HomeMy WebLinkAbout1038 WESTWARD WAY - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - - - -
1111 TA MESA - , . - • - PE IT NO. - ' TRACT NO. LOT NO. BLDG.NO. - 6696 I I /Ca/ 2 TI
CTLON PERMIT • a
Project Address 0 r . 1 • I" Le• -)a- TYPE OF CONSTRUCTION ' U'NEW��❑ ADD ALTE• •TION U REPAIR
Applicant's Mailin Addle55 �p El CONVERSION ❑ DEMOLISH L�OTHER d1' —" A.P.# • Zone
• 2.67FF- yQ,c•�� J eftn�cC RI PT ON OF WORK ••��4r .j_.- -
Owner's Name T �r�' w� / - IU-S' `l v b1P7i�� S Main Building: Accessory Building:- •
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Address . FOUNDATION N STRUCTURAL E Front N
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- TYPE OF PERMIT GRADwe
Arch/Eng. •
License No. ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - B I
Address Rear
❑ OTHER A ,
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Contractor's Name C Velf4 1'"- e t - Phone /s-f 7 PROJECT DESCRIPTION SQ. FT.' 2-006 OCCUPANCY • C Right - G
Address(mailing) JY`/ZI /ler C. Gp.N .ew v1C CONSTRUCTION TYPE _ VALUATIONS 1/0S'D "� S Left R
F. -•� /� E
City License No. ?. /7s ZONE GRADING CU.YDS. ACRES - Ping. Ref.# Park.FeeS $ . O
LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req./Provided • ' ' U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and It''— KOOI Use of Building: - E
/� my license is in f II for; and effect. — ,( -
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PLUMBING FEES Planning Notes:
License Classf�ense - • E
-state KE -.S Signature '
1 " Bar Sink Showers N
`%+ t-ORRKERS'COMPENSATION DECLARATION , - _ T
\-:;riereby 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 thereof (Section - -
3800, Lab. C. /�/�(r L !1 Backflow lydgation Sewer Cap 1 ELECTRICAL FEES ,
�91'CY No. VJ ComPanY ••510-.!'�-'•C�k. •
Mertified copy is hereby furnished. ' Bathtubs Sewer Connection Automatic Washer . 'Transformer 0 15.50 KW
Certifietl,4opgg is filed with the city •Ing - 0 50+ KW
Date x/' 7�"7!7 Applicant �/ Clarifiers Solar Collectors Construction Pole Sub.
EXEMPTION,FROM WORKERS'COMPENSATION DEC•ARATION Di3hwasher- - • "Sola!Piping
(This section need not be completed If the permit Is for one hundred ($100) or P 9 " , ' 'Cooking Unit -' Meter :hp to 100 amps - -
less). ' , '
I certify that in the performance of the work for which this permit is issued, I Drinking Fountains 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- r 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❑0-1 HP 0114-8
Workers' Compensation provisions of the Labor Code, you must forthwith -
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comply with: such provisions or .this permit shall be deemed revoked. Gas Service Outlets' Water.Closet . F.A.U'. Ino.Solar ❑9-15 HP ❑16-15+ •
"
CONSTRUCTION'LENDING AGENCY •
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater - Fixtures
of the work for which thi;_permit is issued (Section 3097Civ. C.)• - 'MICrOWav¢
Lender's Name aJnW - Kitchen Sink - Water Service .
- . Device Boxes 'Pole Light .
Lender's Address Lavatories - - 1
OWNER BUILDER DECLARATION j , Outlets Range
I hereby affirm reason (Section
I am exempt from the Cdntractor's License Law for the 1 P-Trap ' - -
following reason (Section ]031.5 Business and Professional Code: Any city or i .. 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
• file a signed statement that he/she Is licensed pursuant to the provisions of - - - _
a Contractor's License Law(Chapter 9 (commencing with Section 7000) of
.vision 3 of the Business and Professions Code) or that he/she is exempt - . ' Generator 00-5 KW 05-15 KW Trash Compactor
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 Reinspection Fee 3
eenalty of not more than five hundred dollars($500). Pe $25 Issue Fee $
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered - MECHANICAL 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 ❑
thereon, and who does such work himself/herself or through his or her own Zoning Aroved BDate
employees, provided that such improvements are not Intended or offered for Canopy Type II ❑ ppy
sale. If, however, the buildingor Improvement Is sold within oneyear of com- Duct-Under Ground
d Application Approved By Date
pletion,the owner willhave the burden of proving he/she did not build or im-
or the purpose of sale). Duct-Structural Refrigeration System Application Issued By Dat
U I, for
o
LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 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
builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ 2O. OE] SMIP $ ..,S2,tractor(s) license pursuant to the Contractor's License Law). - - PLAN CHECK $ PERMIT
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting _ I PLAN CHECK $ _ ENERGY P.C. $ -
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTU GRADING $
information is correct. I agree to comply with all city and county ordinances - - -. ELECTRICAL $
and state laws relatin• to buil•'•- construction, and hereby authorize repre- - .
sentatives&this carte e , pon the above-mentioned property for - PLAN CHECK $ MICROFILM $
inspectio oses. 'alb .4. /('-,4--
t X3 MECHANICAL $ TOTAL FEE $ 2o• CO
Signature ��� Date U
Drivers' License or SS# - Reinspection Fee $25 • Issue Fee $ 3 PLAN CHECK $
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N.
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod'Assessor ,
CONSTRUCTION AND PLANNING `' R .&SPA
APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
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Temporary Electrical Service or Pole. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
;a Electrical Conduit'Utitity-Undrgrnd. I 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
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5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6, Electrical.UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58., Electrical Conduit-Undrgrnd.
B. Fouridation n.. 59. Gas Pipe, ❑ Undrgrnd., Test
9. Water;Pipe-Undrgrnd 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Prope`ty Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer:Cap 63. Heater & Vent-Final
13. Roofi•Drains - 64. Plumbing System - Final
14. Rough Plumbing - • 65. Electrical-Final
15. Rough Electrical-Conduit • 66. Solar System-Final
. 1;6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Roughtlectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
26. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure ^ 70. Underground Hydro
22. Ducts, Ventilating. 0. 71. Product Piping 0 Gas ❑Oil
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' 23. Gas Pipe-Rough & Test • 72. Underground Flush
24. Roof Framing73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar'Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame,and'Flashing 76. Dry Standpipe
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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-Final80. FOOD CERTIFICATE ISSUED
33. Final Electric Notees:: ii_9_sr? Ac. - 4
34. Final Heating & Air Conditioning
-.4.4÷4-°--M-1%) c/ql ^ -r
35. Final Gas Pipe-Test O �i 97
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 � •
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50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date • -
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in G mple ely —U��SppeJJ���nk OnlyAPPLICATION FOR STRUCTURAL PERMIT
RECEIVED BY DATE RECEIVED DATE ISSUED
AUILDI NG//13 /
ADDRESS ((�� !/_�..
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; 4/5_4,4;2_0/iQp�Q PERMIT NO.
OWNER G/�f/ Aal-
MAIL
ADDRESS`4-0" it,/, BUILDING
ADDRESS/e7 N e, h164,ley" Kf
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TEL/n r- P4(
CITY N./? , n Nr'1`J7J /2- TRACT 1-`COTa i/ OCK
CONSTRUCTION rl / // NEW ADD ALTER REPAIR OVI G/� MOUSE(
LENDER 1:ft/-'Ri_n"'.�i_ p�C�/
BRANCH /(y
ER
ADDRESS / to— s. O A, /R, ' ,I VAALUELUE �
ARCHITECT sfe TEL./ ate- /d $
OR ENGINEER NO.h g"Z-71 r� FIRE i
ADDRESS 9 4J.- �� � Q ZONE TV PE�GROUrTFJ
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APPROVED
CONTRACTOR 04.04 ^ BY DATE /
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ADDRESS •
TEL. j�r7�./rr�,'�` NO.OF USE OF NE�
CITY NO. /yt op PLAOF; BUILDING
F STATE / Q CITY / YARDS APPROVED YARDS AP VED
LIC.NO.rl b R g2? LIC.NO. MAIN BUILDING ACCESSORY UILDING
SIZE p • : • `` (FROM C/L STR ET
n. OF LOT �N� NOW•• • i' RONT , FT.
Q USE OF
co) EXISTING BLDG. R.SIDF -�lQT FT.
cn
FSeparate permits are required for L.SIDE T. FT.
electric,plumbing and heating work. 7F
REAR a /FT. FT. t.
CM
f.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET.. BET.MAIN&
AC MAIN BLDGS. ACCESS.BLDGS.
Q DD----__ C URP. 710 3 APPROVED C-17-'740,
} �•.L�n ,BY ROV J - J 1�. DATE / a I-�-,
W HOLD FOR SPECIAL REQUIREMENT;
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I hereby acknowledge that I have read this application and state 4
n
C the the above information Is correct and agree to comply with m
0• all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of a
the State of California, i.•► �a ,q
1 � / �aw 9 N,
I hereby certify that I am properly licensed as a contractor under ♦/ (0 SQ. FT. �'�'�/D • O a
the State of California Business and Professions Code, Division 3, THEE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business VALUATION a
and Professions Code, Division 3 Chapter . PERMIT FEE $ ,it
ro
////��, tif PLAN CHECK $ eno
Signature ofli�L o
Permittee ism $ TAX $ LL
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Authorized Agent TOTAL PAID $