HomeMy WebLinkAbout606 LASSEN LN - Building Permits�
•� City of Costa Mesa Pla�.��ing Department
Post Office Box 1200
77 Fair Drive
(�(] Costa AAesa, California 92626
� �iJ��o WJI�J� e (714) 55G5245
REQUESTFOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. �o� y� Date X-� /�—' ��
Lot No.
Address
The deyeloper of the above entitled tract desires to sell the above
set forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he, s4�e�theq)�(was o��l ,t—/�� advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the
City at the time the final tract map was approved.
The City assumes no liability for [he enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless
from any claim resulting in damage or personal injury to the undersigned by
reason of the atorementioned uncompleted condition.
By
By
ey
CMF 0569-26
111311RYiNE BOULEVARD,SUlT€ 210
TI6CTIN. CALlfORklli 92&80
AVVlicant to till in all spaces except those within neavy boreer lines antl sign all avPraoriate aeclarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT _, PERMir No.' ZS TRACT NO. LOT NO. UNIT•NO.
erojeccAddress � Oi. Lns�OrY�.. �L�� .
ApplicanYS Mailing AddreSs ���-0� 1� 1(�](�1�C� TYPE OF CONSTRUCTION � NEW /aDD ALTERATION REPAI R
-- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner's Name ��"�'�"��n ���1 �q�1 Phone _ DESCRIPTION OF WORK/USE OF BLDG.
Address ��� l--r�-SS2K'� �--h
Arch/Eng. License No. � -
Address
Contrecmr'sNam o�,�,,.� o '� �3
Addresslmailing) ����� , `\O'l1QJ�C��1 CS -�J" � �
Ciry License No. 3 � � �3
LICENSED CONTRACTOR DECLARATION �
I heteby atfirm that 1 am licensetl untler provisions ot Cbarter 9(commencin9
with sec[ion ]000) of Division 3 of the Business antl Professions Cotle, antl
my license is in fu force antl eftect. ��
LICE052 �Id55 � � LIC C - � �O�
Date ' � — ' Si9nature ��n�� � � � �0.� r �
WORKERS'COMPENSATION OECLARATION �
'.herebypffirm that I Itave a certiflcate of consent to selt-insure or a<ertificate
! Workers' Compensatlon Insurance,-or a certitietl copy thereot (Section
,800, Lab. CJ n n
PII��olicy No�%C-���1y�,� Company�� ^���C1-h
�ertifietl copy is hereby furnish¢tl. ;
ertifietl copy is filetl with the city BuilQlpg`f�ivisie(r
Date APPlicant T`— � �
E%EMPTION FROM WORKERS' COMPENSATION DECLARHTION
(This section neetl not be completetl if [he permit is for one huntlretl ($100) or
Iess).
I cerfify lhat in the pe�fo�mance o( th¢ work for whlch Ihis pErm�t is issuetl, I
shall not employ any person in any manner so as to become subject to the ,
Worke�s' Compensa[ion Laws of Califomia. , , �
Oale Signature
NOTICE: If, after making this tlecla�ation, you shoultl become subject to the
Wo�ke�s' COmpensation provisions of the Labo� Cotle, y0u must forthwitlt
comply with such provision5 or. ttti5 permit' SM1a11 be tleemetl revoketl.
CONSTRUCTION LENDING AGENCY � •�
I hereby affirm that there is a construction lentling agency Por the performance '
ot the wark for which. [his permit is issuetl (Section 309] Civ. CJ
Lentler'S Name=' �
Lenaer's Atltlress �
OWNER BUILDER DECLARATION � � �
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business ana Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, aemolish or repair
any structure, prior to its issuance, also requires [he applicant for such permit
to file a si9netl statemen[ that he/she is licen5etl pu�suant lo ihe provisions ot
the Contractor'S LicenSe Law (Chapter 9(commencin9 with Section 7000) of
OiviSion. 3 of tM1e Busine55 antl Protes5ion5 Cotle) o� that ne/she is exempt
ierefrom antl the ba5is fo� the allegetl exemOtion. Any vlolation of Section
031'.5 by any applicant for a permit subject5 the applicant to a civil
�endlty of not more than five huntlretl tlollars ($SOOJ. -
LJ I, as owner ot the property or my employees with wages as their sole
� compen5ation, will tlo the wo�k, antl the SVucture i5 not intentletl o� otteretl
for zale (Section ]044, Business ana Protessional Code: The ConVactor's �
License Law tloes not apply lo en owner of a p�operty who builtls or improves .
thereon; antl who'tloes such work himselt/herzell or through nis or her own
employees, provitletl thal such improvements are not intentleE or offeretl for
sale. If, however, the builtling cr improvement is soltl wilhin one year ot com-
pletion, the owner will, have the burtlen ot proving he/she tlitl not build or im-
�rova forthe purpose of sale).
1, as owner ot the property, am exclusively cont�actinq with litensetl con-
tractors to construct tM1e project (Section 7044, Business antl Professions Cotle:
The Coniractor's �icense Law tloes not apply [o an owner of property wha
builtls or improves thereon, antl who mnt�acts for such projects with a con-
tractor(s1 license pursuant�to the�ConVactor's License Law�. I am aware that
proof o( Ibei� Worker's Compensation in5u�ance shoultl be P�ovitletl to me..
❑ I am exempt untler Section � B. & P. C. for this reason
Date Owner
I hereby certify that I have reatl this application antl state that the above
information is correcL 1 agree to comply with all city antl.county ortlinances
antl state laws relating to builtling st�uction, antl hereby autha�ize repre-
sentative ot this city to(((ll���[� ter p n the above-mentioned oroperty (or
inspecti�u�osps�^ \\,� h - ` \_1 —
Signatu Q�J.U._�+-M) v� � oate�
orivers' �icense or 55 � '
TVPE Of PERM17 , LJ GRADING LJ FOUNDATION IJ STRUCTURAL
❑ TENANT �y�� ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER �
PROJECT DESCRIPTION 54. FT. OCCUPANCv
CON STRVCTION TVPE VALUATION $ _
20NE GRADINGCU.VDS. ACREi
Remarks: � �
Bar Sink
Backflow Preventer
Backflow Irrigation
Clarifiers
rinkin9 Fountains � �
loor Droins'
loor Sinks '
as Service ,OuNets
lavamries
P—Trep
Roof Orains
Reinspection Fee � $15
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating .
Exhaust System ❑ Multiple ❑
FirepUFact Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 sru O i oo,000 eT
Reinspec[ion Fee � $15
CMF 0865�46, rev.4/84 White - euiltling; Canary - Applicant; Pink - Accounting; Goltlenrotl -Assessor
PLUMBING
Showers
" Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal'
�WaterCloser - '
. Water Heater
Water Service
Issue Fee��
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑t00,0008T
System fiepair/Alteration
laue Fee
FEES
$ 3
$ 3
A.P. #
S Main Building:
E
T Front
ARear
C Right
K Left
S
Ping. Ref. #-
Planning Notes:
Auromatic Washer ' �
Construction P.ole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electtic
Fan �
F.A.U.
Fixtures
Device Boxes
Outlets
1929 IIL08/84
Zone -
Accessory Building:
Parking Req./Provided
ELECTRICAL '
Transformer ❑ 15-50 KW
❑ 50+KW
� Meter ❑up to 100 amps '
Mecer ❑over100amps'
Sub Panel
Momrs �41 HP �i �- 8
' Inc.Solar �9-15 HP �i6-15+
Microwave -
. Pole Liglit
fiange
Garbage Dispoul I I� Standing Section:
Generator DO-5 KW �5-75 KW Tresh Compactor
I Reinspection Fee I$15 I I luue Fee
DEVEIOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
euilding Approved By �-y��y�
Application Issued By�,IJ""��
6�OU •TL
FEES
$ 3
Z
O
N
1
N
G
R
E
Q
M
T
5.
SUMMARV OF FEES '
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ �� ENERGY P.C. $
EIECTRICAL $ OlJC7 GRADING S
PLAN CHECK 50% $� MICROFILM 5 �p+,.�,.�
MECHANICAL � $ TOTAL FEE $ _9 � C
PLAN CHECK 25%' $ �
. CONSTRUCTION AND PLANNING • POO. ;PA
� APPROVALS Permit#����+,/�'S Date� Inspector pppROVALS 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, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. _ � 60. Backwash Lines, P-Trap, O 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 OGas' ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank 0 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 .j ag � �1 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
41. Solar pomestic-Final
42. Backflow Preventer • �
43. Backflow Irrigation .. ... . . '
44. ,Landscape Irrigation System ' .
45. Sound Attenuation � �
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING '
48. Special Requirements Completed '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date -
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
For Applicant to Fill :n Completely — Use [nk Only
owN e a�[/ECt2/E2 C�/Tf/1P?ilEl- �1
MAIL / 2'—O �/, ��% L/[.E�.
ADORE55
CITV L'LL G/I(J.�A� NOL
BRANCH /v�y���
ADDRE55
ARCHITECT TEL.
CONTRACTOR (p �Q rf��P��IL
AO�RESS
TEL.
CITY NO.
��IC.NO. G/�/!�S LICyNO.
51 Z E I NO. OF BLDCS.
pF LOT NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
elec[ric, plumbing and heating work.
USE OF BUILDING AND WOFK TO 8E PERFORMED
_::nn;53-; ...:: rZ%.:
APPLIC:�7'ION �OR STRUC7URAL PERMIT
RECEIVED BV DATERECEI ED DATE ISSUED
- D-
A.P. NO.
/ -O - O/ P
A�oaE $!o�-do8 e� (La�s�4� .
TRACT LOT /' BLOCK '
NEW A D A T R R P I
rv
��
APPPOVED
OVALU$ /��QO /�
(!
i GROU�
DATE fl �1�0/��
f1E � NO.pF USEOFNEW S (�
j �G P�� Z BUILDING
VARDSAPPFOVED YARCSAPPROVED
MA�N BUILOING ACCESSOPY BUILDII
iOM C/L STREET)
DISTANCE BET.
MAIN eLDGS.
VAF. qW i�r.
C_U.P.aIE j
r^.'� Y^_. _..
. �v : ... � ti..
BET. MAIN &
ACCE�. BLIX3S.
DATE
APPROVED
f�
I hereby atknowledge thet I he�e reetl [hls appllcation antl sYate �^
n
that the above information is Corract and egrea to tomply with m
all laws regulating builtlinB conrtruccion, and I shall not employ
any parson in violallon ot fhe workmen's compensation laws of m
the Stata of California. �
I hereby cartify that I am DrapBrly Ifcensatl as a conttactor under SQ. FT. N
the S2ata of California Bus(ness entl ProfeRions Code, Division 3, THE AMOVNTSHOWN UNOER VAIIIATION IS FOH m
Chapter 9, antl tnat such licensas are in full torce antl effect, or I THE PVRPpSE OF ES7A9L6HING A PERMIT FEE ONLY: �
am exemot lrom the OrOvisions ot t�e5tate of Calitornla B�siness VALUATION PERMIT FEE ) a
antl Profassions Cotle, DivisiOn 3, Chaptar 9. s L i � N
/ ♦ /K ���� / PLAN CHECK E �
Signature o4 y �/ O� /j<� ` 2 • l LL
PermiRee �� �L g���OO� TAX E S �
/
Avchorizetl ABont
TOTALPAIO E %�� �� u
9
vnrv�n �LTZER ENTERPRISES . � uA�e g-20-76
JOB ADDRESS 600-608 Lassen Lane BUILDING PERMIT N0. 42516
APNo. 41A-071-01 LOT TRACT FIRE ZONE VALUEE 195.000.00
soa '�`�" SUBCONTRACTOR
cns � "
W4TER (/ u} ,7-S li . � �+.71 Pfumbin
ROUGMPLUM9ING i^.�7 7.� R...L n�...�'rL _
SPRINKLING SVS�GM
MISCELLANEOUS
ROUGH MEnTING AND AI CON�ITIONING
TEMPORARY SEFVICE OR POLE
UNOERGROUNO � P�WER �
ROUGH WIRING
TRENCHES I� FORMS STEEL REINF.
FLOOR SVSTEM /L��` (�((-YL
BONO BEAM I I STEEL REINFORCE
SHEATHING C $ -i�
FRAME AN� FLA5MING - ' � . �.
LATHlNG — IN OIIT �
PLASTER, BROWN COAT G -
STFUCTURqL FINAL '
HEATING, VENT., REPPIG. ANO A.C., FINAL '`%
PLUMBING. FINA4 AND GAS TEST i. KIJ tF'�I�I
ENTS
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