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Home My WebLink About413 BRYSON SPRINGS - Building Permits' � CITY OF COSTA MESA � BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE: B_COMBO Sub Type: RES_ALT JOB ADDRESS: 413 BRYSON APN: 93786048 Vicinily: KITCHEN Const Type: V-B SCOPE OF WORK: MINOR REPLACE 6 LIGHT FIXTS F OWNER: N CA Phone: APPLICANT: B Phone: 9 CONTRACTOR: Phone: Cell: ARCHITECT: ENGINEER: ��' � . "� ,. .. Zoni�ng �'.". � � � ,,:« ,� , PERMIT NUMBER: BC08-00138 STATUS: DATE ISSUED: ' � ISSUED BY: .'< x,.;.�' p ,. � �rimary Occ , �'f;':r�k�.. ..p:��: ;:Z t�.�' ; � ISSUED 04/02/2008 RMD N.REMODEL TO REPAIR/REPLACE DROP CEICINGLII ALTER DUCTING, VD�2�OUTLETS AND DRYWALL WORK ,�> �, �-"��+ � F I ljvl �RJORI�E=STOVALL TR Address: ,%MELTON, RENA M �`- ��' UniL COSTA MESA, . ;, : . ..y:' :' . , � - �.1 �`3 t ,a ' r'Cdy/,Stete/Zip: '413�BRYSON SPRINGS - � �� .`ai' r . —" .- — r:-. � __ , BRETT � °� t .' � Address '�,� � � ` Unit: 537 � .,�t' ��City/State/zZip: _ - , A "y�� 5 �I' : .4 ... .. , .. . _ .. . . . NER BUILDER . ' " License No: 000000 ,,- - 'l �.;ti ,�;'-; Address: Unit: � "` � � - � _� .City/St2te:' - • - -- .. . � .. �� ZipCode _ , e�' _ _ — _ _ _. . ----- _ :��4 ,-,t � License No. ., � PHONEi r ;; �:� ' License No. - . "-- ".. -PHONE:� I PERMIT FEE :SUMMARY,�:, �' , ` Building Plan Check: �:, �� ,- $000;`'.- � -. � Building Fees: ,��,a i"$23.50 '��.. Eleclrical Fees: $32,30 Mechanical Fees: _ .�.. $37 20 ��: •. , � . " . _ ',. : , ..:. , ,, . , ._, _ ... Plumbing Fees , $0.00 � - " � � ` SMIP Residential: a '= $0:50 ��-' -'� : � - SMIP Commercial: ^' �� $0.00 ' � ." _„ . TOTAL FEES: �$83:50;--:__. . ,- _ . ^Re(er to fee receipts for all fees paitl /or pmject 4-� �� ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under this permit to be wnsidered legal, such work must comply with all applicable codes, and all required inspeetions and final approval must be oblained. Failure to oblain inspections and fnal approval will result in the expiretion of this permit. COOE/, INSPEC710NTYPE 1816 Fized System Final Fire Prevenlion 1266 Pool Spa Final 200 Final Re-Roof 207 Final BIocWRetaining Wall 202 Final Fadory Fire Place 203 Final Sign 204 Final Demolition DATE IN7IliALS LOUEO INSPEC710NTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/OccuOancy D�TF NTIM WORKBRS' COMPENSA710N DECLARATION: + I hereby aff rm untler penalty of peryury one of ihe following declarations: ❑ I have and will mainlain a certilcate of consent to self-Insure for vrorkers' compensation, as provided for by section 3700 of the Labor Code, for the pertortnance of the vrork for which ihis permit is issued. ❑ I have and will maintain workers' compensation insurance. as required by sectbn 3700 of the Labor Code, for the peRortnance of the v,ork for which this pertnit is issued. My vrorkers' compensation Insurance carrier and policy number are: Cartier. (Thu secYion neetl rrof be mmplefetl Mfhe peimfi is relue0 al one hunOretl Policy Number: ��I"certify that in [he peAormance 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 vrorkers' compensation laws of Califomia, and agree that it I should become subject to the workers' compensation provisions of Section 3700 oF th�6 Cotle, I ShHI Or with c ply wi�h IheSe provi5ion5. �-z - o �' / Appli s i9naWr Dale ._. �_.-9- _ WARNING: FAILURE TO S CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT 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 LABOR CODE, INTEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn tha[ I am licensed under provisions of Chapter 9(commencing with Seclion 7000) of Division 3 of the Business and Pro�essions Code, and my license is in full force and eHect. Lic. # Class # Conirador's SignaWre oa�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm [hat there is a consWc[ion lending agency for the peRormance of the xork fa which this pertnit is'ssued (Sec. 3097, Civil Cotle). Lender'S Name: Lender's Adtlress: SignaWre Date OWNER-BUILDER DECLARATIONS: I hereby affirm that untler penally o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or ihe 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 s[ructure, pnor to its issuance, also requires the appliwnt for such pertnit to file a signed statement Ihat he or she is licensetl pursuant to the provisions of the Contractors License Law (Chapter 9(wmmencing with Section 7000) o( Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for Ihe alleged exemption. Any violation of Section 7031.5 by any applicanl for a pertnit subjects the applicant to a civil penalry o( not more than five hundred dollars ($500).): � . I� as owner of ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the siructure is not intended or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of property who builtls or improves thereon, antl who does such vrork himself or herself or through his or her ovm 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 burtlen of proving that he or she ditl not builtl or improve for purpose of sale.). ' ❑ I, as owner ot the property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professbns Code: The contractas License Law dces not apply to an owner o! property who builds or improves Ihereon, and who cont2cts for such project with a contractor(s) license pursuant ro the Coniractas License Laws.). , . , � Owner ID verified by driver's I� Y ❑ No Diiver.'s License No. � '� Eicpires: � Z �Z �a Verification of Ownership by (type o( document, i.e. - property tax bill or deed): .. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � - � ❑ I hereby certify lhat no excavatbn frve (5) or more (eet in depth into�which a person is required to tlescentl, will be made in connectbn vrith v.ork auttarized by this pertnit, antl that no building struc[u2, scaf(dtling, falsev.ork, or demolition or dismantling thereof, will be more than ihirty-six (36) fee[ high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administ2tive Code�. ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of IndusMal Safety, as noted above, unless such person has a permit to do such vrork from the tlivision. Applicanfs SignaWre Dale Division of Intlusinal Sa(e[y Permi[ Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: t. Will the applicant or present or (uture building occupant need to file and certify a Business Plan for emergency response to release or ihreatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, wilh some exceptions, that a Business Plan be fled with the Costa Mesa Fire DepaAment by every business which has at any one time tluring a reported year a quantity of hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic (eet ot compressed gas at standard tempe2ture antl pressure). 2. Does or will the appliwnt or present or future building occupant neetl to file a registration form for awlely hazartlous materials? ❑ Yes ❑ No (Section 25533 of Ihe Califomia Health antl Safery Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one [ime has on �and a quantity of acutely hazardous matenals equal [o or grealer than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will t�e applicant or present or tuture builtling occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Sec[ion 25534 01 the Cali(omia Health an0 Safery Code provitles that the Costa Mesa Fire Department may require the preparation, certification and filing wi[h [he Fire Department of an RMPP by businesses which are required to register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Sately Code been (ully complietl with7 ❑ Yes ❑ No 5. Does or will ihe applicant or present or fulure builtling occupant require for the work which is the subject of [his application a permit (or such wnstruction or modifcation (rom lhe Soulh Coast Air Qualily Manaqement DistricCor from any other air polWtion control district or agency? ❑ Ves ❑ No (Section 658502 of Ihe Califomia Govemment Code requires [hat the requested information be fumished on applications fa rron-residential building permits�. 6. Will any pan of the faciliry to be wnstructed under this permit be within 1000 feet irom lhe outer boundaries of a school? ❑ Yes ❑ No Qf yes", the facilily must meel lhe requiremenl o( Sections 25534 and 42303 of the California Health antl Safery Code). 7. If a permi� from ihe South Coast Air �uali�y Managemant Dis[rict or other air pollution conirol district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Heallh antl Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (I('yes", attach certi(cate of wmpliance from ihe appropriate air pollution� control officer). � � � CERTIFICATE OF COMPLIANCE: I ceRify Ihat under penalty of peryury lhe. information qiven above is correct. I agree to comply with all state lavrs and city ordinances regarding Hazardous Materials and Emissions. � ' CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF.ENTRY: I certify under penalty of perjury that I have read this application and state that ❑ I am exemp� under sec. Ihe information given is correct 1 agree to comply with all s[ate lavrs and ci[y ordinances relating to building wnstruction, and authorize representatives of Business antl Pro(essions Code for lhis reason: the City o( Costa Mesa to enter upon [he above-descnbed property for � inspection purposes. I agree not to occupy or allow occupancy of any buildinq "� authorized by [his permi[ until final inspec[ion. /^ y ^� • Sign re of Owneqs) Da1e ai r � i -_oate (�—L ��. 305]-46(3/01) � T— q - n0/or p� E pPiiq 1 Da�e / �� —' _" CITY OF COSTA MESA BIIILDING DIYISION 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • vnvw.ci.cosia-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: P08-00094 PERMIT TYPE PLUM 5�� STATUS: ISSUED APN: 93786048 �� L.,^ ID C DATE ISSUED: 04/02/2008 �' ISSUED BY: RMD ORZE.,f;. ''. �t_ , � : :�:--. JOB ADDRESS: 413 BRYSON-SRRINGS CM .'' Suite/Unit: ` Vicinity: KITCHEN , �sk" �' `� - � ". . - ,� /- f.: - � r. - �- . ', .\ . SCOPE OF WORK: OWNER: PHONE: APPIICANT: PHONE: �ELOCATE A DISHWASHER, STOVE 1-4 OUT�ETS AND REPLACE KITCHEN SINK. qa�: � T: � TR Address: %MELTON,tRENA M' COSTA MESA, CA -Ct /St t /Z' ' � 413 BRYSON SPRINGS '' � ��; _. :ts'�. .-. _ . . i y a e ip. .. . , � BEASLEY, BRETT ; :'� - . � ". � Address: � . � � "-.735•1537 �. � �.�� ; � � ' ' . - CitylStatelzZip: ' . !,: � `:F . .. � OWNER,BUILD�R' � License No. �000000 . �' - "r,_�-i- . .. `�PHONE: � ' . :`r - CONTRACTOR; Address: Ciry/State: ARCHITECT: ENGINEER: j,.'• ��! ZipCode` " � � � . -� � CELL: ' � ,: , -. . . . . ', `,1 S. _ _ , . .. - _ License No. , !,�,, . .- Licen`se.No.� '.. � � : � '.�X� 1_, , i " . :t i. � , � PLUMBING PERMIT FEE SUMMARY. � . � � PLAN;CHECK PEE: . - $0.00 � �; PERMIT FEE ':. $49.25 , ' , '" � , TOTAL FEES:. .. . - -$49.25 _ r. .. . . � PHONE:, � PHONE: ' f. NOTICE: The vrork authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28. § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must comply vrith 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 ot this permit. OC DEI. IXSGECTIONTYPE 1816 Fixed System Final Fi2 Prevention 1288 Pool SOa Final . 200 Final Re-Roof 201 Final BIocWReWining Wall 202 Final Factory Fira Place 203 Final Si9n 204 Final Dertwlition DRTE INT171RL5 SODEt INSPEGiIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Eleciriwl 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilaing/Occupancy o� ixmuis WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalty of perjury one of the tollowing declarations: ❑ I have and will maintain a certificate of wnsent to self-Insure for workers' compensation, as providetl for by section 3700 of the Labor Code, for the peRortnance of lhe work for which this permit is issuetl. ❑ I have and vrill maintain v.orkers' compensation insurance, as required by sectbn 3700 0� the Labor Code, for the peAortnanca of the vrork for which this permit i5 i55ued. My workers' compensation Insurance carrier and policy number are: Cartier: (Th4 mSim neetl nol eo mmpefee atlie permd a valued at me nurrdietl dodarslEfo01 arkss ) Policy Number: � � I�certify that in the peRormance of the work for which this permit is IssueC, I shall not employ any person in any manner so as to become subject to t�e vrorkers' compensation laws of Califomia, antl agree Nat if I should become SuDject to the workers' tompensation provisions of Seclion 3700 0� the L ode, 1 shall foAhwith comply with these provisions. t/ " z - o�' plipnt' Dale G- WARNING: FAILURE TO SECUR 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 ADDff10N 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 affirtn iha[ 1 am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pro�essions Code, antl my license is in full force and effect. Lic. # Class # CanVatla's SipnaWre CONSTRUCTION LENDING AGENCV: ❑ I hereby affum lhat there is a constnicfion lending agency fw lhe peAarmance M the xwk la which tlris permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lentlef'S Atldre55: OWNER-BUILDER DECLARATIONS: I hereDy affirm lhat untler penal[y of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or the tollovring reason (Sec. 7031.5, Business an0 Professions Gode: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior m 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 Protessions Code) or that he or she is ezempt therefrom and ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicanl for a permit subjects the applicant to a civil penalry of nol more than fve hundred dollars ($500).): ,[a; .I, as ovmer of the property, or my employees with v,ages as their sole 'compensation, WILL DO THE WORK, and the structure is not intended or oflered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an ovmer of property who builds or improves ihereon, and who does such work himself or hersel( or through his or her own employees, provided that such improvemenis are not intended or offered for sale. If, however, the builtling or improvement is sold wilhin one year of completion, the owner-builder will have lhe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LJCENSED CONTRACTORS lo constmct lhe project (Sec. 7044. Business antl Professions Code: The contractors License Law dces rrot appty to an owner of property who builds or improves thereon, and wfio conVacts fw suc� project with a cmtractor(s) license pursuant ro the Contractors License Laws.). ❑ I am exempt under sec. 8usiness antl Pro(essions Code for lhis reason: y- Z rp�'' 'SiB�� re ' ;.-Dale DOSld6 (YOI) ' Owner ID venfietl by driver's licen. , Y ❑ No Driver's License No. � Expires: /Z /Z /O Verifwlion of Ovmership by (rype 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 descentl, will be made in connection with work authorized by this permit, antl that no building structure, scaffdding, falseaork, or demolition or dismantlinq thereof, will be more llian ihirty-sa (36) teet high. �Chap. 3.2, Grp 2. M 2. Sec. 341, Title 8, Califomia Administra[ive Code). ❑ As ownerbuiltler, I will not employ anyone to tlo work which would require a permit from the Division of Industnal Safery, as notetl above, unless such person has a permil lo do such work from the division. AOPliwnl's SignaWre Dale Oivision of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: t. Will the applicant or present or future builtling occupant need b file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health antl Sa(ety Code requires, with some exceptions, that a Business Plan Ge filed with the Costa Mesa Fire Department by every business which has at any one time during a reporletl year a quanlily of hazardous ma[erials equal to or greater [han a v+eight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet ot compressetl gas at standartl lemperature antl pressure). 2. Does or wiu the applicant or present or luture building occupant need lo fle a registralion form for acutely hazardous matenals7 ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, wilh some exceptions, requires registration with the Costa Mesa Fire DepaAment by each business which al any one time has on hand a quantity of acutely hazardous materials equal to or greater [han a vreight of 500 pounds, or a volume ot 55 gallons, or 200 cubic teet of compressed gas at standard temperaWre antl pressure). 3. Does or will the applicant or presenl or future building occupant neetl to prepare an RMPP (Risk Management and Preventlon Progrem for acutely hazardous materials�? ❑ Yes ❑ No (Section 25534 of ihe Califomia Health and Safety Code provitles ihat ihe Cosla Mesa Fire Depanment may require [he preparation, certifiwtion and filing vrith the Fire Department of an RMPP by businesses which are required to register aculely haz2rdous materials with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 af the Califomia Health and Safety Code been fully complietl vnth? ❑ Yes ❑ No 5. Dces or will the appliwnt or present or (uWre builtling occupant require for lhe work which is Iha subject of this application a pertnit (or such wnstr�ction Or mOdifiCalion from Ne SoUlh Coasl Air Qualiry Management DiSlrict or from any other air pollution control disirict or agency? ❑ Yes ❑ No (Sectbn 658502 of ihe Cali(omia Govammen[ Code requires thal Ue requesled infortnation be fumishetl on applications for rqn-resitlential building pertnits). 6. Will any part of the (acility to be cons[ruc[ed under this pertnil be vrithin 1000 (eel from Ihe outer boundanes of a school7 ❑ Yes ❑ No (If'yes". Ihe lacility must meet the requiremen[ o( Seclions 25534 antl 42303 of the California Health and Sa(ety Code). 7. If a pertnit from the South Coast Air Quality Management DiSMcI or other air pollution control distncl or agency is required for ihe wnrk which is the subject of lhis application, have all ot the disclosures prescribed by Califomia Health and Safety Code Section 42303 been matle't ❑ Ves ❑ No 8. Qf'yes", atlach certifcate of compliance tmm the appropnale air polWtion. control oKcer�. � � � CERTIFICATE OF COMPLIANCE: I certify that under penalty of peryury the infortnation given above is cortect. I a9ree to comply vrith all state laws and city ordinances regarding Hazartlous Matenals and Emissions. , $ign2lure �ale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty o( perjury Ihat I have read this application and s[ale ihal the information given is correct. I agree to wmply wilh all slate laws and city orEinances relaling to building construction, and authorize representatives of Ihe City of Costa Mesa to enter upon the above-described properry for insDection purposes. I agree not [o occupy or allow occupancy of any building authonzetl by I�is pertnit until final inspection. 5'gn eqs) Da�e y-z -ol ( n /orAul�o z pplit'ant � .Dd1G (77a) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.cBaUILDING PERMIT �� FAIA DRIVE, COSTA MESA, CA 92626 Job Address: 413 BRYSON SPRINGS Suite: Vicinity: 413-423 Parcel Number: 93786048 Zoning: npp�icant: BATIOFF,JOHN AddreSS: 17182 ARMSTRONG AV � - . . _ � . . ' Phone: (949) 852-9955 IRVINE, CA Zip: 92614 Owner: BRIGHTON SPRINGS HOA Address 412 BRIGHTON SP ' COSTA MESA, CA Phone: C.M,CA Zip' 92627 Contractor: DAVEY ROOFING INC Address: 17182 ARMSTRONG AV IRVINE, CA 2ip: 92614 Arch : Address: Phone: Zip: � License: Phone: (949) 852-9955 License: � 700710 Eng: Address: Status: ISSUED Applied: 04/23/2001 Issued: 04/23/2001 ISSUED BY: �/Y� Phone: License: TEAR OFF CEDAR SHAKE INSTALL-30 LBS FELT REROOF 21 SQ W/40 YR COMP. SHINGLES AND 51 SQ W/BUR. Plan Check: , Permit: SMIP Res: SMIP Com: Other: Inspection: ,- Total: $0.00 $125.25 $0.55 $0.00 $0.00 $0.00 $125:80 � FEE SUMMARY : , --- -- ' " - - = Calc Valuatiorc — - � � - %� � ` �Claim Valuation: ,�' �: . //' � - � _ _ � %/�i; . . ��', ' '_ , �j ,i ' _, �; � . �•` � �/ , '^ =�' •',_-=_ ` � o , � '� �/ `��A\� � i - � � PLANNING-B ZONING- r �% ' �j �� i ', SETBACKS � % �i � ��V� .'� ,, , .� „ ,�j%�� : �� /'.,�, �; i, i �� -�_� , � f-%/ /. �A �` .J MAINSTRUCTURE�Front` 0-'0 � Rear 0-0 � . Left 0•0 �' Right 0.0� , �� ' � � / ` _ - - - - , . / „ './ � �.,, � --V �� G i ACCESSORY Front ..=0-0 �� , ,� Rear, 0-0 . Left 0-0 . ', � RighL � 0-0-:�� .� . ,_ � � � .'i,- _, - �, , ' � � , � : � . PARKING Existina: '-b;��,'��..Reauired: 0- `� Pr000sed:, :p�' i; J;' ,- NOTES: -- . � . - , ;, i,[.> , , . . ,. _ %.�- . 35,a77.00 $5,471.00 ' ;. '�� , NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically eXpire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 1 BO 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 I required Inspectlo�s and finel approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: Q14) 7545626 I zue�e leroo) WORKERS'COMPENSAnON DECLARAnON: � I heraty attirm untler penalry of per�ury one oi the lollowing declaretions: ❑ I have and wlll mainteln a certificate at consent to self-Insure lar workers' compensation, es provideC tor by section 3700 of Ihe Lebor Code, for the pertortnance of Ihe work for which ihis permlt is Issued. :D�jl have end will maintain workers' compensatlon insurence, as required by seqion 3700 of Ihe Lebor Code, for the perlormance ol Ihe work for which Nis pertnit Is Issuetl. My workers/' �om�p�e�ns�etlo�n Insu(�°� cerri Ilcx number are: . Carrier. pcWU!/� • `Y Al'1/� PolicyNumber: � �QC7��)�l (This secNon neetl not be canpleted i! the permiNs velued et ane huntlretl tlollers ($100) or less.) ❑ 1 certity Ihat in the peAormance oi the work for which this permit is issued, I shell not employ eny parson in any manner so es to become subject to t�e workers' compensetion laws of Califomie, and agree that tl I ahould become sub�ect to �he workers' compansation provlslons of Sectlon 3700 oi tha Labor Coae, I shell tort�with comply with Ihese provision�� p��_ �+ � /1 Ap�� pSigneture: cT\ \ �'�-Rl\ lDate: "1"r2��V I �WARNINO:FAILURETOSECUREWOR 'COMPEN TIqJCAVEfiAGEISUNL4WFULANOSHQLSUBIECT'AN'EMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOqJEHUNORED THIXISPNO DOLLARE (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DMMGES 0.5 PROVIDED FOR IN SECTION 3108 OF THE tABOR COOE, IMEFEST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm:ihaPPam licensed under provisions of Chapter 9(commencing with Snction 7000) ol Olvislon 3 ot the Businass and Pr ess�i yns Cotle, end my license Is in full torce ana eXect. Lic. a �%�� %� �J Class x C�`I Conir��s Signature: �_ j ete: '2 „ � ��, �r CONSTRUCTION LENDING AGENCY: ❑ I �ereby attirm ihet there is e construction lending egency for ihe Dertormence ol lhe work tor which this permit is issued. (Sec. 3097, Civll Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm thet untler penelry of per�ury thet I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or wunry which requires a pertnit to consiruct, fllter, Improve, tlemolish, or repair any structure, pnor to its issuance, elso requires the epplicant for such permit ro iile a signetl stetement ihet he or she Is Ilcensed pursuant to the provislons of the Contractore License Lew (Chepter e(cammencing wlth Sectlan 7000) of Didslon 3 of the Business antl Prolessions Cotle) or that he or s�e Is exempt therelran end the besis far Ihe ellegetl exemption. Any violation af Section 7031.5 by eny aOP�icant for a pertnit subjecis ihe appllcaN to a clvil penalry o� not more than five hundred dollers ($500).): ❑ I, es owner of Ihe property, or my employees with wages as t�eir sole compensation, WILL DO 7HE WORK, and t�e siructure Is not Intended or oNered lor sale (Sec. 7044, Busineu end Professlons Cotle: The Cantrectors License Law does nat epply to an owner oi property who builds ar improves thereon, and who Coes such work himself or hereelf or throug� his ar her own employees, provided thet such improvements ere nat intendetl or ottered lor sele. If, however, ihe building ar Improvement is soltl wit�in one year ot completion, the owner-builtler wlll have tha burCen ot Drovinp ihet he or she did not builtl or improve for purpose of sele.). ❑ 1, es owner of lhe properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business entl Professions Code: The conirectors License Lew does not epply �o an owner oi property who bullds or improves lhereon, ena who coniracis tor such project with a contrector(s) license pursuant to the Contrectors License Lews.�. ❑ I em exempt untler sec. Signatura: Owner ID venfied by drivets license. ❑ Ves Venfication of Ownership Ey (type at tlocument, i.e. Business enA Professions Code for this reeson: ❑ No DriveYs License No. property tex blll or deed): Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICA710N: ❑ I hereby certity that no excave�ion tive (5) or more feet in dept� in�o which e person Is require0 to descentl, will be mede In connectlon wlih work euthonze0 by Ihis pertnit, entl that no 6uiltlinq structure, sceftolding, telsework, or demditlon or dismemling Ihereot, will be more than t�irry-slx (38) feet higR (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calilarnia Adminisiretive Cotle). ❑ As ownerbuilder, I will not employ anyone Io do work which waultl require e parmit trom the Division ot Industrial Safety, es notetl ebove, unless such person has e permit to tlo such work tmm the division. Signature: Date: Divisian of Indusinal Safary Pertnit Number: CERTIFlCATE OF COMPLJANCE AND AIJTHORIZATION OF ENiRY: I certily under penelty ol Derjury ihet I have read this applica�ion end state Ihat the infortnation given is conect. I agree to compty with all state lews end ciry ordinances relating to building consiructlon, an0 euthonze representatives ot Ihe Ciry of Caste Mesa to enter upon the above-tlescnbed properly for inspectian purpases. I e9ree not to occupy or allow occupancy of eny building authorized by ihis permit until finel inspection. COOE t. INSiECT10NTYVE 1676 Fixetl Sysiem Final Fire Prevention 1286 Poal Spe Finel 200 Final Re-Root 201 Fina1 61ocWRetaining Wall 202 Final Factory Fire Placa 203 Final Sign 204 Final Demolition PAIE )t�15 - 1,..D/ �L Date COpE� INSPECTIONTYPE Qdjf� J(j�$ 206 Finel Mechanical 20B Finel Plumbing 210 212 220 Final ElecMcal Final Pire Prevention Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy '��, ��' �3 /5 � /7� I 9� �/� z 3 �+ COSTA MESA BUILDING-SAFETY DEPARTMENT APPL[CA"[ ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVED BV �` For Applicant to Fill in Completely — Use Ink Only .BUILDING A,P, NO. ADDRESS BUIIDIN � OWNER OR ADDRE55 � TENANT M.D. Janes Co. Inc. MAI LING SPACE NO. ADORE55`Z9rjO Airwa D-9 cirv Costa Mesa, 92626 nTio�979-337 /O�oZS� _ ... __. NEW, ADD F � k7 6. Q h y �" F G W F� Q G a � r � a w a� 0 a a �{i� S 3 BRANCH owr ADDRESS � ARCHITECT .,. . . .�. TE4... ..�,. USE CONTRACTOF (�]] ADDRESS CITV STATE LIC. NO. SIZE OF LOT Irreg USE OF �, CITV LIC. NO. NO. OF BLDGS. � NOW ON LOT Separate permits are required for electric, plumbing and heating work: Unit Condominium & Attached Garages . 1 hareby acknowledBe that I have reatl this application antl state that the ebove informaiion is correct and agree to comply with all laws reBulatin8 buildin8 construction, and I s�ell not employ any person in violation of tha workman's compensation laws of the State of Californla. ' I he�eby certify that I am p�ope�ly licensetl as a contracto� untler the State of California usinass antl Professions Cotla, Divisian 3, Chaptar 9, and that s h licenses ara in full torca antl aftect, or I em ezempt from tha rovisio of the Stat¢ ot Californie Business and Professions Cotl , ivis' n, Chapter 9. Signatura of Permittae or /Ol A�thorized Agen D � � Z � � TER REPAIR APPROVEOSETBACKS DATE PLANNING ACTION �G� �l � %C; DATE / �G / /.� / APPROVED APPROV �� ' O- ROLD FOR SPECIAI. REOUTREMI VALVATION $ 217�70� DEMO m � i : m N 7 VN UNDEfl VALUATION IS FOR m -ABLISHING A PERMIT FEE ONLV: � PERMIT FEE $ a J� m PLAN CHECK $ �/ � ^ �i o TAX g s,��- LL f U TOTALPAID $ ��'//n� �¢ �� OSTA MESA BUILDINGSAFETY DEPARTMENT APPLICATION F07F STRUCTURAL PERMIT -` ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 I � PERMIT ' TQ - � For Applicant to Fill in Completely — Use Ink Only �� BUILDING A.P. NO. AD�RESS BUILDING OWNEROR ��I AODRE55 TENANT UNIT OR MAILING �� $PACE NO. qDDRE55 � TR.NO. LOT BLK. TEL.�jVJ ' CITV `j �j NO. ' NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCfI ' LENDEF BRANCH OWNER ADORESS VALUE ARCHITECT TEL. USE $ OR ENGINEER N ADORESS ZONE TVPE GROUP APPR n �J4 � CONTRACTOR BY DATE �/ � `L � ADORESS TEL. CITV NO. STATE CITV P.PPROVE� SETBACKS LIC. NO. LIC. NO. � SI2E NO.OFBLDGS. (FROMGLSTREET) OF LOT NOW ON LOT RONT FT. USE OF EXISTING BLOG. � Separate permits are required for L. SIDE electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WOflK TO BE PERFORMED P�qNNING CTION DATE APPROVED APPROVED I hereby acknowledge that I hava reatl this applicetion entl state � that the abova informetion is correct antl apree to comply with all laws regulatinp builtling consttuction, and I shall not emplay � any person in violation of the workman's compensation laws of � the State af Calitornia. m I hereby cartify that I am properly licensed as a contractor untler SQ. FT. �+ the State of California B ness and P�ofessions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl that suc wenses are in full force antl effect, or I THE PURPpSE OF ESTABLISHING A PERMIT F E ONLV: � am axempt trom the o isions of the Staie ot Calitornia Business VALUATION PERMIT FEE $ y antl Professions Cotle D1 isio 3, C rpter 9, m PLAN CHECK $ '^ Signatu�e Ot � Permittee $ TAX $ � o� U Authorizatl ABe Dat TOTAL PAI D e - • Fca� inia9YJ9 464.Q0 • � F�y W � S a y y S F � -i�. � F�+ R 6. Q � � F i��;2r�90�.� G— — � Q . COSTA MESA BUILDIaG-SAFETY DEPARTMENT �/�f'L 57 6�9 , 46.70 TL L�'� � AP ICATION FOR STRU URAL PERMIT �.......... �..... ..w�..�.��o..,....� ..r.�.�nacv�.. I E IT ' For Applicant to Fill in Completely — Use Ink Only N� 4 9 0 5 0 BUIIDING /� � A.P. NO. � I� V � � ADORESS C.9 BUILDING / � �O OWNEROR ADDRE55 L.� TENANT � UNIT OR MAIIING �'SO SVACE NO. ADD R E55 TR.NO. LOT BLK. TEL. CITV �b NO. EW ADD LTER REPAIR MOVING DEMOLISH CONSTRUCTI N LENDER �/ /\ BRANCH OWN ADORESS US ,� lji _ _ � VAWES � ARCHITECT TEL. �� OF ENGINEER p k, � I ADDRE55 ZONE ^ � TV�r GROVP� APPRO CONTRACTOR BV DATE Q �ZS ADDRESS TEL. CITY NO. STATE CITV %�PPROVED SETBACKS LIC. NO. IIC. NO. . SIZE NO.OF BLDGS. (FROM C/L SATREET) �n{ OF LOT NOW ON LOT OM. V FT. / 4 USE OF � EXISTING BLDG. 7 Separate permi[s are required for L SIDE � V FT. � electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PL.4NNING ACTION (pQ/G�p � � �—Ic�j/ � APPflOVED I/—� �O APPROVE /y � � 7 I hereby acknowletlge thet I heva reetl thls applicetion entl stete that ihe above information is correct antl aptee to comply with all lews raBuleting building consvuctian, entl I shell nat amploy any person In violatlon af the workman's compensatlon laws af Me State of Calitornia. / 1 hereby certity thet I am properly licensetl ea a conirector under �� SQ. FT. the State ot California Businass antl Profesalona Code, Dlvislon 3, THE AMOUNT SMOWN UNDER VALUATION IS FOR Chaptar 9, antl that such licenses are In tull forca antl effeci, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exampt from the provislons ot the Steta ot Calitornla Bualnezs VALUATION PERMIT FEE $�S end Professions Cotle, Dlvision 3, Chapiar 9. $IBneiure of / �,,,i,,,,,,��777 PLAN CHECK § Permittee $ r/�-/ p/D ^ TAX b s or . � ...� / I Authorized ABent Date TOTAL PAID S 6 Q z7 � ��o-� C�-/ I COSTA MESA BUILDING-SAFETY DEPARTMENT � � ' � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ' For Applicant to F81 in Completely — Use Ink Only BUIlO1NG / � / ADDRE55 G� OWNER OR U� � TENANT � � MAILING ��pQ ��,Q� ADDRE55 � F C a Q � y 2 F C w F Q O ..l > .�'a � u� 0 C< a Z � x 3 CITV BRANCH ADORESS ARCMITECT CONTRACTOR ADORE55 pTV STATE LIC. NO. SIZE OF LOT NO. TE�. TEI. NO. CITV LIC. NO. NO. OF BLDGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work: UILDING AND WOPK TO BE PEFFORMED �C�y�� 57/�29/79 _,. 79.77 TL ��.�,� PPLICATION OR S UCTURAL PERMIT � N° 49051 A.P. NO. J I .7 BUILDING e_ ADDRE55 (�Y/ UNITOR f SPACE NO. N� I ADD �ALTER APPROVEDSETBACKS PLANNING ACTION �� 78 — � I hereby acknowlatlge that I have reed thia epplication antl stete that the ebova Intormatlon is corract and eB�ee to comply wich all laws raBulatlnB building construciion, and 1 shell not employ eny person In vlolatlon ot the workmen's compansation lews of ihe Siate at CelHornie. %� I hereby ceriify thet I em proparly Iicansetl as a contrector under O`�"-" SQ. F tha Smte of Cellfornia usiness entl Protessions Code, Divbion 3, THE AMOUNT Chaptor 9, entl that s h Iicansea ere In 7ull force antl attect, or I THE PURPOSE C em exampt from th ovlsions f tha State of Celifornia Businesz VALUATION and Professions Ca Iv slon 3 Chepter 9. SlBnaiure af /�� O � Permlttee �� ar �Authorizetl ABa R �i� `� s OATE a � > m 7 JN VNDER VALUATION IS FOR m ABLISHING A PERMIT FEE ONLV: e PERMITFEE S 8/OD v � PLAN CHECK 8 � "� � o TAX $ � s f u TOTALPAID s7q_'77 a