HomeMy WebLinkAbout2195 CANYON DR - Building Permits(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77�FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
2195 CANYON DR
B
PLUMBING PERMIT
Parcel Nunmber. 42204158 " . "
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Applicant EZPINOZA, AG�USTIN=�`'"�� '
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Address: 1518 ENpEAVOUR PL� "' � '
SUITEA'%�, , AA.���� �- 'Phone:
, ' ANAHEIM. CA ., A �' % �/'- � --� Zip:
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Ownec �STEW�R,:MICHAEL
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.'Address, 1580 SUPERIOR AVENUE
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Status: ISSUED
Applied: 05/05/2005
Issued: OS/OS/2005
ISSUED BY: 1`�' �'�`�--�
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Contractor., ' PMC P�UMBING.CO, �,`_ ..'.�.
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� Address:'; �!1578 ENpEAVOUR PL'� ' ` � �
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REPIPE GAS SYSTEM F.ROM METE
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ISSUE FEE
Backflow irrigalion
Backflow Preventer
Bathtub �� ,
Clarifier System
ConnectQce,Soda,etc)
Dental Units � � �
Dishwasher` �'•
Drain, Floor ����
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (t-4 outlets)
Gas (Over 4 oullets)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
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(714)997-6481 _ , ' •'
92801 � �
735156. - - - .
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OF PERMIT `,';
IVE, WATER HEATER AND FURNACE.
..p'r 1,
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AMT QTY ,AMT ��� QTY �
523.50 - Laundry Tub / Washer �'$0.00 0 �� Sump Pump �
50.00 0 Landscape Irrigation � 50.00 -�0 Swimming Pool�" '�
�$0.00 0 P-Trap $0.00 0 T2p Primer .' .
$0.00 0 Pressure Regulalor ' �� -, 50.00 0 Urinal � �� � ' �
$0.00 0 Process Piping (per 10 N) �$0,00 0 Vacuum.Brkr Bkflow(1-0)
$0.00 � 0 Receptors � �$0.00�,,,0 Vacuum Brkr BkFlow(5+)
$0.00.�'; 0 ,- . SepticTank . ., ' " $0.00;''r;;0;�� �f.:��;k�Wash;Basin -
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� $0.00 ���` �0 '� Sewer Cap for Demo, ' � $0.00 0 � , Wash Basin Set � ,
! E0.00 ,'0� �� `- Sewer Connecl � �'%. 50.00, � 0. �- �-.Waste and,Vent System �
-50.00'�' 0'�`��SewerPri'vateLine � � 50.00 "0��°�,.�%IYVaterClaset�(ioilelj � �
�30.00 %,�0• �- =�Shower� � - - E0.00 ,,0'; ��%`� WalerHeater/vent -
$0.00 ' 0'.;� �Sink,�ba�- � - 50,00'.� 0.��� � �Water,Piping priat or Rep.)
$0.00 � - 0.' � �� $ink, commercial $0.00� 0 Water Re-pipe ,
�$0.00-�� 0��;/� �- Sink;Floor, $0.00��0�. AWaterService'
$0.00- ��`-0 �- � " Sink,-kitchen , � � �- :�-$O.00.I-� 01 � \ �� Watei Softener
$0.00� �� -'0 �� `� � �� Sink, seryice7mop " ; i ., � $0.00 C-0 ��� -�;OTHER'
$9.80 �1 , � . Spa (pnvate) ��.' . � �„ $0.00- "JO � � .- �'VIOIATION
50.00 0 � � Spa(public) 30.00-,��O�C�"'_'-�" PLANCHECK
30.00 0 - - „_ �- v , "��"� � " REINSPECTION
ao.00 o - . - -- - " �-
AMT
$0.00
-$0.00
$0.00
$0.00
50.00
$0.00
'� $0.00
$0.00
/ $0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 533.30
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized hy this �permlt shall comply with all appiicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: -This pertnit shall automatirally axpire erW become void if work is not commenced wlthin�180 days, or if xrork is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In order torthe work authorized under this permit to be consideretl legal, such xrork must compty with all applicable codes, and all
required Inapeetlana and llna! approval musi be obiatrted. Failure to obtain InspecCions artd final approva! wilf resWi in the expiratton ot this pertnit.
FOR INSPECTIONS CALL: (714) 754.5626
[wwo lawl
WORKERS'COMPENSAnON DECLARATON: � �
I hareby eHirtn under penelty ol perjury one af the following declarations: ;" • � � ' . '
❑ I heve entl wlll maintein a certificate of consent to selt-Insure tor workers'� compensetion, es provitletl br by section 3700 ot the Lebor Cotle, for the pertormance of ihe
�worN�fdj which �his perml� Is issued. ' � � .
❑ 1 ceniy that in tha
compensetlon law
compty wit� t�ese
�
workers' campensetlon Insurence, es raqulretl Dy section 3700 oi Ihe Lebor Codo, for the pertortnance W t�e vroM lor whlch this pertnll is issuetl'
'Jon In,w rance carrler antl poll number ere: � ^
; Lvv�h-cY`Sr��.�-� ��.5. rorc�yN 3 �9C/J �,�i
nplefed i/ Ne rml( Is velued et one hundred doflers (S I00) or less.) �
ot �he
w aoomoN
LICENSED COHTAACTORS DECLMAT
I hereby aNirm ipaLl.emJicen d un r pp
torce end�ettect. uc.y. J �
C sgnet�re:"7�
I
CONSTAUCTION LENDI AGENCY: �
❑ I hereby efllrtn t�at Ihere is e conslru
Lentlefs Neme:
SlgnaNre:
Idi whic is permit is issue4 �I shall not employ any person in eny manner so es to becorima sub�ect to Ihe workers' '
that It ould become sub�ect to Ne wwkers' compensetlon provisions of SecUon 3700 of Ihe LeDor Cade, I shall forthwith
I�,,,.--� �5 = S— O 5
S IXJ GE IS UMAWFUL M1D SHALL SUBIECT AN EMPLt�YER�Q'CRIMINAL PENALTIES AND CML FlNES UP TO ONE MUNDRED
T OF ENS4TON, UAMAGES /S PROVIDED FOR IN SECfIIXJ 3lOfiOF THE UBOR CODE, IMEREST, M!D ATTORNE`/'S FEES.
3 of Chepter 9(wmmenGng with Section 7000) ot DlWsion 3 of the Business anQProf�ons Cotle, antl my Ilcense is in full
Cless a C
_ Daie: _ T" S — o .7
Ientlinp agency tor the peAortnance of the work tor which this permit is issued. (Sec. 3097, Civil COUe).
Lendefs Address:
Date:
OWNER-BUILDER DECLARATONS:
I hereby afflrm t�at under penelry ol perjury Nel I em EXEMP7 FROM TME CONTRACTORS LICENSE LAW tor Ihe lollowing reason (Sec. 7031.5, Buslness entl Professlons
Cotlo: Any ciry or wunry which requires a permit to consiruct, eller, Improve, demolish, or repeir any atmcNre, prior to Its iuuance, elso requires the epplicant lor suc� pertnit
ta file e signed stetement that he or s�e Is Ilcensed purauent to the pwNslons ot t�e Contrectors License Lnw (C�epter 9(wmmencing with Sectlon 7000) 01 Didsion 3 of the
Business enC Protessians Code) or ihet ha or she is esempt Ihereiram antl the basis lor che alleped exemptlon. Any vloletlon of Sectlon 7037.5 by eny ep011cant for e pertnit
subJects the epplicent lo e civll penelry of nol mare then live hundretl Collars ($500).):
❑ I, es owner of t�e properly, or my employees wllh wages es their sole compensellon, WILL DO TME WORK, antl t�e structura Is not intendatl or atleratl tor sale (Sec.
7044, Business end Professions Cotle: The Coniractoro License Lew daes not epply to an owner of properly who 6ullds or improves thereon, flnd who does such work
himsell or hersell or Ihrough his or har own employees, proNded that such imprrnements are nol Intentled or oHered for sale. II, howeveq the bullding or Improvement is
sold wilhin one year of wmpletion, the ownar-builtler will have the burden of proving Ihat he or sha tli0 not builtl or improve tor purpose oi sale.). �
❑ I, as owner ot the properry, am E%CLUSIVELY CONTRACTNG WITH UCENSED CON7RACTORS to construct the pmject (Sec. 7044, Business and Professions
Cotle: The contrectors license Lew does not epply to en owner ot properry w�o builtls or Improves thereon, and who contrects for such pro�ect wilh a contrector(s)
license pursuent Io the Coniractors Licen50 LewSJ. ,
❑ I em exempt under sec. Business end Pmfessions Code for Ihis reeson:
Signeture: Da2e:
Owner ID veAiletl by tlrivefs license. ❑ Yes ❑ No Drivefs Ucense No.
Vedlicatian of Ownership 6y (rype of document, I.e. � property la�c �III or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION:
Expires:
❑ I hereby cenify Ihat no excevetion five (5) or more teel in depih into which e person Is requlred to descend, wlll be made in connectlon with work euthorized by Ihis
permi�, end thel no building siructure, sCafloltling, telsowork, or tlemolition or dismantling Ihereol, wlll be more ihan �hiAy-six (36) leet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title B, Celifomla AAminlsiretive Code�.
❑ As owner-builder, I will not employ enyone to do work w�ich would require e pertnit Irom the DlWsion of Industrial Satery, as noted above, unless such person hes e
permil to tlo such work Irom �he tlivision.
Signature: Date:
Division o1 Indusirial Safery Pefmit Num6er:
CERTFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENfAY: I certiy under penalry ol per�ury t�at I heve reed this epplicatian end state ihat Ihe intortnation given is
coneCt. I agree to mmply with ell stete lews end clty orAlnences relating to huiltling construction, entl authodze representatives ot Iha Clry oi Costa Mesa to enter upon Ihe
ebove-descAbetl O�rtY �or inspectlon purposes. I agree not to oaupy w ellow occuDenry al eny building eut�arized by ihis permit unlil linal inspection.
CODE t.
1616
1266
200
�fixetl Systam Final Fir�F'r
Pool Spa Final
Final RaRoot
201 FIne181acWRelaining Well
202 Finel Fectary Fre Place
203 Final Sign
20C Final Demditian
Q�lE � . . . �.
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COOE� INSPECTIONTYPE
206 Finel Mechanical
20B Finel Plumbing
210 Final Electrical
212 Final Fire Prevention
220 �Final�Planning Appmval
222 Final Site
250 Finel Bullding/Occupanry
PA7E 1[�1�LS.
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