HomeMy WebLinkAbout3337 WYOMING CIR - Building PermitsC
Applicant to /ill in all spaces except lhose witnin heavy DorEer Iines anE sign all a00roD��ate Eeclarations.
CITV PF COSTA MES�14+� CONSTRUCTION PERMIT PERM O. TRACT NO. LOT NO. UNST Nn.
Project Address 33 •� I��1�0 YYi I G �-1 �
Applicant's Mailing Address SG Y'i1 �
Owner's Name �-� Phone 5�y' ��'
Addreu 333_? � u_o� 11'td i� 1�'
Arch/Eng. License No.
Address
Contractor'sName /7 uY1�b � ��J � n phone��
Adtlresslmailing) r'�'/ X 3`��
Ciry License No. � 4�10 �
LICENSED CONTRACTOR DECLARqTION
I �ereby affirm [hat I am licensetl untle� provlsionz of Charte� 9(commencin9
with seclion ]000) ot Division 3 0( tna Buziness antl Professionz Coae, antl
my Iicense is in iW I Porce antl effecL � 1
License C a s G— Li ns No �S ���
Date �4' Si9nature
WORKERS' COMPENSATION DECLAR ION
1 hereDy aifirm that I have a certiticate oi wnsent lo salNnsure or a tertificate
o/ Workers' Compensation Insurance or a certiti tl copY there f(Section
3800, La�. . O � / r� —
Policy No. b / ompany � __
i�ietl copy is hereby tumishetl.
�ti(ietl copy is file ith t city Bull i I' i ,
e A licant
E%EM 1__�KERS'COMPENS TION DECLARATION
(This section neetl no[ be completetl if the p¢rmlt is for one huntl�etl (SI00) o�
less�. `
I certity [hat in thE Pertormance ot the wO�k fo� which [his pe�mit Is Issuetl, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of Callfomia.
Date Signa[ure
'NOTiCE: Ii, aiter making this tleclaration, you shoula become subject to tne
Wo�kers' Compensation provision5 of the Labor Cotle, you must forthwith
complY with such provisions or tnis permit shall be tleemetl revoked.
CONSTRUCTION LENDING AGENCV
1 hereby at9rm that tpere is a cons[ruction IenUing agency for the performance
ot Ihe work for which t�is permit is issuetl ($ectlOn 3097 Civ. CJ
Lentler's Name
Lentler'S Atltlress
OWNER BUIIDER DECLARATIOtJ
1 hereby af8rm that I am exempt from the Contractor's License I..aw for the
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
County whith rGqui�es a pe�mit to construct, aller, improve, tlemOlish or te0ai�
any structure, prlor to its issuan<e, alzo requires t�e applicant for such permit
lo iNe a signetl slatement that he/she is licensetl pursuant to Ihe provisions of
the Contractor's License Law (Chao�er 9(commencing wiih Section 7000) of
Division 3 of [he Business antl Pro(es5ion5 Cotle) or that he/Sh¢ is exempt
theretrom antl the basis tor the allegetl exemption. Any violation of Section
7031.5 by any applican[ for a permit zubfects the applicant to a<ivil
�nalty of not more than five huntlretl tlollars (g500). '
Ll I, as owner ot the property or my''employees with wages as their sole
�ompensation will do the work, antl [he structuro is not intentletl or offeretl
br sale (Section ]044, Business antl Profe551ona1 Cotle: The Con[racto�'S
License law aoes not appiy to an owner ot a orooerty who OuilGs or improve5
th¢reon, an0 who tloes such wo�k himselt/herself or through hi5 or her own
employees, provitletl that sucn improvements are not intentletl or otteretl for
sale. If, however, the builtling or improvement is soltl within one year of com-
pleilon, tne owner will have Ihe burtlen of proving he/she tlitl not buila or im-
prove for [he purpose oT sale).
❑ I, as own<r of the proDerty, am exclu5ively contractlnq with licensed con-
tractors to cons[ruct the project (Sectlon 7044, Business antl ProfeSsionS Code:
The COntraCtorY �icense Law doe5 not apply [o an owner of prope�ty who
builtls or imDroves tnereon, antl who coniractt tor such projects with a con-
trac[or(s Ilcense pursvant�to�the ConVactor's License Law). I am aware that
prooi o� th¢Ir Worker's Compensatlon insurance shoultl be provlAetl to me.
� I am exemot untler Section B. & P. C. tor this reason
Dale
antl
c:
Owner
ve reatl
cou
above
TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR —
❑ CONVERSION ❑ DEMOl.ISH ❑ OTHER Ap #
DESCRIPTION OF WOFK/USE OF BLDG.
S Main Building:
E
TYPE OF PERMIT GRADING�( FOUNDATION STRVCTURAL T Front
❑ TENANT ❑ ELECTRICAL L� PLVMBING ❑ MECHANICAL B Rear
❑ OTHER %�
PROJECT DESCNIPTION 5(7. FT. oCCUPANCv C Right
K Left
CONSTRUCTIONTVPE VAIUATION$ $
ZONE GRADWG CU.vDS. ACRES P�ng. Ref. �
Remarks: ��n AM,n.n�.�' C1.n� /1JnnA/D PlanningNotes:
3ar Sink
3ackflow Preventer
3ackflow Irrigation
3athtubs
Clarifiers
Jishuvasher
Drinking Founlains
Floor Drains
Floor Sinks
3as Service ��—OuUets
Intertepmrs
Kitchen Sink
Lavatories
P—Trap
Roof Drains
qainspection Fee $15
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ a i oo,000 eTu � i oo,000
gri rs' License a S� _ �
qainspection Fea $15
CMF 0865-46, rev. 10/84 White - Bulltling; Canary - Applicant; Pink - Accounting; GoltlenroG - AsSessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Clou[
Water Heater
Water Service
Auto-Wash
Issue Fee
Hoodor Typel ❑
Canopy Type 11 ❑
Refrigeration System
❑0.700,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
6�67 12/26/85 5a�. T�
—
Zone
Accessory Building:
Z
O
N
I
N
G
R
Parking Req.IProvided E
�
M
T
S
� ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit Meter ❑up to 100 amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Eleciric Sub Panel
Fan Mo[ors00-1 HP 01'/:-8
F.A.U. Inc. Solar �9-15 HP 016�15+
Fix[ures Microwave
Device Boxes Pole Light
Outlets Range
Switches Sign
Garbage Disposal ;Standing Sections
Generaror �0.5 KW �5-75 KW Trash Compactor
FEES
$ 3
Reinspection Fea $15 luue Fee $ 3
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved 8y Date
Building Approvad By Data
Application luuad By �— Dat a0
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ ��y� PERMIT 2 '
PLUMBING $ Ti+l� �-+'w ��UANCE $ f�vv
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $
$ 3 PLAN CHECK 25% $ , ,�n
CON$TRUCTION AND PLANNING POOL & SP. _
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary EleCtrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � -. 53. Steel Reinforcement �
3.'ElectricalConduit`Utility-Undrgrnd. 54. Forms �
4:'Electrical Conduit-Undrgrnd. ` 55. Electrical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6' Electricat UFER Grnd. �� 57. APPROVALTO COVER-GUNITE
7.-�Footings � 58. Electrical Conduit�Undrgrnd.
8. Foundation 59: Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrg�nd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. �Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing _- 65. Electrical-Final
15. Rough Electricnl-Conduit 66. Solar System-Final
76. Rough Electric Wirin9 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Faciory Fireplace APPROVALS Permit #�
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling ($tructural) & Monocoat 75. Dry Chemical
27. Fraine and FlasFiing ��"� ���� 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL �
29. Insulation 7$. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICA7E ISSUED
33. Final Electric . - Notes: � � � ' -
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-7est /L LJ��.y' LlEv
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing / Zj��" �✓J
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
i
42. Backflow Preventer -
I
43. Backflow Irrigation .
44. Landscape Irrigation System
45. Sound At[enuation
46. Handicap Regulations .
47. FINALSTRUCTURE&BUILDiNG
48. Special Requirements Completed
49. Electric Releasa. to Edison �
50. Gas Release to $outhern California Gas Co
51. CERTIFICAT� OF OCCUPANCY
No. Date
�
a
c�,�rY or cosz��-� r�;s� �...,�v��s�r roiz occvP�ncY
TKF�CT NO,_ �[� 9� ' DATE
LOT ho._ 3 3 • ' �
ADARESS 3 3 � � ��
�
The cieveloper oi the above entitled tract desir.es to sel.l ihe
above sei; iorth lot prior to the time that the tract has been
completed and it.s str.eets accepted by the City of Costa Mesa .
The under�igned, by executing this anreement, ackno�olednes
that (he-she-they)
(was oY wer
advised
thai: thi� tract has not been given final.inspection noY has
it been �ccept�ed by ihe City of Costa Masa as havi.ng complied
with tlie conditions of approval Wi11CY1 were imposed by the cii:y
�t tlie time the iinal txact niap taas approved.
The city asswnes no liability for the eniorcement o£ the.conditions
necessary for appr.oval other thzn those conditions protecL-ed by
s urety bond,
The undersigned agrees to indemnify and hold the city hacmless
frcrl any claim zesu).ting in c?amage or persor.al irjuxy to th�
undersi.yned by reason of the.aforenientioned uncompleted condition.
� �R�� . . - � � . BY �L�C�i4 , .
�7 ��� �� /py/rchaser
__ !� /
���� � ���
� `
��:
Developer �d7�r authorized
representa ive
� •
u Lender
�
;OWNER JAY, Earl F.
708ADDRESS 3337 Wyoming Circle
' ERAL CONTRACTOR Owner-Bldr.
Ai No. 139= 11-0 LOT TRACT
INSPECTIONS Si natu
SOIL
GAS
W ATER
ROUGH PLUMBING
PROP. SWR, IINE � HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CON�ITIONING
TEMPORARY SERVICE OR POLE
UNDERGFOUNO � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF. �
FLOOR SVSTEM
BON� BEAM STEEL REINFORCE
SHEATHING
FRqME AN� FLASMING �
L 'NG - IN OUT
F .ER, BROWN COAT
ELECTRIC
FINAL ANO GAS T
FINAL
111�1�
DATE .11-3-71
BUILDING PERMIT
SUBCONTRACTOR
:�'
:
COSTA MESA BUILDING-SAFETY DEI
P.O. BOx 1200 COSTA MESA, CALIFOR
For Applicant to Fill in Complei
Z .
aU
z
za
Oy
am
�7
J N
Q W
f0 J
• (tl
J Q
U �
Za
w �
aw
W Z
J Q
m Z
J �
W W
�
ZH
�O
70
H
z
Q
U
J
a
a
Q
0
F"'
�
z
0
�
U
�
�
H
N
Z
OWNER
cirv G,7�
CONSTRUCTION
BRANCH
ADDRESS
ARCHITECT
CONTRACTOA
ADDRESS ��
dTV� Sl��
STATE
LIQ NO.
SI2E
OF LOT
USE OF
EXI5fING BLDq.
SIZE OF
NEW BLDG.
EXTEFIOR WAL.L
COVERING
USE OF BVILqI
��
/�/m S if
C.�C/[�
L.
TEL.
NO. �
CITY
UC. NO.
NO. OF
FOOMS
ROOF
COVERING
WORK TO BE PER
�
I hereby acknowlad0e that I have reatl this apD���ation antl stata
that tha ebove �nformetion is correct and agree to comply w(th
al� laws regulat��p builtling construction, antl I shali not employ
any person in ��olation o7 ihe workman's compensation laws of
the Stata of California.
I hareby certify thet I am properly licenutl as a controctor untlar
iha Siate of California Business antl Protessions Cotle, Divisicn 3,
Chepter 9, antl thet such licenses ara in full force antl etfect, or I
am exampt iram Ihe provisions ot tha $iate of CelHornle Buslness
antl Profession; Code, Division 3, C�apter 9.
SlOneiura ot ,� � ( �,
Permittee ���/�Y
Autho�ix¢tl ApOnt
� PA�L �{_.ir:t�:nnn
"DV - a-71u•,s=�� 174 cv . �
i'
APPLICATION FOR BUILDING PERMIT
RECE ED BV DATE RECEIVED DATE ISSVE
/_3- /_g_.
/3 PERMIT NO.
A.P. NO. / / '�
BUIID�NG .'{�3 � �,
ADDRESS ✓"
TRACT rJ (L LOT. BLOCN
OVED
NO.OF ,
� PLANS G
YARDSAPPROVED
VAR. 9W
E OF
VAPDSAPPROVED
DATE
.
-3-
m
W
SQ. FT. o
THE AMOUNT SHOWN UNDEF VALUATION IS FOR '
THE PURPOSE OF E5TABLISHING A PERMIT FEE ONLV: Q
VALUATION /VY m
PERMIT FEE $ '�� �
� ]
m
$ � PLAN CHECK $ �� E
f�� �-� °
LL
TOTA�FEE S �-
l" . _
' ��n�.3
z .
o- U
Z Q
O c~i�
am
J�
J N
Q W
(O J
m
J Q
U N
Za
w �
aw
J �
m Z
J �
W W
0
Z H
W �
��
�o
�—i�
I�oV —4-10P"-1°00 134# *** 141.00
eMsn
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
ForApplicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
REC DE�V D,�aa �VE� DATE ISSUEO
BVILDING 7
ADDRESS OII1711 C1PC
PERMIT NO.
OWNER ModulaY� Technolo IT1C. �+�P� NO. rt/1 A 7
MAIL BUILDING � � ��
aooaess 110�-} E. ]_7t]] St.. ADDRESS 3337 Wyoming Circle
CITV Santa EiR2. No`�547-g673 TRACT 6695 LOTJ3 BLOCK
CANSTFUCfION EW A P
�ENDER
X
BRANCH Main Office
owNeaModular Technology, Inc.
ADDFESS 1g0 S. Broadwa .52I1 Dle O VALUE
ARCMITECT TEL. SE Residence 5 15�70�
OR ENGINEEF Kermit Dorius N 675-1164
FIRE �
ADDRE55 ZONE TVPE GROUP
APPROVED
CONTRACTOR BV �ATE
ADDRESS S�e �
2 E NO.OF USE OF
CITV `S�e ryp�' PLAN$ � eUILDING �� �
STATE CITV �'ARDSAPPROVED VARDSAPPRO ED
���. No. 252549 �,�. No. 16go MAIN BUIL�ING ACCESSORV BUILDING
SI2E NO.OFBLDGS. (FROMC/LS EETI/�
OFLOT 7{ g NOWONLOT__ FRONT FT.i/' FT.
USE OF
EXISTING BLDG. -- � S � FT
SIZE OF NO. OF �/�
NEW BLDG. 1 B2 S ftOOMS STORIES L. SIDE v' / FT. � FT.
EXTERIOR W L ROOF
COVEflING er PI�S COVERING WOOC�. 5�1111 12 REAR �FT. FT.
USE OF BUILOING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN &
MAIN BLDGS. ACCE.�. BLDGS.
Construct new residaice with attached CURP �y+v'�S`�n a�.vArTRoveoS �J—�J
garage. .oaaaoveo �_ _7�
HOLD FOR SPECI L REQUIREMEA!T5
I heraby acknowledge that I have reatl this nppllcation antl state
tha[ the above into�mation is correct antl oB/ee to compty with
oll laws regulating building construction, end I shall not employ
eny person in violation of 2he workman's compensation laws of
JJa �%� °
tha Stata ot California. �y �
I hereb ceriif that I am /�✓ SQ. FT. (/—� �
V V properly licensad es e eontractor vntler
the State ot California B�siness entl Pro(essions Code, �ivisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licenses ere In t�ll torca antl ettect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
am exempt irom the roy �sions ot the $tate o C lifornia Business �
antlProfessionsCo rGisfon C apter VALUATION l%�_ o
PERMIT FEE $ � S
Sie�ature ot // (�^J �
Perm(ttee 5 �(�/� � PLAN CHECK S // ' f
/ (
Autho�iiatl Agent �/-� �
TOTAI FEE $