HomeMy WebLinkAbout1035 WESTWARD WAY - Building Permitslir
COSTA MESA BUILDING—SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Compl ely— U Ink Only
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING ,`/ /,// �`
ADDRESS ,7 /�/3✓/ Vt/// �� �/
1.146.2..
?_OIr 0.2030 PE RM IT NO.
OWNER y-lr1-zt6 TCS r /4(JM/a r/ �
MAIL / BUILDING
ADDRESS 1Js _, . � rtes ADDRESS _fin /I. a'
CITY Ng NOTEL/4.r 74/Z TRACT , r�C(e,Ty/e� O :LOCK
CONSTRUCTION '' /I /^ ///� JJ I s W ADD A _ : '1.II[ytmir u•
LENDER �ywe iQG►"
BRANCH 5A+4 ^�// ,
�rOW R QJr 4-ockiQ/ 7A
ADDRESS / �LA -r_ I VALUE
ARCHITECT /) TEL L6/ $
OR ENGINEER C? , Ch NO 4.Z'.2/.s
FIRE
ADDRESS$ 1,6,5e;;;59- / ZONE
PPROV ED TYPE GROUP
CONTRACTOR �wtiPr BY DATE iiiiii
ADDRESS 0.0F USE OF N 4/CITY NOL r PLANS BUILDING
F STATE CITY YARDS APPROVED YARDS APP'. ED
g LIC.NO2 Egg . 3 LIC. NO. MAIN BUILDINGACCESS
ILDING /
1.14 SIZE 6[-� ^ NO.OF BLDGS. (FROM C/L$T ET)
L OF LOT l Ac__ NOW ON LOT FROM /FT. / FT.
LID XE OF /0 / // {,
EXISTING BLDG. _R.SIDE /O F /Jelm
FT,
U)
Separate permits are required for L.SIDE (�{ T. FT.
electric,plumbing and heating work. fY//�'
W _ REAR FT. FT. ‘
[.. USE OF BUILDING AND WORK TO BE PER ORMED DISTANCE BET. BET.MAIN E.
G PiZt ��`: /�J MAIN BLS. ACCESS. BLOCS.
1/�D/w[/I/_ W n , - DATE
C VRP. A� 71, �p3 APPROVEDC.1 74
gSL.AAM1.k �y ROVED/�i, I ✓/`—J-DATF /—2-/—*
tr_ 77
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HOLD FOR SPECIAL REQUIREMENTS
0 I hereby acknowledge that I have read this application and state r`
N
EM that the above Information is correct and agree to comply with m
Ow all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of x
Irl the State of California. HP /✓�1/� D /� m
I hereby certify that I am properly licensed as a contractor under SO. FT. �� / A19(/ w
the State of California Business and Professions Coda, Division 3, THOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ rz
and Professions Code,Division ,Chapt 9. CoC
PLAN CHECK $
Signature of o
Permittee $ TAX $ Li.
f
U
Authorized Agent TOTAL PAID $
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 8695 I I /I;U/ - '-. 0: . I
CITY OF COSTA MESA 1 PERMIT NCI TRACT NO. LOT NO. BLDG.NO.
- CDt,;STRUCTION PERMIT L . $ - / $1 9s ���
Project Address /a35 L.JP,S7 t+JG.rd TYPE OF CONSTRUCTION LI NEW�DD L LTERA�ION U REPAIR
❑ CONVERSION ❑ DEMOLISH OTHER r`/o CSA—llF' . .Zone
Applicant's Mailing Addr sstt A.P.#
i`...... fP si-- i4/C..�l� • CRIPTION OF WORK • c- - S �-
Owner's Name one �'� � S Main Building: • Accessory Building: Z
• 0
Address TYPE OF PERMIT . GRADING A FOUND• ION U STRUCTU'AL E Front ' N
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear _
Address // /�J ❑ BOTHER A • N
Contractor's Name( itnv,.A ea D{c' 'Phone s5-710371 PROJECT DESCRIPTION SQ. FT. -� info OCCUPANCY ^ C Right G
��� CONST RUCTION TYPE VALUATION$ �O,SV S Left R
Address(mailing)/y L( „wore G,s,.dw R--
7� , ZONE GRADING CU.YDS. ACRES. Ping. Ref.#. Park.Fees $ Q
City License No. U
LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
T
with section 7000) of Division 3 of the Business and Professions Code,and C - kpor Use of Building: E
my license is Ip fuel•force .nd effect.
^ License Class `-"•-3 ens' 6' - j e-2-- • _ PLUMBING FEES Planning Notes: E
`b 'late /7-g- a • Signature ill iv a.-y�-
Bar Sink Showers - N
I ORKERS'COMPENSATION DECLARATION T
nereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink *- S
of Workers' Compensation Insurance, or a certified copy tpereof• Section
I 3800, Lab. ,�,tire/5-
: �-47- / 1 w� Backflow Irrigation Sewer Cap • ELECTRICAL FEES •
\'J ICY NO. co Company .-Tr.VV `f- ' .
Certified copy is hereby furnished. Bathtubs • Sewer Connection • Automatic Washer Transformer 0 15-50 KW
Certified copy is filed with the city 99uil ng Divisr. ffj • 0 50+ KW
Date Applicant c w. VUQ1r1 . Clarifiers Solar Collectors Construction Pole Sub. : ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARA> N - Dishwasher - •
-
(This section need not be completed if the permit is(or,one hundred ($100)or - Solar Piping Cooking Unit Meter ❑up to 100 amps • - . - -
Iecs) DrinkingFountains '
I certify that in the performance of the work for which this permit is issued, I Solar Tank • Dishwasher • Meter Dover 100 amps
Shall not employ any person In any manner so as to become subject to the . , •
workers'.Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric •Sub Panel '
Date Signature —
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks - Urinal Fan Motors 00.1 HP 01%a-8
Workers' Compensation provisions of the Labor Code, you must forthwith _. —
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets • Water.Closet F.A.U. Inc.Solar ❑9-15 HP 016-15+
CONSTRUCTION LENDING AGENCY. t • - . ,
I hereby affirm that there Is&construction lending agency for the performance Interceptors. Water Heater Fixtures Microwave
of the work for whit tthis�ermit is Issued (Section 3097 Civ. C.) _ _ _ ,
•
.
Lender's Name - Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address
OWNER BUILDER DECLARATION • Lavatories - - - Outlets Range r
I hereby affirm that I am exempt from the Contractor's License Law for the P-Tra
following reason'(Section 70315 Business and Professional Code: Any city or P . , Switches Sign
•
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 Roof Drains Garbage Disposal .
Standing Sections
`''of Contraile a ctor'ned s License L cense Law (Chtatement that apter she is licensed
l(commen Ing with Sectiursuant to the on 7000)ofrovisions f ,
vision 3 of the Business and Professions Code) or that he/she is exempt - Generator ❑0.5 KW ❑5-15 KW Trash Compactor
! erefrom 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 Reinspection Fee -
Uenalty of not more than five hundreddollars($500). pe $25 Issue Fee $ 3
I, as owner of the property•or my employees with wages as their sole MECHANICAL Reinspection Fee I $25 Issue Fee' $ 3
compensation, will do the work,and the structure is not intended or offered 'i FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENTS: •
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0
thereon, and who does such work himself/herself or through his or her own - Zoning Approved By Date
employees, provided that such improvements are not intended or offered for Canopy Type 11 0
sale. If, however, the building or improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date
pletlon, the owner will have.the burden of proving he/she did not build or Im- -
rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By Date
I. aS owner of the property,am exclusively contracting with licensed con- ❑Q100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct- Ventilating SUMMARY/� OF FEES •
The Contractor's License Law does not apply to an owner-of property who BUILDING PERMIT $ -/De SMTP $ DSD
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple System Repair/Alteration
_
Z2,7-40
tractor(s) license pursuant to the Contractor's License Law). a PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# ISSUANCE. $
• PLUMBING $
Date OwnerHeating System& Ducting PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BT _ ELECTRICAL $ •
GRADING $
information is correct. I agree to comply with all city and county ordinances _ -
and state laws relating to building •• Duction, and hereby authorize repre- ----- -- - - - PLAN CHECK $ MICROFILM $
sentatives 0 this cit enter '/the above-mentioned property for �J
inspection • sec^ V ,� �. - MECHANICAL $ TOTAL FEE $ `0•SD
SiDrivers' �- + Date//�s5 Reinspection Fee -
Drivers' License or 55 - $25 Issue Fee $ 3 • PLAN CHECK $
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
C ` '
CONSTRUCTION AND PLANNING ` PC &SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
• 2. Soil pipe-Undrgrnd. - 53. Steel Reinforcement
'3. Electrical Conduit Uiility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding
•
• 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings • 58. Electrical Conduit-Undrgrnd. • •
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd,' 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House'Connedtion , 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final - •
•
13. Roof Drains - •- 64. Plumbing System - Final
14. Rough Plumbing • 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough'Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1.18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
,20. .Rough'Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating •
71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test • t, 72. Underground Flush
24. Root Framing . 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Root Sheathing , , 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat. 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing.& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV, FINAL
•
30. DryWall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: /1-7- (3
34. Final Heating& Air Conditioning /
�/����.e��"./6
35. Final Gas Pipe-Test /
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final .
41. Solar Domestic-Final
42. Backflow Preventer •
43. Backflow Irrigation
44. .Landscape Irrigation System •
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50: Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY , •
No. Date