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HomeMy WebLinkAbout2809 LA SALLE AVE - Building Permits • w M CITY OF COSTA MESA ? I:4111111 BUILDING DIVISION • , :4„' DEVELOPMENT SERVICES DEPARTMENT PERM NUMBER 4• PERMIT ' ., oA`° P02-00756 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2809 LA SALLE AV Status: ISSUED Suite No Applied: 12/20/2002 Issued: 12/20/2002 Vicinity: Parcel Nunmber: 14167209 ISSUED BY: Applicant: PAUL KAMINSKY''- v ^� Address: 11612 KNOTT ST," , , Phone: (714)895-1246. ' V,; ' -:-`., V GARDENGROVE,-CA- _ _ Zip: 92841 - ��� Owner HIMMER;-ADOLF:TR ' 7 �� \ Address 2809 LA SALLEAVE �`� --,V;-:•'• / ;, v Phone: \' A - ' , - ' COSTA MESA,CA Zip' 92626 • `�` •'�_� - Contractor• ,'.-NOCK PLUMBING %. ' , Address: ., 11612 KNOTT ST; " , --. .• �. - _ Phone :(714)895-1246 , ' _ A ,/'\ ' \ GARDEN GROVE,CA Zip: 92841 . \ ' 1 _ - License: 707775 V - - r `- .,Arch / En / - � - _ 4 /. \� - . Address: .s • .� Phone: i 1y/' _License: > �,' �- . - SCOPE OF PERMIT', ' o " INSTALL NEW WATER HEATER ' - ' v ��FEE'SUMMARY �'j'% '- �� AMT., QTY ? AMT :,QTY '�� � ' _,'AMT QTY ISSUE FEE`''' - ' $23.50: ' ' .1*--,-*.- Laundry Tub/Washer moo., ''-0 _ 1;yi Sump Pump ' C ' , $0.00 0 Backflow irrigation. ,$0:00 N.y0 , Landscape Irrigation- ' $0.00 0 Swimming Pool /$0.00 0 Backflow Preventer (.$0:00-, 'CrP-Trap -,i $0.00 0 -- Trap Primer ' v $0.00 0 Bathtub `, N ;$0.00 ' 0 `,-` Pressure Regulator - $0.00 '0 - Urinal' /, ,7 ,/ $0.00 0 Clarifier System y v v`, $0.00' 0 Process Piping(per 10 ft) $0.00 "0_ „ Vacuum Brkr Bkflow(1-4) $0.00 0 Connect Ice,Soda,etc \ - ` ( ) ,`$0.00,--, 0 , Receptors�� $0.00 -_ 0 - --` 1, Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units \ $b.00 "- b • Septic Tank - $0.00 0_ , v Wash Basin"v,,/ $0.00 0 . Dishwasher `$0.00'', 0 - , , Sewer Cap for Demo .. $0.00 ' 0"' ' Wash-Basir.Set $0.00 0 Drain,Floor $0.00, 0. Sewer.Connect - $0.00 0 Waste'and Vent System $0.00 0 Drain,Rainwater $0.00 ' '0 Sewer Private Liner $0.00 .0 . ;;Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0- - Shower ' . . - $0.00 ,0 ' . Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar _ . .$0.00, ,.0 _ - Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial - - $0.00.. - 0- " Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor • - " $0.00 0 Water Service $0.00 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) • DECLARATIONS \rJ WORKERS'COMPENSATION DECLARATION: 1, I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carder: —7,4e ,'vto'€ do,t Ora- Nr 2 Policy Number: se 7/kzxD.71 o0 (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensafioa.lawe-oFC7m mla agree that II I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pjiMr[on Applicant Signature: / Date: rZ •2 0 •612— WARNING: 2,WARNING:FAILURE TO SECURE WORKERS' • TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED TFIOUSAND DOLLARE(5100000),IN ADDITION TO! •• T OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Li —7Q�7-7"7 r Class# 036 f//d/ Contractor's Signature: 1. Date: r2 • 7 o•o a CONSTRUCTION LENDING AGENCY: b ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to tile a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more then thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Dees or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? ❑Yes d No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I ogre omply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above- nbed pr party inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. gnature Of Legal Owner(s) Date �Z •Z o . o z - • d/Or Authorized Applicant Date ;ODE# , • ni•. I PAH MEALS CODE# INSPECTION TYPE RAIl J 1616 Fixed Syste inal Fir: Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -1'7 '173'a3 (J e _ 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ - •_ rte- _ __. ___ 'CITY OF-COSTA MESA. • CONSTRUCTION PERMIT PERMIT NO. i TRACT NO! LOT NO. U-NIT;NO. I 1 - ' �� - = Project Address 2809 LaSalle, Costa Mesa Q 2.0 Z�' ' + rr 11 ISI ' ' - ppp ++��rr 4Applicant's Mailing.Address /•26 Commercial, C.M. 92627 • TYPE OF CONSTRUCTION ;❑ NEW Li ADD 0 ALTERATION ❑ REPAIR' - ',7824 B/�� �yJ • •CI:OAF!_ 'Tl - _❑ CONVERSION ❑ DEMOLISH ❑,OTHER • ' - I • Owner's Name James Yamanaka Phone S2F6-'8725 • ' ' - .' - - A•P.'#• • -, , -- - • _ (Zone - I - DESCRIPTION OF WORK/USE OF BLDG. „r Address 'AR6x�aaom�xsx�J�xW� 9809 LaSalle; C.M.'= Re-roof with Class A fiberglass sh pg/es 5 Main Building: • Accessory Building: .Arch/Eng. ' - ' • . License.Nd. . ' - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION LJ STRUCTURAL , 'T' Front - - - • 0 • Address -- ' • . . • ^ ❑ TENANT ❑.ELECTRICAL• ❑PLUMBING ❑ MECHANICAL ,B _ - • N Rear- ' Contractor's NameCrnnk Rrh. Rfg. Co. ' - Phone 548 5569 ❑ 'OTHER - - _ A•- ' '7 PROJECT DESCRIPTION SQ. FT. 9 600 - OCCUPANCY C Right ! N Address lmailing)I 196'-CommereVal Way. Costa Mesa K” - - G CON ST RUCTION TYPE VALUATION$/{,R59-nn ,S Left City License No. 005999 a ZONE - GRADING CU.YDS.; • - ACRES e - R - Ping. Ref. #1 Parking Req./Provided - • E LICENSED CONTRACTOR DECLARATION j ' - : ` - - ll I hereby affirm that am licensetl under provisions of Charter 9 (commencing ,Remarks. - ' , -Planning Notes: I ; _ ! - M ,with section 7000)-of Division 3 of'the Business and Professions Code, and ' • In • • I T my license is in full force and effect. '677 ' ` ' r • 1- S ((((yyyy��11 -License Class C-39 J - License r %. y3 'Date' • ^B/1/R5 - Signature . e'e i_, •r PLUMBING - FEES ', : • • r I 1 1 1 '^'OR KE RS'COMPENSATION D ARATIOIV 1 reby affirm that I have a cerbate of consent to self-Insure or a certificate + Bar Sink Showers ELECTRICAL FEES • workers' Compensation I -•ranee, or a_certified copy thereof_(Section - I _ _ _ Backflow Preventer - Service Sink - - - -' - - ' X00, Lab. c.))��� Automatic Washer Transformer ❑ 15-50'KW- Policy •No. PC/Cl 184462 Company • Home • Backflow Irrigation - j ❑ 50+ KW • Certified copy is hereby furnished. g Sewer Cap. Construction,POle Sub., - - •Certi 1¢ is filed with the city illi DI Bathtubs Sewer Connection Cooking Unit Meier Dup id 100 amps Date d/ Applicant -urar`�c �PB�. Roofing Co. • • • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers 1 Solar Collectors Dishwasher _' Meter Dover 100 amps - .,.. , (Thissect:on need not be completed if the permit is for one hundred($100)or; - less). . Dishwasher, Solar Piping Dryers ❑Gas ❑Electric Sub Panel ' I certify that in the performance of the work for which this permit is issued, I , • shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank: - - Fan ' Motors❑0-1HP ❑1,• .-B workers' Compensation Laws of California. • Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑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 - - -- - — - - - - comply with.such provisions or this permit shall be deemed revoked. UriOal Fixtures Microwav¢ I CONSTRUCTION 'LENDING AGENCY Gas Service ' Outlets Water Closet • Device Boxes Pole hereby affirm that there is a construction lending agency for the performance - Li ght ' of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors -. Outlets Water Heater' ' ' Lender's•Name - - Range Lender's Address Kitchen Sink' • - - Water Service . ' ' Switches Sign 1 OWNER BUILDER DECLARATION, - • I hereby affirm that tam exempt from-the Contractor's License Law_for the Lavatories -.Auto-Wash Garbage Disposal ;Standing Sections 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 - • Generator ❑0.5 KW 05-15 KW Trash Compactor -any struct use, prior to its issuance, also requires the applicant for such permit - - P , 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 ' vision 3 of,theBusiness and Professions Code) or that,he/she is exempt - - I - refrom and the basis for the alleged exemption. Any violation of Section , - • • t , - •' • ' 31.5 by any applicant for a permit subjects the applicant to a civil ' - - - - ' • . penalty of not more than five hundred dollars($500). , + - • . 7 0 f, as oWner Of the property or my:employees with wages as their sole ' Reinspection-Fee I $15 , $ 3. 1 Issue Fee , • - - • , 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 ' ;F.EES . , 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: femployees, provided that such improvements are not Intended or offered for Boiler • •- Hood or Type I 0 - sale, If, however, the building or improvement is sold within one year of com- , - . . - . Canopy Type II 0 , Zoning Approved,By— • Date • pletlon, the'owner will have the burden of proving he/she did not build or im-, ' Duct-,Under Ground -- Building Approved By Date ' prove for the purpose of sale). - ' 0 I, as owner of the property,am exclusively.contractiriq with licensed con-' • Duct-'Structural Refrigeration-System �' Application Issued By' - ' Date// 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 ❑100,000 BTU -_ . . SUMMARY 0 FEES 1 -builds'or improves thereon,and who contracts for-Such projects-with a can- ' tractor(s) license pursuant to the Contractor's License Law). Ilam aware thatBUILDING PERMIT $ • '&O SMIP • $ _ -' f Exhaust System 0 Multiple 0 System Repair/Alteration , proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ am exempt untler Section B.& P.C.for this reason, Fire I/Fact,Bit. ICBG# Fire Dampers I 1 P I • PLUMBING $ , ISSUANCE $ I- Date Owner I • ' Heating System& Ductingi • Registers , • PLAN CHECK 25% $ ENERGY P.C. $ •_ • I hereby certify-that I. have read-this application and state that the above" ' -- ❑0.100,000-BTU 0100;000 BT -' -' '- ELECTRICAL $ ;GRADING ' $ '_ information is correct. I agree to comply wit. I city .nd county ordinances - and state law. elating to buildin• constr ..pr, and .ereby authorize repre- j MICROFILM $ sentatives of is city to•ente .•o e a•.ve- boned sop ty f PLAN CHECK 50% $ • inspection pu a�. / }' MECHANICAL $ I TOTAL FEE • $ Zle •Sc_..) Signature •.`/ _ XT's Dat 1 I Drivers' Lied(- or SS 9F � r Reinspection,Fee ,$15 Issue Fee $ 3; PLAN CHECK ; 25% $ , 1 I CMF 0865-4fj, --v.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor V CONSTRUCTION AND PLANNING I POC 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-Undrgrnd. - 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System61. '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 ElectricNotes: . 34. Final Heating Si NI.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 Domestic-Final 42. Backflow Preventer ' 43. Backflow Irrigation - - - 44. ,Landscape Irrigation System - .r 45. Sound Attenuation 46. Handicap Regulations . - 47. FINAL STRUCTURE& BUILDING ,Q,((5/81" . fre,....---: _ - ; 48. Special Requirements Completed /J}�' 49. Electric Release to Edison ' _ _ _ _ , 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY . . . . . _ . No - •• Date • -_ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 8227 12/04/86 '. . __ _- . .. __ _ _ .. . .- _ _- - - PERM O. TRACT NO. PLOT NO. _ . 1- '._ I - I • ' .-5.)00_ "TL CITY-OF dress MESA p9CON�R CTJq�PERMIT —26,41 • Project Address '�I� _ Q n //� TYPE OF CONSTRUCTION ❑ NEW L I ADD, LJ'ALTERATION lid'REPAIR i - ' ' Applicants Mailing Address 4 !Q* ( /, ' ❑ CONVERSION • ❑ DEMOLISH ❑ OTHER Owner's Name e { - _ A.P.#_ .. _ _ __ .. _.t Zone _ __.- >/1 .�� a.�. Phon2-� - -i I' ,DESCRIPTION OF WOR K/USE OF BLDG. ' Address ' +'�� 7; z(�J S Main Building: - Accessory,Building:i• , Arch/Eng.' License No. TYPE OF PERMIT d GRADING• • , i6UN DATIora ❑ STRUCTURAL E Front + • O i • • ❑ TENANT .❑ ELECTRICAL Lfr*LUMBING ❑ MECHANICAL B , N Address -• p r/,� • : I Rear • I�� + ��i' Phone R 1`-/�(iQC ❑ OTHER • ' A Contiactor's Nam •t. "C• Right . "` N ' j ' ' PROJECT DESCRIPTION SQ. $T. . OCCUPANCY K I G Address(mailing) /t - CONSTRUCTION TYPE VALUATION$ • s Left ' City License No. 1 )U/-O ZONE- - ' GRADING CU.YDS. ACRES Ping. Ref. # , 'Parking'Req./Provided E ' LICENSED CONTRACTOR DECLARATION' • - _ •- I hereby affirm,that,' am licensed undor'provisions of Charter 9 (commencing Rebiarks:" - 'Planning Notes:; _ M with section 7000) of Division 3 of the Business and Professions Code, and _ - - -- - - - - ' my license is in f.•• fyrceand effect. ' - --'� • C( . - - - • RECFIVED License Cl.s / e �CC;ui 2 lu86 . s Op Date ..3L •Signature�L�� '� _ / {. ^ PLUMBING t I ;FEES I - ) WORKERS'COMPENSATION DECLARATION Bar$ink' • 'ShOW¢R ' •reby affirm that I have a certificate of consent to self-insure or a certificate _ - - - • { ELECTRICAL FEES • t Vorkers' Compensation Insurance, or a certifie copy thereof (Section •- - - ,�! I Backflow'Preventer -Service Sink' . -- Automatic Washer ' Transformer ❑ 15-50 KW - i - PolicyNoS11 1 Com an -' - • I ! ! 1 J0, La l 7a" p v ,fit MCHC-Ly" Backflow irrigation ;Sewer Cap I • Construction Pole Sub 0,50+KW ertified copy is hereby furnished. Y - r is CerJ�'f'e is Vile with the city a/u�(/�Inpp�'i/u/15/q�r/s/��/� Bathtubs` - Sewer Connection - • Cooking-Unit - ( Meter ❑up to 100.amps - :,,i Date / Applicant r>'1�%' 1 LY'"L. /' •`-� - - - - - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION . Clarifiers ,,, - . -Solar Collectors Dishwasher 1 Meter.❑Over:100 ampi,, ' ' , (This section need not be completed if the permit is'f or one hundred ($100) or • - less). i Dishwasher - - • . I Solar Piping_ ; Dryers ❑Gas- ❑Electricl Sub-Panel- _ I I certify that in the performance of the work for which this permit is issued, - - 1" -' shall not employ any person in any manner so as to become subject to the Drinking Fountains' • ,Solar Tank • Fan „Motors❑0-1.HP ❑1'/-81 ,. j Workers' Compensation Laws of California. - - i : ' Date Signature • - - - . ' r Floor Drains.) , ' , " ' ' Swimming Pool w/Spa • • nc. ❑ Solar 09-15 HP 16X15+ " • I. -NOTICE:At,after-making this declaration,you should become subject to the ._.— - - - - _ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • t Urinal Fixtures ' i i • comply with such provisions or ,this permit shall be deemed revoked. Microwave ' , CONSTRUCTION LENDING AGENCY I Gas Service Outlets Mater Closet • ' i - Device Boxes r • ' I hereby affirm that there is a construction lending agency for the performance' - - - i Pole Light • of the work 'for which this permit is issued. (Section. 3097 Civ. C;) - • Interceptors -Water Heater Outlets ! Ran e 1 Lender's Name • - f - a 9 ' . Lenders • .Address ' - Kitchen Sink ... _'__. ._ ...Water Service , - -i - Switches -- : - - - Sign '-'_c _--` _ -- ' OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's'License-Law for the Lavatories .Auto-Wash Garbage Disposal • Standing Sections 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 Generator ❑0.5'KW ❑5-15 KW ` • • any structure, prior to Its issuance, also requires the applicant fe h permit Trash Compactor i to file a signed,statement that he/she is licensed pursuant to the provisions of ROOF Drains I ) the Contractor's License Law(Chapter g with Section 7000) of i , - "vision, 3 of-the-Business-and Professions Code) or-that-he/she is exempt - - - - .--- -- -- -- • - - - - - - rehom and the basis for the alleged exemption. Any violation of Section 1 , - i I - I I I • 11.5 by any applicant for a permit subjects the, applicant to a civil - ' • -natty pf not more-than five hundred dollars ($500). ' ' . , I 0 i, as.owner; of the'property or my employees with wages as their sole Reinspection Fee . Il $15 ! • ,Issue Fee. $ 3 • JI - - ,compensation, will do-the work,and the structure is not intended or offered - - Reinspection Fee ; .I.$15; Issue Fee :4' : $ 3 ,for. sale (Section..7044, Business and professional Code: The Contractor's - • MECHANICAL FEES - Licensee'Law does-not apply to an owner-of a property who builds or improves __ >- 7 ! '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 Boiler ' Hood or 'Type I ❑ - •sale. If,-however,_the building or improvement is sold within one year of com- - Canopy 'Type II 0 , - Zoning Approved By I •- Date •• *- pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under-Ground - ' ' I tr ' I prove for the purpose of sale).: - - Build ing'Approved By f DateI,/ ❑•'',as owner of.the property, am:exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By •- • - ' " • -• ' Date /2" -•10 FJ tractorsto 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 - i ' 00=100,000 BTU ❑100,000 BTU : • - , . I '-SUMMARY OF FEES • - • t ' builds or improves thereon,and who,contracts for such projects with'a con- • _ ,tractor(s) license pursuant to the Contractor's License Law). I am aware that- t : BUILDING PERMIT $ SMIP $ of Exhaust System ❑ Multiple4❑ , System Repair/Alteration - _ proof their WorkeCs Compensation insurance should be provided to me.. I _ •- - PLAN CHECK $ /'- • .PER - ❑ am exempt under Section Bi& p.C.for this'reasoin - Firepl%Fact.Blt.-ICBO• •# Fire Dampers J PLUMBING $ ,_ r --ISSUANCE - $ t `µ Date - 1— ` - owner' - ' , '- ' - . .: Heating System & Ducting- Registers ' - i t PLAN CHECK 25%. $-- ENERGY P C- $ `_ -I hereby certify •t hat I have read this application and state that the above ', - Do-WO 000 BTU ❑100,000 BTL, - I I + .GRADING $ • •• • ' ,information is correct.-I agree•to comply with all city and county ordinances,- - ' • - ELECTRICAL $ - , and state laws relating to building construction, and hereby authorize repre-, i - -• MICROFILM - $ ,r. - i Sr Isentatives or this-city,to enter,upon the abve-mentioned-property for- • - - PLAN'CHECK 50%` $ _ inspection p es// p/ 2 '' - - - . MECHANICAL ; $ •TOTAL FEE +3i $ -s--06) OU - Signature //A - te / . Date/ , .. 't c. .•1 ! '.Drivers' Licenhe or --J2Vl " i Reinspection Fee , '$15 • ' Issue Fee c $ 3 ; PLAN CHECK 25%- $ I • ' 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 • n� 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-Undrg nd. - 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test - . 9. Water Pipe-Undrgrnd. 60. Backwash,Lines, P-Trap, OjUndrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK :ls 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/SPASYSTEMS 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 O 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 PREY. FINAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED ' - 33. Final Electric Notes:y{e(}j] /it &isle Antic z.,6.0 34. Final Heating & Air Conditioning 47 Lgnat As PSI jai k gm. L - . 8.X 35. Final Gas Pipe-Test 7 36. Hood or Canopy • 37. Final Factory Fireplace - . 38. Final Plumbing . . '39. Water Service-Final • 40. Gas Service-Final • - 41. Solar Domestic-Final ' 42. Backflow Preventer . :43: Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . _ 47. ,FINAL STRUCTURE & BUILDING 48. Special Requirements Completed. - 49. Electric Release to Edison . 50. Gas Release to.Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY No Date , OWNER 11ESA DEL MAR O. ' DATE 940-63 JOB ADDRESS 2809 La Salle Ave. BUILDING PERMIT NO. 205211 ._ GENERAL CONTRACTOR Mac co Realty Co. VALUE $ 20,288.00 " . AP No. LOT 6 TRACT 5252 FIRE ZONE 3 DESCRIPTION OF WORK Res:&At.ria r. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE El Soil IfC /0-3-4?q7'' PERMITS ISSUED Gas " / SUBCONTRACTOR DATE NUMBER Water e161/opt J-h /7-c-O� .. Rough Corn. Refrig. Air Cond. 0 Rough Heating /2.73-x:7 ` ) OCT 2 1963 �,a}�ri h Rough Plumbing /2 -943 ;(c(r-� ��Tir 1963' ,Tt'e'D`�31\4 Miscellaneous '4 — Prop. Swr. Line 0 House Con. 0 St. Swr. 0 Va p-.v io-� .0 y �, OCT 2 8 1963 ' Ptd 1,-43 Sprinkling System ✓(r_1--.- 3-/-/-.6 y, 1 lc'__e-------OCT Construction Pole /Lz� //AL.C3 /p ,,,,'.J /i-/3- b3 . 7 ti 33Ibx Underground Li Power 0 ��(g Rough Wiring /a-h2-15 -2/5- Trenches Forms:g-- Steel Reinf. Q.,' / .7 o -6s Floor System �'d-1/-63 Bond Beam 0 Steel Reinforce 0 _ Sheathing /11S - /9-3- c') Frame and Flashing /P,y-tf n---/K-63 Lathing- In.©- Out Lg! Jr, 9 i9.. -c3 Plaster, brown coat if',s d /-"74-1-y Refrig. O Air Con. ❑ Final Heating, Final ,. •✓ 3---z—&-v Plumbing Fixtures, Final Pit--;,,,,_s 3-/a-Cy Final Gas Test /;h ..?-/d--6v Electric Fixtures, Final B 3-//-Cy i_____ Building, Final '"..- - 3-4.1.-E;y OCCUPANCY r Form BU4-6M-3-63—S-B P FEE RECEIVED 20524 • SEP 1 0 1963 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS ,72.07 AA- 54[Zr' A I/E COSTA MESA. CALIFORNIA.: For Office Use Only r RECEIPT NO. PERMIT OWNER. Mesa Del Mar Development Co. R_MIT NO."f 1 MAIL RECEIV O B TE �C81V �E 19Y8bpy ADDRESS 3800 E. Coast Highway /p ,� 5L� i CITY Corona Del Mar, Calif. No:Or.34220 BUILDI 5 ARHITECT ORENGINEERMacro Realty CO. 2NO 0 COSTA MESA. CALIFORNIA ADDRESS 3800 E. Coast Highway FIRE ,�jJ ZONE TYPE 'GROUP\ CONTRACTOR Hi=o Realty Company APPROVED BY DATE ADDRESS 3800 E. Coast Highway ZONING / ZO E NO.OF USE OF NE '(•t � " CIT"(�nTT1DA Del Mar California / PLANS I BUILDI�_ LIC.STALEGAL 9E 808-SB 1 TNO.20g39-SB-1 TNO. DESCRIPTION Lot #6 - Tract 5252 98 SIZE _ NO. OF BLDQ o OF LOT 72 x in NOW ON Loa q,P.NO. USE OF NOneYARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM , (CENTER LINE ST.) ,n CENTER OF STREET 0! REAR YARD 2811e FRONT 5 V FT. IN. • SIDE YARD I LEFT 5'6" I RIGHT 51 C/ R.SIDE 0 FT. IN. DESCRIPTION OF WORK' L.SIDE /S FT. �/ N. NEW I I II ALTERATION I -II ADDITION I REAR - - A FT. / IN.// z . REPAIR I IIMOVING II DEMOLISH I BYPROVc D ,AT/E ( 'J SIZEBUILDI 1811%5412" ROOMS NO. OF 6 STORIES 1 EXTERIOR WAI1..Lwood ROOF shake m Living area 1896 COVERING skpuccoo & p IRCOTVVERING. , - • . USE OP BS Single F8 lly Kesi enc°eM°•attached garage Plan #400-B • 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 OF ESTABLISHING A PERMIT FEE ONLY. PLY WITHALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDINGNG CONSTRUCTION. VALUATION LES • SIGNATURE OF PERMIT FEE $ PERM ITTEP By:Mo opo o^T C(*4 JT g°159g°159MF / $ 20,288.00 PLAN CHECK $o5 AUTHORIZED AGENT Dal HA6 ///���� RO z TOTAL FEE $ % 4