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HomeMy WebLinkAbout295 16TH PL - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. /O{,461 - PE T NO. TRACT NO. LOT NO. UNIT NO. 9��5 2I I V�6a CITY OFCOSTq,MESA 1g s RUCTION PERMIT - �—/7 - nC IL Project Address pl (p�7 �I� ," i ,1L 5 • f LI 'Applicant's Mailin Address les 331L) Aide .4149h9/M TYPE OF CONSTRUCTION LJ NEW u ADD LI ALTERATION Li REPAIR Owner's Noe 's„ � CAA�n Phone y{�7�(ry J3/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone 2 45/1 Ger 4e DESCRIPTION OF WORK/USE OF BLDG. AddressS Main Building: AccessoryBuilding: / E Z ( t� Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING r-L,I FFOUN DATION ❑ STRUCTURAL T Front • 0 \V\Iv Address ❑ TENANT ❑ ELECTRICAL LK PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam Phon 0 OTHER - • - "� PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing)/J33 W' /sr LpO� A��/.h fan K G ��� CON STRVCTION TYPE VALVATION$ S Left City License No. • ZONE GRADING CU.YDS. ACRESR 1 LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided • E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: RL� NI 0 with section 7000) of Division 3 of the Business and Professions Code,and t E'tig0 JAN 2 9 Q my license is in full f- ceyi••effect. • ^/�)- I,vi�1J T V Licen Class ' Li ins _ °i.0".f' !G Date-. �acn Signature rt/Z%n� + PLUMBING FEES WORKERS'•COMPENSATION DECLARATION - - -- -- - 1 hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES r ` Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 70, Lab. C.) p -7- Automatic Washer Transformer 0 15-50 KW -ulicy No. Ar. Company t4V eR?its" Backflow Irrigation Sewer Cop Construction Pole Sub. 0 50+KW S�ertified copy is hereby furnished. • LCeL}ifled copy A.filed with the city/,�i in visi9q p _ -_� -/ Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps . Date/4-2 c-TE 3 Appl leant/ssrp// L �t.7 LT/Y�7/G/ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps - (This section need not be completed if the permit is for one hundred(S100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric 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 Motors❑0.1 HP ❑1%-8 Workers' Compensation Laws of California. - Date Signature Floor Drains ' • Swimming Pool w/Spa - F.A.U. Inc.Solar ❑9-15 HP 016-15+ - '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 MiaOwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light 1 hereby affirm that there is a construction lending agency for the performance - q 9 of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors Water-Heater P_F p© Outlets Range Lender's Name 9 Lender's Address Kit • • chen 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 - Disposal Garbage following reason (Section 7031.5 Business and Professional Code: Any city or 9 ;Standing Sections . county which requires a permit to construct,alter,improve,demolish or repair P-Tra any structure, prior to its issuance, also requires the applicant for such permit p Laundry Trays Generator ❑0.5 KW❑5-15 KW 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 11.5 by any applicant for a permit subjects the applicant to a civil _ alty of not more than five hundred dollars($500). • ' -i 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 own Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler ZoningA roved sale. If, however, the building or improvement is sold within one.year of com- Canopy Type II 0 pP By Date pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under GroundBuilding 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 tractors to construct the project (Section 7044,Business and Professions Code: ' .I + i 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 su•ch projects with a con- •_ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUI LDING PERMIT $ SMIP• $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I'am exempt under Section B. & P.C.for this reason — Fire I/Fact.Blt. ICBG# Fire Dampers PLUMBING $ r — p /�� a'� ISSUANCE $ Date • Owner Heating System& Ducting Registers �! ENERGY P.C. $ PLAN CHECK 25% '$ I hereby certify that I have read this application and state tnat the above 00.100,000 BTU 0100.000 BTL - ELECTRICAL $ GRADING '$ information Ied. I agree to comply with all city and county ordinances and state lawss relating to building construction, and hereby authorize repre- - MICROFILM $ inspection of tj}}}ttt�is city to enter upon the above-mentioned property for -- PLAN CHECK 50% $ inspection p r ses. A / /a 13 f f' •9v Signature '/os3.. //yZN�-/ Date !]N Y MECHANICAL $ TOTAL FEE $ Drivers' License or 5$# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ l CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING POOL ?A 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, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. ^.- 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.1Structural Floor System 61. APPROVAL TO DECK 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 68. APPROVED FOR PLASTERING 18.,Rough Electrical-I 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 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑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 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:(-1-J-il7 °mac, 4g nit 20.3 Ulf,. LCD 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer .) I- 4.. 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 -- _ - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. STA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. • CTION PERMIT , � Sea 9 0423 1 O/17/84 • - 21e5O T Project Address 295 16th Pl., Costa Mesa TYPE OF CONSTRUCTION H NEW ❑ ADD W.ALTERATION Li REPAIR . Applicant'Mailing Address 126 Commercial, C.M. 92627 0 CONVERSION ❑ DEMOLISH ❑ OTHER A•P•# ' Zone • Owner's Name 'Norman Smedegdard'" Phone &�64n-7317 DESCRIPTION OF WORK ' S Main Building: Accessory Building: Z ��yy�� �^ p •�,, E - D u/ Address 23 Jasmine Creek nr-, Cnrnna 'F'-1 Mar TYPE OF 1-3i1:11" G DING ❑ FOUNDATION ❑ STRUCTURAL T Front - N / Arch/Eng. ' - License No. ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B tet— - Rear • J Address - ❑ 'OTHER C •Right N G ' Contractor's Name Crank Rrnc Ron?ing Cct hone�48-w.5�569. PROJECT DESCRIPTION SQ. FT. 2100 OCCUPANCY mutt/plh K R l • 9 CON ST RUCTION TYPE npar'1'mentc VALUATION$ 2,11c9_00 $ •Left _ _ E Address(mailing) • •rur- '• . • . • - _ e J City License No. CC 5943 I ZONE • GRADING CU.YDS. _ ACRES Ping. Ref.# Park.Fees $' • U LICENSED CONTRACTOR DECLARATION Remarks: , - Parking Req./Provided 1 I hereby affirm that I am licensed under provisions of Charter 9(commencing • - R with section 7000) of Division 3'of the Business and Professions Code,and Use of Building: i • my license is in full force and,effect. - - E , License Class C-39 ' License Ncy i • PLUMBING FEES Planning Notes: M • i • E Date '10116184 Signature .yam l - , N �( Bar Sink Showers • ORKERS' COMPENSATION DECLARATION T • hereby affirm that I have a certificate of consent to self-Insure or certificate ' Backflow Preventer Service Sink - - ' S , of-Workers' Compensation Insurance,,or a-certified'copy-thereof (Section - - - - - -- - - - 3800, Lab. C.) Backflow Irrigation Sewer Cap I • • ELECTRICAL FEES Policy No. 25274 Company___Zen.ab 1'h • _ certified copy is hereby furnished. Bathtubs Sewer Connection; Automatic Washer Transformer 0 15-50 KW , Certified copy is filed with the city Building Division. ; . , ❑ 50.+KW Date1(7�16/R4 Applicant •a. • e _ _ Clarifiers Solar Collectors Construction Pole Sub. , ' •• - _ __ - -. EXEMPTION FROM WORKERS'CO the permit one RATION - ' -- Dishwasher '" ` Solar Piping ' • - (This section need not be completed if the permit is for one hundred ($100)or P 9' � 'Cooking Unit Meter ❑up to 100 amps -' - ' less).I certify that in the performance of the work for which this permit Is issued, I Drinking Fountains • • Solar Tank { Dishwasher Meter Dover 100 amps •shall,not employ any person in any manner so as to become subject to the , • '•Workers' Compensation Laws of California.' • Floor Drains) Swimming Pool vv./Spa . Dryers ❑Gas ❑Electric Sub Panel , Date - Signature - NOTICE:If,after making this declaration,you should become subject to the • Floor Sinks I Urinal l , Fan Motors 00-1 HP ❑1 X-8 Workers', Compensation provisions of-the Labor Code, you-must forthwith ' •- _ • - - . '- y comply with' such provisions or-.this.-permiN1 shall be-deemed revoked.. , Gas Service ' Outlets; Mater Closet - • - — F.A-U. - Inc.Solar HP 016-15+ CONSTRUCTION LENDING .AGENCY . - - - I hereby affirm that there is e-construction lending agency for the performance , Interceptors Water HeaterFixtures 'Microwave of the 'work for which, this, permit .is issued (Section 3097 Civ. C.). . -- -' _ - ' . Lender's Name. ' ' ' • -- l - ' - Kitchen Sink' - Water Service ' ,- - 1- Device Boxes Pole Light Lender's Address - - Lavatories OWNER BUILDER DECLARATION �• _ - Outlets Range , • •I hereby affirm that I am exempt from the Contractor's License Law far the - - - following reason (Section 7031.5;Business and Professional Code: Any City or 1 P—Trap _• - I y: ' - “ , _ Switches. Sign t • county which requires a issue to construct, resaprove,demolish:or repair - - - -any structure, prior to its issuance, also requires the pursuant ant.for such permit I Roof Drains r - _ - y I • Garbage Disposal . Standing Sections ' ''o file a signed statement that he/she Is licensed pursuant to the provisions of - _ - , le Contractor's License Law(Chapter 9(commencing with Section 7000)of 1 - • l ' - - Generator ❑0-5 KW ❑5.15 KW Trash Compactor• ivislon'3 of the Business and Professions Code).or that he/she.is exempt - , t .. _ P t - herefrom 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 _ - 3 1 I penalty of not more than five hundred dollars($500). - • : Reinspection-Fee 1 I - •$25. . Issue Fee $ - - - LJ I,' as owner of the.property or-my employees'with wages as their sole MECHANICAL • Reinspection Fee $25 Issue Fee' , $ 3 I compensation, will do the work, and the structure is not intended or offered - - . - FEES for sale (Section 7044, Business and Professional Cotler The Contractor's - PUBLIC SERVICES REQUIREMENTS: ; License Law does not apply toren owner of a property who,builds or improves Boiler ' 1 Hood or' Type I ; 0 thereon, and who•does-such work himself/herself or through his or her own ' , Zoning Approved By ' ' Date - employees, provided that such improvements are not intended or offered for Canopy . Type II 0 -1 , - , sale. If, however, the building or Improvement Is sold within one year.of com- Duct'-Under Wound • Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or.im- , • rve for the purpose of sale). Duct-Structural t Refrigeration System ,' ' Application Issued.By Date -/D oI, as owner of the property, am exclusively contracting with licensed con- • - r tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU 'SUMMARY OF FEES ' The Contractor's License Law does not apply to an.owner of-property.who _ builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple D. System Repair/Alteration - IBUILDING •PERMIT $ 21 .fin SMTP $ •SO tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT , ❑ 1 am'exempt under Section e.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date • - Owner - Heating System&Ducting i '� PLAN CHECK $ - ENERGY P.C. $ I hereby certify that I have read this application and state hat the above . 00-100,000 BTU ❑i oo,000 BTU— ELECTRICAL $ GRADING $ information is correct:1 agree to comply with all city and county ordinances - - ' .- • and state laws relating Ito building construction, and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives o is city to en -r ••• the above-mentioned property 'for inspection •( 1'ses. • 8 ��� ' MECHANICAL $ • TOTAL FEE $ zi '&O Signature 0 ....i, date Drivers'.License or SS# • — • - ' 1 t7/1 / 4 • Reinspection Fee $25, Issue Fee $ 3 PLAN CHECK $ -CMF 0865-46 rev. 7/83 -White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - - - - - _. - - - AND PLANNING - PC &SPA PPROVALS. Permit# Date Inspector APPROVALS Permit# - Date Inspector • Temporary Electrical Service or Pole 52. Pool & Equipment Location pCONSTRUCTION2. Soil Pipe-Undrgrnd. 53/Steel Reinforcement - ' , • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms' • • • 1 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, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • ' ' 61. APPROVAL TO DECK 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 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 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 PREY. 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 Factory Fireplace • • 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final , 41. Solar Domestic-Final - . . _ - 42. Backf low Preventer 43. Backflow Irrigation - - 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 11.i_.--- t /q�yr�64- • 48. Special Requirements Completed d - • 49. Electric Release to Edison ' . - 50. Gas Release to-Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ' . - ' No. - • Date • Applicant to fill in all spaces except those within heavy border lin es and sign all appropriate declarations. OF COSTA MESA PERMIT TRACT NO. LOT NO. BLDG.NO. STRUCTION PERMIT 1 (%jg2(� r I �.�kI� D424 10/17/64 20p50 Tl, p oject Address. - 2.37 16fh P(.., Costa Mesa TYPE OF CONSTRUCTION U NEW LJ ADD Yid ALTERATION U REPAIR plicant4'Mailing Address. 126 Commercial Way, C.M. 926x7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A•P•# Zone ner's Name Norman Smedegaard Phone 640-7317 'DESCRIPTION OF WORKRa.- nnf/ng ES Main Building: Accessory Building: ZOdress 23 Jasmine Creek Dr. , CdM 92625 U U STRUCTURAL T Front - N TVPE OF PERMIT ❑ GRADING FOUNDATION ch/Eng., License No. - ❑ TENANT ❑ ELECTRICAL ❑'PLUMBING- ❑ MECHANICAL - B - IA Rear .. - Ndress ❑ 'OTHER , ntractor's Name Crnnk Rras.. Roofing Cf)Phone 548-5559 PROJECT DESCRIPTION SQ. FT. 2000 OCCUPANCY mut f/ iC K 'Right - Gdress mailing) - 1�6 Cammarc%n( Way, �)Q$j'OMesa CONST RUCTION TYPE apartments VALUATION$ Ze ]9.00SL¢ft - E• ZONE GRADING CU.VDS. ACRES Pin Ref.# Park.Fees $ Qy License No. 005993 9ENSED CONTRACTOR DECLARATION URemarks: Parking Req./Provided Iereby affirm that 1 am licensed under provisions of charter 9 (comidencing - - Bh section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E license is in full force and effect. ense Class - 'a I _s. Licen o. •26 7 PLUMBING FEES Planning Notes: Mte •0W84 ature L..-. .. ��t._ . NNRKERS' COMPENSATION DEC • RATION + Bar$ink ShOW¢ri Tereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink - S Workers' Compensation-Insurance,-or a certified•copy thereof (Section -- - . -0, Lab. C.) ' Backflow Irr:gatioh Sewer Cap _ ELECTRICAL •FEES icy No. 25274 Company Zenith certifietl copy Is hereby furnished. : Bathtubs Sewer Connection Automatic Washer Transformer 0 15.50 KW Car/1z19qry�Oy 1j1s filed with the city Bu"ding Division. 9 50+KW Date /(J( /b(�4 _Applicant crank Bros., roofing CO., Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Dishwasher Soler •Piping Cooking Unit -- - -' ,Meter ❑up to 100 amps (This section need not be completed if the permit Is for one hundred ($100)or less). I certify'that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person in any manner so as td become subject to the Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas, ❑Electric Sub Panel Date- - _Signature ' • NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors 0o-1 HP 01%-8 ' Workers' Compensation provisions Of -the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.. Gas Service Outlets - . - Water Closet - . F.A.U. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY - _ I hereby affirm that there is a construction lending agency for the performance ' ' Interceptors Water Heater • . Fixtures i Microwave ' of the work for which this .permit is issued (Section 3097 Civ. C.) - • , Lender's Name. - Kitchen Sink Water Service Device Boxes Pole Light Lender's Address - . - OWNER BUILDER DECLARATION - Lavatories _ - - - Outlets Range • I hereby affirm that I am.exempt from the Contractor's License Law for the . • - - following reason (Section 7031:5 Business and Professional Code:Any city or P-Trap - - - - Switches Sign county which requires a permit to construct,alter,-improve,demolish or repair - • - - - any structure, prior to Its issuance, also requires the applicant for such permit I . R _oof Drains - Garbage Disposal • Standing Sections • to file a signed statement that he/she is licensed pursuant to the provisions of , - - _ ,e Contractor's-License Law(Chapter 9(commencing with Section 7000)of _ 1 'vision 3 -of the Business and Professions Code) or that he/she is exempt - • - - Generator ❑0.5 KW ❑5-15 KW Trash Compactor .nerefrom 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 ' ^ • penalty of not more than five hundred dollars($500). - Reinspection Fee ' I $25 • Issue Fee $ 3 U I, as owner of the'broperty or my employees with wages as their sole . — Reinspection Fee $25 Issue Fee • $ 3 compensation, will do the work,and the structure is not intended or offered 'MECHANICAL •- FEES for sale (Section 7044, Business and Professional Code: The Contractor's - -- - - - -- - - - - -- __ - -- - - PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who;builds or Improves Boiler Hood or Type I . ❑ - thereon, and.who does such work himself/herself or through his or her own ' Zoning Approved By (late employees, provided that such Improvements are not intended or offered'for Canopy Type II ❑ • sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground Application Approved By - Date pletion, the owner-will have the burden of proving he/she did not build or im- move for the purpose of sale). Duct-Structural ' Refrigeration System • Application Issued By Dat¢—� J_/Z_ LJ I, as owner of the property,am exclusively contracting with licensed con- 00-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES b The Contractor's License Law oes not apply to an-owner of property who BUILDING PERMIT $ 7 n.o� SMIP $ `S builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 lam exempt under Section B.& P.C.for this reason • Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ • Date Owner - Heating System& Ducting • I PLAN CHECK $ ' • ENERGY P.C. $ i hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000Br ELECTRICAL - $ GRADING $ information is correct: I agree to comply with all city and county ordinances - - - and state laws relating to building const uction,and hereby authorize repre- - PLAN CHECK $ ' lves of this city to enter pan a above-mentioned property for MICROFILM . $ inspection purpo inspection CD — MECHANICAL $ TOTAL FEE $ 20 ,c0Signature �..• Date $ -17'- • I Drivers' License or 55# - Reinspection Fee $25 ' Issue Fee - $ 3 PLAN CHECK $ V — CMF 0865-46 rev. 7/83 - White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-'Assessor - - - - - CONSTRUCTION AND PLANNING - PO. 9 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 LIFER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation / • 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. Th1 -- 60. Backwash-Lines, P:Trap, ❑ Undrgrnd. • 10. Structural Floor System MNWA* 61. APPROVAL TO D CK 11. Property Sewer Line & House Connection 62. Backwash & R cept r-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 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 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 PREY. 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 Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-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 [1 50: Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY . . - . I • . No. Date OWNER GATES, CYRUS H. & E. MERLE DATE 2/20/56 JOB ADDRESS 295 16th St. BUILDING PERMIT NO. 2392 GENERAL CONTRACTOR niJcA R CningrnvP VALUE $ 8,000.00 l 12'_ J BLOCK TRACT 2934 Residence & garage I GROUP I & J TYPE V ZONE Rel FIRE DISTRICT 2413 PERMITS ISSUED INSPECTIONS SUBCONTRACTOR i � DATE NUMBER Footing Trench LL -,- 1. Foundation Forms and Grade to Gara e Rough Framing r�7 -, Plumbing, Rough to Slave��� r .. y .. Plumbing, Rough Complete 04-'°- 3 /2- ri7i ( , ', % . 34.ZJ G V.39 7 L -- Temporary Pole �/ -/y Wiring, Rough "� c /'c J' _i a 1 AT 2 "1 5. .2 .3/ 7 --- Heating, Rough ���//` Heati I, n- , �-i / 7j L,.: Sewe f 1puAr Sewer,St. • r 4M q Q _ (ti TIG — Septic Tank or Cesspool L 'ng, In Out P7-// P, Bring �,,/,-7.-0-7. - Plumbing, ter Plumbing,Final,Fixtures Complete)9 't 07. d Plumbing, Final Gas Test � ?Apr/4_ ,�,c.-� 7-/.j.f n yam,Jam/ Wiring,Final ;41_ 7 -SC 114 .....it 7%0,-. it, iz�/ - Occupancy �jD[1/ - -S^- . V FORM 210 9M 10.99 • OWNER SANTA ANA PATTO HOMES DATE 6-lb-61 JOB ADDRESS 295(A & B) & 297 (A & B) E. 16th Place BUILDING PERMIT NO. 1618 GENERAL CONTRACTOR M. H. Kell VALUE $ 32.323,00 att gar AP. No. i l 7-191 -l0 LOT TRACT FIRE ZONE DESCRIPTION OF WORK.11.-unit apt.hl dg w/ INSPECTIONS La/ DATE I GROUP 1-1 & J TYPE V ZONE g_), 1rground So'�-�jG. Water/k(/ fir./7-6/ SUBCONTRACTOR PERMITS ISSUED 1. .:rground Gas 4L W 7't/c' DATE NUMBER Overhead Water and Gas Rough Heating /., !// �{",2/- / r • '.r -r. • - . 1 (i �� i !A Rough Plumbing / -7 I • ' _ , ,,.•,• -_ Miscellaneous U p' I Ar 1 Prop. House(� Sk Swr. fight) ,r,� �e_„� ,(✓f/74., T/f' 7 40- ,,fig .(' Sprinkling System \Y / ` Heating, Final �/ Ul O 24/-r/ Plumbing Fixtures ,✓// /// Mitt{,I/ Final Gas Test �d;/t /4•/ //-/P•47 Construction Pole • 'TYI.a 2fl.rs 8'-T 6 1 i/.1-67 4 Underground Power Rough Wiring 5.'Ll,d... -t -04.1/•rn , 8. a....a. 4 -it-(/ !S17) (,i %t4t., ) Trenches64 WFormsN/y(B-SteelCt,,., °-"'c' .Qr el Floor System /9 Ir-17-(a/ ( Steel Reinforce Chimney Re-Rod - - b Bond Beam ' " ri _ Sheathing i — / .2._ - - 1 fir _Frame and Flashing / /7J e.- c3• _ �- . - — GP ( i ng. In Out era - ! ./ 0 "/go G 1 t Y,...,ter, brown coat / ' Plumbing Fixtures, Final te g/ril/ !///Electric Fixtures, Final l- Building, Final N-Z7 OCCUPANCY 1 \ ' Form 210-5M--11-59 S-8 P 29 -Fi I T A HOLD FOR SPECIAL REQUIREMENTS 14618 • t�F FEE RECEIVED `�1 • 1 4v��3 / 3 11981 rIIJJ"" MAY COSTA MESA BUILDING-SAFETY DEPARTMENT Y l/_ FINANCE DEPT. P. O. BOX 317 COSTA MESA. CALIFORNIA Ir` CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR�) PRINT p BUILDING BUILDING ca 76�1![� 1�� G" i6•z6�~- 0 MESA. CALIFORNIA For Office Use Only ( RECEIPT NO. P $ 77 OWNER jr__h. A-.,r, G1i-1u Irv,-,..GS l MAIL -T qq RECEIvep BB DATE RECEIVED DATE I UED ADDRESS / <r ///G G J L1tL / - slat 3/- 6/ I /�/Y-!r/ q TEL. BUILDING t2 9S- ����� CITY uikw/?tn-7 /7 a CL.- NO. I`la 17-7-1 ADDRESS ,7 7 /0. V Q)- `c. �6' 6.1/, ) ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER . ,. . NO. FIRE ,/,/ a ADDRESS `I- ZONE TYPE q 'GROUP //7/ I Al, APPROVED \ ATE 61/.".T/ l4: I CONTRACTORsty-y, y-t ADDRESS _ ��'� - / t;T-�q.a. .. - \/:ZONING; / w IX - ZONE PLNOS . ; USBUILDING OF NEW (,11 . CITY , (��LI.' 6:-,..Y-2-,173/� 4G?•f i_' ^STATE TEL "��'I,'/P/LA�/Nl/St //IDUILOINo oi�l.l:/� N LIC.NO. /2 A i 0 NO.,,2I,< 6 - 3 2-.17 DESCRIPTION 1' v1 -f-i ,5'.•` Al Fl-VV�.YI Y�4r/Z CC 10 SIZE / / NO. OR BLDOS. �7 ! ..w OF LOT J /Y A /R7 J /1 I Now ON LOT / A.P.NO. I/ ( •'��! r IO <( ��W EXISTING sLDG. IG SG �Oti.. ¢� YARDS EVES i-1 r / APPROVED ALLOWED f SETBACK LINE FROM ✓ , REAR YARD/g/ FRON R LINE ST.) co '1 I/ CENTER OF STREET ) L•' FT. S•�• IN. • Cr 4 Olt IN. �LL� / SIDE YARD I LEFT 3--/ • /I RIGHT /9 R.SIDE ! FT. DESCRIPTION OF WORK L.SIDE � FT. N. ia NEW I fr....--7-ALTERATION / ALTERATION I II ADDITION I REAR /e FT. IN. \._ r REPAIR I II MOVING I II DEMOLISH I -'-' 6YP.ROV 'mI'�I 1 L DATE.'.f Z1, BUILDING NO.ROOMS � V A I, A � Rt �,! SIZE ( OF V STORIES 0�, GVj 1 (((""" :M EXTERIOR WAL ROOF * p q ..rp• COVERING ��_ ---i-er�r'''ial COVERING ' •�.. 1 11 '1 ° N. 3 R.Y-n ' USE OF BUIL •RK T• BE PERFO.. ,.A ill lir 1 !► �d., ,, // - 4.....-_, Are.,< . i� 9 _ , - 4 / Art � d ar' d4 61� i ,See •�' DATE l / OW I HERESY ACKN •GE THAT I HAVE READ THIS APPLICATI • • UNDER VALUATION IS POR THE AND STATE THAT\ E ABOVE IS CORRECT AND AGREE TO CO PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. ' PLY WITH ALL CITY ORDINANCE° AND STATE LAWS REGULATING --7,-7..+--'. ' BUILDING CONSTRUCTION.` / VALUATION4.0 SIGNATURE OF L-1^ /1 /i•/. 1 e a3. E ILRMIT FEE $ 'C�� a PERMITTEF 777 �" /// �`�� $ 3-2/ PLAN CHECK S 6a `K AUTHORIZED AGENT O . 6-0 K TOTAL FEE $ 7 0 Ir Conditions: - 1. Two for one off-street parking be provided by applicant at his expense, under direction of Director of Planning 2. That 4' residential sidewalks be installed by, the;applicant, at his expense, under the direction of the_City Engineer, along the northerly property line of this property on 16th Place and along the easterly-property line on Santa Ana Avenue.