HomeMy WebLinkAbout958 JUNIPERO DR - Building PermitsUCTION PEfi(MIT •
Aoalicant to illl in all spaees except lhose within �eavy borGer Iines ana sign all approoriate tleclarations.
PER NO. TRACT NO. LOT NO. UNIT NO
�. Rpplicant's Mailin ddre)ss y•V . Unx .C/�T o V![LNG�G,f
Owner'sName W�/P�n"� Phone � " 9W
Address 4S� S'�A+i�pPit�
Arch/Eng. License No.
Address Lle f�"
Contracmr's Name /L � � Phone�L✓IS-�47
Addresslmailingl •-0� u z 4Z(�
Ciry License No. �y` ��� y rµi �- �' S
LICENSED CONTRACTOR DECLARATION
I hereby aifirm that I am licensetl untl¢r provisions ot Charter 9(commencin9
with section 1000) of Oivision 3 of the Business antl Projessl�nsCIDJy,�antl
my license is in full force antl effe t. y�S Y L7
License CIaSs Licens lo. �
Date 9��y" 59 t ` �
WORKERS' COMPENSATION OECL ATION��
I hereby aftirm that I have a certiticat of consent to selt-insure or a certiticate
ot Workers' Compensation Insurance, or a certitletl copy tnereoi (Seclion
,eoa. �b. �s�s� .S �,- F,.�, �/
cy No. Company
rlifietl copy is hereby tum shetl.
Ce�tifi tl copy is fj��wi[h Ihe city Bui i q Divisi
Date ��� APP��cant �
EXEMPTION FROM WORKERS' COMP SATION D LARA IOT N
(This section neetl no[ be compleleE it the permit is for One huntlretl (E300) or
less).
I certify that in the pertotmance ot the work for which thiz p¢rmR is Issuetl, I
sball not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of Califomla.
Date Signa[ure
NOTICE: If, after making tM1is tlecla�ation, you shoultl become subject to Ihe
' Workers' Compensation provisions of Ihe Labor Cotle, you mus[ forthwitn
mmply with such provisions or [M1is pe�mit shall be aeemeE �evoketl.
CONSTRVCTION LENDING AGENCV
I hereby affi�m tM1at tM1ere is a construction lentling agency tor the pertormanc¢
of the work for whicn tnis permit is issuetl (Section 3097 Civ. C.)
Lentl¢r'S Name
Lentler's Atltlress
OWNER BUILDER pECLARATION
I hereby atiirm Nat 1 am exempt irom the ConVactor's Ucense L.aw (or the
following reason (Section ]031.5 Business and Professlonal Cotle: Any tlty or
county which �equires'a pe�mit lo con5[rucl, alter, improve, tlemolish or r¢pair
any strucWre, priar to.ils issuan<e, also requires the applicant for such permit
to tile a signetlstatement lha[ he/she is licensetl pursuanl to lhe provlsions of
roe Contractor's Licenze Lzw (Chapler 9(commencing wi[h Section ]000) of
Divizion 3 ot the Business antl Prote55ion5 Cotle) or [hat Ite/she is exempt
iherefrom an0 the basis for the alle9etl exemplion. Any vlolation of Section
7031.5 by any applicanl for a permit subjects the applican[ to a civil
�enalty of no[ more than five nuntlretl tlollars ($500).
' I, as owner of the prooerty or my employees with wages as their sole
inpensation, will tlo the work, antl che sVucture is not inlentlea or ofteretl
.or sale (Section 7044, Business antl Protessional Cotle: The Contrac[or's
License Law tloes noi apply lo an Owner ot a p�operty who builtls o� Imp�oves
thereon, antl who tloes sucn wOrk himself/herself or throuqh his o� h¢r own
emplOyees, provitletl that sutM1 improvemcnts are not intentletl or offeretl tor
sdl¢. It, �owever, the builtlinq or improvement is soltl within One yea� ot com-
pletlOn, lhe owner will have the burtlen ot proving he/sne tlitl nol builtl o� im-
ptove for tlte purpose of sale).
❑ I, as owner of the Oroperiy, am ¢xcWsively rontractinq wi[h IicenS¢tl mn-
vactors td construct the projecc (Section 7044, Business antl Professions Cotle:
Tne Contractor's License Law does mt apply to an owner ot properly who
builtls or Improves thereon, antl who contracts for such projects with a con-
tractor(s) bcense purouan[ [o the Con[ractor'S License Law). I am aware that
proot of their Worker'S Compensatlon insuvance shoultl be provlCetl ro me.
❑ 1 am exempt untler Section B. & P. C. tor thi5 reason
Oate
Si9nature
Drivers' Lit nse or
— Owner
I have reaa tM1is application antl state that the above
I a9ree to compty wiih all tlty antl county ortlinances
to builtling conSVuction, antl hereby auth0/ize rep�e-
to enter upon Ne above-mentionetl property pto�r
� Daie 9 /�✓ �
, � /K-�
a�
TYPE OF CONSTRUCTION NEW ADD LT�RATION REPAIR
❑ CONVERSION ❑ �EMOLISH ❑ OTHER � q p#
DESCRIPTION OF WORK/USE OF BLDG.
S Main Buildi
E
TVPEOFPERMIT GRA�ING FOUN�ATION STauCTURaL T Front
❑ TENANT ❑ ELECTRICAL ❑ PLVMBIN ❑ MECHANICAL A Reer
❑ OTHER
PROJECT DESCRIPTION 5�. FTD� �1CU� oCCUPANCv P C Right
CONSTRUCTION TVPE V� VALUATION 5�6/i % g Left
ZONE GRADIIVG CU. YDS. nCRES Ping. Ref. #
aemarks:r. . . _ll .-�_ L . /: _ 'tl� .. . _ . L / f /. _ . _ . Plannina Notes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
InterceptOrs
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exheust System ❑ Multiple �
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0-100,000 BTU 0100,OOOBT'
Feinspection Fee � $15
CMF 0865-46, rev, 30/84 White - Building; Canary - Applicanh Pink - Atcoun[ing; Goltlenrotl - A55¢SSor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimmin9 Pool w/Spa
Urinal
Water Closet
Water Servi
Auto-Wash
laue Fee
Hood or Type I ❑
Canopy Type I I ❑
Refri9eration System
❑0�100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
luue Fae
FEES
g 3
$ 3
Automatic Washer
Construction Pole S�
Cooking Unit
Dishwasher '
Dryers ❑Gas ❑EI
Fan
F.A.U.
Fixtures
Device Boxes
OUtleLS
Switches
Garba9e Dispoul
Generator 00.5 KW
Fee
5154 9/14/87
Zone
Accessory Building:
Parking Req./Provitled
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up Lo 100 amps
Merer ❑over100amps
Sub Panel
Motors�41 HP�1'F.-8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Ran9e
Standing Sections
5-15 KW Trash Compactor
$15 Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved By
Aooliration Issued 8v
29a50 TL
..
FEES
$ 3
� SUM pppRV F FEES
BUILDINGPERMIT $ � SMIP $ •S�
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% 3 ENERGV P.C. $
E�ECTRICAL $ GRADING S �
PLAN CHECK 50% $ MICROFI�M S �] Lf `
MECHANICAL $ TOTALFEE S '"�•J O
PLAN CHECK 25% $
2
O
N
I
N
G
R
E
Q
M
T
S
CONSTRUf.TION AND�PLANNING POOL & SPA ;'n �
APPROVALS Permi4�# 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-Undrgmd. , 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. S[eel Reinforcement r;� 56. Rough Plumbing & Pressure Test
6. ElectricalUFERGrnd� 57. APPROVALTOCOVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
77. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumhing 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
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # ' '
i -
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil i
23. Gas Pipe-Rough & Test 72. Underground Flush , '
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 8� 7q, Overhead Hydro i
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. DrY"�'all 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 I, :='
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing � ' � � �
39. Water Service-Final •� �. 'Y •. ' .,
40. Gas Service-Final I " • �,
•41. Solar pomestic-Final � ' ., � • � • (
t
.A2. Backflow Preventer - ' ' ,� �
, i �
,43. Backflow Irrigation � �� i' I �'I
i i �,
44. Landscape Irrigation System ' . ' Y r ^ ' `
45. Sound Attenuation - � '
. u
46. Handicap Regulations ' , � ,
'.:47. FINALSTRUCTURE&BUILDING 7 � �/ ' � �� ' ' '
i I�
48. Special Requirements Completed �. ''. ' � � •
i i'
49.'Electric Release to Edison � ' , � '
50. Gas Release to Southern California Gas Co
51. CEFTIFICATE OF OCCUPANCY . ,
No. Date _ �
4
OWNER
GENERAL CONTRACTOR
AP No. LOT
INSPECTIONS
— ln
k
OCCUPANCY
�ORM BU4 � SM -
TRACT 4260 FIRE ZONE
� Signnture � DATG GROUP
Ln.� J-ic-vc
BUILDING P�RMIT NO. 1
VALUE g 1�, 467.00
D�SCRIPTION OF WORK re6
TYP� '/,ON�
g�'
16613 F� RE��IVED
;, _
COSTA MESA BUILDING-SAFETY DEPARTMENT MAP �°�Z
P. O. BOX 917 C08TA M88A. CALIRORNIA FINA(�CE DEPT. r�t 15 - Tract 4260
CITY Of CUSTA MESA P� 400-aa
For Applieanf fo Fill In Complefely APPLICATION FOR PERMIT
TYPE OR PRINT � - BUILDING
BUILDING
ADDRE6S TllY11 (.'i0 Drive
COSTA MESA GALIFORNIA FOf Offlce Use Only
OWNER nesa Del biar Develooment CO• � RHC6IPT NO. P �r wo.
MAIL p ' P¢CEIVHD BY I DATQ PlCCI ED ;�MT¢�IBSUBD/ �
AOORE65 3,1�� IS� C+03St' �o�aY 4
cirv rona Del Mai' Calif• NO�R'��^2�'� em�o c
ADDRE88
ARCHITECT CLff 0�.5'�@11 �`[ 7EL.
OR ENGINEER ASuOC♦ N0.��3�1zZ�- COSTA MESA. CALIFORNIA .�
ADORE659O2S1 F+• �'lorenae �lve., Downey� FIRE �J
�a y• ZONE TYPE GROU G
CONTRAGTOR Tf•aCCO Coraoration BVPROVED DATE .
ADDRESS 800 E Coast Hi hc.r ZONING
CITY C il �%� —I I PL.nNe Z I eu�tD XO ��/»'.��MQ [.
LV a
LIC.rNO: �SOS—SB—�. NO.�R j��S� �eaAl L�y. �f." T� L� Z60
DEBCRIPTION
OF LOT 696$ s�r• I NOW oN LOT6��� ��
_ A. P. NO.
USE OF j��� YARDS EVES '
EXISTING BLDG. APPROVED ALLOWED
BBTBACK LIN¢ FROM '�r ICENiIR LIN6 BTJ
cemrea oR srxeer 47 � REAR YARD 23 ��.0�� FRONT � S— PT. /-- IN.
SIDE YARD I LEFi �� I RIGHT 8' S�1 R. 91DE v FT. " IN.
DESCRIPTION OF WORK - �. S,oE � F7. -- IN.
NEW I R 7 ALTERATION I II ADDITION REAR z'3 FT. �� IN.
REPAIR I IIMOVING I IIDEMOLI6H I BYPftOVHD �/� DATE � Z-���Z
C .f
6IZED'�1611gJ��2�� NO.OF 6 �. . . .
ROOMS STORIES .
EXTERIOR WALL S�{g.�'1C O ROOF
COVHRING W � COVERING I"I00C�
USE OF BUILDING AND WORK TO BE PERFORMEO
Sirgle Fami Dwell3ng Ia.vi Area 1702 S.F.
dd attached Garage Gara e �� 463 5,:.
Covered Porch 63 S,F,
I HCRHBY ACIWOWLI?DOE THAT � HAVC RGD TH18 MPLIWTION THC AMOONT eHOWN UNDlR VALUATION IB FOR THE
ANO eTAT6 THAT THE ABOVE I6 COPRCGT AND AGPEC TO COM- - pUPP096 OP EBTAlL18H�N6 A vERMIT FEE ONLY.
PLY WITH ALL CIiY ORDINANCES AND BTAT¢ L/.WH R6OULATNO
au1LnlNo CON8TlturnoN. . VALUATION ��'j7 ��/)
SIGNATURE OFM N r P' �� ' PERMIT FEE � cr' '- U(/ a•
PERMITTE �/'j �-�/A, n
B�r $ 10' 1.6•/ • �� PLAN CHECK $ / / . (✓(.J �
AUTHORIZED v µ ` a
70TAL FEE S7 s�O �