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1071 SANTA ROSA AVE - Building Permits
NOV-03-03 11 :23AM FROM-Continent-' Technology Corp T148500323 T-151 P.001/002 F-904 ' I • EI .7Ce t 1071 Santa Roza Que. • 0 Caota Ateaa, ea 92626 °' 714-966-1742 714-850-1696 eM1Se@cant nentatcncdae.cant November 3, 2003 RE: SF 2003 2058 • State of California Department of Consumer Affairs Contractors License Board 12501 E Imperial Highway, Suite 630 Norwalk, Ca 90650 Attention: Burt Morgan Dear Ms. Van Buskirk: I am in receipt of your letter dated October 29, 2003 and I am outraged that you have been misled into believing that any agreement has been reached or that I am pleased with any result concerning this complaint or my first complaint made in 2001. Nothing could be further from the truth then that. It is a blatant and outrageous lie. In my letter to Helen Marcos on Oct. 20, 2003, I specifically stated that the only way I would agree to let Mr. Thompson complete the job he contracted for in March 2001, would be if that job was supervised by your expert and I requested a full and detailed report as to all the findings by your expert, I further stated that I would not sign away any of my legal rights. I also stated in that letter that all further contact be in writing to avoid the situation I am now faced with once again. Helen Marcos stated the day of the on site investigation that she has a very heavy workload—too many cases—this is not my concern nor should it be, the fact that if I insisted upon a detailed written report, it would be very time consuming. I am a taxpayer and my tax dollars help pay those wages. On Friday October 31, 2003 I was contacted by Burr Morgan City of Costa Mesa—Building Permit division and was informed that no permit and or license was ever taken out with the city to do this job. So lets examine all the facts according to Danny Thompson's licenses with you C 39 & HIC he certified that he has no employees and therefore is not required to carry Workers Compensation Insurance—yet his contract with me states he carries Worlanen's Compensation Insurance and he has stated to you his employees did this job and he was not on sight. In his contract with me it states it includes city permits, taxes& inspection fees, yet no permit was ever taken out. As I see it he is in violation of your codes 4104, 4105, 4106,4107 & 4110. Attempts to circumvent requirements and should he now state that he sublet this work that is covered under 4110, subletting in excess of%3 to 1%. I-Iad NOV-03-03 11 :23AM FROM-Continent,' Technology Corp T148500323 T-151 P.002/002 F-904 e t - Helen or any other of your employees done their duties and due diligence this complaint that started in 2001 would long have been resolved. I at this point have to believe that Mr. Thompson employs unqualified & illeeal immigrants to do this work and pays them under the table, that of course not only violates the laws under your licensing requirements but many other such as State, Federal, Labor Laws but also he has violated City laws. It is unreasonable for anyone at the Department of Consumer Affairs to expect me to simply let Mr. Thompson now 2 V2 years later finally complete the job he contracted to do and expect me to believe that he would actually do that,without an inspection and verification from anyone governing his license. I again must reiterate no agreement has been reach. I am appalled with the rampant violation this man has gotten away with and continues to get away with, no wonder there is such a tremendous problem in this industry due to the fact that your employees just want to sweep these complaints under the rug,no one so far at this department has yet to show any care about my rights as the consumer, and I was under the impression that this is where I must go to resolve this. Let me ask you had your rights been violated to this extend and had your Childs, neighbors and your own life been put in jeopardy would you trust that after being ignored for 2 Ya years that Mr. Thompson who so blatantly & openly disregards so many laws will now actually do the work? Respectfully Eike Keil Cc: G. Davis, B Lockyer,B Meder, and B Morgan :0 "'+w CITY OF COSTA MESA - iiel BUILDING DIVISION ' > %j ,.�. ..� DEVELOPMENT SERVICES DEPARTMENT PER NUMBER PERMIT 03-01933 etcotftwinsis e*' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BJLDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1071 SANTA ROSA AV Status: ISSUED Suite: Applied: 11/07/2003 Vicinity: Issued: 11/07/2003 Parcel Number: 41205208 Zoning: Applicant: KEIL, ELKE ISSUED BY: U Address: 1071 SANTA ROSA AVE Phone: 714-966-1742 COSTA MESA,CA Zip: 92626-1619 Owner: KEIL, ELKE Address 1071 SANTA ROSA AVE Phone: 714-966-1742 COSTA MESA,CA Zip: 92626-1619 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT LEHALIZE WORK DONE WITHOUT A PERMIT.TEAR OFF EXIST.WOOD SHINGLES,INSTALL 1/2"CDX PLYWOOD AND 20 YEAR COMPOSITION SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,376.00 Permit: $139.25 Claim Valuation: $6,376.00 SMIP Res: $0.64 SMIP Corn: $0.00 Other: $139.25 Inspection: $0.00 Total: $279.14 - PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 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,§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 fora 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 Inspections 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)754-5626 244646(6.00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: r • I hereby affirrK under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full • force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,Or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • • I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ .•.axe,t der ec. Business and Professions Code for this reason: _ Sffli re: I 21.L1 :. /(— — 0 verified by driver's license. Ths 0 No Drivers Lice + No. 6xpir3 7-e6 •may Verification of Ownership by(type of document,i.e.-property tax bill or d::• : C DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Li a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described roperty for ins.:ct'• •ur•oses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig•: ure Of Legal Own: (s) Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE PAIS INTTTIALS CODE! INSPFCTION TYPE PATE INTIAIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ! 208 Final Plumbing 200 Final Re-Roof (/ _ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy OCT-30-03 03:41PM FROM-Continental '—hnolocy Corp 7148500323 -\ 1-149 P.001/007 F-882 . J Ethe `Kele 1071 Santa.Rana Clue. Caota .Mesa, ea 92626 714-966-1742 714-850-1696 c/c.. —� eddce@cantinentaLcncdee.cam 7/If. `6S0 . 0 23 October 30, 2003 RE: SF 2003 2058 City of Costa Mesa Building —Permit • Attention: Burt Morgan By Fax: 714-754-4856 Dear Mr. Morgan 1 am faxing you copies of a current on going dispute with a Roofing Contractor. You may want to think twice before giving him any more permits in this city. Respectfully Elke Keil fig 4f , CSL 3 7ft , zC4 . 76/ f OCT-30-03 03:4IPM FROM-Continental ' •hnolojy Corp 7148500323 7-I48 P.202/007 F-682 • • Eike stele 1071 Santa Slcoa Clore. Coata.Meea, ea 92626 714-966-2133 714-850-1696 efile@cantinenfal~cnedee cern October 20, 2003 RE: SF 2003 2058 Starlight Roofing Attention: Helen Marcos Hi Helen, I spend a lot of time meditating this weekend in an effort to resolve this matter, and as a Minister I spend a lot of time seeking guidance from my higher self, and always seeking a peaceful and harmonious resolution leaves me subject to people taking advantage of that fact. That having been said lets get down to all the facts pertaining to the roof First of all I would like to thank you and Kevin Kasmarsik and I am extremely grateful to Kevin for the thorough inspection and finding all the other problems that could damage the interior of my just_finished remodeled home to the tune of 5150,000.00, excluding the cost of the roof, which now stands at $10,000.00. This has been an extreme learning experience for me. I am not surprised so that there are so many problems with contractors, do to the fact that my personal experience with the contractors board tells me that they can get away with just about anything. For over a year now I have offered to buy the wood as long as Mr. Thompson would install it at no charge to me and I have told you that a number of times. I have owned several businesses in the past and I conduct my life and business affairs with extreme ethics and honesty, and I am appalled by Mr. Thompson conduct, lack of due diligence and unethical business practices. Lets review the facts. Six month after his workers installed the new roof on my home I find out his crew (since he was never on this job, nor did he ever inspect it for workmanship) has removed the ducting from the air-conditioning unit and all the electric was left exposed on top of the OCT-30-03 03:41PM FROM-Continental 'ethnology Corp 7148500323 --, 7-149 P.003/00T F-B8Z roof. This endangering not only my daughters, my life but also my neighbors. This I call gross negligence & criminal. Mr. Thompson has blatantly lied to you and me he has ignored my letters phone calls and pleas to due the job he contracted to do. It is a fact that I paid him an extra $1500.00 for new wood; it cost me $1500.00 for new ducting. His contract states 100% satisfaction guarantee, it also states that all pipe, vent flashing would be replaced, which apparently is just in the contract but not abided by.Under the terms of this contract I have to let him do the work to not nullify it. I will of course now have his contract reviewed. I respectfully request a complete report of all of Sevin's findings including a copy of the pictures he took I do hereby agree to let Mr. Thompson do all the repairs to complete this job, (and only under the supervision of Kevin Kasmarsik) that was supposedly completed early 2001 and I will purchase the wood necessary for the atrium and on the side of the house. I do want all of this in writing, time at this point is of extreme essence since the rainy season is not far off and under no circumstances will I sign away any of my rights to recover any off the financial cost that I have already incurred do to Mr. Thompson's lack of quality workmanship.Mr. Thompson is extremely lucky that I am not an inspector for the contractors board because not only would he be required to do the job at no cost, he would also be severely fined, pay for the ducting and have his license suspended for at least 30 days. Maybe then contractors would actually abide by their contracts and rules and regulations. Please be advised that I would like to receive the complete findings & pictures from Kevin as soon as possible, so I can forward these to all other agencies that I have been in contact with during this ordeal and now I will also involve the US Attorney (a friend) &possibly my personal attorney. Since my health sanity and well being is very important to me and need closure on this matter I again remind you time is now extremely important Under no circumstances due I want the interior of my home damaged because of thepoor job that Mr. Thompson's employees did. You know what they say. Do unto others, as you want them to do unto you. As you thou so shall you reap. Respectfully, Elke Keil Cc: K. Maddox,B. Moder,B. Loekyer, OCT-30-03 03:41PM FROM-Continent ' Technology Corp T148500323 T-149 P.004/007 F-882 €Me SC.eaf 1071 Santa J2aea Clue. L'ae to.Alcoa, CQ 92626 714-966-1742 714-850-1696 elas@corttine rta2.c wde&.cant October 30, 2003 RE: SF 2003 2058 State of California Department of Consumer Affairs Contractors License Board 12501 E Imperial Highway, Suite 630 Norwalk, Ca 90650 Attention: Supervisor Please advise me as to when I may expect a full report on all the findings by Kevin Kasmarsik I am also again inquiring as to the status of my complaint. I am reiterating that no agreement has been reached on this. In a letter send to you on October the 28th, 2003 I pointed out the fact that under Mr. Thompson's license it states he is exempt form workers compensation insurance; they certified that they have no employees. His contract with me specifically states he has workmen's compensation#7 of his contract, and under the state codes #4105,4106, 4107 & 4110 he is prohibited from attempting to circumvent requirements and also subletting work in excess of'A to 1% of the job. Again I respectfully request hearing from you. Respectfully Elke Keil Cc: B. Meder OCT-30-03 03:41PM FROM Continental hnology Corp 7148500323 T-149 P.005/007 F-882 • California Home Tuesday,Octal 1 7A &Mew cal ifornja• t -;',"7:;lern; ou License Detail CALIFORNIA CONTRACTORS STATE LSF„N Contractor License # 759321 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: • CSLB complaint disclosure is restricted by law (13&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. • Per B&P 7071 17, only construction related civil judgments known to the CSLB are di • Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. • Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 10/28/2003 * * * Business Information * * * STARLIGHT ROOFING 630 NORTH TUSTIN AVENUE ORANGE, CA 92867 Business Phone Number: (714) 997-1761 Entity: Sole Ownership Issue Date: 02/19/1999 Expire Date: 02/28/2005 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * Class[Description// C39 ROOFING JJ * * * Certifications * * * Cert Description HIC HOME IMPROVEMENT CERTIFICATION * * * Bonding Information * * * http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 10/28/03 OCT-30-03 03:42PM FROM-Continenta' -•chnology Carp 7148500323 T-149 P.006/007 F-882 CONTRACTOR'S BOND: This license filed Contractor's Bond number 9026330 in the am $7,500 with the bonding company AMERICAN CONTRACTORS INDEIVI ITY COMPANY. Effective Date: 01/21/1999 * * * Workers Compensation Information * * * This license is exempt from having workers compensation insurance; they certified that the) employees at this time. Effective Date: 12/19/1998 Expire Date: None Personnel List License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request ©2003 State of California. Conditions,of Use Priyacy_Poligy http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 10/28/03 OCT-30-03 03:42PM FROM-Continental Technology Corp 7148500323 T-149 P.OU7/007 F-882 • PROrOSAL AND CONTRACT_AGRE. MENT ' \ Hi! ' STARLIGHT--ROOFING • 630 N. Tustin,Avenue, Orange #112. CA 92867 • Office '(714) 997-1761 Pik THIS AGREEMENT is between Starlight Roofing a licensed contractor,herein referred to as"Contractor"and. Owner //CC Address ,/O 7/ Sri //9 &'zs#, f/CJ e City _ (7-0,57,t /Y26 $ State er-4 Zip __2_2H Phone .±76" / 74/2_ Work 575 b leo 9.6 Fax (Hereinafter referred to as Buyer or Owner IN CONSIDERATION of the promises herein contained.it is mutually agreed as follows: 1. CONSTRUCTION: Contractor promised to furnish the necessary labor,material and equipment and to perform in a workmanlike manner and complete for the Owne:sat � C 2. SPECIoFICATIONS: yf Tear off,26c/—/l sq.existing cedar shaketoof down to deck,clean up and haul away all debris,clean grounds. /6' Replace necessary dry rot as needed(1 x 6) .�. ip lapp boards. Extra Cost(unpainted=$2.20 per fi painted=$8.00 per ft). S(L,t Starlight Roofing will only install new 1/2"CDX exterior grade plywood over entire roof and garage. VO. Install I layer of#30 lb.ASTM felt over entire roof and garage with Simplex capped nails. .A22 Install new(Galvanized)or(Baked Enamel) 18""W"formed valley in all valleys. 'y,''i Replace all pipe and vent flashing,seal and paint with rust preventative paint to match your new roof. fig,_ Install new4ll.r(2")baked enamel trim at all edges of roof. Color: (White),(Brown)or(Charcoal). \e„:2_ Install new starter shingles at all edges ofroof Roof color:O544 fe'w /, e,/ Install new 2 0 sq. elk�(yr.)fiberglass Class A shingles,per manufacturer's specifications. ✓/_ Install new ridge glass on all hips and ridges per manufacturer's warranty. Includes complete clean up,and haul away all debris from job site. Starting date: /9/9 / It71, Contract price includes city permit,taxes and inspection fees. %t Starlight Roofing will provide all material releases and workmanship releases upon final payment. f if_ Starlight Roofing will provide a certificate of completion assuring your"100%Absolute Satisfaction Guarantee." ,� c..2O ) Year warranty supplied by manufacturer. Starlight Roofing provides a ten(10)ycar,one time tranferrable,workmanship guarantee. 42 Starlight Roofing not responsiblefor,,ny-intezior.damage.•vith_maulted-ceilinpc,plants,Furnishings,.etc. . . Customer is responsible for covering these items. ye'S Ns.) /?jr /1 7,-;a4 4.uz cj 3. CONTRACT PRICE: Owner promises to pay or cause to be paid to Contractor in consideration therefore,the"Cash Price"sum of (S41J /. ) !C�t4.r , d2. 9'/-57&O 8/2- " Dollars, Oe Payable as follows: ONE DOLLAR DOWN( /Q� ),BALANCE UPON COMPLETION OF WORK( � .�.rrt��s''� ). 4. TIME FOR COMPLETION:The work to be performed by Contractor shall be commenced within approximatelyJ&days from date ofexecutionof this Agreement and shill be substantially completely with approximately_2=,.working days of said commencement. Contractor,however,shall not be liable for any delays or variations from the foregoing completion schedule which are caused by factors beyond the control of Contractor(such as,but not limited to:rain or other acts of God; acts of war or civil disturbance;and strikes,boycotts,or other obstructive action by labor organizations or employees,or lock-outs or other defensive actions by employers—or which arc caused by acts or neglect of Owner. In the event that any delay or variation from foregoing completion schedule is caused by any of such factors.a reasonable extension of time for commencement and completion shall automatically be deemed to have been granted. For purposes of this paragraph."a reasonable extension of time"shall include sufficient time to allow Contractor to commence and complete his obligations under contract agreements with other parties which were originally scheduled for commencement prior to the commencement date of this Contract,and Contractor shall be entitled to complete said other Contrast obligations prior to the commencement of work on this Contract. 5. CONTRACTOR'S RIGHT TO RESCIND: Contractor retains the absolute tight to rescind this Agreement in writing for any reason whatsoever within three business days Rom the date of execution hereof. Furthermore,in the event that within three business days of the execution of this Contract.Contractor mails to Owner at the address set forth hereinabove written notice of his election to retain the right to rescind for an additional eleven days for the purpose of seeking approval of Buyer's credit,Contractor shall have the right to rescind this Agreement in writing mailed to the above address of Buyer within fourteen days of the execution hereof on the grounds that Buyer's credit has not been approved. 6. ATTORNEYS'FEES: In the event that it becomes necessary to retain the services of an attorney in order to enforce any of the provisions of this Agreement,the prevailing party shalt be entitled to recover reasonable attorneys'fees and costs. For purposes of this paragraph"prevailing party shall be deemed to include any part to this Agreement(or their assigns or successors in interest)to whom payment of any sum is made by another party to this Agreement(or his assigns or successors) in settlement of or as part of the resolution of any controversy,whether or not Court proceedings have been instituted. 7. INSURANCE Contractor shall carry Workmen's Compensation Insurance on all employees. S. STIPULATIONS: Now,therefore,the Owner hereby accepts the above proposal,and the Contractor agrees to perform the work comprehended thereunder,and by and between them as part and parcel of this Agreement the terms and conditions set forth in original writing on the reverse side hereof are understood and agreed upon. 9. Buyer hereby authorizes Seller or successors to make whatever inquiries or investigation regarding Buyers credit ruing as Seller deems appropriate. NOTICE TO THE BUYER: Buyer has been informed by Contractor that the roofing materials selectedBuyer and calledt of the arc NOT coveredby Y oristhementic limitediite wnCopland by the Contractor's Guarantee Agreement contained in the Contact. Buyer is aware that such Guarantee Agreement is to workmanship and excludes all materials. Buyer has been funher informed by contractor that Contractor docs not agree with or endorse the manufacturer'swananty of the roofing materials selected by Buyer and as such Contractor shall not be held liable in anyway for defects in such roofing materials or roofing materials that are unfit for the purpose intended by Buyer. • "YOU THE'BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT." STARLIGHT ' 'OFING OWNER (Buyer) �y7 • By:- • _a r 34 /. REP- SE • ATIVE OWNER'S SIGN/FU E DATE DATE OWNER'S SIGNATURE DATE YOU WILL NOT RECEIVE A BILL PLEASE PAY UPONtCOMPLETION OF WORK ESTIMATE IS GOOD FOR 7/2 DAYS. . 4`,STp 4I CITY OF COSTA MESA - j ." BUILDING DIVISION I „„^ � I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER teb: ni PERMIT E02-00305 Roo (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us - 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1071 SANTA ROSA AV Status: ISSUED Suite No Applied: 04/16/2002 Vicinity: Issued: 04/16/2002 Parcel Nunmber: 41205208 Applicant: KEIL, ELKE AND MCKAY, MICHELLE ISSUED BY: Address: 1071 SANTA ROSA Phone: 714-966-1742 COSTA MESA,CA Zip: 92626 Owner: / KEIL, ELKE AND MCKAY, MICHELLE Address 1071 SANTA ROSA Phone: 714-966-1742 O COSTA MESA,CA Zip: 92626 -0-1C) ili SS Contractor: OWNER-BUILDER • �' Address: QER - y _ -Phone: rr It, Zip: OC? RES License: 0 . - - SCOPE OF PERMIT ELECTRICAL TO INCLUDE: 1 LIGHTING FIXTURE,2 OUTLETS,AND'2 SWITCHES.REF: 602-00506 • FEE SUMMARY . ' Quantity - - Quantity ISSUE FEE $23.50 Temp Dist System/"Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $1.10 1 - up to 50 kva/kw $0.00 0 Recept Outlets $2.20 2 up to 100 kva/kw $0.00 " 0 Switches $2.20 2 over 100 kva/kw $0.00 0 Non Res Appl $0.00 ' 0 Low Voltage Equipment $0.00 0 Res Appl ' ,- $0.00 0 • Low Volt Wiring System/Ckt ."$0.00 , 0 Service to 200a $0.00 0 Misc.Conduit $0.00 - 0 , Service to 1000a $0.00 0 Misc.Conductor $0.00 . 0 Service over 1000a , $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp - $0.00 0 Circus(mech ride or lights) $0.00' , 0 Motors to 10hp $0.00. " 0 Christmas Tree Stand - " $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand- Motors to 100hp -$0.00_ . 0 Other Electrical Fee $0.00 ' Motors over 100hp $0.00 0 " Communication drops $0.00 - 0 ' 'Investigation Fee - - - $0.00 Sub panel to 200a $0.00 0 Plan Check Fee ' $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $29.00 Intermed"Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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, 12-21-92) 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 Inspections 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)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ' - ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the wgrk for which this permit is issued. My workers'compens ti ranee c 'er and policy number are: l/+_��111 Carrier: l\ Policy Number: (This section need not be completed i the mill is valued at one hundred dollars($100)or less.) _ I certify that in the performance of the work for which this permit is issued,I shell not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia,and agree that if I Id become subject to the workers'compensation provisions of Section3700 of the Labor Code,I shall forthwith comply with these/ ...--",......--",t.prion ., , ( I I QV ( 0 e Applicant Signature: f _ . Date: `�" v WARNING:FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND net I ARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.4 Class 4 Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is ‘23:17sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws). ❑ I am exam d/e Business and Professions Code for this reason: 4( (€0 ( // 0 V Signature:!' i Date: 4 1 €0 V Owner ID verified by driver's lice. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: • Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? El Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspectio _urp .�agree not to occupy or allow occupancy of any building authorized by this pg4r - until inalUinspection. (/�_) Ignature Ot Legal wner(s) (T/'( l/IV/^ Date And/Or Authorized Applicant Date CODE I DISSECTIONTYPE DATE MALS CODE! DISSECTIONTYPE DATE IMT ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing .. �p 200 Final Re-Roof 210 Final Electrical it-C.O' 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place • 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition • 250 Final Building/Occupancy CITY OF COSTA MESA a o BUILDING DIVISION >:� ,1 DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER �; /a PERMIT '�a,O' 'Ran # P02-00242 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1071 SANTA ROSA AV Status: ISSUED Suite No Applied: 04/16/2002 Issued: 04/16/2002 Vicinity: Parcel Nunmber: 41205208 ISSUED BY: Applicant: KEIL, ELKE AND MCKAY, MICHELLE - Address: 1071 SANTA ROSA " Phone: 714-966-1742 COSTA MESA,CA Zip: 92626 - Owner: KEIL, ELKE AND MCKAY, MICHELLE Address 1071 SANTA ROSA ' Phone: 714-966-1742 COSTA MESA,CA Zip: 92626 EA O'l�1 EXE1 �lv Contractor: OWNER-BUILDER Mli Address: Phone: Zip: PER D License: 0 ARES , Arch / Eng : _ ... Address: Phone: Zip: License:- SCOPE OF PERMIT PLUMBING TO INCLUDE: 1 SHOWER, 1 WASH BASIN,AND 1 WATER CLOSET. REF.:502-00506. . FEE SUMMARY AMT \ QTY AMT QTY AMT QTY ISSUE FEE $23.50 L. - Laundry Tub/Washer ' $0.00 ' '0 -- Sump Pump $0.00 0 Backflow irrigation $0.00 . 0 Landscape Irrigation - $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 ' . , P-Trap ' $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 ' 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $9.80 1 Dishwasher -$0.00 0 . Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 - . Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 - 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $9.80 1 Drain, Roof $0.00 0. Shower . $9.80 T Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 -• Sink,bar $0.00 - 0 - Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial - , $0.00" - .0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor - $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $52.90 • COMMENTS I SPECIAL CONDITIONS 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: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) • DECLARATIONS WORKERS'COMPENSATION DECLARATION: . I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. sss555 ❑ I have and will c m pens workers'compensation insurance,as required are: by section 3700 of the Labor Code,for the performance of the work for which this permit isued My workers'compensation naey:arder and policy number are: Carrier: Policy Number: (This se tion need not be complete i he permit is valued et one hundred dollars($100)or less.) certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should b come subject to the workers'compensation provisions of Section 370Q of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: ( — e.t. Date: '(0 ( O`C - WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE CISST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sod within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: / Signature: / . _C� Date: 1 /u Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a emit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection rp.II ag not to occupy or allow occupancy of any building authorized by this erl7Jiituntil fin ins ect> l/��7O, S nature Of Legal Owner(s) (T/ , D teU And/Or Authorized Applicant Date ODE f, INSPECTION TYPE DAME INTRIAL$ DOGE f tNSPECT10N TYPE OATS I)ITRIALE 1616 Fixed System Final Fire Prevention 206 ' Final Mechanical 7�j � 1266 Pool Spa Final 208 Final Plumbing -. —a 6� Cbl 200 Final Re-Roof 210 Final Electrical • 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval • 203 Final Sign 222 Final Site 204 Final Demolition .250 Final Building/Occupancy _ t`p EU 4f 9 CITY OF COSTA MESA - BUILDING DIVISION f• ,•- ��,�„. --.' i DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER "4. IPLiki • PERMIT acp4PORRISO vyA M02-00159 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1071 SANTA ROSA AV Status: ISSUED Suite No Applied: 04/16/2002 Issued: 04/16/2002 Vicinity: ___recicy_ Parcel Number: 41205208 ISSUED BY: Applicant: KEIL, ELKE AND MCKAY, MICHELLE ' Address: 1071 SANTA ROSA Phone: 714-966-1742 - COSTA MESA,CA Zip: 92626 _ - Owner: ,KEIL, ELKE AND MCKAY, MICHELLE Address: 1071 SANTA ROSA Phone: 714-966-1742 COSTA MESA,CA Zip: 92626 E.��S.Si- Contractor: OWNER-BUILDER �j 90 j%. 0 / Address: y yptg ' ,Phdne: C Zip: �1^[QtS a� , • License:0 R • SCOPE OF PERMIT MECHANICAL TO INCLUDE: 1 VENT FAN.REF:802-00506 .- FEE SUMMARY ' • Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit . $0.00 0 Inst FAU<100 k BTU $0.00_ 0 Repair/Alt Refrigeration Unit $0.00 0 • Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 _Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace - $0.00 0 • • 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 ." 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/-1,750 k BTU $0.00 0 Vent Fan/Single Duct $7.25. .- 1 - Over 50 hp/Over 1,750-BTU $0.00 0 Appliance $0.00 0 - • Boilers Fire Dampers - $0.00, 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 -0 - 3 To 15 hp . $0.00 0 Inst or Relocate Appl Vent $0.00 0 - 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 . -0 Over 50 hp $0.00 0 Floor Furnace $0.00, '0 Other Mechanical Fee Floor or Suspend Heater - •$0.00 0 Investigation Fee $0.00 Plan Check Fee ' - - $0.00 Reinspection Fee $0.00 - - " - TOTAL CALCULATED FEES $30.75 COMMENTS/SPECIAL CONDITIONS • 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, 12-21-92) 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 Inspections 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)754.5626 2446-48(WOO) • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ' ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and willc maintain w rkers' ncecompensationinsurance,as required red by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compete/ I nce carrier and policy number are: 1 nn�uD Carrier: `'J p0v�r61 Policy Number: �J� K (This section need not be comp fed if the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia,and agree th -if I guld become subject to the workers'compensation provisions of Section 3700 the Labor Code,I shall forthwith comply with these pr isio�s.1 �j9 / ,, .f�J Applicant Signature: 2/�'C__ tE- Y Date: I 1# 1( t v WARNING:FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CITJMINAL PENAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is asold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License ws.). ❑ I am exam )under s Business and Professions Code for this reason: �/ /(� /O� Signature: � Date: j (f Owner ID verified by driver's licete. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes lJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 6 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws ancjcity ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri d pr•• • 'ns•=coon•• •o : -agre of to occupy or allow occupancy of any building authorized by thi,?pbrap until fina�'Inspection. Q a u./ !/V/ te2 Date Dat •nature Of Legal Owner(s) And/Or Authorized Applicant Date CODE T, Il$PECTION TYPE WI MELS CODER JNSPECTIONTYPF OATS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 41-72--0-S 1266 Pool Spa Final 208 Final Plumbing -. • 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • 41 CITY OF COSTA MESA - ,4"4) ` ° BUILDING DIVISION Fe t �' DEVELOPMENT SERVICES DEPARTMENT 'PERMIT NUMBER 1 "Far t PERMIT 44400aa,04' B02-00506 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1071 SANTA ROSA AV Status: ISSUED Suite: Applied: 04/16/2002 Vicinity: Issued: 04/16/2002 Parcel Number: 41205208 Zoning: Applicant: KEIL, ELKE AND MCKAY, MICHELLE ISSUED BY: Address: 1071 SANTA ROSA Phone: 714-966-1742 COSTA MESA,CA - • Zip: 92626 • Owner: KEIL, ELKE AND MCKAY, MICHELLE Address 1071 SANTA ROSA - - Phone: 714-966-1742 ENSIO�j 1` COSTA MESA,CA Zip: 92626 EYT 1�►1 D Contractor: OWNER-BUILDER �L2 Address: pp Phone: pE{� Zip: License: 0 ARES , -Arch : - Eng: [/� Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT _ CONVERT 4 BEDROOM,2 BATH HOUSE TO 3 BEDROOM,3 BATH.ALL INTERIOR WORK.NO ADDITIONAL SQUARE FOOTAGE.CHANGE OUT ALL WINDOWS TO VINYL WINDOWS. • FEE SUMMARY Plan Check: $190.61 - - Calc Valuation: $18,000.00 Permit: $293.25 Claim Valuation: $18,000.00 SMIP Res: $1.80 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $485.66 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 - - PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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,§1,12-21-92) 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 Inspections 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)754-5626 2446-46 WOO) DECLARATIONS f., - WORKERS'COMPENSATION DECLARATION: f I hereby affirm under penalty of perjury one of the following declarations: • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. • ❑ I have and will maintain work rs'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensa/u�n�I s nce carrier and policy number are: ��y�1 Carrier: LJ a', Policy Number: is s bon need not be comets d if the permit is valued at one hundred dollars($100)or less.) I certity that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I sho •become subject to the workers'compensation provisions of Section 3700 f the Labor Code,I shall forthwith comply with these vi '.n, / ! 9I(0 /O Z.- Applicant Signature - Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37050F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.4 Class 4 Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is swithin one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exemrjund sef� Business and Professions Code for this reason: 1/,, /J Signature: ,! __A'./�Gi� � Date: CL/A-070 ` . Owner ID verified by driver's license ❑Yes 0 No Drivers License No. Expires: - Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - ❑ I hereby certify that no excavation five(5)or more feet In depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes II0 No (Section 65850.2 of the California Govemment Code requires that the requested Information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). • CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize represent ives of the City of Costa Mesa to enter upon the above- ascribed pr for insp ctien Oses.I agree not to occupy or allow occupancy of any building authorized b th' p r It u I final inspection. � i �o te Signature Of Legal'Owner(s) Date And/Or Authorized Applicant Date 900E I INSPECTIONTYPc PATE IIBEE..* BODE! IBSPECTIONTYPt PATE UMW 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -. 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site (J 204 Final Demolition 250 Final Building/Occupancy / "LSI-03 ErC. Property Profile Page 1 of 1 Property Profile C 2003 DataQuick Information Systems This information is compiled from public documents and is not guaranteed. Primary Owner: KEIL,ELKE Secondary Owner: Mail Address: 1071 SANTA ROSA AVE COSTA MESA, CA 92626 Site Address: 1071 SANTA ROSA AVE COSTA MESA, CA 92626 b,id E Telephone Number: x Fta vt APN: 412-052-08 , 7e a�>'y� Reference APN: IMEEnt1,lfCensus Tract: 639.071 Housing Tract Number: 6637 Geo Level:0 Lot Number: 51 Page Grid Old: 27-E2 Page Grid New: 859-B3 Legal Description: N TR 6637 LOT 51 Subdivision: Property Characteristics Bedrooms: 4 Year Built: 1969 Square Feet: 1,717 Bathrooms: 2.0 Garage: Lot Size: ' Total Rooms: 8 Fireplace: Number of Units: 1 Zoning: Pool/View: Use Code: Single Family Residence Heating/Cooling: Sale& Loan Information Transfer Date: 05-08-1981 Seller: Document: 01.40511104 Transfer Value: $37,500 Cost/Sq Feet: $21.84 Title Co.: First Loan Ann: Lender: Last Trans W/O$: 03-11-2002 Loan Type: Interest Rate Type: Last Trans W/O$Doc: 0000203448 Assessed& Tax Information Assessed Value: $60,696 Percent Improvement: 66.77 Homeowner Exemption: Y Land Value: $20,169 Tax Amount: $864 Tax Rate Area: 15034 Improvement Value: $40,527 Tax Status: current [Report Menu J [Select New Target Property] http://www.gotitle.com/cgi-bin/profile.asp?rmt=TOPS&graphic=%2Faccounts%2FT07378%2Fcompan... 04/07/2003 03 �dPt( o_s RE ► . t -f avved _TnspecheU,t itict +o Oars; es uo.t. ,ble gr 2 n 4k k eat t , - q 414 al « eci At.e, 6s co& a ray k ,eared eyk r° Aima f %ces . / - edo!, Pes. Nacho ca 0;9, �1� ��y (pviveazte.„ Zi - 7-3 -7/ c/7 ch0k6 /het .;dress ot £4? f 0 7/ Asa_ <err1 s ueicidAd - 5oi - oosoc, -Out / . goo_ -oo305 Gue_cklatzci r Mat- of Pi <ni ' oZ - otZ342— ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 8233 12/04/86 5, j . i' PERMI'''yyy)��,IO. TRACT NO. ' LOT NO. UNIT NO. CITY OF COSTA MESA/�/y/ Cs � UCT,IpERI�IIT y '1 / (1 Ll� ' Prrject Address ICl/ N.. . /6c/ /j-�/L° 1 �f v'� T ,�s �� • , Applicant's Mailing:As dress I —. , ♦ TYPE OF CONSTRUCTION U NEW U ADO U ALTERATION 'p/REPAIR r MJ/7/- i, '1 11 CONVERSION. 111 DEMOLISH ❑ OTHER _ _ A.P.# Zone Owner's Name X711 / Phone It 04 DESCRIPTION OF WORK/USE OF BLDG. Address // / , ` / -- S Main Building: Accessory Building: •Arch/Eng. License No. TYPE OF PERMIT ❑ GRADINGr--a❑ P6UNDATION ❑ STRUCTURAL . E Front O Address - ` /}n/1 ❑ TENANT 111 ELECTRICAL LW PLUM BING ❑' MECHANICAL OTHER . ,p Rear • • N Contractor's Name • f U_I Phone8C0'*s OS' -C Right N / p PROJECT DESCRIPTION :SQ. FT. OCCUPANCY • Address(mailing) C-/s�sti.(/,/(,.L� CON$T RUCTION TYPE VALUATION$ 5 Left G 1 City License No. 7 `� ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - Ping. Ref. # Parking Req./Provided 1 E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • ' Q with section 7000) of Division 3 of the Business and Professions Code, and - M •my license is in f 1. r a and effect. ,(���n • RELEIVEU DEC 0 2 1986 T License la fJ icense�)o. `f(/ �!I S ^ Date Signature earn . ._ % ._ . PLUMBING FEES -v t4 '_ WORKERS'COMPENSATION DECLARATION w r eby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink - Showers - : ELECTRICAL ' FEES vergers' Compensation Insurance, or a certified copy thereof (Se tion - - , a,,uo, Lab. gelannO -7 �(j ,/� J (Seption Preventers Service Sink • - Automatic Washer Transformer 0 15-50 KW .` Policy No: T` NQ� / Company Jt'� I(J.. (-ftT/ Backflow Irrigation Sewer-Cap - ❑ 50+KW - ' Construction Pole Sub. ❑ certified copy is hereby furnished. Date r11jiq y filetl with the city di 1 s1 //// ' I Bathtubs Sewer Connection • Cooking Unit Meter ❑up to 100 amps Date )Ji ^ Applicant �� "(J✓L,s • • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - less). Dishvvasher Solar Piping . • Dryers s❑Gas ❑Electric - Sub Panel • ' I certify that in the performance of the work for which this permit is issued I ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank •. FanMotors❑0-1 HP ❑1'/x-8 Workers' Compensation Laws of California. - - Date Signature Floor •Drains I •Swimming Pool w/Spa F.A.U. - -' Inc.Solar ❑9-15 HP 016-15+ NOTICE: If,after making this,declaration,you should become subject to the . • - . Workers' Compensation provisions of the Labor Code, you must forthwith- ' Floor Sinks Urinal Fixtures • comply with such provisions or this permit shall be deemed revoked. MiCIOWave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work 'for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name / Range Lender's Address Kitchen Sink _ - Water Service - - • -- OWNER BUILDER DECLARATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories s Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap - Laundry-Trays Generator ❑0.5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash-Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000) of1 , 'vision 3 of the Business and Professions Code) or that he/she is exempt - - - - - - - - - - - - :refrom and the basis for the alleged exemption. Any violation of Section J31.5 by any applicant for a permit subjects the applicant to a civil - enalty of not more than five hundred dollars($500). I; as owner of the property or my employees with wages as their sole Reinspection Fee• I $15 Issue Fee $ 3 - ' compensation, will do the work,and the structure is not intended or offered 1 - Reinspection Fee : $15 Issue Fee $ 3 - for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own - • DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • Building Approved By - Date prove for the purpose of sale). II`' p7 0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By (itY•Date / 2- t v tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who • Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- ' tractors license pursuant to the Contractor's License Law). I am aware that_ Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP ' $ . proof of their Worker's Compensation insurance:should be provided to me: _ • - • PLA N'CHECK $ am PERMIT ' 0 1 am exempt under Section B. & P.C.for this reason ' Firepl/Fact.Blt. ICBG# Fire Dampers _ PLUMBING $ s L yISSUANCE $ Date owner • - Heating System&Ducting Registers PLAN CHECK 25% $ - 'ENERGY P.C. $ I hereby certify that .1 have read this application and state that the above 00.100,000 BTU 0100,000BTL ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of t is city to'enter upon.the above-mentioned property for • - _ inspection p ze / 7 MECHANICAL $ TOTAL FEE $ L��J Signature ����C //����ate /�-(fd �}a Reinspection Fee I $15 Issue Fee $ 3- PLAN CHECK 25% $ - - -Drivers' License or SS# - - CMF 0865.46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing &Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ©=Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final] 12. Sewer Cap 63. Heater & Vent-Final zry 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory.Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 1-1.t9 Cjiksva.Aspwt ao4 UPC ism), 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final - 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ;, No. Date 29576 PAIDOO *� JAN -7-69Ens+00 208 108.0E COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92625 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING � //,�����.� � ADDRESD 1071 Santa Rosa l.X/YYWCr RECEIPT NO. ^P COSTA MESA. CALIFORNIA .( /]. /75 (6 RECEIVED ST 4.1 OWNER Seltzer Enterprises-Costa Mesa "w{W/(Ll� ATE TL/I• ) MAIL BUILDING 1 / ADDRESS 144 South La Brea Avenue ADDRESS D ,F__ , TE c TYPE V" GROUPi. ,1 FIRE CITY Los Angeles 90036 No�936-1104ZONE I ARCHITECT TEL..(5714BY APPROVED DATE OR ENGINEER Frank Gonzales NO 7_52-6878 1336 E. Chapman Avenue ZONING ADDRESS OrangeGa.ltfornia 97668 , SON[ I PNO.LA S I USE NEW Res. w/ RI PLANS 2 BUILDING Attach Gas CONTRACTOR George .T. }lel tier k As gee ge LEGAL ADDRESS 144 South La Brea Avenue DESCRIPTION Lot 51, Tract No. 6637 CITY Los Angeles . California 90036 A P.NO. None NOTE: NO NAVE OVERHANG SHALL BE LESS THAN uc No. 201098 NQ, 936-1104 110*TO SIDE e REAR P.L. SIZE I NO.OF SVES LDYS. ALLOWED .(U.B.C.REQUIREMENT) OF LOT NOW ON IAT 0 YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L REET) SETBACK LINE FROM II FRONT FT. FT. CENTER OP STREET REAR YARD2O -6 / SIDE YARD I LEFT 5 I RnIa 15 I R.DID[ I FT. r DESCRIPTION OF WORK L.SIDE ) PT. PT. p. L.-.. NEW X ALTERATION _ ADDITION REAR �) FT. FT. DISTANCE SET. BET.MAIN& MAIN BLDG#. ACCESS.SLOGS. REPAIR _MOVINQ _ __DEMOLISH BUILDING NO.OF VAR.* DATE SIZE ROOMS STORIES 1 C.U.P.* / APPROVED /4 COVERING OR USE tucc o I CROOVEFRINGwood shingle aYPRovED /,(/I OW? a.I �Q USE OF BUILDING AND WORK TO BE PERFORMED A/✓•( n/// i a. fwel1ing and Attarhed Garage I/ � N Plan 403AR - Lot 51 _4 / 9a DQ.rr. 573 /.,/,2124:a;�C�il 0 96`? I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT 6X N UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COY. P1WP05 OP ESTABLISHING A PERMIT P[8 ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION. PERMIT FEE 5 7.77SIGNATURE OF PERMITTEE .rf^ 95 3 e —5"'/ wo ///� $ / PLAN CHECK S AUTHORIZED AGE {% - e�l'ZC< � TOTAL FEE $ //Q