HomeMy WebLinkAbout2233 MAPLE ST - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA ME�sS O,Nt�STRUCTION PERMIT PERfyT NO ^ TRACT NO. LOT NO. UNIT NO. A.P.,H, Zone
Project A dress as / 1APL.C" ,Ll�1C ✓•( a U
/ S Main Building: Accessory Building:
..Applicant's Mailing Address/5157/WI 6N<ROST<r!{ SiCV/RVCt TYPE OF CONSTRUCTION U NEW ll ADD U ALTERATION <REPAIR
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fy- ❑ CONVERSION ❑ DEMOLISH ❑ OTHE& ' T joN
Owir's
Name VJ RA ((A/'� Phone�'vr- � U I Front
Address
,�-�3� /y,B.pGG DESCRIPTION OF WORK/USE OF BLDG. F e S &nMt A Rear
j C Right
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL K
Address n- ❑ TENANT ❑ ELE TRICAL El PLUMBING ❑ MECHANICAL S • Left
Contractor's Name Q.4YS RLoby/r/( Phonen�9369 El OTHER FQ�F Ping. Ref.# Parking Req./Provided
Address(mailing) /SC57/t4YH C gen era- .-ePV(ti� PROJECT DESCRIPTION SQ. FT. �DOO OCCUPANCY�s qqqqqq ,,,,,,��������vv ou Planning Notes:1p�K7 CON ST RUCTION TYPE ' ) VALUATION$ s e City License NO. r 77 ZONE GRADING CU.YDS. ACRE _
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing �JC/ / " ac..o
with section 7000) of Division 3 of the Business and Professions Code, and Remarks: NG!/e or yfwOF E /e for (,q/r ff Cdp1000
my license is in full fccecn effect. / cELECTRICAL FEES
License Cla s ` 'cense Nq. � D ,� J�r� S
Date Signature
PLUMBING ' FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DEC ATION Construction Pole Sub: 0 50+KW
...1, - ar Sink Showers
treby affirm that I have a certificate of consent to self-insure or a certificate
1 Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Duo to 100 amps
_.,00, Lab. C.) (
Policy No. (D(F62-0 Company C1-19 re FS0"�Q Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amp's
Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Cerlil'eepp 9gqpy �jjed with the city B tllgg Divii n. Bathtubs Sewer Connection
Date FROM Applicant /`DECLAR Fan f Motors Do-i HP ❑1X-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit's for one hundred ($100)or F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is Issued, I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave e
Workers' Compensation Laws of California. Device Boxes
Date Signature Floor Drains Swimming Pool w/Spa Pole Light -
NOTICE:If,after making this declaration, you should become subject to the Outlets R
Workers' Compensation provisions of the Labor Code, you ane must forthwith Floor Sinks Urinal 9
comply with such provisions or this permit, shall be deemed revoked. •
CONSTRUCTION LENDING AGENCY "- Gas Service Outlets Water Closet Switches -. Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Clv. 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 Trays
any structure, prior to its issuance, also requires the applicant for such permit
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
-
g.3ksision 3 of the Business and Professions Code) or that he/she is exempt
-=.„
CONSTRUCTION AND PLANNING POC SPA
APPR?VALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe,-Undrgrnd. - 53. Steel Reinforcement j f
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 • i 58. Electrical Conduit-Undrgrnd.
-8. Foundation - 59. Gas Pipe, O 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 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
39. Water Service-Final
40. Gas Service-Final .��� t v1\atAzos�/�/
41. Solar Domestic-Final
42. Backflow Preventer r
43. Backflow Irrigation
44. .Landscape Irrigation System '
45. Sound Attenuation
46. Handicap Regulations
r SP
47. FINAL STRUCTURE& BUILDING IiAy/,
48. Special Requirements Completed
49..Electric Release to Edison •
50. Gas.Release to Southern California Gas Co - •
51. CERTIFICATE OF OCCUPANCY
No. Date /
Costa Mesa Building Department 1 APPLICATION FOR PERMIT
.. — P. O. Box317 el 020 BUILDING 1
- " COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 1 Receipt No. I Permit No.
Building
Address 2233 Maple Street I 3 , 717
Costa Mesa, California
Received by Date Redd/J Is
Date Issued
Nearest ...''.-71-'71:7 p
//—// —S (p //—// r e
Cross St. Wilson St. Building
Address
Owner Jack C. Hirt ler
Mall Costa Mesa, California
Address 419 S. 17th St. Nearest
Tel. Cross St.
City Costa Mega No.Id. S-1159 Zones y I No.of I Type , / Groypv�
Architect or 4ic, i('� Plans (/ .Y//
Engineer Carbon & Middlebrow. Approved
by Date
- 'dress Garden Grove CORRECTIONS
City Lie.
...,ntractorDike and Colegrove No. 461 5
Address 419 H. 17th St., Costa Mesa .
Legal I Lot I
Description I No. 17 I Block I Tract 2966 -
(Attach Metes and Bounds)
of g
SizeNo.of Lot 53 : 117 Now onBldLots none O
Ilse of I No.of 1 I No.of ra A
Existing Bldg. none Families Room
O
Setback Line from 551 Rear Yard 39151
z
Center of Street Side Yard 5 y
DESCRIPTION OF WORKr•
New I X I Alteration I I Addition I
x
Repair I I Moving I I Demolish I
Building No.of t"'
"ear 1205 sqo"Fi. 64 Stories 1 C
ettr..t)riorRoof —
Serino stucco I Covering coma. & roc APPROVALS I
Use of New
Building Single family residence Foundation Location Inspector Date
Forms,Materials,
if:; 1-t/, Under-Pinning "4
Plan Z6EFS Frame: Fire Stops, .p
Bracing,Bolts C
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int. C7
with all City Ordinances and State Laws regulating Al
building construction. Lath.Ext.
Signature of
Permittee Plaster, Int.
•
Authorized Agt e,"c '✓ 6 Plaster,Ext 0
Valuation Permit Fee $ e2 6..MelMasonry Reinforced C•4
A ./ Plan Check $ Al. &t Bond Beam
$ /O/ Y
rd Total7 O 0
Fee $ V 9. FINAL
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PLOT PLAN
Show location and distances from .-
property line and between buildings.
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