �-�s' .t,.�-L�---Z-.r+--' I' "re� � el wner(s) �(��I�� - .qWho�i�BdAppllcam (�Onle'."'�` . CQOF I. INBPECTIONTYPE QdIE INTRIALS 1616 Fixetl System Final Fira Preven�ion 1266 200 201 202 203 Pool Spe Finel Finel Re�Roof Flnal BIacWRetaining Well Final Femory Fire Place Finel SIBn 204 Finel Demolltion CODE 1 IN9PECTION TYPE 206 Finel Mechnnical 20B Finel Plumbing 210 Flnel Eleclrlcal 212 Flnel Flre Prevenlion 220 Flnel Plenninq Approval 222 Finel Slle 250 Finel Building/Occupancy �E � er, �i�� r ' ' R i (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�.�LDING PERMIT n FAIF DRIVE, GOSTA MESA, GA 92626 JobAddress: 3180 PULLMAN ST Suite: Vicinity: Parcel Number: 42707101 App�icant: ORSI GARCIA Address: Owner. O�EN COMMERCIAL REALTY Addres5 �ENCUMBRANCE I CORPORATION - NEWFORT BEACH, CA , , 7 CORPOR4TE-PLAZA Contractor: � . Address Zip: Arch : Address: Zoning: Phone: 774-241-9400x216 ZiP: Phone: � Zip: 92660 Phone:� License: Eng: Address> Status: ISSUED Applied: 02/O6/2001 Issued: 02/16/2001 ISSUED BY: � � . ' � Pbone: . � . . Phone: � " Zip: � � License: License: � - � - SCOPE OF PERMIT - � INSTAL4 STORAGE RACKS IN EXISTING STORAGE AREA FOR "INSEATSOLUTIONS". � ' , Plan Check: • Permit: SMIP Res: SMIP Com:. Other: Inspection: \ Total: $45.01 $69.25 $0.00 $0.50 $0.00 $0.00 $114.76 FEE SUMMARY " Calc Valuation: � � , Claim Valuation: SETBACKS ' '� � � � '� MAIN STRUCTURE Front . 0- 0 �Rear � 0- 0 ACCESSORY Front 0�0 , Rear 0- 0 PARKING exis�inq: . o `, �Required: " o NOTES: : , ' ,�: �� • � ; �" PLANNING & ZONING � �,. � ;, , Lek 0-0 � " �Right';�0-0�: � � Left 0-0 - Right�� .�0-0-� Proposed: 0 � s2,000.00 s2,000:oo NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis untler California statutes and related regulations. (Ord. No� 92-28, § 7, 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 ot 180 daYs. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codas, and all required inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zane�ae �am� WORKERS'COMPENSATON DECLARAnON: 1 hereby ettirm under penelry of peQury one of Ihe following daGarations: �' , . ❑ I heve entl will malntaln e cenificate oi wnsent to selt-Insure for workers' compensatlon, es pravltleA tor by section 3700 ot the Lebor Cotle, tor the pert¢nence of Ihe wark for which ihi5 permii is issuetl. _ � ❑ 1 have and will maintain woMers' compensation insurence, as required by section 3700 of Ihe Lebor Code, for the paAortnance oi Ihe woAc tor which Ihis permit is issuetl. My workers' compensatlon Insurence carner antl policy number are: Carner: Policy Number: .(T6is sec(ion neetl not be comp/eted i! the permit is valued af one hundred Oollars ($100J or /ess.) ❑ I certity thet in the peAormance ol tha work for which this pertnil is issueQ I shall not employ any person in any manner so as to become subject to lhe workers' wmpensetion lews at Callbmla, end egree Ihat if I shoultl �ecome sub�ect to Ihe workers' compensetion provisions ot Section 3700 oi the Labor Cotle, I shell fonhwlih Comply with these provisions. Applicent Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNUWFUL PND SHALL SUBIEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED T/qUSAND DOILAHE ($100,000), IN ADDITION TO THE COST OF CAMPENSATIpJ, DAMAGES AS PROVIOED FOR IN SECTIOtJ �O6 OF THE IABOR CODE. IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Divislon 3 ot �he Business and Pmfessions Code, end my license is in full lorce entl eHect. Lic. q Class k CoNrectofs SlgnaNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is e construction lending agency for the peAormance of ihe work lor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Neme: Lendels Address: Signatura: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirtn thet under penelry o(peijury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor t�e following reason (Sec. 7031.5, Busineu end Professions Cotle: Any ciry or counry which requires a pe�mit to consWCL alter, improve, tlemWish, or repair any sirucwre, prior to its issuance, alw requires the applicant Por suU pertnit to file a signetl statemern that he w she is licerised pursuant to Ihe provisions of the Contrectors Ucense Lew (Chapter 9(commenpng vrith Sectlon 7000) of Divlsion 3 of Ihe Business end Professions Code) a that he or�she is ezempt theretmm and the besis for the ellepetl exemption. Any violation of Section 7031.5 by eny epplicant for e permit subjects the applicant to e civil penalty of not mo7e than five huntlretl tlollars (5500).): �: ❑ I, as owner of the property, or my employees.with wages es �heir sole compensation, WILL DO TME WORK, and Ihe structure is not intantletl or oNered for sale (Sec. 7044, Business and Protessions Cotle: 7he Connactors License Lew does no! apply to en owner of properry who builds or improves thereon, antl who does such work himselt or herself or ihrough his or her own employees, provitletl that such improvements ere not intentletl or otleretl for sele. If, howaver, Ihe 6uiltling or improvement is a sold within one year of completion, the owner-builder will heve t�e burtlen o� proving ihet he or she did not build or improve for purpose of sele.). .� \ I, es owner oi � rty, em E%CLUSIVELV CONTRACTING WITH LICENSED CON7RACTORS to consimct the project (Sec. 7044, Business end Professions Cotle: The c irac�ors L se Law doas no� apply �o an owner ol property who bulltls or Improves ihereon, and who con�recls lor such project wl�h e con�rac�or(s) license purs an�o tha Cont ctors License Laws.). �❑� �I am exempt se Business and Professions Code tor this reason: /' / e' �— ---� � OwRer ID veritiatl by tlnver's Iltense. �Ves ❑ No �i e� , Venficetion ot Ownership 6y (type of Oocument, i.e. - pwperry tax bill or deed): DIVISION OF INDUSTRIAL SAFEiV PERMIT CERTIFICATION: E:pires: ❑ I hereby certity that no excavalion tive (5) or more feet in dep�h into which a person Is requlred to descend, will be matle in wnnection with work euthodzeU by Ihls permit, antl Iha� no building slructure, scaflolding, falsework, or demolition or tlismantling t�ereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Califomia Atlminis�retive Code). ❑ As owner-Duiltler, I will noI employ anyone to do work which would require e permit from the Division of Industnal Sefery, as noted above, unless such person has a pertnit to do such work trom ihe division. Signature: Date: Divi9ion of Industnal Safety Parmit Number: CERTIFICATE OF COMPLIANCE ANO AUiHORVA710N OF ENTAY:.L�rtity untler penalty of perjury ihat I have read this application and state ihet ihe informetion given is correc�. I agree to comply wit� all sta�e laws end ciry ortlina s rela�ing buitding consimction, and authonze representatives of the City of Costa Mesa lo enter upon the ebove�described propeny for inspection purpases. I agree tno occupy or al w occupency ol eny building authorized by this permit umil final inspection. COUE I, INSPECTIONTYPE 1676 Fixed System Final Fire Prevention 1268 Pool Spe Final 200 Final Re-Foot 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demolition QdIE II�dLi COOE 1 INSPECTION TYVE 206 Final Mechanical 208 Final Plumbing 210 Pinel ElednWl 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy QAg 1t�L5