HomeMy WebLinkAbout534 TRAVERSE DR - Building Permits— ' App�icant to Iill in all sDaees except those witnln heavy DorCer Iines an0 sign all apOroOrlate tleclarations.
� CITV OF COSTA MESA CONSTRUCTION PERMIT PE IT.{VO� O TRACT NO. LOT NO. UNIT NO. A P# Zone
Project i�ddress 3 _ � S Main Building: Accessory Building:
. APP�icant'S Mailing A dresi TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
/� ��-� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front �
Owner's Name Phone�_ �(.�¢�� DESCRIPTION OF WORK/USE OF BLDG. A Rear N
Address
Afch/Eng. LicenSe No. TVPE OF PERMIT GRADING�y FOUNDATION STRUCTURAL i K Right G
� Addre55 ❑ TENANT ❑ ELECTRICAL VJ PLVMBING ❑ MECHANICAL , g Left R
� ❑ OTHER
Contractor's Nam Phone R�9�,� Ping. Ref. � Parking Req./Provided E
�Q �y� PROJECT DESCRIPTION 5G1. FT, oCCUPANCv �
Address (mailingl— c�� / �!V Planning Notes:
CiryLicen�No ��� O?;p CONSTRUCTIONTYPE VALUATION$ „ M
T
ZONE GRAOINGGU.VDS. ACRE$ g,
LICENSED CONTRACTOR DECLARATION ii FE8 1 5 19 9
1 hereby affirm that I am litenzetl untle� provi51on5 of Chdrter 9(Commancin9 Remarks:
witn section 7000) of �ivision 3 0( the Business antl Professlons Cotle, antl
my license is in fuu for� an eftect. �.7 ELECTRICAL PEES
License Gr�la'ss�1 LI nse
Date yi.;z�' 59 t � -^�/� PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
� WORKEilS'COMPENSATIONDECLP.RATION 88fSink ShOWers ConstruCtiOnPoleSUb. �50+KW
I he�eby af(irm that 1 have a c¢rtifitate ot tOn52nt to self-insure o� a certiflcate
of Workers' Compensation Insurance, or a certifietl copY thereoi (Settion Cooking Unit Meter ❑up to 100 amps
I 3800, Lab. CJ n �/��/,, ' � �,,-I BackflowPreventer ServiceSink
\ Policy No. �a�y��%��Q Company '�7Ll.f� ��LC.IL-� Backflowlrrigation SewerCap Dishwasher Meter ❑over100amps
�ertifietl copy is �ereby turnishetl. Dryers �Gas ❑Electric Sub Panel
Certifietl c Is filetl with the city B Ing�y 5I .//� BdthtU65 S¢WCf COn02Ct100
Date�_ Appiicant � y/ (� A�� Fan Momrs �41 HP 01 X- 8
EXEM ION FROM WORKERS' COMPENSATION �ECLARATION Clafifi¢fi $plar C011eCtofs
i ssissection neetl not be completetl if the permit is tor one huntlratl (E300) or Dishwasher Solar Pipin9 F�A��� � InaSolar �9-75 HP �i6-15+
I ce�rtify Ihat in [he P¢rtormance oi Ihe work (or which this permR is IsSuetl I FixtUr¢5 MiCrOwave
shall not employ any person in any manner so as to betoma subject to t�e Drinking Fountains Solar Tank
Wo�kets' Compensation LawS of Califo�nia.
Date Si9nature Floor Dreins Swimming Pool w/Spa Devite Boxes Pole Light
NOTICE: If, afte� making thi5 tleClaration, y0u shOultl bG<Om¢ subject to the �ut12L5
Wo�ke�s' Compensation provi5ion5 of [he Ldbor CotlC, y0u Tust forthwith FI001$i�k5 U�ipol Range
comply with Su<h prOVISiOns or NI5 pe�mlt snall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV GaSServiC¢ OUtIeLS SwitCheS Sign
1 hereby affi�m that fhere i5 a canitructlon IenAing agency for the pe�to�mance �
of tne work for which t�is permit is issuetl (Section 309] Civ. C.) InterCeptors Water Heatef � GBrbege Di5po5al $tanding SeCtionS
lPntler's Name
Lentler's Atltlress Kitchen Sink a er er Generator �0.5 KW �5-15 KW Trash Compactor �
OWNER BUILDER DECLARATION _ - /
I he�¢by affi�m that I am Cxempt f�om the COntracto�4 LlcenSe Law fo� Ihe LeVetO�i¢5 AUtO-WeSh
�ollowin9 reason (Section 7031.5 Businesz antl Professlonal Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repalr P-Trap Laundry Tra�s
any st�uclure, priot lo its Issuant2, also requir¢5 thE applicant (or Such pe�mlt ��
to file a signetl statement that he/sne Is licensetl pursuant to the provisions ot ROof Drains
the Contractor's Li<ense Law (Cnap[er 9(commencing wilh SecHon 7000) ot �
Division 3 ot [�o Business antl Professions Cotle) or that ne/she is exempt ReinSpection Fee $15 luue Fee S 3
iherefrom antl Ihe ba5i5 fOr th¢ allegetl exemption. Any violdtion of Section
7031.5 by any aOPlican[ for a permit subjects the apP��cant to a clvil
enalty ot not more Ihan (ive nuntlretl tloiiars (E500�. DEVELOPMENT SERVICES REQUIREMENTS:
� I, as owno� of th¢ prope�ty O� my employe¢5 with wage5 a5 [hei� sole RBinSpBction FaB $15 ISSUB FaB $ 3
ZoninB APProvad BY Date
comDensation, will tlo tbe work, antl t�e structure is not Intentletl or otferetl
for sale (Se<tion 7044, Businesz antl Protessional Code: The Contractor's MECHANICAL FEES . Building Approved By Dat�
License Law tloes nol dpply to an owne� oi a prOper[y wlto bulltls Or Imp�oves
thereon, antl who tloes sucn work himsell/hersclf or tnrou9h his or her own Boiler HOod or T e I ❑ %rPPliWtion ISSued By Dat
employees, provitl¢tl that suctl imprOvements are no[ Intentlatl or otteretl 1or YP
sale. If, however, the builtlin9 or improvement is soltl within one year ot com- Canopy Type 11 ❑ SUMMARV OF FEES
D�etion, the owne� will have t�e burtlen ot prOving h¢/She GIC not bW Itl o� Im- DUCt - UndC� G�OUOd
nrove tor tne ourpose ot sale). BUILDING PERMIT $ SMIP $
❑ I, as owne� of the property, am exclusively contractln9 with licensetl con- Duct -Structural Refrigeration System PLAN CHECK $ PERMIT �
[�aclors [o consbuct [he O�olect ($ection ]044, Business antl PrOfesslon5 Cotle: T
The Coniractor's Licenze Law tloes not apply to an owner of propertY who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $�� V ISSUANCE $
builtls or improvez thereon. antl who contracts fo� sucn oroie<ts wltM1 a ron-
tracmr�sl license pursuan[ ro�ne Contractor•s License Law�. I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $
proof o1 their Worker's Compensatlon insurance shoultl be prowtletl to me. ELECTRICAL $ GRADING S
❑ I am exempt untler Section B. & P. C. �or this reason Firepl/Fact. BIL ICBO �k Pire Dampers � MICROFILM �
�r PLAN CHECK 50°b $
Data owner Heating System & Ducting Registers ' MECHANICAL $ TOTAL FEE
I hereby certify that 1 have reatl tnis application antl state that the above ❑0-100,000 BTU �700,0006T PLAN CHECK 25%
InfO�mation is mnect. I aqree to compty wi[h all ci[y antl county ortlinance5 1 $
antl state laws relaling to builtling con5truclion, antl hereby autho�iEe rep�e- '
s¢ntalives o( lhis city to en[et upOn the above-mentionetl O�operty 1or
inspection pu se [ � n L,
Signature ' Da[e� a-l4•I
Rei�s�ctio� Fee Sts Isua Fee $ 3 G1 Dt]D26460—CQ02b460 T�� „ S,f_'�
Drivers' License or 55 � T
0865-46, rev. 5/88 White - Building: Canary - Applican4 Pink - A<counting; Goltlenrotl - Assessor L+��G+ L'L/ 20/u� Ij17L• 1L•UO
_�.
CONSTRUCTION AND PLANNING POOL & SPA
. APPROVALS Permit # Date Inspector qPPROVqLS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
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, p Undrgrnd., Test
. 9. Water Pipe-Undrgmc{.� � 60. Backwash Lines, P-Trap, O Undrgmd.
10., Structural Floor System 61. APPROVAL TO DECK
1}. Properiy Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewe� 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
✓
�1�. 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
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structureq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe •
26. 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: Z . j�Y L�F7-�,4eD, �,'� ��
34. Final Heating & Air Conditioning .. ��„CtU ``�n�.r �K�-.�r�A ���i Z0,3
35. Final Gas Pipe-Test (� �. L��
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final �
'1 7
40. Gas Service-Final Ci"_
41. Solar pomestic-Final:.� ;';
.
42. Backflow Preventer-i � � -''
_. ,. . 'y-
� r- ,
43. Backflow Irrigation;;: � ��
44. ,Landscape Irrigation System r,
45. Sound Attenuation , " " ,�
46. Handirap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison � •
50. Gas Release to Southern California Gas Co -�,a /� ��
51. CERTIFICATE OF OCCUPANCY , � �
No. Date �;•"
DESCRIPTION OF WOAK
FIRE ZONE VA
SUBCONTRACTOR
Service or Pole
V GV V)
PERMIT NO
� `asos
COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. 90%917 COBTA M88A, CALIFORNIA
For Appliaant to Fill In Complefely
TYPE OR PRINT
BUILDIN6 �
AD�RE55
COSTA MESA, CALIFORNIA
■ MAIL
USE OF ^��
EXISTING BLDO.
BETBACK LINE FROM �
L
CITY OF C�DSTA MESA
AUG 19 1965
APPLICATION FOR PERMR
ZONINCi
xo. o� uee
nune.,% eun
AU�T� �u8 i�o5
� LEOAL -P'L. � `S - L�Z . .Y�• GJ�
DfiBCPIPTION
� A. P. NO. �'7/` 4, �lJ�_`Y'
af1 _ I.C\.. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
EFT � I RIGHT
DESCRIPTION OF WORK
45
1 HEREBY ACKNO LEO08 THAT 1
RNO 6TRTE TMAT HE ABOVB 19
PLY W�TH �LL CIT ORGINANCEB
BUILOIN6 CON9TH ION.
SIGNATUREOF `
PERMI7TE
AUTHORIZED AGENT
7
YARO9APPROVED
MAIN BUILDING
VAR. �
e�
YARDSAPPROVED
AGGESSORY BUILDIN6
BET. MAIN @
ACCE55. BL[
DATE
RBAD TH19 PPLICATION THE M1MOYNT BXOWN UNOBR VALUATION 18 FOH TH8
�T ANO AO 8 TO COM� PUFPO38 Op EBTABLIBHINO A PEPMIT PE8 ONLY.
TAiH uw HouuilNo ypLUATION
� PERMIT FEE $
$ ,� 2�`� % .,� d