HomeMy WebLinkAbout2954 RANDOLPH AVE - Building Permits _ _ - t7o:U 1
Applicant to fill in all spaces except those within heavy border lines and.sign all appropriate declarations. .
• CIT,YOF COSTA MESA.. CONSTRUCTI N-PE• RMIT pER T NO. TRACT NO: LOT NO. UNIT NO. r. ex e)75 E t 6+:oFJ0 TL
•'Prole¢t'Address Ty /U!/✓P!)L/7F•�)4�_ E az o y� A
Applicant's Mailida AddressnTYPE OF CONSTRUCTION U NEW' U ADD U TE RATI REPAIR
1 • 6y? �� El CONVERSION ❑ DEMOLISH ❑ OTµ�/���ER • A.P.#
Owner's Name f, - .,Q ' _ Phone DESCRIPTI K/USE OF BLDG. •M•1A
Address ZCF� IG/A/24/) ,i�N•- A'JG 7� _ S Main Buildine' - Arrn«nry R„'ld'..n'
aliimis
•Arch/Eng. License No. TYPE OF PERMIT LJ GRADING rr---I❑-I FOUNDATION ❑ STRUCTURAL T Front Z0
Address j ❑ TENANT ❑ �F ECTRI CA tJ PLUMBING ❑ MECHANICAL • B Rear N
Contractor's Nam..•.I / v. •- P415?
0 OTHER /F(D� A I.
/ n / PROJECT DESCRIPTION 5 //FT. DCCUPANCV C Right - N
Address(mailing)/772:�OT/�//S r�tf✓C � l/ K G
iv/9, r�/ ,. ;; CONSTRUCTION TYPE$pZd'e+J• VALUATION$ T/Z CO r� $ Left . R
City License No. `rfi �"- ZONE G RF(DING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - •Planning Notes: - M
M
section 7000) of Division 3 of the Business and Professions Code and .
my license is in full foga • - ect. � - - T
License Cl s l.: 2. Lic No% , S
Date, . Signature -.- ai - . — - PLUMBING FEES
WOR ERS Cs MPENSATION 0 CLAR• ION Bar Sink Showers ELECTRICAL FEES
'•ereby affirm that I have a certificate of consent to self-insure or a certificate•
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Servic•e Sink - - 1 -
.00, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer:Ca - 0 50+KW
P Construction Pole Sub.
BCertified copy is hereby furnished.thcity
Certified copy is filed with the city Building Division. Bathtubs .• Sewer Connection Cooking Unit , Meter ❑up to 100 amps
Date_ Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers • - Solar Collectors Dishwasher Meter Dover 100 amps
(This Section need not be completed if the permit is for one hundred($100)or
less). A Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel •
I certifythat in the performance of thew k for w ich this permit isE{K�65ueQ I - '
shallemploy any person in any a@ o come su bj t to the Drinking Fountains • Solar Tank Fan '
Worker tbn Laws of Cal'fo a. Motors❑0-1'HP ❑1%-$
Date S Signature tom'"+ Floor Drains Swimming Pool w/Spa F,A.U.
'NOTIC if,after making this declaration,yo should become subject to the _ Inc.Solar 09-15 HP ❑16-15+
Workers' Compensation provisions of the' Labor Code, you must forthwith Floor Sinks Urinal - -- _ Fixtures
comply with such- provisions or this permit shall be deemed revoked. 'Microwave -
LENDING ENDING AGENCY Gas Service Outlets . Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance - Pole •Light+a
of the work for which this,permit is issued (Section 3097 Civ. C.) interceptors ,Water Heater - Outlets `r,
Lender's Name - - - Range IZ ,
Lender's AddressR ' • Kitchen Sink . , , Water Service Switches Sign dr
OWNEBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License,Law for the . Lavatories Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or - - 9 P Standing Sections - ;...---/,':
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 for such permit Trash Compactor ii
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 - K! -L -
Oivlsion 3 of the Business and Professions Code) or that he/she is exempt - .
^refrom and the basis for the alleged exemption. Any violation of Section i !.
31.5 by any applicant for -a permit subjects the applicant to a civil - . . ' r
•natty of not more than five hundred dollars($500). - - '
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee • $ 3 ; - -- -•
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee • . _ $ '3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES r- -
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: '-
employees, provided that such improvements are not Intended or offered for Boiler I Hood or Type I 0 p .
• sale. If, however, the building or Improvement Is sold within one year of corn- Canopy Type II 0 - Zoning Approved By - Date •
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under GroundBuilding Approved By '‘• Date I
prove for the purpose of sale). - , ,I l
k ^— (
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System Application Issued By /ilDate �('' 2�Q.57—
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 00-100,000 BTU 0100,000 BTU , SUI1r1MhRV OF FEES
builds or improves thereon, and who contracts for such projects with a con- • - - (D'/
tractor(s) license pursuarit'to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $' r VD SMIP,. ' $- ,ED.-
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date Owner 'Heating System& Ducting Registers •
PLAN CHECK 25% $ _ ENERGY P.C. $
I hereby certify that I have read this application and state that the above- 06100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $
information'is cosssaect. I agree to comply with all city and county ordinances
and state laws,relating ul g cons uction,and hereby authorize repre- - - I MICROFILM $
' sentatives of thi cit • r upo• the above-mentioned ro•erty,for PLAN CHECK 50% $
inspection�p, ses. re n MECHANICAL •
$ (061, 7o
_% �\
' Signet / i. ' /__ ,Date / TOTAL FEE $; (• ��/
Drivers' License or 5 # , - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ,
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting;Goldenrod - Assessor - . . -
• CONSTRUCTION AND PLANNING POO/ SPA - - •
f
/"APPROVALS Permit#- Date Inspector APPROVALS Permit# Date Inspector
1f Temporary Electrical Service or Pole 52. Pool & Equipment Location •
2: Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms •
A. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
r '•6. ElectricalUFERGrnd. . 57. APPROVAL TO COVER-GUN ITE
]. 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 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 - i
. 22: Dudts, Ventilating • 71. Product Piping 0 Gas 0 Oil
•
▪ _23.-Gas-Pipe-Rough & Test . 72. Underground Flush - '
• 24..Roof Framing -73. Undergrnd.Storage Tank D 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
31.1Plaster Brown Coat - 79. FINAL INSPECTION• -
32. Electrical Power Meter-Final , ` 80. FOOD CERTIFICATE ISSUED
/-; "�{,i
�
. • 33. Final Electric Notes: ,o/71/S ! !� c97(
7. 34 Final Heating & Air Conditioning , /"^ ---74-,--r-87.0„;9-5.-
35.
�.y�. -`/J?}-
35. Final Gas Pipe-Test (IL/
/i (I ��� CJiG�! ??� U
Pipe:Test ••• -.C�-ct .�
36. Hood or Canopy .U I`ll -
37. Final Fac•tory Fireplace °
38. Final Plbing -
r-S vice-Final
a erQice-Final
41. r Domestic-Final . ,
42. Backflo Preventer '
Backflovv Irrigation
a
dscape Irrigation System
agme
d -Attenuation •
I ' 4
ica Regulations - EXPIRED
IItAL STRUCTURE & BUILDING Incomple Inspections
e al Requirements Completed Viir
i Uate Sig
49. IectnctRelease.to Edison
50. Gs Reline to Southern California Gas Co i
I. 51.'CERTIFICATE OF OCCUPANCY
No. Date ,