HomeMy WebLinkAbout921 TANANA PL - Building PermitsApplicant lo fill in all spaces axcep� t�ose witnin �eavy Dortler Iinas an0 sign all aoVroOriate Geclarations.
CITY OF COSTA MESA CONSTR UCTION PERMIT PER NO ,/ TRACT NO. LOT NO. UNIT NO.
(� �,, // 7073 II/I2/86 3Io=_,
Proiec�Address q� � �1�INi�'(�ir'+ 1-'l.t-T�.�C . r
�'� TVPE OPCONSTRUCTION NEW' ADD ALTERATION EPAIR
� Appli[ant's Mailipng Address (� � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, � . Zone
Owner's Name `d-���\�c ��� Phone jZCpn� _� y,.y���,
DESCRIPTION OF WOR}4I�.$E O� F ZDG
Addreu ��� �"� e- . (�) ip_ SN�Q�/ �� �� %C'.'gQ 3l4 � S Main Building: � Accessory Building: �
�
Arch/Eng. License No. TVPE OF PERMIT � FOUNDATION STRVCTURAL T Front p
Addreis � ���,p� ❑ TENANT ❑ ELECTRIGAL ❑ PLVMBINg ❑ MECHANICAL A R¢ar N
ConVactor's Nam � � Phone OSSL=vK.J� � OTHER � n � � C Ri ht N
�ROJECT DESCRIPTION �Sa.FT. OCCUaA 9
Adtlresslmri'�nl 72 Q f Qyl��rl•} �y��Ql-{�.Im � K �
�—� CONSTRUCTIONTVPE VALUATION$ /� g Left R
CiryLicenseNo. �� ��� � ZONE GRADINGCU.VDS. ACRES E
^ LICENSED CONTRACTOR DECLARATIi3N Ping. R¢L dk Parking F¢q./PrOvided
L Q
I ha�eby afflrm [ha[ I am litensetl untler provislon5 0l Charlor 9(CommOnCing Remarks: PWnning Notei: M
with sectlon 7000) of Olvision 3 oi ihe Buslness antl ProleStions Cotle, antl T
my Ilcense is in I II torc a tl effect. ,j�Q� O� �
I Licansc C 55 I en c No.- - S
Date Signaturo PLUMBING FEE$
WORKER'COMPENSATIONOECL RATION Ba�$ink ShOW¢�5 ELECTRICAL FEES
� 1 here�y aHi�m lhat I have a certlfiWte of consent to self- e or a cerlHiwle
Oo/ Workers' Compensalion Insurance, or a cer[Hietl <opy thereof (SettiOn BackflowPreventer $Ervic¢Sink '
3Boo, Lab.�y.,� ��%�'� n` �-- Automatii Washer Transtormer ❑ 15�50 KW
Policy No. ��� �� �`� ComOan�h � ����1'�✓1�• 8ackflow Irrigation Sewer C2 ❑ 50 + KW
� � P Construction Pole Sub.
q,Certifietl copy is hereDy fumis�etl.
JaCertiri a co tilea wrtn tne city B' ' vision. Bathtubs Sewer Connection Cooking Unit Meter �up to 100 amps
�Date� 1+,- Applicant
EXEMPTI FR M WORKERS' CO ENSATION DEC A ION Cld�i(i¢�5 $OIa� C011¢C[O�5 Di5hwd5h¢! Meter Oover 100 amps
(This sectiOn neetl nat be mmpletEtl if [he permit I5 fOr on¢ ¢tl (b100) Or
Iess). Dishwasher Solar Piping Dryers �Gas ❑Electtic Sub Panel
I C¢rlity that in lhe performanta o1 th¢ wOrk fOr whith th15 p¢rm4 i5 i55u¢tl I
znall not emo�oy any perzon in any manner so as to become subject to tf�e Drinking Fountains Solar Tank Fan Motors 00.1 HP O7 h� 8
Workers' Compensa0on Laws ol Califomla.
Oate 5ignature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Salar 09�15 HP 016�15+
'NOTICE: I/, at[er making this tleclaraUon, you shoultl become sub�act to cha
WOrkCrs' Compen5dlion pfovi51on5 Of lhG LdbOr COtlO, y0u muSt Iorthwilh FI00! SiOkS Ufi081 Fi%Luf¢5
compry with suGh provisions or tbis pe�mll snall bo tleemetl tevok¢tl. MIUOwdv¢
CONSTRUGTION LENDING AGENCV Gas$erviCe OuUetS WaterClOset DaviCeBoXei Po12Li ht
1 M1ewby afllrm Ihat Ihere Is a consl�uctlon Ientling a9ency la� Ihe porlo�mance 9
Of [ho work tor which thi5 permil IS IssuOtl (SnCUon 309] Civ. CJ ' •
Interceprors Water Hearer Outlets Ran e
Lantler's Name 9
�enaer's Aaaress Kitchen Sink Water Service Switches Sign _
OWNERBUILDEH OECLARATION ~ -
I hareby a/firm Ihat I am exempt lrom Ihe Con[�ac[o�'s Llcensa Law tOr thu LBvdtO/i¢5 AUtO�W85h
following reason (Sectlon 7031.5 BuSiness antl Pro/essional Cotle: Any tltY or Garbuge Disposal ; Standing SeCti0n5 '
county which requires a permit to construct, altor Improvu, aemolish or repalr P-Trap Laundry Trays � Generator �65 KW �5-15 KW ' ' -
any ilruclure, prbr to its issuance, also reqWres t�o applicani for Suth p¢rmlt TrdSh COmp2Ct0l
to fil¢ a signed Statement thal he/She is Ilcensetl pul5uanl to th8 prOvlsions of RoOi DlainS
the Contrat[or's License Law (ChaO�er 9(commencin9 wlth Sectlon 7000) o(
Division 3 of [he Busine55 antl Protessions Cotle) or that h¢/She Is exempl _ ,
theretrom and [he ba5iz fOr the allegetl exemptlon. Any violatlon of Section -
7031.5 by any applicant for a permit subjects tM1e ap0licant t0 a clvll ��
�enalty of not more [han five huntlretl tlollars (E500). .S
I, as owner of the property ot my emplOy¢¢5 wi[h wag¢s as tbeir Sol¢ Reinspac[i00 F80 .$1$ ISSu¢ P88 $ 3 � ,
CompensatiOn, will tlo the wotk, antl th¢ structu�e is not Intentletl or otf¢r¢tl ReinSpeetion FBB $15 IAu2 F¢e� ' �+ � $ 3
lor sale �Section 1o4a, Business antl Professional Cotlo: Thn ConVactor's . MECHANICAL FEES
Litense Law tloes not apply to an Owner o� a D�ope�ty who bulltl5 or ImOroves
thereon, antl who tloez sucn work ni�nseli/hersell or througn his or ner own DEVELOPMENT $ERVICES REQUIREMENTS:
em0loyces, provitletl tha[ suth ITprOvement5 ar0 nOt In[CntleO or offer¢tl for BOiI¢f HOOd O� Type I ❑ • /'
sale. I/, however, t�e builtling or improvement is so1E wit�in one year of com- Canopy Typ21I ❑ Za^�^9 APVroved By Date
pletion, [ne owner will have tbe bur�en of provin9 he/Sh¢ tlltl not Duiltl o� Im- DUCt - UndC� GrouOtl Building Approvad By DetB
provB �ar [hc purpose of Sale). �
❑ I, as own¢r ot the'O�operty, am excluslvery contractln9 '�'��h Iicansetl con- Duct -StrucWral Refrigeraiion System AppliWtion 154ued By �, Dat
tractors to construct tne oroject (SCCHOO 7044, BUSitI¢55 dntl P�Ot0551005 COtle:
Tne Contrac[or's LicenSe faw does mt apo�Y �a an ownor ot property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU � SUMM��PEES �
builtls or Improv85 [hereon, anG wno contracts tor such Drojects witn a con-
tractor(s1 license oursuant to tne Contractor's Uconse Law). I am awara tha[ Exhaust System ❑ Mul[iple 0 System Repair/Altera[ion BUILDING PERMIT $ SMIP $
prpof o( tneir Worker4 Compensatlon insurance snoula �o provitletl ro ma. PLAN CHECK $ PERMIT
❑ 1 am exempt untler Section e. 6 P. C. lor this roason Firepl/Fact. Blt. ICBO �/k . Fire Dampers p�UMBING $ ��UANCE $
Date owner Heating System & Ducting Registers P�AN CHECK 25% $ ENERGY P.C. $.
I hereby certi(y that I have rea0 this appliwtion antl state that the abova ❑4100,000 BTU �100,0008 ' ELECTRICAL $ GRADING $
inbrmation is correct. I a9ree to comOty wi[h all clty antl mvnty ortlinancez
antl state laws �elating to D�iltling construClion, antl he�eby au[ho�ize re0�e- PLAN CHECK 5�°a' $ MICR�FILM $
sonlativas of lhii cily lo ente� upan the abOve-monUoned pr perty 10� .
inspectlon purpo MECHANICAL S TOTAL FEE $,
Si9nature Reinspeetion Fee $15 Issue Fee � $ 3 PLAN CHECK ' 25% $
Drivars' License r 55 $ —
�mr Utl6�-40. �ev. 1V/04 wn�ie - euua�ng; canary - sappucam; vinK - a�.ccounung; uoiaenroa -.�+.ssesso�
�INSTRUCTION AND PLANNING � POOL & SPA
� Date Inspector Date Inspector
. � APPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical Service or Pole . 52. Pool & Equipment Loca[ion
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '
4. Electrical Conduit-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, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, Q Undrgrnd:
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer 4ine & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap - 63. Heater & Vent•Final
13. Roof Drains 64. Plumbing Sys[em - Final
14. Rough Plumbing � 65. Electrical-Final
' 15. Rough ElectricaLCondui[ 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Eiectrical-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, Ventilating 71. Product Piping O Gas ❑ Oil
� 23. Gas Pipe-Rou9h & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ 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. Plaster Brown Coat 79. FINAL INSPECTION �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED '
33. Final Electric Notes:
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test
36. Hood or Canopy � .
37. Final Faaory Fireplace � �
38. Final Plumbing ,
39. Water Service-Final �
40. Gas Service�Final .
41. Solar pomes[icFinal
42. Backflow Preventer •
43. Backflow Irrigation
44. Landscape Irrigation Syste'm � � � � �
45. Sound Attenuation X P 1 R E D
46. Handicap Regulations - ��5
47. FINALSTRUCTURE&BUILDING 8---. �
48. Special Requirem0nts Completed
49. Electric Release t0 Edison 'Y'
- ' 1
50. Gas Release to Southern California Gas Co �J
�f
51. CERTIFICATE OF OCCUPANCY
No. Date
\
�rF��:2
� COSTA MESA BUILDING-SAFE'fY DEPARTMENT
P.O. BOX 73W GOSTA ME8A, CALIFORNIA Y10.T6
For Appp�ont fo Ftll In Compfatcly
TYPE OR PRINT
ioRe�B"a° 921 Tanana Place
COSTA ME3A. CALIFORNIA
t St, �coRee
FIRB
�lY• NO. �3�-7J1 ZON! �
APPRO�
[enr ck Ho 5 6-56i er
Place Casia Mesa
zo
R. Schmid
uv.�
andolph Ave. Df1C111►
Cali £ • A. P. NC
MO. OI �LDO�.
U6E OP
E%ISTIN6 BLOd,
sere�cKun�r�or I.[� 29•5�
C8NT8R Or �TR[t{ 47 RBAR YARD
BIDiYARD LiF{ J� RIQMT 7�
DESCRIPTION OF WORK
I HCRP2Y ACKNbWI.[DOR TXAT 1 NI�Vi RHAD TXtO �PPL�GTION
AN� BT�iB TXAT TX[ AGOV[ 1� CORqBR�AND AO0.B6 TO COY.
PLY WITX ALL CITY ORO)NANCL ANO �TAT[ I,AWY R[OYNTINO
BUILOINO CONBTpp�/O�N. /^1/
81GNATURE OF A 1_ l r. �. �
PERMI7TB���VDv�MA. AI'/L/"-�.7��
AUTNORR[D q6RM
FEB 17-67cnsa00 714++ **tr*99.C(
APPLICATION FOR PERMR
BUILDINO
For Offim Use Only
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VALUATION
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