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Home My WebLink About3457 SANTA CLARA CIR - Building Permits(714) 754-5273 • FdX (774) 754-4856 77 FAIF f7HI Vt, GUS I A MtSA, GA 92626 Job Address: 3457 SANTA CLARA CI Suite No Vicinity: Parcel Nunmber: 41205143 Appiicant: STARK, CHRIS Address: 7229 VARNA AVE NORTH HOLLYWOOD, CA Owner: NUECHTERLEIN, EARL F Address 3457 SANTA CLARA CIR COSTA MESA, CA Contractor. ALAP ASSOCIATES GP Address: 7229 VARNA AVE Arch / Eng : Address: NORTH HOLLYWOOD, CA PLUMBING PERMIT Phone: (818) 407-1247 2ip: 91605 Phone: Zip: 92626 Phone: (818)407-1247 Zip: 91605 License: 771905 Phone: Zip: License: Status: ISSUED Applied: 07/14/2000 Issued: 07/14/2000 ISSUED BY: �� %�i� IlY` � T 9 SCOPE OF PERMIT CHANGEOUT EXISTING WATER HEATER, EXTEND EXISTING GAS LINE, & INSTALL NEW WATER PIPING. ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etG) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valv¢ Gas (1� 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 $0.00 $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 Laundry Tub / Washer Landswpe Irrigation P-Trap Pressure Regulator Process Piping (per 10 ft) Receptors Septic Tank Sewer Cap for Demo Sewer Connecl Sewer Private Line Shower Sink, bar Sink, commercial SinK, Floor Sink, kitchen Sink, service/mop Spa (private) Spa (public) AMT $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $o.00 $0.00 $0.00 $0.00 $0.00 Qn 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-0) 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 PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.�0 TOTAL CALCULATED FEES: E51.75 QTY 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord: No. 92-28. § 7. 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 penod of 180 day5. 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 Inspections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby eflirtn under penalry of perjury one of the tollowing tlaclarations: ❑ I have and will maintain a caqqqi cate of consent to self-Insure tor workers' compensation, as provitled for by section 3700 of the Lebor Code, for the pertormance of Ihe __wyqrforw�ic��ispermit� ued. . [}�hav an mamtain cers' compensation i urance, required by section 3700 oi the Lebor Code, for the perfortnance of the work for which this permit is issued. =My orke � compensati Insurance carner an polic�ber ere: Carrier: - � �po�icy Numb"er:--O/��GY�Z/.SZ/ .(This sectlon need not be completed i! fhe p rmit is v ed one huntlreU tlollers ($700) or less.) ❑ I certify that in Ihe pertorm w or wh this permit is issued, I shall not employ eny person in any manner so es to become subject to the workers' compensation laws of Celif ni that ii hould become subject b ihe workars' compensation provisions of Saction 3700 of the La6or Code, I shall forthwith comply with these provisio . �AppllcenfSlgnatura:—� �Data: �� L'C7 �WARNING;.FAILURE40'SECURE WORKE ' PENSATION �VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CPIMINAL PENALTIE$ AND CIVIL FINES UP TO ONE HUNORED THOUSAND OOLLARE (5100.000), IN ADDITIIXJ TO THE W5T OF COMPENSATION, DAMAGES AS PROVIDED fOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRAC70RS DECLARATION: I hereby attirm ihat I am licensed under p ' s Chapter 9(commencing with Section 7000) of Divisiom3�ohihe�Business and Profe ons Code, antl my license is In full torce antl eHect. Lic. # � 7� �Class,#_ Y �—.3� Contrector's.Signature:l Date: �3 � .��n r CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a construction lending agency tor Ihe pedormance of the work tor which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lenders Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm that untler penalty of per�ury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or county which requires a permi� to construct, alter, improve, demolish, or repair any simcture, prior to its issuance, also requires the applicant for such permit to tlle a signed statement Ihat he or she is licensed pursuent to Ihe provisions of the Contrectors License Law (Chaptar 9(commencing with Section 7000) ot Divislon 3 of ihe Business antl Professions Cotle) or thet he or she is exempt ihereirom and ihe basis for ihe allagea exemption. Any violation of Section 7031.5 by any epplicant for a parmit sub�acts the applicant to a civil penalry of not more than five huntlretl tlollars ($500).): ❑ I, as owner ot the property, or my employees with wages as their sole compensation, WILI DO THE WORK, and Ihe structura is not intended or oHered for sala (Sec. 7044,4Business and Professions Code: The Contractors License Law dces not apply to an owner oi pmperty who builtls or impmves thereon, and who does such work himseltor 6erself,or ihrough his or her own employaes, providetl Ihai such impmvements are not intentletl or oflered for sala. If, however, tha builtling or improvement is sold witfiin one.year,of completion, ihe owner-builder will have ihe burden ot proving that he or she did not builtl or improve for purpose of sale.). i ii� ❑ I, as owner of lhe�propetly, em EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS lo construct the prolect (Sec. 7044, Business and Professions Cotla: The contracrors L'icense,Law tloes not apply to en owner of property who builds or improves thereon, and who coniracts for such project with a contractoQs) license pursuant to ihe Conirectors License Laws.). ❑ I am exempt under sea `�2c� Business and Professions Code for this reason: SignaWre: *�- Date: Owner ID verified by drivers license. ❑ Ves ❑ No Driver's License No. Expiras: Verification oi Ownership by (rype ot document, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAPETV PERMIT CERTIFICA710N: � ❑ I hereby certity ihat no excavation five (5) or more faet in tlepth into which a person is required to descend, will be made in connection with work authorized by ihis permit, and that no building stmcNre, scaifolding, falsework, or demotition or dismantiing thereol, will Ge more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from ihe Division of Intlustrial Safery, as notetl above, unless such person has a permit ta do such work from Ihe division. SignaWre: Division of IndusMal Satery Permit Number: Date: Will Ihe applirant or present or tuWre builtling occupant need to file antl cenify a Business Plan for emergency response to release or threatened release ol a hazartlous material? ❑ Ves ❑ No (Section 25505 of the Calitornia Health and Safery Code requires, with some exceptions, ihat a Business Plan be filetl with Ihe Costa Mesa Fire Depanment by every business which has at eny one tima during a reported year a quantiry of hazardous materials equal to or greater ihan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperature and pressure). ......._ ... ........ . .......... ................ Does or will ihe applicant or presem or future building occupent need to file a regisiration form for acmely hazardous materials9 ❑�Yes ❑ No (Section 25533 of ihe California Health and Safety Code, with some ezceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materlals equal to or greater than e weight of 500 pounds, or e volume of 55 gallons, or 200 cubic feet oi compressed gas at stantlartl temperaWre and pressura). Does or will ihe applicant or present or future building wcupant need to prePare an RMPP (Risk Managemem and Prevention Program for acutety hazardous materials)? (Section 25534 of ihe Califomia Heal�h and Safery Code provides Ihat the Costa Mesa Fire Depatlmem may require the preparation, certification and filing with the Fire Depariment of an RMPP by businesses which are required to register acutaly hazardous matenals with Ihe Fire Deparimant. 4 N an RMPP is presenity requiretl, has Section 25534 of ihe Califomia Healih and Safery Code been fully complied with? ❑ Yes ❑ No 5 Does or will ihe eppllcent or presen� or �uWre bulltling occuparn requlre mr me work wnlcn IS tna sublec� of lhis a pucation e germlt for such constmction or motlification irom the South Coast Air �ualiry Management Disirict or from eny other air polWtion control disirict or agency? � Yes LJ No (Seciion 658502 of Ihe Caiifomia GovemmeN Cotle requires �hai Ihe requested intormation be tumishetl on applications for nomresidential builtling permits). """' . ....."".._. ......."""' . _ ............... ._ ..... 6 W III en ert of the facilit to be constmc�ed under this ermlt be within 1000 feet irom iha ou�er boundaries of a school� � yp y p . ❑Ves ❑No Qf yes", the faciliry must meet ihe requirement oi Sections 25534 end 42303 of the Calitomia Healih end Satety Code). 7 tl a permit from ihe South Coast Nr �ualiry Management District or other air polWtion conirol tlistnct or agency is requiretl tor the work which is the subject ot this application, have all oi ihe disclosures prescnbed by Californla Health and Satery Cotle Section 42303 been matle? ❑ Ves ❑ No 8 Qf'yes", atlach certificate ot compliance irom the appropriate air pollution conirol oRicer). CERTIFICATE OF COMPLIANCE: I certiTy that untler penalry of perjury the iniormation given a6ove is correct. I agree to comply with all siate laws and ciry ordinances regartling Hazardous Materials and Emissions. Signature: CERTIFICATE OF COMPLIANCE AND , correct. I agree to comply with all state above-tlescribed propertyforinspectio2 COpE N, INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Damoli�ion . 2A66-46 Date: YF ENTRY: I ceAify under penalty ot perjury that I have reatl this application antl state that ihe information given is iances reiating to building constmction, and au�hodze representatives of Ihe City of Costa Mesa to enter upon the not to occupy or allow occupancy of any building authorized by this permit until final inspection. ont xTrtin� COUEN INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupancy �RTE INTRIALS c (714) 754-5273 • Faz (714) 754-4856 • www.Cl.Cos�e-mesa.Ca.us _ 77 FAIR ORIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job nddress: 3457 SANTA CLARA CI Suite: Vicinity: RESIDENCE AND ATTACHED GAR4GE Parcel Number: 41205143 Applicant COFFEY, BRIAN Address: 2428 NEWPORT BLVD #5 COSTA MESA,CA � Owner: NUECHTERLEIN, EARL F Address 3457 SANTA CLARA CIR COSTA MESA, CA � Contractor: THE ROOFING SPECIALISTS Address: 2428 NEWPORT BLVD #5 COSTA MESA,CA Zip: 92672 Arch : Address: Status: ISSUED Applied: 12/052001 Issued: 12/05/2001 Zoning: R1 R1 ISSUED BY: ' Phone: (949)722-8846 Zip: 92672 Phone: Zip: 92626 Phone: (949)722-8846 License: 734068 Eng: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T!O EXISTING WOOD SHAKE ROOF & B.U.R. AT FLAT, INSTALL 7116" OSB OVER SPACED SHTG, 1 LAYER 30# FELT ON PITCHED & 1 LAYER 28# FELT ON FLAT,�REROOF WITH "ELK PRESTIQUE" 30-YEAR COMP & MODIFIED RUBBER. 24 SQUARES Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $111.25 $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING LeN 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 sa,aso.00 $4,860.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlons and (inal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 244Bd8 (8�W) WORKERS' COMPENSATION DECLARATION: � � I hereby eflirtn untler penalty of perjury one of the tollowing tleclarations: ❑ I have and will maintaln e certifiwte of wnsent to self-Insure for workers' campensetlon, es provide0 tor by section 3700 of the Lebor Code, lor ihe pertormance of the �� work ior which this permlt is issuetl. I have end will maintain workers' compensation insurance, as require0 by sectlon 3700 of the Labor Code, for the perfortnence oi the work for which Ihig pertnit is Issued. My workere' com ensatlon Insurance carder end policy number are: �p Cflrtier. hT�� f�� Poliry Number. L v) 7�G � (This section need nat be camp/eted i! fhe permif is veluetl at one hundred dW/ers ($100) or IessJ ❑ I certity Ihat in the pedormenca of the work for which this pertnit is issueq I shall not employ eny person in any manner so as to bacome subject ro the workers' wmpensa0on laws ol Celitomia, end egree that'' shoul0 bewma sub�acl Io Ihe warkers' compensation pmvisions of Sectlon 3700 at t�e Lebor Coae, I ahell torthwith compty with these provisrim65. < C Applicant Signature: Date: � z �—O ( WARNINO: FAILURE TO SECURE WORKERS' COMPE N COVERAOE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENPLTIES /NO CIVIL FINES UP TOONE MUNDRED hKKl$AN� Dq1ARE (5100,000�, IN FDDIiION TO TH T OF COMPENSATIIXJ, DAMAGES AS PfiOVIDED FOR IN SECiION 3]O60F THE LABOR CODE, IIJrEREST, AND ATTOqNE`fS FEES. LICENSED CONTpACTORS DECLARATION: I hereby eHirm Ihe� I em force end ettecl. Lic. N_ CamrecbYs Signeture: of Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business and Protesslons Code, an0 my license Is in full Cless q � - '� 9 � Date: t Z '-�o "�/ CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn ihat t�ere is e consiruction lending agency tor the peAormance of ihe work for which this permit is issuetl. (Sec. 3097, CIvII Code). Lendefs Neme: Lender's Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I �ereby ettirtn Ihet untler penalry oi perjury that I am EXEMPT FROM THE CONTFACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which raquires e pertnit to consiruct, al�er, improve, demolish, or repair any structure, prior to iis issuance, also requires the eppliwnt for such pertnit to file a slgned statement t�et �e or she is Iicensed pursuent to the provLsions of Ihe Contrectors License Lew (Chepter 9(wmmencing wlth SecOon 7000) 01 Dlvision 3 oi the Business end Prolessions Code) or t�at �e or she is exempt iherelram end Ihe �asis lor Ihe elleged exemption. Any violetian ol Section 7031.5 Dy any epplicant for e peml. subjects tha applicant to e civil penalry ot not more than five hundred dollars ($500).): ❑ I, es owner of t�e property. or my employees with wages as their sole compensation, WILL DO T1E WORK, and ihe sirucmre is not Intendatl or oflerad for sale (Sec. 7044, Busineu end Professions Code: The Con�ractors License Law tloas not appty lo an owner of properry who builds or improves ihereon, and who does such work himself or hersell or through his or her own employees, pmvided that such improvements are not imended or oHeretl tor sale. If, however, the buildinq or impwvement Is soltl within one year ol completion, the owner-builtler will �eve the burden ol proving Ihat he or she did not build or improve lor purpose of sele.). ❑ I, es owner ol the property, em EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to consiruct ihe pro�ect (Sec. 7044, Business entl Prolessions Code: The contrecior5 Litense Law does not apply to an owner oi property who builtls or impmves i�ereon, and wh0 conlracts for 5uth project wlth B conirector(s) license pureuant to the Contractore license Laws.). ❑ I em exempt under sec. Signature: Owner ID verilletl by dnvers Ilcensa. ❑ Ves ❑ No Business end Prolessions Cotle for this reason: Veriticetion of Ownership by (lype of tlocument i.e. - property lex blll or deed): UIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Orivers License No. Date: Expires: ❑ I here6y cantly that no excevation five (5) or more feet in depih into which e person Is required to descend, will be made in connection with work euthonzed 6y Ihis pertnit, and Ihat no building structure, scaHolding, falsework, or demolition or tlismaniling Ihereol, will be more Ihan �hirty-six (36) tee� hiph. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Calilomia Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to do work which would reQuire a permit irom the ONision of Industnal Sefery, as noted ebove, unless such person has e permit to do such work irom Ihe diWsion. Signeture: Date: Division of Industrial Selery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AU1T10RIZATION OF ENTRY: I certify under penelty ot perjury that I have read this epplication entl state thet Ihe iniormation given is correct. I agree to comply wlih ell state laws and clry ordlnances rela�ing to building constmciion, end au�horize representatives ot the City of Coste Mesa to emer upon ihe ebove-tlescribed property for inspection puryoses. I agree not to occupy or ellow occupancy of eny buiiding authorized by this permit until finel inspection. COUE I' INSPECTIONTVPE � 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Ra-Root 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition �g �� 9�l � COOE I INSPECTION TYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Flnal Fire Prevention 220 222 250 Final Planning Approval Final Site Final BuildinyOccupency Dele —�O—C Date PAIE Ixrm�LS • 1 (7�a) �5a-52�s • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT �� rnin univc, w��r rv��.+,.... ��o« Job Address: 3457 SANTA CLARA CI Suite: Vicinity: FRONT OF HOUSE Parcel Number: 41205143 npp�icant: NUECHTERLEIN, EARL F Address: 3457 SANTA CLARA CIR COSTA MESA, CA - Owner: NUECHTERLEIN, EARL F Address 3457 SANTA CLARA CIR Contractor Address: Zip: Arch : Address: COSTA MESA, CA Phone: Zoning: R1 R1 Phone: Zip: 92626 Phone: Zip: 92626 Phone: License: Eng: Address: ISSUED BY: Status: ISSUED Applied: 11 /07/2000 Issued: 11/07/2000 Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 12 LINEAL FT OF 6' HIGH BLOCKWALL WITH NEW GATE ALONG FRONT OF HOUSE. Plan Check: $15.28 Permit: $23.50 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 inspection: $0.00 Total: $38.78 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 22- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 FEESUMMARY PLANNING & ZONING Lefl 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 82ao.00 so.00 NOTICE: The work authorized by ihis permit shall comply wilh all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. , INSPECTIONS: In order for the work authorized untler this permit to be considered legal, such work must comply with all applicable codes, and all requlred inapectlons and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a46-6818�00) r � WORKERS'COMPENSATONDECLARATON: I hereby aflirm under penalty of perjury one of ihe lollowing declarations: ❑ I have entl will maintain e certilicate of consent to self-Insure for workers' crompensetion, as pmvided for by section 3700 0l the LaDor Code, lor ihe peAormance of the work for whic� ihis permit is iuuetl. ❑ I heve end will maintain workers' compansatlon Insurance, as requiretl by secGon 3700 oi ihe Labor Cotle, for ihe pedortnance of ihe work tw which ihis permit is issued. My worker5' compensation Insurence carner antl policy number are: , Carrier: Policy Number: (TM1is secfion need not be completed il fhe Oertnif is veluetl ef one hundretl dollars ($ f00) ar less.) ❑ I certity that in the pertormance of the work br which ihis permit is iSsueQ I shell not employ any person in eny menner so as fo becoma subjecf to Ihe workers' compensation laws ot Califomia, and agree ihat ii I should 6ecome subjecl to the workers' wmpensalion provisions ot Seciion 3700 0l the Lebor Code, I shall fort�with comply wi�h �hese provi5ions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SHRLL SUBIECi PN EMP�OYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TOONE HUNORED TMOUSAND pOLLARE (5100,000), IN ADORION TO TME COST OF COMPENSATION, DPMAGES AS PROVIDED FOq IN SECTION 3]O60F THE UBOR COOE. INTEREST, AND ATTOqNE1^S FEES. LICENSED CON7RACTORS DECLARATION: i I hereby eNirm that I em licensed untler provisions of Chapter 9(commencing with Section 7000) ol Divislon 3 0l the Business end Pmlessions Code, entl my license is in full '�, force entl ettect. Lic. N Class p Coniraaofs Signeture: Date: CONSTRUCTION LENDING AGENCV: � ❑ I here6y affirm that there is a consiruction lending agency for the pertormance of the work lor w�ich this pertnit is iuued. (Sac. 3097, Civil Cotle). Lentlefs Name: Lenders Atldress: SignaWre: OWNER-BUILDER DECLARATIONS: Data: I hereby attirm Ihat unGer penalry ot perjury Ihef I em EXEMP7 FROM TME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professlons Cotle: Any ciry or wunry which requires a permit ro construct, alter, improve, demolish, or repeir eny strucWre, pnor to its issuance, also repuires the applicant for such permit to tile a signed statement ihat he or she is IicenseA pursuant to the pmvisions of t�e Contraqors License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the Business end ProFeSsions Code) or Ihat he or she is enempt therelrom and the basis lor Ihe ellegad ezemption. Any violation ot SeCtion 7031.5 by any appliwnt lor a permit subjecis the applicant to a civil penalty of not more ihan five huntlred tlollars (S500).): ❑ I, as owner ot Ihe property, or my amployees with weges as their sole compensa�ion, WILL DO TME WORK, and Ihe simcWre is not intendetl or ofteretl tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apPly to an owner of property who builds or improves ihereon, end who does such work himself or herseN or Ihrough his or her own employees, provided that such improvements are nol Intentled or oNerad for sale. If, however, the building or improvement is .—sotld within one year ot completion, the owner-�uilder will havo ihe burden ol proving Nat hn or she did not builtl or improvo for purpose ol sale.). ❑ I„as owner of the pmperty, am EXCWSIVELV CONTRACTING WITM LICENSED CONTRACTORS to conSWct the proiact (Sec. 7044, Business and Pmfessions --Cotla: The contractors License Law aoes not apply to en owner of property who bulltls or Impmves Ihereon, antl who contracts for such projeci with a contrecror(s) license pursuant �0 the Con�ractor5license Lews.). � I em eaempt u r sec. usiness antl Professions Code lor ihis reason: Signawre: ��ic� � � e � Owner ID venfied by dnvefs license. ❑ Yes ❑ No Drlvefs Ucen58'Nor�/ Venlica�ion of OwnerShi b � p y(rype ot tlxumem, i.e. - praperty taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify thai no excavation fve (5) or more fee� in depih into which a person is requiretl �o descend, will ba made in connection with work authorized by thls permit, and that no building strucWre, scalloltling, falsework, or demolition or dismantling thereoi, will be more than thirty-sia (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. ' 341, Tl�le 8, CelifOrnia Adminis�ra�ive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permil from the Division ot Indusirial Selery, es notetl ebove, unless such person hes e permit lo do such work from ihe division. Signature: Date: Division of Inaustrial Safery Pertnit Numhar: CERTIFICATE OF COMPLIANCE AND AUfHORVJl710N OF EMAY: I cenity under penelry of perjury �ha� I have read this application antl state Nat the infortnation qiven is correct. I egree to comply with all state laws end ciry ordinances relating m builaing construction, and euthorize representa6ves ol the Ciry ol Casta Mesa to enter upon Ihe ebove-described properry f/o'r ins�pe./ctio�n pu/rpjoses. I e9ree not to upy or ellow occupanry ol eny building aut�orized by thisJpertnit %until final inspection. � �! �/L �J�lRS_:1 ��.1/r� l �— / — � �SignaWreOf�legal.Owner(s) � Data � AnNOr Aut�onzetl Applicani Da�e GO�E 1, INSPECTIONTYPE 1616 Fi:etl System Final Pire Prevenlion 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Faciory Fire Place 203 FinalSign 204 Final Demolition Q�jj �NfITIRLS lZ-LJ-vd � CO�E 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 270 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy OpTE INTm�Lg � � �a Y � Ir ' %�-� � .L � c�� : . �.. . �� - �� — ��-��.�-��v ._ . Y ::;.v:V t, . � x �.:r .: . . ,_ � r CiTY Os= CGSiA h,�i�:�r� : �;, �. � � ��_ � - - �-� s sa( oi pinar, sn:y spacifcaticrs MUS i 6e f;ep; cn ihis jou at a!I iim2s a:�d il is ¢�i��;nii :::� C� b.fy� G`!N1;jC,.' Of icl0,u'l�l;,'i S�R1Z't%f�i1CUi NTd�Ef� �t3I11!Sik;:l ii�iiil o ��{Y�Y�� 0� Lfii��) ,� !}a!ely, Chy oi Coeta Me;a. l jOD ' O I�� ;:ie stamping Cf 1hiS Fiy9 2i�d Sj:9ciliC.lio.^.5 �F?A4L idOT be 6k �1?o rerl�.l or lo b: aa � p;,ro :i fhr v!r�!"iion of any proviaio,i � cf rny ^;y rf i:r,!a `.fi,sa ilydir•�n�e 4ndlor a1a10 I� i�:"'v�IuSa'1L�fv.fR'i� i /: � i_iflll ^tlb'^1�!(i�L�lBiif�TO'�I`�^db� �'.�� n ' , ±'( . u � . ,. .. '�f IJ . . ��n i;�i •.i'h'�i ;C� L's <.�f p.",'.. ��5� rf�,�--�"l� _ _-==�=�'-= � ��, .�:-^, �� _,- _- �.,�:.- ._� -�,� . .� _. . 3� :i�C� ;;=i�F�i�. .,�: -. n=G. T �' " '..e" ' ' "_-�r�� nv.;.T .. .. . . _ ..y J ;.! 1 U� r- .��_ �i ;�.� � L,,r � � Ji ,�y'aiv7 y�,�D � _��A� �� _ - .- � r � � "'_ — . . . .DRiV�w�-y �j6.�t: G;�.� �, G�- � a � �� O�� F �� oti 5 J. �- �i � � R - � � D : � � ... � r.-.-.4�%c.V ( ySo... .,.::t�:^ ; ,.,�.��:-,,;,.• .`j�..-;�F r G�: ��f � . . , w� �''t.,... :,~":;:�/ y. : Gc—c�e.%i��D, � G R� . . .7�.�o.�a_wc.�.� �LDT Go � O i:� ur��a '. S" ' Fa � t.�� 5�6 ��_ ' '"_-a�.�'� 3 Y5'7 S� C�d C'�,.� C� �� i. ... 9.? 6.� 6 E�Q � F �j / / I/l1�"C�/-��i�L �iiv � ( T'� % � 1fi,QGi�/i,4 S. �,.�. AOP�lcant to fill in all CITY OF COSTA MESA PEg� IT NC �tlfif�fRUCTION PERMIT .(�" . Address License No. within M1eavy EorCe� lines antl Address �— Contractor Phone �'w�- Address � - - LICENSED CONTRACTOR DECIARATION 1 hereby aHirm tha[ I am licensetl untler provislons of Chart¢r 9(com- man<ing with se<tlon 7000) of DlvVsion 3 of tne Business antl PfOtE55I0lIS COtl¢� dlltl Ty IiC<OS¢ IS I!1 t1111 fOfCO dOtl Cf(¢CS. Litense Class License No. Date Si9nature WORKERS• COMPENSATION DECLARATION I hereby affirm that 1 have a tertlficate ot consent to selbinsure or a Clrtiflwte ot Worker5' COmp¢nSatiOn'Insurance, or a certifie0 coOY thereot (Section 3000, LaC. CJ. cy No. Company .:ertlfietl coOY 75 hereby furnishea. LJ Certitletl copy Is tilea witn the city Bulltling Divislon. EXEMPTION FROM WORKERS• COMPENSATION DECLARATION (This 5¢cUon nEetl not be Completetl if Ihe permit IS for one huntlretl SE100) or leu). � certity that In the per(ormance o( the work for which this permit is issuetl, I shall not employ any person In any manner so as to become sub)ect to the Worker5' Compensation Laws ot California. Ddt¢ Si9natur! NOTICE: It afler making this tleclaration, you shoultl become suGject to the WOrkerS' Compen5ation provi5ion5 of the Labor Cotle, you must torthwith comply with such provisions or this permit shall be tleemea rBVOk¢tl. ' � -' - CONSTRUCTION LENDING AGENCV I hereby aftirm that there is a construttion lentling agency for the per- formance ot the work /or which this permit is issuetl (Seccion 309] Civ. CJ. Lentler'S Name Lender's Atldress OWNER BUILDER DECLARATION I hereby a(firm t�a[ I am ezemp[ trom.[he Contractor's Llcenre �aw for the tollowing reason (Section ]031.5 BUsiness antl Profe55ion5 Cotle: 'Any city. o� county which requlres a permk to construct, alte�, irt�prove, tleroolish o� repair any Structure, prior to it5 I55uanCZ, al5o r¢- qWr25 the applicant for such permi[ t0 flle a signetl statement ihat M1e �5 IICCfISEd pUI5Udf1� f0 IIIE provisians Oi II1C COOIldCLOI'S L�C2f152 LdW (Chapter 9(cOmmenCing.with SectlOn �000) ot Olvision 3 of the P��siness antl Grolession5 Cotle) or that he is exempt therefrom antl the ' for the alle9¢tl exemption. Any violation of SeCtion �031.5 by_ apPli�nt to� a pe�mit subjects tne applicant to a civil penalty aot more than five huntlretl.tlollars ($500). ❑ I, a5 owne� ot the property, o� my employee5 with wages as thelv sole compen5ation, will tlo the work, antl the�structure Is not intentletl o� o(t¢retl tor sal¢. (SeCtion ]046, Buziness antl Rofe55ions Code: The ContrdCtor's License Law tloes not apply to an owner Of a p�operty wM10 builtls o� Improves tM1ereon, and who tloez su<h wo�k himselt or through M1is own employees, provitletl lhat such Improvements a�e nol Intentletl ot offeretl to� sale. If, however, the builtling or improvement is sold within one year of mmpletion, the owner will have the burtlen ot proving he tlitl not builtl o� improve fo� the purpose of sale). ❑ I, as owner of [he property, am exclusively contractih9 �+��h Iicensetl contractors to construct the project (Section �044, Business antl P�o(essions Cotle: The ContraCtor'S License Law tloes not appty fo an owner of property who builtls or improves the�eon, antl who con- lratts from such projects with-a canVacto�(5) Iicesnetl pu�suant to [I12 COOIfdCfO!'S LICCfISC LdW). _ ❑ I am exempt untle� Section B. 8 P. C. fo� this reason Date Owner I her¢by certity that I have reatl this applica[ion and sta[E that Ihe above mf0/mation i5 wnecL 1 a9ree fo comply with all City antl couniy ortlinances antl state laws relatin9 to Const�uction, antl hereby autho�iie r¢P�esentatives o( thi5 city to enter� upy n the above mentionetl p�operty foj--iytspa��,tlp/� poses, pJJ/_ � Sl9nah�e ��-e01 �GvCa.e..�..pate `7-5' 8/ �� n all appro LOT 7NO. 'Y`G BLDG. NO. TVPE OF CONSTRUCTION � O NEW ❑ ADD ❑ ALTERATION ❑ REPAIR � CONVERSION ❑ DEM( ❑ OTHER DESCRIPTION OF�WOp{( � TVPE OF PER T pq/ /k ❑ GftADING ❑ FOUNDATION ❑ $TRVC ❑ TENANT ❑ ELECTRICAL OPLUMHING ❑ ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCV CO(y$ZRUCTION TYPE _ V ALUATION� ZONE GRADING CU. VDS. ACRES _ REMARKS: PLUMBING BATHTUBS TOILET$ LAVATORIE$ KIT. SINKS SERVICE SINKS - PLAN CHECK SHOWERS URINALS DOUBLE LAVS DISHWASHERS SUMPS F1.00R SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP WATERSERVICE ALTERATION GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOIARTANK COLLECTORS SOLAR PIPING SVS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SVSTEM 0-300,000 BTU_ AND DUCTING 300,000 + gTU _ REFRIGERATION, 0-100,000 BTU_ SVSTEM 100,000+BTU_ �OILERS BTV SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE ISSUE FEE CMF 0865-46 Wnite-Builtling; Canary-Appli<ant; Pink-Accounting; Goltlenrotl-Assessor � � r �� p - ., A.P. � � IG —f_ ZONE � •� D SETBACK L T. IDF YARD 5ED RIIGHTAR REAft VARO(TO PKG.SPACE REQ. STREET WIDTH 20NING APPROVF SPECIqL CONDITI ELEC7RICAL 4620 S/J4/61 PLNG.REF. PROVIDED PARK FEE $ PLAN CHECK TRANSFORMER �"1 KW_1-30 KW _ APPLIANCE 30-SOKW_SO+KW_ MOTORS p-1 HP_1-30 HP _ (INC. SOLAR) 30-50 FiP 50 + HP _ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS MAIN SUB SERVICE AMP ISSUE FEE APPLICATION APPROVED 17.00 Tt e DATE SUMMARV OF FEES BUILOING PERMIT . $ �Q/• g.'�, SMIP - $ � S� PLAN CHECK .S� PERMIT - ISSUANCE S � PlUM81NG 5 GRADING $ PLAN CHECK $ � � ELECTRICAL $ S . PLANCHECK � - MICROFILM E MECHANICAL $ TOTAL FEE $ PLAN CHECK $ ' LE55 AD- VANCEPC $ FINALFEE S •OD CONSTRUCTION AND PLANNIN � POOL & SPA ., `th ,!. APPROVALS Permit #� Date Inspector qppROVALS Permit # t � Date Inspector t. Temporary Electrical Service or Pole 43. Pool & Equipment Location � 2. Soil ipe-Undrgrn - 44: Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrn �' "� 45. Forms � 4. Electrical Conduit-Undrgrn " � � � 46. Electriral Bonding . tee ein orce � �, • 47. Rough Plumbin & Pressure Test � 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings � 49. Electrical Conduit-Undr rn 8. Foundation ' 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra � Undr rn 10. Struc[ural Floor System � 52. - APPROVALTO DECK - - 11. Property Sewer Line & House Connection ' � 53. � Backwash & Rece tor-Final � 12. - Street Sewer Connection . � 54. Heater & Vent-Final � . 13. Rough Plumbing � ' 14. Rough Electric-Conduit �56. Electrical-Final 15.- Rough Electric-Wiring - - -- � - 57. SolarSystem-Final � • �� - 16.. Rough Heating.& Air Conclitioning encing & Access Approval - - 17. Ducts, in Structure�•� ' � 59. APPROVED FOR PLASTERING � 16. Ducts, Ventilating , � 19. Gas Pipe-Rough &Test. 60. POOL/SPA SYSTEMS FINAL � . 20. Roof Framing ' � - • 21. Roof Sheathin ' � ' . 22. Frame and Flashin � NOTES: • � . 23. Insulation � � 24. Lathing & Siding � 25. Drywall Nailing � ' 26. Plaster Brown Coat - � ' 27. Electrical Power MeterFinal ' ' ' 28. Final Electric 29. Final Heating & Air Conditioning ' � � - 30. Final Gas Pipe-Test � • 31. Final Plumbing � � � � 32. Water Service-Final � � � � 33. Gas Service-Final 34. Solar pomestic-Final � 35. .Landsca e S rinklin S stem �`, 36. Sound Attenuation - - � - - 37. - Handicap-Regulations - - - � ' 36. FINALSTRUCTURE&BUILDING 2. � 39. Special Requirements Completed 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. � 42. CERTIFICATE OF OCCUPANCY � ` 'No - Date � � . , ,� . - '�"`' 29567 COSTA MESA BUIIDINCrSAFET'( DEPARTMENT P.O. BOX 7T00 COSTA MESA, CALIFORNIA 926E6 For Applicant fo F711 In Completaly TYPE OR PRINT .ODRE58 3457 Santa Clara Circle COSTA ME3A, CALIFORNIA ,....,�o Neltzer F.nterorises-Costa Mesa BIZE OF LOT USE OP arr S' � n�a'rr DESCWPTION OF WORK BUILDINO NO.OF s�ze ROOMS EXTERIORWALL SC.11CCO R�' COVERINa GOVHRINO W UGHOFDUILDIt1GANDWOR TOl6PtRP0 Dwelling anc�Attached Plan 401BR - Lot 42 2Z1�]11 J 16' I XBR68Y ACKHOWLLDO[ TXAT 1 MAV[ 11HAD TMIP APPLIGTION ANO BTATH TNAT TM6 ABOV6 Il CONqBGT 11ND AOpE[ TO COM• PLv wiTX ALL e1TY OpDINANCIO AXO �TAT[ LAWY R[OYN1i1M0 B�ILDINO CONBTRUCf10N. SIONATUREOP P6RMITTfifi ` AVTHORIZ[D AGi rGin JAN-7-6�;�00 198K ***fiii5.5( APPLICATION FOR PERMR BUILDINf3 for OffTca Use Only R[C[IR tl0. IlqMIT NO. � ZONIN(3 zona xo.or uacorHcw ES. w R1 �un� 2 emto�noAtYarh.Gar ou'ce�mox Lot 42 Tract 6637 w, r. r+o. None NOTC: NOGV[OVi11HANOSNALLOHLE88THAN 90' TO 810[ 4 P6AR P. L 8AVE8 ALLOW[D (U.B.G.RECUIRHMENTI YARDBAPPROVHD YAROSMPROVED MAIN BUILDINO ACCHD80RY BUILDINO (FROM C/LIITR[CT) / � VAR. � 1 c_u_n_ DATE " �G J ' / ' a w � ��a �.�. o " � a TMH IIMOUHf eXOWN UND6R VALUATON 19 ROR TX8 j PURroee OP 4TI�BLI9HIN0 A PERMIT P66 ONLY. 3 ES VALUATION � � � PERMITFEE � a ��0.5� ��/Ea w