HomeMy WebLinkAbout972 LANSING LN - Building PermitsAVVlicant to fillln all spaces except those within heavY boreer Iines ana sign all apvropriate tleclaratlons.
�COSTA MESA CONSTRUCTION PERMIT -, PER"^13 No^ _,,� TRACT NO. LOT NO. UNI7 NO. �
Address A77 T,ansinq Ln, C,M. 92626
Applicant'sMailingAddress LZ6 Commercial CI"1 92627
Owner'sName p�'1il FiPl(T31 Phoneg64-7400
Address �77 r,anGina Ln. C.M. 92626
ArchlEng. License No.
Address
Contractor's Name CY3rik Rr, RC)f i rncT phone 4�6`�
AddresslmailingL�CnmmarCl3L��_..�..�Zh77 �
city License No. _QQS.gg_3
LICENSED CONTRACTOR DECLARATION '
�1 hereby affirm tnat I am licensetl untler provisions of Charter 9(mmmencing
with settion 7000) of Dlvision 3 Of the Busine55 antl Protessions Cotl¢, dntl
,` my licen5e is in f�ull tpOrce antl efleGt.
�LIC2(152 CId55 _1..=) LICE NO.
\ Date_]��Q��S. Signature ��
\WORKERS' COMPENSATION D C,LARATION � �
1 hereoy affirm that I have a certiticate of consent lo self-insure or a cer Iflcate
1 of Workers' Compensation InSurante, or a certitietl copy thereof (Section
� 3800, Cab. C.) - —� � �
PolicyNo.P�LL1E.iiG.Z_ Company�Q1i12 TI1S._
�Ceriified copY is hereby turnishetl. , ,
Certifietl copy is filetl with the city Builtling Dlvision.
Date����j_ApplicSnt $p}t_$,�p.S- . —
EXEMPTION FROM WORKERS' CO N T�� A0. T
� This section neetl not be comple[etl if e r on 0 0�
less). �
1 certlfy [hat in tM1e peiformance Of t ork (o� whlcn tltis pevm�t I is. e I
shall not employ any person in any manner zo as to become subje t to the
Workers' Compensation Laws of California.
Date, ' � Si9nature
�NOT,ICE: If, afte� making tnis decla�ation, you ShOultl becOme subject [o tlte
Worke�s' Compensation provisions of ,Ihe Ldbor Cotle, y,ou must (orthwith
comply with zuch provisions or this pe�mlt shall be tleemetl revoketl.
CONSTRUCTION LENOING AGENCV
1 hereby atfirm roa[ tnere is'a construction lentlin9 agency for�the per(ormance
of the work for whicn this permi[ is issuetl (Sec[ion 3097 Civ. C.)
lPntler's Name
Lentler's Adtlress
OWNER BUILDER DECLHRATION � ' �
I her¢by affirm'thzt I am exempt trom [he Contractor'S License �aw tor the
following reason (Sec[ion 7031.5 Business antl'Professional Cotle: Any tity or
county wnich requires a permit to construct, alter, improve, tlemolish or repair
any structure, prlor to itz issuance, also requires the applicant tor such permit
to file a siqne0 statement that he/sh¢ is Iicensetl pur5uant to tM1e provi5ion5 ot
the Contractor's License Law (Chapter 9(commencinq witn� Section'�000) of _.
-Division 3 of the Business antl Professions Cotle) or tM1at he/she iz ¢xempt
therefrom antl the basis for the allegetl exemption. Any violation of Section
�031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of mt more than tive huntlretl tlollars (5500).
I, as owner of the p�op¢rty ov my.employees with wa9es as thei� sole '
� compensation, wi11 tlo the work, antl the sbucture is not intentletl or ofieretl
for sale (Section ]044, Business anG. Professional Cotle: The Contractor's
Licen3e ldw tloes not appty to an owner of a property wno bulltls or improves
thereon, antl �who tloes sucn work nimselt/herselt or through his or her own
'� employees, provitled that zucM1 imp[ovements are not �intentletl o� ofte�etl tor
sal¢. If, however, the bulltlinq o� Improvement i5 Soltl wlthln one year of tom-
pletion, the owne� will have the burtlen Of prOving he/she tlItl not builtl or im-
�ove�for the purpose ot sale). • .
LJ I, as owner of tne proDerty, am exclusivety contracting wlth licensetl con-
tra[tors to construct the pro�ect (Settlon 7044, Bu5ine55 antl Prote55ions COtle:
- The ContracCor's License Law tloes not apoly to an owner ot property who
builds or improves lhereon, antl who wntracts tor �such proiects with a con-
tractor(5) iicense pursuant to the �Con[raCtor'S License Law). I am aware that
proot o( !neir Worker'S Compensation insu�ance shoultl tle providetl to me. ,
. L7 1 am eaempt untler Section . B. & P. C. for this reason
Date Owner
I hereby cer[ify tM1at-1 have reatl this appliwtion antl State that the above
iniormation is correct. I agree to co ply h all city'antl county ortlinances
antl state la elatlng to builtlin c n ruc' n, antl hereb autnoriz re rg-
9 Y �. P
sentatives f tl's city to� ter u o t ab�e-mentionetl proppr[y jor
inspection s. �/
Signature b
Driv¢rs' Li 5¢ or 55 � —
CMF 0865-46, rev. 10/84 Whi[e - Builtlin9;
TYPE OF CONSTRUCTION U NEW I.J ADD LX� ALTERATION LI REPA1 R
❑ CONVERSION. O OEMOLISH ❑ OTHER �
DESCRIPTION OF WOFiK/USE OF BLDG.'
_ � ahin�.le5-
TVPEOFPERMIT GRADING FOVNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICA� ❑ PLVMBING ❑ MECHANICAL �
❑ OTHER '
PROJECT DESCRIPTION , Sq. �F7.�_i�9Q+Q� OCCUPANCv�lY1�L
�CONSTRUCTION TVPE Y'�$.j_�g]}�y�_� VALUATION $ �_� 76���.
ZONE GRADING CV. VDS. AC0.E5
Remarks:
Sink
Preventer
Irrigation
Clarifiers
Drinking Fountains �
Floor Drains '
Floor Sinks . - -•
Gas Service Outlets
Interceptors _
Kitchen Sink '
lavarories
Roof Drains
Reinspection Fae
$15
DuCt-UnderGrountl
Duct � Sttuctural
Duct - Ventilating
Exhaust System � Multiple
Firepl/Fact. BIL ICBO #
Heating System & Ducting
❑aioo,00a eTu Oioo,00a
Reinspection Fae
Applicant; Plnk - Accounting; GOICenrotl - Assessor
$15
FEES
$IIOWCfS
Service Sink - �
Sewer Cap
Se'vwer Connection
Solar Collecrors
Solar Piping '
Solar Tank
Swimming Pool w/Spa
Urinal �� � -
Water Closet
Water Heater �
Water Service
AULO�W25I1
Laundry Trays
Issue Fee -. � $ 3
1ANICAL FEES
Hood or Type I ❑ '
Canopy Type I I ❑ �
Refrigeration Sys[em
❑0-t00,000BTU ❑100,OOOBTU
System Repair/Alteration �
�Fire Dampers � �
Regisfers, �
. Issue Fee � $ 3
jG Main Buildi
�c
T Front
�B Rear
A
�C Rieht
1K Leh
jS
'Ping. Ret. #
Plannin9 Notes:
�Automatic Washei '
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas. �Elec
Fan
F.A. �.
Fixtures
Device Boxes •
OuUets
switcnes
Garbage Dispoul
Generator �0-5KW C
Fee
1986 10/II/8S
Zona
Accessory Building:
Parking Req./Provided �
ELECTRICAL ' :
� � Trenstormer ❑ 15-50�KW �•
❑ 50+KW
- Meter ❑up to 100 amps
Meter ❑'over 100 amp '
5KW
$15
Sub Panel , ,
Motors OO-1 HP O1 h
Inc.Solar'�9-15 HP [
Microwave
Pole Light �
Range '
s�s� �
; Standing $ec[iuns '
Trash Compactor �
DEVELOPMENT SERVICES REQUIREMENTS:
Zaning Approvad By
� Building Approved By �
Aoolication Issued Bv
Fee
��o:��
Z
O
N
I
N
G
R
E
Q
M
T
S
FEES
SU AR OFFEES '
BUILDINGPEFMIT $ ' SMIP: , $ � •��'
PLAN CHECK $ - PERMIT �
PLUMBING $ � ISSUANCE $
I
PLAN CHECK 25% $' ENERGY P.C, 3
ELECTRICAL '$ � GRADING ,$ '
P�AN CHECK 50% $ MICROFILM $ ?
MECHANICAL $ TOTAL FEE � $ �`�•'SD
PLAN CHECK 25% $ ' : �
aNSTRUCTION AND PLANNING POOL & SPA
PPROVALS Permit# Date Inspector AppROVALS Permit# Date Insper.ror
1. Temporary Electrical Service or Pole 52. Pool & Equipment �ocation �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforceme�t
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Cor�duit-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, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
i t. 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, Ventil0ting 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Ffush
24. Roof Freming 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Fleshing 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:
T ,
34.-- inal ting'& I1ii onditioning
35. Fin/I Gas Pipe-Test
36. Hood or CanoPY
37. Final Factory Fireplace
3S. Final Plumbin9
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
4A. .Landscape Irrigatfon System
45. Sound AttenUation
46. Handirap Regulations
47. FINALSTRUCTURE&BUILDING �� �
48. Special Requi�ements Completed
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
N�. Date
�
"�GENERALCONTRACTOR Air Vent Axrti
�s APNo. 1 1-721-01 LOT 10 TRACT
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON.
MISCELU
ROUGM HE
TEMPORA
UN�EPGR(
ROUGN WI
TRENCHE:
FLOOR SY
ANO AIR CONDITIONING
FORMS I I STEEL REINF.
FRAME AND FLASHING
LATMING - IN �J OUT n
PLASTER, BROWN COAT
STRUCTURA�� FINAL
HEATING, V�NT., REFRIG. AN� A
PLUMBING. FINAL ANO GAS TEST
ELECTRIC, C�NAL
BUILOING, FINAL
DATE
BUILI
VALUE
SUBCONTRACTOR
� ?_9 •
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. eOX 1200 COSTA MESA. CALIFORNIA 92626
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t�,R 26-69PA��OO 667 �*fi***9.0�
crisn
APPIICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVED BV DATE RECEIVEO DATE ISSUED
ADORESS � � �"' � � � � �Jy �-
OWNER ^� � A.P. NO.
p�%�
MAIL ^ � BUILD�NG '
ADDRESS S�c{ ADDRESS
TEL TRACT b13 LOT BLOCK
CITV Cp ' � NO.�y- -
CANSTIiVCTION ��_ ^+ '�'�
LENDER /��i•-a
BRANCH ,a^�
OWNER � . /./ I '�' F
ADDRESS VALUE (�
ARCHITECT TEL. S 5 O ��Fr O O
OFi ENGINEER
FIRE
ADORESS ZONE TVPE GROUP
,P.PPROVED .g� /
CONTRACTOR BV DATE 9
ADDRESS � Q/ S. r� [ C' /L'
20N NO.OF USE OF NEW
A�I /C TE� D' �' PLANS � BUILOING ���
dTV .y r� NO. �
STATE CITV �'ARDSAPPROVED VARDSAPPROVED
LIC. NO. /� 2 LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SI2E NO.OF BLDGS. (FROM GL STR�T)
OF LOT NOW ON LOT � RONT FT FT.
USE OF `
E%ISTING BLpG. �J FT
SI2E OF NO. OF �!S � �C�
NEWBLOG. D 2- ROOMS I STORIES � 1.51DE FT. FT.
EMEIiIOF WALL ROOF � I
GOVERING COVERING REAR C FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED OISTANCE BET. BET. MA�N &
MAIN BLDGS. ACCESS. BLDGS.
/ /� • VAR..$ DATE
/./� �/ Q O C.U.P. � APPRpVED
APPROVED
I hereby acknowletlBe that I hava reatl this application end state ,
xhet the above InformaUon is correct antl aprea ro camply with
oll laws repuletinp bulltlin8 construction, entl I shall not employ /
ony person In violation oi the warkmen's compenution laws of
the Stata of Celifornie.
I hereby certify that I am properly Iiconsetl os e cantroctor undor SQ. FT.
the State of California Business antl Protessione Cotle, Divleicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chepter 9, antl thnt such licanws are in full torca end eftect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
om esampc from tha provlsions of tha Stem of CelHornle Businesa VALUATION
ontl Protesslons da, Oiviflon 3, Chop[er 9. PERMIT FEE §
Slp^otura of �� �Cn, � �� �
Permittae �" 5 �i�\ PL4N CHECK $ -��
I/ � �y..��
Auchorizatl AOent TOTAL FEE 5 .!/ V
� �3970
.
COSTA MESA BUILDING-SAFEfY DEPARTMENT
P.O. BO%91] COSTA MHBA, CALIFORNIA
For Appllcanf �o Fill In Complefefy
TYPE OR PRINT
DRE59 / /� t+8II81R� Lane
COSTA MESA. GALIFORNIA
� �o�N��ev�oe �Yalt Boder
■ 6TATE
�R Brattain Contracto
1304 17. Commonwealth
eu
6842
O O � vnw�nw ���e.
USEOF
EXISTING BLD6.
BETBACK LINE PNOM G
C6NT6R OP 9TReHT / � REAR
SIOEYARDI LEPT I RIGHT
DESCRIPTION OF WORK
EXTERIOR WAI.L�tuCCO I R��P
COVERING COVERINO
U66 OF BUILOINB AIVD WORK TO BE PfiRFC
Tract 5340 — Lot 10
Plan 612B
R-1 Residence `i_/ C
1 HBPEBY ACKNOWL8D08 THGT 1 M�Ve RHAO T'
ANO 9TATH THAT TH8 ABOVB 19 CORpBCT AND
PLY WITH �LL ciTY OqpINANCBB AND BTATH U
BUILO�NO CONeTqUR10N.
SIGNATURE OP L
PERMITTE
AUTHORiZED AOENT
�ITY aT C7STA MESA
pC��
�1t,j1TIdR�OR PE
BUILDING
ZON(NCi
NO.OR /� ueeor
PLANO / OU�LD11
NOTH: NO EAV E OV ERHANO BMALL BE LESS THAN
90' TO 81DE 3 REAR P. L.
8AVH8
ALLOWED fU.B.C.REQUIREMENT'.
YARDBAPPROVED YAROSAPPROVE�
MAINBLIILDIN6 _ ACCESSORYBUILDIN6
C
VAR. �j
��
.73i=
�-- l i s4. �.
Z ,p•
L�CATION TXH I�MOUNT BHOWN UNOHR VALUATION 19 FOq TX8
TO COM. PUflP088 OP 89TABL19HIN0 A PEPMIT FEE ONLY.
��UIwTINd yqLUATION /Q
� PERMITFEE E� (
���.�$z ...,.