HomeMy WebLinkAbout611 LAKEVIEW LN - Building Permitsr
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COSTA MESA BUILDING-SAFETY DEPARTMENT �
P.O. BOX t200 COSTA MESA, CALIFORMIA 92626
APPLICATION FOR BUILDING PERMIT '
For A plic fil! in Compl tely i
EC BV DQ.TE ECEIV DATE ISSUED
BVILDIN ~ �
ADDRESS �� �
PERMI .
HELTZE A.°. No. "O�e - 3 I `- "-
OWNER �
MA I L BUILDING I
nooaess 740 N. La Brea Avenue P.DDRES ��
z �p :
a U CITV LOS eles CA 90038 No � 937-217 TRACTV� LOT BLOCK j ��
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Z Q COKSTRUCTION , �
o N LENDER United California Bank �
am �
J N BRANCH Main Branch �
OWNER
m J ADDRE55 LUE � �
J a OR ENGINEEa Fields 6-Silverman TEL. 93J-217 •
V Q FIRE
W Q ADDRE55 113 N. S3R Vicente Beverl ti�11S ZONE TVPE GROUP �
aw
APPROVED
J O CONTRACTOR George J. Heltzer BV OATE .
m Z
�¢ nooaess 740 N. La Brea Avenue
W� W TE� Z NO.OF USE OF NEW 5 CpN��= �
Z� cirv Los An eles CA 90038 No• 937-2171 �3� Puras Z BUILDING G,R
0 STATE CITV �'ARDSAPPROVED VAflDSAPPROVED '
' N� uc. No. 3144 UC. NO. MAIN BUILDING ACCESSORY BUILOING
� 7O �FROMGISTREET)
SIZE NO.OF BLOGS.
OF LOT NOW ON 40T None ONT FT. FT. �
USE OF �
EXISTING BLDG. I Z FT 1
F 512E OF NO.OF { I
Z NEWBLDG. ROOMS STORIES 2 L SIDE � FT. FT. I
a EXTERIOR WA RDOF ? 1 •
V COVERING islaster COVERING REAR ✓O FT.D FT.
= USE OF BUILDING AND WOFK TO BE PERFOFMED DSTANCE BEf. , BET. MAIN $ i
a Reside ial MAIN BLDGS. ACCFSS BIDGS. I
a ����� ' CVRP.��C _fj �� qPPROVED(J ��D��J I
0
F APPFOVED
�
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O STA7c
i
V I �ereby acknowlatlBa thet 1 have raetl this eD0lication antl rtate �— �
� that t�e ebove informetion is correct enC apree to comply with
� ell laws reBulatinp building conrtruccion, entl I shall nof employ ,T�
� eny parwn in violetion oi x�e workmnn'� compensetiOn lewc Of �
y ffie State of Celitornia. /J m �
Z �
. I hereby certify ihat 1 em pro0erly licensetl as a conttactor untler ��SQ. FT. `��� ��'� o��_///���
the $tate ot California Business antl Professionz Cotle, Divlslcn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �C \
Chepter 9, antl <hat such licenses are In tull torce an0 efieCt, or 1 THE PURPO6E OF ESTABLISHING A P�RMIT FEE ONLV: \
am exempt from Me p�v' ions of tha State of CelHornie Busineas VALUATION '
antl Protessions Cotle, lon 3, Chaptar 9. N �
PERMff FEE $ 1 O ]
Sipnature ot �] m
Permlttae $ / J �DO P�qN CHECK $ /� � E
o` �
— Authorizetl ABent — ' _ — ' " " — -- _"" LL I
TOTAL FEE $ I
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Applicant to fill in all sDaces except those within neavy bortler lines anC zign all appro0��a�e tleclaralions.
CITY OF CQSTA MESA CONSTRUCTION PERMIT PERM NO. TRACT NO. LOT NO. UNIT NO.
��� �,. .,����, c.n � �a Q 9
Project Address �/ �
AppliCdnt'sMailingAddl255 �� GJP�YO � TVPEOFCONSTRUCTION NEW ADD AITERATION PAIR
r� � ❑ CONVERSION ❑ OEMOLISH ❑ OTHER A p *,
Owner's Name hone,�• � 39 DESCRIPTION OF WORK/USE OF BIDG.
Address � - S Main Buildin9:
Areh/Eng. License No.
Address —
Contractor's Name �Phone
Address (m� I'ngl n � �7 J�
City Licenw No � � ✓.
LICENSEO CONTRACTOR DECLARATION
I hereby a/firm [nat I am licensetl untler provislons ot Cbarte� 9(commentin9
with seciion ]000) ot Division 3 0l tne Business antl Profeszions Cotle, antl
my license is in /uIl ntl elfect.
License la 'c se
(.�'�ate ` � Signa[ure '
� JHKERS' COMPENSATION DECLARATION
.�ereby aifirm that 1 nave a certi(icate of consent to selt-insure or a certiticate
� of Workerz' Compenzation ,Insu�ance, or a cer8fietl copy the�eo( ($ecti n
r 3800, Lab. �,j���/���/ p� Company
� Policy No. ��
rtifietl copy is �e�eby furnishetl.
Cer}itietlf}�p is tileG with the city in "o
Oatei '"� /r_� f}�� APPlicant
EXEMPTION FROM WORKERS' COMPENSATION DECLFRAT
(This sectian ne¢tl not be compleletl if the permit is for one huntlretl (S 00) or
less).
I certity tltat in M¢ pertormance of th¢ wOrk to� which tnis petm�t is i5suetl, I
snall not employ any 0¢�son in any manne� so as to become Subject to the
Workers' ComDensation Laws o( CaliPornia.
Date $i9nature
NOTICE: If, aiter making this tleclaration, you shoultl become subject to tne
Worke�s' Comp¢nsation provisions of th< Labor Code, you must fo�ttlwith
comply with such O�ovision5 or tnis pe�mit sltall be tleemetl revoke0.
CONSTRUCTION LENOING AGENCV
I M1ereby affirm lhat l�ere i5 a Const�uctlon lentling agency tor the pertormance
of th¢ work tor whiGh Ihis permit is IsSuetl (SeGtion 3097 Civ. CJ
Lentler's Name
Lentler's Atltlress
OWNER BUILDER UECLARATION
I bereby afflrm that I am ezempt trom [he Con[�actor's Llcense Law for ttte
tollowinq reason (Sec[ion 7031.5 Business antl Protessional Cotle: Any city or
coun[y wttiGh r¢qui�es a permit to consVUCt, aller, ImOrove, tlemolish o� �epair
any sVucturq prlor to its issuance, also requires the applicant for sucn permit
lo flle a Siqnetl Stal¢ment lhal ne/she is IicPnsetl pur5uant to ltte provisions of
'he Contractor'S License Law (Chapter 9(commencing witn Section 7000) ot
. DiviSiOn 3 of the Buziness antl Protession5 Cotl<) Or tnat he/she is exempt
,therefrom antl the basis for the allegetl ¢x¢mp[Ion. Any violatlon of $ectiOn
' ']031.5 by any applicant fo� a permit subjects lh¢ applicant to d civil
�enalty of not more Ihan tive huntlretl tlollars (E500).
LJ I, as owner oi the property or my employeez wlth wages as their sole
<ompensation, will do tne work, antl the zVucture is not intentleC or oHeretl
for sale (Section 7044, Business an0 ProfesSional COtle: The Contracto�'S
License 1. w tloes not apply to an owner of a property who builas or improves
thcreon, antl who tloes sach work hlmself/herselt or ihrough nis or her own
amployees, O�ovitletl tM1at su<h improvements are not intentletl or o(feretl for
sale. I1, howev¢r, [he bullding or improvomant is soltl within one yea� of COm-
pletlon, the owner wlll have lhe buttlen ot proving he/she �Itl not bui10 or im-
prove for lM1e purpose of Sale).
❑ I, as owner ot the property, am exUusively contracting with licensetl con-
IraGtors to construC[ [he project (Section 7044, Busine55 antl Professions Cotle:
The ConVactor's License l.aw does n0[ dPPty to an owner of properW who
builtls or imD�o�es thereon, antl who conVacts for such projects wlth a con-
tractor(5 M1cense pursuant to the ContraC[or's License Law). I am aware that
proof o� Ihei� Wo�ke�'s Compensa[ion Inzurance shoultl be pwvitletl lo me.
❑ I am exempt untler Sectlon B. & P. C. for this reason
Date Owner
1 hereby certify that I have rea�
Information is correct. I agree to
Signature � ✓/ / (ti�
Drivers' License or 55 � —
E
TV.PEOFPERMIT GRADING F,OUNDATION $TRVCTURAL T FfO�t
�❑ TENANT ❑ ELECTRICAL lidPLUMBING ❑ MECHANICAL B Rear
O OTHER A
PRWECT,DESCRIPTION SQ.FT. OCCUPANCV C Right
CONSTRUCTIONTVPE VALUATION$ g Le(t
ZONE � GRADWG CV. VDS. ACRES Ping. Ref. #
qemarki� Planning Notes:
Preventer
Irrigation
Dishwasher
Drinking Fountains -
Floor Drains
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
ReinspeMion Fee � $15
Boiler
Duct - Under Ground
Duct - SVucWral
Duct - Veniilatin9
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0-100,000 BTU � 100,000 BT
Reinspection Fee � $75
CMF 0865-46, rev. 30/84 White - Builtlin9; Canary - Applicant; Pink - Accounting; Goltlenrod - Assesso�
$IIOWEfS
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Wa[er Heater
Water Service
Auto�Wash
Laundry Trays
Isue Fee
Hood or Typel ❑
Canopy Type II ❑
Refrigeration System
❑0-100,000BTU ❑100,000
System Fepair/Alteration
Fire Dampers
Registers
Isue Fee
FEES
$ 3
FEES
$ 3
5249 2/17/61i
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. ❑ 50 + KW
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A. U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW �5�75 KW
Meter ❑up to 700 amps
Meter ❑over700amps
Su6 Panel
Mo[ors � 0.1 H P � 7 X- B
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
Sign
S[anding Sec[ions
Trash Compactor
Fee �$15 I I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By �
Application Issued 8y
5oq�' TL
FEES
$ 3
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SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ �—�— PERMIT
PLUMBING $ .J •uV ��UANCE $
PLAN CHECK 25% $ ENERGV P.C. 5
ELECTRICAL $ GRADING S
PLAN CHECK 50% S MICROFILM $
MECHANICAL S TOTALFEE $ �
PLAN CHECK 25% 3
CONSTRUCTION AND PLANNING POOL & SPA �
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
. �
1. Temporary Electrical $ervice or Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms R� ��
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressu�eTest
6. Electrical UFER Grnd. 57. APPROVAL TO COVER;G;UNITE
7. Footings • � � 58. Electrical ConduirUndrgr�nd
. r -', `_, .
8. Foundation 59. Gas Pipe, � Undrgrnd., T�st ,
,�,
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap;�O�Undrgmd.
10. Structural Floor System 67. APPROVAL TO DECK �'.:
7 7. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal
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 77. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑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 No<e5: Z.ya� �,�r-�v,eo. �,t,p
,
34. Final Heating & Air Conditioning �y �� ��C� L�
�S Pr�2 2a.3 u, ('G.
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace ' .
38. Final Plumbing ' . . � - `
39. Water Service-Final � .
40. Gas Service-Final . � �
� 41. Solar pomestio-Final � . -
42. Backflow Preventer � � .
� 43. Backflow Irrigation �
44. Landscape Irrigation System � •
45. Sound Attenuation � - �
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING � �
48r Specia� Requirements Completed �
49. Electric Release to Edison � � �
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY � . ,
No. Date '
, ,