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Home My WebLink About971 UNION ST - Building Permits(71d) 754-5273 • Fax (714) 754-4856 � CITY OF COSTA MESA � 6!/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT, PERMIT JobAddress� 971 UNIONAV Suite No Vicinity: Parcel Number: 42244212 Applicant: Address: Owner. Address Contractor: Address: Arch / Eng ; Address: PEREZ, MARTHA ALICIA 971 UNION AVE COSTA MESA, CA PEREZ, MARTHAALICIA 971 UNION AVE COSTA MESA, CA MECHANICAL PERMIT Phone: 949-631-7969 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: Phone: Zip: License: PERMIT NUMBER ��,�b_ 0 0��9 77 FAIR DRIVE, Status: ISSUED Applied: OS/102000 Issued: OS/10/2000 ISSUED BY: SCOPE OF PERMIT CONSTRUCT A DEMISING WALI IN AN EXIST. BATHROOM TO CREATE TWO BATHROOMS, CREATE AN EXTERIOR ENCLOSED WATYER HEATER AREA, INSTALL 5 SKYLITES ICBO# NER 216., C/O OF WINDOW IN THE K17CHEN AREA. BATHROOM VENT, REF B00-00666. ISSUE FEE Inst FAU <100 k B7U Inst FAU >700 k BYU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers � Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Neater $23.50 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $7.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 0 0 i 0 0 0 0 0 0 0 0 FEE SUMMARY Repair I Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System Evaporative Cooler Commercial I ncinerator Domestic Incinerator Comoressors / Absorotion Systems Upto3hp/100kBTU 3To15hp/500kBTU 15 To 30 hp I 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1.750 BTU Boilers Upto3hp 3To15hp i5to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES Quantity $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 30.00 0 $0.00 0 $0.00 0 $Q.O� 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 530.75 NOTICE: The worK authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. N0. 92•28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is notcommenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for ihe work authorized under this parmit to be considered legal, such work must comply with aIl applicable codes, and all required Inspectlona and finel epprovel must be obtained. Failure to obtain inspections and final approval will resutl in the expiration o( this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION OECLARATON: � � � p I hereby ettirm under penalry of perjury one of the lollowing dederetions: ❑ I �ave antl will maintaln a cenificate of consent to selt-Insure tor workers' compensation, as provided for by sectlon 3700 0l the Lebor Code, br ihe peAormance of the work tor which this permii Is luuetl. ❑ 1 have end will maintaln workers' compensatlon insurence, as requiretl by sectlon 3700 of Ihe Labor Cotle, for Ihe peAortnance o1 ihe work for which Ihis permit is issued. My workers' compensation Insuranca carder end policy number era: . Carrier. Policy Num6er. (Thls section need nof be comDle(ed!! fhe permif fs veluetl a( one hundred dW/ars (St00) or less J ❑ I certiy that in the peAortnence of the work for which this permit is Issued, I shall not employ eny person in any menner sa as to become subject to the workers' compensation laws oi Califomia, antl egree t�at it I 5houlA becnme subject to ihe workere' compensation provislons of Seclion 3700 ot Ihe Lebor CoEe, I shall forthwith comply with Ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHFLL SUBIECT AN EMPLOVER TO CRIMINAL PENAITIE$ AND CIVIL FlNE$ UP TO ONE MUNDPED THWSlWO �OLLARE (5100.0OO�.IN ADDITION TO THE ODST OF WAIPENSATIIXJ, DAMAGES PS PROVIDED FOH IN SECiION 3]W OF THE LFBOR CODE, IMEREST. AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLAfiATION: I hereby aftirtn thai 1 am licansed under provisions of Chepter 9(commencing with Sectlon 7000) of Division 3 of the Business and Protessions Cotle, antl my license is In full fome antl ettect. Lic. N Cless M Contracrors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aMirm thet there is a consiruction lentlin9 egency tor Ihe pedormance ot the work tor which this permit is Issued. (Sec. 3097, Civil Cotla). Lender's Name: Lender's Atldress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirm ihat under penatry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or county which requires e permit to consiruct, elter, Improve, demolish, or repair any stmdure, prior to its issuance, also requires the applicant for such permit to ille a signetl statemeN thet he or she is licensed pursuant to the provisions of Ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) ol Division 3 ot Ihe Business entl Professions Code) or thet ha or she Is exempt therefrom antl the Desis for the allegetl exemption. Any viola�lon ot Sectlon 7031.5 by eny epplicant for a permit sub�ects the applicant to a civil penalry ot not more then Ilve hundretl dollare ($500).): ❑ I, es owner of the properry, ar my employees with weges as Iheir sole compensetion, WILL DO THE WORK, end the structure Is nol intended or ottered for sale (Sec. 7044, Busineu end Professions Code: T�e Contrecbrs License Lew does not epply to an owner of property wha builtls or improves Ihereon, antl who tloes such work himself or herself or �hrough his or her ov.n employees, providad Ihat such improvements are not intended or ottered tor sale. If, howevar, Ihe building or improvement is soltl within one year of completion, Ihe owner-builder will have the burden ol provinq Ihet he or she did not build or improve tor purpose oi sale.). I, as owner ot Ihe property, am E%CLUSIVELY CONTRACTING WITM LICENSED LONTRACTORS to construct ihe pro�ect (Sec. 70G4, Business antl Professions Cotle: The croniractors License Lew tloes not epply to an owner of properry who builds or improves thereon, and who comrects br such pro�ect with a contrector(s) license pursuant to tha Contractors License Lews.). ❑ I am exe t under� sp7p�`� Business end Professions Code for this reason: SignaNra: ��Y�KB�6 �� zpires: RIt i,�r ; . Venfication of Ownership by (rype ol daument, i.e. - property tax bill or tleetl): i.( . DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity Ihat no excevation five (5) or more feet In tlepth into which a person Is requiretl to descenq will be made in connection with work authonzetl by this pertnit, and ihat no building sWCWre, scaflolding, talsework, or tlemolition or dismantling thereoi, will be more �han t�irty-sis (36) teet high. (Chap. 32, Grp 2, Atl 2. Sec. 341, Title 8, Califomla Administretive Code). ❑ As owner-builder, I will not employ anyone to do work whlch woultl require e permlt from the Division of Industriel Safety, as noted ebove, unless such person has a permit to do such work from the diWsion. Signature: Date: Division of Industrial Setety Permit Number: CERTiFICATE OF COMPIJANCE AND AUTMORRATON OF ENTRY: I certity untler penalry of perjury that I heve read this application and state ihat the information given is correct. I egree m comply with all state laws and Gry ordinences relating to bullding constmction, and authorize representetives of ihe City ot Costa Mesa to amer uDon ihe ehove�- Qescnbed prope for inspection purposesp. 1 egree not to occupy or ellow occupancy of any building authonzetl by this perrt/yt untll fi/�¢I Inspection. �e%� ��aC S .S /�� / v�i�� Signature f Legal Owner(s) 'Date AnNOr Aufhonzed Applicant CQDE t. INSPECTIONTYPE QS¢, 1�L5 1818 FIxeA Sys[em Final Fire Prevention 1266 Pool Spa Final 200 Final Fe-Roof 201 Final BIocWRetaining Wall 202 Flnal Facmry Fire Place 203 FinalSign 204 Final Demolition 2446a8 COpE I INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electriwl 212 Final Fire Prevention 220 Final Planning Approvfll 222 Final Site 250 Final BuildinyOccupancy i �J I �7�a� �sa-sz7s • Fax (��a� �sa-asss Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: MCITY OF COSTA MESA N BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT 971 UNION AV 42244212 PEREZ, MARTHA ALICIA 971 UNION AVE COSTA MESA, CA PEREZ, MARTHA ALICIA Address 971 UNION AVE COSTA MESA, CA Contrector: Address: ELECTRICAL PERMIT Phone: 949-631-7969 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: PERMIT NUMBER E00-00434 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OS/10/2000 Issued: 05l10/2000 ISSUED BY: �� ► ' � � �� L/ ►' SCOPE OF PERMIT CONSTRUCT A DEMISING WALL IN AN EXIST. BATHROOM TO CREATE NVO BATHROOMS, CREATE AN EXTERIOR ENCLOSED WATYER HEATER AREA, INSTALL 5 SKYLITES ICBO# NER 216., C/O OF WINDOW IN THE KITCHEN AREA. 7 LIGHTS, 6 OUTLETS, 4 SWTICHES REF B00-00666. ISSUE FEE Temp service te5t Res. a/c packag¢ New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept OuUets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Molore to 1 hp Molors to 10hp Motors l0 50hp Motors to 100hp Morors over 100hp ' Communication drops Sub panel to 200a Pale Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 523.50 $0.00 $0.00 $0.00 50.00 $0.00 $7.70 $6.60 34.40 50.00 $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 �uantiry FEE SUMMARY Temp Dist System / Lighting Busway/700k Standing Section Misc Electrical Equipment Trans(ormers up to 1 kvalkw ................up to 70 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. Conductor Circus ( gen or ride) Cirws (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 50.00 50.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E42.20 COMMENTS I SPECIAL CONDITIONS Quantity 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with ali applicable handicap access requirements under Califomia stalutes and related regulations. (Ord. No. 9248, § 1, 7241-92) EXPIRATION: .This permit shall automatically expire and becrome void if work is notcommenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor tha work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectione and tinal approval must be obtained. Failure to obtain inspections and final approval will re5ult in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 , WORKERS' COMPENSATION DECLARATION: �— �'�'' .� I hereby etfirm untler penelty of perjury one of the following declarations: � � ❑ I heve and will malntaln e certilicate of cronsent to setl-Insure for workere' compensation, as provitled for by sectlon 3700 oi the Lebor Code, for the pertormance of the work lor w�ic� t�is pertnit is issued. ❑ I have and wiil meinteln workers' compensatlon insurance, as requiretl by section 3700 of Ihe Lebor Code, for Ne pedortnance of ihe woAc for w�ich Nis pertnit Is issued. My workers' compensetion Insurence carner and policy number are: . Cerner; Policy Number: (This sectian need not 6e completed i! the permit is ve/ued af one hundred dollars ($100) or less.) ❑ I certily Ihat In the pertortnance of Ihe work for which this pertnit is issued, I shall noI employ eny person in any manner so as to become subject to the workers' compensation laws ot Celitomia, end egree �hat if I shoultl become su6ject to �he workers' compensa�ion proNslons oi Section 3700 ot t�e Lebor Cotle, 1 s�all Forthwith comD�Y'Nith these provisions. ApplicaN Signeture: Date: WARNING: FAILURE TO SECURE WOflKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUflIEGT AN EMPLOYER TO CRIMINAL PENALTIE$ AND CNIL FlNE$ UP TO ONE HUNDRED iliQU$ANO DOLLARE (5100,000). IN ADDRION TO THE CQS� OF CAMPENSATIQV, pAM4GE5 AS PROVIDED FOR IN $ECTION 3]OB OF TME IABOR COpE. If�lrERE$T, AND ATTORNEV'$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am licensetl under provisions of Chapter 9(commencing with Section 7000) o( Division 3 of �he Buslness entl Pmteuions Code, and my license is in full �orCe 2nd BfletL LiC. k CIB55 N Conlraclofs Slgnature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirm Ihet ihere is a consiruction lending egency for ihe perfortnance of lhe work for which Ihis permit Is issued. (Sec. 3097, Civil Code). Lenders Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lentlels Atltlress: Date: I hereby aflirm thet untler penalty of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he following reeson (Sec. 7031.5, Business antl Professions Coda: Any city or county whlch requires a pertnit to constmct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires ihe epplicant for such permii to file e signed stetament Ihet he or she Is licensetl pursuant to ihe provisions ot the Comractors License Lew (Chepter 9(commencing wlth Sectlon 7000) of Division 3 of Ihe Business end Protesslons Code) or Ihel he or she is exempt therefrom and the basis for the alleged oxemption. Any vloletion oi Sacllon 7031.5 by eny applicent for e permit subjects the epplicant to a civll penalry of noi more than live hundretl tlollars ($500).): ❑ I, as ownar oi ihe property, or my employees with wa9es as iheir sole compensalion, WILL DO THE WORK, end the structure Is not intendetl or offeretl for sale (Sec. 704a, Business end Professions Code: 7he Contrectors License Law does not apply to an owner of propeny who builds or Improves Ihereon, end who does such work himsell or herselt or t�rough his or her own employees, provided �hai such improvements are not intendetl or oNeretl for sale. If, however, ihe builtling or improvement is sola wlthin one year ot completlon, the owner-builder will have the burden ot proving ihat he or she did not builtl or improve for Ourpose ot sele.). �I, es owner of the property, am EXCLUSIVELV CONTPACTING WITH UCENSED CONTRACTORS ro ConSWCt lhe prqeCl (SeC. 7044, Busine55 end Professions Codo: The conireciors License Lew does not appy to an owner oi property who builds or Improves thereon, end who contrects for such pmjeci with a contractor(s) license pursuant ro the Contracrors License Laws.). /'� ❑ I am exe t unde �a� ' Business end Professions Code tor this reason: / �-�., ignature. �n.�_L/2�� Date: S //f �o11H L]wiwHO'verified by dnvers license. ,�s � No Veritication of Ownership by (rype of tlocument, i.e. - pwperry tax 6ill or DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICATION: ❑ I hereby certiry that no excavation live (5) or more feet In depih Into which a person is requiretl m tlescen4 will be made in connection with work authorized by this permit, entl ihat no 6uiltling structure, scaMolding, telsework, or demolition or dismantlinq Ihereot, will be more t�en thirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle B, Calilomia Atlministretive Cotle). ❑ A5 owner-huiltler, I will not employ anyone to do work which would require a pertnit irom the Division of Intlustrial Safery, es noted above, unless such person has a permit to do suc� work irom tha tlivision. Signeture: Da�e: Division ol Indusirial Salety Permit Number: CER7IFICATE OF COMPLIANCE AND AU7HORVATION OF ENTRY: I cenify under penalry of perjury that I have read this application entl state that the infortnation given is correci. I egree to compy wiih all stete laws end ciry ortlinances relating to building construction, and authorize representatives of the City ol Casta Mesa fo enter upon the ebove-desc�rop� Inspection pQ �ses. I agree not to occupy or ellow occupency of any builtling authorized by his pe t until final Inspection. M �T,'Y�i�\ �Od Siqnature Ot Legel Ow er(s) a� AnNOr Aulharizetl Applicant e 40DE t. INSVECTIONTYPE 7616 Fizetl System Final Fire Prevemion 1266 Pool Spa Final 200 Final Re-Roof 201 Finel BIocWReteining Wall 202 Finel Factory Fire Place 203 Flnal Sign 204 Final Demolition 2ddfi<6 p� INTRIRLS C�Qf,t INSVECTIONTYPE 206 Final Machanical 20B Final PlumDing 210 212 220 222 250 Final Electncal Final Fire Prevention Final Planning Approval Final Site ' Finel Building/Occupancy P9lTE INTRIRLS .labAddress: 971 UNION AV Suite: ` Vicinity; ROOF Primary Occ: R-3 Dwellings/ Cong Res <10 Parcel Number. 422442� 2 Type of Construction: V-N Zoning: App�icant: ' PEREZ-RODRIGUEZ, MARTHA A Address: 971 UNION ST COSTA MESA, CA Owner: PEREZ-RODRIGUEZ, MARTHAA Address 971 UNION ST COSTA MESA, CA Contractor: OW N ER-BUI LDER Address: Zip; Arch : Address: Phone: Zip: License: Status: ISSUED Applied: 01/08/2007 Issuetl: 07/08/2007 Phone: 949-631-7969 y � Zip: 92627-4022 ISSUED BY: / v Phone: Zip: 92627-4022 Phone: �icense: 000000 Eng: Address: Phone: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30# FELT, 4:12 PITCH, 40 YEAR COMPOSITION SHINGLES AND REPAIRIREPLACE SHEATHING qS NEEDED. 20 SQUARES INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: �97.25 SMIP Res: 50.50 SMIP Com: �0.00 Other: $0.00 Inspection: 50.00 FEE SUMMARY Calc Valuation: �a,000.00 Claim Valuation: sa,000.00 Total: $97.75 PLANNING & ZONING SETBACK$ MAIN STRUC7URE Front 0- 0 ACCESSORY Front 0-0 PARKING Existin : o Rear 0-0 Left 0-0 Right 0-0 Rear 0- 0 Left 0- 0 Right 0- 0 Reauired: 0 Pr000sed: 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § t, 72-27-92) 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 tlays. . . INSPECTIONS: In order for the work authorized under this permit to be consideretl legal, such work must comply with all applicable codes, and all requlred Inepections and flnal approvel must be obtainetl. Failure to obtain inspections antl final approval will result in the expiration oi this permit. FOR INSPECTIONS CALL.: (714) 7545626 2an6�a61sro0I WORKERS' COMPENSATION DECLARAY�ON: ' '" ` I hereby eHirm under penalry ot perjury one of the following tleclarations: ❑ I have end will maintain a cartiticate of �nsent to self-Insure lor workers' compensa�ion, as provitletl for by section 3700 of �he Lebor Cotla, lor the pertortnance of ihe work tor which this pertnit is issuetl. _ ❑ I �ave arW will maintain workers' compensaUon insurance, as requiretl Dy sectlon 3700 of tha Labor Cotle, for Ihe pertortnance of �he work for which Ihis pertnit is issuetl. My workers' compen5ation Insurence Cartier antl policy number ere: Carrier: Policy Number. (Thi sec(ion need no( be completed il fhe permit is veluetl at one hundred dollers (S100J or /essJ � - :eertity that in the peRortnance oi tha work for which Ihis pertnit is issueQ I shall not employ any person in any manner so as to become subject to ihe workers' ' compensetion lews ol Califomia, end agree Mat it I should become subject to the workers' compensation provislons of Section 3700 of the Labor Code, I shall forihwith comply with these pr�oy,isons � n��canr.s��u;�e:�-�i'i� � �.4-9� oa�e:_ f�%- �g-6 � WARNING: FAIWRE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AN� SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSAND OOLLARE (5100,000�, IN AODITION TO THE COST OF COMPENSATION, DAM4GE5 AS PROVIOED FOq IN SECTION 3]O60F TME LABOq CADE, INiEREST, AND ATiORNEY'S FEES. LICENSED CONTRACTORS DECIARAT10N: I hareby ettirm tha� I am Ilcensed under prov�sions of Chapter 9(commencing with Section 7000) of Division 3 of �he Business and Pmfessions Code, entl my licansa is in full force entl eMect. Lic. u Class :� Contractor's SlgnaNre: Date: CONSTRUCTION LENDING AGENCV: ❑ I herehy eRirm Ihat ihere is a consWclion lending agency tot the peAormanCe of l�e work for whic� �his permit i5 issuetl. (Set. 3097, Civil Code). Lendefs Neme: Lenders AAdress: Signawre: Dato: OWNER-BUILDER DECLARATIONS: I hereby eflirm that untler penalry oi perjury Ihat I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, eusiness end Professions Code: Any ciry or county whic� requires e permit to construct, alter, improve, demolish, or repair eny stmcNre, prior to its issuence, also requires the applicant for such permit to fila a signad statament ihet he or she is licensed pursuant to ihe provlsions ot the Conirectors License Law (Chepter 9(commencing with Section 7000) oi Division 3 oi the Business antl ProfeSsions Code) or Ihet he or she is exempt Iherelrom and ihe basis for the alleged exemption. Any violetion of Saction 7031.5 by eny applicant for e permll �su cts the applicant to a clvll penalry ot not more than five hundretl tlWlars ($5�0) J�. �, s owner of the property, or my employees with wages es their sole compansation, WILL DO THE WORK, and Ihe simcWre I5 not intentletl or oMered br sale (Sec. 7044, Business and Prolessions Code: The Contractors License Law does not apply to an owner ol propeny who huilds or improves ihereon, and who does such work himself or herself or ihrough his or her own employees, provitletl thet such improvements are not intended or oHered for sale. If, however, Iha 6uiitling or improvement is 5old wi�hin one year of tOmpletion, �he owner-builder will have Ihe burden of proving �ha� he or she did not build or impmve lor purpo5e ol sele.). ❑ I, as owner ol the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 704a, Business and Professions Cade: The contrectors License Law tloes not apply to an owner ol property who Duilds or improves Nereon, and who contrects for such project with a contracror(s) _Llicense.pursuant to the Contrectors License Laws.). Business and Professions Cotla br Nis reason: Owner ID ven�ied by tlriver5liten5e. � 5 ❑ No Verification ol Ownership by (type oi tlocum�i.e. - pwperty tax bill or DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cartity Ihat no ezcavation fiva (5) or more feet in depth into which e person is required to descen4 will be made in connection with work authorized by ihis permit, and i�at no buildinq s�rucWre, 5�holding, falsework, or demolition or tlismantling ihereof, will 6e more than thirty-slz (36) leet high. (Chep. 32, Grp 2, An 2, Sec. 341, Title B, Calilornia Atlministrative G�e)� ❑ As owner-buildar, I will not employ enyone to do work which would require a permit from ihe Division of IndusVial Safety, es noted ebove, unless Such person hes a yermil to do 5uch work imm the divisio�� Signa�ure: Date: Division oi Industrial Sefety Permit NumOer: CER71FlCA7E OF COMPLJANCE AND AUfHORIZATION OF ENTAV: I cenity under penalty of perjury that I have reatl ihis application and stete that the information given is correcL I agree to comply with all stata laws and ciry ortlinances relating to builtling consiruction, and euthonze representatives ol t�e Ciry of Costa Mesa to emer upon the above-described property tor inspection purposes. I egree not to occupy or ellow occupency of eny building euthorized by lhis permit until final inspection. � O�-n�o7 iignature'OIL"egai'Owner(s)--�---__„� LDate� �-, AnNOr AuthoriTed ApPlicant Date COOE !. INSPELTION TYPE 1616 Fi:etl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Finel Final Re-Roof Finel BIocWRe�aining Well Final Factory Fire Place Finel Sign 204 Final Demolition R E UfjQJ�$ _ _ _/� �� /�/� v COpE� INSPECTIONTYPE 206 Final Mec�anical 208 Final Plumbing 210 Finel Elecincal 212 Final Pire Prevention 220 Final Planning Apprwal 222 Final Si�e 250 Final Building/Occupenty QP� NTRIAL .. � � (774) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Addless: 971 UNION AV Suite No Vicinity: Parcel Nunmber: 42244272 Applitant: PEREZ, MARTHA ALICIA Address: 971 UNION AVE COSTA MESA, CA Owner: PEREZ, MARTHA ALICIA Address 977 UNION AVE COSTA MESA, CA Contractor. Address: Arch / Eng : Address: PLUMBING PERMIT Phone: 949-631-7969 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 05/10/2000 Issued: OS/10/2000 ISSUED BY: . ' � � .�►.•. / � SCOPE OF PERMIT REF B00-00666. RELOCATE WASHER AND DRYER, AND WATERE HEATER. NEW WASH BASIN, TOILET AND BATHTUB. REPLACE EXIST. TOILET, WASH BASIN AND SHOWER. ISSUE FEE Backflow irrigation ' Backflow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwatef Drain, Root Drinking Fountain Expansion 7ank Gas EaAhquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT 523.50 $O.OD $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 80.00 $0.00 $6.15 $0.00 $0.00 $0.00 $0.00 $0.00 Qn FEE SUMMARY Laundry Tub! Washer Landscape Irrigation P-Trap Pressure Regulator Process Piping (per 10 R) Receptors Septic Tank Sewer Cap for Demo Sewer Connect Sewer Private Line Shower Sink, bar Sink, commercial Sink, Floor Sink, kitchen Sink, service/mop Spa (private) Spa (public) AMT $9.80 $0:00 $0.00 30.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 59.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Qn 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PtAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 $0.00 $0.00 $79.60 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E110.55 QTY 0 0 0 0 0 0 2 0 0 2 1 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: 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: �n order for the work authorized under this permit to ha wnsiderad legal, such work must comply with all applicable codes, and all required inspeatfons and (inal epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a4&a8 (8N0) WORKERS' COMPENSATION DECLARA710N: � � —�" I �ere�y ettirm untler penalry ot perjury one of the followinq declarations: ❑ I heve and wlll maintein a certificate at consent to self-Insure tor workers' compensatlon, es provided for by seclion 3700 oi �he Labor Code, lor the pertortnance of Ihe work 1or which INs pertnit is issued. ❑ I �ave entl wlll maintain woMere' compensa�ion Insurence, as required by section 3700 of the Lebor Cotle, tor Ihe pedormance of Ihe work for which this pertnit Is Issuetl. My workers' compensatlon Insurance carrier end policy number are: Cartier: Poliry Number: (Thls 5ec0on need not be comp/efed i1 the peimit is velued af one hundred dollars ($100J or less.) ❑ I certiy thet in Ihe pertormance oi tha work for which this pertnit is issue4 I shall not employ any person in eny menner so es to became sub�ect to the workers' compensation laws oi Celifomia, entl egree Ihet If I should bewme SuC�ect to the workers' compensation provlslons ot Section 3700 ot the Lebor Code, I shall lorthwlt� comply with Ihese proNsions. Appllcent Signeture: Dai9: WARNINO: FAILURE TO SEWRE WORKERS' WMPENSATION ODVERNGE IS UNLAWFUL AND SW1lL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES MID CNIL FlNES UP TOIXJE HUNDRED TiKK1SrW D OOILAHE (5100.000),IN ADDRION TO THE COST OF COMPENSATION, DAMAGES PS PROVIDED WR IN $ECiION 3108 pF THE LABOR GODE, IMEREST, AND AT70RNEl^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm thet I em Iicensetl under provisions ot Chapter 9(commencing wit� Section 7000) of Olvision 3 ot the Business antl Professions Code, anG my license is In tull force entl effect. IJc. N Clau a Contrectors SlgneWre: Dete: CONSTRUCTON LENDING AGENLY: ❑ I hereby ettirtn that ihere is e consiruction lending agency tor the OeAormance of t�e work for which this pertnit is issuetl. (Sec. 3097, Civil Cotle). Lender's Name: Lentler's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirm thet under penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, 8uslness entl Professians Cotle: Any ciry or county which raquires e permii b construct, alter, improve, tlemolish, or repair eny structure, pnor to its Issuance, also requires the appliwnt for such permit to ille e signed statement Ihel he or she Is Iicensed pursuant to the provisions of the Contractors Ucense Lew (Chapler 9(cammencing wich Section 7000) ol Dlvlsion 3 oi the Business end Professions Code) or t�at he ar she is exempt therefrom and the basis for tha elleged ezemptlon. Any violation o� Saction 7031.5 by any epplicent for e pertnit sublects Ihe epplicent to e civil Oenelty of not more than five hundred dollars ($500).): ❑ I, as owner ol the property, or my employees wl�h wages as i�eir sola compensatlon, WILL DO TME WORK, end the structure Is not Intended or oHeretl for sele (Sec. 7044, Business end Pmtesslons Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work hlmself or herself or Ihrough his or her own employees, provitletl that such impmvements are not Intended or oHe�etl lor sale. If, however, Ihe building or improvement is �sold wilhin one yeer of completion, �he ownerbuilder will have the burden of proving iha� he or she tlid not build or improve for purpose of sale.). I, as owner of the propeny, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (SecJ044, Business antl Pmfessions Code: The contrectors Llcense Law tloes not epply to en owner ot property who bullds or improves ihereon, entl who coniracis for such projeci wiih a contrector(s) license pursuent lo the Contreclor5 LitenSe Laws.). ❑� Owner ID venfietl by tlrivers license. - Vedficetion of OwnerShip by (type of,c Business and Professions Code for this reason: s ❑ No i.e. - property tex bill or tleatl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I hereby cenify Ihat no excevetion tiva (5) or more feet in tlepth in�o which a person Is required to descend, will be made in connection with work euthorizetl by this permit, and Ihat no building structura, scaHolaing, falsework, or demolition or dismantling thereol, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title B, Calilomia Atlministretive Code). ❑ As owner-bulltler, I will not employ anyone to tlo work which would require e pertnit Irom the Division of Intlus�rial Safety, as noted ebove, unless such person hes e permit to da such work from ihe division. Signature: Dace: Division oi Intlustrial Safery Pertnit Number: CERTFICA7E OF COMPLIANCE AND AU7HORIZATION OF EMRV: I cenify under Denalry of peryury t�at I have reatl this epplication entl state Ihet the information given is correct I agree to comply with all state laws and ciry ordinances relating to �uilding construction, and authorize rapresentetives of ihe City of Coste Mesa to enter upon ihe ebova-descnbed property for inspection puryoses. I agree not to occupy or allow acuDancy of any building autho'zed 6 this perml�=vrtMlipel inspection. G�Sf�/ , J Signa f Lega etv And/Or Authorizea Applicant Date COpE �. INSPECTIONTYPE Qajf, IMRIALS 1616 Fi:etl System Final Fire Preven�ion 7266 200 201 202 203 Pool Spe Final Final RB-Rool Final BIaWRetaining Well Final Factory Fire Place Final Sign 204 Final Demolition cooe" wsrecnoxrrve 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 272 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency GAIE L�B (714) 754-5273 • Fax (714) 754-4856 •��ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 971 UNIONAV Suite: Vicinity: Parcel Number: 42244212 npplicant: PEREZ, MARTHA ALICIA Address: 971 UNION AVE COSTA MESA, CA Owner: PEREZ, MARTHAALICIA Address 971 UNION AVE Contracror: Address: Zip: Arch : Address: COSTA MESA. CA Phone: Zoning: Phone: 949-631-7969 Zip: 92627 Phone: Zip: 92627 Phone: License: Eng: Address: Status: ISSUED Applied: OS/10/2000 Issued: OS/1012000 ISSUED BY: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT A DEMISING WALC IN AN EXIST. BATHROOM TO CREATE TWO BATHROOMS, RELOCATE WATER HEATER TO THE GARAGE . KITCHEN AREA TO BECOME DINING AREA , KITCHEN TO BECOME DINNING. ALl REMOVED WALLS ARE NON BEARING WALLS. FEE SUMMARY � Plan Check: $72.31 Calc Valuation: Sa,soo.00 Permit: $11125 Claim Valuation: Sa,soo.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $184.06 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0-0 Reauired: 0 PLANNING 8 ZONING . Left 0- 0 Left 0- 0 Proposetl: 0 Right 0- 0 Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia 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 it work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlona 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 zaa&ae le��l I WORKERS' COMPENSA710N DECLARATION: � � � I hereby eHirtn under penalry ol perjury one ol the lollowing declarations: � , ❑ I have antl will maintain a certificete o1 consent to self-Insure for workers' compensation, es provitled for by section 3700 ot the Labor Code, lor the peAormance of Ihe work for which lhis pertnil is issuetl. ❑ I have and witl mainiain workers' compensatlon Insurflnce, es required by section 3700 ot Ihe Lebor CoOe, tor ihe perfortnance of the woAc for which t�is pertnit is issuetl. My wOrkers' compensatlOn InSurance cerder enA policy number are: Carrier: Poliq Number. (This section need not be camp/ete0 il fhe peimit is ve/uetl ef one hundred dollars ($100) or less.) ❑ I certily that in Ihe pertortnence of Ihe work lor which this pertnil is issued, I shall not employ eny person In eny manner so as to Decome Sublecl to the workers' compensation lews oi Cellfomia, entl egree Ihet If I should become subject to the workers' compensetlon provislons af Sectlon 3700 ot the LaDor Code, I shall tonhwith Com01y with �hese provi51on5. Applicent Sipneture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSAiION COVERAOE IS UNLAWFUL AND SHALL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSANO OOLLARE ($100,000�, IN ADDITION TO T//E COST OF COMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I am licensed under provisions oi Chapter 9(commencing with Section 7000) of Oivislon 3 of the Business antl Professions Code, ena my license is in tull �orce and effect. Lic. # Class a Contractafs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn ihat there is e cons(ruction lentling egency for the pertortnance of the work for which Nis permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lenders Address: Signeture: Date: OWNER•BUILDER DECLARATONS: I here6y ettirtn that�urider,penelty of perjury Ihet I em EXEMPT PROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Businass ana Professions Cotle: Any ciry or coun'ry,which requires a permit to construct, alter, improve, demolish, or repair eny simcture, prior to its issuance, elso requires ihe applicant for such permlt to file e slgnetl stetement thaPhe or sh'e is Ilcensed pursuent b the Orovisions of the Conirectors License Lew (Chapier 9(commencing with Sectlon 7000) ol Divlsion 3 oi the Business and Professions Code) or.tha(,he or she is exempt therefrom and the besis for ihe elleged e:emptlon. Any violation oi Section 7031.5 by any epplicant lor e permit sub�ecis ihe applicam to e civil panatly of not more then ilve hundred dollars ($500).): ❑ I, es owner ot �he Droperty, or my employees with weges es Iheir sole compensation, WILL DO THE WOFiK, antl �he siructure is not in�entle0 or oflered for sale (Sec. 7044. Business and Professions Code: The Contractors License Lew does not apply to en owner ot propeny w�o builds or improves Ihereon, antl who tloes such work �imselt or herselt or thmug� his or her own employees, proNded that such improvemenis are not intended or oMered tor sale. If, howaver, Iha building or Improvement is sold within one year of completion, the owner-builder will have ihe hurden of proving ihat he or she did not build or improve for purpose ol sale.�. ❑ 1, as owner af the property, em E%CLUSIVELV CONTRACTING WITH LICENSED LONTRACTORS to conSWd ihe prqect (Sec. 7044, Business antl Professions Cotle: The contractors License Lew does not apply to en owner ot pmpeny who builds or improves Ihereon, entl who contraas for such project wl�h e contractor(s) license pursuant to ihe Contrac�ors Llcense Lews.). 7C ❑ �wnert6veritied by drivefs license. Verilication at Ownership by (rype of Business ❑ No property �ax bill or Code for this reason: Dnvers Licen;b No. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certify ihai no ezcavation five (5) or more teel in tlap�h into which a person is required to descend, wlll be made in connection with work euthodzed by this permit, antl thet no building siructure, scaRolding, falsework, or demolition or dismamling thereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celitornla Atlminisiretive Code). ❑ As owner-bullder, I will not employ enyone to do work which would require a permit Irom the Division of Industrial Safery, as notetl above, unless such person has e permit to tlo such work irom ihe division. � SigneWre: Date: Division ot Industrial Satery Pertnit Number. CER7IFICATE OF COMPLIANCE AND AIJTHORIZATION OF ENTRV: I cenify under penalty of perjury that I heve read Ihis wrrect. I egree to comply with ell i ortlinances relating Po building consiruction, end auNodze represent� ebove- cribed prop for � ection purp65es. I a � ot to occupy or allow xcupency of any 6uilding euth rized y i ,��,--��_� Signatur Of Legal wner � And/Or Authonzed Applicant COpE �. INSPECTONTYPE QajE iMrnu�s 1616 Fixed System Final Fire Prevention 1266 200 zoi 202 203 Pool Spa Final Finel Fe-Roof Flnal 81ocWRetaining Wall Finel FaCtory Fire Place Finel Sign 204 Final Demolition ,/ yOUE� INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Final Electncal 212 Final Fira Prevention 220 Finel Planning Approval 222 Finel Site 250 FlnalBullding/Occupancy state that the information given is of Cos�a Mesa to enter upon the � inspection. PdI€ 1t�L$ A'IIIELLER. ARNOED E. AP. No. 117—� INSPECTIONS OCCUPANCY DATE DATE 10-1l�-60 VALUE § 1�OjU.UU FIRE ZONE DESCRIPTION OF WORK D7.ri.Rm & Gara�f OUP I & J TYPE V ZONE SUBCONTRACTOR I _ PERMITSISSUED PI Form 210—SM-11-59 S-B P � /�� . 3_ 5�; COSTA MESA BUILDING-SAFETY DEPARTMENT p. O. BOX 917 C08TA MEBA, GLIFORNIA For Appileant to Fili in Completely TYPE OR PRINT� A�DREISS / � `�N�D/IJ '/ C COSTA MESA. CALIFORNIA TEL. � SIZE 0 I L./ / �/� HO. OF BLDOB. OF LOT Jr0 " .�I•J 'J "�Al• TNOW.oN � USE OF 3 EXISTIN BLDG O E HBTBACK 4�N8 FROM � �� CHMeN oP 8Tpe8T ' REAR YARI SIDE YARD I LBFi ' I RIGHT DESCRIPTION OF WORK BUILDING �. / NO. OF SIZE � g ROOMS 2XTERIOR WAL ROOF COVERING GOVERII USE OF 9UILDING AND WORK TO BE FEE RECEIVED (9-e�' I 'i�-f 9G D O/�lt.(^ �1FpINA�pNNC'E OEPT. APPtiF7 T(�7' l��r, �I��IT BUILDING For Office Use Onl y HECHIPT NO. � �Q[RMIT BUILDING NO. OI � �lANB - YARDS APPROV 3 , «�,eq FRONT APPROVED MESA, CALIFORNIA ING U88 OP ! BUILD�NG ) 1 HERBBY ACI(NOWLEDOH THAT I HAYE qHAD TN�B ARLIGTIOH 7Hg AMOUM BXOWN UND¢R VALUATION IBYOR TNH AND BTATE THAT THS ABOVE IB CORAECT AND A6NE8 TO LOM- pURPOBC OP EeTASL18HING A PEqMIT PEl.ONLY. � PLY WITN �LL CITY OfiDiNANCEB AND BTATE LAW9 RHOULATN6 eu1tDIN0 coxeTitu loH. /�C^-, � VALUATION g � � PERMIT FEE � SIGNATURE OP ��[. � �'�- $ m PERMITTB '�T/t��% � g ff g p� PLAN CHECK $� F AUTHORIZED AGEN7 - ' � � 0 OTAL FEE �,