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HomeMy WebLinkAbout158 TULIP LN - Building Permits CITY OF COSTA MESA SERVICE REQUEST & PUBLIC ASSISTANCE FORM Date 7- 0?-c2, �yy _ Time 0 � Caller's Name moi/ it-E /f/ILGF. �CC�/P �f / Address 0 /6?s (�.G� C (7 y Phone / 77 Nature of Request: (location, type, severit ) } -43-eAd,-6-77J �'7t�C<< / C L di --- d—t/J_7 e_x_, ,-tic/ ---I2.rf—r ✓06 Cc—$- 7� - , Referred'to 7_/ Call back fl Service Only Information Only Person Receiving Call f�c e 7 r/Le'- --- �,: ; w ,/G ✓amu ---nc 7- 4- - .7s_ • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MF,SAG .�NSTR UCTIQN PER/MIT----: PERM1ayV0. TRACT NO, LOT NO: UNIT NO. • • • • Project Address I/�Q U�,/ /� Z. ,,t'7np�g640$ /TJ `/3 7 • 1 Applicant's Mailing�Adddrr-eesss��• /S33: L(/ ,ny OL� / TYPE OF CONSTRUCTION ❑ NEW H ADD U ALTERATION H REPAIR Owner's Name 1�T/`L1EL Phone/ '/ �� E CONVERSION El DEMOLISH ❑ OTHER - A.P.# • - Zone DESCRIPTION OF WORK/USE OF BLDG. Address SAmG - - E Main Building: • n1 Ilnrir 9. ss AcceorlyltyTr ilding: rl- c Or 'Z Arch/Eng, License No. ' TYPE OF PERMIT .❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front 0 Address Qac q A ^ ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's NamePI9 LS !'LU�.O/IUCD Phone ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N A • ddress(mailing) - _ Li �'J - K Left 011 2/ - CONSTRUCTION TYPE VALUATION $ R City License No. / ZONE GRADI NG CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION - - Ping. Ref.# Parking Req./Prov' ed ny a I hereby affirm that am licensed under provisions of Charter 9(commencing ReRiarkS:Y, Planning Notes: 1":' . 2 8 �`�� M with section 7000) of Division 3 of the Business and Professions Code,and RECEIVE T • my license is in full force a.. of - d/,Sin L' S License lass _ L ce e i / - \.l Date i .7 Signature -�1.� at, PLUMBING FEES WORKERS' COMPENSATION DECLARATION Bar Sink - Showers ELECTRICAL : FEES - I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certifi copy thereof (Section \ Backflow Preventer Service Sink 3800, Lab. C.) (/U Automatic Washer Transformer ❑ 15-50 KW Policy No. OQy1 /U Company RIIe � Backflow Irrigation Sewer Cap ❑ 50+KW i, Construction Pole Sub. ,Certified copy is hereby furnished- D Certid cjlpy's tyled with the city Bud 'ngOivi n. �•� _. �f Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps Date (�a—�4 Applicant �/ f C��L et<�Y/� - 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). Dishas wher Solar Piping -- - - Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan I . Motors 1:113-1 HP ❑1'h-8 ' ' Workers' Compensation Laws of California. _ Date Signature Floor Drains Swimming Pool w/Spa • F.A.U. • Inc,Solar ❑9-15 HP 0i6-15+ • NOTICE:If,after making this declaration,you should become subject to the - - 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 • CONSTRUCTION LENDING AGENCY 'Gas Service Outlets Water Closet - Device Boxes Pole Light• • i • I hereby affirm that there is a construction lending agency for the performance n • of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors ,/ sa Water Heater o Outlets Range ' Lender's Name _ - 'Gend'er's Address - Kitchen Sink - Water Service - - Switches Sign •• • 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 Laundry Trays Generator 1110-55 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 Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of • Division 3 of the Business and Professions Code) or that he/she is exempt - - - therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil • - peenalty of not more than five hundred dollars($500). L 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 ' 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 ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or , Type I ❑ Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II ❑ "Diction, the-owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By - Date prove for the purpose of sale), - ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat 7' / 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 • SUMMARY 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 thatBUILDING PERMIT . $ - SMIP $- Exhaust System D Multiple ❑ System Repair/Alteration proof oftheir 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 • $ MVVMM ISSUANCE $ - Date Owner Heating System& Ducting Registers • PLAN CHECK 25% $ ENERGY Pt. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU ❑100,000 BTL • ELECTRICAL Si- • GRADING $ information is correct. agree to comply with all city and county ordinances • and.state laws relating to building construction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $ - sentatives of this city to en er u or, the above-mentioned roper y„Jor - - /')• inspection purpos /J n ,r,%`^�' OV MECHANICAL $ TOTAL FEE $ �OV Signature 79J � : • . Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS tl /\CMF 0865-46,rev, 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor , CONSTRUCTION AND,PLANNING POOL &SPA APPROVALS Perm # Date Inspector APPROVALS 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 it i t. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings I/.;; • 58. Electrical Conduit-Undrgrnd_: 8. Foundation • 'C-_ 59. Gas Pipe, 0 Undrgrnd.,Test; 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O_Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ll tt 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 ' r 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 70I . Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 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 -re 30. Drywall Nailing HEALTH DEPT. REQUIREMENT . . 31. Plaster Brown Coat 79. FINAL INSPECTION i • • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1. fVl I 33. Final Electric - Notes:So•23.8st csC,Fr c4,00, c.¢,(J 34. Final Heating & Air Conditioning /2•/6•11l •Q/ng-f- 6cpl(Z(,O 45 Pee a3 0,l• LED 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ---/ i i - f 39. Water Service-Final I' • - • '!7 . 40. Gas Service-Final :41. Solar Domestic-Final •-- - - - j 42. Backflow Preventer s ( . .43. Backflow Irrigation j r 1 ' n • r� 44. Landscape Irrigation System I • 45. Sound Attenuation C. C/ 46. Handicap Regulations I-- '47. FINAL STRUCTURE & BUILDING ' r. j' . 48. Special Requirements Completed .' . • 49. Electric Release to Edison p - 50. Gas Release to Southern California Gas Co - - • - 51. CERTIFICATE OF OCCUPANCY / - ' • No. Date I - - . • OWNER HOODENPYLE, ARTHUR T,. DATE 6-28-61 JOB ADDRESS 158 Tulip Lane, A,B,C,D & gar. BUILDING PERMIT NO. 1L723 - GENERAL CONTRACTOR Shoreline Construction VALUE $ 32,1113.00 gar, AP. No.118-07L-18 LOT TRACT FIRE ZONE DESCRIPTION OF WORK(L-plea w/det.h-oar, INSPECTIONS 1e.y_e , DATE I GROUP H & J TYPE V ZONE R-11 Underground Soil Ali<U.G. Water/y}y,$' --/y-(, PERMITS Underground Gas /A'J^IZcT' �.. SUBCONTRACTOR DATE ,Z.,� "UMBER Overhead Water and Gas nd _ Rough Heatinglat8 ya I31ou�$ d Q.. -..� 3-? -EA 'j c. f�� 4.�.W'I� Rough Plumbing -- -ft- /y.,,,_- F. 0�yr' - w 7_b-" • Miscellaneous to-o. / 'R-;�,,,� yt lt,-o� ; — . _ '3 , •:t, ' d. ! • Prop, Swr. liar House C St. Swr. S-'.- --- --_ r_ / -, ai 7 i- • "./ Sprinlding System 0 U it ,4p Heating, Final XS �, ,t,kl Plumbing Fixtures Jv/ Final Gas Test/5"--/S--/s=1_5-&-r- M,k.r 0-10-4' I 2 Construction Pole n �t-12,.,. i l Underground Power 1.1.r�'r , l�,� ,�f � Rough Wiring I / ^.C/ _ nor, ,-, 9-029 6/ /b 5s3° N `I i a✓ Trenches Forms Steel 7 ;2J2 _, - Floor System //V �/ Steel Reinforce Chimney Re-Rod /; , Bond Beam 1 I I ' I V.1\)/ Sheathing /J in, /q� C. ( 1 l k ��- Frame and F"la�s . g r / /�1 7... / $�' C Lathing, In./ Out r ' _ / __ .,�„ Plaster, brdm',n1 at ITj ca-,2 - f ,K Plumbing Fixthres, Final �/�.:}�,�S //-pp 0 y-�/(/' Electric Fixtures,Final ..3-/ti Jy2L-1,- v Building, Final //ijilS /2.7/-6 / ..y OCCUPANCY / I / t Form 210-5M-11-59 5-6 P UNITS A,B,C,D, & GAR. HOLD FOR SPECIAL REQUIREMENTS 14723 • 7. .3 ,fr FEE RECEIVED c:.: . COSTA COSTA MESA BUILDING-SAFETY DEPARTMENT JUN211061 r P. 0. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLICAT& FQRCf{AIIMESA Ni..I.6r TYPE OR PRINT `° BUILDING r BUILRESS DING /rg'> /p A ea tKo �1 ADD `Al COSTA MESA. CALIFORNIA / For Office Use Only OWNER //o �('G/(r DO� �,( RECEIPT NO. PHRMIT NO / !!! T lv7z MAIL 7X— JO,/ ��� RECEI.{ED BY DATE RE(AIyED,� OAT=�BUED�I ADDRESS _ /C// I --.0 1-// 6 g CITY G6sr,4 ,4'tra TNEOLA44e J-) ADDRESS l OR ENGINEER (-Aar TEL ¢s' COSTA MESA. CALIFORNIA ( ,,,\\\ FIRE 7�/// rl ADDRESS 5:74,--‘7-//4/y..4-. \ /�J4444�/�, r ///// ZONE TYPE /� GROUP /"' IN CONTRACTOR ./ / (��L//2/,C E1.vli- APPROVED BY DATE ADDRESS 2_2.,86 02—r2e._-7— g/'V1 ZONING /`— //' //���� //A� \//\ /�} ZONE NO.OF USE OF NEW J CITY l . LY��� /4'( E3,4 ISP/LANS n, I BUILDING /// _0442 LTC.NO. /7z f//// / - /->/I!/NO.M C J' L?F DESCRIPTIONLEGAL P /C ©/� �J o2 • Oe✓..I pC7Wh�'� �Qj OF LOT//J JC V ‘ I NO. OF NOW ON LOTB D �" 7- fr1 y7 � ,a-- . ,/ p ��' �J ' A.P.NO. f/ .�- CI77 —/ (1 /-9 fdT- �VCI USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED •� SETBACK LINE FROM (CENTER LINE ST.) ? _ L,ry/ /J CENTER OP STREET- REAR YARD FRONT J FT. 1L 7.-.(A_&14-1 q it C0 SIDE YARD I LEFT I ` I RIGHTR.SIDE SFT. IN. DESCRIPTION OF WORK L.SIDE /♦Q X23, SFT. 1.1 (1-'. IN. ` • NEW .2/ V ALTERATION I II ADDITION I REAR ( /I ) 1'FT. I I IN. REPAIR I I MOVING I V DEMOLISH APPROVED 71J /I 0 DATE f0' (9l /I X- BUILDING 77/( • NO. OF /� 4' (_ �(if SIZE �J v ROOMS•. T STORIES II --C4-21-,e....0-6........ 1 Ilk -11 EXTERIOR WAL ROOF / 7 s p . 10 COVERING 1Vito COVERINr 0•-• IL._ �= ( 1 r/ye� "�• USE OF BUI •INC AND WORK TO BE PERFORMED ^TU pi PL£YSf %N 1 2 1 ' 3 in _` it • a-4-- ISI &*. ?at-R, '* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION m THE AMOUNT SHOWN UNDER VALUATION 16 FOR THE (VO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY. FLY WITH ALL CITY ORDINANCES A D STATE LAWS REGULATING •C BUILDING_CONBTRUCTION. Al, VALUATION /'' .r• --- OF P PERMIT FEE $ 67•2-� Int �j� �i�r1A L (�g'+.�G2/ $ 'lj y3-� PLAN CHECK S O7,12— L-}('jp F • (AGENT J�Lf� �- ✓✓J••• TOTAL FEE $ /,1 — u 'f I