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Home My WebLink About364 16TH PL - Building PermitsAoO�icant to till in all soaces exceot ��ose within neavy eortler Iines ana sign all aoomo��ate tleeiantions. CITN OF COSTA�MjE�SA CONSTRUCTION PERMIT PERMIT NO. _ T�iACT NO.,, LOT NO. UNIT NO. � Praject Address .L� �� ' ApplicanYs Mailing Address � n—�� Owner's Name ��'1 �/f.e�'I �-P.51�phone7l�L-/�y Address � � �k' LJ�U�.Y Rr'�A GAl-9�G� Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) Ciry License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensetl untler provisions of Charler 9(commencing with seclion ]000) of Diviiion 3 Of the Business antl PrOfe55ions Cotle, and my license is in full force antl etfect. License Class �icense No. Date Siqnahre 'VORKERS'COMPENSATION DECLARATION iereby affirm Ihat I have a certifica[e ot consent to self-insure or a certiticate , Workers' Compensation Insurance, or a certifietl copy [hereoi (Section 3800, Lab. C.) Policy No. Company eCertifietl copy is hereby furnishetl. Certifietl copy is filetl with the clty Builtling Division. Date Applicant EXEMGTION FROM WORKERS' COMPENSATION DECLARATION (This seclion neetl not be compietetl if the permit is for one huntlretl ($300) or IessJ. I certi(y tM1a[ in the perto�mance of th¢ work (or which �5 perm�t i5 i55uetl, I shall not empioy any person in any mann¢r so aS to , ome subject to the Worke�ompE9%tion l.aws ot Galit�`. Date+ /� 9��U Si9nature NOTICE: If, after making this tleclaration, you sho tl become subjec the Wo�ker5' Compen5ation Provisions ot the Labor otl¢, y0u Tust f f with comply with such provisions or this permit shall be tleemetl r�voketl. GONSTRUCTION LENDING AGENCV I hereby alfirm that there is a consbuctlon lentlin9 a9ency for the performance ot [he work for which this peYmit is issuetl ($ection 3097 Civ. C.) Lentler's Name Lentler's Atltlress ' OWNER eU1LOER DECLARATION 1 bereby affirm Lhat I am exempt from the Contractor's License Law tor the following reason (Section ]031.5 Business antl Professlonal Code: Any city or county which requires a permit to con5[ruct, alte�, ImO�ove, Eemolisn o� re0ai� dOy SllIICIOIE� O�IOI f0 IIS issuance, dlso �equi�es lhe applicdnt fo� such permit to file a signetl Statement that he/She is licensetl pur5udnt to [ne provisions Of the ConVactorY l.icense Law (Chapter 9(commencing wlth Section']0o0) of 7ivision 3 ot the Business antl Professions Cotle) or [hat he/she is exempt �heretrom antl tne basis for Ihe allegetl exemption. Any violation of Section ]031.5 by any applicant to� a pe�mit SubjeGts tM1e applicant to a civil 'p�eynalty of not more than five huntlred tlollars ($500). ' yp i, as owne� ot Ihe prope�ty or my employees with wages as thei� Sole 'COMpensation, will tlo the work, antl the structure is not intentletl o��o(ter¢tl fOr sale (Se<tion 7044, 9u5ine55 antl Profe55ional Cotle: The Contracto�'S License Law tloes not apply to an owner of a property who builtls or improves ther¢on, antl who tloes such work himself/herself or IhrOugM1 his o� her own emO�oYeeS, provitletl that such Improvements are not intentled or offeretl for saie. If, however, tne builainq or improvement is soltl within one year of com- pletion, the owner wiil have the burtlen of proving he/she tlitl not builtl or im- prove tor the pur0ose of sale). ❑ I, as owner of the property, am exclusively mntra<tln9 with licensetl con- tractors to construct the pro�ect (Section ]O4a, Business antl Protessions Cotle: The Contractor's License Law does mt appry to an owner of property who builtls or improves thereon. antl who wntracts fo� suth oroiects with a mn- tractor(5 hcen5e pursuan[ to me Contractor's License Law). I am aware tha[ proof o their WorkeYs Gompensation insurance snoultl be provitletl to me. ❑ I am eaemp[ untler Section � B. & P. C. Por this reason Date /��t;,�l�� I hereby certify tha[ I in(ormation �s correct. antl'stale laws relatin9 SC11(dtIVCS Oi LhIS CIIy InSDection purposes. Signature �� Drivers' License or 5�. 0865-46, r� Owner �ep�e- y for T TVPE Of CONSTRUCTION R51. NEW LJ ADD IJJ ALTERATION IJ REGAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLOG. N� SToKA6 TVPE OF PERMIT IIY,GRA�ING� FOUN�HTION �j'$TRUCTURAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL O OTHER PROJECT DESCRIPTION SQ FT �-� nrr ooni7rv CONSTRUCTlONTVPF � VAll1GT1(1N$ YSIO ZONE GRADING CU. VDS. ACRES Remarks: Sink C� Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Servic.e OuUets Interceptors Kitchen Sink Lavatories Roof Drains _ ReinspeMion -Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO dk Heating System & Ducting ❑ 6100,000 BTU � 100,000 BTi Reinspection Fee Wnit¢ - Builtling; Canary - Applicanh Pink - Accounting; Goltlen�otl - Assesso� $15 S PLUMBING Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Type I ❑ CanoPY TVPe II ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System flepair/Alteration Fire Dampers Registers Issue Fee A.P. # S Main Bui E T front B Rear A C R' K . Left S Ping. Ref. # FEES Automatic Washer Construction Pole Suh. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric $ 3 FEES $ 3 Zone Accessory Building: ELECTRICAL Transformer ❑ 15�50 KW ❑ SO+KW Fan F.A.U. Fixtures � - � Device Boxes OULI¢LS Switches Gar6age Dispoul Generator 00.5 KW �5-15 KW Meter LJup to 100 amps Meter ❑over100amps Sub Panel � Motors �0-1 HP � 1 h- 8 Inc.Solar �9�15 HP �i6-75+ Microwave - � - Pole Light � . I� Range Sign . Standing Sections Trash Compactor Reinspection Fea J$15 � � Issue Fee FEES $ 3 N 1 N G R E � M T S. DEVELOPMENT SERVICES REQUIREMEN q Zonin9 APProved BY �/ � Date _ /d /� -BO 8uilding Approved By ' - Date SUMMARV OF FEES BUILDING PERMIT $ 2• Uo gM�p $ .SO PLAN CHECK $ 6. �o PERMIT � PLUMBING $ �SSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ � PLAN CHECK 50% $ MICROFILM $ Q ' MECHANICAL $ TOTALFEE $ I I 1.3D PLAN CHECK 25% $ \�� 01 000168D4-OpQ16SOb Y�JY' D�+TE: 1OJ11/$$ TIfIE: 16:Oa 119.30 � ,, �� f.ONSTRUCTION AND PLANNING APPROVALS Permit# i. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. 3�' Electri.cal�Conduit Utility-Undrgrnd. �:, 4's Electri�al;Conduit-Undrgrnd. UFER Grnd. � 7. Footir�gs '� 8.<Foundation . � � ,� 9�,� lNateC�Pipe-Undrgmd. .i 1 • ., li 10. S�uctura1 Floor System ..i ' � 1 i. Property,Sewer Line & House Connection 12. Sewer�:Cap 13. Roof Drains r 14. Ro�gh�Gl�mbing 15. Rough Electrical-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure . 22. Ducts, Ventilating � 23. Gas Pipe-Rough & Test � 24. Roof Fram?ng �, i 25, Roof Sheathing � � i, , 26. T-Bar Ceilin9 lStrucwral) & Monocoat 27. Frame and Flashing 28� Lathing &_$iding 29, Insulation � 3D, Drywall Nailing . - 31, Plaster Brown Coat . 32. Electrical Power-Meter-Final 33. Final Electric � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � ' 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final � � ' � 41. Solar pomestic-Final ' 42. Backflow Preventer i . 43. Backflow Irrigation � 44. Landscape Irripation SYstem 46. Sound Attenuation � 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 4$. Snecial Re,quirements Comp�leted 49. Electric Release to Edison 5�. Gas Release to Southern California Gas Co 51 `CERTIFICATE OF OCCUPANCY No._ . _ Date . __ PO� e SPA Date Inspector { APPROVALS Permit# _ 52. Pool & Equipment Location � 53. Steel Reinforcement ' , 54. Forms � 55. Electrical Bonding 56. Rough Plumbing & Pressure 7est 57. APPROVALTOCOVER-GUNITE � � � 58. Elecirical Conduii-Undrgrnd. , 59. Gas Pipe, � Undrgrnd., Test y�: 60. Backwash Lines, P-Trap, � Undrgrnd. - �� 61. APPROVAL TO DECK 62. Backwash & Receptor-Final � ' 63. Heater & Vent-Final i� ": "64. Plumbing System - Final � 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING i 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. ProductPiping�Gas ❑Oil � 72. Underground Flush � 73. Undergrnd, Storage Tank � Gas ❑ Oil � 74. Overhead Hydro � .. . , '_ � . 75. Dry Chemical � 76. Dry Standpipe � 77. FIXED SYSTEM FINAL � 78. FIRE PREV. FINAL NEALTH DEPT. REQUIREMENT � 79. FINAL INSPECTION I 80. FOOD CERTIFICATE ISSUED � Notes: Date Inspector t� ' � . • '� /� :. ,i . ' C;. ' � i ,�' '� �: :� +. �j ., V'►` .� � � '7�� CClSTA MESA BUILDING DEPARTMENT , �� P. O. BO% 31� COSTA MESA, CALIFORNIA eui�oirv¢ ADDRE55 FOR APPLICANT TO FILL IN 364 �,16th -,�ee� � COSTA MESA. CALIFORNIA OWNER �^1ILGROWE,CONSTRUCTION CO.� INC. ADDRE55 11933 Stanton Blvd. c�rv ��eim, California ARCHITECT OR ENGINEER ADDRt TNo TW 3-3135 LIC. NO. IIp!! CONTftACTOR T. P. Gregg c��v No: ,,poREss11933 Stanton Blvd., TNo LEGAL LOT DESCRIPTION NO. �� BLOCK A.P. NO. OFLOT 52.95 x 135.�7 tISE OF . EXISTING BLDG. ,-�(� I�� ,l�' r`' l� a/� O� ��2.6�5 d� s{ 1� 'JJ FINANCE DEPT. ''T`' �� ncr4 nn«. APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY �{ FIRE V ZONE , 20NE� 3-3135 APPA BY _r 3345 r+o. oF e�ocs. NOIIQ now orv �or SETBACK LINE FROM �O� REAF VARD SVr CENTER OF STREET SIOE YHRD �/ORIGHT �� LEFT � DESCRIPTION OF WORK NEW_ _ X ALTERATION • IADOITION FEPAIR I MOVING ,IDEMOLISH S�ZELOING �tp x S7 ROOMS O STORIES 1 GO c EXTERIOR WALLNt�CCO qOOF rnvcniur J1 111e COVERING CiDIIli1_ $TFTE THPT TXE ABOVE IS CORRECT GNO A CITY OR�INPNCES AND STATE LAWS REGVL TION, ^�� SIGNATl1RE OF `dL AUTHORI COSTA MESA. CALIFORNIA DATE CORRECTIONS f 6 �� IS APPLICATiON nN0 "O COMPLT W!TH ALL Bl11LU1NG CONSTPUC� VALUATION PERMIT FEE S /�j i / 6 �� PLAN GHECK $ � TOTAL FEE $ � � "BMF �3693 r CGSTA MESA BUILDING DEPARTMENT +t P.O.BO% 31� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BU�LDING '��l�j��^�— ADDRE55 `(�JL COSTA MESA. CA�IFORNIA OWNER MAIL CITY ✓ �' � ARCHITECT OR ENGWEER ADDR. LEGnL ILOT oescniPno� No. A.P. NO. ' OF LOT h '� • �� USE OF EXiSTING BLDG. � SETBRCN LINE FROM CErvTER Oi STREET 0 TEL. � NO. r LIC. NO. � NO. OF BLOG6. DESCRIPTI'ON OF WORk NEW �� ALTERATION ADDITION REPAIf. MOVING �EMOLISH BUILDING Ll � NO.OF SIZE O ROOMS STORIES EXTERIOR WAL`.� M - ROOFo�w�ie � � `-._ .-....�.. .�.. r�nve if . r COSTIV a FE618-S�Q�yese 329a irA**17.�� APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. pERMIT ND. g3 'ECENE�iY_J O�/TERECE�VEO' ppT�/I�SfSU, �II .✓i l Y^1 L� BUILDING /j � �� / /� ADDRE55 ,J /� COSTA MESA. CALIFORNIA FIRE 20NE 20NE NO.OF TYPE ,� I PLANS �� / BVPROVE� -�G�l��ATE � � i/�7�t CORRECTIONS i� 1�:� I' t! �� P R�� _. . L ' . `.J � SVu�,�.� - �., H / l�Lr 1. $TATE TNiT TXE .�BOVE I$ CORRECT .�ND .�GREE TO COMPLY WITN ALL CITY ORDIN�NCES AND STATE leWS REGULSTING BVILOING CONSTRUG norv. VALUATION SIGNATURE OF � PERMIT FEE S �� PERMITTEE � � � � �' � PLAN CHECK $ /// � s /� — AUTHORIZE� AGENT % ' j ily�J/ TOTAL FEE $ �� — ��