HomeMy WebLinkAbout612 TERMINAL WAY - Building Permits9lECTADOpESS: 61Z TERMINAL WY
OWNEWSNAME: ROSE GRAYSHOCK
aooeess: 1130 PESCADOR DR
N.B. 92660
RHLH/ENGINEEP:
ROOflESS:
HEG.NO.:
UNIT:
UNIT:
PEflMITTEE:BRIAN SINGER (719)598-7564
AOOflE55: S3ISZ REDHILL AV
TUSTIN CA 92680
LICENSEO CONTBACTOB OECLAflATION: I hereby af�irm �hat I am licensetl un0er pmvisions of C�apier 9(commencing with Sec�ion
7000) ol Oimsion 3 o�lhe Business antl Pmiessions Cotle. antl my license is in fullforce antl ellect.
ciTv uc.: srare uc.: cass: EXP :
,Oate: Signaiure:
WOflREBS' COMPENSPTION oECIAHFTION: I hereby allirm that I have a cenificate of consen� lo self-insure or a cenificate of worker5'
Compensa�ion Insurance. or a ceni�ietl copy t�ereof (Section 3800. Lah. C�.
POLICY NO.: E%P. OATE:
COMPpNY:
i ❑ Cetlilied coDY is hereby furnis�etl. ❑ Cerli�iea copy is fileA wil� Ihe city Builtling Division.
�a�e: Ap0licani:
E%EMPTIONFflOMWUPNEBS'fAMPENSATIONDELIAflFTION: Qhi55et�ionn¢etlnOlEecomplele0illhepefmiiisforonehuntlr¢tl�S100�af1¢55�.
I cetlify iha� in t�e pedormance ol Ihe work for which this Dermit is issueq I s�all not emDloy any Oerson in any manner so as �o Uecome
5 I ta the Warkers' Compensaiion Laws oi Calibmia.
,
ate: Signamre:
OTICE If, a�ter making IhiS Aeclaralion, you ShoWE became suUlecl �o Ihe Workers' Compensation Omvisions oi Ihe Labor
Cotle, you mu51 forthwii� comply with such pmvisions or Ihis permi� shall Oe deeme0 revokeA.
ONSTFUCTION LENUING AGENCY: I �ere0y aifirm �Aat ��ere is a consimction lentling agency far the pedormance of �he work lor
which Ihis permit is i=sued �Section 3097, Civ. C).
IEN�EP:
A�ONESS:
OWNEX BUILOEB OECLAflATION: I �ere6y a��irm tha� I am exempl imm I�e Con�ractors' Siate License Law lor IAe foilawing �eason
(5¢c�ian 7031.5 Business an0 Pmi¢Ssional Code'. Any Cily Of tounty whith requires a permil �o cons�mtl, al�er, imprOve, tlemolish, or
repair any s�rutWre. priar ta iis issuance. also requires the apPlican� lor sucA permi� to file a signetl s�a�emeni Ihai Ae/she is Iicense0
puauam lo Ihe pmvisions ol �he Contracmrs' S�aie License Law (Chap�er 9(commencing wilh Sec�ion 7000) o� �ivision 3 0� �he Business
and Pmlessions Cotle) oriha� he/s�e is exemptthereimm and the basisforthe alleged exemption. Any violation of Section 7031.5 by
any applican� �or a permit subjecls Ihe applicant to a civil penal�y oi no� more �han five hundred tlollars (5500�.
I, as owner o� Ihe D�oDe�Y o� my employees wi[h wages as �Aeir sole compensa�ion, will do �he work, ana ihe
❑ struc�ure is not intendetl or oflered br sale (Seclion 704a, Busmess anU Professional Coee: The Contractors' Slate License Law
OoeS noi apply Io an owner Oi a Omperty who Oui105 or impmveSlhereoq an0 w�0 tl0e5 5uth work himSelBhefsel� or ��fough
his or her own emploYees, pmvided Ihal such improvements are nol iniended or oife�e0 for sale. I�, however the builOinA o�
impmvement is 5010 within one year oi comple�ion, Ihe owner will have the burden ol pmving he/s�e Oitl no� builtl or impmve
lar Ihe Durpose oi sale�.
I. as owner of �he pmperiy, am eKclusivety conlraciing with licensetl conVactors to cons�mq t�e pmject (Seclion 7044. Business
� antl Prolessions CoOe: T�e Contracmrs' Sia�e License Law tloes not ap0ry to an owner of pmperty who 6mI0s or improves �hereon
ane who contrac�s tor such projec�s with a coniractoqs) license Dursuant �o ihe Coniracbrs' Sta�e License Law). I am aware
Iha� proof of theu Worker'S ComDenSaiion insurance 5houlA 6e pmvitle0 �o me.
I am exempt untler Sectian: B. 8 P. C.
lor ��is reason.
a1e Uvne[
I ere�y cetlily I�at I am aware ol ana untlerstan0 ihe requiremen�s of Calitomia Heal�h anU Safely Code Sec�ions 25505, 25533, antl
25534 and I�a� I or anyfuWre builtling accupaniwilllwill not�circle one) nee0�o comply wi�h saitl s�a�e codes an0i�e �equirements�or a
permii for conSlmc�ion or motli�ication tmm Ihe Air �uality Management DiS��ici. Residen�ial cons�mction applications are exemp� fmm
t�ese provisions.
Dat¢: Applitan�:
1 here�y ceitilyl�ai I have rea0ihi5 apPlication antl stale Ihalihe abovein�ormation is carrecL I agree�o comply with all city and coun�y
orOmance5 antl Slale laws relating to OuilOing ConS�mtli0n antl heBby aulhOrize re0�esentative5 Oi �his aty to enter upon Ihe ahove-menli0ne0
pf B y �Or InSp¢Ciipn pUr005¢S.
le' Signa�ure'.
Dreer's uce�se or Sociai Secuniy �:
t6<1 46 W�ile—Builtling, Green—Cotle EnlorcemenL Canary—Appllcanl; Pink—Revenue', Goldenrotl—Assessor
' ' CITY OF COSTA MESA — HUILDING PERMIT PERM NO: E 0?0894
PERMIT NO: E 070894 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION ; 1QOAMP SERVICE SQ FT;
CLAIM VALUE; CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: UPGRADE SERVICE
�t+ra�c�**�c+t*�*+t**�ac+t��*r�-�r*�r****+t�**�t�tr-*+t**�-r*+r�t*+�x��t-+�r**�r*+tx+r�r*�*�r*�rr-*�t-�r�r****�t+ta�«**�-*
Z O N I N G R E Q tJ I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN AGFIT; FT IN
PARKING RE • PROV; PARCEL; 00000000 ZNE: REF NO;
PLANNING N TES>
7
1f iEiE iE 1f iEff if iE�lf if if it M iFiifE 1F if fE iE if if iE iE if if 1E 1f 1E1f if�lE if ff1f�lEiE if M iEif if if if if if ifif 1f1f ifiE if�1F 1f if 4 if iE 1f if 1F 1f if iEM iE �fiF iF if�iEifif jf 1EiE if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ,
DATE:
HUILDING APPRO��ED HY : DATE:
APPLICATION ISSUED BY; DATE; ����� �
itMifififiElEiEiElEjFkiEifififiEiEikiFicif iEiEifx-iE�fiFifiEiE �lf
ifiFitif�)lifilifiEiElEKif�GiElEiEiFifMltiFiElfjkififiEihififNiEjfafifiE jfifMffifififjFiFiFiEK##i4ifiFifif�E1F�G�f%ififiElEiF�fitiRlEiEaEiEifjfiEiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADIP]G
PERMIT 20,00
SOt SMIP/NON—RES
PLAN
ISSUE FEE 15.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 20.00 15.00 0,00 35.00 35.00 .00
REVENUE DIVISION TOTALS--> COLLEGTED: 35.OU �VEftf5HORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
35,00
i! iF % sf if iE iF If kiFif M iflf if �f k if if if if if aE iE if ik if ikif iE iF if jE 1f if if 1f iE iE 1lif t� 4 1f if iflf iEif if if ?E�k if if Y iF if iE M af M ifit +t if if �f iF if iF iF +f iE ifit i! 1E fF
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 2 RECEPT/OUTLET 1 ST 20 EA. ,75 1,50
ELE 1 SEAVICES BELOW 600 C' S BELOW 201 AMP 18,50 18,50
END OF FEES
Qi �U2755±1-001'5bSi ?-CsT =S,9C:
oA7E= OI/?6�45 TItIL= 11:"n4
CONSTRUCTION AND PLANNING
APPROVALS Permit �
1, Temporary Elsctrical Service or Pole
2. Soil Pipe�Undrgmd.
3,_Etectrical Conduit Utility-Undrgrnd.
4. Electrical Condoit•Undrgrnd.
r�
5.' Steel Reinfo�ca,mdr; t
6.-Et'ectrlcai UF6R XSmd.
,�.�� >,�_
"9. VVater Pipe-Undrgmd. .
70. Struaural Floo� Svstem
11. Property Sewer Line & House Connectio�
72. Sewer Cap y
-c
73. Roof Drains � 7
. o.
14. Rough Piumbing� � 6.
15. ftough ElectriCai-Condu;t
r
16. Rough ElectriCWiring
17. Rough Wiring Siyn
78. Rough Electrical��T Bar Ceiling
19. Rough Heatin4 & Air Conditiomng
20. �Rough Factory Fireplace ; .
21. Ducts,in Strutture
22..�Jucts, Vent(lating
23. Gas Pipe�Rough & Test �.
24. Roof Framing -
�ZS. Roof Sheathing ,
26.�T�Bar Ceiling iStructurail & h4onocoa;
'27. Frameand flashing . .
28. La.hing & Siding •
29. Insulation �
30. Drywail NaiGng
31. P�aster BrowreCoat •
32.' Electrical Powar Meter-Fir;ai
33. Final Electric� �
34. Finat Heating & Air Condi?ioning
35. Final Gas Pipe-Test � ,�
36. Nood or CanopY - _ '
37. Finai Factory Fireplace -
38. Finai Plumbing
39. Water Service-Final . '
40. Gas Service-Final . �
47. Soiar pomeetic-Pinal
42. Batkflow Preventer .
43. 6ackflow Irrigation '
44. Landscape Irri9ation System ' "
45. Sound Atten�ation ,. „
46. �Nandicap Regulations
47. FiNAL STRllCTURE & BU1LDfNG
48. FINAL Pl.ANNING
49. Electric Reiease to Edison
50. Gas Release to Southern California Gas Cc
51. CERTIFICATE OF OCCUPANCY
Dace
Date
e
Pc. _ & SPA
�°� APPROVALS Permit # "
52. Pool & Equipmen2 Location
53. Steel Reinforceme�t
54. Forms
55. Electrical Bondi�5
56. Hough Plumbing & Pressure l'zst
57. APPflOVAL TO COVER�GUNITE
58. Eiectnca� Conduit�Undrgrnci.
59. Gas Pipe, (�I Und�gr�d., Tese
60. Backwasn Lines, P-Trap, O Undryrnd.
67. APPP,OVAL TO DeCK
62. Backwash & ReceFtor�Final
63. Heater & Vent�Finai
64. Plumbing System - Final
65. Electricai-Finai
66. Solar SYstem-Final
67. Fencing & Access ApProval
68. APPROVED FOR PLASTERING
69. POOUSPASYSTEPASFINAI
FtRE DEPL fiEQU1REMENT _
� APPRO:VAIS � .�Permit?F '
70. Undergriiurid HYdro '
77. Product Piping C Gas ❑ 0��
72. Undergrowtd Flush �
' ,73, Undergmd.Storage'iank OGas ❑Oii
74. -Overhead Nydro
75. bry Chernical . � '
� 76. Dry Standpipe � �
� 77. FIXEDSYSTENdf�NAL
� 78.•FIRE PREV. FI�ti�AL '
HEALTH OEPT. REQUIREMENT
79. FINAL INSR�CTIQN - • �--
' ' 80. FOOD CERi"IFICATE ISSUED -)
Notes: .
Date � tnspecior
�
�
JOB
ar
F
St.
l�I
SUBCONTRACTOR
�` 24924
� COSTA MESA BUILDINGSAfETY DEPARTMEt�fr
'P.O. BOX 120! COSTA ME4A� CALIFORNIA Y2E2E
For App11mM'fo Flll In Compbtoly
PE OR PRINT
eU1LDIN0. �p
AODRHYD Ci
COSTA MESA. CALIFORNIA
0
STATE
LIC. NI
II12E
� BHTOACK
�/w/J/ e
Ho. o� e�.no�.
DESCRIPiION OF WORK
�1 X6R6lV I
AND BTAT6
PLY WITM I
sU1LO1NG C
� AUTH0111Z[D AO[Mr
��
.1 M�V6 11fAD TNI�
CBTY 0� �:�S �.� MESA
NOV 19 1965
�[cn'r Ho.
tea�t A N11 ��
ouee�max !`�df
A. P. NO. //`" v
Nore� No uve oveRHwe
YARDB MPROV [D
MAIN BUILDIN6
( FROM C/L QTR[[T)
VAR. JQ
D— ��
aNwu ee �¢sa rH�n
YARDBAPPROVBO
ACC6LBORYBUILOINO
BET. MAIN G
ACCESH. BLOOB. �
DATH
APPROV2U
....,e //" /
� f.ni r p,
q
BQ. F�. �
TMl AMOUM �MOWN UNDlR VALUATION 18 POR TX8 �
�YRI�ai 01 iRMLIlMINO A PlRMIT PBi ONLY.
VALUATION GU 9 m.p �
PERh11T FE6
1��� �y �
s w
� TOTALPiB � S�