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Home My WebLink About2816 SHANTAR DR - Building Permits r rt a y CITY OF COSTA MESA 1 BUILDING DIVISION ).-77a. F t :�. i DEVELOPMENT SERVICES DEPARTMENT PERMI UMBER k IIPPlia PERMIT %Inseams*tie B05-00123 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2816 SHANTAR DR Status: ISSUED Suite: Applied: 01/20/2005 Vicinity: Issued: 01/20/2005 Parcel Number: 13940305 Zoning: R1 R1 ^ Applicant: LUGO, ALEX _ ISSUED BY: c�\1 Address: . 17686 CORINNE WAY ./' - - - - - - Phone: 562 254-6296 RIVERSIDE;CAI-"- , Zip: 92504 Owner FEINSTEIN, LOUIE', ' Address 816 SHANTAR DR, / - - - 'v A \ �- /� vyN'AA LOSTA MESA,CA Zip: 92626 \ Contractor: PARADISE POOLS Address: 17686 CORINNE WAY .. - Phone: 951 757-8572 - - RIVERSIDE,CA - - - Zip: 92504 . -License: 788593 - - . - . - I - Arch : _. - ' _ ' Eng: - - - - • Address: ' " - N- Address: •• - ' - - - ` Phone: - _ Phone: - Zip: License: License: " - -- SCOPE OF PERMIT -, . : . ' ' NEW GUNITE SWIMMING POOL-420 SQ. FT. ,../'J- - _r •-- + , • 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 - -1 ; Other:- $0.00 - Inspection: ,-$0.00 - Total: $485.66 PLANNING &ZONING - ' • SETBACKS , . . ". MAIN STRUCTURE Front- 0-0 - Rear- -0-0K , _Left 07 0 ' - Right 0-0 - ACCESSORY Front -0-0 Rear - 0-0 Left 0-0 - ' Right 0-0 ' ,' PARKING Existinq: 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(6/00) • DECLARATIONS „ E ) 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 sell-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 thisr itIs issued, My workers'corntion I (7urance�ca .'nrrier and polis ber�nare: 1111 6 C Carder: pa �r Policy Number. NA (This section neH e c lore.' d a i/rh permit/s valuet ne u I ntlred (dollars $100)Or less.) ❑ I certify that In the pe .rman.k 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 alifor and agree that if I should become subject to the workers'compensation provision of Section 3700 of the Labor Code,I shall forthwith comply with these pro isions Applicant Signature: _ 4.4111 �� Date: GAJ—" WARNING:FAILURE TO SECURE - RS'COMPENS• ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($106,000),IN•.DmON TO THE••••T 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 license.under.rovision .1C :.t- .(commencing with Section 7000)of Division 3 of the Business,apd Pr fessions C e,and my license Is in full force and effect.tic.# A ,an Class# C , Contractor's Signature: Date:_ ' V CONSTRUCTION LENDING AGENCY: 1 CII hereby affirm that there is a construction lending ency 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 Ls 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 Ucense Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's 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 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 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 toprepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? 1:1 Yes 0N (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 end 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 aElplication a permit 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 A -IZATION 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 wi h all state law' ' d city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection pu•• s.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • Signature Of • ner s) ate 58 %thdltartAtiih.rized App cant ate ;ODE E DIRECTION TYPE 1N11fIAL$ CODE( INSPECTIONTYPE QZ¢, gilII151$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1286 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 �� %1 7 li I It--0, , .PAcne:(562)778-460 PAX: (652)7766460 January 10,2001 Authorization To Sign Permits For Contractor I hereby authorize the following person(s)to act on my behalf in obtaining permits from the Department of Building& Safety and to sign permit applications for me . I am properly licensed as required by the State of ;, California. ,fid' This authorization shall continue to be valid until'the Department of-' -' Building&Safety is notified in writing that such authorization is cancelled by its contractor. , *. d I Persons Authorized: 1) Allen Negrete - - -- -•- = Oa 2)Jorge Negrete li7 F 3)Alejandro Lugo 111111Wrik - :1 r. 4)Julia Negrete Thank You; 4Lt € rge Negrete I Paradise Pools �ApRA ANDERSON K N�j qpm MO pawm O 1f COMM.11248616 �-�— �//L��, �� 03,:rittp1`:NOTARY PUBUCCA�60RNIA� v �r'"7. - a Q� ��" LOS ANGELES COUNTY 0 i! • ♦ p , 2 COMM EXP.JAN.7,200b - i JIM 1 j 7500 Scout Ave. Bell Gardens, CAA 90201 deg : ID 40 22 -Lew e • cl Z.40I BEL606 0911-1 X314 `�{� L b0/aa/E :Paniaoeb W y abed `SO 'e a <- LbOL0E2.6O6 ,Wd°-. WWW l ke.JI b,UI V.1I • 31508 1998 CALIFORNIA BUILDING CODE 31508 L c Division I1—PRIVATE SWIMMING POOLS(STATEWIDE) A C C ,VOTE;There re,,morn fire vrhjrrt u,lural government modification. The applicable local g Oflinl Mem requirements at the time of application for a building Apermit a Inch he verified. C A NOTE:Then'enurdard.s become applicable commencing Januurt I, 1998,to a prir<rle.single-famile home for which a construction pennit for a new swimming A pool Iran been issued on or after Jarman.1, /998.. A C A A SECTION 3150B—DEFINITIONS to afford protection that is equal to or greater than that afforded by A c . any of the devices set forth in Items 1-4, inclusive. C C As used in this division, the following tens have the following C A• meanings: Reference:Health and Safety Code Section 115922 C A Authority:Health and Safety Code Section 18942(6) ' C C • APPROVED SAFETY POOL COVER means a manually or AB 3305, Statutes 1996, C925 A A power-operated safety pool cover that meets all of the perfor- A A stance.standards of the American Society for Testing and Materi- A C n/s(ASTM), in compliance with Standard F/346-9/. SECTION 315213—ENCLOSURE;REQUIRED C C CHARACTERIS7TCS C A ENCLOSURE means a fenceC , wall or other barrier that iso- A A lanes a swimming pool from access to the home. 32 D n enclosure shall have all of the following characteris- C CA C EXIT ALARMS means devices that make audible, continuous tics: C C alarm sounds when any door or;vindow that permits access from I. Any access gates through the enclosure open away from the A C C the residence to the pool area, that is without any intervening en- swimming pool and are self-closing with a self-latcAhing device C A• closure, is opened or is left ajar. Exit alarms may be battery oper- placed no lower than 60 inches(1524 mm)above the ground. C A A cited or may he connected to the electrical wiring of the building. 2. A minimum height of 60 inches(1521 rum). A A PUBLIC SWIMMING POOL means a swimming pool aper- 3. A maeirnwrr vertical clearance frown the grand to the bottom A C aced for the use of the general public with or without charge, or for of the enclosure of 2 inches(51 nun). A C the use of the members and guests of a private club. Public swim- C C ruing pool does not include a swimming pool located on the 4. Gaps or voids, if any do nor allow passage of a sphere equal C A to or greater that 4 inches(102 mm)hr diameter. A CC grounds of a private single-family home. CC C 5. An outside surface free of protrusions. cavities or other C A SWIMMING POOL or POOL means any structure intended A A for swimming or recreational bathing that tai water over physical characteristics that would serve as handholds or foot- A C holds that could enable a child below the age of five years to climb c A 18 inches(457 mm)deep. "Swimming pool-includes in-ground overA CC and above-ground structures and includes, but is not limited to, . A C hot tubs. spas.portable spas and nonporable wading pools. Reference: Health and Safety Code Section 115923 C AC Authority: Health and Safety Code Section 18942(6) C C Reference: Health and Safety Code Section 115921 AB 3305. Statutes 1996. C.925 - C C Authority: Health and Safety Code Section 18942(h) C A AB 3305, Statutes /996. C.925 A C SECTION 31538—AGREEMENTS TO BUILD;NOTICE C L A OF PROVISIONS A L A SECTION 3151B—CONSTRUCTION PERMIT - A L ASAFETY FEATURES REQUIRED Any person entering into an agreement to build a swimming pool A A shall give the consumer notice of the requirements of this article. A L AC Commencing Januar I. 1998. except as provided in SectionReference: Health and Safety Code Section 115924 A L A 31545. whenever a construction permit is issued for constructionAuthority: s•c Health and SafeCode Section !8942(6) A L A of a new swimming pool at a private, single-family home, it shall AB 3305, Statutes 1996. C.925 A L CA be equipped with at least one of the following safety features: C L A he pool shall be isolated from access to a home by an endo- A L f. A -SECTION 31548—EXEMPT FACILITIES C L. sure that meets the requirements of Section 3152B. A L C 2. The pool shall be equipped with an approved safety pool 3154.18 The requirements of this anile shall not apply to any of t A the following: A '_l C cover C A1. Public swimming pools. A A Che residence shall he equipped with exit alarms on those • A A doors providing direct access to the pool. 2. Hot tubs or spas with locking safety covers that comply with A C the American Society for Testing Materials—Emergency Perfor- C A e11 doors providing direct access from the home to the swim- prance Specification 05E14-ES /3-89). CC . AC ming pool shall be equipped with a self-closing, self-latching de- 3. Any pool within the jurisdiction of anypolitica(subdivision A • lace ce w 'th a release mechanism placed no lower than 54 inches A C that adopts an ordinance for swimming pool safety that includes C A (1372 mm)above the floor A C requirements that are at least as stringent as this division. C A• 5. Other means of protection, if the degree of protection af- 4. An apartment complex or any residential setting other than a AC• forded is equal to or greater than that afforded by any of the de- single family home. C A vices set. forth in hems II. inclusive, as determined by the C C building official of the jurisdiction issuing the applicable building Reference: Health and Safety Code Section 115925 A C pennir. Any ordinance governing child octets to pools adopted by Authority:Health and Safety Code Section 189420 A A a political subdivision mi or before January I. /997, is presumed AB 3305. Statutes 1996, C.925 DIVISION OIoBUILI CITY OF COSI 1-294.16 S pP11yi BY lids iQoDs aid SDeafcdlonsMUST be keg 1 CHAP.318,DIV.I 1998 CALIFORNIA BUILDING CODE FIGURE 318-4 FIGURE 318-5 C A C A C A C A A C A C A C C 111111111' A Ac 1111111t1.41i1;111.11illmn;4'min.Iill A AA LLL AL level ...�11�� 410- . A E ..�;'� 1'min. CA L ._ ire_ TIM A L P ' rnr., aa:rl7v( A L m AL AL C L A L C L A L C L A L C L A L C L A L C L A L FIGURE 31B-4--PERPENDICULAR FENCING DIMENSIONS ON SLOPING GROUND C L A L C L A L C L A L C L A L C L A L C L • A L C L A L C L A L AE C L C L INSIDE OUTSIDE C L A L C L A L 5' 1 A L clear C Fencing SPace /i/` C L �/ Cl t "/ A l` /i. ��i_ " C L /' C L •' C L A L C L A L CE L E CL A L C L lilt in 9010101ZWIll 2 E lI 1O Y LD FIGURE 31B-5—EFFECTIVE FENCING HEIGHT A L /0 A 'I `Ih " 1-294.15 01251:+i i EUM era is:?:',qz Lrn;aii.q to Warr M CITY OF COSTA MESA t et BUILDING DIVISION Fita„,,, DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER 4. j !1 PERMIT -I*!oPo.g$o� E05-00045 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT • Job Address: 2816 SHANTAR DR Status: ISSUED Suite No .Applied: 01/20/2005 Vicinity: Issued: 01/20/2005 Parcel Nunmber: 13940305 • • Applicant: LUGO, ALEX ISSUED BY: Address: 17686 CORINNE WAY " 2 ' ' - Phone: 562254-6296 - " _-�, RIVERSIDE,'CA' Zip: 92504 .�=_ A , Owner' r FEINSTEIN, LOUIE': :" S. - " Address,''2846 SHANTARDR--_ • �.�� ,%j \��•_A Phone: N� i COSTA MESA,CA Zip: 92626 Contractor:. PARADISE POOLS Address: 17686 CORINNE WAY - `N Phone: 951 757-8572 ' • , ,RIVERSIDE,CA Zip: 92504 ' License: 788593 ,- ( ,SCOPE OF PERMIT, - - ' NEW GUNITE SWIMMING POOL-420 SQ. FT." -- . •. , _ , ELECT. PERMIT IS FOR POOL EQUIPMENT. FEE SUMMARY Quantity - Quantity' ' - 1SSUEFEE � $23.50 Temp Dist System/Lighting '$0.00 0; - - Temp service test $0.00 Busway/100 ft - Res:a/c package., $0.00 Standing Section New Res(1-2 units) : $0.00 0 _.,.,--.7.:7' Misd Electrical Equipment New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 a -'0 , Pool/Spa 1, .,$49.50 1 - , up to 10 kva/kw $0.00.`7 0 Lighting Fixts '$0.000 'up to 50 kva/kw•.' ` -$0.06- 0 : , Recept Outlets - $0.00 0 up to 100 kva/kw ' $0,00 , , 0 Switches . $0.00 0 •'' � ' 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(meth 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 $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee '' _ ' $0.00 Motors over 100hp $0.000 '- - . - , Communication drops $0.00 0 „„ ' ----Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) 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 . 2448.46(6/00) DECLARATIONS ( ) ( • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 I hay 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 for which this permit is issued. (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 Ins ranee ca er and policy umber are: /' Cartier: 3 , ---�i -1 v v Policy Number: I Cl s50-7 (This sect/on T�not be completed if the p It is valued at one hundred dollars($100)or less.) ❑ I certify that in the perfo ance 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 C fomi , nd 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 provisi ns. / � Applicant Signature: Date: I `3. WARNING:FAILURE TO SECURE W VSATIOJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED TH00 SAND DOLLARE($100,000),IN ADD ON TO TH 90ST 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 nder provisions of Chapt: I (commencing with Section 7000)of Division 3 of the Business and Professi ns Code,and my license is in full force and effect.Lic.# • � Class# CO- S Contractors Signature: -. Date: ( }e, _ 1 's s— 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 requiree 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 properly,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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's 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 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 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 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 Govemment 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 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No e (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 C MPUAN E 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 ply v ith all state laws and cityordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described pro arty for in pection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si nature Of Legal Owner(s) L��l r th Applicant I y Date CODE 6 INSPECTION TYPE PATE ItMILE CODE A INSPECTION TYPE 9A ItirnALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing E^ �d 200 Final Re-Roof 210 Final Electrical —$ -o C _ikfr-An 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 BUILDING DIVISION f • ,.„•. ,w DEVELOPMENT SERVICES DEPARTMENT P T NUMBER PERMIT VA 5 WQ) `*aarerrw li MOS 00032 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2816 SHANTAR DR Status: ISSUED Suite No Applied: 01/20/2005 Issued: 01/20/2005 Vicinity: • Parcel Number: 13940305 - - - - _ ISSUED BY: Applicant: LUGO, ALEX Address: 17686 CORINNEWAY ' - - ' / ) I y Phone 562 254-6296 ' "- RIVERSIDE,CA --- - Zip - 92504 ``':\ "\ / - - - - Owner: . ".FEINSTEIN„LOUIE - �/ N Address: 2816 SHANTAR-DR - - - '�� , �� :, Phone: - - ` COSTA MESA,CA Zip: 92626 " " , • 'Contractor: PARADISE POOLS Address: -17686 CORINNE WAY - - -Phone: 951757-8572._ - RIVERSIDE,CA Zip: - 92504 - _• - License:788593 "" _ . " ' SCOPE OF PERMIT c NEW GUNITE SWIMMING POOL-420 SQ;FT._ ,_. - _ _, ' MECH. PERMIT IS FOR POOL-HEATER: . :: - -/- -' -- .. - - FEE SUMMARY - - , -Quantity: ISSUE FEE . $23.50- -- , .-Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit Inst FAU>100 k BTU-' $0.00 0 Ventillation System . i $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 "4'5/' .'$0.00 0 Refrig Sys<100 k BTU $0.00 0 `'.-Domestic Incinerator ' , $0.00 0' ' Refrig Sys>100 k BTU $0.00 0 -.I.>, -.7 Compressors/Absorption Systems , -,,' i 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;000k"BTU --,l'. .. $0.00 ' 0 VAV Box ' , $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00. 0 , Over 50 hp/Over 1,750 BTU / - /$0.00 0 Appliance $0.00 0 - - Boilers Fire Dampers $0.00 0 , ' ' Up to 3 hp.-- , . - ,_'. '$14.70 1 Smoke Dampers $0.00 , .0 _' ' 3 To 15 hp - _ j:." $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. . . -2 ,/ $0.00 0 Air Handlers> 10000cfm $0.00 0 , ' ' " Over 50 lip '- , $0.00 0 Floor Furnace $0.00 -0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 _ ' Investigation Fee ,-, $0.00 _ PlamCheck Fee �- $0.00 L --- - - -Reinspection Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) ' EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or aband ned 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 coded all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration O this permit. FOR INSPECTIONS CALL: (714)754-5626 ?---,/ 2446-48(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 work for which this permit Is Issued. My workers'co &aeon Ing ce carrier and policy mbar are: I !6 6 1.,e5-0--71.,e5-0--7Carder: Policy Number (This section nee not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the rk 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 Califoml ,and 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. aS Applicant Signature: Date: --t e--) ""--- WARNING: WARNING:FAILURE TO SECURE WORKER ENSATION ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RNES UP TO ONE HUNDRED THOUSAND DOLLARE(S100.0W),IN ADDITION TO THE COST PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under pr ier.✓](commencing with Section 7000)of Division 3 of the Business and Profe Ions Code,and my license is in full force and effect.Lk.a 1[f1 1af'f7_ Class a J Contractors Signature: Date: % — -a 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: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 properly,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,an,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: Date: Owner ID verified by drivers license. 0 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,1alsework,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: 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 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 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 permit 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (II 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 __...._o.air_p._ 8 (II yes',attach certificate of compliance from the appropriaate air ollution 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: I Date: CERTIFICATE O OMPU• •E 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 misty 'Ras:te laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described p perry fo •acn•urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. i o e re Of Le. I Owners) Die /{__ And/Or Authorized .plicant Date - CODE I INSPECTIONTYPE QAI[ fNTRlALS CODE INSPECTION TYPE QdIE �Urt1RI��$,1n 1618 Fixed System Final Fire Prevention 206 Final Mechanical V-3-66.— '-k " 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 i , CITY OF COSTA MESA - 4 BUILDING DIVISION >:� ..�i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t. i1 t PERMIT ce"^' P05-00045 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2816 SHANTAR DR . Status: ISSUED Suite No Applied: 01/20/2005 Issued: 01/20/2005 Vicinity: • _ _ ISSUED BY: I/fit Parcel Nunmber: 13940305 - "'. ?�'. O" Applicant: LUGO, ALEX,j% : •- I J Address: 17686 CORINNE WAY,- - .-, ' , ' . / / , C Phone 562 254-6296 /, '� 1 RIVERSIDE,CA �i - Zip 92504 N��\ /, :, l Owner: FEINSTEIN,'LOU_IE , - ..�,< / jA-7�� , Address 2816 SHANTAR;DR " > \ Phone: COSTA MESA,CA Zip: '92626 V :,, ,_" Contractor: PARADISE POOLS = � Address: ' 17686 CORINNE WAY' ,a'' ` - � '\ "' t• - - Phone: 951 757-8572 - - y / - , - ' " RIVERSIDE,CA Zip: 92504 - License: 788593 , -- - _ . • Arch / Eng • Address: • , - • ' n Phone:. - _ - - - - License: c - - - - - SCOPE OF PERMIT " ' - . NEW GUNITE SWIMMING POOL-420 SQ. FT. ' PLUMBING IS FOR POOL EQUIP. ✓' t- FEE SUMMARY _ • AMT QTY - AMT QTY - AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump-Pump- . / i'/ $0.00 0 Backflow irrigation, $0.00 0 . Landscape-Irrigation $0.00 0 . ' Swimming Pool /,-• ' , $60.75 1 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` j $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 $0.00 0 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 SewecPrivateiine- $0.00.; -0 Water Closet(Toilet) $0.00 0 , Drain,Roof $0.00 0St ower- '-- __ rt $0.00- -0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 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 suspendedor 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-or this permit. FOR INSPECTIONS CALL: (714)754-5626 4 / 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 vjork 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' pe pe do Insu ce carrier 9 oil�Lnnumbs(are: � Cartier: ! t T 1� Qty Policy Number: L .�,�q.•�L (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the perfo dnce of e 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 C Ilfomia, d 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 provi ons, /� Applicant Signature: Date: r' Z/�'—'U WARNING:FAILURE TO SECURE WORK 'COMPE TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(51 W,WO),IN ADD ON TO THE OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am liceritn d pr visio o .':it •(commencing with Section 7000)of Division 3 of the Business and Professi e,and my license is in full force and effect.Lk.# i Class# C Contractors Signature: . Date: / CONSTRUCTION LENDING AGENCY: 11 ❑ 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.It 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.). ❑ I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's 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 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 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 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 Aft 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 end 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 • r 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 s . : laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property f' inspec purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signa r Legal Owner(s) Date And/x ¢:•Ap•icant 1 Date-� CODE I. INSPECTION TYPE PATE INTRIAL$ CODE. INSPECTIONTYPE DATE EOM 1616 Fixed System Final Fire Prevention 206 Final Mechanical ry 1266 Pool Spa Final 208 Final Plumbing %. - 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 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 n. • 4105tp CITY OF COSTA MESA 111:it ,t, BUILDING DIVISION PE IT NUMBER r•r w•.'^� I DEVELOPMENT SERVICES DEPARTMENT 4. ,-/ PERMIT E99-00984 • (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 - ELECTRICAL PERMIT Job Address: 2816 SHANTAR DR Status: ISSUED • Suite No Applied: 10/21/1999 Vicinity: REAR YARD Issued: 10/21/1999 Parcel Nunmber: 13940305 ISSUED BY: Applicant: GENTILI, DON Address: 10617 LAWSON RIVER AVE. CA Phone: (714)378-9976 FOUNTAIN VALLEY Zip: 92708 Owner: FEINSTEIN, LOUIE Address 2816 SHANTAR DR . Phone: COSTA MESA, CA Zip: 92626 RF' Contractor: SWIMRITE ROCK POOLS INC �i cylBE� Address: 10617 LAWSON RIVER AVE. ++ii' CA Phone: (714)378-9976 �' ,n.C � FOUNTAIN VALLEY Zip: 92708 DA v1w�-n / License: 755551 T/ I° �Vur� SCOPE OF PERMIT INSTALL 3 ELECTRICAL OUTLETS FOR INSTALLATION OF NEW PORTABLE SPA&BBQ IN REAR YARD OF EXISTING SINGLE FAMILY RESIDENCE. 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 $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $3.30 3 up to 100 kva/kw $0.00 0 Switches $0.00 0 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 1 hp $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 $0.00 0 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 $26.80 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. a 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 • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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. El 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'co pens tion Igwrance car9'er and policy number are: �—�'7 Carrier: S4i7 1-1.,.0 Policy Number: 75-3S /7c c-T/ (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for whic this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Car rnia,and agree that if I d become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these pr is' n moi, Applicant Signature: L ��"c`-c-v/ I Oct- Date: 7�al/J' WARNING:FAILURE TO SECUR ORKERS'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 37060F 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.p C-S //// Class a C'�3 Contractors Signature: L TC - '�7 ,- ,"/" Date: /0/9,/79 CONSTRUCTION LENDING AGENCY: MVV/ [ ❑ 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 heFself 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 witheone year of.co^p`�on 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 l:aw,doeslnot 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. - 3T.12#7 Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑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). 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: 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 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 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? U Yes U No (Section 65850.2 of the California Govemment 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 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? ❑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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. UnA1144111g Of Leei91.4ner(s) /Or Authoriz6d Applicant ( / `Date' CODE* INSPECTION TYPE DATE JNTRIALS CODE* INSPECTION TYPI< DATE INTRIAI9 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing eat 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 2446-46 M` CITY OF COSTA MESA ;`y' 9 BUILDING DIVISION PE IT NUMBER ' DEVELOPMENT SERVICES DEPARTMENT •y'c�q• • PERMIT P99-00596 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT • Job Address: 2816 SHANTAR DR Status: ISSUED Suite No Applied: 10/21/1999 Issued: 10/21/1999 Vicinity: IN REAR YARD Parcel Nunmber: 13940305 ISSUED BY: Applicant: GENTILI, DON Address: 10617 LAWSON RIVER AVE. CA Phone: (714)378-9976 FOUNTAIN VALLEY Zip: 92708 Owner: FEINSTEIN, LOUIE Address 2816 SHANTAR DR Phone: COSTA MESA, CA Zip: 92626 Contractor: SWIMRITE ROCK POOLS INC Address: 10617 LAWSON RIVER AVE. CA Phone: (714)378-9976 FOUNTAIN VALLEY Zip: 92708 License: 755551 Arch l Eng: Address: Phone: Zip: License: SCOPE OF PERMIT INSTALL 1-GAS OUTLET FOR INSTALLATION OF NEW BBQ IN REAR YARD OF EXISTING SINGLE FAMILY RESIDENCE. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 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 $0.00 0 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) $0.00 0 Drain, Roof $0.00 0 • Shower $0.00 0 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) $6.15 1 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: $29.65 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 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. • 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' mpensation Insurancy carrier and policy number are: / Carrier: j- Z,7z' /7,1•744 Policy Number: G 5 3Y7 2,,1r' (This section need not be completed if fhe 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 Calif rnia,and agree that if hould beco e subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these prov' I yyy J/ .47 Applicant Signature: 4, Date: al?e/ � WARNING:FAILURE TO SE E WORKERS'COMPEN COVERAGE I5 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),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.rtgyia'locs 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.tt '7 , Y Class It ((( r �� / Contractor's Signature: � r ,� Date; /ry�P//� CONSTRUCTION LENDING AGENCY: `! L ❑ 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 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's 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 B.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 Califomia 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)? ❑Ves ❑No (Section 25534 of the Califomia 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 application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan 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 Califomia 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 representatives of 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. 4_111)11 i n ure Le pP er(s) / / /„., Date An O th d A nt �1/02/ Date CODE E INSPECTION TYPE PATE INTRIAIS CODES INSPECTION TYPE p) INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical I 1266 Pool Spa Final 208 Final Plumbing "?iO•U 3 200 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 2446-46 • ADDRESS OFBMLDINS 2816 SHANTAR DR WIT: CITY OF COSTA MESA — BUILDING PERMIT OWNERS NAME IF I0q%0: LOUIE FEINSTEIN FLOOD: AE-46 PERM NO: B 08438t ADDREss, 2816 SHANTAR DR — A COSTA MESA CA 92626 PERMIT NO: B 084388 PLAN CHECK NO: . N GOVT: N SUPP : N ( 714 ) 641-8`187 ' APPL.MMUNGADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH ARCHITECT OR ENGINEER: MHO.: JOB DESCRIPTION : RESHEATH &REROOF/OSB BOARD AND 30YR COMP SQ FT: 7, 285 ARCH OR ENG.'5 ADDRESS: UM: CLAIM VALUE: 7, 285 . 00 CALC—VALUE: 7, 285 . 00 GROUP OCC: : R-3 /U-1 aRRRACTOWSNAME: ORANGE COAST ROOFING ( 714 ) 631-1924 CONTRACTORS MAKING 3027 ROYCE LN COMMENTS: TEAR OFF WOOD SHAKES AND LEAVE WOOD SHINGLES AMES& COSTA MESA CA. Lama; 4346 ***** ***** ********** *** ********** * **SI*** ****** * ** *** f******** ** ***** 92621 MT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby antro under penak perjury i. I am • -under. • -..'• .d Chapter B SETBACKS (commencing 7090)of Division 3 of the Business and PyrryLICN0with 35937 ucCuss: C391.w. O 43r674 EXP : '06/98 MAIN BUILDING ACCESSORY BUILDING f�_ ,90 FRNT: FT IN REAR: FT IN FRNI: FT IN REAR: FT IN Dere; 6 ConD�� L LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN . . OWNER BUILDER DECLARATION:I hereby dhre under penty d perjury that I am exempt from the Contractors .e Law for the following reason(section 7031.5 Business and Pmeesinna Code:Any city or county which requites a permit Io construct.alter,improve, PARKING REQ: P RO V: PARCEL : 13940305 Z N E: REF NO: 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 PLANNING NOTES>e f e licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the [ lusinese and Professions Code[or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than five hundred dollars($503D. iE*********************************************************if*********.********** ❑ I.es owner 4 the properly or my employees with wages as thee sole compensation,will do lin work.and the structure is not intended D E V E' L O P M E N T SERVICES R E Q U I R E M E N f•T S or offered for sale(Portion 7044.Business and Professions Code:The Contractors License Law does rout apply loan Mime,of property who beide or improves thereon,end who does such work himself or herself or through his or her own employees,provided that such -Ar— improvements are not Intended or offered for sale.n,however.me building orimproement is sold within one year o the w ZONING APPROVED- BY DATE: wr oeMwider will have the burden d proving he or she did not build or improve for the purpose d sale). ❑ I.as owner of the prcyerty.am exdusivery contracting with licensed contractors to construct the projed(Section 7044,Business and BUILDING APPROVED BY : a _ DATE: /"' Professions Code:The Contractors ac license Law does not apply to thean owner of pts Leon L or improves thereon and who ,��/ contracts for such projects o with a cendoes of pursuant to pr License Law). �h ❑ I am exempt under Section: B.&P.C..for this reason: APPLICATION ISSUED BY: aa� S/ `., DATE; 71T177. �j� Date: Owner LEGALIZATION:N. F E E S MM .f R Y STRUCTURAL SEGMENT:Y I do hereby candy that I ant aware d and understand the requirements of Caliomu Health end Salary Code Sections 25505,25533,and 25534.and that lorany future building occupant win/will not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ' GRADING a permit for construction or modification from'hake OuabtyManagement District Residential conerrrction animations from these PERMIT 137. 25 . 57 Provisions. Da„ Applicant: SMIP/NON—RES PLAN - . 50 WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaatore: ISSUE FEE ❑ Ihave and:MI maintain acertificate dconsent mself-insure for workers'commpensation,asprovidedfor bySectcn3700of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.i«aeped«ma ed wwork f«wschm « apmnaeaed. TOTALS----> 138 . 32 0 . 00 0 . 00 138 . 32 138 . 32 . 00 Q1 have and wR maintain workers'compensation insurance,as required by Section 3700 d the Labor Code,or the performance d the work la which this permit'e issued.My workers'compensation insurance carrier and policy nu bee are: Denier: SATE FUND 1 EXPIRE REVENUE DIVISION TOTALS--> COLLECTED: 138 . 32 OVER/SHORT: . 00 Policy Number: 7, — • IrVsai 01 /01 /' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK his section need not be completed A'the permit is Mar oro hundred dollars/S1oofor '�,.) , 137 . 25 1 . 07 ❑ I cents that in the performance of the work for which this permit is issued,I 'I not em.• • person in manner -to wonders'become subject to the compensation laws of Calnomie. and agree n 1 Y, oma su• -• to the . :. . ********************Se********************************************************** om cpensation provisions of Section 3700 of the Labor Code,I shall fonhwlt .•'py with T. ..•, (�� G 1 4 I N D I V I D U A L F E E BREAKDOWN •e-- Date: G G 7 Applicant: I ` _ I I J Warning:Failure to secure workers'compenstiton coveraga/s unlawful,one shed subject an employer to criminal premise and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dal/an($704000).M aeditron to de cost of compensation,damages as provided for In Section 3706 of the Labor Code,Interest,endattomey'a fou. SFC 1550 ALTER BY VALUE COMMERCIAL NOZONE 1 . 00 1 , 550 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that construction is a estruction fending agency the e SFR 5735 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 735 . 00 performance of the work or .icy this permit is issued (Section 3097,Civ.C). END OF FEES LENDE' t NAME: ENDER'S .ee ROSS: I candy that) �:read N'. :..dation, .mete that Ma above imormetionis ..l agree tocanpy with dl city and aunty ordirarras and state laws .::ing to. •. .. . .. and hereby: Dor¢°represent f-.:d this dry to enter upon the above-mentioned properly tnr inapedion•i ••�-'. •VID MILL j 08-25-13'37/10:38 Np/$138.32 ILWARl i� Dale: e IF- 52 1'EktIITn084388 V 1 Sig .:.red• Agent/A•.'.f. .rector , • (5151-46.WP) White-Building 6 Safety;Green-Fie;Cavy-Applicant;Pink-Revenue;Goldenrod-Assessor • - . , CONSTRUCTION AND PLANNING POOL ,PA APPROVALS -Permit# - • Date Inspector APPROVALS - Permit# Date Inspector 1. Temporary Electrical Service or Pdie_ 52. Pool & Equipment Location t 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 LIFER Grnd. _ 57, APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. _ ' 8. Foundation • . - , 59. Gas Pipe, 0 Undrgrnd., Test 2 t 9. Water Pipe-Undrgrnd. - 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 Capen 63. Heater & Vt•Final , _ , 13. Roof Drains - ' 64: Plumbing System -•Finai 14. Rough Plumbing - - .65. Electrical-Final 15. Rough Electrical-Conduit , 1 66. Solar System-Final i 16. Rough Electric Wiring 67. Fencing & Access Approval ' 17. Rough Wiring Sign r - - - 68. APPROVED FOR PLASTERING ' 1 18. Rough Electrical-T Bar Ceiling - . . 69. POOL SPASYSTEMS-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 O Oil 23, Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing • $'2.4 17 4,444----"I4..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 PREY. FINAL 30. Drywall Nailing .. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . 79. FINAL INSPECTION 32. Electrical Power Meter-Final80. FOOD CERTIFICATE ISSUED _ i .t 33. Final Electric / . Notes: 34. Final Heating& Air Conditioning �i - 35. Final Gas Pipe-Test - . . .. .. 36. Hood or Canopy t• 37. Final Factory Fireplace . - . , ' 38. Final Plumbing 2'4--' • 39. Water Service-Final 40. Gas Service-Final - t 41, Solar Domestic-Final I : 42. Backflow Preventer - • .43, Backflow Irrigation , 44. Landscape Irrigation System,- . - • 45. Sound Attenuation - - 46. Handicap Regulations 47,. FINAL STRUCTURE & BUILDING 11...2R-17 Caen 46'. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 511 CERTIFICATE OF OCCUPANCY ' • ____. No. Date 7 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - • CITY'OF COSTA.MESA • - 2 I _ a PERMIT NO. 'TRACT NO. LOT NO. BLDG NO. ( 5R1)c`t;- I /O4�BTS' t ,7 . _'CO�BTRUCTION PERMIT. Iy I` - ' -n.) (c, 09 i I . 5 • .. — . •! , it' - • ,Cc: `TI Applicant's Mailing Address - '•a (C' .. a TYPE OF CONSTRUCTION- IJ NEW -LI ADD 'LI ALTERATION +• U REPAIR ' I r `•'r • 0 -I I 1 v- 3, , 'r Project Address •t 15 , r I •1 , I : • ❑ CONVERSION tEl DEMOLISH • OTH l _ G , + 1 . ! �1 I I`• 1 �/ke I LL 77 .,2. r ESCRI•PTIONJOF WO•RK I ��' • Owner's Name / �� /t^//�1 � `��'Phohe y- O C/ P 412L/Z 0 • Arvi : OO 1 ' • ' i - IZONING REGULATIONS" '-- ' . Address2R / 5 HA/LTTRA - I (J I�-� - - TYPE OF PERMIT' ' .LJIGRADING''1. FOUNDATION.; A P:#' '•/J'_� 1+63 -Q.S .ZONE 1� I1 1 , p�i"�' Arch/Eng -• I - { License No - ' ❑ TENANT ❑,ELECTRICAL' ❑.PLUMBING 0-MECHANICAL ,pLNG. REF.5V .. • _ 'BUILDING 1!C/'/! Li Cb ' • I t •-CET Ar`- C/1'CT• A 1'-,-'t✓ 1 yy"��,� Address' ,` s , �l• �c /� 1- ' I • •• 1(j _- .:OTHER }sem/ t n. • ! - _ TO BUILDING- _ B ,lel t '{y� fY/"sa< Contractor s Name cttVul `LRS�u'/2 JJ R'phon@' jl PROJECT DESCRIPTION SQ FT.' - I r - OCCUPANCY,,-rte'+'.' t PROPERTY LINE - "REAR YARD'(To P/L) i ~ ' y -: { , ; f CONSTRUCTION TYPE ' ' I VALUATION • � Ia:cJ .LEFT SIDE YARD 1 -. l �'f Address(mailing) - ` f ( _ RIGHT SIDE VARD c o t '" I . ' ° - , ZONE ' ` { ' GRADING CU.YDS: ' 'ACRES - PKG.SPACE;REQ. i PROVIDED , .. i r ,`, :] License No: ii _. . r I 1 •'n : LICENSED CONTRACTOR DECLARATION I i Remarks: 1 tit • I I I ' a i ( 1 'STREET WIDTH : 1 I I 'PARK FEE-$ , j• I `•I< {� e . l-herebyaf/lrm that I•am Ilcensed under provisions of CChartef 9(commencing ' - " •- - - Pinta .. . with section 7000) of Division 3-of the.Buin qssantl Professions Code,antl ! • I I ' t I I t 1 I• • t •SPECIAL CONDITIONS: I ko.AJ _ •', •pi . e- 1evoQi// :" .. Ilc. . ds In full force and affect. J, - I - ^ P I� p I' License Class' �/ �l}dense No 1 i - ` i I ' PLUMBING ' , i 1 ; j , et f(tea- o_ terv✓L,T ✓e- t 1, c2f' to ;tyI0.Pa K;S {Q >1 I' _ e ' ' i Signature ' . _ ! • , rLv4KERS'COMPENSATION DECLARATION 1 ; z 1 t Bar Sink _Sewer Cap' - _ 1 , ELECTRICAL 1 _ii / `;eby affirm that I have a certificate of consent to self-Insure ora certificate ! Backflow Preventer.. - . _ ' ._ _Sewer Connectio_n:__ ,__• _ _ I .- _ ClOver •100 ' - .•• .1 3`..Workers' Compensation insurance or a certiftedEcopy thereof�(Section t - ' 3900, Lab. CJ I ' 1 .I '' ; Backflow Irrigation Solar Collectors • • Policy No. : i 1 Company , Construction Pole i i I - _ _ . ' i . RCertified-copy Is hereby furnished..' i I 1 • 1 Bathtubs I I 1 1 Solar Piping , i I i I Certified copy Is filed with the city Building Division. . , � i e•• ■s ■ I Date i Applicant 1 I i I I ; Clarifiers j 1 I Solar Tank , i r , ',-EXEMPTION:FROM WORKERS'COMPENSATION DECLARATION' "1 -- --- - '- - -- 'J. - (This section need not be completed if the permit Is for,one hundred($100)or .1 Dishwasher [ Swimming Pool w/Spa s ■ ■ ■• ■ , - '-•- 1 less): t 1 1 4 1 • - 1 , I certify that In the performance of the work forwhich this permit Is Issued I 1 1 Drinking Fountains ( Urinal t + ' shale not employ any person In any manner as to beco a subject.to the I - '. I I workers'-Coln psation,Laws of Callfgrnja/I//per I ) /P/� t 1 Floor Drains' j I I 1 Water Closet' ' I. 1 I • • Date' ( I "t LYS - Signature J(a•I/ ' / "' fG-1-t-X .-sem , - I L.NOTICE:,If,.of er-making this declar4tlon,.you.should_bead subjedt to the-{. __ Floor,Sinks _„ '_ _J. --, Water Heaters _.. _. + I _,-, I 1 Workers'. Compensation provisions of.the Labor Code, you must forthwith r - -- •- - . i t ' comply with: such 'provisions or'•this'•permIt!shall be;deemed revoked:" l Oak Semina' • SOutletsl 'Water Service I-" I „• J aI. I I I CONSTRUCTION 'LENOING`-AGENCY . ' c• ' t • '" 1 - r - ' ' ' ^' I t1 I hereby affirm that there is a•construction lending agency for the-performance Interceptors I r': y r... 1 , . I 1 Outlets { 1 ' of the work for whichi this, permit Is 1 Issued'•,(Sectionu3097. Civ. C.)'' ' ' -- - - Lender sj Name;- i •_• ' t '- r . ' -• s , KitchenISmk1 r'' ` 1 . I _s ; ( r i i 1 - 1 Lender's Atltlress I ' • - - • - • Switches I ^ ' OW NE RIEUILDER DECLARATION r. '. D - ' 1 - Lavatories 1- 'r t r 4 ' •! ! • •• ' , { 1 eiebyjetfirm that I am 7031 pt Hrom the.Co Professional Law for the i ■ ■ s ' i following f rims (Sects m exec 5:Business and Professional Code: Any city,or , :1 I P Trap; _ ' t i C r t i : + I i I ;county which requires a permit'to construct,alter,improve;demolish:or/repair , , „ _ - , - • any structure;prior to Its issuance,.also requires purse p)ican tfor such permit I « I Roof Drains, a, J i s, • - _ I ■ s I i file t-signddractor statement.that he/she Is licensed pursuant to he:provisions of • ■ • lsion Ir 3,ofr the BusiP ss andhPrrofessions Code),,orrjthat.t e/she-s'extion empt•i of I � Showers .. , L 3.f _ i I i iv+ I Reinspection,Fee' $15 1 $15' .a..efrom and the;basis for the alleged exemption. Any-ylolationt ofl Section ' - --l• ss • • I '$ 3 I J31•,5 by,:any'applicant for, a{permit:subjects •the applicant to a.civil I =- ' F I✓ ' i I -• r -11 _ I `penalty of not more than five,hundred dollars($500): ' '- ; ,, • . t. , i r Service Sink i Issue Fee b $ 3 - St74VtQ2 i r' ''i - T ZyE - t I L1 i t r r I I i Zoning Approved BY •Date Ipensation; ilndoe the work; ortmy emucturess not wages' or offeredf sole j • • _ I ' Pim ' 1 ,� ! I forandMECHANICALApplicationBy sale Law 7044, Business and'Professional-Code::The.Contractor's ----- • - -- - - - -- - - - ---- - - ( License Law does not apply to,an owner of a property:who builds or Improves ' I Boiler . - rr. ' , - . Refrigeration System 1 j i j I ■ I ! i. I - 1 - I g'5 . ! thereon,land ovIdedoes'such work.himself/herself or through his or her own ' i I .-, i r i Application Issued ey Date �1 employees, ed that such;improvements are•'not intended or offered for'.' - i (]0-.100,000 BTU 0100 000 BTU sale. If, however,the building or Improvement is sold within one yearlof corn- Ducii Under-id-round. 1 ; { , - 1 i 1 ! I I • ' SUMMARY OF FEES I 1 ' II Diction, the wneriwlll have the burden of proving he/she did not build or im- ' r I -- : ' ry 1 - i ! rove for the purpose of.sale). , 1 1 i ,„ ! 1 1 { Duct-Structural I 1 'I System Repair/Alteration I UILDING PERMIT $ 11%:� • 1 SMTP , ( ^5�$ 1 I .,� U I•as owner of the property,am exclusively contracting:with:licensed con- Q I mC • I • I I tractors to construct the project (Section 7044,Business and Professions Code: i , Duct-Ventilating 1 I E ! i i t ; LAN CHECK' $ 'LZ a35 i PERMIT i ' I '. ' , ^The Contractor's-License Law does-not-apply-to an-owner-of-property who"� - ` , i i ISSUANCE! 1 $ r , builds or Improves thereon,and who contracts for such projects with a con- i I Exhaust System 0 Multiple 0' I 'PLUMBING $. 1 - 1 tractor(s)license pursuant to the Contractor!! License Law): ( 1 I E 'A P-I R D • I , I I l GRADING ; ' $ ' 1 ' 0 Tam exempt under -ction ' B.&P C.for this reason i I Fire I/Fact.Blt. ICBG•# ' i i { ' ;PLAN CHECK; i $ • . n I - '/ r . : ' i 1 Ii1COf11 lase Ind I ; $ .- . r l [� I R 'ELECTRICAL- $ 1 I 1 Date ` Owner; • �' iL __r _ - I Heating System&Ducting I i I I 1 , ( I ; 1 1 I j i ' MICROFILM $ ..I:heresy er Ify..t ate. •ave-reatl-this application aotl,state_th t-t •.above _-;.. DD'.100,D00`BTU-❑1DD,BD0 BTI✓__ _ ' r_ PLAN CHECK' $ I information is correct.I agree to comply with all city and'coiinfp • nances t I I I �- —'- =2 Sig .�--•' ——{ i i , ' ' TOTA LIFEE' $ thor I Date-t- MECHANICAL I $ ' ' r aentati to laws relating.to building construct)above- hereby authorize repro- I : 1 i - I I i sentatives of I thisIcity;to enter'upon th above-mentioned ,Property for ! Hood o. Type I ❑' I • : Reinspection Feeli $15 I s ' ' 1 i I i LESS I s ' Inspection gyrposgs. /�, / • I ; ' Canopy. -Type II 0. 1 III I I 1 PLAN CHECK' I $ . ADVANCED PC $ i ; I signature ce! h,SS 11 Dated N 1 I ! , ; - } i ' I I I 1 ; { + - I t I '•c 1 Registers fk ( i Issue Fee ) I $ 3 • I , t I ; I FINAL FEEL $ �,�1� ,.�, Drivers''License or�55'# V ! CM F'0865-46 rev:12/82' White-'Builtlin9:Canary-Applicant Plnk=lActountin9;Goldenrod'='Assessor' "'`"'-'•'i'-•— -'•'-"-' ^--'W-(^"-�"""'^ -- "-"�- •-� -•-- -' - -•-+ •+•�--+-_+.-•.:- -'•��.,,--+._,--...^ .. .. .L,,.._._- o o _r J a + o POi SPA - ` I 1 i CONSTRUCTION AND PLANNING - r '_o - � + _ =Date �; ,Inspector ;,> '{ - Date - 'Inspector' , VPPROVALSI.. Permit# `• - _ ^ - APPROVALS :3Permr4# - ! , r O.Temporary Electrical Service;or.'Bole r+c ... 'n'. ' ? ' € ': ";52.-_Pool &@Equipment,Location - '- i. :r: •- •, ' _ 1 • v '2.I Soil Pipe-Undrgrnd. g =rip : : . _y , i> rr :':::•°!5 f' :53 -:Steel-Reinforcement ;r 4° -' e,,_ -,. _,•, • ' -' 4"-.,., 'I '3,1Electrlcal Conduit Utilitvil ndrgr"hd. ' 1N g y 1;1, I "Pi 1` r ?54'.7F_orms' •-•:.-1,-,c,-;:,.;-...":,,:-:::: �t. - ` _ I �• i I I8 _ '° g _ . ° t- n ' - 4 !TTt4.'Elecrical Conduit-Undrgrnd.-. >_ I A , -. { ='o _ 6-6'- :Electrical Bft onding-- - '1, ; i 5,(Steel Reinforcement 1 ; n - 17r.. = - 1 ;•- o ;=` } e56,-Rough Plumbing& pressure;fest e Li [ I : i - 16,lElectricalUFERIGrndl 1 • - ' rts ^ ,x.0'4 '- _ -- ` y257-'.;APPROVALTO:COVER-GUNITE -•�- ' - •f ` 7.1 Footings i 1 1 ' i o e" 1 - ' ' 1 " , S j' �58._E_lectrical•Dpridu_it_Undrernd _ _ '•J . ' • . , 8.IFoundation 1 : I 1 I I ' • < ' - - ; j59.(Gas Pipe ❑ Undrgrnd Test' `'t C ••••• I I 9.,Water Pipe;Undrgrnd. ., ! � i i 5-s 1.?„ '_60. BackwasheL-ine-s PtTrap0 Undrgrnd. ° • ; 1 ; 10,1Structural FloorSystem c''l i ! z_ "i 1 I ;g t l 1, >61.'APPROVAL TO DECK-: ' i - 11.!Property Sewer Line & House'Connection' ! i< ' �62 -6ackwasht&.Receptor Final:' :, '- ; ;1 12.ISewer Ca Pi I ^ ? I _e _a I ; 2;63.rHeater& Vetit Final 0. C. T. - - ' 13. R'oof Drains , j i I ' ^' = =' { 1 - '84.:Plumbing System-•Final ,.e_ ;�-'. _ - 4..• 1 I , I ,. C . 1 C , ,t f in ‘-:-5-4.-- - - -C� . C 14.1 Rough Plumbing I 1 I. SI > _ I - 7 P =65. Electrical-Final -.. . - !. ' c "15: Rough-Electrical-Conduiti -'--' r ,.--i'- -- - - ;66. Solar SysterriFihal ---sr --7--,-- i-'-, 7-'" r"" c1. 0-16. Rough Elects is Wi[ing c j ,�nm'-ti: I'm t a:I r' _?'i,-tr 167F;Fencing&Access.Approvaf---i; - - 1 -;-M--; 17. Roug`Wiring-Sigrf ; ": I• 1' 17 1 51 ` ` 168 APPROVED,FOR PLASTERING, ,..I •i Dcr I 18, Rough Electrical''-T`Bar Ceiling ' ' :3 i- I '1 ; 1'a, j'..' I.t.69!. 'P00 VSPA'SYSTEMS FINAL 1 1 ' .c., ! :', ; '1( i '19.rRough Heating& AirConditioning f: I 1 I I It. ; I• I FIRE'DEPT: REt t QUIREMENT i_ - ' ' r • 1. 20. Rough FactoFy Fireplace I '1 II 1 1 ' - I 1 � 1 I ' f I. + - .• _1 a APPROVALS Permit# ' I 21 D^ucts*in.Structurel 1 i I •I 1' I1 1 j I I 1 , ; ;70" Underground Hydro ' , .C.22!4,Ducts,'Ven`tilating; I n I I Il 11 1 ! j 1 I I 171; P'roduct'Piping0Gas 0Oil 7 S r23.1Gas.Pipe-Rough&Test` i ' IV I° , FT-TT - i", t;- '72. Underground Flusli- I- - - - ' - .7 I . I - 1 • t 1 + f I z ''24 4 Roof Framing I 1 ' cu 1 i 11111 ; j r 1 r; i^,'i v ' " t . t 'r; , 17; Undergrnd Storage.Tank.O Gas C Oil • ' j ' ' - .-a 25' Roof Sheathing 1 � > 1 li^C ^ I l - 1 , Iif- , a: I i 4 74. Overhead Hydro • 1' j I I i' - 26.1 T.Bar Ceiling`(Structuralll& Monocoat ; ` I " , ;! ` ' 3.1 ' I 17,5. Dry Ch• emial t a. 1 - I ' , - - 27,,;Frame-and'Flashing ^ I l I '; :; ` ,. I . 1 I j ! 1 176. Dry Standpipe' • I 11 28,_ Lathing &Sidmg F = 1 1 ' II it 1 i I 1 •i I 1 i 77: FIXED:SYSTEM FINAL ir•I ' ' ' i _ _ 29.q tnsulationj I .` ", r 1 1 11 I 1 1 I I ; 1 1 I 1 78. FIRE PREV. FINAL' , ' ,j .•-" ' " r'30:1,Drywall Nailing ; i -, "j 11 ;i ' 1 i I I • I ; 1 1 Notes: I t . 1 - ;;r; ?I •C-t 9 : ' • I 1 11 T l r -I ( i l --- - - rr.91__.x.- ''31 dPlaster Brown Coat; ; I I It L I1 ' 1 I . I I t } ' i . r, , , a 32A Electrical Power Meter-Final i 11 'IL I} I 1 1 i 1 1 1 i i ` 1 i -I f t I •' , 33.I Final Electric 1 1 t._.IL_.f_' '1 1 I' I , - - ,-- , - -. . _-. .,.. -- -. .-.. - _ 34, Final'Heating&Air-Conditioning -,].7{ ; I - 1 1 . . . , .i n x 1 -I IT, • K - I I - I i - 35. Final(GasPipe-Te'sti:. t- I H . i . ' !.."T, 1= 1 .. 1,. --' . - -i•+ '. .. - _ _ c.,r,:- . . . •I_.. r5 i ' n s. c i n i ! ; = 1' 1' ' 1 -- . --1 ` I c i T .r - 36. Hood�od:., : r.e`J�. °i^ai i31 ri • L ' - 7, 1- I : �.I 1 „ I ,-+ T.c ; c_ 1,- = :` - - - 37. Final Factory Firepiacet I • a} • I ' 1 " i' I • I - 1 i I _ ' . I n 1 - I r -, . 5 m l I ' I 1 I. 38. FinalPlumbing I I -. h { y TF. I i- ' + 1 i ^ , 4 n -, 1 1 i 1 I4: . --4 Ir i . , i 1 I 1' 39. Water Service-Final .1 I I 'i •'.1 I I ,• s ' • I 1 ' 1_ _ r I ' • -. y 40. Gas Service-Final I _`i 1 I r i ti' i, J. I ' I 1 _ 1 1 i 1'_i • 41. Solar Domestic-Final I I , i _Hi i_ I E ! , ' L 1 1 • 1 • . ' ' I .1 42. Backfqlow nr.eventer. I 1 !•_i - :n - -I _i _. _ sI.-.p"'_ - --'Ir '--.._L '_I ;1 h 7. I- i , II , , r. 43. Backflow Irrigations 1 . 'I C;?I U al I > it = _ --;: fc 1 E'X P I1R E 0 i 44. Landscape 1- ••' 4ion SysfemI .i >nl -. = !-0 ! r' I I i •-Inco/mplete Inspectiutla .- 45. Sound=Attenuatlondirn 1 '1 'It v t^ i I a ' . Oats 7/ SIg' - C - _ i 46. Handie`apRegulatioiisi 1 '1 .i ._ 1- I Itri ,I 1 • 1 1 !( .. . t - 47.:FINAL STRUCTURE& BUILDING= ( ' I I E t I I �a +y LF ! ; I 1 ' IjF 48. Special RequirementsJCompleted 11 11. I I '1 I ' ' 49. Electric'Release to Edison .1'' 1 r �:_ ! t I I ` ' ' • , -1 I at- -- 1 r f t i I i i _ 11 50. Gas .release'to Southern California Gasteo , I 1 I 1 1 � , ! .,..;,..::.'1. I - ' ! . . 51. CERTIFICATE OF OCCUPANCY ,if • I I I ' ' I, - No ! I !Dale 11 - i 1 I I VI I - - OWNER HURTADO F DATE 9-11-70 JOB ADDRESS 28)6 Shantar Drive BUILDING PERMIT NO. 32250 I 'IERAL CONTRACTOR Air:Vent- Knell DESCRIPTION of WORK Patio Cover )o. 119-401-05 LOT 5 TRACT 414R FIRE ZONE . VALUE $ 770.00 ) INSPECTIONS Signature Date GROUP J TYPE 1 ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSU D GAS Date Number Si.nature `�WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE❑ HOUSE CON. n SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES FORMS 0 STEEL REINF. Q FLOOR SYSTEM BOND BEAM STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n tR, BROWN COAT $ ,1URAL, FINAL Electric HEATING, VENT., REFRIC. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n Ir ELECTRIC, FINAL BUILDING, FINAL ACP- IV/ii'; r' L25OSEP 14-70cNsa00 270 j.4 ****BM COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • • APPLICATION FOR BUILDING,PERMIT For Applicant to Fill in Completely RECEIVED BY DATE RECEIVED DATE ISSUED AUILDING � $nlo c5hnn 'tn r lir y �� G ADDRESS 11 1 / p— 7//— / E, LI U 1., ke A.P. NO. / 3 A/C-3-0 PERMIT NO; OWNER 1 MAIL _ BUILDING ADDRESS 3 vv, -p ADDRESS,D ,Fr f (p hon `.a� rc hr • 0 0 t, o MS CITY Q 0 St. Q' NOL 6-y6.44. . TRACTit 3 q9ill TE . , LOT BLOCK ZZ Q NEW ADD ALTER REPAIR MOVING I)FMOI ISH LENDER RCFION ON LENDE `� a D - '4/O Y2 f fC J BRANCH ' I JN OWNER LC NIA I-il4r/® Q W - ADDRESS CO J I VALUE ARCHITECT r TEL. S r S. dig I $ J Q OR ENGINEER rc i± i. t O. / •. —/ - - -- , - UQ FIRE LL CC ADDRESS 3f7 h Am rfsY McI2` Ale 1.�. .••••"�,,- T Z ZONE TYPE GROUP .d n.W APPROVED /�f�,�/�j{{qq�� j • W Z CONTRACTOR YCnt -kOm / BY // , DATE / —/J-7a m0 Z iia V ? & t 5-4- ��/� JZ .ADDRESS W W TEL. // ZONE NO.OF USE OF NEW ZF CITY Chi h O N0.6()E- 9 Yy PLANS BUILDING �,2TN � — 0 STATE CITY YARDS APPROVED YARDS APPROVED in¢ LIC. NO. 1 70 i Q ' LIC. NO. MAIN BUILDING ACCESSORY BUILDING 70 SIZE 7//X r INO.OF SLOGS. (FROA� 77 OF LOT /0 a I NOW ON LOT / FRO r •A''' - FT. USE OF / /� ,/ F— SIOf ZE EXISTINGOBLDG.Sr"yr/' it /., dL)CL V fLtJe& r(r_P. B.SID *�<T. FT. F 2 NEW BLDG. r. NO.`-ROOMS STORIES 3 L.SIDE ••?o FT. FT. •Q EXTERIOR WALL ROOF A o COVERING COVERING ,l/rJ ne - REAR 20 FT. FT. —I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL a MAIN BLD GS. ACCESS. BLDGS. A! Nisi VAR.# DATE o open ?Si /td - Cl QU-Cr- C.U.P.# APPROVED N s3 f ( K f1� , —AAPPROVED/lay(DATF / [/ - /'✓ . 2 0 UI hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ • I— any.person in violation of the workman's compensation laws of N the State of California. zI hereby certify that I am properly licensed as a contractor under Q.)VSO. FT. o the State of California Business and Professions Code, Division 3, THE A OUNT SHOWN UNDER VALUATION IS FOR Chapter 9. and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION �/ and Professions Code,Division 3,Chapter 9. q ,V- A..t 0e V PERMIT FEE $ A V 5 D al Signature of di /, /J�� 7 �•y0 Vim_. Permittee ni../ l halr'04 i /�/�'/ ..!%/C/1J77L1 $ / PLAN CHECK $ a X/3 �n u. Authorized Agent TOTAL FEE $ I/ r(/ V OWNER Cyt maw OI24 DATE . 11-12-75 JOB ADDRESS 2816 Shantar Drive BUILDING PERMIT NO. 140841 GENERAL CONTRACTOR Owner/builder DESCRIPTION of WORK Family Room No. ]39-1+03-05 LOT 9 TRACT 43+9 FIRE ZONE VALUE $ 9,500.00 ,PECTIONS Signature Date TYPE V GROUP I ZONE Kl SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS rrA` ,ROUGH HEATING AND AIR CONDITIONING GAJ 'a77,7;fly . 1fTEMPORARY SERVICE OR POLE UNDERGROUND n POWER 111ROUGH WIRINGr� T' LE/ %l io,)c Neati and Vent. TRENCHES LJ FORMS n STEEL REINF. L� Q //— .jB � Y a-asj. 3/S FLOOR SYSTEM W BONO BEAM n STEEL REINFORCE n /ee� - SHEATHING � -�/ AC /f 7? FRAME AND FLASHING 1.,a /z2 -13= 7,..c LATHING - IN in OUT n R1r.._ /--_I2.-96j PI -ER. BROWN COAT ).LC )-/Z 9/, URAL. FINAL RE .5 / 'f/,'' .a_--�E-1 4-4, /.21--,r 97gr—' P. .�G, , NREFRIG. AND A.C., FINAL tj 3.3\-3 �I'' V PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL ,--.Z., I • - BUILDING, FINAL 790 1-0-)- ' e 4084 , _F Ali; :. ,r,v i 7-/5-.'—oo �It,7r. d*78.67 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely—Use Ink Only ty [� �1�/ n�J //�/�.� REC IV BY DATE RECE E ITTE ISSUED ADIDRESS 2 o/6r $/1'A/V / Aa `/✓t/ ... i' �- `C,l /� ) r�/ -11).... PER IT NO. OWNER Me<f✓DLH /</ML E 7 BUILDING �/ / MAIL 2�I d/� s'NA,l/?Ali ADDRESS �tp / � ADDRESS J 7 CITY C'05 /g ni S A NOL 97, 294- TRACT LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMOLISH LENDER AYL'il/E • BRANCH f/PA ' r / - / / OWNER ADDRESS yd/fne • hVALUE ARCHITECT TEL. US i/ //fEs--/ = OR ENGINEER /Yen NO. FIRE / ADDRESS Active ZONE TV E r GROUP J7-+ CONTRACTOR Ot flirt -' their BY• PROVED %A _ DATE (I 111---71 R 71 ADDRESS !CJ�a S/�A.G///'�/t. e' I - TEL. ZONE NO.OF i USE OF NEW CITY C Cc - NO. PLANS BUILDING I-1 C)TA //_ sN �/g SX 44 � . STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING IQ SIZE . /� ! NO.OF BLDGS (FROM C/L STREET/ d OF LOT //�Q+ )( �1W (NOW ON LOT / FRONrAlltit D FT. Q USE OF fi '/ 'LSI. ,n EXISTING BLDG. Rai/PER/et _B-SIDE ' I. FT. c F Separate permits are required for L.SIDE Z„...., FT. FT. electric,plumbing and heating work. �J••¢¢ ' 'ifO I REARZa FT. FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QCI MAIN BLDGS. ACCESS. BLDGS. ,(J� p VAR.# DATE a 40oD FA".S' /LV/I FJ AO K / C.U.P.# APPROVED } —SA�ROVE7 DATE] (-I 1.1e7 a a GU 0 I hereby acknowledge that I have read this application and state n w„ that the above information Is correct and agree to comply with Ow all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of �� ...TTTW.•• the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. w the State of California Business and Professions Code, Division 3, T Or AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter.9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: - am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E ��rr q and Professions Code,Division 3,Chapter 9. Sl✓r � &CA PLAN CHECK $ o16 p.e 2 Signature of '/1 /',� LL Permittee. /tf�./ l Et../ /�/J TAX $ r f Authorized Agent TOTAL PAID $ 71.1, • OWNER PACESETTER WEST JOINT VENTURE DATE OCT 2 3 1962 JOB ADDRESS 2816 Shantar Dr. BUILDING PERMIT NO. 18051 GENERAL CONTRACTOR Andros Land Co. VALUE $ 207112.00 _ AP No. 139-403-05 LOT 5 TRACT 4349 FIRE ZONE DESCRIPTION OF WORKReS.w�att .gar. INSPECTIONS Signature DATE GROUP Iguj TYPE V ZONE R-1 Soil — //Sz'y PERMITS ISSUED Gas -E.;_ __ /247k/7/SUBCONTRACTOR DATE NUMBER Water 4._ 4- _�e_-a _ Rough Corn. Refrig. 0 Air Cond. 0 _ Rough Heating p2 -.�j „7-,�7�_dA /887 Rough Plumbing (it-�� .- - -',9 //ea_d _9.7� Miscellaneous /-e '�� G �- Prop.Swr.Line 0 House Con.E-St.Swr. ❑ i' _� rJRt? 7) R'tJ,..i k///// C j ti/t. Sprinkling System Construction Pole Underground 0 Power ❑ _ • _ Rough Wiring near/rr; i Ce[EJSC de-ct-2 'CE / -17-o y7J`J7/Z Trenches 0 Forms U Steel Reinf. 0 $yid .1...51-“.. Floor System . 3-L1—//444.12.-,~ Bond Beam 0 Steel Reinforce ❑ Sheathing _ Frame and Flashing _ - _L _ Lathing — In ma- Out [9/"e,ifL y' pt �c7---&3- =r1J-H /-I/ Plaster, brown coat �`ppry '2��...63 Refrig. D Air Cond. 0 Final Heating, Final // /S3 Plumbing Fixtures, Final Y�/,�� 31//�/� Final Gas Test /t / !!moi . Electric Fixtures, Final 3 '7 Building, Final /� //1.9- 1 OCCUPANCY .. FORM BU4-5M — 7-61 1 Priv FE RECEIVED tot.--40bI23196? • COSTA MESA BUILD G-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT Lot 5 T/YPE• GOOR PRINT Tr,. 99 BUILDING BUILDING ADDRESS ��0/(�J L�/'7/17YTnx� ,p,✓ ,OST�A. C/yp,LIFO NIA For Office Use Only �G in / cc/6' (/.-l//2GC✓-z I RECEIPT NO. P� I OWNE - � M ,]C MAIL RECEIV�BY I DAy.�RECEIVED r� 2 U IJV2 ADDRESS 1610 West Coast Highway /✓ /L4--c' QP`�) CITYO..M'161655 ADD EISS 2S/(lj Iq/ Newport Bench, CalifCnlif /fL ARCHITECT TEL COSTA MESA. CALIFORNIA OR ENGINEER E. G. Kaltenback N03361 ADDRESS 9772 Katella Ave. , Anaheim FIRE / n ZONE TYPE (/� GROU P, APPROVED O CONTRACTOR Andrnc I rind Cnmpany BY DATE ADDRESS 1653 Minnrrn Drive ZONING lie I Z NO.OF OBE OP N I 1 CITY Coctn Mesa Cnlif �'°�� l/ I PLANS �/'I BUILDING4.W X LIC..TNO. 187166 TEL.AE Ki 9-0395 I LEGALLot j- 7-Rt 3 fay. DESCRIPTION SIZE I NO. OF BLDGS.o OF LOT I .I NOW ON LOT A.P.NO. 1 r . I a- Q USE OF YARDS EVES EXISTING BLDG --- APPROVED ALLOWED SETBACK LINE FROM / (CENTER LINE ST.) L CENTER OP STREET REAR YARD5. FRONT J• T. IN. .7 tr. SIDE 'YARD (LEFT / ( RIGHT � R.SIDE 0 FT. IN. DESCRIPTION OF WORK I r] X L.SIDE / FT. IN. NEW I II ALTERATION I V ADDITION I REAR LI I// REPAIR I II MOVING I II DEMOLISH I BYPROVED 14// FT. DATE -3^6,>. BUILDING NO. OF I `✓ �1/(�I ) Iv` SIZE ROOMS STORIES 1 tJ"t! EXTERIOR WALLppWOOd ROOF shakes COVERING O Stucco I COVERING USE OF BUIL ING AND WORK TO BE PERFORMEDI Single cam;ly rPCI(lance with attnrhed 7nrngP 47 - /ii-7c7 - seep' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNTSHOWN DEG VALUATIONISFOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES. 1/4AND STATE S REG LATINO BUILDING CONS ION. ` ///J� VALUATION • /6� PERMI URE C / L/ /t A. A lK . PERMIT FEE $ (/(�_ PERMITTEE //C `/(/(/1/�-�>> / / / / •��y//q� $��//� PLAN CHECK $ (3 '� `n AUTHORIZED AGEN 'r /_ / • / TOTAL FEE $ / y---