HomeMy WebLinkAbout838 WILSON ST - Building Permits9
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CITY OF COSTA MESA CQy,N�S�RUCTION PERMIT .�PE IT NO. TRACT NO. LOT�NO. UNIT NO. �
Project Address ��g ' V � 5 b 1�` 1'.� �
Applicant'sMailin4Ad ress SC3h � N�'•,/S ,�" �
Owner's Name � Phone
Address � 3� ( SdY� • � �
Arch/Eng. License No. .
Address
Contracto 's Name T Nt�.�IIY R��'�" r�kx�,���.S�34-OGO 7
Addresslmailin.gl �1�i�1T /�5 //'N/v`V�ci� Py<' �4
City license No. �� �S
LICENSED CONTRACTOR OECLARATION
I hereby affirm that I am licensetl untlet provisions of Cha�te� 9(tommencing
with section ]000) of Division 3 of the Business antl Professions Cotle, antl
my license is in (W t rc e ect. � �
Licensy Ql�s � cense No. 4 S�Q I,
Date-1 � 51g t � - ��-� —p �
WORKERS'COMPENSATION DECLARATION V
' hereDy atfirm that I have a certificate ot consent to selbinsure or a certiflcate
Workets' Compensalion InSurance, or a certifietl cOpy Iher¢Of (Section
l00, Lab. CJ
PoliCy No. Company -
❑ Certitietl mpy is nereby tumishetl. ,
❑ Certifietl copy i5 tiletl with the ciry Builtlin9 Division.
Date APplicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tbis s¢ction neetl not be mmpletetl if the permit i5 for one �untl�etl ($100) oi
less).
I certify that in the Oerfo�mance of tFe work for which thi5 Oe�mi( is issuetl,.l ,
shall not employ any person in any m ner so a ecome Subj C� [o IhG
Worker p n n Laws ol Californ a. 4
Di[e Si9nalure �
NOTICE: If, att r makinq.tM1is Uecla�atio , you shoultl become subject to �e
Workers' Compensation provisions ot the Labor Cotle, you must fori» th
[ompty with sucM1 provision5 or thi5 permit Shall be tleemetl �evOketl.
CONSTRUCTION LENDING AGENCV
1 hereby attirm tnat tnere is a wnstruction lentlinq aqency lor the pertarmance
of the wark ior which this permit is issuetl (Sectlon 3097 Civ. GJ
Lentler's Name
Lenaer's.Atltlress
OWNER BUILDER DECIARATION
I hereby affirm that I am exempt from the Con(ractor's License �aw for the
tollowing reason (Section ]031.5 Business antl Professional Code: Any city or
munty wM1ich �equires a De�mit to con5truct, alter, improve, tlemoli5h or repal�
any st�ucture, pdot lo its isSuanC¢, alm �equi�es the applicant fOr such Oe�mit
to fiie a signetl statement thai he/she is IicenSetl pursudnt to tne pwvisions ot
the Contractor's License law (Chapler 9(commencing with Section ]000) of
Oivision 3 of the Business antl Professions Cotle) or tnat he/she'is exempt
�er¢from antl Ihe baSis fo� the alle9¢tl ezemp[ion. Any violation of Sectlon
]31.5 by any ap0���ant for a permit subjects the applicant to a civil
penalty of not more than five huntlretl tlollars (E500).
❑ I, as owner of the property or my employees with wa9es as their sole
compensation, will tlo the work, antl the structure is not intentl¢tl or ofte�etl
for sale (Seclion 7044, Business antl Protessional Cotle: The Contractor's
LicenSE ldw tloes mt apply [o an owner ot a property who buiitls or improves
thereon, antl who tloes such work himself/herself or through his or her own
employees, provitletl that sucb improvements are not in[entletl or offeretl for
i sale. If, however, the builtling or improvement is soltl within one year of <om-
pletion, the owner wlll nave the buraen ot proving he/she tlitl mt bulltl or Im-
�rove for [he purpose o( zale).
I, as owner of the property, am extlusively <ontracting with licensetl con-
tractors to constru�t the project (Section 7044, Business antl Professions Cotle:
The ConVacror's License Law�tloes not app1Y lo an owner of property who
builtls or imvroves thereon, antl who conVacts tor such projectz with a com
tractor(s) htense pursuant [o Ihe ConVactor's License Law). I am aware Ihat
proof of tM1eir Wa�ke�'s Compensation insu�ance shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. for Ihis reason
Date Owner
I hereby certity that I have reatl this application antl state tnat the above
information is correct. I agree to compty with all tlty antl counW ortlinances
antl State laws �elating to builtling const�uction, antl hereby autho�lie re0re-
sen[atives o( his aly en[er upOi Ihe above-mentionetl pro ert fo�
inspectlan pur ses.
Signature � - 6�"�a � ^� - Daie�
orivers' License or 55 � �-
U�
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVEASION ❑ DEMOLISH ❑ OTHER A p#
DESCRIPTION OF WOFK/USE OF BLDG.
S Main Building:
TVPEOFPERMIT GRADING�4 FOUNDATION STftUCTURHL T FrOnt
❑ TENANT ❑ ELECTRICAL YS PLUMBING ❑ MECHANICAL B Rear
❑ OTHER A
PROJECT DESCRIPTION 5�. FT. OCCVPnNcv C Right
.CONSTRUCTIONTVPE VALUATION$ S Left
ZONE GRADING CU. VDS. ACRES p�n9. Ref. �Ik
Remarks: �%A �• .v� l7 �O K�A 1!� l l Aw O 1.. _ � 1� C Planning NOtes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
I nterceptors
Kitchen Sink
Lavatories '
P-7rap
Roof Drains
Reins�ection Fea � $15
Boiler
Duct-Under Ground
Duct - Structural
Duct - Ventilating �
Exhaust System � Multiple
Fiiepl/Fact. Blt. IC80 �k
Heating System & Ducting
❑0-100,000 BTU �100,000
Neinspection Fea � $15
CMF 0865-46, rev. ]0/84 White - Building; Canary - Applitant; Plnk - Accounling; Goltl¢nrOtl - A55¢Ssoi
Showers
Service Sink
Sewer Cap
Sewer Connection
$olar Collecmrs
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fae
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration Sys[em
❑o-ioo,000eru ❑ioo,aoo
System Repair/Alteretion
Fire Dampers
� Registers
Issue Fae
FEES
$ 3
FEES
$' 3
i5e� zioeia�
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Auromatic Washer Transformer ❑ 15�50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit
Dishwasher
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Bozes
Outlets
Switches
Garbage Dispoul
Generator �0.5 KW �5-15 KW
Meter LJup to 100 amps
Meter �over 100amps
Sub Panel
Motors�0.7 HP�Ih-8
Inc.Solar �9-15 HP �i6-15+
Microwave
Pole Light
Range
Standing Sections
TraSh Compacmr
Fee �$15 � � Issue Fee
DE VELOPMENT SERVICES REQUIREMENTS:
Zoning Approved 8y
Building Approved By �1 '
7v0� TL
FEES
$ 3
Z
O
N
1
N
G
R
E
Q
M
T
S
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PEfiMIT
PLUMBING $ � ISSUANCE $ .
PLAN CHECK 25% 3 ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM 5 �'] (�/�
MECHANICAL 5 TOTALFEE $ �
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING POOL & SPA �
APPROVALS Permit# 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
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, � Undrgrnd.
10. Structural Floor System 67. APPROVAL TO DECK
7 7. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains ' . 64. Plumbing SYstem,- Final
74. Rough Plumbing 65. Electrical�Final
75. Rough Electrical-Conduit 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceilin9 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 � 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 (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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Flnal Electric ' Notes: � � �
34. Final Heating & Air Conditioning , •�
35. Final Gas Pipe-Test `
' ,ri i . s+a. L
36. Hood or Canopy
�' � .C-�r
37. F.inal Factory Fireplace
38. Final Plumbing 11/� %��' � �
39. Water Service-Final , _
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
'43. Backflow Irrigation
,44'. Landscape Irrigation System ' • . •
'45. Sound Attenuation
46. Handicap Regulations � ,'
47� FINAL STRUCTURE & BUILDING
48. Special Requirements Completed •
49. Electric Release to Edison . ' �
50. Gas Release to Southern California Gas Co "
51. CERTIFICATE OF OCCUPANCY
No. Date ,
.. -.
354�38
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Comp/etely
BUILDING ,�l �/ �SO N
ADOflESS /v �
OWNER ( (_/4.VTN /I/D�H/V!!`/�
I
M A I L ^ ^/ BUI LDING
Z .
ADDRESS S /�- / yI I�— �+DDRESS
W W � TEL.
d U CITV �O I L. R No. ..q A TRACI
Z
Z Q CANSiPUCTION W A
O N LENOER
d m
J � BRAN
J N pWNER
Q ADDFESS
4 Ael
J Q ARCHITECT TEL. S ltJl
Oli ENGINEER N
U Q FIRE
W � ADDftESS ZONE
a w APPROVE
1
J O CONTRACTOR _ � Z, BV
m Z
J ¢ ADDRE55
SEP 26-72PAIo001013� *-***C/�
CXSA J.v�
II
FOR BUILDING PERMIT
��VCE' /7 DVIi7�si
BLOCK
w w TEL. ZONE �/f NO.OF USE OF NEW
ZF CITV NO. r` P�'�'� � BUILDING �
w� STATE CITY YARDSAPPROVED VARDSAPPROVE�
�� LIG. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDI
� � SI2E NO.OF BLDGS. (FROM C/Ir,STREET)
OF LOT NOW ON LOT FROM
USE OF
EXISTING BIOG.
F SIZE OF NO. OF
Z NEWBLDG. FOOMS STORIES L.SIDE
U E%TEflIOR WALL ROOF
COVERING COVERING REAR
USE OF BUILDING AND WOR TO BE PEFFORMED DISTANCE El
MAIN BL
� VAR. #
O C.U.P.�
r APPROVEO
�
z
0
V1 hereby acknowletlge Ihet I have �eatl this application antl sta[e !
� ffiai xhe above information is correct antl agrae to comply with �
� all laws repulating builtling const�uction, antl I shall not employ
�,,, any persOn in violation Ot [he warkman'S compensation laws Ot
N the State ot Calitornia.
ZI hereby certify that I am Oroperly licensetl as a contrecror untler
[he Stare ot Calitornie Business antl Protessions Cotle, Divisicn 3, THE AMO
Chapter 9, antl that such licenses are in full force antl eftact, or I THE PURPf
em exempc from the provisions o� the Stete of California Business
and ProfesslOns Cotle, Division 3, Chap e� . V%��VATION
Sipnaiure o�e�� ��G��� ��/�/}�� III---���
Permittea /✓� �i��L/// !/� -' $ �D
Aut�orizetl Agent
BET. MAIN &
ACCESS. BLD
DATE
� �
0
VALUATION IS FOR �
A PEflMIT FEE O Q
m
E 5 �
�
KS E
� LL
I $
OWNER NORMAN
�JOB ADDRESS 3�
�`NERAL CONTRACT
� Jo. 115-57�-17
�f� INSPECTIONS
(@' SOIL
� GAS
WATER
ROUGH PLUMB�NG
PflOP_ SWA. LINE 0 HO��
SPRINKLING SYSTEM
W. Wi
LOT
MISCELLANEOUS
ROUGH HEATING AN� Alk CONOITIONING
TEMPORHRV SERVICE OR POLE
UNOERGROUNO � P4WER �
ROUGH WIRING
TftENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BON� BEAM � STE�LftEINFORCE n
SHEATHING
FRAME AN� FLASHING
LATHING — IN n OpT [�
TER.BROWN COAT
HEATING. VEN
aii�i niur. ciuei
AN� A.C. FINAL
i TEST
TRACT
DATE 9/26/72
BUILDING PERMIT N0.
SUBCONTRACTOR
OW NER BRZSTOL ESTATES DATE 9-S-S6
JOBADDRES3 83i rif1150R Street BUI�DINGPERMITNO. �3559
GENERALCONTRACTOR S. V. HllIlS8IS2P VAWE � S�OS6.00
• 13 s�ocK TRACT 2873 Single Res. w/att, gar.
GROUP I St J TVPE V ZONE Rjl FIRE DISTRICT 36Z3
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
, , / i DATE I NUMBEH
Foundation Forms and Grade to
Plumbing, Rough to Slab
Plum6ina. Rouqh Compl<
�
�
Heating, Final %%/P 5 - )�Y6
Sewer, House / Sewer, St. � � S /o//�/Y6 Lu %t��-2 �0 - �l -._�� %O lo .� -'
1�- �
SepticTankor�..�sspoo� `J7/� S /D�//�,,i�[ ��I.�i � �a, /h-�%-�i� 7Ii/ .3 --
L �ng, In Out� �U^����-� %�"�.L- �
P..=,.ering y�� � ' .
Plumbing, Final, Fixtures Complete %{4eS -/)iS � /��c" / ` '
Plumbing, Fin.al Gas Test /.S" YVl. � j /�,'/D� S� i .._� _� �
Wiring, Final —� „ ' /0 _ G�- � . t � �
Occupancy �ij7 (! /J�Yvi � .v /� -/ 7•j G
FORM 210 3M IO�vS
Y posta Mesa Bailding Department APPLICATION FOR PERMIT
�'� . P.o.B°x3" �R23 BUILDING '�
' " COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permtt No.
nadre� b'38 �t1i�s-o.,� ST. ,35�
Costa Mesa, Ci&I1fOPi113� Rece� by Da�te/Rec('�d./ /�Date Issue�
Nearest � ��bC �� i�d b -/���5 G
CrossSt. G �y�'�q Building
� Address
Owner o j � s% %" 'S
Mail -_� n Costa Mesa, California
Address ,C � l/� Nearest
_—� � • TwL .� . Cro55 St.
or " � Lic.
No.
.egal I Lot � �
:ription No. �� Block � � Tra`�ct�7
ach Metesand Bounda)
No. of Bldga
01 Lot G d��ljU Now on Lot 0
�f No.of No.of
ting Bldg. —' I Families I Rooms
ack Line from , Rear Vard ,��'�•
er of Strcet .�d Side Vard ��.,f �
DESCRIPTION OF WORH
IAlteration I I Aadition I
Demolish
Stories
rior
:ring `/ LU � Coverin9 0 APPR,��1.���'
BuildinNeW /--� Foundation Location Inspe¢to
g�"''� LF r�"� -� f�� q Forms, Materials,
!y- � �p Under-Plnning
' �q� �� S Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have mad this Application �
and state that the above is correM and agree to rnmply Lath. Int
with all CYty Ordinances and State Iaws regulating
building mnstruction. Lath. Ext
Signatureof
Permittee � Plaster,lnt
Authorized Agt-�f�_��� ��Jj�,_el Plaster. Ext
O
a
c�
2
D
r
0�
Valuation Pe�mlt Fee $ �/ rrC — Masonry Re�nrorcea I v I
Plan Check $ �� � �
Bond Beam
$ ���'�00 Total
Fee $ �� FINAL =
RM 309 10�66 D. P. S S,
ri.vi ra..yi�
Show locatlon and distancea trom
property Ilne and between buildinga
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