HomeMy WebLinkAbout1613 WHITE OAK ST - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
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PER IT NO. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA rytESA CppNSTRUCTION PE MIT 'i
/(0/3 �r/h/>'P /0//4Y- -�t �O �� 6147 10/28/86 5.00 :�
Project Address U REPAIR
A. J Li 4_1(7-40/A--1
TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION
Apnt's Mailing Addr`tt, 3 �'✓ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
A)
Owner's Name //gV D�-� Phone •SZ6 DESCRIPTION OF WORK/USE OF BLDG.
b Address �.9�� S Main Building: • Accessory Building::
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING�-❑ FOUNDATION ❑ STRUCTURAL E Front O
Address �7 �f ❑ TENANT ❑ ELECTRICAL R PLUMBING ❑ MECHANICAL B Rear • N
\ Contractor's Nam- it ' et./ .5 7?' // J. P one/ �--3 O ❑ OTHER A I
r �p' e/r» PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right •
G
Address(mailing)/533 Lodi?
�q3 // CONSTRUCTION TYPE VALUATION$ S Left
City License No. U ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION CI
Ping. Ref.4 Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: , Planning Notes: RECEIVED QC I 8 M
with section 7000) of Division 3 of the Business and Professions Code, and 4
my license is in full force elle1'. -7 • I .a T
Liceni las33,.�7 ✓.'n Livens No. _ / S
Date iii'd� ^ 4a Signature _- PLUMBING FEES
WORKERS' COMPENSATION DECLARATION / ,
Bar Sink
'iereby affirm that I have a certificate of consent to self-insure or a certificate Showers ELECTRICAL FEES
Workers' Compensation
JeA v en' Z.✓S _ Automatic Washer - Transformer 0 10-50 KW
Policy No. VE Y- Company 7� Backflow Irrigation Sewer Ca ❑ 50+KW
- P Construction Pole Sub.
ert if fed copy is hereby furnished. -
Cert'`prie o is filed with the city`•ll ddin• .Nisi I Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps -
Date /0 Apogean UFA...„ / 1.L..1 _
EXEMPTION FROM WORKERS'COMPENSATION DE'LARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or
\ less). Dishwasher - Solar Piping Dryers ❑Gas DElectric Sub Panel
' 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 California. Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 •
Date Signature _Floor Drains Swimming Pool w/Spa F.A.U.
..v\ NOTICE:If,after making this declaration, you should become subject to the Inc.Solar ❑9-15 HP ❑16-15+
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Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY ,• Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 'Civ, C.) Interceptors Water Heater //��
Lender's Name ry- (10 Outlets Range
Lender's Address Kitchen Sink - Water Service Switches Sign
OWNER BUILDER DECLARATION ,
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal •
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections •
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑O-5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law (Chapter 9(commencing with Section 7000) of
-ivision 3 of the Business and Professions Code) or that he/she is exempt -
-
erefrom'and the basis for the alleged exemption. Any violation of Section - •
331.5 by any applicant for a permit subjects the applicant to a civil -
penalty of not more than five hundred dollars ($500).
D I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee -$ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or Improves
thereon, and who does such work himself/herselfor through his or her own m DEVELOPMENT SERVICES REQUIREMENTS:
not -
employees, provided that such improvements are 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 11 ❑ Zoning Approved By rDate -
.pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By , Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
'
tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP .
of Exhaust System ❑ Multiple 0 System Repair/Alteration $
proof their Worker's Compensation insurance should be provided to me.• PLAN CHECK $ PERMIT
o I am exempt under Section • B.& P.C.for this reason Firepl/fact.BIt. ICBG 4 Fire Dampers PLUMBING $ t5-, ISSUANCE $ •
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
II hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTGRADING $
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 50% $ MICROFILM $ _
sentatives of Ftp is city to enjer pon the above-mentioned property for , ,\_
Inspection ptyfpb s. y ,/ ' MECHANICAL $ •
h-U
Signature ( .Jx��
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL &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 Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. .55. Electrical Bonding ( s
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, D',Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK Eli
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finabi
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 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: SC-1f7 ten- cgal) t.EA
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 6/1/47 I-40
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 & E3UILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
•
51. CERTIFICATE OF OCCUPANCY t •,
No. Date
AUG 7 195`
'
10087
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUDREING 1613 White Oak St. tr �U
COSTA MESA. CALIFORNIA TOR OFFICEUSE ONLY
Land
I RECEIPT NO. I 1 BPh'?OWNER Rosslane Land Co. Y 791 P
MAIL RECEIVED BY 1 DATE RECEIVED Alf)AT ISSUED
ADDRESS 1+19 E. 17th St. /. yJ/��—/�� ////_5-1 I Alin U 1d559
CITY Costa Mesa TNO.�8�59 BUILDING
ADDRESS /(L7/,R (i(7/(1-e%, iet/LI ,[
AF 'ECT Carlson & LIG. COSTA MESA. CALIFORNIA
OR ;INEER NO.
MiddlebrookFIRE
n ,[ n
ADDRESS Garden Grove ZONE TYPE ..1L— GROUP 11-fir/
Dike & Colegrove, InCSTATE 167 293 APPROVED /
CONTRACTOR Lit.NO. BY DATE
ADDRESS 419 E. 117th St., Costa Mesa ZONING
LEGAL LOT 2822 SORER NO.OF USE OF NEW �/)
:. DESCRIPTION NO. 189 BLOCK I TRACT K / PLANS I BUILDING
A.P.NO. �4.,I?�J•- APPROVED\ //�/�'/ / / /j 7[
BY f//J�/y DATE eft / .1 /
SIZELOT 65 C NO.NOW OFOON BLDGS.LOT none YARDS EVES
OF ?[ 101 I REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT L 79 FT. IN.
SETBACK LINE FROM 551 23�
CENTER OF STREET REAR YARD L• R.SIDE C
SIDE YARD (LEFT '9! (RIGHT 61 r L.SIDE .( FT. IN.
DESCRIPTION OF WORK • A/ /
REAR c. -'0, ✓ FT. IN.
NE I X II ALTERATION I II ADDITION _
REPAIR I II MOVING I I DEMOLISH
BUILDING 1/150 NO.OF
SIZE ROOMS 6 STORIES 1
EXTERIOR WALL._
COVERING ._3LUCCO COVERING Rock
USE OF BUILDING AND WORK TO BE PERFORMED
Sinele family residence with
attached garage.
Plan 14W
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCT •N. VALUATION
/ / /
SIGNATURE OF ' - en1 PERMIT FEE S 34.00
PERMITTEEWO • -
$ 'T 1 'SS.Z PLAN CHECK $ 17.00
AUTHORIZED AGENT D ''�"e & Colegrove, Inc. 1++ TOTAL FEE $ 51.00
OWNER KTFFFdi� B K 'JR.
SEP 1 4 19E' DATE 6_6-6o
JOB ADDRESS 1613 White Oak BUILDING PERMIT NO. 12163
GENERAL CONTRACTOR 0. F111ott VALUE $ 69.Q.00
AP. No. LOT TRACT ' FIRE ZONE DESCRIPTION OF WORK slab for fat.r .
INSPECTIONS DATE GROUP 1 TYPE V ZONE Ri
1=-,. 17rground Soil U.G. Water PERMITS ISSUED
Gltitrgiound Gas --- SUBCONTRACTOR DATE _ NUMBER
Overhead Water and Gas
Rough Heating _
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches/f/97d Formsent Steelle/619 6_/0-6e
Floor System _
Steel Reinforce Chimney Re-Rod _
Bond Beam _
Sheatl{ing
Inane and Flashing
7tng, In Out
�QPi'ter, brown coat
Plumbing Fixtures, Final
Ir Electric Fixtures, Final _
Building, Final
OCCUPANCY e. -Ijr ,f,4 a-/e-6C 4 4 -
Form 210-5M-11-59 S-B P " 12163
.:. . 12163 FtE REC If T A. II c s
COSTA MESA BUILDING-SAFETY DEPARTMENJ b-tg htat
r,�ti 117:: +
P. O. BOX 317 COSTA MESA. CALIF
!iss 444-al
For Applicant to Fill In CoR4Ye6Fl T. �gPfitiC ' F�QFOtg IT • 3'
TYPE OR PRINT (Q„j 4
BUILDING ��n�B1-�- (:
ADDRESS 1613 White Oak ri 3 ll D,i• I'pov—D
COSTA MESA. CALIFORNIA V,wir:Office—Use Only
RECEIPT NO. IVIn NO.
OWNER • A A . Kier far .Tr I ILyM1I CJ
AMAIL DDRESS 1613 White Oak RECHAVPD.BY I owTE REC--h I pAT�[ ,12
s�.I'•(f/r7(.lt� (/F R4
�L.n^y Y�11
CITY Costa Mesa TEL Kl• BUILDING//A3 /, ) �, / ,T/'
NOT —f QZA ADDRESS f(/ (�//f.Li•E/ CY
AR
OR 'EN.SNEER Self CT TEL. MESA. CALIFORNIA
•
FIRE✓/
ADDRESS ZONE TYPE y GROUP,
APPROVED �''^/� G h
CONTRACTOR fl.. F',11intt BY r/ 7IATE / (J
ADDRESS P.5fin j�TAWIrat Riva. ING �I
. NO.OP USE OF NEW.,AY
CITY _Cnata Mesa Cal ifnmi a ( ( IPL eN• BUILDING ����{//VV
STATE /J / 94:1,0e,
O TEL. Li �4 LHDAR �L / �7 y LY
STATE . I l� NO. 1.�.- D6BLRnnGN �p// '� �/`
OF LOT 65 x 10L SIZE I NO. OF BLOCS.O1 "7--0.-..-X `
NOW oN LOT A.P.NO, /
USE OF • Residence YARDS EVES
EXISTING BLDG. APPROVED A LOWED
CSETBACA UE
ENTER OPNeE FROM
REAR YAR02 aft. (CENTER LINE ST.)FRONT
FRONT 0/Lt FT IN.
SIDE YARD I LEFT 9 it. I RIGHT 3 ft.._ R.SIDE V �FT. IN.
DESCRIPTION OF WORKall 11-1* A _j N
I1
L.SIDE -t_fI .
NE`, I IIALTERATION I II ADDITION I X REAR ( 1 FT. IN.
REPAIR I V MOVING I II DEMOLISH I BYPROVED (As (./ OAT /EI (�. .-6
BUILDING NO. OF
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED . `� / ^ L
. •-siden e - S . R • e - LeeGe - , i , .
.3 I. p - . . :: .. D T.a , , - - Ini.:
a a - opts&room plus .ala 4.
i i t s _T T 3 -- .T n d�,t... w '
• i G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
HE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO CON. THE AMOU - SHOWN UNDER VALUATIONMI1F FOR ONLY.PURPOSE ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONBTRU N, V T ane7 60
VALUATION
SIGNATURE OF ----7 PERMIT FEE $ 4[
lt J Q v F
PERMITTEE
$(y0, PLAN CHECK S
AUTHORIZED AGENT YYYY��� // 9
AL FEE S /• E
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