HomeMy WebLinkAbout492 ABBIE WAY - Building Permits�- -
(714) 754•5273 • Fau (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 492 ABBIE WY
Suite No
Vicinity:
Parcel Nunmber: 11737209
Applicant: FULTS,GREG
Address: 379 ROCHESTER ST
COSTA MESA, CA
Owner: VALAINIS, MARIS P
Address 492 ABBIE WAY
COSTA MESA, CA
PLUMBING PERMIT
Phone: 949-650-7828
Zip: 92627
Phone:
Zip: 926273762
Contractor: THE FULTS COMPANY GENERAL CONTRACTORS
Address: 379 ROCHESTER ST
COSTA MESA, CA
Arch / Eng : �
Address:
Phone: 949-650-7828
Zip: 92627
License: 530390
Phone:
Zip:
License:
SCOPE OF PERMIT
INSTALL NEW F.A.U. 75K BTU. 1 GAS OUTLET.
ISSUE FEE
BackFlow irrigation ,
BackFlow Preventer � �
Bathtub
Clarifier System '
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
$0.00'
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$0.00'
$0.00
$6.15
$0.00
$0.00
$0.00
$0.00
$0.00
QTY_
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
FEE SUMMARY
AMT
_ Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
. P-Trap $0.00
. �� Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
SepticTank $0.00
' Sewer Cap for Demo $0.00
Sewer Connect $0.00
� Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
� � Qn
0
0
0
0
0
0
-0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS I SPECIAL CONDITIONS
Status: ISSUED
Applied: 07/24/2001
Issued: 07/24/2007
ISSUED BY:
� Sump Pump ' _
- Swimming Pool �
'�, Trap Primer , � �
, Urinal �� /
_ � Vacuum�Brkr BkFlow(7-4)
Vacuum Brkr BkFlow(5+)
� Wash Basln
Wash Basin Set
Waste and Vent System
-. Water Closet (Toilet)
Water Heater / vent
Water Piping Qnst or Rep.)
Water Re-pipe
Water Service
Water Sokener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCUTATED FEES:
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
529.65
Qn
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlihin 1 BO days, or if work is suspended or abandoned
tor a period of 180 days. i
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable �cotles, antl all
requlred Inapeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aauae la�oo�
WORKERS' COMPENSATION DECLARATION: � �'
I hereby eMirm under penalry of perjury one of the following tlecleretions: � ` . � .
❑ I,heve end will meinlain e certiflcete of consent to self-Insure for workers' compensatlon, es provided for by sedion 3700 at the Lebor Code, for the pertormence of the
wark for which this pertnit Is issued. '
❑ I have and will maintein workers' compensation insurance, es requiretl by sectlon 3700 af tha Lebor Cotle, tor the peAortnance of the work for which this pertnit ls issued.
My workers' compensatlan Insurance ce/rler antl policy number ere: .
Cerner. . I Policy Number� �
(ThI sectlon need not be complefed ll fhe perm/t is velued ef one hundred dollers ($f00) or Iess.J
I certity thet in the perlortn� ce of Iha work for which this pertnit is issued, I shell not employ en rson in any menner so es to bewme suDject to the workers'
com aws of �gllfo ', e ihet if I should bewma sub�ecl lo the workere' co nsation provisions ot Secllon 3700 of ihe Lebor Code, I shall forlhwlth
c ith th , .�7 ' n / I O I
I tSlpnaWre� • : � L�Y
W INO: FAI TO SECURE WORKERS' COMPENSA7ION COVERAGE IS UNLAWFULAN� SHALL SU&1 O CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
RE (5100.000), IN ADDITION TO TME CQST OF COMPENSATIIXJ, DMMCaES AS PPOVIDED FOR IN SECfIIXJ 31O60F THE LABOR CWE, IMEREST, AND ATTORNEV'S FEES.
)NTRACT RS DECLAHATION:
that I Ilcen�nde�rovisl�ns of Chepter 9(commencing wlth Sectlon 7000) of Divl n 3 0l ihe Busines� and Professlons Code, and my Ilcense is In full
k
CONS�'RUCTION LENDINO AGENCY:
❑ I hereby aHirm that there Is a cons
Lendefs Name:
Slgnature:
lending agency for the peAormance of the work lor which this permll is issuetl. (Sec. 3097, Civil Cotle).
Lentlefs AdOress:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eNirtn thet under penelry of perjury thet I em EXEMPT FROM TNE CONTFiACTORS LICENSE LAW far the following reason (Sec. 7031.5, Business and Professlons
Code: Any ciry or counry whlch requires e pertnit to construcL elter, improve, demolish, or repalr eny siructure, prior lo ils issuance, elso requires ihe applicent for such pertnit
to flle a slgned stetement that he ar she Is Iicensed pureuant to Ihe proNslons of the Contractors Llcense Lew (Chepter 9(commencing with Section 7000) of Dlvision 3 of the
Business entl Protesslons Code) or thet he or she is exempt iherefrom and the 6asis for the elleged exemption. Any violation of Section 7031.5 by eny appllcant for e pertnit
subjects the epplicant to a civil penalry of not more than five hundred dollars ($500).): ,
i
❑ I, as owner of the properry, or my employees with weges es their sole compensatlon, WILL DO TME WORK, and ihe structure Is not intended or offeretl for sale (Sec.
7044, Business and Protessions Code: The Contractors License Law does not epply to an owner of properry who builds or improves thereon, and who daes such work
himself or herself or through his or her own employees, provided that such improvements era not Intentled or oflered tor sele. If, however, the building or improvement is
sold within one year ot compl�tion, the owner-builder wlll have the burden of proving ihat he or she did not build or improve for Durpose of sale.).
❑ I, es owner of the property, em�EXCLUSIVELY CONTRACTING WITN LICENSED CONTiiACTOHS to construct Ihe praject (Sec. 7044, Business and Professions
Code: The con�ractors�LlcenSe Lew does no� epply ta en owner a� property who builds or Improves ihereon, and who conVacts tor such pro�ect with e contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am ezempt undeasec ��' 1 ��'� �� �.` r�7� Business end Professions Code for this reason:
Signature: ���«�`��%-- `�� Da�e:
Owner ID vedfled by tlrivefs licen5e. �. � Vas ❑ No Ddver's License No. Expires:
Verification af Ownershlp by (type of document, I.e. - property tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certity ihet no excavation Nve (5) or more feet In tlepth into which e person Is required to descend, will be made in connectlon with work authodzad by ihis
permit, end thet no bullding structure, sceNolding, falsework, or demolition or dismantling thereof, wlll be more than thirry-siz (36) teat high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Californle Administrative�iCode).
❑ As owner-builtler, I wlll not employ enyone to do work which would require e pertnit from the Division of Industrial Sefety, es noted ebove, unless such person hes a
permit to do such work from the divlsion.
Signatura:
Division of Industnal Setety Pertnit
Date:
Will the applicant or present or future Dulltling occupant need to file end certity e Business Plan for emergency response to release or tnreatened releese of e hazerdous
metedal7 ❑ Yes ❑ No I
(Section 25505 ot ihe Celifornia Heelth and Sefery Cotle requlres, wlt� some ezceptions, Ihet a Business Plen be tlled with the Coste Mesa Fire Depertment by every
business which has et eny one time during e reported year e quantity of hezerdous meteriels equel to or greater than e welght of 500 pounds, or e volume of 55 gallons,
or 200 cubic feet of compressed gas et standard tempereture end pressure).
.........................................................._........................................................................................................................_..............................................................................:......................................_..............................................................
Does or will the applicant or present or future building occupan� need to tile a registra�ion torm for acutely hazardous materials7 ❑ Yes ❑ No
(Section 25533 of the Callfomia Heelt� end Safery Cotle, wlth some exceptlons, requlres registratlon with Ihe Casta Mese Fire Department by each business which at eny
one lime hes on hantl e quantity of eculely hezerGous materlels equal to or greeter then a welght of 500 paunds, or e volume of 55 gellons, or 200 cubic feet of
comp�eued gas et standard tempereture end prassure).
..................................................................................:...........................................................................................................................................................................................................................................................................................
Does ar will the applicant or present or tuture buildinq occupant neeG to prepare en RMPP (Risk Manegement and Prevention Program for acutely hazardous materials)7
❑ Yes ❑ No i
�Bp9rtmBni O7 en HMYP by bU5lOB55i
...........................................................................................
4 If en RMPP is presen�ly requi�ed, hes
...........................................................................................
5 Daes or wlll the applicant or present i
fmm the South Coest Air Oualiry Men
(Sectlon 658502 01 Ihe Califomia G0�
wni eny pan ot tne tacniry to oe co
Qf "yes", the facility must meet ihe
..........................................................................
If e permit ifom the South Coast
Fire Department may require the preparation, certification and tiling with the Flre
metenals with the Fire Depertmenl.
. .........................................................................—.........................—.......................................................................
25534 af the California Heelth and Safety Code 6een fully complied withS
.............................................................. . .............................................................................................
bullding occupent requlre for the work which is lhe subject of �his a plic
Distdcl or from any other alr pollution coNrol tlistdct or agency� � Ve.
I Code requires Ihet Ihe requested infortnation be fumished on epplicatioi
...... ...... ...... . . ...... .........................................................................
........ .... .
itler this permit be within 1000 feet trom Ihe outer bountlaries of e school
i of Sections 25534 and 42303 of the Celifornia Health end SaFery Code).
.....................................................................................................................................................:......
Menegement District or other eir polWNon wnlrol tlistdct or agency is
�ed by Celifomla Heelth and Safery Code Sectlon 42303 been mede? [
on a permit for such constmction or
�J No
for non-resitlential building permlisl.
wark whith is
(If'yes", atlach cehificate of compliance from the eppropriate air pollution control oXicer).
CERTIFICATE OF COMPLIANCE: I certity that under penalry of perjury the information given ebove is corred. I agrea to comply with all state laws end ciry ordinences
regarding Hazardous Meterials and Emissions.
Signature: I Dete:
CEHfiFlCATE OF COMPLIANCE AND AUT}10RVATION OF EMRY: I certify under penelry of perjury that I have read this epplication and state that the inlormation given Is
conect I egree ro comply with ell stare laws end ciry ordinances relating to building construction, and euthonze rep�esematives of the Gty of Costa Mesa to enrer upon the
above-described property for inspection purposes. I agree not to occupy or ellow occupancy oi eny buildinq euthorized by this permit until final inspection.
COOE �. INSVELTION TYPE
1616 � Fized System Final Fire Pi
1266 Pool Spa Finel
200 Flnel Re-Roof
201 Finel Block/Retelning Wall
202 Final Factory Fire Place
203 Final Sign
204 Finel Demolition
� / � O qate
l
Date
�$ �QpF.� INSPELTIONTYVE " '
206 Finel Mechanical
208 Final Plumbing
270 Finel Elecirical
212 Finel Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
�E �
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 492 ABBIE WY
Suite No
Vicinity:
Parcel Number: 11737209
Applicant: FULTS ,GREG
Address: 379 ROCHESTER ST
COSTA MESA, CA
Owner: VALAINIS, MARIS P
Address: 492 ABBIE WAY
COSTA MESA,CA
MECHANICAL PERMIT
Phone: 949-650-7828
Zip: 92627
Phone:
Zip: 926273162
Confractor. THE FULTS COMPANY GENERAL CONTRACTORS
Address: 379 ROCHESTER ST
COSTA MESA, CA
INSTALL NEW 75K BTU F.A.U.
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair/Alt Gooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping . .
Factory Firep�ace �
Hood w/Mecn Exhaust �
VAV Box
Vent Fan / Single Duct
Appliance
Fire Damper5 '
Smoke Dampers . . . �
Inst or Reloc�te Appl Vent
Air Handlers � 1�OO�cfm
Air Handlers > 10000cfm
Floor Furnaca
Floor or Suspend Heater
Quantity
$23.50
$14.80� '1� -
$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
so.ao 0
$0.00 -0
$0.00 0
$o.00 0
Phone: 949-650-7828
Zip: 92627
License: 530390
SCOPE OF PERMIT
FEESUMMARY _
Status: ISSUED
Applied: 07/24/2001
Issued: 07/24/2001
ISSUED BY:
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commerciallncinerator �
Domestic Incinerator -
Comoressors / Absomtion Systems
Upto3hp/100kBTU '
3 To'15 hp / 500 k BTU �
15 To 30 hp / 1,000 k BTU � ,
30 To 50 hp f],750�k�BTU _,
Over 50 hp / Over 1,750�BTU
Boilers
Quantity
$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.�0 0
$0.00 0
� - Up to 3 hp - ' ' , "$0.00 0
' 3 To 15 hp , � "�� ` , � $0.00 0
15 to 30 hp �" - � � � ' ', $0.00 0
30 to 50 hp , . � $0.00 0
Over 50 hp, . . $0.00 0
OtherMechanical�Fee " � �
Investigation Fee � - � $0.00
. PlanCheck�Fee " , $0.00
Reinspecyon Fee � , $0.00
� TOTAL CALCULATED FEES E38.30
COMMENTS / SPECIAL CONDITIONS
NOTICE: The Work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes antl related
�.� regulations. (Ord. No. 92-28, § 1, 72-21•92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is�susp ed or abandoned
for a period of 180 days.
INSPECTIONS� In order for the work authorized under this permit to be considered legal, such work must comply,with all applicable codes, and all
required Inspecllona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
IFOR INSPEC710NS CALL: (714) 7545626
2446-46(W00)
WORKERS'COMPENSAnON UECLARA
I hereby aHirm under penelry of perjury one
❑ I have end will melntaln a certificete c
work for which this permit is issued.
❑ I have and will maintatn workers' cromF
My workers' compensatlon Insurance
Cartier:
❑ l�ertity that .in tye pedormence of
TO
�f��xfn that I
ettect. Lis
J)ONSTRUCTON'LENDING AGENCY:
❑ I hereby aHirm thal there Is e wns
Lender's Neme:
Signature:
OWNER•BUILDER DECLARATIONS:
I hereby eHirm thet under penelty ot perj
Code: Any city or county which requires
to fila e signetl statement t�et he or she
Business antl Professions Code)�or that
sublects the applicent to e civil penalry o�
❑ I, as owner of ihe property, or my e
7044, Business and Professions C
himself or herself or [hrough his or
soltl within one yeer of completion,
r'• ��•
❑ I, as owner of,the propeiry; am EX�
❑ I em exempt under sec. _
Signamre: —
Owner ID verified by tlrivefs license.
i
Ven(icelion of Ownership by (type of
the following declarations: �. � � , �
msent ro seN-Insure for workers' compensation, es provided for by seqion 3700 of the Lebor Code, for the pedormance of the
n Insurence, as requ'rred Dy sectbn 3700 W the labor Cotle, ta fhe perinrmence d tAe work for which this pertntl is issuetl.
and policy number ere: _ '
Policy Number � -
one
oNess.)
which this permit is Issued, I shell not employ eny person in eny,manner so as to bacome subject to iha workers'
a If I should become sub�act to the workers' compensetion pravisions of Section 3700 of tha Labor Code, I shall fotlhwith
COVEPAGEISl1NLAWFULANDSKALLSUBIEC ANEMFLOYER
= COMPENSATION, DAMAGES AS PROVIDED FO
jpter 9(commencing with Section 7000) ot Division 3 of th
Dete:
PENALTIES AND CIVIL FlNES UP TO ONE MUNDRED
OR CODE, IN�EREST, ANO ATTORNEY'S FEES.
Professlons Cotle, and my license is In full
lending agency for ihe pedormance of the work far which ihis pertnii is issuetl. (Sec. 3097, Civil Code).
Lendels Address:
Da�e:
iryithet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Protessions
e:parmit to constmct, alter, improve, demolish, or repair eny structure, pnor to its.issuance, also requires the applicent for such permit
Is Iicansetl pursuent to the pmvislons of �he Contredors License Law (Chepter 9�,(commencing with Section 7000) of Divislon 3 of ihe
�e or she is exempt theretrom end the basis for the elleged exemption. Any violation of Section 7037.5 by any applicant for a permlt
� not more ihan five huntlred do(lars ($500).): 4
mployees with wa9as es their sole compensation, WILL DO THE WORK, entl the structure Is not intendetl or oHered far sale (Sec.
�de: The Contrectors License Lew does not apply to en owner ot propeAy.wNo bullds or improves thereon, antl who does such work
hei own employees, provided that such improvements are not intended or ottered for sele. If, however, the building or improvement is
the owner-builder wlll have the burden of proving that he or she did not builtl or improve tor purpose of sale.).
:L'USIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tlie projed (Sec. 7044, Business and Professions
r Aoes not appty to an owner of property who builtls or improves thereon, and whb contracts tw such project w'uh a conlracta(s)
� Licensa Lews.).
DIVISION OF INDUSTRIAL SAFETY PER
❑ I hereby certify that no azcavation fivi
pertnit, and that no building strudure
341, 7itle 8, Califarnie Adminisirative
❑ As owner-builder, I will not employ e
permit to do such work from the divis
Signature:
Division o/Industrial Safety Permil
1 Will the epplicant or present or future
material4 ❑ Yes ❑ No
(Section 25505 of the Califomia Heal
businesa which has at any ona time c
or 200 cubic feet of compressed gas z
.............................................................................................
2 Does or will ihe applicant or present o
(Section 25533 of ihe Calitomla Healt
one time has on hand a quentiry ot
compressetl gas at stendard temperel
_ .......................................................................................
3 Does or will the applicant or present o
(Section 25534 of the California H
Depertment of en RMPP by busini
........................... . ........................................................
4 If en RMPP is presently required, I
....................................................................................
5 Does or wlll ibe epplieant or prese
from Ihe South Coast Air Oualiry h
(Section 658502 of ihe California
....................................................................................
6 W ill any part of the feclli�y to be co
(If'yes", the facility must meet the
CERTIFICATE OF COMPLIANCE: I
regarding Hazardous Materials and E
SlgnaNre:
CERTFICATE OF COMPLIANCE AND �
correct I a9ree to comply with all stete
ebove-described propertyforinspection
COOE N. INSOlCIION TYPE
1676 Fizetl System Final Flre Pi
1266 Pool Spa Finel
200 Final Re-Roof
201 Final Block/Retaining Wall
202 .Final Factory Fire Place
203 Finel Sign
204 FinelOemolition
Business and Professions Code tor this reason:
Date:
Yes ❑ No Driver's License No.
nt, i.e. - Property taY bill or deed):
Expires:
(5) or more feet in depth imo which e person Is required to descend, wlll be made in connectlon with work authonzed by this
scaHolding, falsework, or demolition or dismantling thereof, will be more than )hiAy-siz (38) feet high. (Chap. 32, Grp 2, An 2, Sec.
:odwl. �
to do work which would require a pertnit irom Ihe Divlsion ot Industrifll Setety, as noted above, unless such person has e
Date:
occupent need to fila end cehify e Business Plan tor emergency response to release or threatenetl release of a hazardous
a
at a Business Plan be filed with dhe Coste Mesa Fire Department by every
equal m or greater Man a weight of 500 pounds, or a volume ot 55 gallons,
tuture builtling occupant neetl to file e regisiratlon rorm for acutely nazartlous malenals7 U Yes LJ No
antl Safery Cotle, with some exceptions, requlres registretlon wlih ihe�Costa Mese Fire Department by eaCh buslness which at any
icutely hezerdous materials equal to or greeter than e weight of 500 pounds, or e volume of 55 gellons, or 200 cubic faet of
re and pressure). . �
.........................................................................................................................................................................................................................................................................................
future building occupant need to prepare an FiMPP (Risk Management and Prevention Program for acutety hazardous mateAals)?
and Satety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
�� which are required to register acutely hezerdous materiels with ihe Fire Department.
Districf or from any other air pollution control distnct or eqencyl ❑
Code requires ihet ihe requested iniormation be furnishetl on applica
....................................................................................................................................................
�er this permit be wilhin 1000 feet irom ihe outer boundadesof e sch�
of Sections 25534 and 42303 ot the Califomla Heelth and Safery Goc
......................... . .................................... . ............................................................................:........
Nanegement DisMct or other air pollution control districl or egency
ad by Galliornia Health and Safary Gode Section 42303 been made7
❑ No
,nomresidential
No
or
that under penalty of perjury ihe information given above is correcL I egree to comply with all state lews antl city ordinances
Dete:
J1T10N OF ENTRY: I cenity under penalry of perjury that I have read ihis application and stata that the intormation given is
city ordinances relating ro bullding constructioq end authorize representatives of ihe City of Costa Mesa to enter upon ihe
I egree not to occupy or ellow acupancy of any building authorized by this permit until final inspection.
Q�IE
__ r, , , Dete
INTRIpL3 COOE� INSVECTIONTYPE�
206 Final Mechanical
208 Finel Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Finai Buil
Q9jE ItlTRIALS
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
492 ABBIE WY
RIGHT SIDE OF GAR4GE
11737209
Applicane VA4AINIS, SHERI
Address: 492 ABBIE WAY
CO5TA MESA, CA
owner: VAIAINIS, MARIS P
Address 492 ABBIE WAY
COSTA MESA, CA
Contractor: OWNER-BU ILD ER
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+unit5)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 7000a
Service over 1000a
Motors to 1 hp
Motors lo tOhp
Motors to 50hp
Motors to t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ELECTRICAL PERMIT
ISSUED BY:
Phone: 949-642-5490
Zip: 926273162
Phone:
Zip: 926273162
Phone:
Zip:
License: 0
Status: ISSUED
Applied: O6/25/2007
Issued: O6I25/2001
SCOPE OF PERMIT
RELOCATE ELEC METER TO AN APPROVED EDISON LOCATION 8 UPGRADE TO 200A SERVICE FOR AN
EXISTING SFD. .
7 SERVICE TO 200A
`APPLICANT ADDED 8'LIGHT FIXTURES & 1 SWITCH TO EXISTING ELECTRICAL PERMIT ON
7/2/07.
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$8.80
$0.00
$1.10
$0.00
$0.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
, •0
0
0
8 .
0
1
0
0
,�
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
� � Busway I100 ft .
Standing Sedion
Misc Electrical Equipment •� : �' `
Transfortners up to i kva/kw
................up to 10 kva/kw .
.................up to 50 kva/kw � , �
� .................up to 100 kva/kw �:
..................over 100 kva/kw
Low Voltage Equipment �
Low Volt Wiring System / Ckt �
Misc. Conduit �
Misc. Condudor .
Circus ( 9en or ride) �
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspedion Fee
Quantity
$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
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00 �
$0.00
$0.00
TOTAL CALCULATED FEES $63.90
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order foY lhe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaaws (woo)
WpRKERS' COMPENSATION DECLARA'
I h�reby eNirm under penelry ot perjury one
❑ I have end will malntein a certificete o
work for which this pertnit is issued.
❑ I heve end will maintain workers' comp
My workers' compensetion Insurance
Cerrier:
❑ I certify thet in the pertormence of ihe
compensation lews of Celifornla, and
comply with Ihese provisions.
Applicant SlgnaNre:
'�'ARNINO: FAILURE TO SECURE WORKERS' CC
TNOUSAND DOLLAFE ($700,000). IN ADDITION T(
LICENSED CONTRACTORS DECLAR
I hereby eNirm ihat I em licensed untler
force end e(fea. Lic. #
CanfreaoYs Signeture:
CQNSTHUCTION LENDING AGENCY:
❑ I hereby atfirm that ihere is a cons�
Lender's Neme:
Signemre:
OWNER-BUILDER DECLARATIONS:
I hereby aflirm that under penelry of perjun
Code: Any city or county which requires a�
to file a signed statement thet he or she is
B�siness end Professions Cade) or that h�
subjeds the applicant to e civil penalry of n
❑ I, as owner of iha property, or my em
7044, Business and Professions Cod
himself ar herself or through his or ht
sold within one year ot completion, lh
�-- I, es owner of Ihe property, am El(CL
_�--�Code: The conirec�ors Licensa Law c
licanse pur5uant to Ihe Conirectors C
�r�f
❑ I em exempt untl� 5ec.. �� �, •
OW�r ID veritied by dnver's license.
Venfication of Ownership 6y (type of
DIVISION OF INDUSTRIAL SAPETY PER
❑ I hereby canify ihal no excevation fivi
permit, and thet no building structure
341, Title 8, Califomie Atlministrative
❑ As owner-6uilder, I will not employ e
permit to do such work from Ihe�divis
Signeture:
DiVision of Industriel Safety Permit Number
d ihe following declerations: � - � , � �
consent ro self-Insure for workers' compensatlon, es��provided for by section 3700 of the Labor Code, for the pertormance of the
es requiretl by sectlon 3700 of the Lebor Code, for the perfortnance of the work tor which this permit is issued.
umber are: � �
� Policy iJumber:�_
orless.)
for which ihls pertnit is iuuetl, I shell not employ any person In any manner so es to hecome subject to the workers'
�het if I should become sub)ect to the workers' compensatlon provisions of Sedlon 3700 af the Labar Cade, I shall forthwith
Date:
ISATION COVEPAQE IS UNIAW FUL AND SHALL SUBJECT AN EMPLOVER TO CHIMINAL PENALTIES AND CIVIL FWES UP TO ONE HUNDRED
COST OF COAIPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, IMEREST, AND ATTORNEVS FEES.
ot Chapter 9(commencing wilh Section 7000) ot Division 3 of the Business and Professions Code, entl my license Is in full
Class #
Date:
lending agency br Ihe performance of t�e work tor which this permit is issued. (Sec: 3097, Civil Code).
LBnder's Address: '
Date:
het I em EXEMPT FHOM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business and Professions
3rtnit to constmct, alter, improve, demolish, or repeir eny atrucWre, prlor to its�,issuance� also requires ihe applicant for such permit
:ensetl pursuant to ihe provisions of ihe Coniractors License Lew (Chap�er 9, (commencing wi�h Section 7000) of Division 3 oi the
or she is azempt therefrom end the besis for tha alleged azemptlon. Any violetion of Section 7031.5 by any applicant for a permit
: mare than five hundred dallers ($500).): ��'
oyees with wages as iheir sole compensalion, WILL DO THE WOFiK, end the structure is not intended or ofFered for sale (Sec.
7he Contractors License Law does not apply to en owner of property who builds or improves thereon, and who dces such work
own employees, providetl Ihat such Improvements are not intendetl or oftered for sale. If, however, Ihe building or improvement is
owner-builder will have the burtlen of proving that he or she did not build or improve for.purpose ot sele.).
iSIVELV CONTRACTMG WITH LICENSED CON7RACTORS to consiruct t6e project (Sec. 7044, Business end Professlons
es not apply to an owner o1 property who builds or Impmves thereon, and who coniracts for such pmject with e coMrector(s)
BnSB L0w5.). �f
/. /J �� 8usiness end Professions Code for ihis reason: ,...--_.-
�s ❑ No �iiver's License No. /�✓'/ �� � ' � / �Expires: [�.
I.e. - property tat bill or deetl): �"`— -" "
(5) or more feef in depth tmo which a person is required lo descend, will be mede in connecfion with work authodzed by this
sceHolding, felsework, or demolition or dismantlinq thereof, will be more then�thirry-six (36) teet high. (Chap. 32, Gry 2, An 2, Sec.
to do work which would require e pertnit from the Division of Intlustriel Sefery, es noted ebova, unless such person has e
Date:
1 WIII Ihe applicant or present or fuWre bUilding occupant need to file end certlty a Business Plfln for emergency response to release or Ihreatenetl release of a hazardous
materiel? ❑ Yes ❑ No I �
(Section 25505 ot the Celifomia Health and Sefery Code raquires, with some exceptions, Ihat e Business Plen be tiled with the Costa Mesa Fire Department 6y every
business which has at any one time d'uring a repoeetl year a quantiry of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
.or 200 cubic feet of compressed gas at standa�d tempereture and�pressure). �
...... .................................................................................................................................................................................................................:..........................:............................... ....................... ...................................................
2 Does or will the epplicant or present or�future building occupent neetl to tile a ragistretion fortn for ecutely hazardous�materials? ❑ Yes ❑ No
(Sectlon 25533 of the Gelifornla Haelth flnd Safety Cotle, with some exceptions, requires registretion with the Costa Mesa Fire�Department by eech husiness which at any
one �ima has on hend a quantiry ot ecutely hezardous meterlals equel to or greater then e weight of 500 pountls, or a volume oi 55 gallons, or 200 cubic teet of
compressed gas et stantlartl tempereture end pressure).
........................................................................................................................................................................................................................................................................................................................................................................................
3 Does or will the applicant or present orl fuNre building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous meterials)?
❑ Yes ❑ No �
DBPatlRI0f1[ Ot 8n HMYY Dy bu510
.................................................................. . ................
4 If en RMPP is presently required,
...................................................................................
5 Does or will �he epplicant or pres�
from the South Coast Air Ouality 0
(Section 65850.2 of ihe California
...................................................................................
6 W ill eny part of ihe faciliry to be c�
(If'yes", Me teciliry must meet the
...................................................................................
7 If e permit fram the South Coasl
iealth and Safery Code provides that the Costa Mesa Fire DepeAment may require the prepar
esses which ere required to registar acutely hazardous materials with ihe Flre Department.
..........:......................................................................................................................................................................:...........................
has Section 25534 of the California Heelth a�tl Safeb Code been fully complied with7 ❑ Yes
�istrict or trom eny other air polWtion wnirol district ar agency?
Cotle requlres ihat the requested iniormetion be iwnished on ap�
...........................................................................................................................................
iar this permit be within 1000 feet from the outer boundaries of a
of Seclions 25534 antl 42303 ot ihe California Healih end Safety
...........................................................................................................................................
denaaament Dislrict or other air oolWtion coNrol distdct or eaE
Yes
certitication and filing with tha Fire
No
or
8 (If'yes", attach ceRificele of compliance from the eppropriate air polWtion wntrol otticeq.
CERTIFIGATE OF COMPLIANCE: I certiry that under penalty ot perjury the intormation given ebove is correct. I agree ro comply with all state laws antl ciry ordinences
regarding Hazardous Materials antl Emissions. , �
Signature: � Dale: �
CERTFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penelty of perjury that I have read ihis epplication and state that the information given is
conect. I egree tog comply wilh ell state laws entl ciry ordinances relating to building construction, antl euthorize representatives of the Ciry of Costa Mesa to enter upon the
ebove-describe roperty or inspeption u,r�oses._ I egre,not to occupy or ellow occupency ot any building authorized by'this permit uptil tinel inspection.
! n n / /
�vlNL% !% QJ/YLL,O./ / �oY �
SignaNre Of Legal Owner(s). ., _. - Date _
_... .. i_ i� " _
S9Q,.Fj, INSPECTIONTVPE
1676 Fixed System Final Fi�e Preven!
1266 Pool Spa Finel
200 � Flnal Re-Rooi
201 Final BIocWRetaining Wall
202 Final Factory Fire Place , ,
Z03 Final Sign
�04 Final Demolition
jl� �yjQJ� �QQ$,[ INSPEC110NTYPE
206 Final Mechenical
200
210
212
220
222
250
Finel Plumbing
Flnel Eledricel
Finel Fire Prevention
Final Planning Approval
Final Site
Final Building/Occupenc
(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT �
Job Address:
Suite No
Vicinity:
Parcel NUnmber.
492 ABBIE WY
RIGHT SIDE OF GARAGE
11737209
Applicant: VALAINIS, SHERI
Address: 492 ABBIE WAY
COSTA MESA, CA
Owner: VALAINIS, MARIS P
Address 492 AB81E WAY
COSTA MESA, CA
Conhactor: OWN
Address:
RELOCATE ELEC METER TO AN
� EXISTING SFD.
1 SERVICE TO 200A
Quantity
'Status: ISSUED
Applied: O6/25/2001
Issued: O6/252001
ISSUED BY:
Phone: 949-642-5490
Zip: 926273162
��
�
�Pho
: 92627 162
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units) �
New Res (3+units)
Pool / Spa
Lighting Fixls
Recept Outlets
Switches
Non Res App1 � �
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to ihp
Motors to 10hp
Motors to SOhp
Motors to 1 ODhp
Motors ovef 100hp
Communic2tion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pale
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 , `
$0.00 .
$0.00
$0.00��'
$30.50
$0.00
$0.00
$0:00
$0.00 �
$0.00
$0.00
$0.00
0-
0�
�p..
1
0
0
0
0
0
0
0
0
0
0
0
0
0
& UPGRADE TO 200A SERVICE FOR AN
FEE SUMMARY
� Quantiry�'' �
Temp Dist System'/ Lighting $0.00 0�� �
Busway /100 ft $0.00 0 -� �
Standing Section $0.00 0 -
Misc Electrical Equipment $0.00 ' 0 �
Transformers up to 1 kva/kw $0.00 -, 0
................up to 70 kva/kw _ _ $0.00 � p '..
:................up to 50' kJa/kw- : "- - $0.00 0
.................up to 100 kvalkw $0.00 � 0
.......:..........over 100 kva/kw � : � $0.00, . j , 0 �
Low Voltage Equipment �. -; " $D.00 �. 0` , �
Low Volt Wiring System`/ Ckt , � $0.00 ' � �0 �� , �
Misa Conduit - $0.00 .0 �
Misa Conductor . , ,� $0.00 " 0
Circus ( gen or ride) $0.00 0
Cirws (mech ride�or lighls) $0.00 ' 0
Christmas Tree Stand � ; $0.00 0
Fireworks Stand , '$0.00 0
Other Electrical Fee $0.00
Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $54.00
COMMENTS I SPECIAL CONDITIONS
'
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspeetlons and final approval must be obtained. Failure to obtain inspections end final approval will result in lhe ezpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
zaaesa �e�oo)
, .
WOHKERS' COMPENSATION DECLARATION: . "' �
I hereby eftirm under penelry of perjury one of the following declarations: -� �
❑ I heve end will meintain a certificate oflconsent to self-Insure for workere' compensetion, es pmvided for by section 3700 of the Lebor Code, tor the performence of the
work for whiCh Ihis permit IS issued.
❑ I have end will maln[eln workers' compensatlon insurance, es requirad by section 3700 of the Labor Code, for the pertortnance of the work tor which this pertnit is issued.
My workers' compensatlon Insurence cartiar and policy number ere: . .
Carrier. � ' � Policy Number:�
(This section need not be completed i! the permlf is velued at one hundred dollers ($f00) or less.f
❑ I certify that in the pertortnance of the work for which this pertnit Is issued, I shell not employ eny pereon in eny manner so es to become subjed to the workers'
compensetion lews of Celitomie, end egree ihet If I should become subject to the workers' compensstlon provisions of Saction 3700 of the labor Code, I shall forthwith
comply with these provisions.
Applicent SlgneNre: I Dete:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDRION TOITHE CQST OF CAMPENSATION, DAMAGES AS PRONDED FOR IN SECiION 37060F THE LABOR CODE, IMEREST, AND ATTORNEVS FEES.
LICENSED CONTHACTORS DECLARATION:
i
I hereby eHirm ihet I em Ilcensed under provisions of Chepter 9(commencing with Sedion 7000) of Dlvision 3 of the Business antl Professions Code, and my Ilcense is In full
torce and etfecL Lic. A I Cless A
Contractofs SigneNre: � Date:
CONSTRUCTION LENDING AGENCY: I , „
❑ I hereby eNirtn that there is e consiruction lending egency for the pedormance of the work for whiCh Ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Name: � Lender's Address:
Signature: I Dete:
OWNER-BUILDER DECLAFiAT10NS: I �
I hereby affrtn thet under penalry of perjury,thec I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business end Professions
Cotle: Any city or counry which requires e permit to consiruct, elter, improve, tlemolish, or repair any strucWre, pAor to its issuence, also requires ihe epplicant for such permit
to file e signetl statement that he or she is Ilcensed pursuent to ihe provlsions of Iha Conirectors License Lew (Chapter 9,(commencing with Section 7000) of Divislon 3 ot ihe
Business end Professions Code) or thet he' or she is e:empt therafrom and the besis for the alleged exemption. Any violation of Section 7031.5 by any epplicent for e permit
sub�ects the epplicent m e civil penelry of not more than five hundred dollers ($500).): �
i
❑ I, es owner ot the property, or my employees with wages as thelr sole compensatlon, WILL DO THE WORK, and the structure is not intentletl or oHered for sale (Sec.
7044, Business and Professlons Code: The Contractors License law does not apply to an owner of property who bullds or improves Ihereon, and who does such work
himself or he�self or through his or hei own employees, provided that such improvemenis are not intended or ottered for sele. If, howevar, the building or improvement is
� �Itl within one year oi comple�ion, the owner-builder will heve the burden of proving that he or she did nOt build or improve tor purpose of sele.).
I�Y I, as owner of the property, am EJ(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the projed (Sec. 7044, Business and Professions
Code: The contractors License law does not epply to an owner of properry who builds or improves thereon, and who contracts Por such prqect with a contractor(s)
license pursuant to the Contrectors Llcense Lews.).
❑ I em exempt u sec. �� Bus�ness antl Professlons Code for ihis reason:
Signature: �4� Date: U
Owner ID veritied by drivafs license. 0 Ves ❑ No Drivers License No. Expires:
Verification af Ownership by (type of tlocument, i.e. - properry taz blll or deed): �
I
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -
❑ I hereby certity ihat no excavetion five (5) or mora feet In depth into which e person Is �equiretl to tlescend, will be made in connection with work euthorized by this
permit, and thet no bullding stmcture,�scaflolding, felsework, or demolition or dismantling theraof, will be more than�ihirty-six (38) feat high. (Chap. 32, Grp 2, Art 2, Sec.
. 341, Ttle B, Califomia Administretive Code). �
❑ As owner-builder, I wlll not employ enyone to tlo work which woultl require a permit from the Division of Industriel Safery, es noted ehove, unless such person has e
pertnit to do such work from the divislon.
�Signature: � I. Date:.
Division of Industnal Sefety Permit Number
HAZAROOUS MATERIALS AND EMISSIONS CERTIFICATION: �
1 Will the epplicant or present or fulure building xcupant need to fila end certify e Business Plan for emergancy response [o,release or ihreatenetl releese of e hazardous
metedal? ❑ Yes ❑ No I
(Section 25505 of the Calitomia Health entl Setery Code requires, with some exceptions, that e Business Plan be filetl with the Coste Mesa Fire Depatlment by every
business which hes at any ane time during a reported year a quantiry of hazerdous meterials equel Io or greater than e weight of 500 pounds, or e volume of 55 gallons,
or 200 cubic feet of compressed gas et standard tempereture and pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or present or�future huilding occupant need to file e registration tortn for ecutely hazardous metedals? ❑ Ves ❑ No
(Sectlon 25533 of ihe Califomie Health end Sefery Cotle, with some ezceptions, requires registretion with the Costa Mesa Fira��Department by eech business which a[ any
one tlme hes on hand e quantity at ecutely hezallous metenals equal to or greeter than e welght ot 500 pountls, or e volume ot 55 gallans, or 200 cublc feet of
compreuetl gas at standard temperaNra and pressure).
...............................................................................................:............................................................................................................................................................................................................................................................................................
3 Does or will the epplicant or presenl or, tuNre building occupant need to prepere an RMPP (Risk Menagemem entl Prevemion Pmgram for ecutely hazardous matarials)?
❑ Ves ❑ No
(Section 25534 ot the Califomia Health and Satery Code provides that the Costa Mesa Fire Depariment may require the preparetion, cenification and filing with ihe Fire
bepertment of an RMPP by 6usinesses which are requlretl to register ecutely hazardous materlals with the Fire Depertment.
...............................................................................................:.......................................................................................................................................................................:....................................................................................................................
4 If an RMPP is presently required, has Section 25534 of ihe Californie Heailh end Safety Code been fully complied with7 ❑ Ves ❑ No
...............................................................................................:............................................................................................................................................................................................................................................................................................
5 Does or wlll Ihe epplicent or present or future builtlinq xcupant requlre tor the work which is the sublect oi this a plication a permil for SUCh constmction or moditicallon
from the South Coast Air Oualiry Manegement Disirict or irom any other air pollution contml distnct or agency? � Yes LI No
(Sectlon 65850.2 of the California Government Code requires that the requestetl Informetion be furnishetl on applications for non-residentiel building permits).
...............................................................................................:........................................................................................................................................................................................ �....................... ...................................................................
6 W III any part of the faclliry to be constructed under �his pertnit be within 1000 teet from the outer boundaries of a school7 ❑ Yes ❑ No
Qf'yes", the facillry must meet Ihe requirement of Sections 25534 end 42303 of ihe Celitomia Healih and Satary Code).
...............................................................................................:............................................................................................................................................................................................................................................................................................
7 It e pertnit irom ihe South Coest Air'.Ouelity Manegement Disirict or olher eir pollution control district ar egency�is required far tha work which is the sublect ot ihis
applicatlon, have ell of the disclasures'prescdbad by Celtlornla Health and Satery Cotle Sectlon 42303 been matle? ❑ Ves ❑ No
............................................................................................................................................................................................................................................................................................................................................................................................
B pf "yes", attech certificete ot compliance from the eppropriete eir polNtion control oNicer).
CERTIFICATE OF COMPLIANCE: I certity Ihat under penelty ot perjury the intortna�ion given above is corred. I agrea to comply with all state laws and city ordinences
re9artling Hazardous Materials and Emissions.
SignaWre: I Oate:
CEHTIPICAIE OF COMPLIANCE ANU AUTFiORIZATION OP ENTRY: I certify under penalty of perjury that I heve read this application and state that the intormation given is
correct I egree to comply with ell state laws end ciry ordinances relating to building constmction, and authonze representatives of the City of Costa Mesa to enter upon the
above-d scr pd property fo� ins cti uJpnses. e not to occupy or ellow occupancy of any building authorized by this � it y�til�al jnspection.
� pn
/ol //
Signature Of Lagal Owner(s) - at
I
And/O� Authonzad Applicent Data
COpE�, INSPECTIONTVPE ' QB¢ 1NiII�L�4 44PEk INSPECTIONTYPE' � �Rg f�jj�^�
1616 Fizetl System Final Fire Prevention ' 206 Final Mechanical
i
1266 Pool Spe Finel 208 Finel Plumbing
200 Finel Re-Roof � 210 Finel Elecirical
201 Finel BIocWRetaiNng Wall 21 Inel Fire Prevention
202 Final Factory Fire Place i 220 Flnal Planning Ap�pro/vfjal � _ �
203 fin� I Sign 222 Final Site !{��� `^
1
204 Final Dem on I 250 Final Building/Occupancy
�
�
492 ABBIE 7,0.�-I
/
�
-18"DEEP TREMCH. I Z
P�C CONDU IT VdIT}i ( 3)
N° 3 CONDUCTURS, cn
N° 8 GROUND TO IOOA
SUBPANEL.
a
ALLEY '
/
/
, NOTES
lO NEW METER LOCATION. pVERHEAD
SERVICE DROP, IYZ" RIGID CONDUIT
MAST �3)N° 2/O CONDUCTORS.
O2 OLD METER.SET JUNCTION 80X, TIE
IN TO EX�STING SYSTEM.
O3 NEW SYSTEM GROUND� BOND TO COLD
WATER PIPEWITH N44 BARE WIRE
TO NEW METER.
4O NEW SYSTEM SUPPLEMENTAL
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cBaU1LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: d92 ABBIE WY
Suite:
Vicinity:
Parcel Number: 11737209
,4pp�icant: FULTS,GREG
Address: 379 ROCHESTER ST
COSTA MESA, CA
Owner: VALAINIS, MARIS P
Address 492 ABBIE WAY
Zoning:
Phone: 949-650-7828
Zip: 92627
Phone:
COSTA MESA, CA Zip: 92627-3162
Contrectoc THE FULTS COMPANY GENERAL CONTRACTORS
Address: 379 ROCHESTER ST
Phone�. 949-650-7826
COSTA MESA,CA
Zip: 92627 License: 530390
Arch : Eng:
Address: - Address:
Phone:
Slatus: ISSUED
Applied: 07/24/2001
Issued: 07/24/2001
ISSUED BY: �n'A�.�_
i
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF OLD ROOF, 1-15LB FELT�AND 30 YR COMP. SHINGLES. -
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00 -
$97.25
$0.50
$0.00
$0.00
$0.00
$97.75
SETBACKS - �
MAIN STRUCTURE Fronl 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Proposed: 0�
- .Calc Valuation:
Claim Valuation:
� .
Right �0- 0' �
� Right 0-.0 �
$3,500.00'
$3,500.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremeots under Califomia statutes-�related
regulations. (Ord. No. 92-28, § 1, 12-21-92) J% _
EXPIRATION: This permit shall automatically expire and become voitl if work Is not commenced within 180 days, or If work is suspended or abandoned
for a period of 1 BO days. c.: ".-� l-
I
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with=all applioable codes, and all
required Inspectlona and final approval must be obtained. Failure ro obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626 �_-� =~
=— �
zaas-as �s�oo�
WOdiKERS' COMPENSpTION DECLARATION:
1 hereby aHirm under penalry of perjury one of the followinq declaratlons:
❑� I heve end will maintein e certificate of consent to self-Insure for workers' compensetlon, es provided for by section 3700 of tha Labor Code, (or tha perfortnance of the
�work tor which this pertnit is luuetl.
I heve and will maintain workers' compensetion insurance, es requiretl by secGon 3700 of the Lebor Code, for the pertormarice of Me work for which ihis pertnfl is issued.
�" My workers' compensation Insurance certier antl policy number ere: — Y �
Cartier: � Policy Number.
���(This ��/sectlon need not be canpleted il fhe permit Is velued aJ one hundred dollars ($100) or leu.)
�certity thet in the peAo of the work for which this pertnit is issued, I shall not employ eny person In any manner so as to become su6jed to the workers'
compans s a' a, if I should become sub�ect to ihe workers' compense' rovislons of Sectlon 3700 of ihe Lebor Code, I shell forthwith
c thes � /J�
plicant Signa[ ' Date� � ' �'1� ' � �
. AILURE T SEC RS' COMPENSA ION COVERPGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE NUNDAED
THOUSANO DOl1ARE ( ,p00), IN ADD ION TOIT�'�E COST OF COMPENSATION, DAMAGES AS PflOVIDED FOR IN SECTIIXJ 3105 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CO ECLARATIO,N: �
I hereb i et I em license untle pr visions o Chapter 9(commencing with Sedion 7000) oi Divys{ 3eff of the Bysin�j Professions Code, and my license is in full
f a eHecL lic. u � Class #
Contr aols SlgneNr �� \ DaD�e. T_ •!,
CONSTFiUCTION LENqING AGENCY:
❑ I hereby aMrtn that ihere is e cons
Lenders Name:
Signature:
lending egency Por the peAormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Atltlress:
Data:
OWNER-BUILDER DECLApATIONS: '
I heraby eHirm thet under penalry af per�ury ihet I em EXEMP7 FROM THE CONTRACTOHS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professlons
Code: Any ciry or counry Wnicb.reguires a-permit to construct, eller, Improve, demolish, or repeir eny strucNre, prior to its Issuance, elso requires the epplicant for such permit
ro file e signed stetemeriF4hef he�or.'slie is licensed pursuent to the provisions of the Contrectors License Lew (Chapter 9(commendng wlth Saction 7000) of Divislon 3 of the
Business and Professlohs1Code) ar thefhe or.�she is exempt theretrom end ihe besis for t�e elleged exempHon. Any violellon of Section 7031.5 by any epplicant tor e partnit
sub�ects the epplicant�to�a'civil�penalry of noYmore than five hundred dolleis ($500).):
.. �
❑ I, es owner of the property, or my employees with wflgas es their sole compensation, WILL DO 7HE WORK, end the structure is not intentletl or offered for sale (Sec.
7044, Business and Professions Code:,The Contractors license Lew does not apply to an owner of p�operty who builds or improves ihereon, and who does such work
himself or herseN Or thraugh his or her own employees, provided ihat such Imp�ovements era not Intentled or oflered for sale. tl, however, the bullding or Improvement is
sold within one year of completion, the owner-builder will heve the burden of proving that he or she did not build�.or improve for puryose of sale.).
❑ I, as owner ot the properry, em E%CLUSIVELV CON7RACTING WITH LICENSED CONTRACTORS to construct the projeq (Sec. 7044, Business and Professlans
Code: The contractors License Lew does not apply to en owner af property w�o builds or Improves thereon, end who contrects for such proJect with a cantractor(s)
license pureuant tO the Conhacfors Lkense Laws.).
❑ I em exempt untler sec. � Business entl Protessions Cotle for this reeson:
Signeture: � Date:
Owner ID verifietl by dnvefs license. ❑ �Ves ❑ No Drivefs License No. Expires:
Venfication of Ownership by (rype oi document, I.e. - property taz blll or deetl):
DIVISION OF INDUSTq�pL SAFETY PERh
❑ I hereby cetlify thgt no excavetion five
permit, and that np building siructure,
341, lltle 8, Celifornle Administrative (
❑ As owner-builtler, � will not employ ar
pertnit to do such Work from the divisi<
Signature:
Division of Induslrial Sefety Permi[ Number:
1 Will Ihe epplicent or present or future t
materlal? ❑ Yes ❑ No
(Section 25505 W �he Calitornie Healtl
business which hag et any one time du
or 200 cubic feet of compressed ges et
............................................... . ...............................................
2 Does or will the applicant or present or
(Section 25533 of the Califomia Health
one time hes on hantl e quantiry ot e
compressetl ges at stantlerd temperatu
.............................................................................................. .
3 Does or will the epplicant or present or
CERTIFICATION:
or more feet in depih into which e person is required to descentl, will be mede In connection with work euthorizetl by this
ittolding, felsework, or tlemolition or dismantling thereof, will be more lhan thirty-siz (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
to do work which would require e permit from the Division of Industrial Safety, es noted ebove, unless such person hes e
Date:
acupant neetl �o file end certify a Business Plan for emergency response to release or ihreatened release of e hezerdous
�quires, with some exceptions, thet a Business Plan be tiled with the Costa Mesa Fire Department by every
a quantiry of hazardous matenals equal to or greater than a weigM of 500 pounds, or a volume of 55 gallons,
e buiming occupant neea �o rna a registrauon mrm ror acuceiy nazamous mawriais � L.I res u rvo
Sefery Code, wlth some exceptlons, requires registratlon wilh the Costa Mesa Fire Depertment by each business which et eny
ly hezerdous materlals equal to or greeter than e welght of 500 pounds, or a voiume of 55 gellons, or 200 cubic feet ot
id pressure).
(Section 25534 ot ihe Calitornia Heelth and Sefety Code pro�
Depertment of en RMPP by businesses which era required to
...................................................................................................:...........................................
4 If en RMPP is presently reQuired, has Section 25534 of the Ci
from the Soulh Coast Air Oueliry �
(Section 658502 ot ihe Califomia
. ...................................................................................
6 W ill any pert ot the tacllity ta be cc
(N'yes", the faciliry must meet the
application, have all ot Ihe disclosures p
. ......................................................................................
pf'yes", attach certificate ot compllance
CERTIFICATE OF COMPLIANCE: I cei
regarding Hazardous Matarials and Emi:
SigneWre:
�a ro prepare an
ihaf ihe Costa �
(Risk Manegement and Prevention
Fiie Department may i
materiels wlth ihe Fire
g accupent require for ihe work which Is ihe subject of
t or from eny other air pollution conirol district or agenc�
reQuires thet ihe requested intormation be tumished on
Sections 25534 and 42303 of ihe Celitornia Health and Satery Cotle).
.....................................................................................................................................................
negement DisMct or other air polWtion crontrot disMct or agency rs
by Calitomie HeaHh and Sefery Code Sectlon 42303 been metle? [
for acutely hazartlous materials)7
certification and filing with the Fire
an a Permit for such constmcllon or
I�J No
tor nomresidential bulltling permits).
....... ......................................................................
LI Yes ❑ No
Ihat under penalty ot perjury the intormalion given ebove is corred. I agree to comply with all state laws and ciry ordinances
Dete:
CERTIFICATE OF COMPLIANCE AND AUiHORIZA710N OF ENTRY: I certiy under penalry of perjury that I have read this�application and state that the information given Is
carrect I agree to comply wilh ell state laws and ciry ordinances relating to bulltling constmction, and euthodze representatives of the CIry ot Costa Mese to enter upon Iha
ebove-described property for inspeclion purposes. I agree not �o occupy or allow occupancy of eny building authorized by lhis permit until final inspection.
CODE�. INSPECTIONTYPE I
1616 Fixed System pinel Fire Prevention
1266 Pool Spa Plnal �
200 Final Re-Roof
201 Flnal Block/Retaining Well
202 Final Factnry Fi�e Place
203 Final Sign I
204 FinelOemoliti6n
��
% � 2� • � �B
o �e
�$ COpEt INSVECTIONTYPE
206 Final Mechanical
208 Final Plumbing
' 210 Final Electrical
212
220
222
250
Flnal Flre Prevention
Final Planning Approval
Kinal Site
Final Building�Occupancy
pdiE iNTmn�s
'i=��
(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 492 ABBIE WY
Suite:
Vicinity: REAR PROP LINE
Parcel Number: 11737209
Applicant: VALAINIS, MARIS P
Address:
Owner. VqLAINIS,'MARIS FAUL
Address 492 ABBIE VJAY . . �
. �� - - COSTA MESA, CA-�' �, ..._ .
Contractor: �pWNER-BUILDER
Addisss:
2ip:
Address:
Zip:
Phone:
License:
Zoning:
Phone: 949-642-5490
2ip:
Phone:
Zip: 92627-3162 �
Phone:
License: 0
" Eng:
� Address:.
Status: ISSUED
Applied: 06/19/2002
Issued: O6N9/2002
ISSUED gY:
� ' �.
V�� � �
, _\
�`� �
Pha�e.
License:
. SGOPE OF P-ERMIT _ ,.
CONSTRUCT 40 LF, 6' HIGH BLOCK�WALL ON THE BACK PROPERTY LINE PER CITY STANDARDS. I CONFIRMED WITH
DAVID CHO FROM TRANSPORTATION SERVICES AND HE HAS OK'D THE WALL WHICH BORDERS ON THE EDGE OF A - .
GARAGE & ALLEY. � .
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
$2122
$32.65
$0.50
$0.00
$0.00
$0.00
Total: $54.37
SETBACKS
MAINSTRUGTURE Front 0-0
ACCESSORY FroM 0-0
PARKING Existinq: o
��L�ST��I
Rear 0- 0
Rear 0- 0
Reauired: 0
FEE SUMMARY
Calc Valuation:
Claim Valuation;
PLANNING & ZONING
Left 0- 0 Right 0- 0
Left . 4 0 Right 0- 0
Proposed: 0
$aao.00
$o.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot this permit.
POR INSPECTIONS CALL• (714) 7545628 _
�
. .
WdRKEHS' COMPENSATION DECLARATION: ' .
I hereby aflirtn under penalty of perjury one of the following declaretions:
❑ I heve end will maintein e certificete of Consent to self-Insure for workers' compensation, as provided foi by section 3700 oF the Lebor Code, br the performence of ihe
work for which thi§ pertnit is issuetl. � .
�;�� I have end will meintain workers' compenselion insurence, es required by section 3700 of the Lebor Gode, for Ne pertortnanre ot the work for wluch this pem�it is issuetl.
� �'M'�y��workers' compensatlon Insu�ance'cerrier end policy number era:
_Carri� � � cP6lcyNul"`�'�mb'�e�
(This secNon need not be completed Il Me permif is velued at one huntlred dollers ($f00) or less J �- --
❑ I certily thet in the performence of the work for which this permit is issued, I shell not employ eny persan in any manner so as to become subJect to the workers'
compensetlon lews of Callfomla, end egree ihet If 1 sfiould bacome suD�ect to ihe workare' compensatlon provlslons of Seqion 3700 of ihe Lebor Code, I shall forihWlih
comply with these provislons.
�Apptice�ti ign� a"'"`—tu"�re� � �Dete:
G'xS
WMNINO: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SNALL SUfl1ECT AN EMPLOVER� CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE ($100,OOOJ, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3)p50F THE UBOR CODE,IMERES7, AND AT70RNE'/'S FEES.
LIQENSED CONTRACTORS DECLAPATION: '
1 hpreby aHirtn that I em Ilcensed under provlslons of Chepter 9(commencing with Section 7000) of Olvislon 3 of the Business and Protesslons Code, and my license Is In full
forCe end eHectatic_ tA �. � ass'q
QCmmectaPs 51�'pnetwe`.~ �
� C�„ �
CONSTRUCTION LENDING AGENCY: � � �
❑ I hereby eHirm4hat there Is e construction lending egency Por the pertortnance ot the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: lender's Addrass:
Signeture: Date:
OWNEfl-BUILDER DECLARATONS: �
I h�reby eflirm that under penalty of per�ury thet I em EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end PrWesslons
Code: My ciry or counry which requires e permit to construct, alter, improve, demolish, or repeir eny structure, prior to its issuence, also requires ihe epplicant for such permit
to qle e signed stetement ihat ha or she Is Iicensed pursuant ta the provislons ot the Contrectore License Lew (C�apter 9(commencing with Section 7000) of Division 3 of the
Business end Pro(esstons Coqe) or thet he or she is exempt therefrom and fhe basis for the elleged exemptbn. Any violetlon ot SecNon 7031.b by any eppltcenf for e pertnit
subjeds the applicant to e civil penelry ot not more then fve hundred dollars ($500).):
� I, as owner of the property, or my employees with wages as thelr sole compensation, WILL DO 7HE WORK, end the sWqure Is not intended or otteretl for sele (Sec.
7044, Business and Professions Cotle: The Contractors License Law does not apply to en owner ot pmpeny who builds or improves Ihereon, and who does such work
himself or herself or [hroUgh his or her own employees, provided that such improvemenls ara not intended or ottered tor sale. IF, hoWever, the building or improvement is
sold within one year o� completion, !he owrter-bullder will have ihe burden oi proving ihat he a she did not buiM or improve !or purpose o� sals.).
❑ I, as owner of the property, em El(CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business and Professions
Code: The contredors License Lew daes not epply to an owner oi property who bullds or Improves thereon, end who contracts for such pro�ect with e contredor(s)
license pursuant to the Conirectors License Laws.). -
❑ I em eaempt un r sec. Business and Professions Code ta ihis reason:
SlgnaWre�. �� ,. � � Dete: 6 �9 02
�
�Yner ID venfied b���il�vefs Ilcense. ❑ Yes ❑ No Drivers License No. � Expires: 'L �B oy
Verificatiou of Ownership by (type ot document, I.e. - proparty tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
i
❑ I hereby certify that no excavatlon five (5) or more Feet In depth into which e pereon is requiretl to tlescend, will be made In connection with work euthorized by [his
permit, antl that no building structure, sceHolding, falsework, or demolition or dismantling ihereof, will be more than thirry-six (36) teet hiqh. (Chep. 32, Gry 2, Atl 2, Sec.
341, Ttle B, Callfomia Atlministretive Code).
❑ As owner-builder, I will not employ enyone to do work which would requlre e permit trom the Division of Industnel Satety, es noted above, unless such person hes e
permit to do such work irom the division.
Signature: Date:
Division ot Industrial Safery Permit Number:
HAZARDOUS MATEHIALS AND EMISSIONS CERTIFICATION:
1 WIII ihe applicant o� present or future 6uilding acupant need to file and certify e Business Plen for emergency response to releese or threetened release of e hezerdous
materlal7 ❑ Yes ❑ No
(Sactian 25505 of the Calitornla Heallh �and Sefery Code requires, with some exceptions, thet a Busineu Plan be filed with the Casta Mesa Fire Deperlment by every
business which has at eny one time during a reponed year e quantiry of hazardous matenels equal to or qreater then a weight of 500 pounds, or e volume of 55 qallons,
or 200 cubic feet of compressed gas at standard temperature end pressure).
..................................... . ......................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or presant or future building occupent need to file a registretion form for ecutely hazardous materials7 ❑ Yes ❑ No
(Section 25533 ot the Cali(omia Health and Sefety Code, with some exceptions, requires regis(re0on wIM Me Coste Mese Flre Department 6y each buslneu wMch et any
one time has on hend a quantlry of ecutely hazerdous materlels equal ta or greater �hen e waight of 500 pounds, or e volume of 55 gellans, or 200 cubic teet of
compressetl gas at stentlerd tempereture end pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
3 Does or will the epplicent or presenl or future building occupant need to prepare en RMPP (Risk Menegement and Prevention Program tor ecutely hazardous materials)7
❑ Ves ❑ No
(Sectlon 25534 of it�e California Heelth and Sefery Code provides that ihe Cwta Mesa Fire Departmenl mey require Ihe preparation, cetlification and (iling with the Fire
bepertment of en RMPP by businesses which ere requlred b register awtety hazerdous meterials wit� the Fire Depflrtment �
....................................................................................................:.....................................................................................................................................................................................................................................................................................
4 If en RMPP is presently raquired, has Section 25534 of the Celifomie Haellh end Safery Cotle been fully complied with? ❑ Yes C] No .
....................................................................................................: ..............................................................................................................................................,.............................,........................................................................................,...............
5 Does or wlll Ihe appllcant or presenf or fiiture building occupant roquire for Ihe work which 4s the subjeci of ihis e plicetion e Eermit for euch consiruqion or motllNcetion
tram the South Caast Alr �ualiry Mensgement Distdct or irom eny other air pollution cantrol dislrid ar egencyt � Vas u No
(Seclion 658502 of ihe Celifornia Government Code requires thet the requested information be fumished on applicatlons for noo-residential building parmits).
.....................................................................................................:..............................................................................................................................................................................................................
6 Willan .......................................................................
y Deh of the faciliry to be constructed untler Ihis permlt be within 1000 teet from the outer bounderles ot e school? ❑ Yes ❑ No
(If'yes", the faciliry must meet the requirement of SeCtions 25534 and 42303 of the Celifomie Health and Safery Cotle).
.....................................................................................................:.....................................................................................................................................................................................................................................................................................
7 H a permit from ihe South Coest Air pualiry Menagement Disirlcl or other elr pollu�ion conirol disinct or agency Is required for the wotk which is the sub�ect of this
eppllcatlon, heve all of the disclosures pre5cdbed by Celifomie Health end Sefety Cade Section 42303 been matle9 ❑ Yes ❑ No
.....................................................................................................:......................................................................................................................................................................................................................................................................................
8 (H "yes", atlach cetlificate of compliance From the eppropnete air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certiy that under penalry of perjury the intormetion given above is correct. I egree t0 comply with ell stete lews and city ordinences
regarding Hazardous Metenals and Emissions.
Signature: Date:
CEpTIFICATE OF COMPLIANCE AND AU11iORQATION OF EMRY: I ceniy under penalry of perjury ihat I have read ihis applicetlon and stele ihat the information given is
correct I agree to comply with II stete law entl ciry ortlinances releting to bullding constructlon, end euthodze represematives of the Clry of Caste Mesa to entar upon Ihe
ebove-described property for i e�s ose��l egree not to xcupy or ellow occupancy of eny building authorized by this permit uniil�n � i�spection.
r� lo � IOL
��
ature Of Legal Owner(s) � Date
AnNOr Authorized Applicent Date
S90E � INSPECTIONTYPE � pajF �Lfl Se4.PE! INSiECTIONTYPE Qd¢, fyjpJ�§
1616 Fized System Final Flre Prevention 206 Finel Mechenicel
1$88 Paol Spe Finel 20B Finel Plumbing
200 Finel Re-Roof 270 Final Electricel
201 Finel Block/Reteining Well 'i L � 272 Final Fire Preventlon
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
2p4 Final Demolition � 250 Final Builtling/Occupancy
�
J
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Copirn� Op�ioaal �
Channel Bbck With 1-3/8�
Horiiontal Top of all
Fencn
For Fences 5' or Less
Ven. Bars 3/B"yS at A' �O" O.C.
For Fences Higher Than 5'
Ven. Ban 3/8"� at 32" O.C. �
Fill Cells Solid With Grout
W �ere Steel Ocwrs
Rc�nlnrcin9 Sleel $hall
Conform to Sec.A�15-39
A.S.T.M.
All Steel to be lapped
24" or to Code
NATURALGRADE
TWO J/8"O BARS J
CONTINUOUS TOP I
6 BOTTOM y_�
L
MOQ�ZSTEEI MUST 9E TIED IN
PIACE A� TIME OF TRENCN
�NSVECTION. o
R S
4 U
Y W
a =
> z
e
� �
W O
u r
Z
w n
LL
��
yA � N
D^
�KIDiN
SEE CMa
� BELOW
WIDTH
THICKNESS
DEPTH OF EARTHTOOTM
SPACING OF EARTHTOOTH
FOOTING RE�UIREMENTS CHART :
14 . .
10" .
24"
i2'
14
10"
20"
14�
BUILDING DIVISION �
:
12"
8"
16��
16'
GENERAL- NOTES
MORTAR; pna Parf Plasfic Cement, and
TArtE Parts Sand
GROUT; One Part Cement Tlvee anA
One Hal} Parts S�ond
COPING: One Part Cement, Three
POf1S 50114
CONCRETE: Weil M�aed 1:2-V2:3-i/2
Ma� of 7- 1/2 Gal;ens of
Walar Per Sack of Cement
GROUT MAV BE POURED FROM TNE TOV
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREASOF MORIIONTAI REIN
FORCEMENT SMAL� BE CIEAR, CIEAN 6 -
fREE OF ALL MORTAN DEBNIS, ETC.
�M C�" C4RTI+TCOTM
VJ iHE HEiGTH Of FENCE
B�LOW BOTTOM OF �OGTiNG
SCALE: I/2�� = I'
12"
8"
12"
16'
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• IHIS SKET�i LS FOR WFiRMAT70NAL PURP06F5
ONLY. APPLICqNT LS RFSPONSIHLE FOR PROVIDING
AN ACCURATE REPR6SFMA770N OF 7}�t PROPFR'IY
A1 CASE i[iE SiL�PE AND SI7.E DO NOT CORRESPOND
WITti 7HE INFORMA770N PROVIDID ON 7'H155F�J'.
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• SOIIU WALIS/tENffS BERVEQ�12'b' k 6' A1 fff]GFIT SHALL
BE SElBAIX AT LFASf 10' FROM FROM PROPER7Y LINE.
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• SOIm WA115/FFNQ�S SFIALL NOT ID(�D Y 6• QJ }�IIGHT
N7I}�I ]V OF 7HE FROM' PROPERTY IWE (NO'f CURB LWE).
LJI�/ �� W�" � • VER�Y DSI'AN� EROM CURH TO PROPER7Y LIIJE
AND SHOW ON PfAN. VERh7G1ION FROM Tt� Q[Y5
`�� FNGINFIItING DIV610N S REQ[JDt�. CAIl. (714) 754-534?
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BLOCK WALL LAYOUT FOR BUILDING PERMIT
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