The URL can be used to link to this page

Home My WebLink About2916 HARBOR BLVD - Building Permits Applicant to fill in all spaces except those within heavy border lines and-sign-Ill appropriate declarations. - 9409 3/1-5/05 _I •c?" "' � c T L •CITY OF COSTA MESA 1 C /NST�pR��ICTIIOO NN PER�M.b1- - P IT NO 6O� TRACT NO. LOT NO. rUNIT�A�6. � •, Project Address 2 q/G ,/ 412&.e /7 z 2/7/ / 5 — 1 • Applicants Mailing.Address ddre55 77t y»� TYPE OF CONSTRUCTION. NEW U ADD '� ALTERATION U REPAIR _ I�Z �GCL Phone CI CONVERSION ❑ DEMOLISH'❑ OT ER - „ A pt _ , - I Zone • Owner's Name, •E •IPT QUI • /USE O DG.7...- /LG Address • �� ,•C G ? - S Main Building: - - Accessory Building: Arch/Eng. License No. TYPE OF PERMIT GRADING FOUNDATION CI STRUCTURAL - T Front • ' , O Address ❑ryF.ENANT CI ELECTRICAL ❑ PLUMBING r CI MECHANICAL B• A Rear - N Contractor's Name q � / 75006a rift OTHER I /)��'�Z,/ //�Q� G�hone /�, ,./ C Right N (((( Address(mailing) / 2 `7f1fa��y �J� 7, _.r' PROJECT DESCRIPTION SQ. FT. OCCUPANry)/C , CON ST RUCTION TYPE - -VALUATION$ / •SL/(/ $ Left' R City License No. 77a ~✓ S ZONE GRADING CU.YDS. ACRES • E LICENSED CONTRACTOR DECLARATION • Ping. Ref.# Parking Req./Provided, a I hereby affirm that I am.licensed under pro '_'•ns of Charter'9 (commencing Remarks: Planning Notes: - M with section 7000) of Division 3 of the :usi ss and Professions Code, and \ my license Is in full tore- a.• effect. / , - T Lice .ss ' Li �. S Date %A Signature ��/�-' f 2�� i PLUMBING • FEES "'O RKERS'COMPENSATION DECLARATION LA RATION �I ' r\ ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL . FEES ' Workers' Compensation Insurance, or a cern Bar Sink Showers fed copy thereof (Section Backflow Preventer - Service Sink - - • • Automatic Washer Transformer 0 15-50 KW 3800, Lab. /I ,y PolicyNo 4126 -944 Como AIG L/,/� Backflow Irrigation Sewer Ca 0 50+ KW 9 P j Construction Pole Sub. HCertified copy is hereby furnished. C ie py A filgd with the city I ' Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps Date -. (P -15S 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). .!I I certify that in the performance of the work for which this permit is issued, I Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I- I, shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors 00-1 HP 01%-8 ' Workers' Compensation Laws of California. I ,I I . Date Signature Floor Drains Swimming Pool w/Spa F.A.U. nc.Solar 09-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the till Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks 1 Urinal - - Fixtures Microwave- --' , Ili comply with Such provisions or this permit shall be deemed revoked. `1{ CONSTRUCTION LENDING AGENCY t I1 0 I hereby affirm that there is a construction lending agency for the performance Gas Service Outlets Water Closet Device Boxes - Pole •Light • tip, of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name Lender'siAddress ' - Kitchen Sink Water-Service - Switches ' 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 r - Laundry Trays Generator ❑0-5 KW ❑5-15 KW • any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ,Drains - the Contractor's License Law(Chapter 9(commencing with Section 7000)of ' lvision 3.of the Business and Professions Code) or that he/she is exempt ,erefrom and the basis for the alleged exemption. Any,violation of Section • - - • • /031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500), - ; $ 3 U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15. Issue Fee compensation, will do the work,and the structure is not intended or offered - - j Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - - MECHANICAL - FEES ' 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 goiter Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for -_ ' sale. If, however, the building Or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By //n/ J7 Date 2 pletion,the owner will have.the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By oy f .lam - Date J// ($(,� it prove for the purpose of sale). J// /(� 0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By Data'YYY `.� tractors to construct the project (Section 7044,Business and Professions Code: ❑0-100,000 BTU ❑100,000 BTU The Contractor's License Law does not apply to an owner of property who Duct-Ventilating SU ARY OF FEES • 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 Exhaust System 0 Multiple 0 System Repair/Alteration • . BUILDING PERMIT $ / a- O SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ - ERMIT I ❑ I am exempt under Section- B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLAN CHECK $ ISSUANCE $ — PLUMBING $ - Date Owner Heating System& Ducting • Registers • PLAN CHECK 25% $ ENERGY P.C. 1$ ' - I hereby certify th. I h..e read this application and state that the above ❑0-100,000 BTU 0100,000 BTL -- - ELECTRICAL $ GRADING $ information is correct. I a• ee to comply with all city and county ordinances i and state laws relating t• •dilding onst action hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ inspection of this cit o e er he !. ntioned property for i inspection puree'es . - MECHANICAL $ 44' 2.7, V5 TOTAL FEE $ 242.3• ��- Signature SS , '� Date_ Drivers' License or' - l Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ • a CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Plnk -Accounting; Goldenrod -Assessor 'CONSTRUCTION AND PLANNING PO, &SPA APPROVALS Permit - .' - Date Inspector APPROVALS Permit • : Date- • Inspector '.1 Temporary Electrical Service or Pole ' • . . 52. Pool & Equipment Location • - - • ' C2. Soil Pipe-Undrgrnd. - - - 53. SteehReinforcement n ' 3` Electrical Conduit Utility-Undrgrnd. - 54. Forms . , - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ 5.-Steel'Reinforcernerit - - • 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.• - 57. APPROVAL-TO COVER-GUNITE . ' ,--7,"Footings c - - 58. Electrical.Conduit-Undrgrnd. 8.'1Foundation 59. Gas Pipe,Q Undrgrnd.,Test : <?9. ,Water Pipe-Undrgrnd. , - ' 60. Backwash Lines,P-Trap, 0 Undrgrnd. ' , • 1O Structural Floor System r - '' ' 61. APPROVALTODECK . - _ 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-Fina{ , ,_16. Rough Electric Wiring - 67. Fencing & Access Approval . 17.'Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.:Rough Elecfrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' _ 4 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • . 20. .Rough Factory Fireplace APPROVALS' Permit# s - 21. Ducts,in:Structure - 70: Underground Hydro , 22, Ducts,-Ventilating" • 71. Product Piping0Gas 0 Oil 23. Gas-Pipe-Rough & Test,. - 72. Underground Flush - 24..Roof Framing, � 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25.FRoof Sheathing74. Overhead Hydro - _26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' . - 27. Frame and Flashing :76: Dry Standpipe1. . • 28. Lathing €& Siding 77. FIXED SYSTEM FINAL \ 29. 'Insulation 78. FIRE PREY. FINAL ,,,/� ,, 30..Drywall Nailing 1 . , HEALTH DEPT. REQUIR L''MENT -_ 31. Plaster Brown Coat ; 79.- FINAL INSPECTION 32.,Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED I 1 . 33. Final Electric 1 Notes: ' - 34. Final Heating & Air Conditioning . ' r 35. Final Gas Pipe-Test . . 36. Hood or Canopy - - . 37. Final Factory Fireplace _ - • 38. Final Plumbing • 39. Water Service-Final , 40. Gas Service-Final 4 . • ' - 41. Solar Domestic-Final • , , - -.. 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 . ' ' Completed 49. Electric Release to Edison ' i - ' - - - - , 50. Gas Release to Southern California Gas-CO I .. 4 ' 4 I 51. CERTIFICATE,OF OCCUPANCY. ' * .. . _ - - . _ ' No. Date . . . _ _ _' • _-- , _ - _