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Home My WebLink About282 BAY ST - Building Permits(714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 .Iob Address: 282 E BAY ST Suite: Vicinity: ENTRY WAY Parcel Number: 42621312 Zoning: Applicant: WALKER, KIM Address: 282 E BAY ST " , "" - - ISSUED BY: � / �." � . Phone: 949-764-9017 - _ - COSTA MESA; CA ' � 2ip: 92627-2130 � ', ''� � � � � owner: WALKER,-MICFAEL C, AND KIM �- � , �� Address 282 E BAY ST�. � � - - - ' � � � - ' ' � Phone: �� • ` ' � COSTA MESA, CA � � Zip: 92627-2130 ; , �' ��- �- Contradoc , '. �� Address � ' " - - 04! �, . � _ , / , . ' Phone: - � � Zip: � � - ' License:- ' � � �� . � - � � \ � � _ � , . �. � � �� - Arch : - " ., ji'' � _ Eng. - . � �� , " , . Address: � - , � � . . _ , . --; Add�ess:; , � - Status: ISSUED Applied: 01/22/2002 Issued: 01/22I2002 Phone: /� , Zip: . . � � ,: License: - %, �. , Phone: . • � `License: � \ SCOPE OF PERMIT ,•-: � v � �^ - � �� ,..., . � REPAIR SOFFIT AT ENTRY WAY. REPLACE�LIGHTING IN RESIDENCE WITH CAN LIGHTING. � FEE SUMMARY Plan Check: $0.00 � Calc Valuation: Permit: $3875 � , / � Claim Valuation: % SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 � � Total: $3925 � � A� - SETBACKS MAINSTRUCTURE Fronl 0-0 - ACCESSORY Front 0-0,� PARKING Existina: o NOTES: Rear 0. 0 Rear 4 0 Re uired: 0 FLANNING & ZONING � Left 0- 0 Right 0- 0 � -- Left 0- 0 - Right � 0- 0 Proposed: 0 . �Si,000.00 87,000.00 NOTICE: The work authorized by this permit shall compty with all applicable handicap access raquiremenis under Calitomla statules and related regulations. (Ord. No. 92•28, § 1, 1241•92) EXPIRA7ION: This permit shall automaticalty e�cplre and become void if work is not commenced wlthin 180 days, or II work is suspended or abandoned lor a period ol 180 days. INSPECTIONS: In order for the vrork euthorized under this permit to be considered legal, such work must comply with all applicable codes, arM all requlred Inapectlone and finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545828 � WORKERS'COMPENSATON DECLAAATON: I hereby aHirtn untler penalry of perjury one of the following declarations: ' . - ❑ I heve entl will mainteln a certitica�a of con5ent to self-Insure for workers' compensellon, es provided for by section 3700 of ihe Lebor CqEa, for the pertormance ol the work tor which Nis permit Is issued. ' ❑ I have entl wlll maintain workers' compensation Insu2nce, as requiretl by section 3700 0l the Lebor Cotle, tor the peAortnance of Ne work for whlch NLs pertnit is IssueO. My workers' compensation tnsure��e cerrier and policy number ere: ., Cerrler. Policy Number: (Thfs sec(ion neeC noi be camp/e(etl il fhe pemtitls valued af one hundred tlW/ers ($100J or IessJ ❑ I certity Ihet in the pertormance o< <ha work for which Ihis permit I5 I55ueQ I s�all not employ any pereon in any manner so as to become subject to the workers' wmpansailon lewa of Calitomia, enA a ree lut tl I should �ecome suD�ect to Ine warkers' campensetion provisions of Septlon 3700 0l tne Le�or Code, I shell IOMwith comply wlth Ihese provisions. I �f /'�� ApplicaNSigneture: � • Date: � ZLi V WARNINO: FAILURE TO $ECURE WORKERS� �1FENSATION COVEMpE IS UMAWFUL AND SW1LL SUBIECT AN EMPLOYER TO CRIMI PENALTIES AND dVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN AODfT10N TOTHE WST OF COMPENS4TION, DAA41GE5 AS PROVI�E� FOq IN SECTION 31080F iHE LABOR WDE, IMEflEST, AND ATTOfiNEY'S FEES. UCENSED CONTRACTORS DECLApAnON: I horaby alfirm Ihat I em Ilcansetl untler p�ovisions oi Chapter 9(commencing wl�h Section 7000) of Dlvlsion 3 of ihe Business and Professions Code, entl my Iicense Is in full force entl eflecL Lia x Cless q ContractoYs SlgneNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereDy attirm ihet Ihere is e construction lentling agency for the peAarmence ot the work for which this permit is issuad. (Sec. 3097, Civll Coda). Lentlefs Neme: Lentlers Address: � Signature: � Date: I hereDy aHirm thaT�citle��penelry ol pellury Ihat I em EXEMPT FROM THE CON7RACTORS LICENSE LAW for Ihe IWlaxing reason (Sec. 7031.5, Buslness an0 Protessions Code: Any ciry or county;wMch��raquires e pertnit to canstruct, alter, improve, demolish, or repalr eny swcture, prior to its issuance, also requires Iha epplicant for such permil to lila a signed stetemem tfiat he aislie.l5 Iicensed pursuant to Ne O��sions o1 the Contrectors Ucense Lew (Chapter 9(commendng with Section 7000) ot Division 3 of the Business end Protessians CoCeJ o7�Na��he-or she is exempt thereiran enE the besis br the ellegetl exemption. Any violation oi Sectlon 7031.5 by eny applicant tor a pertnii sub�ects the aODlicant to a civil penalry;W ��a more ihan frve hundred dollars (5500) J: '11 � N ❑ I, es owner of the properry, or my employeaz with weges as iheir sole wmpensetion, WILL DO THE WORK, and the structure is not Intended or oMeretl for sale (Sec. 7044, Business end Professions,Gode:?he ContraMors Licensa Lew does not epply to en owner oi property who builds or impmves thereon, antl who does such work himself or �ereelf or ihmugh his�a her own employees, provided that such improvements ere not intentled or oflered for sale. It, havever, the building or imprwement is sold wit�in one year of wmpletion. the owneo-builder will have the burden of proving that he or she did not build or improve for purpose o� salaJ. ❑ I, es ownar of the property, am EXCLUSIVELV CONTRACTING WITH LIGENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions Code: The comractors Licensa Law does not appty to an owner ol pmpeny who builds or impmves t�ereon, and who comrects tor such proiect with a wntractar(s) license pursuant to the Contractols License Laws.). ❑ I em e:empt under s c SignaWre: _� Owner ID vontied by ddver's license. Business antl Professions Code for Ihis reason: Date: DrivefS LiCense No. Expires: Verlflcation of Ownership by (type ol tlocument, I.e. - property Iaz blll ar deetl): DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby cenlly t�a� no ascavation five (5) or more feat in depth into which e person Is required to descentl, will be mede in connectlon wilh work euthorizetl by ihis permit, antl that no builtling structure, scaHolding, falsework, or tlemdi�ion or dismantling thereof, will he more Ihan thirty-six (36) faet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltla e, Cellfomla AdminiSlraUve Code). ❑ As owneo-6ullder, I wlll nol employ anyone to do work which woultl require a pertnit tmm the Division of IndusMel Sefery, es notetl above, unless such pereon has e permit to tlo such work tmm Ihe dihsion. Signature: Date: _ Division at Intlusirial Safety Pertnil Number: CERTIFlCATE OF COMPLIANCE AND A�NORPJITON OF EMRY: I certity under penelty ol perjury that I heve read this applicalion antl stale t�at the infortnetion given is correcl. I egree to comply wlth all s;ete laws end ciry ordinences relating to bull0ing construction, end authotlze representetives ot the Ciry ol Coste Mesa to enter upon the above-describetl prope n �e� �/p/g� s. agr ot lo occupy or ellow occupancy of eny builtling au�horized by/y�is permit u/ptil finel inspection. ^�7��E�+t/L(�[' � / 7 7i/ L Z � Signature 01 Legal Owner(s ' �� Dete And/Or Aulhorized Appliwn� cooe.. insvecnoNTrve 1818 Fixed System Final Fire Praven��on 1286 Pool Spe Finel 200 Final Re-Rool 201 FInaI BIocN/Retalning Well 202 Finel Factory Fire Place 203 Final Sign 204 Flnal Demolilion - .. _ _ PAg. It�lL9 COOE I INSPECl10N TYPE 206 Finel Mechanical 208 Final Plumbing 210 Finel Elettriwl 212 Finel Fire Prevention 220 Final Planning Approval 222 Finel Site 250 Final Building/Occupenry Q� � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 282 E BAY $T Suite No Vicinity: Parcel Nunmber: 42621312 npp�icant: WALKER, KIM Adtlress: 282 E BAY ST - i" � " � � � " - . _- ;��-� � . � � ; � ,,� ' - �Phone: 849-784-8017 � COSTA MESA'CA" ' ' Zipt 92627-2130 � �',�' ., . . . � ; i / i". ; ' � � • " ' Owner / WALKER, MICHAELC, AND KIM � Address 282 E BAY-ST �- _ ." -. ' . , ._ . Phone: � COSTA MESA, CA Zip: 92627-2130 Contractor. OWNER BUILDER Address: ' � - � - � � � � .- Pfione: . . Zip: -.. License: 000000 Status: ISSUED Applied: 07/22/2002 Issued: 01/22/2002 ISSUED BY: '/ i�� . � � �, � ' _� � � . . . ' � . � /� � ' / �, � __ . _ _ , SCOPE OE PERMIT . . , REPAIR SOFFIT-AT ENTRY WAY. REPLACE LIGHTING IN DWELLING WITH CAN LIGHTING, MISC:- . ELECTRICAL WIRINGTO REPLACEOUTLETS AND SWITCHES: : 18 CIGHT FIXTURES, 13 OUTLETS, 9 SWITCHES. , - � REF:802-00099.�� . ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res, (3+units) Pool / Spa Lighting Fixts � Recept Outlets , Switches Non Res Appl � , Res Appl Service to 200a � Service to t000a Service over 7000a Molors to 7hp Molars to 10hp Molors to SOhp Molors to 700hp Motors over 700hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermetl Pole Quantity 523.50 $0.00 $0.00 $0.00 0 $0.00 0 $0,00 0 . , 819.80�. i�.�_�8 ... . $14.30�c�� 13 $9.90 9 ao.00 0 $0.00 0 $0.00 0 $0.00 ' 0 $0.00 � - � 0 ; $0.00 0 $0.00 0 $0.00'- , � 0- -- $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 FEESUMMARY ' Quantity Temp Dist System I Lighting 50.00 0 Busway 110o ft So.00 -o - � Standing Section $0.00 0� .', Misc Electriwl Equipment 50.00 "� 0 - Transformers up to 1 kva/kw 50.00 . 0 ................up to 10 kva/kw . .--, _ $0.00 0 .................up l0 50 kva/liw $0.00 � 0 .................up to 100 kva/kw $0.00 , 0 . ..................over 100 kva/kw , , 50.00 " 0 Low Voltage Equipment ""� 50.00 � 0 Low Volt Wiring System / Ckt $0.00 0 Misc. Conduit 50.00 0 Misc. Conducror . $0.00 " 0 Circus ( gen or ride) � $0.00 ' 0 Circus (mech ride or lights) -50.00 0 Christmas Tree Stand 50.00 0 � � Fireworks Stand , � � 50.00 0 Other Electrica6Fee $0.00 Investigation Fee $0.00 Plan Check Fee 50.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES E67.50 COMMENTS / SPECIAL CONDITIONS ,� INOTICE: The work aulhorized by this permit shall compty with all applicable handicap access requirements under Califomia statules and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This pertnit shall aWomatically expire and become void if work is not commenced within 180 days, or if work is suspendetl or abandoned for a period of 180 days. ' INSPECTIONS: In order for the work authorized under Nis permit to be wnsidered legal, such work must comply with all applicable codes, and all requlred Inspectlona and final epproval must be obtained. Failure to obtain inspections end final approval will resufl in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545826 . zua�e �elao� WORKERS'COMPENSATON DECLARAnON: I hereby eHirm unAer penalry ol per�ury one of Ihe Iollowing declaratlons:' � ' ❑ I�heve entl wlll mainteln e certlficate of consent to selt-Insure for workers' compensatlon,�as prodtled for by secNon 3700 of the Lebor Code, for (he peAormence af the work tor whlch Ihis permit is IssueO. . , ❑ I have eM wlll malntaln workers' compensatlonJnwrance, a5 requireG by sectlon 3700 ot ihe Lebor COOe, for ihe peAortnance ol Ne work far w�kh thl5 pbrtnll is Issuetl. My workers' compensatlqP Inyor�nce cerrla� jd policy number are: .„ Cartler. Poliry Number: �s sect need not be comp/et�l the bemLt Is v&lued af one huiMred doliars ($100) or less.) v certity t�et in t�e pertortnance ol tha work for which this pertnit Is issuad, I shall nol employ eny person In any mannar so as lo become subject to the workers' compensetlon laws of Celllomla, en apree Iha� If I should become suD�ect to the workero' compensatlon proNsions of Sect n 3700 of Ne Labor Cotle, I shell torthwith compy with these Provislon p/%�y q-� r� 1l Appllrant Slgne[ure: ��i� {�Y/ Date: I L L/' `�� WARNIN�: FAILURE TO SECURE WORKERS' COMPENSATION CqVERA E IS UNL5WFl1L M1D SNALL SU&IECf rW EMPLOYER TO CRIMINAL P TIES D CML FlNES UP TO ONE MUNDRED T/10USRIJD DOLLAflE (5100,000). IN ADDRION TO THE COST OF COMPENSATION, DAMAGES /S PPOVIUED FOR IN SECTIdJ 3I08 OF THE 1A80R CODE, IMEPEST, AND ATfORNENS FEES. LICENSED CONTRACTORS �ECLARATION: I hereby affirtn that I em Iicensetl untler pmvisions ot Chapter 9(commencing with Section 7000J ol Division 3 ot the Business and Protessions Code, antl my license is In tull force end eHect. lJc. a Clau M Contractors SlgnaNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereDy ettirm Ihet there is e consiruction lending agenty for the peAormance ot the work lor w�ich ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lendels Nemo: Lendefs Address: signewre: ' oa�e: OWNER-BUILDER DECLARATIONS: I hereby eNirtn Ihat under penelry of perjury thel I am EXEMP7 FROM 7HE CONTHACTORS LICENSE LAW for tha tollowing reeson (Sec. 7031.5, Business end Prafesslons Cotle: Any ciy or counry which reduires e Dermit to construct, alter, improve, demolish, or repelr eny structure, pdor Io Its issuance, elso requires the apDlicant for such pertnll to /ile a sipned stetoment that he or ahe Is licensed pursuent ro the pmvisions of Ue Conlrectors Ucense Lew (Chepter 9(commenUng with Section 7000) of Division 3 of the Business end Pmtessions Code) or thet he or she is exempt therefrom entl the �asb Por tha ellagetl ezemptlan. Any vialatlon oi Section 7031.5 by eny applicant for a perm0 sub�ects Ihe applkant to e dvil penalty o1 not more ihan live hundred dollars (5500).): ❑ 1, as owner oi tha property, or my employees with wages es Iheir sole compensatlon, WILL DO THE WORK, entl tha sWcture is not IntenOetl or oMered for sele (Sec. 7044, Business and Pmfessions Coda: The Contractors License Law tloes noi appry to en owner ot property who builds or improves thereon, and who tlaes such work himself or hersetl or Ihrough his or her own employaes, provided that such imprwements are not intended or oHered for sele. If, however, t�e building or improvement is soltl within one yeer of completion, the owner-builtler will have ihe burden of proving that �e or she did not build or improve tor purpose oi sale.). ❑ I, as owner oi lhe property. am E%CLUSIVELV CONTiiACT1NG WtTH UCENSEO CONTRACTORS to construct th0 project (Sec. 7044, Business and Professions Cotle: 7Te contractors License Lew does noi eppty to an owner al propeny w�a builtls or ImOroves therean, entl who contrects tor such pmject with a comrector(s) licensa pursuant to the Contractws Licanse Lews.). ❑ I em exempl untler sec. ��jp�antl Professions Cotle for t�is reason: SignaNre: Owner ID venlled by drivers Ilcense. � ❑ No ' Vedficetlon o1 Ownership by (rype ol document, I.e. - properry tax Dill or tleatl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Dafe: � �% 2� " c_ ' Drivers Licensa No. —r� pires: ❑ I hereby ceNfy that no excavellon five (5) or more leet in depth into which a person is requiretl to descend, wlll be mede In connection with work authorized by Ihis . permii, and that no building structure, sceflolding, felsework, or demditlon or dismamling thereof, will be more Ihen thirry-sb (36) ieet high. (Chep. 32, Gry 2, Art 2, Sec.. 341, Title 8, Celitomia Atlministrative Gode). ❑ As owner-builder, I wlll noi employ enyone to tlo work which would require e Oermit Irom the Division ol Industrial Salery, as noted ebove, unless such person hes e pertnit to do suCh work from the tlivision. Signature: Date: Division of Industnal Satety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUiHORVATION OF EMFiY: I certily under penalry ol perjury ihat I have reatl t�is epplication antl state thet Ihe Iniormation given Is correct. I agree to compy with ell s:ete laws enG ciry ordinences relating ta building mnstructlon, and euthorize representetives of the Ciry ol Coste Mesa to enter upon the ebove-describetl property lor inspec'o �ses. I e�e no a opeypy or allow occupency ol any builtling euthorized qy lhis permit,un@ final Inspection. iT� �\ I 1 Z�i � U � Signature Ot egal ner(s) T— Date AnNOr Authanzed ApPlicant Date COOE I, INSPECTIONTYPE 1816 Fi�etl System Final Fira Prevention 1266 Pod Spe Final 200 Final Re-Root 201 FInal.Block/Retaining Wall 202 Final Faciory Fire Place 203 Final Sign 260 Finel Demolilion .. PeiE u�ets yODE� INSPECTONTYFE 206 Final Mechanlcal 20B Finel Plumbing 210 Finel Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Finel Site .. 250 . Finel Builtling/Occupancy PAff 1[{iIDAL4 !�i � :d" ' OWNER PECA RALPH UAT� t3-15-bb JOB ADDRESS� 282 E BaY Street BUILDING PERMIT NO. 26016 GENERAL CONTRACTOR Owner-Builder DESCaiP't'ION oF WOIiK Utility Laundrv Att. AP Nn l lR�lh?�(lii T.(1T TRACT FIRE ZONE VALUE $ 1.000.00 SUBCONTRACTOR or I �—"' �'�° =� ��s1 .., ;. � �COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN iaooR�ss 282 ay Street I COSTA MESA. CALIFORNIA IAD RESS �9 F'• 1(tl+ `�t• ARCHITECT OR ENGINEER ICONTRACTOWJ.RB Hiiu LEGAL LOT p oESCRIPTION NO. 17 BLOCK A.P. NO. IUSEOF none EXISTING BLDG. SETBACK L�NE FROM 1 /• LIC. NO. 6; `�m`ic. 7333 TEL. NO. � TRACT �� f O no.ov e�ocs. �ow o� �or none EAR YARD 1�' SIDE YARD RIGHT LEFT yV' ' DESCRIPTION�OF WORK -• NEW A ALTERATION ADDITION REPAIR MOVING DEMOLISH BI/ILDING NO.OF SIZE ROOMS STORIES E%TERIOR WALL ROOF COVERING COVERING BUELDFNGEW S 1@ F3IIL�1 Re3ldeIICE � Garaee Attached ,��E R��11ED , „_a-y_5-�� .,« � �� clTr OF COStA NffSp APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY COSTA MESA, CALIFORNIA NO.OF TYpE ' / G � PLPNS CORRECTIONS ST�TE THAT TNE �BOVE IS CORRECT �N� AGHEE TO COMPLV WITH nlL CITV ORDINANCES AND 5 TE 1�W5 HEGl1LATING BUIlO CONSTRUC� TION. V/ LUATION SIGNATURE OF �� PERMIT FEE $ 2�00 PERMITTEE 1[ nn PLAN CHECK $ lO�W �n.� g 13,690.00 ,p M AUTHORRED AGENT DI[� AND COLEGROVE, 1+�C TOTAL FEE $ tyc��W �dr �— 260 � .. YCOSTA MESA BUILDINCrSAFETY DEPARTMEM P.O. BOX 7P00 - COSTA MESA, CALIFORNIA Y2626 For Appllcan9 to F711 In Complefaly TYPE OR PRINT 7DRE'8G �2 e �3,��sr COSTA MESA, CALIFORNIA uuve K�1�OF�1 �n�1T.NC Il'11�� -6-� TRL ��- �. NO. IHO. O! �Lp01. Now ON LOT ,.�eE YROACN LIM[ IROtl h-� CeNT611 OP PT116[T RQAR YARD t[J' �(J "O J n e1DeYA D LirT RIOFR S—� DESCRIPTION OF WORK Pd BUILDINO �` < i,ir��r �,ANN�� . 1 H6p68Y ACKNOWL[pO6 TXAT 1 MAV[ 11HAC TNIO MPLIGTIOM AND BTATB TNAT TX6 ABOV6 1� CORR[R�AND AORB[ TO COY• PLY WITX ALL CITY OPDINANCt� AND RATi L11WY R[OIl1.ATINO BUILOINOCONeTINCTION. { � 81GNATUREOP �' / / PERMITTHa ICiJ—��✓ i� AUTHORIZ[D AG[NT R[C[lYfD ta� AUG 15-66 00 73843�**�*6.00 APPLICATION FOR PERMR BUILDING Fo� Offlce Uae o�►y wtcnrrHo. _ n 2 � s TYPH OROUP r DAT! � ZONIN(i u.a or Hcw 7i eui�mHo F � �I t R 3a�`a _rc(1— � 6 IIHANO SXALL E8 L688 TNAN BAVE6 ALLOWiD YARDB MPROVBC MAIN BUILDINO vwn. Je YARDS MPROVBD ACCEYeORY BUILOINO DATH � J a � �c-ui O ec. Rr. " � 0 n�s wrourrt cxowh uHoex v��u�nox �e roa n�e i •UPPO![ 01 [YTApL10NIN0 A P81iM�T P8H ONLY. 4� VALUATION �� PERMIT FeH p s � Q� �% . w TOTALFHE S �/ PNOdECT AODflE55: � 8 � E BAY $T OWNEfl'S NFME: PECA RALPH D noonEss: w 8 2 �AY ST COSTA MESA,CA 546-1900 pflLH/ENGINEEP: aooncss: uxrt: 92627 flFG.NO.: uxiT: PEXMITTEE: VIC BASCUNE ( 714 ) 495-4640 , aooness: � g g q 2 ANDREA LAGUNA NIGUEL CA 926'17 LILENSEO CONTBACTON OEClA8AT10N: I hereGy aflirm thai I am IicenSeA un0er O�ovisinns ol C�ap�er 9(commencing wi�� Sec�ion 7000) ot Div��sion 3 0� Ihe Business antl Pmlessions Code, ane my license is in lull lomc antl eHect. c�rr��c.: 052qgp STATELIC�560843 ��^ss�_3^6 Qate: � �' 2 % " � L—� SignaWre: ��-��.v-,� JIOBREflS' COMPENSATION OECLANATION: I he/eby alfirm ��at I have a certilitaie o� con5eni l0 Sel4insure or a tetli�icate o� Work¢rs/ Compensation Insurance. or a cenified copy ihereaf �Section 3800. Lab. C). PO�ICY NU.: F%P. DRTE: COMPANY: i❑ Certifietl copy is hereDy fumishetl, ❑ CeNhetl capY is filed wilA �he ci�y Builaing Didsion. Dale: Applicanl: EXEMPTIONfflOMWOflREflS'COMPENSATIONDECUMTION: (ihi55ectionneetlnolbecompletetli��hepermi�i5loronehunOreU(511p�orleSS). I cerlity I�ai in ��e pedOrmante of ��e work lOr w�iCh IhiS permi� is issued, I shall noi employ any person in any mannef So as Io OeCome subleci lo �he Workers' Compensalion Law I Calilomia. �,-�- n � �� _ lxa�cw-��. r Oate: �^ ? } � �'� Signalure: C N�TICE: I�, af�er making �his declara�io , you ShoWa be[ome suhlec� to th¢ Wo�kers' Compensa�ion prOvision5 0� I�e Labor CDtle. you mus� Iarlhwiih Comply wi�� SUch pmvisions or �his permi� Shall Ae tleemetl revoke0. CONSTPUCTION LENOING FGENLY: I Aere�y allirm Ihal Ihere i5 a wnstmc�ion lending agenCy lof ��¢ p¢riormante oI Ne work �or which �his permi� is issued (Sec�ion 3097. Civ. C). ' LENDEfl: � p�ONE55: OWNEH BUILDEfl OECL4NpTI0N: I hereby affirm t�al I am exempl imm t�e Coniracrors' Slaie License Law lor ihe followinp reasan �Seclion 70J7.5 Business and Pmlessional Cotle: Any ciiy o� cOunly which requires a Oermit �o conSVuc�, alter, impmve, demolish, or repair any SlmcWre. prior Io iIs issuance. also requires Ihe applicanl lor suc� permi� Io lile a SiAneO Slaiemen� Ihal he/she is licensetl pursuam m t�e pmvisions ol lhe Conlractors' S�ate License Law (Chapter 9 �commencing wiU Section 7000) ol Division 3 0l ihe Business and Pmfessions Coee) or Ihat he/she is ezempt iherefrom antl I�e basis �or ��e alleped exemp�ion. Any violation o� Section 7031.5 �y � any applicant for a permii suhlecls �he applicani �o a civil penally o� not more than live hunJreU tlotlars (5500�. I. as owner ol Ihe pmpeny or my employees with wa�es as ineir sole compensation, will Oo Ihe work, anU ihe ❑ slmclure is not imenaed or oifered lor sale (Seclion 7044, Business antl Grolessional Code: The Coniractors' State License Law' does nol appty to an owner o� a pmperty who 6uild5 or improves Ihereon, an0 who tloes suc� work �imsel�/herself or I�mugA - �i5 or Aer own ¢mpl0yee5, provitlea Ihal suCh impmvemenls are n01 in�enAetl af offet¢tl for Saie. II, however �h¢ buil0ing or im0�ovemenl is 5010 wiihin one year ol comple�ion. Ihe owner will have �he burtlen of pmvinp he/she tli0 no� Ouiltl or impmve �or Ihe purpose ol sale�. I, as owner of ��e pmpeny, am exclusively contracling wi�h licensed contracmrs m constmct the D�oject (Section 7W4, Business ❑ and Prolessions Coae: The Con�mctors' Slaie License Law does noi apply lo an owner ot pmDehY who builtls o� imp�oveSlhereon an0 who toniracls for SUt� projecls wilh a COnlraCi0r�5)litense pursuant to the ConVa[tors' Slaie LlCense LaW). I am awafe Inal omol of Iheir Worker's Compensation insurance should �e provieeU lo me. � I am e�emD� unJer Section: B. 8 P. C. lar Ihis reason: �ate: Ownec I do hereby cenily Ihat I am aware af anU untlerslane Ihe repuiremenis ol Califomia Heallh an0 Salety Coee Setlians 25505, 25533, antl 25534 and Ihai I or any �uWre builtling occupanl will/will noi (circle one) neetl �o compty wiih said s�aie co0es and Ihe requiremen�s lor a permi� lor consimc�ion or modihcatian �mm the Air Oualiry Management DisVicl. FesGenlial con5�mciion application5 are e�¢mpt �mm ihese Drovisions. �aie'. ADP�iCanP. I here�y terlilylhai I haveread �his apPlicalion antl Sia�e l�al t�e a�ove in�ormali0n is torreCL I aA�ee IO tomply wilh allci�y an0 toun�y ordina�rcesarbsialelawsrelalingtobuilaing nslmclionan0�erebyaulhorrzerepre5en�ative5o��hi5cilyloenieruponlheabove�men�ionetl, � property fo� inspedion purposes. /� _ � n / �� oaie'�-.1 7� �% SignaWre: �/�-,� 3/1.O�iJ'�-e� � % Iorivefs License or Social Security n: 164t�46 WNte-BUAdmg: Green-Coae Enbr<emenC CanarV-APPlicant: Pink-Fevenue: GoltlenroE-Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 05117 PERMIT NO; M 051177 PLAN CHECK NO; N. GOVT: N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION : FAU CHANGE—OUT SQ FT'; CLAIM ��ALUE; CALC—VALUE: GROUP OCC: / COMMENTS: NO STRUCTURAL WORK APPROVED �*�r**r.�r�*�x**�e**�e�t*�r*�r**x�r�t*x�**�t* x�t**�t�r�e**+t��r�r**�rx��r**�r*x*�r*�***�r+t***±� ��*�***� Z U N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL; 42621312 ZNE: REF NO: PLANNING Nt7TES> i �****��+��+�**��e�**�****«��***��r*�**,��«*�***��*�*,r��+��***��*,��***��**«*��*�« D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: ' "A DATE; 2 Z MIEiElElEih�kif�Eii1E1f1F1F1E1FIfY.�iflElfiF . IfiflliEifiFlElfiFiE iflE 1f M�f if 1t IE iE iF kiF iE If iF If if IF IP k iE k if 1E iE iE iE iE iF 1E if If 1! if� �F iE ik if if iF M If IF if if if iF if if iF if if iE if # if iE �E 1k if 1f IE IE iE iF iF 1k aE iF ik if iE 3F iE �k iE �1F � if )f if LEGAL.T.ZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMHING ELECTRIC MECH9Noo FIRE SMIP/RES GRADZNG , '15Y SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK , TOTAL PAID DUE TOTALS----> ' 9,00 15.00 0,00 24.00 24,00 .00 REVENUE llIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 29.00 If 1f 1F If If i! iF iE ik if 3E If IE 1f 1f iE 1f iF If iE if iF i! iE i! iF If if iE'7E if iE IE �f if if ik iF If iF 1f iF iFiP 1E kif if iE iF IF iE if iF iE if iFif 1E �IE IE If iE iE if iE # 1f 1E i4 if if IE if 1f �Y 1E iE �k I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9,00 END OF FEES OI OdfJ81`1G—JG031`12 "��+7 �' !3R?F: e2�a,i�t Tii'E: l3:1?. CONSTRUC710N AND PLANNING � POOL & SPA APPROVALS Permit # - Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location i 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Co�duit•Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement __ 56. Rough Plumbing & Pressure Test _ � � 6. Electrical UFER Gcnd. :! 57. APPROVAL TO COVER�GUNITE 7. Footings ' - � 58. EleMriwl Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test , 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. , 10. Structural Floor SYstem -� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor�Final � 12. Sewer Cap � 63. Heater & Vent-Final • : 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing � 65. Electrical-Final � ;1 15. Rough Electrical•Conduit 66. Solar System-Final � 16. Rough Elect�ic Wiring 67. Fencing & Access ApProval 17. Raugh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL - 19. Rough Heating & Air Condiiioning FIRE �EPT. REQUIREMENT - - c . 20. Rough FBctory Fireplace �� *. � � �j a �APPROVALS �= Permit # l . t " 1 Y .1� ' 21. DuCts, in^Structure � , , ' -_' � � ` � � � � � � . 70. Unde�ground:Hydro 22. Ducts, Ventilating� , . � � + t -71. Product`Pipin9 O Gas ❑ Oil 23. GarPipe-Rough & Test . ` _ -� _72. Underground FlusFi - 24.>Roof Framing '� •• • 73:' Undergrnd. Storage Tank O Gas ❑ Oil • 25. Foof Sheathing � ' - „, �'7q, Overhead Hydro- c 26. T-Bar Ceiling IStructural) &�Monocoat ' �-. 75.-Dry Chemical ' - _ 27. Frame and Flashing; �j " , ' ' 76. Dry Standpipe ' ;� ; � �' ' 28: Lathing & Siding �� . 1 . . . 77,= FIXED SYS7EM�FINAL . 29. Insulation _ ', - � '� '� � � 78;=FIRE PREV. FINAL . . �� 30. Drywall�Nailing . ' � , . u HEALTH�DEPT. REQUIREMENT _31. Plaster Brown Coat" ' � � 79: FINAL INSPECTION '- '1 32.,Electriea4PoWer MeterFinal; � ' . ,. , �80.�F000 CERTIFICATE ISSUED � , 33. Final Electric ' ? ' � • ' ' No'tes: '' - � '� , �34.-Final Heating & Air.Conditioning � � �� . •� • �: ' 35.'FinalGasPipe-Test� . T' • `_'=_ ' ` - t- ,36. Hood or CanoPY . ._ , _ < . L . ' -. : ` 37.=Final FactorY Fireplaces ' � ' '` '� ;�� ,� ' , ` 38. Final�Plumbing . � . �� . ' `�� I ��„i . . � ` 39. Water Service-Final , ' ti '' W ��. - "� M _ 40. Gas Service-Final , ; ,,. ' ' - , ' ' �-. ;41. Solar pomesticFinal :. - � •• �� ¢c = - 42. Backflow Preventer, ' ' '{ y _ Y � _43. Backflow Irrigation - - .• �� - � '= � ,- � V., v • � ) • � � ,44. Landscape Irripation System, � - . , , � c � - . _ '45..Sound Attenuation � i•�� •� , � � • <y � � :46. ,Handicap Regulations - - ' ' . � _ ` �- ., 47. FINAL STRUCTURE & BUILDING " : � � ,' 48.'FINAL PLANNING � � �• ; . ' r49. ��Etectric Release to Edison � - ' �i � 50. Gas Release to Southem California Gas Co � �^--` '� � � ' -'�. 51. CERTIFICATE OF OCCUPANCY , _ No Date