HomeMy WebLinkAbout1848 KENTUCKY PL - Building Permits • - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. , LOT NO. UNIT NO. -
/e�fQ'- - iceN'-r-uC: 2/ i°Lt 13 2 7 7 �9 CDS B i(�i 4 27 3/17/B? 29.38 TL
Project Address .fin/ u
Applicant's Mailingq Address /'/set&Gx 392 c4' PIt'R TYPE F CONSTRUCTION NEW U ADD ALTERATION LI REPAIR
( - / r?fy)/BZ-Z?OQ CONVERSION ❑ DEMOLISH ❑ OT.ER l . ' A.P.# 1 �9 v4/ /4-{', Zone �/
Owner's Name t%!J jet
r/C PRone (O9
p DESC• •TION OF WORK/USE •F BUG. A ' L C' >
Address (/) � ' /C¢ �J,-/..Gr icy: PL / L c • / •...Ard7r - . • r • S Main Building: Accessory Building:
Arch/Eng.A/GN/4e.V f(OLOO Z/'gJLicense No. /70 6 TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL T Front /� .5 / 0
iii Address /'2.3 3.0 R01F C F../1R/ro//S' JJ��Fio 70/ ❑ TENANT 10 ELECTRICAL ❑//PLUMBING ❑ MECHANICAL B Rear Q r N
Ltractor,sName,tc,7X,tC
• CO44pate, Cp1 1;1-0OTHER /'�/ c q 3�7 •TSQC RightN
+�j � PROJECT DESCRIPTION SQ. FT. OCCUPANvress(mailing) t QVk ] y73 CFt KG
'�1 (yCONSTRUCTION TYPE VALUATION$License No. 0L1l22 . 7o2•Y7 ZONE ' GRADING CV.YDS. ACRES --- RENSED CONTRACTOR DECLARATION • Ping. Ref. # Parking R...e,,,q////Provided E
eby affirm that I am licensed under provisions of Chatter 9 (commencing Remarks: Planning Notes: J Ut�il, on A M
00 with section 7000) of Division 3 of the Business,and Professions Code, and •
my license is in full force an`effect. ^1'` S
I License Class " I I Licen - . • O.`1
7" Date 7,_tb'&''� Signature- ' / •r.
- PLUMBING FEES
♦r WORKERS'COMPENSATION DECL Jr: - Bar Sink Showers
W I hereby affirm that I have a certificate of consent to self-insure or a certificate _ ` ELECTRICAL FEES
of Workers' Compensation .Insurance, or- a certified copy thereof (Section ckflow Preventer Service Sink
3800, Lab.�1 ^. 4 - Au , atic Washer Transformer ❑ 15-50 KW
Pol' No. `��Op� •.Compa y 1-' tE • Back Irrigation Sewer Cap 0 50+KW '
/ Constru on Pole Sub.
Certified copy is hereby furnished.
Certified copy is filed with the city B At • .Ivision. Bathtubs Sewer Connection Cooking Uni Meter ❑up to 100 amps
Date 3-t-1-�7 Applicant /i A A - -
EXEMPTION FROM WORKERS'COM-, NS• CLARATION Clarifiers Solar Collectors - Dishwasher Meter Dover 100 amp
F (This section need not be'completed if thepermitIs for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Elect' - Sub Panel
1 certify that in the performance of the work for which this permit is issued, I 1
shall not employ any person in 'any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors DI HP ❑1'/a-8
Workers' Compensation Laws of California. - _
—
• Date Signature Floor Drains Swimming P. w/Spa F.A.U. r ❑9-15 HP ❑16-15+
NOTICE: If,after making this declaration,you should become subject to the- - —
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks inal Fixtures •
comply with such provisions or this permit shall be deemed revoked. - - - • Icrowave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Wa Closet Device Boxes Pot- ight hereby affirm that there is a construction lending agency for the performance 9 t
of the work for which this permit is issued (Section 3097 Civ. C.) •
Interceptors ater He. -r Outlets Range
Name
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 Section
county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays -
any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0 : KW 05-15 KW 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
Division 3 of the Business and Professions Code) or that he/she is exempt -
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).
LJ I, as owner of the property or my employees with wages as their sole Inspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered •
Reinspection Fee $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/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for oiler Hood or ' Type I ❑ ( •/ 7- .O2
sale. if, however, the building or improvement is sold within one year of com- Canopy Type H ❑ Zoning Approved By to / �.l
plebe n, the owner will have the burden of proving he/she did not build or im- Duct- er Ground Building Approved By Date ^f ']
prove for the purpose of sale). •
/Z511 ` /^ 7,
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structura Refrigeration System Application Issued ByDate /
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 P 11,000 BTU
builds or improves thereon, and who contracts for such projects with a con- - SUMMARY OF FEES
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple System '-.air/Alteration - . BUILDING PERMIT $ I1' 50 SMIP $ 4. .f
proof of their Worker's Compensation insurance should be provided to me. PLAN $ ��• .3R PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# . . Dampers PLUMBINGN CHECK $ RMIT ISSUANCE $
Date Owner Heating System& Ducting Regis
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify th.t I have read this application and state that the above E]0-'100,000 BTU 01001:.BTI. • ELECTRICAL $ GRADING $
information is correj . I agree to comply with all city and county ordinances
and state laws rr la I g to building construction, and hereby authorize repre-
sentatives of •ty to enter upon the above-mentioned property for -
inspection pure -sf13)—n—
` p
Signature A Date 3- 1-� MECHANICAL $ TOTAL FEE $ IT. 3 O
Drivers' Lice~e or SS# '-Inspection 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
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-UndrQrnd. 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 i . .. i .
39. Water Service-Final -
40. Gas Service-Final •
Losmi41..Solar Domestic-Final • -J
42. Backflow Preventer i l�`.�. 'J t
2.
n w'\
43' Backflow Irrigation ' • ,d
44. Landscape Irrigation System .� ,4 �Xi ,. (l •
45. ISound Attenuation yixd" �pC.1O//LtE1((J�'� ,,��}� -r�JV'3'�
46.'Handicap Regulations es-04. c .�"�' -
47`. •
FINAL STRUCTURE & BUILDING -
48. Special Requirements Completedt
49.Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY t •
No. Date -
4
1203 FE,, RECEIVED
MESA BUILDING-SAFETY DEPARTMENT -• AY 1 6 11J%
P. O. BOX 317 COSTA MESA. CALIFORNIA FIN ICE DEPT.
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1848 Kentuckv .ace
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. Pi$W1T H6-D(�I
OWNER Vermont Avenue Land Co. . Inc.MAIL I AI 1IG(9e3
ED
ADDRESS 419 E. 17th Street RCE I Lo- -/W.-i1Vl MAY
i11B7D1980
CITY Costa Mesa Nclj.i 8-1159 BUoReINGs
ARCHITECT ER'(!ar1son & Middlebro COSTA MESA. CALIFORNIA
OE
ZONEFIRIR '�
CONTRACTOR o `////n���Y
ADDRESS Garden Grove TYPE GROl1R/
Dike & Colegrove, Inc. APPROVED
BY DATE
ADDRESS 419 E. 17th St. ZONING
Costa Mesa ZONE R-1 I PLANS 2 NO.OF I USE OF BUILDING att gam
CITY w/ gar
LIC.NO. 167293 TEL. Li 8-1159 LEGAL
DESCRIPTION Lot 46, Tract 3648
SI ILOT 601 X 95! I NO. OP SLOGS
NOW ON LOT hone A.P.NO. none
USE OF none YARDS EVES
EXISTING BLDG. APPROVED ALLOWED ( /
SETBACK LINE PROM (CENTER UNE ST.) .t--) 4- k.c r/(/
CENTER OF STREET 651 REAR YARD 301 FRONT c.--z)
1/// FT. f IN.
SIDE YARD I LEFT 71 I RIGHT 71 R.SIDE 7 FT. IN.
DESCRIPTION OF WORK
L.SIDE r•n) FT. IN.
NEW I X V ALTERATION I II ADDITION I REAR ,� ✓ FT. IN.
REPAIR
IIMOVING I II DEMOLISH I APPROVED W T DATE
BUILDING L^ NO. OF 5-13-
SIZE 1560 sq.ft. 60
ROOMS 7 STORIES 1
EXTERIOR WALL , ROOF
COVERING Succo I COVERING Comp.
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage.
Plan 20CR
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 OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNAERM TURE
OF Dike & Colegrove, Inc. PERMIT FEE $ 36.°° NN
/� $ 16,101.00 PLAN CHECK $ 18.00
AUTHORIZED AGENT �(/ ,�� TOTAL FEE $ 54.00 0