HomeMy WebLinkAbout968 LANSING LN - Building PermitsApplicanl to fill In all ipaces except those wit�in �eavY Dortler Iln¢s and sign ali aDorovriata aeclaratians.
CITY OF COSTA MESA �
CONSTRUCTION PERMIT
Project Address
Applicant's Mailin9 Addreu . Q
Owner'sName {�,�, Bg�-��g{�� Phone ����r
Address oan i n....;.,,-, i,,..,. n__i_ .�,,,,.. r�n nococ
�
Arch/Eng. License No.
Addreu
Convactor's NamP �'rnnG Rrnc_ F?nnP ipg�Q�phone�9
Address (mailingl i�F. rnmmarr i n l �,/ (` t P4 cn 79r97
City License No. ��49� -
LICENSED CONTFACTOR DECLARAT�pry
� I hereby a(firm that I am Iicensetl vntler p�ovi5ion5 0( Chart¢r 9(Commencing
� with zection ]000) of Division 3 of the gusiness antl Protess' ns Cotle, antl
my license is tn full (orce antl e(fecL '
.�" �icense�ciass --3 � � qo
`' Date� n,T. �/�,''— Signa i
� WORKERS' COMPENSATION CLARqT10N
1 hereby atflrm that I have a certiticate ot consenl to Selbinsure or a certtflcate .
. of Workers' Compenzation Insurance, or a certlBetl copY thereot (Settlon
3800, Lab. C.)
Policy No. 2�zi} Company?An%t%�
�Cer[itietl copy I5 M1er¢by turnl5ttetl.
Certitietl copy Is filetl with the ci[y Builtling Division.
. Date Applicant '
EXEMPTIO FROM WORKERS' COM7�NSATION DECIARFTlO
(This section neetl not be completetl if the permit is for one hunare0 ($100) or
less).
1 certify that in the per/ormance of tha Wo�k for which tbis perm�t is ISsuetl, I
shall not employ any person in any man�er so as fo becoma subject ro the
Workers' Compensdtion Laws of Callfom�a.
Date $i9nature
NOTI[E: If,mfter makin9 this tleclaration, ypu ShoulC bewme subjact to tne
workers' Compensation provisions of the Labor Cotle, you must (orthwith
comply wlth such provisions or thi5.petmit.snall Ee.tleemetl revOketl.
CONSTRUCTION LENDING AGENCV-
I her¢by aHirm that there is a mn5tructioq-lentling agency Tor the perto�mance �
of roe work for wbich this permit Is issuetl (Section 309] Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION - -
I hereby affirm that I am exempt from the Contractor's Licensa L.aw for tne
followin9 reason (Section 7031.5 Business antl Professlonal Cotle: Any city or
county wn��h raq Wres a permit to constrUct, alter, Improve, demo�ish or repair
any StrucWre, pAOr to Its Issuance,•alm �¢quires [he'appliwnt for such pe�mlt
to tile a signetl statement that he/she Is �icensatl pursuanl to lhe provisions ot '
the Contractor's License Law (Chapter 9(commencin9 wiih Section 7000) ot
" DHision.3 of the Business antl Professipns Cotle) or that ne/she is exempt
the�elrorn antl the ba5i5 fOr [h0 all¢getl Qxemptlon. Any vlolatiOn.ot 5¢ctlOn
]031.5 by any applicant for a oermlt subjects the applicant to a civil
�enalty of not more than tive huntlretl tlollars (§500).
I, as owner of tM1e property oi my employees with wa9es as thelr sole
compansation, will tlo the work, antl the structure is not intentletl or ot(eretl
(or salo (Sectlon ]044, Business antl ProteSslonal Cotle: The. Contractor's
LicenSe Law tloes not apply to an owner Of a property who builtls or improves '
[he�eon. antl who'tloes suc� w0/k �IT581t/h¢�self or through Ns or her own
eTploYees, provitletl that Such improvements are not intentletl or offe�etl fOr
sale. It, however, tha building or improvement is soltl within one year oT com-
pletion, the owne� will hava the burtlen qf proving he/she tlitl not 7uiltl or Im- �
�IOve �Or the purpo5e of sale).
I, a5 Owner Of the property, am exclu5ively contrattlng�wlth IiG¢n5¢tl COn-
trac[ars tu construtt tha project (Section 7044, Business antl Profe551ons Cotle: ,
The Contractor's License Law does -not apply to an owner of property who
builtls or Improves thereon, antl who contracts for such projects witn a con- •
traclor(5) II<ense pursuant to the Contractor's Llcense Law). �
❑'I am exempt untler 5ection , 8. & P. C, for thlz r¢ason
Date Owner
1 hereby Cartity that I have /ea0 Ibls appp<atlon antl sta[e that the above
intormatlon is correct. I agrAe comply N.It II clty antl county ortlinances ;
and state laws relating to py�i ' g const�uc n, antl hereby authorize repre-
sentatlyeT�� this, tlty ,�,y/e t n upon t above-menUonea property tor
. �.,,�,4 S�-7 I , .,.,.. , ,..,. �
TYPE OFCONS7RUCTION NEw u Aoo
� CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK �,,.._ _�_
ALTERATION FEPAIR
TVPE OF VERMIT LJ GRADING LI FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ EIECTRICAI ❑ PLUMBING ❑ MECHANICAL
❑ OTHE0.
PROJECT DESCRIPTION sQ. FT. 2G66 OCCUPANGv�S�
CONSTRUCTIONTYPE �gc VALUATIONS�
20NE GRADINGCU.VDS. ACRES_
Remarks:
Bar Sink
Backflow Preventer
BaCkflow Irrigation
Bath[ubs
Clarifiers
Drinking Fountains
Floor Drains �
Floor Sinks .
Gas Service - C
Interceptors
Kitchen Sink
Lavamries ..
P—Trep
Roof Drains
-Reinspection Fee � $25
Duct= UnderGround
Duct-Structural �
i
Duct - Ventilating
Ezhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ w oo,000 sTu O i oo,000 er
� O i' e' e e o'S5 qf — �� I I Reinspeetion Fee I .$25
CMF 0865-46 rev. 12/63 Whlte - Builtling; Canary - AOP���ant; Pink - Accountlng; Goltlenrotl - Assessor
Showers
Service Sink .
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Pipin9
Solar Tank
Swimmin9 Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Isue Fee
Hood or Type I O
Canopy Type I I ❑ ,
Refrigeration System
❑0-100,OOOBTU ❑700,000
System Repair/Alteration
laue Fee
A.P. ;I�
S Main Building:
E
T Front
B Rear
A
C Right
K Left
S
Ping, Ref. #
Parking Req./Provided
Use of Building:
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
J%LVa ���%���1
� 2one
Accessory Building:
Park.Fees $ �
ELECTRICAL .
Transformer ❑ 15-50 KW
❑ 50+KW
Dryers L1Gas LlElectric
Fan
F.A.U.
Fixiures
Device eoxes
Outlets �
Switches
Garbage Disposal
Generator�00.5 KW �5-15 KW
Meter LJup to �100 amps
Meter �over100amps
Sub Panel
Motors�QiHP�i%-8 '
Inc.Solar 09�15 HP �16-15+
Microwave
Pole Light
Ran9e
Standing Sec[ions �
Trash Compactor
S 3
Reinspection Fee $25 Issue Fee
FEES
� PUeLIC SERVICES REaUIREMENTS:
Zoninp APProved BY
Building,Approved By
Application Issued Bv �A�'
$ 3
0
�%n�H T
FEES
$ 3
O
N
I
N
G
R
E
I
F
E
N
E
N
T
(o SUMMARV OF FEES O
BUILDING PERM T $ � SMIP $ ' ' `�
PLAN CHECK $ � PERMIT
PLUMBING ' $ ��UANCE $
PL4N CHECK 25% $ ENERGY P.C. $ -
ELECTRICAL $ GRADING $ �
PLANCHECK 509G $ � MICROFILM �$
MECHANICAL $ TOTALFEE $ �
PLAN CHECK 25% $ � ' 7�. (�o
CONSTRUCTION AND PLANNING � � , ; ,� : _ POOL & SPA , -� ,. ::, - - -
•-APPROVALS Permit# Date Inspector. . APpROVALS PermiY# ' Date ��� I'nspector; �
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, � �1. � " � _ � '-'� +�� •
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test � � � -
6. Electrical UFER Grnd. - _-- 57. APPROVALTO COVER-GUNITE -
7. Footings ' .58. ElectricalConduit_Undrgrnd. .-' .
8. Foundation ,, � 59. Gas Pipe, O Undrgrnd., Test " '
9. Water Pipe-Undrgrnd. ' ' 60. Backwash Cines, P-Trep, O Undrgrnd. � , -
10. Structural Floor System 61. APPROVA'L TO�DECK � -� �
11. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal. ' , i
12. Sewer Cap 63. Heater & Vent-Final '- : .
13. Roof Drains . - 64. Plumbing $ystem -, Final `�' - �
14. Rough Plumbing 65. Electrical-Final -' � -
15. Rough Electrical-Conduit • 66. Solar Systzm-Final ;
16. Rough Electric Wiring � . . - - 67: Fencing & Access Ap`proval a � - - " i - - "
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING ;� ..
18. Rough Electriral-T Bar Ceiling � 69. POOUSPA 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 �OOiI � � ' r
i
23. Gas Pipe-Rough & Test � '72. Underground Flush. � � +
24. oof Framing � • �73. Undergrnd. Storage Tank O Gas ❑ Oil , �
25. � oof 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 PFiEV. FINAL . '
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat , 79. FINAL INSPECTION . i
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � ,
.33. Final Elect�ic � � Notes: �
..M''-... . ,. _�. . , � -,� /3;� "o k �
34. Final Heating & Air Conditioning ' � • r
35. Final Gas Pipe-Test � ' - - . _ ,
36. Hood or Canopy . � , � . , i'
37. Final Factory Fireplace ' '. � . , -
38. Final Plumbing � � . - ',I ' � '
39. Water Service-Final � � � . . '
40. Gas Service-Final , , � � ' � �
41. SolarpomesticFinal - _. . _ _� ' .
� -, - .c I
42. Backflow Preventer � � , - � � . � � , ,
43. Backflow Irrigation . � � .. '•! ' �
44. Landscape Irrigation System ' � � • � . , ,
45. Sound Attenuation � , ; • � . ' " : •"-" • ,
46. Handicap Regulations � � � - � . . " � � � - ' �
47. FINAL STRUCTURE & BUILDING � � � ' , ' � . ' • '
� . -;�
48. Special Requirements Completed � - � , ' ' ' � ' ' `
I �
49. Electric Release to Edison - ` � , � - ' '- .- � . . �I �
50. Gas Release to Southem Califomia Gas Co � � � ' .`,; .
51. CERTIFICATE OF OCCUPANCY . +, - • -�---'-- � �- � - . '
i'. r
No. Date - - - - � _ -.- - • -- •
�• ?3971
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 CO9TA M6HA, CALIPOHNIA
For Appllcant to Fill In Completely
TYPE OR PRINT
rr_u�
GOSTA MESA. CALIFORNIA
CC�Y Land Company
1304 W. Commonweslth Ave,
13 04
if
0
■ BETBACK LINE FROM
No`871- 2710
nos�44-6842
Tuatin
tors, Inc.
th Ave.
3 71- 2710
NO. OP BLDaB.
5
DESCRIPTION OF WORK
BUILDIN� � YY1 �' NO.OP
512E .2 'd ROOMH � HTORIEB
EXTERIOR WALLStuCCO ROOF SLl �.E
COVERING COVERIN6 �
US6 OF BUILDI(iG AND WORK TO B8 PERFORMED
Tract 5340 - Lot 11
Plan 447CR
R-1 fteaidence �/ �f. c��
1 XEREBY ACKNOWLEOOE TH�T 1 X�VB P8A0 i1118 A L�C�TION
ANO BTATE TXAT iH8 ABOVH IB CORflBCT AND AOq88 TO COM•
PLY WITH ALL CITY OPOINANCHB AND 6iAT8 1.�W8 qHOUTATINO
BIIILDINOCONBTHURION/ / .
CITY Oe C�STA �ES�A
IwnxLI�ATIONFOR P
BUILDING
ZONING
NO.OR U86
�. PLANB BUII
NOTE: NOEAVEOVERI
90" TO 8I DE @ REAR P
EAVE9
ALLOWEO
YAFlDSAPPROVED
MAIN BUILDIN6
o�re�ssueo
YARDSAPPROVEO
ACCESSORV BUILDINO
L.81DE S Ff,
y
REAR F�.
D19TANC8 BEf. BET. I
MAIN BLDG3. ACCE
VAR.$C OATE
TN8 AMOUNT BHOWN UNOEP VALUATION IH FOR TH8
PtIRPOSB OP EBTABLIBHINO A PEPMIT F[g ONI.Y.
Irenmirre- • . : ' - -' /`y"1 ^
AUTHORIZE� A6ENT S � ' / �/ �
vvnran �uK"L '� ll�mnu� �. V GI v�
SOB ADDRESS 9� Lansing T ane BUII.DING PERMIT NO. 2584�
GENEAAL CONTRACTOR p,]_um KOOl Awn1nQ DESCRIPTION OF WORK p1vm. petio
VALI
TYPE
SUBCONTRACTOR � Date
,�
' 25843
j' COSTA MESA BUItDINCrSAFETY DEPARTMEM
P.O. 00X 1200 COSTA MESA� CALIFORNIA 02E7E
For ApplimM ro Fifl In CompteNly
� TYPE OR PRINT
COSTA MESA,
,�/�d
CITYOr C�S;A MESA
A►PLICqf�lil Sf�t �R
0
�N�I I ��UNO � I �YILO MO� �
S
'�°"� �.. �-� l /, TR . S
� A. P. NO. � � .
��O NOTB� NO PJ1VC OVBRNANO BXALL �H LlHB TMAN
DO' TO SIDB Q RHAR P. L
EAVEB
No.o�eLDo�./ ALLOWED �U.B.C.pECUIRHMBNTI
NowONLOT yAPDBMPROVlD YARDBAPPROVHD
MAIN BUIL�INO ACC6DBORYBUILDINO
DESCRIPTION OF WORK
BUILDINO NO.OR
BIZB ROOM9
H%'fCR10R WALL ROOI
DAT6
1 HRrtRer wCKNOWLiDO[ TUT.1 NI1V6 RfAC TY11� A��YGTON TM[ 1140UM �MOWry UND6R VALUATION 18 IOR TMC
I�NO BTAT6 TMAT T/ll AOO 10 R[Ci�A AON[i M CAY. AIMMGG[ O� [tTAGY6NIN0 A P6qMlT !H[ ONIY.
a�v w�rH w�� ciTr ono wn� sr�n ws eaouunno yALUATION
emto�noconerx�cri i �" C
HIONATURC OP PHHMIT FEB
PHRMI7T8
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