HomeMy WebLinkAbout973 LINDEN PL - Building PermitsAPPLICATION FOR A BUILDING PF"`41T
F'QEEDOM �IOMeS
BUILDING PERMIT NO. Eiacviw� ao
Tract� Block Lot /, Permit No. C
-1 ^� /K Plumbing , ¢
Atldess `�'3 ����EN 1'C. `V7A ��a 8G� PermitNo. �
D
cros: Macnanlwl a
Area Street ��u6��c S Permit No. �
. �AM g. 1305C�A �
Owner G O G�q Type of Project: ❑ New ❑ Alter ❑ Atltlitlon
Atl0�e55 ;�1 E� I P� . C, �, ❑ Repair ❑ Gonvait ❑ Demo ❑ Occupanty Pmt.
N �V
❑ty O �Q �� Z�P 7/L�j hone 6 A.P. Sup. Dis4/
Insp. Area
ArthiteCt/ / / ./ Zp�e SPI. Pmt. No.
esigne� G G (YJcense No.
Atltlreu ,� � ST Setbacks P/L Front C/L St. Street WiCth
Vartls Le(t 9 ear
���y �O� G�• Zip Phone b O
� ava ro . e 9 . .
EngineerDO� u �N�.K E-�S9a
c rk ng SpaCBs equ re rov e overe
a Aaaress i�� � aq
m CItY GOSTd wc( SA ZiP Phone Hei9ht Sto�es Famly
Y LICENSED CONTRACTOR'S DECLARATION Park Fees Yes Fee
u
� Requiratl No C.T. Recelpt
m I hereby effirm that I am licensed vntler provisions of Chapter 9
t Icommencing �vith Section 7000 of Division 3 ot the Business and Zoning Approvetl BY: Date
Professions Cotle, entl my licensa is in t�ll fOrce and effeci).
� Llcense Clas License Number
> Dete Connactor MiSc. '
� Address ProPosetl Vse
of Structura
jy Cltyantl2ip Phona
� CONSTHUCTION LENDING AGENCV
� I heraby affirm chm Nere is.e construction lantling agency for the
a performance ot the work for which this permit is issuad (Sec. 309], Occ. TyOa Cotle
Civ. C.1. Class Const. Year
C Lantler's Name USE/OCCUPANCV SI2E SQ. FT.
Lantler's Atltlress
'� OWNER-BUILDER DECLApATION
r 1 hereby affirm thut I am exompt from the Contractdr's License Law 1�
� tor t�e tollowin8 reason:
� [� I, as owner ot tha property, or my employees with wa8es as chair 2.
sole compensetion, will do tha work, and the snucture is not
r intentletl or offored for sale.
3 ❑ I, as owner af [he property, am ezclusively mntracting with 3�
Iicensetl con[racrors to construct the prolect.
❑ I am eaempt n er Sec. P for s reawn
Y .,,, ,' �j�Q � f, �
� Dat�wner�SlC(/1�`L �ywr%
�' --�— Total Valuation
E WORKERS'COMPENSATION DECLARATIOM
� I hereby affirm cM1et I have a cartificate of consont So self-insure, EnCloathmBflt PolTlt ReqUlletl ❑ V05 ❑ No
or e certificate of Workers' Compensation Insuranca, ar a certitietl
C cop�� thereo(. Gratling PmL Gratling
� Policy No Company Requiretl ❑ Ves ❑ No Pmt. No.
d ❑ Certifietl topy is hereby fumishetl. Rougb Gratling 9
C ❑ Certitietl copy is filatl wiih Orange County, EMA, qpprovetl by: �ate fD
a Data Applicant 3
CERTIFICATE OF EXEMPTION
FROM WORKERS'COMPENSA710NINSURANCE Z
(Thia section neetl not be completed it parmit is tor $t00 or lassl. C
1 certify that in the parforrt�ance of the work tor which this permi[ is Q
issuetl, 1 shall not omploy any Derson in any manner so as [o bemme ^
sublett m the Workeri Compensetion Laws of Cali(ornia. PERMIT FEES
' Da[e Applican[
NOTICE TO APPLICANT: It, after making this Certificate ot Structural E Plan Chack E
Examption, you s�o�ltl became subjac[ to the Workari Compensation
provisions of tha Labor Cotla, you m�st forthwith comply with such SCeclal
EleCtritdt S Invest. s
provisions or thiz permit shall be daemetl revoketl.
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE p�umbing S
TNAT THE A60VF INFORMATION IS CORRECT. I AGfiEE TO
COMPLV WITH ALL COUNTV ORDINANCES AND STATE LAWS
RELATING TO BUILDING CONSTRUCTION, AND HEREBV AUTH- Mecnanlwl S
ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON
THE A80VE MENTIONED PROPERTY FOR �NSPECTION PUR- q�e-Gratle
P ES. InsPection E
Q. � �O � I� I�O Pre-Gratle Parmit
SiBneturo of Applicant or Agen Date Rec. No. E Issue S
uQQOLI�i A. �'An1E�
Print AppllcanYs/Agent's Name
All s ces within this box must be completed to process P�an Issuante
� Cneck By: ApproveC:
�,mr u�o>-no �eu-[a� rev. o/eo
[ TY OF COSTA MES,_
CALIFORNIA 92628 P.O. BOX 1200
FROM TME OFFICE OF TME DIRECTOR OF BUILDINQ SAFETV
Project Address 73 � „
Project Name
o.mers Name Y�f12DL � C�ftm P
O�mers Address �-jM �
oaners Telephone �`�io ' S3 ��-�
�rmit # �i90o 2�
� ct
City Use Only
I C6-�� as O.aner, Eontracta�' Agea�- (strike out all
except one) do hereby attes that e�rtployment of any person, or persons, is not
anticipated at the time of seeking the above-referenced permit. In the event that
any person, or persons, are e�loyed under the prwisions of this permit, I shall
inenediately cause a valid Certificate of Worlanens Co�ensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own mst, and to indemnify and hold harmless, the City,
its offioers, agents and/or e�loyees, fron and against, any and all liability,
damage, costs, lcsses, claims and expenses, hcaasoever caused, resulting directly
or indirectly frcm, or connected with the improvement under this pernut.
I further state that I have read and fully imderstand the implications and re-
sponsibilities of the above statements, and will crniply with all provisions of the
Contractors State License Iaw found under the Business arrl Professions Code,
Division 3, Chapter 9, of the State of California.
—�1�e(`'ir�� �,c�n��
Print Name
— - �
signature
CMF 0777-46
�1c�c�.. 31 j 1 1 � �
Ik�te
ACP���ant to fill in all spaces wit�in heavy borOer lines anO sign all appropriate Eeclarations.
CITW OF COSTA MESA PERMIT NO. TRACT NO.' LOT NO. -BLDG. NO.
COPtSTRUCTION PERMIT {�� G% p (e
Address
Address
Address
Y / TVPE OF CQNSTRUCTION
' P J� NEW Ji'���:D ❑ ALTERATION
KLJREPAIR ❑CONVERSION ❑DEMOLISH
License No. ❑ OTHER
DESORIPTION dF WORV� �
1 hereby atfirm that I am Iicensetl untler provisions of Charter 9
mencing wlt� section ]q00} ot Division 3 of the Busines
Protessions Cotlerantl_ fnv/ Iicense is in tull force-�a��
Date'� / r� Si9nature�ae'
WORKERS' COMPENSATION DECLARATION
I hereby aftirm that I have a cerfifitate of consent to self insure or a
cerUticate of Worker5' Compen5ation InSurance or a Certifietl copy
thereot ( t o 3 0��(
P^iity N y pany
'ertlfietl copy is hereby furn etl.
�t1iifletl jopy is tiletl with Ihe City Builtling DiviSiOn.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This settion neetl not be completetl if the permit is for one huntlretl
($100) or less).
I cerHfy that in the performance of the work for whiGh this permit is
Is5ue0, 1 Shall nOt ¢mploy dny p¢r5on in any mdnne� so as to become
subject to the Workers',Compensation Laws of Callfornia.
Date $i9ndture
NOTICE: If after making tnis tleclaration, you shoultl become subjecc
to the Workers' Compensation provisions of tne Labor Cotle, you must
fort�with comply with such provisions or this permit 5hall be deemetl
revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirril that [herE I5 a cOnstructiop lentling agency fo� the per-
formance oi the work /fpp)r whicp tbis permit is issuetl (Section 309]
Civ. C.1.--' / ��/1L
Lentler's Name d
Lentler's Atldress
OWNER BUILDER DECLA0.ATION' -- '
I hereby affirm that I am exempt �rom.the Contractor's License Law for
the't011owing reason (Section ]031.5 Bu5ine55 and Professions Cotle:
Any City or Wunty whith requires a permit to ConStruct, alter,
improve, tlemolish or repair any,structure, prlor to its issuance, also re-
quives the applicant fo� Such pe�mit to fil¢ a signetl Statement that he
is li<e05etl pul5uant to th¢ prOvisiOnS of thC ContrdCtar's Litens¢ Ldw
(Chapter 9(COmTEn[inq with Section 7000) of DivisiOn 3 ot the
BUSInCss antl Ptde55ions Cotle) o� that be is exempt theretrom antl the
basis for [he allegetl exemption. Any violation of Se<tion ]031.5 by
- applirant for a permlt subjects the applicant to a civil penalty
"t more lhan five hundretl tlollars (E500).
., a5 owne��of tM1e Oroperty, or my empioyee5 with wages a5 their
sole compensation, will tlo the work, antl thC struGture is not intentled
or ofteretl tor sale. (Section 7044, Business antl Rofessions Cotle: The
Cont�acto�'s License Law tloes not apply to an owne� of a property
who builtl5 ar improves thereon, dntl who tloes Such work himself or
thro�gh his Own Employees, provitletl that 5uch Improvements a�e not
Intentletl or offeietl for sale. If, however, tM1e builtling or Improvement
is sold within one year of completion, the owner will have Ihe burden
of p�oving he tlitl no[ builtl or improv¢ Por thC putpose of sale).
❑-I, as owner ot tM1e property, am exclusiv¢ly mntracting with
licensetl wnVactors to mnstruct the project (Seciion 7044, Business
and Professions Cotl¢: The ContraCtor's License Law tloe5 not apply to
an owner of property who builtls or improves thereon, antl who con-
t�acts from such projec[5 with-a contraGtor(s) Ilcesnetl pursuant to
tM1e Contractor's License law).
❑ I am exempt under Section B. & P. C. for this
reason
Date Owner
1 hereby certitythat I have reatl this application antl siate that tne above
in/ormation i5 wrrect. I aqree to comply with all City antl county
ortllnantes antl a[e} s relating to con5truction, antl hereby authoriie
representatives/� f/pii city to nter u on Ihe above ention tl
proPertY tor�SPEk� �P � - 9 �-
Signalure V D e �
�- ��-��
TVPE OF PERMIT
O GRADING ❑ FOUND TION ❑ STRUC
❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑
❑ OTHER
pJiOJECTDESCRIPTION .
SQ. FT.
OCCUPANCV_CONSTRUCTIONTYPE _
VALVATION ZONE
GRADING CU. VDS. ACRES _
REMAR
PLUMBING PLAN CHECK
BATHTUBS
TOILETS
LAVATORIES
KIT.SINKS � -
SERVICESINKS .
FLOOR SINKS
DRINKING FOVNTAINS
SHOWERS
URINALS
�OUBLE LAVS
DISHWASHERS
SUMPS
FLOOR DRAINS
INTERCEPTORS CLARIFIERS
SWIMMINGPOOL PTRAP -
WATERSERVICE ALTERATION
GASSERVICE OUTLETS
WATER HEATERS BTU OUTPUT
SEW ER CONNECTIONS
SOLAR TANK ] COLLECTORS
SOLAR PIPING SVS.
ISSV E FEE
MECHANICAL PLANCHECK .
HEATING SVSTEM 0-100,000 BTU,
AND DUCTING 100,000 + BTU,
REFRIGERATION 0-300,000 BTU_
SVSTEM 100,000 + BTU _
BOILERS gTV
SVSTEM REPAIR,ALTERATION
EXHAUSTSVSTEM MULTIPLE
ISSUE FEF
Drivers' License or 55 ��� — �
CMF 0865-46 White-Bulltling; Canary-Applicanh Pink-A<countinq; Goltlenrotl-Asseszor
!,875 9/ I I /8I 1545';
ZONING REGULATIONS
A.P. �
20NE PLNG. REF. �
REAR VARD (TO P/L)
PKG.SPACE RE�.
STREET WIDTH
ZONING APPROVED BV
SPECIAL CONOITIONS:
ELECTRICAL
PROVIDED
PARK FEE $
PLAN CHECK
R'JSZ'�—
GENERATOR 0-1 KW_1-30 KW
TRANSFORMER
APPLIANCE 10-SOKW_SO+KW
MOTORS 0-1 HP 1-30 HP
(INC.SOLAR) 30-SOHP 50+HP'
FIXTURES OUTLETS ' SWITCHES
GAS TUBE SIGNS
POLELIGHTS �
PANELS MAIN SVB
SERVICE ' 'AMP
ISSUE FEE
APPLICATION APPROVED BV
SUMMARY OF FEES
BUILDING
PERMIT $
PLAN CHECK $
PLVMBING $�
PLAN CHECK $
ELECTRICF.L $�
PLAN CHECK $
MECHANICAL $
PLAN CHECK $
�
SMIP $
PERMIT `
ISSUANCE $ -
G RADI NG- - $"
.g
MICROFItM E
TOTAL FEE $
LESS AD-
VANCEPC $_
FINALFEE $"�I��
�
CONSTRUCTION AND PLANNINQ POOL & SPA - ,
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector„
�
1. Temporary Electrical Service or Pole ' 43. Pool & Equipment Location
2. Soil ipe-Undrgrn� 44. Steel Reinforcement '
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn � 46. Electrical Bonding -
. tee ein orce 47. Rough Plumbin & Pressure Test -
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE � -
7. Footings 49. Electrical Conduit-Undr rn '
8. Foundation 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe-Undrgrn - 51. Backwash Lines P-Tra ❑ ndr rn
10. Structural Floor System 52. APPROVALTO DECK
11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final
12._ Street Sewer Connection � 54. Heater & Vent-Final •
13. Rough Plumbing
14. Rough Electric-Conduit �56. Electrical-Final
15. Rough Electric-Wiring ' - • 57. Solar System-Final
16. Rough Heating & Air Conditioning • encing & Access Approval
17. Ducts, in Structure - 9. APPROVED FOR PLASTERING
18. Ducis, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. floof Sheathin �
22. Frame and Flashin NOTES:
23. Insulation ' � ' �
24. Lathing & Siding '
25. Drywall Nailing '
26. Plaster Brown Coat � � �
27. Electrical Power Meter-Final
28. Final Electric �
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test �
31. Final Plumbing '
32. Water Service-Final -
33. Gas Service-Final
34. Solar pomestic-Final � '
35. Landsca e S rinklin S stem � �
36. Sound Attenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING -
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY . �
No Date
� ����_� �� 1 7�
�:•��' 1 � 1:.1
•.-• _.-
APNo. 115-524—OS LOT ]17 TRACT 1712 FIRE ZONE VALUE
II :CTIONS Si nature Daro TVPE V—N GROUI
sm.
��s SUBCONTRACTOR
W�TER �r e�.._.:__
PROP. SWR. LINE �� HOI15E CON. U
SPRINKLiNG SVSTEM
MISCELLRNEOUS
ROUGH HEATING AND �IR CONURIONING
TEMPOFARV SEPVICE OR POLE
UN�ERGROUNO � POWEH �
ROUGM WIFING ��
TRENCHES � FORMS STEEL REINF.
FLOOR SVSTEM
� 90N0 BEnM [� STEEL REINFORCE ❑
� SHEATHING
Id FRqME ANO FLASMING
� LATNING — IN � OUT [�-
� PLPSTEF.BROWN COnT
ST" 'TURAL, FINAL
�N H� .G, VENT., REFFIG. RNO A.C., FINAL
PLUMBING. FINAL RNO WS TEST n
(1� ELECTRIC, FINRL
BllIL01NG, FINAL
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� COSTA MESA BUILDINGSAFETY DEPARTMENT- 'APPLICATION F(lILS1�ROl:IUM�CL PERMl:f06•26
P.O. eOX 1200 COSTA MESA, CALIFORNIA 92626 "> '� -
RECEIVE V PERMIT
For Applicant to Fill in Completely — Use Ink Only N° � 5 0 8 6 0,
BUILDING I A.P. NO. �5�5 •�O
ADDRESS I
OWNER OR / � t � ADORE55 � L/MGLG '
TENANT N•LQ C Qh�
UNIT OR
MAILING � Q m�— SPACE NO.
AOD R E55
TR.NO. �/ LOT / BLK.
(� � TEL.
CITV ��� 11� jL'`� NO. y—'�
CONSTFUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER O - �G� v
BRANCH n
OWNER (�
ADDRESS VALUE
ARCHITECT TELr� USE � SfO�^ (it�• E3% %9%•
OR ENGINEER �^e 2 S I� N �' `� ��
AD�RESS -y �a^4 -NQ� (� {� ZONE TV �' N GROUP � �
APPROVED p
CONTRACTOR Q �(f� I BV DATE O� Ib—C/�
ADDFESS
TEL.
CITV NO.
STATE CITY P�PFROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OFBLOGS. (FROMC/LSTF�EET2) I
OF l0T NOW ON LOT ONT Z FT. O
VSEOF /� � �I
EXISfING BLDG.
Separa[e permits are required for L SIDE �� '
electric, plumbing and heating work.
REAR
U�5 O H LDING AN4 WORK T.B PERFOR ED PL.ANNING iiCTION
�r�e>
DATE
` v}� APPROVED
APPROVED �� i /l ��/ ,�
�� �G
I hareby acknowletlge thet I have read this epplication entl rtate `, I VI.K i�,{�C� r �/�O 'T n
that Ne ebava Informatlan is correct entl eBree to comply with ,.,
oll laws reguletlnB builtling consiruction, entl I shall not employ [� 2�b �
eny person in violation ot the workmen's compansation lews ot QYR C. T m
ihe Stete ot California. '
m
I hereby cartify thaf I am properly licensetl esacontractoruntler SQ. FT 3 29 �•— �
the State ot Celifornla eusinass antl Profeuions Cotle, Dlvlsion 3, THE AMOUNT S OWN UNDER VALUATION IS FOR m
Chapter 9, antl thet such licensas are in full forca antl effect, or I THE PURPOSE OF ESTABL6HING A PERMIT FEE ONLV: �
am ezemp[ irom Me provisions ot the Staie of Callfornta Business V ALUATION PERMIT FEE S / q
and Protezsions Cotle, Division 3, Chapter 9. �b' � u+
PLAN CHECK y `^
� p
Sipnatura af ' �' LL
Pa,o�naa s 32�ZI2•— TAx s 2.z6 �
Authorizetl ABent Date /"-' TOTAL PAID 5 2O
Tl:
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT �
636 Narth Broadway , . � �' � � � � �
. v SANTA ANA, CALIFORNIA
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