HomeMy WebLinkAbout1057 WESTWARD WAY - Building Permits •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PER?NO_ TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESACONSTRUCTIONCONSTRUCTION PERMIT IL/ J;� A.P.# I Zone
Project Address ��'( ',sir r �; - 1 " I S Main Building: Accessory Building: Z
Applicant's Mailing Address i a�• / TYPE OF CONSTRUCTION Li NEW U ADD U ALTERATION LJ REPAIR
•��/17��` ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front O
Owner's Name '� Phone r` �rZL����rr 6 DESCRIPTION OF WORK/USE OF BLDG. A Rear N
•
Address LI
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION STRUCTURAL I C Right G
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL $• Left R
Address pp,,,...///���///yyy
Contractor's Nam. Li . ,a. /1.1 L' Phone 005- 0 OTHER Ping. Ref.# Parking Req./Provided E
�QJ, ) tp/ I / v - PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ Q
Address(mailing) .R.,J • / WC/ Q C/ CONSTRUCTION TYPE VALUATION$ Planning Notes:
City License No. L .7(3M
ZONE GRADING CU.YDS. ACRES RE[:FIVFD MAY 1 1989 7T
LICENSED CONTRACTOR DECLARATION $'
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code,and
my license is In full f. c- ..d effect. O��P ELECTRICAL FEES
,c-•) Ucense I ss w I icens' o.
�J y /'� C.----•"-'
� PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
e Signature
v- JRK RS' OMP I have OE A 10 Construction Pole Sub. 0 50+ KW
i hereby affirm that I have a certificate of consent to self-Insure Ora certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (Sect'on Cooking Unit Meter ❑up to 100 amps
1 3800, Lab. Backflow Preventer Service Sink
Policy No. _` g'l Company " Backflow Irrigation Sewer Cap Dishwasher Meter Clover 100 amps
�_C�ertified copy Is hereby furnished.
-� ercertjja 7 filed with the city Byf�trty0'WI 7op� a Bathtubs Sewer Connection _ Dryers ❑Gas ❑Electric __ Sub Panel
Date ! //PP Applicant (/�i/� (1�C/C Fan Motors❑Pi HP ❑1'h-8
EXEMP ION R M WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(Thissection need not be completed if the permit is for one hundred ($100) or F.A.U. Inc.Solar ❑9.15 HP❑16-1$+
less). f Dishwasher Solar Piping -
I certify that in the performance of the work for which this permit is Issued 1 Fixt Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensationprovisions of the Labor Code, you must forthwith Outlets Range
p Floor Sinks Urinal 9
comply with such provisions or this permit shall be deemed revok¢tl.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Switches Sign
I hereby affirm that there Is a construction lending agency for the performance Water Closet 9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION - - -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry TraVs
",structure, prior to its issuance, also requires the applicant for such permit
", 'ale a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
of
/�t ivision r3 of thetor's License
Bus ne s aw ndh Profester sions Code)I or trhat ith he/she isction exempt
therefrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee $15 Issue Fee $ 3
7031.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
compensation, will do the work,and the structure is not intended or offered MECHANICAL
for sale (Section 7044, Business and Professional Code: The Contractor's FEES Building Approved ByDate
License Law does not apply to an owner of a property who builds or improves ee _ -
thereon, and who does such work himself/herself or through his or her own Application Issued By Date C��
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
rove for the purpose of sale). BUILDING PERMIT $ SMIP $
U I,t as owner of thet property,roject exclusively7044, contracting ing with licensedioncon- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT �`-
helors t construct the project s(SectiontBo
and of property
Code: �✓
The Contractor's License Law does not apply to an owner ie property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING $ C•DO ISSUANCE $
builds or improves thereon.and who contracts for such protects with a con- '— ENERGY P.C. $
tractor(s) license orpursuantker' to me Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $
proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers $ MICROFILM $
PLAN CHECK 50% $
Date Owner Heating System&Ducting Registers MECHANICAL $
I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100.000 BTL
TOTAL FEE $ 4700
Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to en •on the above-mentioned property for
Inspection pur seSs-t" or -
Signature 2 z [ Date c- /tr/+7
Drivers' Li nse or 55 v
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 1iaTE: 05/17179 TIDE: 15:26
• t
ONSTRUCTION AND PLANNINL 'L & SPA
C
' APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
•
1_1Terriporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement
3.-Electrical Conduit Utility-Undrg}nd. 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
i
Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation , ' 59. Gas Pipe, 0 Undrgrnd.,Test
. 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 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
Cu . Rough Wiring Sign 68. APPROVED FOR PLASTERING
'18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
'2Q. Rough Factory Fireplace APPROVALS Permit#
x-2211, Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31.,Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ff-3o-a4 L CO
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final fl
42. Backflow Preventer (-3
43. Backflow Irrigation a
r
44. Landscape Irrigationtem
i
45. Sound Attenuation r.
46. Handicap Regulations-'
47. FINAL STRUCTURE& BUILDING
48. Soecial Requirements;Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co nit
t
51. CERTIFICATE OF OCCUPANCY
:
No. Date - ''
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
ESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 9342 I ' /1r/ PL j. T
TION PERMIT -. 7� 7
uject Address L0. 3 CAI• . TYPE OF CONSTRUCTION 1J NEW ❑ DD LIA/{� f7ERATIO ❑ REPAIR '
c
Applioanls Mailing Address ��1t '! Q CONVERSION ❑ DEMOLISH� OTHER ^/ero + A.P.9N, Zone
Owner's Name /[/C-374-6/Ci i ( ,a�w•'etPhone CRIPTION OF WORK _�!-J' Off- l of ` �i1- .� .T�
/ _. .` s // • s a• .c....“....0 —
Main Building: Accessory Building: Z
Address TYPE OF PERM T S GRADING I FOUNDATION U STRUCTURAL E Front • N
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear I .
Address ��j ❑ A N
OTHER - C Right G
Contractor's Name CuLlitbel... gat{I, I S Phone` D /1 PROJECT DESCRIPTION SQ. FT. 2000 OCCUPANCY �_ K R
Address l mailing) / l ber r''' ect
City License No. -!
e4 rQLQ_ CONSTRUCTION TYPE VALUATION _last
g Left E
.'64/fr� 7 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ D
I\
V LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing _ R
l with section 7000) of Division 3 of the Business and Professions Code,and - Use of Building: E
my license is in full force and effect.
\ Ucense Class — u ices • 9.-0, j77 . _
PLUMBING FEES Planning Notes: M
.:` i;Date — ^ !°7 Signature S r.iti� E
k-‘•••••yWORKERS'COMPENSATION DECLARATION Bar Sink Showers T
T
MI hereby 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.)/.7,4()..-3/57-.. d3 5,71,: e 1 Backflow Irrigation Sewer Cap ELECTRICAL FEES
Poli No. 6 7 0 Company_ J/ C� ,
ertified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer •Transformer ❑ 15-50 KW
Certified copy is filed with the city Building Division.
0 50+KW
D2te Applicant Clarifiers Solar Collectors Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping
(This section need not be completed if the permit is for one hundred($100) or P 9 Cooking Unit Meter Cup to 100 amps
less). DrinkingFountains
I shall
no that the performancepersonin the work for aswhich this permit is Issued,I Solar Tank Dishwasher Meter Dover 100 amps
ort ' employompeany person f any manner so as to become subject to the
Workers' Compensation Laws California. Floor Drains Swimming Pool vv/Spa/Spa Dryers ❑Gas ❑Electric Sub Panel
Date Signature — ,
NOTICE: If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan
Workers' Compensation provisions of the Labor Code, you must forthwith - Motors 00-1 HP ❑1'fi-8
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets
CONSTRUCTION LENDING AGENCY Water Closet F.A'.U.- Inc.Solar 09-15 HP 016-15+
I hereby affirm that there Is a construction lending agency for the performance Interceptors Water Heater Fixtures +•
of the work for which this permit is issued (Section 3097 Civ. C.) Microwave
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
•
Lender's Address Lavatories
OWNER BUILDER DECLARATION Outlets - Range
I hereby affirm that I am exempt from the Contractor's License Law for the P-Tra •p reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign
county which requires a permit to construct,alter,improve,demolish or repair
ny 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
• ie Contractor's License Law(Chapter 9(commencing with Section 7000)of-
Division 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 •
penalty of not more than five hundred dollars($500). Reinspection Fee I $25 Issue Fee - . $ 3
LJ I, as owner of the property or my employees with wages as their soleReinspection 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 Approved By nate
employees, provided that such Improvements are not intended or offered for • Canopy Type II ❑
sale. If, however, the building or Improvement is sold within one year of com- Duct'Under Ground • Application Approved ByDate
pietion, the owner will have the burden of proving he/She did not build or im- ' ////J
drove for the purpose of sale). • Duct-Structural Refrigeration System Application Issued By ,�. .' 10 i Data,d,./ -3
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 qF 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 $ -O,o0 SMTP $ v LS-0
tractor(s) license pursuant to the Contractor's License taw). PLAN CHECK $ _ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $
Date Owner Heating 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 GRADING $
Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK • MICROFILM $
sentatives of this city enter up. t e above-mentioned property for $
inspection n .. .aes. /� S. /7---1,---8.3
/(�ata MECHANICAL $ TOTAL FEE $ az C, lid
Signature .s:_�._ _� /TOW Date
Drivers' License or SS 7f ��� �- Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
. •
tON AND PLANNING iL&SPA
%PPA(3VALS Permit# Date Inspector APPROVALS Permit# Dib Inspector
Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd- • 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd-,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing •
65. Electrical-Final -
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling •
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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: 11/2/A, Ole 1j_""�""' n
34. Final Heating& Air Conditioning � _^ -A - r ''C
•
35. Final Gas Pipe-Test `_"'--``
36. Hood or Canopy TpL i„ A �J�-/ 0
37. Final Factory Fireplace l/6-�c-��// j
�G
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
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF-COSTA MESA. - • PERMIT NO. TRACT NO. LOT NO. BLDG.NO.
1)11. CONS1ThJCTION PERMIT B r2''' 931 1 I :11E/ .7 FLrL_ Ti
•
Project Address /f1'? - TYPE OF CONSTRUCTION ❑ NEW El ADD LYALTERA ION U REPAIR
❑ CONVERSION ❑ DEMOLISH CJ OTHER �/e/Y)G•-fes •
Applicant's Mailing Addr s -
�/ � '�-• A.P.# Zone
(.""[-al b/ J NOS-entPh nESC RIPTION OF WORK 'v'9 ( -eel ^!(G-1S R. s-<
Owner's Name one / ear / S Main Building: Accessory Building: 2
AddressTYPE OF PERMIT ❑ GRADING 111 FOUNDA ION U STRUCTUR'LT Front 0N
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B I
Address El OTHER A Rear N
Contractor's Name Cu9�w�. �,�c� 'Q Phone-c://-0...T--2/ PROJECT DESCRIPTION SQ. FT.2C''''::43 OCCUPANCY K
C Right G
'/ J c„ p CONSTRUCTION TYPE VALUATIONS (a Sb s Left R
Address(mailing) Uy ZI ��'�-'3 • G Gm V-�. E
City License No.
Z y9/J� ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q
LICENSED CONTRACTOR DECLARATION Remarks: I 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 Use of Building: E
my license is in full fore• and effect. PlanningNotes: M
License Class C sense No �Z� PLUMBING I FEES
'Date tee 3 Signature u tZ* �I�ta_ - E
WORKERS'COMPENSATION DECLARATION Bar Sink Showers _ N
I hereby affirm that I have a certificate of consent to self-insure or a certificate S
of Workers' Compensation Insurance, or a certified cry thereof Tection- Backflow Preventer Service Sink Sormrs
S
3800, Lab. C�/'i5 yS �• .f J (1 Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. o Company J' t.._ Au..." •
Certified copy is hereby furnished. • Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW
ertifled copy is filed with the city Building Division. ❑ 50+ KW
Date Applicant Clarifiers Solar Collectors Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping
(Thissection need not be completed If the permit Is for one hundred ($100)or P 9 Cooking Unit Meter pup 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 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%-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 09-15 HP 016-15+
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater ' Fiktures
of the work for which this permit is issued (Section 3097 Civ. C.) Microwave
Lender's Name Kitchen Sink Water Service . Device Boxes Pole Light
Lender's Address .
OWNER BUILDER DECLARATION Lavatories Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the p-Trap following reason (Section 7031-:5 Business and Professional Code: Any city or p _ - • Switches Sign
county which requires a permit to construct,alter,Improve,demolish or repair
,y 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
he Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0-5 KW ❑5-15 KW
Division 3 of the Business and Professions Code) or that he/she is exempt 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 Fee f •
'
'Elenalty of not more than five hundred dollars($500). Reinspection $25 3 Issue Fee $ -
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 0
thereon, and who does such work himself/herself or through his or her ownZoning Approved By Date
employees, provided that such improvements are not intended or offered for Canopy Type II 0
sale. If, however, the buildingor improvement is sold within oneyear of com- Duct-Under Ground
d Application Approved By Date
prove the owner sewill have-the burden of proving he/she did not build or im-
orove for the purpose of sale). Duct-Structural Refrigeration System � Applio5tion Issued By .�•/17. Date 1i�ib�83
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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ e26- SMIP $ • '.5-�
tractor(s)license pursuant to the Contractor's License Law). PLAN CHECK $ - PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above '00-100,000 BTU 0100,000 BTL GRADING $
Information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating • building cons uction, and hereby authorize repro- • MICROFILM $
sentatives of this cityl . cgs n he above-mentioned propertxfor 'PLAN CHECK $•
/,
inspection •uy ses. C ' fi / to MECHANICAL $ TOTAL FEE $ e "'S-e
Signature. 1� Date /1
Drivers' License or SS# '# ' Reinspection Fee $25 Issue Fee $ 3 , PLAN CHECK $
CMF 0865-46 rev. 7/63 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
tit
! ,CONSTRUCTION AND PLANNING iL& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
trii 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. • - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding
5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line House Connection 62. Backwash & Receptor-Final •
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas 0 Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank OGas OOil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: N/A)/r,? `{ , ZL 6[ S - •Of
34. Final Heating & Air Conditioning y <04--a 35. Final Gas Pipe-Test "9:2L
36. Hood or Canopy i
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
111
3 I
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in C mpl-tely —Ue Ink Only
/sgRECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING 0 / /�
ADDRESS ay /
/✓�� ST Li i 03 PERMIT NO.
see.�
OWNER !✓. .0
BUILDING
ETEWSPeleirn- 111 ADDRESS� r - :._ sae
o/
TE p L (rot
CITY �_A Nary _ / _ _ L
CONSTRUCTION ��-t/t of n I,• sgsT erLOC K.
LENDER cry�p ./—i .A■--1, fvLs7�—
BRANCH "S_A
ADDRESS / d OWNED ���YQ• Il �., 4 �/
/ " VAL E
ARCHITECT /) TE `�.ie%!. / $
OR ENGINEER C.i- Ia L v b -
nn-- �,s FIRE —.
ADDRESS 204 _ry,,3 jt%tW 7/-LSn. ZONE TYPE • GROUP Ag
APPROVED
CONTRACTOR Cieentp^ BY DATE
ADDRESS
TEL. ''yam/p'�� ��yy O.OF USE OF NE /�
CITY NO. /("�( -/ LANS� BUILDING /44/
F STATE / CITY YARDS APPROVED YARDS AP-`OVED
5w LIC. No.24 gg2_ LIC.NO. MAIN BUILDING ACCESSO'sr BUILDING
0. OF LOT s S NOW ON LSIZE NO.OF OS `I (FROM ReNT Cl� T. I I air FT.
AS
HUSE OF P
EXISTING BLDG. „ R.SIDE OT. FT.
9 Separate permits are required for L.SIDE O FT.
electric,plumbing and heating work. III777
W FT
REAR I FT. .
i„„ USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& t
CMAIN BLDDGGS`.'/ ACCESS, BLOC'S. '7/
DATE
:1 I / ) V C U.P.4Pe ' L(�—n63 APPROVED/7/Y
' `/
t. APPROVEO(?L J RI tT- D /� /_
a.
/// OLD FOR SPECT ' C hia •
a. I hereby acknowledge that I have read this application and state • N.
cg that the above information Is correct and agree to comply with m
lY . all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of
W the State of California. IQ///�1 _ ♦/ASO#.164d.
dI /f�,�s
• I hereby certify that I am properly licensed as a contractor under j ./ 7 SO. FT. 413 A/.J�R-. . U n
• the State of California Business and Professions Code, Division 3, THE 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:
to
am exempt from the provisions of the State of California Business VALUATION a
and Professions Code, Division 3,Chapter 9. PERMIT FEE $ N
In
PLAN CHECK S n
Signature ofa,‘T________ o
Permittee $ TAX $ V.
U
U
Authorized Agent TOTAL PAID $