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HomeMy WebLinkAbout2803 SHANTAR DR - Building Permits CITY OF COSTA MESA . BUILDING DIVISION Fr..Re,.,,�, ) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us J. ...4 FOR INSPECTIONS CALL: (714)754-5626 4 °seen.`a PERMIT NUMBER: BC08-00518 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 10/27/2008 - 'ISSUED BY: KJB JOB ADDRESS: 2803 SHANTAR DR CM Suite/Unit -....1--. . APN: 13940234 •.Zoning:R1, _, Vicinity: Primary Occ: .R-3 Const Type: V-B • SQ FT 0 : Valuation::- $6,500.00 SCOPE OF WORK: NON-STRUCT:.BATHROOM REMODEL- REPAIR DRYWALL AS NEEDED; TILE WALLS, 3 LIGHT FIXTURES; " 1 OUTLET, 2 SWITCHES, REPLACE TUB/SHOWER, SINK&TOILET. - OWNER: WHITE,TONI - - Address: 2803 SHANTER OR" - `••Unit: Phone: City/State/Zip: COSTA MESA,,CA ' , APPLICANT: MORAD,OSHRAT ` -; - Address: - -Unit: : Phone: 818 519.77060. :City/State/zZip: • W.(43 1 8 CONTRACTOR: DIVINE DEVELOPERS INC. .• . 4. . License.No. 884148 -" . Phone: (800)985-55181 ' Address: 4872 TOPANGA CANYON BLVD#355Uriit: - Cell: City/State: WOODLAND HILLS, CA - - ,ZipCode 91364 ARCHITECT: - License No. - PHONE ' • . ENGINEER: License No. COMBINATION PERMIT FEE SUMMARY Building Plan Check: $0.00 ., ' . - Building Fees: $139.25' Electrical Fees: $34.85 .: . -,,:,,,':- ' - : . , 4 Mechanical Fees: $0.00 Plumbing Fees: - $62.70 . SMIP Residential: $0.65 - - - - SMIP Commercial: -`,:",$0.00 - TOTAL FEES: $237.45 **Refer to fee receipts for all fees paid for project - - . . :2 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I. INSPEcnoy TYPE DATE !MODALS CODE/ INSPECTION TYPE DATE, INTTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical !2/Oi)c5{ C464-4,1% rn 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 • I Z.I t fat - WORKERS'COMPENSATION DECLARATION: ' .. • Owner ID verified by drive,., 'cense. ❑Yes ❑ No ' I hereby affirm under penalty of perjury one of the following declarations: Driver's.License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification.of Ownership by(type of document,i.e.-property tax biff or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. - ,. . \9 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 •DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized l' by this permit,and that no building structure,scaffdding,falsework,or demolition carrier:;- - J I or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (rnu seaion need.grb mperede permrtuvem at one nundnatfalars($100)or)ess.) 2.Art 2 Sec.341,Title 8,California Administrative Code). Policy:Number: II ((66// .---f ``��(0) l/l/ ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should beco sub'ect to the workers' compensation provisions of Section 3700 of Applicant's Signature the L or ,I shall forthwith comply with these provisions. 11) IIJJ C' Division of Industrial Safety Permit Number: Date App4onl's Signature Coate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one lime during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my licenseisin fullulforce and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No CLIC:#` 1 s `l\\' Class#- (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by — CUMi k, each business which at any one time has on hand a quantity of acutely --a's Signature _ - `--Date_____J hazardous materials equal to or greater than a weight of 500 pounds, or a c------------ volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affum that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature • • /I.; 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: r , ' Health and Safety Code been fully complied with? 0 Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No 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 (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the properly, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided thatsuch improvements are not intended or offered for sale. If, however, the building or improvement is sold within one,year of control officer). completion, the owner-builder will have the burden of proving that he or she. CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or.improve for purpose of sale.). information given above is correct. I agree to'comply with all state'laws,and city ordinances regarding Hazardous Materials and Emissions. ❑ 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 signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a cattractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. • the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: - the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized,by this permit until final inspection. Signa re •alOwnegs) e / Signature Date qr. 0 j Da 005746(3mr) GAnd/w Authonzed Applicant G.Dele--a • CITY OF COSTA MESA - • • - ,,..it'J4. BUILDING DIVISION las fy, T. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us • S. FOR INSPECTIONS CALL: (714)754-5626 . PERMIT NUMBER: BX08-00328 PERMIT TYPE B_MISC STATUS: ISSUED. . APN: 13940234 DATE ISSUED: 11/17/2008 • Zoning: R1, ISSUED BY: RMD • • JOB ADDRESS: 2803 SHANTAR DR CM `" -Suite/Unit: • Vicinity: GARAGE Primary Occ' ., Const Type :?? SQ. FT: 0 `'Valuation : SCOPE OF WORK: DRYWALL REPAIR, INSULATION,AND 6 LIGHT FIXTS, 1 OUTLET AND 1 SWITCH IN GARAGE ONLY. NO OTHER WORK AUTHORIZED UNDER THIS PERMIT - OWNER: WHITE,TONT , Address:: 2803 SHANTER-DR Unit City/State: COSTA MESA', CA. . Zip Code: 92626 Phone: 714-557-3846 . ,. - APPLICANT: MORAD "',OSHRAT rI _1- Address: . . . Unit: City/State: .2;; I , Zip Code — , - . Phone: 818 519-7,706 - CONTRACTOR: DIVINE PERS INC ': - • License No ` 884148 Address: 4872 TOPANGA CANYON BLVD#355 - '.`' Unit: City/State: WOODLAND HILLS • , CA -,'_ ' Zip (800)985-5518 Cell: . . , . Code: 91364 Phone' ARCHITECT: " • License No. + ' • - Phone ENGINEER: _ .... License No. Phone - FEE'SUMMARY Building Plan Check $0.00 Building Permit $$8 80 '4". .. Electrical Permit -" $8.80 SMIP Residential $0.00 , .. SMIP Commercial - - $0.00` - . TOTAL FEES • •"$106:05 • 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . 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. CODE I. INSPECTION TPF. MTh IN1RIALS CODE# INSPECTION TYPE " RATE INnnALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - - 1266 Pool Spa Final 208 Final Plumbing �,y 200 Final Re-Roof 210 Final Electrical '2.I2/41/ _Walt 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 I LIL/OS WORKERS'COMPENSATION DECLARATION: • Owner ID verified by drive._..cense. 0 Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth intowhich a number are: person is required to descend,will be made in connection with work authorized ti- F by this permit,and that no building structure.scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap. 3.2,Grp (This section need not bbeecompleted✓the 'perm mss valued al one hundred dollars(5100)or less.) 2 Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy Number: Ig_LJ f:::)--7L ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safely,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of Califomia, and agree that if I should become subject to the workers'compensation provis'ons of Se tion 3700 of the Labor C ,I II forthwith comply with these pro isions. Applicant's Signature Date 1l Division of Industrial Safety Permit Number tappliranfs Signature (_Date' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material'? ❑Yes ❑No ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my licengfull ( ce 6n9-effed. _ 0Li �Licr#' Class#— (Section 25533 of the Califomia 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 Contractor s Signature Date._ - - hazardous materials equal to or greater than a weight of 500 pounds, or a 4. volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? Yes 0 No Lender's Name: ) (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Californiathe ia Government Code requires that requested 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 information be furnished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No 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 8. (If'yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). . completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). . information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materialsand Emissi , ❑ I, as owner of the property;am EXCLUSIVELY CONTRACTING WITH' ons. , LICENSED CONTRACTORS to construct the project(Sec..7044, Business and Professions Code: The contractors License Law does hot apply to an owner of Signature Date .- .property who builds or improves thereon,and who contracts for such project with a contractor(s)license pursuant to the Contractors License Laws.). CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: ' the City of Costa Mesa to enter upon the.above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. . SignalurOl Oegal eqs) Dale Signature Date )< 7 j 47).A • 305] 6(3b]) "And/or Authorized Applicant I rDale,, - lbCITY OF COSTA MESA • BUILDING DIVISION it i ..wyvit� ; 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us S. !��1A��rooFOR INSPECTIONS CALL:(714)754-5626 ' wwnnmm . PERMIT NUMBER: BC08-00425 • PERMIT TYPE: B_COMBO STATUS: ISSUED . Sub Type: RES_ALT DATE ISSUED: 09/03/2008 ISSUED BY: YH JOB ADDRESS: 2803 SHANTAR DR CM Suite/Unit APN: 13940234 f • • ...Zoning:R1, _ Vicinity: _ Primary Occ: R-3 . Const Type: SQ. FT;" ' 0 - - -'.Valuations- $6,000.00 SCOPE OF WORK: NON-STRUCT. BATHROOM REMODEL- REPAIR DRYWALL AS NEEDED,TILE WALLS, 1 FIXTURE, 1 OUTLET, REPLACE SHOWER,SINK BiLOILET. • , : "-_ ,; OWNER: WHITE,TONIC -, • . Address:.,2803 SHANTER DR t .,i. ., . Unit: Phone: '` _City/State/Zip: 'COSTA MESA,CA • A PLICANT: MORAD,OSHRAT Address: I ''- ;Unit: Phone: 818519- " - 7706 �.City/State/zZip: CONTRACTOR: DIVINE DEVELOPERS INC - -License No. '884148 Phone: (800)985-5519 '- - Address: 4872 TOPANGA CANYON BLVD#355Unit:: Cell: • City/State: WOODLAND,HILLS, CA rZipCode 91364 A CHITECT: License No. ,. PHONE. ENGINEER: ` " - License No. PHONE:=p COMBINATION PERMIT FEE SUMMARY Building Plan Check: $0.00 Building Fees: Electrical Fees: $25:70 Mechanical Fees: ;. - Plumbing Fees: - $52.90 -' :, SMIP Residential: _ - - SMIP Commercial: _';--„$0.00” ' - ,F :a " TOTAL FEES: $204'.45.-• , , . **Refer to fee receipts for all fees paid for project _ - . - . • 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE S. INSPECTION TYPE DATE INTITIALS CODES. INSPECTION TYPE DATE INTTMLS 1616 Fixed System Final Fire Prevention - 206 Final Mechanical • //'�/y�, 1266 Pool Spa Final 208 Final Plumbing pp 200 Final Re-Roof 210 Final Electrical /aha/0(ray J 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 L2/2ldv.,by Nnl3() C. • WORKERS'COMPENSATION DECLARATION: Owner ID verified by drii ense. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' - Verification of Ovmership by(type of document,i.e.-property tax bill ordeed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. • ' -------9 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: J i or dismantlingthereof,will be more than thirty-six (This section need not be completed/the Permit is valued at one hundred dollars(5100)0i less.) (36)feet high.(Chap.3.2,Grp ���� 2,Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy Number: t. 7 k 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor d.,e�shall forthwith comply with these yr,pryvjsio2rt5. \ \O� /1 .0/tel Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SU9JECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my licensgjs in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Ca p`"{ 1 Lql Class# (Section 25533 of the California Health and Safety Code, with some 1 O 1 exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Can raCtor'ssignature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? 0 Yes 0 No Lender's Name: (Section 25534 of the California Health and Safety Code provides that the Lenders Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption, Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No 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 8. (If"yes", attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). . . completion, the owner-builder will have the burden•of proving than he-or she ' CERTIFICATE OF COMPLIANCE:'I Certify"that ander penalty of perjury the did not build or improve for purpose of sale.). - . , . information given above.is correct. I agree to comply with all state laws and - city ordinances regarding Hazardous Materials and Emissions..- • ❑ 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 Signature - property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractors)license pursuant to the Contractors License Laws.).. certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. • the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: • the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Owner(s) \ e� Signature Dale l/ 3067-06(3/07) Pndlor Put zed Applicant Date CITY OF COSTA MESA .'sr BUILDING DIVISION f�ninj AIP 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us `).�. . FOR INSPECTIONS CALL: (714)754-5626 '^ra.niw PERMIT NUMBER: E08-00291 PERMIT TYPE ELEC STATUS: ISSUED APN: 13940234 DATE ISSUED: 07/14/2008 • ISSUED BY: KJB JOB ADDRESS: 2803 SHANTAR-DR CM .Shite/Unit ; Vicinity: SCOPE OF WORK: MISC ELECTRICAL`-WORK TO INCLUDE: 1 LIGHT FIXTURE,6 OUTLETS;3 SWITCHES: OWNER: WHITE,TONI Address:- 2803 SHANTAR DR 'Unit:• • - PHONE: 714-557-3846 -- ' ; City/State/Zip: :COSTA MESA CA APPLICANT: WHITE,TONT _" -" Address - 2803 SHANTAR DR Unit: PHONE: 714-557-3846 - City/State/zZip: COSTA'MESA,CA, CONTRACTOR , Address: City/State: • - ZrpCode: - • .. . CELL: • ELECTRICAL PERMIT FEES . _ Electrical Plan Check Fee. $0'.00 Electrical Permit Fee: $34.50 Reinspection Fee -$0.00 - TOTAL FEES $34:50 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. SODE S. INSPECTION TYPE DATE INIINAL$ CODE! INSPECDON TYPE, DATE INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical I L.r /ffT c4E3-'41 201 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive. _...sense. 0 Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: .. . ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property taxbill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized Carrier, by this permit,and that no building structure,scaffdding,falsework,or demolition (nussectio,need not ce ovnpetedethe pared k vAlued at one hundred dollars(sroolorless.l 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). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless iss ed, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject the workers' compensation provisions of Section 3700 of the Labor e,I shall forthwit •m r wit-these provisions. Applicant's Signature Dale < / 1 I n S' Division of Industrial Safety Permit Number: - II Applicant's Signature Da a HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes ❑ No Lic.# _ — Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 01Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such Construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested 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 information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): - of the California Health and Safety Code). ❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for , sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE:'I certify that under penalty of perjury the did n build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and .city ordinances regarding Hazardous Materials and Emissions. I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH - NSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and stale that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: - the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occu•-ncy of any building authorized • s Permit until f•al i- •- ;on 2 C - 7 ( c75/ 0 no/ a Legal owners) Date C Sign to /Dat 5746(3/07) And/or Authorized Applicant Date PROJECT ADDRESS: 2803 SHANTAR DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 079056 OWNER'S NAME: BELL, GENEVA H ADDRESS: 2803 SHANTER DR PERMIT NO: B 059056 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JrARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT. REROOF W/ASHPLT SHINGLES SQ FT: 5430 ADDRESS: UNIT: , " CLAIM VALUE: 5, 430 . 00 CALC—VALUE: 5, 430 . 00 • GROUP OCC; R-3 / PEflMITTEE: MESA ROOFING ( 714 ) 548-3012 ADDRESS: 843 W 17TH COMMENTS; SMOKE DETECTOR REQUIRED IN THE HOME CM CA 92627 ******Sri-*******************************-********************************** ***** , CENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS 000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS ITY LIC.: 035681 STATE LIC.:56415' LASS • !9- /7,-9z- signalurr/ `it _ MAIN BUILDING ACCESSORY BUILDING ORKERS'COMPENSATION DECNflATION: Ihere� affirm roar lhaacenificate of consent to sel4insure orate iticate of workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN O KERS'ion�5 yE{N t RN: (heof re, acdmhatI abaciLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN OLICY NO.: WY,1 �vv LVVL EXP.DATE: 1+7/01. /93 ' COMPANY: FREMONT PARKING REQ: PROV: PARCEL; 13940234 ZNE: REF NO: i Certified copy is hereby furnished. li Cendied copy is riled with to• city Vg of 'Sion. PLANNING NUTES> dr )or les * ******************************************************************7.jc/_L% 2Applicant' i., LDEVE' OPMENT SERVICES REQUIR EMEN•r.T S - EXEMPTION FROM WORKERS'COMPENSATION DECLARA ON: (Tbs section,...not b•completed it the permit is for one huns). I cenify 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. ZONING APPROVEDL BY DATE: Dale: Signature: BUILDING APPROVED BY : \ � . DATE: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor ^ Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. n - , I. '� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: 44 • �— DATE. (�Jf�� — whichthispermitisis_sued(Section 3097.Civ.C). **************'3E*******' ' " ' ' •' �' ' ' ' ********** ,*.** **ic**1i* LENDER: ******************************************** • **********************%**** ADDRESS: LEGALIZATION:N F E E SUMMA STRUCTURAL SEGMENT; Y • r i/- OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANICFIRE 'j. SMI'P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 , 00 4 . 54 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMID/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN J and Professions Code)or that he/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). ISSUE FEE L" , I. as owner of the property or my em loyees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL »a, PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 81 , 54 0 , 0 0 0 . 0 0 81 , 54 y 81 . 54 .00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED : 81 . 54 OVER/SHORXT; .00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT t GRADING PLAN—CHECK 81 . 00 . 541, I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business , "t ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***'***'*****'**-*****'****"*"**'*'**'******************************* **** *********iF**** that proof of their Worker's Compensation insurance should be provided to me. IND I VIDUAL F E E BR E A K D W NZ ❑ I am exempt under Section: B.8 P.C. for this reason TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dat . Owner: SFR 5430 REROOF BY VALUE RESIDENTIAL NOZONE 1' e 00 5, 430 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and • END OF FEES T , 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a , l permit tor construction or modification from the Air Quality Management District.Residential construction applications are exempt from // these provisions. rt-P ,, Date: Applicant: 1 hereby cemfy that I have read this application and state that the above information is correct.I agree to comply with all city and county Sl ,1 '. / I ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. /G / I , 3 V.—./5/`9>'' Signator , -, _�— Drivers License or Social Security 01 6012390 7—GD 1234G8 TO-r DATE: 09/14R2 TILE. :.1:2u 1641-46 While—Building:Green—Code Enlorcemenl;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor i .�. 1 1• �. . CONSTRUCTiUN AND PLANNING - f - POt SPA / Date- Inspector Date Insp/ctor ' APPROVALS Permit# I ) APPROVALS Permit # 1. Temporary Electrical Service or Pole - `52. Pool & Equipment Location f 2. Soil Pipe-Undrgrnd. •- ; r , 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms- - 4. Electrical Conduit•Undrgrnd. 'i 55. Electrical Bonding - ‘, 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test • 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. %I , 60. Backwash Lines, P-Trap, 0 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 i 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing I , 65. Electrical-Final - r 15. Rough Electrical-Conduit •,r • 66. Solar-System-Final 1 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 # t - , . , 21. Ducts, in Structure: - _ -.70. Underground.Hydro 22. Ducts, Ventilating I- - .-•• -71• Product Piping 0 Gas 0 Oil 23. Ga; Pipe-Rough &Test - I 72. Underground Flush. r 24. Roof Framing • - 73. •Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing " 74. Overhead Hydro .. 26. T-Bar Ceiling (Structural) & Monocoat till. • 27. Frame and Flashing76. • 28. Lathing& Siding - i 29. Insulation - - SYSTEM FINAL . '.I _ 30. Drywall Nailing - I iso . DEPT. REQUIREMENT 31. Plaster Brown Coat 1 I-4'. • 32. Electrical Power Meter-Final I1'tMPTU • .33. Final Electric 34. Final Heating& Air Conditioning: 35. Final Gas Pipe-Test', a - 36. Hood or-Canopy r ' 4 . ' It..- 37. Final Factory Fireplace I/ j 38. Final Plumbing --1-- j 39. Water Service-Final ! I '2'1 40. Gas Service-Final I/ )- 41. Solar Domestic-Final 42. Backflow Preventer i I 43. Backflow Irrigation 1"1/-19.2... Lar `,,,,,t, - 44. Landscape Irrigation System - �� 45.-Sound Attenuation t ‘K!/,� � • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' 48. FINAL PLANNING • n 49. Electric Release to Edison t - 50. Gas Release to Southern California Gas Co '' I t? I - ' (..-.11 - - 51. CERTIFICATE OF OCCUPANCYI • No. Date , 1 . CITY OF COSTA MESA CALIFORNIA P.O. BOX 317 From the Office of the Planning Department March 4, 1963 Mr. John Klug % pace®etter Homes Cover Bldg., Newport Beach, California Dear Sir: The City of Costa Mesa wishes to advise you that in revising street addresses, the numbers listed below were changed: Old Address New Address rhe 2000 Caliert 2803 Shantar Drive For your convenience we are listing the agencies below that we will notify of this change. In addition to those listed, you may desire to notify your correspondents of the change. Your cooperation in this matter is appreciated. Very truly yours, A. L. Dunn, Director of Planning • IC By:1%Dave Leighton, DL:rlb Planning Technician cc: Southern California Edison Company Southern Counties Gas Company Costa Mesa County Water District Pacific Telephone Company U. S. Post Office County Clerk (4) �� Public Works Department Engineering Department cV Q + iY 3' Building Safety °r ' 0 File Gf %u3 Csd 6 I 1 13 OWNER PACESETTER WEST .TOTNT vENTLIBE DATE OCT 2 3 1962 JOB ADDRESS ,moci n-----i+-,,Lava. .2 X0.3 J. BUILDING PERMIT NO. 17934 GENERAL CONTRACTOR Andros Land Co. VALUE $ 18,177.00 AP No. 139-402-34 LOT 82 TRACT 4349 FIRE ZONE DESCRIPTION OF WORKRes.W/a t.gar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZO11iF R-1 sJ/- .2. PERMITS ISSUED c /A SUBCONTRACTOR DATE NUMBER !/ Water i_[ - ` '_ Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating E'1/2/ _ ei� l/ Je i // � /a---,� 7-(s1 /D dr - Rough Plumbing /5:41 /rr , Ter.;./ /i/ -n 3 700$ ---- Miscellaneous Miscellaneous Prop.Swr.LinCHouse Coma-St.Swr. 0 -/c JRN2 4 ItcaMVI- Cop l H. MT 28196,_y y g Q S s,t- Sprinkling System N �Q�Ii. Construction pole (,�f�'''_/` Underground D Power U ry•��" Rough Wiring #YGh I ^41.67 //Lff.� 7`(L�J Ali Ci(L!' /o77G 7 J 3 f'yy 11I(3 r'J'M Trenches 0 Forms 0 Steel Reinf. D /-4'-[L- T' Floor System It) M 1 i-lyj2._ Bond Beam 0 Steel Reinforce 0 Sheathing �`'�`. 'j-3- �v . Frame and Flashing %y �a G 3 Lathing - In Out Kir- vt i -E s Plaster, brown coat F3 //7 3-/93, Ref rig. 0 Air Cond. 0 Final ating, Final r-,4( -7-4/12- 3 .umbing Fixtures, Final 51/2"17-27/ 12_ Final Gas Test Electric Fixtures, Final /?ilii y/-4-C.3 Building, Final 445?-1-'7" OCCUPANCY FORM BU4-5M - 7-61 1'(914 • ~. 17934 FFE RECEIVLU 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT OCT1 DEPT. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT. / TYPE ••j PRINT BUILDING BUILDING - .: ( /�1/W/�� f. ADDRESS ''" -r - • COSTA MESA. CALIFORNIA ,For Office Use Only .y d I RECEIPT NO. I P171:10. MAIL 6'. w RECEIV'D BY OA jHECEIY�ED � DATE ISSUED ADDRESS /6 7 ���^/L�D/' 6 �j ,�B % DLJ -,1'11C 9 3 1562:, -/ CITY [ O-41fl. 41Gi4- T 9 TMJ ADDRESS erne/ ii�ii /� ARCHITECT L^a r No: COSTA MESA. CALIFORNIA OR ENGINEER/�A`Y� /.. o //- �/y� ADDRESS 14:44.4-4/ 441/f�4 / -w/ /� //. ZONE TYPE // GROUPyI / // CONTRACTOR .44 444"10 a 1 APPROVED U / ,f,/ �/y�p�/ BY DATE ADDRESS /6 53 /(«l�4 i/�C ZONING /�� ZONh I NO.OF 2I USE OF NEW.Th 7Z)(FATAS CITY // R .�' PLANS BUILDING /J(A/ �� STATE / �I/� C. TELL/ /l. 4c -LEJGAAL � �� -/_. �1„ LIC.NO. r /L NO.R` 71J� DESCRIPTION , ..0.--, <.----- /(•I r BI ZE fie k/9 0 I NO. OF BLOCS. y OF LOT V USE OFjam,! ^ Now ON LOT A.P.NO. / 31— '90 2 — 3 y YARDS EVES EXISTING BLDG. /l.C�i y 11S. APPROVED ALLOWED SETBACK LINE FROM Q (CENTER LINE ST.) /!_ `I 5-14171-4141‘1. � a CENTER OF STREET REAR YARD �l/ FRONT ^J�/ FT. ` / Q17� IN. SIDE YARD I LEFT /3 I RIGHT R.SIDE S FT. /� IN. DESCRIPTION OF WORK L.SIDE I J PT, N. NEW I X I ALTERATION I II ADDITION I REAR FT. IN. II MOVING I II DEMOLISH I i REPAIR APPROVED ///frP DATE •/Z�/.` '♦„ //// BY L(J�N BUILDING / NO. OF 7' / SIZE ta[ �O ROOMS / STORIES • EXTERIOR W.41.1.0, ROOF /. J/4c COVERING /(/c i.O (COVERING�JLT k U F BUILDING AND WORK B-E ^RI.�ECD �/ L - air2S.c)CS fv sV 6 G is ;,...C6 e'‘,:,41--.00 g , oPielitt IP I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDE 2LUATI ON IS OR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL C ORD! NCEB AND 8TH{ LAWS REGULATING BUILDING CO•- - CTI.- O 1 / / VALUATION / 61-(j n SIGNATORA."e 0 PERMIT FEE $ bO. W PERMITTE' �' D �/n Bp D /, $ /d �"7/ /• PLAN CHECK $ 30. " AUTHORIZED •!/ate lei 4 " • C, rc TOTAL FEE $ /O- 0