HomeMy WebLinkAbout3057 LOYSBURG BAY - Building Permits LEGION IRON
Fabricators of 1836 Acre St.
Structural Steel Nato, California 91760
Miscellaneous Iron (714)735-6300
Ornamental Iron St. Lic. #285388
July 15, 1983
RE: Pentridge Cove
Randolph St. , Tract 10871
Costa Mesa
The Janes Co.
SUBJECT: SPLICING BEAMS:
Unit..E, 4 each
Unit C, 1 each
Per plan enclosed drawings
Certified Welders:
Manuel Pena E 1739
Roger Kleppe E 5407
All beams spliced in the shop of a licensed fabricator.
Lot # 13 Permit B 7509 •
764 Windgate Bay
• Lot # 15 Permit B 7511
3042 Kittendale
Lot # 37 Permit B 7534
741 Schenley Bay
Lot # 39 Permit B 7536
3057 Loysburg Bay
Lot # 47 Permit B 7544
3041 Loysburg Bay
„• _ Applicant to fill In all_spaces except those within heavy border lines and sign all appropriate declarations.
3 CITY OF COSTA MESA PERMIT O/, r :TR T • LOT NO. • BLDG.NO. 1
CONSTRUCTION PERMIT. ' • ( eat 0735 b/cl /83 • �J a•/3' TL
Appl•icant's Mallin• Addr SS - I 'r �r TYPE OF CONSTRUCTION - NEW ADD LI ALTERATION' REPAIR : : • _..
Project Address /0 �/• / fel' • r�'r ❑ CONVERSION ❑ DEM 15H ❑'•T :ER �e1 _ f • - ' 1 i'
•
Owner's N2 •0 • 1 k. alb'sAl �/ , DESCRIPTION-OF WORK I .1 i I//A71,APIIMIticautiotI2W -
one I• _ •. III/ ZONING REGULATIONS'
, Address' r. :TYPE OF PERMIT ❑ GRADING•U FOUNDATION STRV L517' A.P: /--}I (9, 3I -17 ZONE a,- .
Afch/Eng f 1, :en. Lit¢ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL' - PLNG.REF#.�.c /1 Q BUILDING -'
%�tI Aim I_ - W '"I-IUIa errn.�rie Cn sT
Address D'e• 's+!^'r""^ • ❑ 'OTHER - TO BUILDING r
•••}�����•••///����� -�G / �[/ f� PROPERTY LINE. �1 REAR YARD(TO P/LI
' Contractors Na; �•A •:
r i .'•I,.:. a .POOL. ,A.. - -
r°C ..... ' --: A- - i' .NNING7c -- '' rte, r' -c - ' 5
. - - ` - - :
5i - ' t- ,:_ - Date '. - 'Inspector - = - ` Date Inspector '
- SAPPROVALS ;; Permif#' - , � . • - APPROVALS .- �Permit�# � - .
''. .1- Temporary'Electrical Service er:Pole ^ -I $,1 iS•,. ° 1(52: Pool & Equipment.Location terc - • -
F F? ,Soil PipetUndrgrnd:' _Jr ' F ..2._ ! ' u. ' ,y y._ f• t.; •'.5.4;Steel Reinforcement _ .�„ , # . . ,
- 3? Electrical Conduit Utility Undrgrnd. I f.�; -+ r I . 54;" Forms j' - `
4 4; Electrical.-Conduit-Undrgrnd',; : r - ii i tr..: .i r; E :;,55.-, Electrical Bonding - . _ ` '
57 Steel Reinforcement. , ,_ •n• `-:- ! : ,, ; • - C ' 56. Rough-Plumbing& Pressure Test •- • '
6: iElectrical,UFER'Grnd It �•L'• iI !I,; 9 • 3' 57`'' APPROVAL TO COVER-GUNITE:
7. Footings i I ''I ! o m I ?•I • ' T58c •Electrical[Conduit-Undrornd: l• t
8. Foundation• 1 i ! - 9 i ' ° 59. Gas Pipe;DUndrgrnTest ,
- !
9.,Watei Pipe-Undrgrnd. ! ( - • : -• 60Back:vash'Lines,•PTrap, 0 Undrrnd. - •• •
10. Structural Floor System 1 ` t• ' ' - i :.61. APPROVALTO DECK v 9•:•
11.''No' Sewer tine'&iHouse;Conne,ctioni _ e'- ' ',62. 8ackvdash &`Receptor-Filial _ - - -
12. Sewer Capp. •,y ! , i - , - rn '_63. Heater-&Vent-Final '- - - • -
13. Roof'Drairis _ i ?. 1 c '64. Plumbing System- Final'': _
14. Rough Plumbing ' - I ' ' - '65. Elecirical`-Final" ' 1 . '. . . _
1 15"Rough Electrical=Conduit'i"- -i';! . r- '1 --z"-T.- - -Ti-` -'66. SalariSystem-Final-. , - . - -- • - - -
,-16. Rough-Elec'triclWiring. ,• 1 i• „1.: : '':-'c 11, 1 •67' Fencing& Access-Approval, - - -
"._1.7.IRough Wiring Signi2 ` r' I ' i ,!'':'' I• I I I : :` ; • "i r 68,' APPROVED FOR'PLASTERING ', -
i 18: Rough:Electrical'TrBai Ceiling i! ! 11 . I - i • IT I : - 69.! POOL/SPA SYSTEMS FINAL ! : . .
1 19. .Rough,Heating&'Air Co 'nditioning I 7 , • I . ' , ! FIRE DEPT-REQUIREMENT -
I
- 201'$Rough".Factor"y Fireplace i ' 1 I i 1 I I APPROVALS', Permit# ! '' , •
21.!Ducts,in Structure 1 i i; I j I I ( I 70.j Underground Hydro
;22..Ducts-Ventilating ! II p I I ' Oil -- .
l ; ! I I 71. Product Piping 0 Gas 0
r 1i-23.,Gas=Pipe-Rough &^Test c i I e'i l! . I •72.! Underground Flush • -
24.iRoofFraming'. •1. ' rI , 1,_ i, 11,.; •.. I ., ! _ 1 X73.4Uhdergrnd.Storage�Tank0Gas- 0Oil '
r • a I I
r 25.'Riiof SFiet,ring . I I I!.:1' Ir I:: , : 'I : 174r Overhead Hydro , - •
-26. 4-1--:Br Ceiling(Structural).& Monocoat ;- I • X75: Dry Chemical -
:
F
+- I.27rame and F.lalshin . .- (i I it II I yS I a/5/QI$ 76.i Dry Standpipe ;
. ; 28 iLathinb&'Siding r :I I I 1,1 Il I I (( I I- I I X77. F,IXEDSYSTEM_,F,INAL , r_ I ' • '
29. .� I 1. 'I1. I 1 I I ! j78. 'FIRE PREV. FINAL , I
'30.iDrywaII Nailing >;•t a I I I) I I DS I .?ia f/3 y I Notes: . ' ; , , _
- 31c,Plaster:Brown Coat L. 4. r I ; .! 1 I I l I I I I ! I I '
IJ P I ', , If I ' I l
n 32. 'Electiical Power Meter-Final I �� l I 1 1
c +�.!_ i._ I_ i 1_ L
Cr 1,3$�FinaLElectric _w_ l 1,1 :,d�..-�•! J.., I ' 1 I i '-. I I _ _..
e 34. Final Heatingi&IAir Conditioning I I 1 r" I 1 I I '�
I I
35. Final Gas Pipe=Test ( I" II'' i - '1I = i_: I'.. I I '�_Zi^ I.' 1 • 1 :�: I _ , r • -
c .
36. Hood or Canopy' I '' _ I nI - I E I , 1` 1 ^ 1 r I 1 . ; - - .
37. Final FactoriyiFireplac'e. ( x I -' I
i ' 1 lv I • I •: I I ( i 1 - •
38. Final Plumbing I ! I 1 n' . - .' ,! i i i _
ii
39. WateruServioe-Final . i .r • ! ' I I i I , ' 1 , I 1 . ' I
40. Gas Service-Final i II ! • I
41. Solar Domestic.Final I , iI -- - - - - - - - ---. -
42. Backflow P.reventei l I 't,! r_.'. I I. 1 _. _ .- .
r '
1. 1 . ' '
,_i .
n
43. Backflow Irrigatio =i I f^ - '-,, C- ' j._ -
44. Landscape-Irrigation•SYsteml I 12 r , I P 1 1 > ' I t?I I , , • ' _ -
45. Sound Attenuation, , I -. 1 ; V I: I .1 - ' ' - 1 - ••
` «: _
46. Handicap Regulations) ! i ..e '? 1 I I._ r ' I - -
47. FINAL STRUCTURE & BUILDING ' ! ,
II I l I I 1 l� fa9lp��^r�� l I r- i I .
p�
48. Special Requirements Completed d I 7 k'0'7I 'help ' , I I I •- • -
49. Electric Release to Edison _ ! •
50. Gas Release do t I Southern California Gas Co i t 1 i
51. CERTIFICATE OF OCCUPANCY 1 ;_ __L.1 '_ _!__ L . ' __+_,- __ .. ':_ ,
No Date .'
•
/ Applicant to fill In all spaces except thole within heavy border lines and sign all appropriate declarations. -
(VV/ F COSTA MESA a PERMIT NO. TRACT NO. LOT O. ; BLDG.NO..
CO RV.TION PERMIT .. P 759
oeou 6/PI/H3 3 -0!] ' TL
\y Applicant's Mailing Address a•7• ,r ieir�Ti TYPE OF CONSTRUCTION' NEW ❑ ADD Li ALTERATION U REPAIR - . . .
�•• Project Address • r -a Cof C ❑ CONVERSION ❑ DEMOLISH ❑ OTHER •
Owner's Name T CS CPhone ha -2a es/ DESCRIPTION OF WORK
1 �1/' /1 ZONING REGULATIONS
Address ,Q•t PrI'PLUc1 y ' O' .
'\ TYPE OF PERMIT U GRADING I��Ug FOUNDATION- U STRUCTURAL A.P.# _ ZONE .
Arch/Eng, _ License NO. 0 TENANT ❑.ELECTRICAL LYPLUMBING ❑ MECHANICAL • .PLNG.REF.# ' BUILDING -
// CFTnAry n t CT
❑'OTHER REAR YARD (TO P/U
Address - PRO EIRTY LINE
Contractor's Name -'1.1-6'
J lam 1 - PP.ho.In�e,:^T 31 gbia PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Addfess(mailing) • (h' X 187 `�1rrr"'^ ' CONSTRUCTION TYPE VALUATION 5'• 1 LEFT SIDE YARD RIGHT SIDE YARD I'
ft I • g8/111/7
/�In , ZONE GRADING CU.YDS. •,ACRES PKG.SPACE REQ. PROVIDED 1
License No. _ - /�
LICENSED CONTRACTOR DECLARATION /3
Remarks: . . 7 53 (9 - STREET WIDTH PARK FEE$
I hereby affirm that-I am licensed under provisions of Charter 9(commencing ' - -
with section 7000) of Division 3 of the Business and Professions Code,and . , SPECIAL CONDITIONS: ' I -
my license Is In full force and effect.
• License Class' License TI-0-I-� 0 - PLUMBING , •
- �,
Date.n'/r 'kM) Signature /1//n'• ee!/1t1t4f//j/
WORKERS'COMPENSATION DECLAARA OTQ N - Bef Sink Sewer Cap 1 ELECTRICAL ,
(.hereby affirm.that.I have a.Certificate of consent.to self4nsure.or a certificate.. Backflow'Preyenter - Sewer Connection - - - - - Automatic Washer- ' _. . 'Meter-❑over 100 amps • - • _ • .
'f Workers' Compensation Insurance, or a certified'copy thereof (Section?' - - '
3800, Lab. ) 1 Backflow •Irrigation Solar Collectors Construction Pole Sub Panel I
Polley No. •
�•O� �9�s'2Y"7/T Company 07 i351 - - - - , �/ - • Cooking Unit Sub Pole
Certified copy Is hereby furnished. ,.- 1 , �Bathtub? I Solar Piping ct-
❑Q Certified copy s filed with the city Bu Itling Diyisl Dishwasher •
— Motors ❑0-1 HP ❑1x-R
' Date (P-In-r• ' Applicant f'•4-4-11/1- XYr) Ki/11 Clarifiers Solar Tank : • - - -
EXEMPTION,FROM WORKERS'COMPENSATION DECLARATION / • J Dryers ❑Gass ❑Electric • Inc.Solar ❑9-15 HP 016-15+
(This section need not be completed if the permit is for one hundred ($100)or • Dishwasher . Swimming Pool w/Spa _
less): Fan' , 'Microwave
' I certify'that in-the performance of the work for which this permit Is Issued •I Drinking Fountains Urinal I .
shall not employ any person in any manner so as to become subject to the - - - - ,j - F.A.U. Pola'Light •
'
Workers':Compensation Laws of California. I , 1 ' Floor Drains i(r Water Closet
Date Signature Fixtures •
NOTICE:If,after making this declaration,-you should'become Subject-to the- • - Floor Sinks - ,• - Water Heater - -- - -- --- - - `- _- _ _ _. Range - - - - -. - t
Workers'; Compensation provisions of the Labor Code, you must forthwith - I
comply ;with; such provisions or this ,permit I shall be .deemed revoked. - Gas Service -Outlets I ' 'Water,S¢rvice - Device Boxes ' Sign •
CONSTRUCTION LENDING AGENCY ' I ' I
- - --- - - - - I / J , Outlets ' Standing Sections
I hereby affirm that there is a'construction-lending agencyfor the performance, ' Interceptors ' - - _ ' '
of the work for. which this permit is 'issued .(Section 3087 Civ. C:) - ` •
Lender's' Name ' ' ' - - i Kitchen Sink r ., I I a _ Switches - Trash Compactor ,
Lender's Address: ' - ' • .• � - - .
OWNER-BUILDER DECLARATION - ' - 3 Leveturies -' ' ' - / Garbage Dispo581
I hereby zlfirrn that I am exempt from the Contractor's License Law for the' p_Tre - - (P - Generator ❑0-5 KW ❑5-15 KW
following reason (Section.-7031.5 Business and Professional Code: Any city or P . -
county which requires a permit to construct;alter Improve,demolish or repair - • Transformer ❑i5-50 KW I '
any structure, prior to its Issuance,also requires tlie'appiicant-for such permit ' Reof Drains • - -
' to file a signed statement that he/she is licensed pursuant to the provisions of , - - 050+KW.
the Contractor'YLicense Law(Chapter 9(commencing'with Section 7000)of Reinspection Fee $15 •
s .Division 3-of the Business and Professions Code) or that'he/she is exempt /. Showers - , , - Reinspection Fee $15 - - - ,
,fytherefrom and the basis for the alleged exemption. Any violation of Section - •'• _ - Meter [pup to 100 amps ' Issue Fee- " - '$ 3
y:J-7O31.5 by-any applicant for-a permit subjects the applicant to a. civil • Service Sink .. I Issue Fee - '-
enalty of not more than five,hundred dollars($500). - } $ 3 Zoning Approved By Date
I.'as!owner of,the property br my employees with wages as their sole - • MECHANICAL ,
l compensation will'do the work;and the structurelis not intended or offered „ Application Approved By • - - Date -
•
for sale'(Section 7044, Business and Professional Code: The Contractor's - 9
License Law does not apply to an owner of a property who builds or improves Boiler Refrigeration System Application Issued By /L/�y�)/.s� -/� r+ s
' thereon, and who does such Work himself/herself or through his or her own pP / V Date .
employees, provided that such improvements are not intended or offered for Duct-Under Ground ❑0-100,000 BTU ❑100,000BTU'
sale. If, however, the building or improvement is sold within one year of com- - ' SUMMARY OF FEES • •
pietion,the owner will have the burden of proving he/she and not build or im- - -
prove for the purpose of sale). Duct-Structural System Repair/Alteration BUILDING PERMIT $ - SMIP , $
LJ I, as owner of the property, am exclusively contracting)with licensed con-
tractorstoconstruct the project (Sectlon,7044,.Buslnessend Professions Code: _ Duct-Ventilating - - . ,__ _- _ PLAN CHECK S. ' PERMIT ,
The Contractor's License Law does not apply to an owner of property who - ISSUANCE $ 1
builds or improves thereon, and who contracts for such projects with a con- 1 ' Exhaust System 0 Multiple❑'- 'PLUMBING $I 7 3.—'
tractor(s) license pursuant to the Contractor's License Law)! - • PLAN( CHECK $ /0 GRADING j $
0 Cam exempt under Section B.& P.C.for this reason • Firepl/Fact.Blt. ICBG s I - ' '
1 1 i I • I '• - 1 ELECTRICAL, $ ' I I I $
Date 4 Owner ' - Heating'System& Ducting 1 s s MICROFILM $ '
' I hereby. certify that I have read this-application and state that the above ❑O-100,000'BTU0100,OOOBTL •—.. - - --•- - .PLAN CHECK $ _'
information Is correct. I agree to comply with all city and county ordinances . - • - I I ' TOTAL FEE ' $ I
and state laws relating to building construction,and hereby authorize repre- . Hood or Type I ❑ MECHANICAL, 1 $, I I s s
•
sentatives of this/city to enter upon the ab v -mentioned property for VP ' Reinspection Fee• $15 - I LESS ' '
inspection purpose . v o � ! Canopy Type II ❑ ,PLAN CHECK( • $ ADVANCED PC , $
Signature h. iib /�L��V�`--�./ Date '(Y •/5 t3' - , •- • 1 ,
Drivers' License or•SS 1. ( 1 , ' Registers • Issue Fee $ 3 ' •• FINAL FEE $ 33'-
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor -
1 'CONSTRUCTIONS;AND;PLANNING < '+ :71" •' L. 7 ^ -� - '- POOL&APA •>- -
' c ni - =1 " s' ..Date ^Inspector - •' : Date Inspector '
6 i _: LS Permit# . - ;_-t.77:: ; APPROVALS ;Permit.# - • _
r ZIII.
Temporary Electrical Service or Po - .::•;::.::•;:: o•
le H - F' "52 & m
Pool Equipment Location ' - : _ - --'
?� 2' mSoil Pipe Undrgrnd • i I .n !,:'I4
I Si 669-:„?C 533 Steel Reinforcement r - i - - •
3! Electrical Conduit Utility-Undrgrnd! I µ; - I r ''5,4._ Forms -' . 'c;,: , ' -
°'' •4' Electrical Conduit-Undrgrnd =•-• i 3-1,:,. ` ` 1 v m g il:t` - 55
Electrical Bonding' '
5: Steel,Reinforcement I •,-;; "' I ' ' " i ° � `^E_ ; 56. Rough Plumbin & Pressure-le-ft
1 f ;4,_
,� 9 In N'_ , J 9
6: 'Electrical LIFER Grnd., ' ,_ . ' ; 1-' G `n ' `0'- - - .57: APPROVAL COVER-GUNITE� ,
7. Footings I I I I o �o � . w, > ' = `' . 58. Electrical Conduit-Undrarnd. . . '
8. Foundation a I I 8 L _' :i..4', s; ; A!..'`, ;,, , 59. GasPipe;O-'Undrgrnd.,Test - . '
9. Water Pipe�Uridrgrnd. ' I . - I ) ; t, . '• • "I''..,.., _ - , 60. Backwash'Lines,P-Trap, 0 Undrgrnd. _
10. Structural Floor System ' r° o•I ; 4 j i'', : , 61. APPROVAL TO_DECK - - • - ' : .
11.'Property Sewer Line &1Housertonnection; i- r, E 62. Backwash &:Receptor-Final ...,=
12. Sewer Cop . 1 q� '• •
j ' iii : i.63. Heater& Vent-Final _ - -
13. IRoof1Drains ' � • j I �`•'. . i,'y• :: I •64. Plumbing.System'-,Final - -
14. Rough Plumbngl ."' La "/ - -
1/3/��✓gl• `85. Electrical-Final i
X15.-.Rough-Electrical.Conduit-l--T-l- -1.:---TIT,--;.: -I ' r '.66.,SolaFSystem=Firial. ' --� - -
'16,1Rough Electric Wiring. - I < II Ir....-1- ;";:r I tr 1- .67.1 Fencing&=Access:Approval _
r17.,Rough Wiring Sign`s 'j :r I ` ) !! I,::: I' [ I G ` - 1I.. . ? i:;I c' I 68' APPROVED -1:3R-PLASTERINGF
-
- 'li 18:IRough::Electriica1-T:BaiCeiling; II I' : I I I , I - Iii .69. POOL/SPA SYSTEMS'FI NAL ' . .
19: RoughrHeating&IAir'Conditioning II I : ; r I i 1 j I ( :FIREDEPT,,REQUIREMENT_ • -
, i 20.'Rough.Factory Fireplace . I II Q. I I I I I APPROVALS. I Permit#
• ' 21. !buds;in Structure; - ' •i I I I I 1 I 70.' Under round Hydro .
- 'II 22.IDudts1. , Ventilating . I ; I !I (1 H I I I ' . I I I 01.1 Product Piping 0 Gas ❑Oil
11,23. Gas Pipe-Rough & Tesi ,a a rs'I; 72.' Under round Flush, ! •
I... l 1, I I. 1 ;:III 9
i :,-24.,Roof Framing c I• "I IIc;;;;g I' I'I I N;a: I:-;,I; I . .1. 93.1 Undergrrid.Storage Tank O Gas ❑Oil '
.` -25. Roof Sheathing :•;.I lc ',_;, I., 11 ' ' I` - l- I I' 174., Overhead Hydro _
- -26. +.71-13r Ceiling (Structural),& Monocoet' I ` 1'1 I „I s'I j • :75.: Dry Chemical •
�27. Frame and Flashing; l 1, Ii j' I " ; I I I I 76. Dry Standpipe I
1 28.4Lathing& Sidingl 4 } H I I .I II I 1 I I ;: 1 I I 1177.: FIXED SYSTEM FINAL - ,
L29_Il1nsulation 5 I _ i' I I II I i i I I I I I 178,; FIRE PREV. FINAL •
`, a 30.b ywall Nailing - I 'I I ! II I• I I ' I , I I I Notes:; • I
- 31.:Plaster'Brown Coat; i ' I 1 iI '' ! i- I - I , I - I- I j - ' ; i - -- - .
32.'Electrical;Power Meter-Final I II i- I I _I •
!) _ _ ! I_ ' I ; :
;t 33.,Final Electric I 7......I ....i..„.1.-,,:4 i' _ i _ , [_.I ,.. 1.'..._' „,... ..4 _ . . • .
34. Final Heating&,Av Conditioning II I I I I I I I I I I I I I ! • ^ c
JJ I
"' li h rtl P• IT; I r- F! o, i _ I I... -_ _ I-- ' I I
35. Final Gas;Pipe-Test: N I j I C' II I _ i'• I" I r I .` I - 1' - - ! - - _ . - s
36. Hood or;Canopy; l r :n i ':i, E ' ! r I I Iii _ .1 -,• ,-_ i .
37. Final Factory Fireplace; t I ct ,I 1:4 Ik I j _ •
-
38. Final Pluinbin9 i I I I I of h I ` dt.,/I _' i I _ , .
39. Water Service-Final; ' 'I II I I j 1 1 !' j I I i
I ,
40. Gas Service-FinalI I I I I ' I , I . 1 • ' _
41. Solar Domestic-Final I I I I 'I I ' ; ' - ' -
42. Backflow Preventei I I �m I-- _�_ T_i__-_' - -1,_ -4 • _ _r - '
43. Backflow Irri anon '•r� 4-i ' ",
44. Landscape lrrigation-Systeml I PI: I'.-' ' I ' - ' '
45. Sound:rrAttenuatiori I'r I `_I I I ii IC i l I I I I :. I
Ic ( .
46. Handicap Regulations I l 1 -d jz . I ,.1 . I
47. FINAL STRUCTURE & BUILDING'S , I ' I - I . I
4 i, I , 1 I 1 ,; ! - I _ .
48. Special Requirements Completed ' I ! I I ' I ! I ; , .
N I i , I I I
49. Electric Aelease!to Edison I I -p ( i t I i _1_ I_ i .- ; - .
50. Gas Release to Souihe�n California Gas co I I I I 1 I ' i .. i
51. CERTIFICATE'IOF OCCUPANCY 11 I , '_.4____! --!---1 - • I --_ l : •
'' . I Date i _ 1_I
No v -I I i I _l
' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA _ i PERMIT NO. TRACT NO. LOT NO. . BLDG.NO. '
CONSTRUCTION PERMIT - • '•
°' '- /VI - ?70t3. 7 I -
I� 1 .
Applicant's Mailing Address I:i -s s •r.5 ._ e -S - - TYPE OF CONSTRUCTION" NEW CJ ADD-•H ALTERATION -L I REPAIR _ L- ' - -
ProjectAddress '3057 •'T,nySbiirg ,Ray, ❑ CONVERSION '❑ DEMOLISH ❑ OTHER -' •• '
Owner's Name M.T). .TRn•c CO: Phone • DESCRIPTION'OF WORK '111P T.R.1 fireplace - '
, _ - -ZONING REGULATIONS
Address _ _ - •- TYPE OF PERMIT ( H GRADING ❑ FOUNDATION IJ STRUCTURAL A.P:'yk - - , ZONE -
Arch/Eng. r ' License No. ❑ TENANT ❑r ELECTRICAL ❑ PLUMBING, ®"MECHANICAL. - PLNG. REF.# _n•
- - •- BUILDING
nen-Berk k i-vi CT• "
Address ❑ OTHER - ' • -' ' ' ' ' TO BUILDING '
Contractor's Name Coa St Ti replace -Phone 6'39-1E2 it PROJECT DESCRIPTION SQ, FT. '_ ` �OCCUPANCV - PROPERTY LINE _ " • REAR YARD (TO P/L)
1 r� .7 - LEFT SIDE YARD RIGHT SIDE YARD ' i : '
Address(mailing/ .1 OAO_Jy LV - $atavl a ,Orange, 99. , ' CONSTRUCTION TYPE VALUATION -
LioenseNo. • 14.06 • - , ZONF - - GRADING CU.YDS: ACRES ' PKG.SPACE REO. I PROVIDED
I
LICENSED CONTRACTOR DECLARATION 1 Remarks: ./Z -7L5-4,)C - STREET WIDTH _ PARK FEE$ • ' r
Lhereby,affirm that I:am licensed under provisions of Charter.9(commencing (/,l - ' , 1 I.�
with section 7000) of Division 31 of the Business and Professions Code,and . I . SPECIAL CONDITIONS: ' ., '
my license is in full force and effect. i ' -
' License CIS s ' -• I •e - o. I PLUMBING . - f
' Date • : Signature #4111 . . /......,. /re- 1 - ,
'ORKERS'COMPENSATION DEC 'R•TION - Baf Sink i - Wer Cap , ELECTRICAL
hereby affirm that I.have a Certificate of consent to.self sure or.a.certificate ' ' _ .- • _ Automatic Washer •Meter ❑aver 100 amps •- '
of Workers' Com tion Insurance,'or' certified'copy thereof (Section Beckflow'Preventer•^ r - • Sewer Connection I - - - - - v
DI 33 /59JC Aetna Irrigation . , Construction Pole Sub Panel , ,
3800, Lab. C.) 1 Ol-I•t5 O(',( A Backflow Solar Collectors
Policy No. 1 Company ( • 1 e i Cooking Unit I Sub Pole ' • '
Certified copy Is hereby furnished. 1 ; Bathtubs 1 • Solar Piping , ' `
Cert�f igtl nog inked with the city R / Diyi$ipjl",( , 1
Date I f 1 hjLt3 Applicant eiip • I/.AftJ•�'/��/' Clarifiers Solar Tank _ •
Dishwasher - 'Motors ❑0-1 HP ❑t'/a-8 • j l
EXEMPTION'P ROM WORKERS'COMP NS- ION DECLP(RATION •1 - Dryers- Gas ❑EIeC[fic ` Inc.Solar'Dy-15 HP 016-15+
Dishwasher •. . Swimming Pool w/Spa
(This section need not be completed If the permit is for one hundred($100)'or (• - ,
, less). i4 I •- -- , - Fan ' Microwave ,
I certify'that In the performance of the work for,which this permit is issued, I ' Drinking Fountains',- Urinal j 1I r ,
shall:not employ any person In any manner so as to become subject to the � I . - F.A.U. ' '1.'', Pole Light
Workers' Compensation'Laws of California,' r ' Floor Drains• {' Water Closet I , •
Date - • ( Signature - - ' - i •
Fixtnre_s _. Range _,
NOTICE:'If,-after making-this declaration;you should become subject to the- - 1' Floor Sinks ; -- _i - - -- - -- --. - - - - - .,-- . . _ _
•
� Workers' Compensation provisions of.the Labor Code, you must.forthwith - - Device Boxes l .- ,
comply with' such ,provisions or this_permit ,shall be•deemed revoked., Gas Service• ' -tOutlets - Water Service :p , ' --. ' Sign • ,
I CONSTRUCTION-LENDING AGENCY ' - ' - 1 , - • ,
I hereby affirm that there is alconstruction lending agencfor the performance Interceptors , ' •I - Outlets Standing Sections
y •
• ,
of the ,work for which,this- permit is ,issued .(Section 3097' Civ. C.), ' - - ' -
i Lender's' Name" - - ' - Kitchen Sink' - _ - I .I I 0 Switches . 1 1 1• 'Trash Compactor
I Lender's' Address Y - -- i I ' _ - - ' r Garbage Disposal I 1 ,
OWNER'BUILDER DECLARATION - i - ' i �. I Lavatories I .v• _ I � ,
I hereby that I am-exempt from the Contractor's License Law for the- _ - i - - Generator 0015 KW ❑5-15KW ,
I following reason (Section'7031.5 Business and Professional(Code: Any city or - • P TiaP - • , - - - 1 - 1 i ' I '
'county which requires a permit-to construct',alter Improve;demolish or repair 1 - ,. , _ _. ,,, _ - Transformer 015-50 KW ' I '
any structure; prior to Its Issuance, also requires tile-applicantLfor such permit - 1 Roof Drains I I
to file a signed statement-that he/she Is licensed pursuant to the:provisions-of - - ' - 1 Y i ❑SU 4 KW' •
- the Contractor's License Law(Chapter 9(commencing with Section 7000)of - �- • - i I I .Reinspection Fee , $15
Division'3-of the'Business and Professions Code) or that he/she is'exempt Showers r , c - • ReinspectioniFee $15 ,
, therefrom and the basis for the alleged exemption. Any violation-of Section . - _ Meter ❑up to 100 amps 'Issue Fee •$ '3
,•7031.5 by any applicant for a:permit subjects the-applicant to a-civil -< ' I - . $ 3 .. - -
enalty of not more than five hundred dollars($500), • .-• i,• ' Service Sink " ) r 1 - Issue Fee � Zoning Approved By Date •
U I,•as'owner of the property or. my employees,with wages as their sole MECHANICAL
. compensation will do the work,and,the structure is not intended or offered =: Application Approved By Date
' for sale (Section 7044', Business,and;Professional.Code: The,Contractor's -- - - - '-- - . ,
• License Law does not apply to an owner of a property who builds or improves Boiler • ' Refrigeration System , Application Issued By �- /� I Date ///.i�/o -'
thereon;.and who does such'work himself/herself or through his or her own '.- - pp.
employees, provided that such improvements are not tended or offered for El 0-100,600 BTU 0100,000 BTU.
sale. If, however, the building or improvement Is sold within onelyear'of com- Duct- Under Ground SUMMARY OF FEES
eroven,'the owner will have the burden of proving he/she did not build or im- '
' prove for the purpose of sale). , - - Duct-Structural , System Repair/Alteration 'BUILDING PERMIS $ SMTP $ . i I
1. U i,as-owner of the property, am exclusively contracting with'licensed con- -
tractors to construct the project-(Section 7044,,Business and.Professions Code:- - - ,' Duct:Ventilating. ; ,_- 'PLAN CHECK $ ' PERMIT t I
The Contractor's License Law does not apply to an owner of property who - , ' .. ' ' ISSUANCE,. 1 $
1 builds or improves thereon,and who contracts for such projects with a con- , Exhaust System 0 Multiple 0; , , PLUMBING ' $; I
' tractor(s) license pursuant to the Contractor's License Law): ; - - 1 I , GRADING ' ' $
0 i am'exempt under Section , B.& P.C.for this reason 1 Firepi/Fact,Blt. ICBO.#3195 1 I 1 4 00 PLAN CHECK, ' $ ' •
ELECTRICAL S. _ $
I Date ' owner - -' HeetingiSystem&Ducting -' MICROFILM $
I-hereby-certify-that i-have read-this l-application and-state-that-the above - 00-100,000 BTU-❑100,000BT --- ' -- - •-- - - .PLAN CHECK ' S. , I
information is correct. I agree to comply with all city,and county ordinances ' ' ' '7 ; TOTAL FEE: $ '
and-state laws relating to .rind' 't construction,and hereby authorize repre- 'MECHANICAL $ 7.00 I
, sentatives of-t s-• I o enter upon the above-mentioned property for ' Hood or Type I ❑: Reinspection Fee) $15 LESS I
• inspection our.• es.� i ' l ' Canopy Type II ❑• , 'PLAN CHECK $ ? • OO ) ADVANCED PC •
$
Signature �.. .... ' DateJ.l/16/831 I i I
Registers - 1 Issue Fee I $ 3 i i i OO
Drivers' Licari - or S # •_ _
•
•
CONSTRUCTION AND PLANNING • POOL &SPA p
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 i 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 Cap63. 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 49,42//91 �`C APPROVALS Permit#
21; Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑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
30. Drywall Nailing Notes:
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 y/7 i4qc1t
�� "
38. Final Plumbing v
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
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.
CITY OF COSTA MESA 1 ' . . . PER ITN10,. "TRACT NO. LOT NO. BLDG.NO. - •
. 7236 11J/ I j/w . SeL- it
CONSTRUCTION PERMIT' . •
! �! 1o�p_1 (0gcr5 7/-02 ,3
Applicant's Mailing Addr:._ ' •• 4 . • as Lt., ��. 'et�• TYPE OF CONSTRUCTION IC4.N EW-1U ADD ALTERATION U REPAIR
4 /Man/ 0 CONVERSION 0 DEMyiy MER - '
Project Addrera - (/'/M1r.1'
Owner's Name ' ,, ��1 'hone qx1 7t DESCRIPTION OF WORK • ZONING REGULATIONS
'- •• -' t -_ . /ea m-
Address • TYPE OF PERMIT 0 GRADING 0 FOUNDATION ❑ STRUCTURAL A.P.#r ZONE
Arch/Eng. License No- 0 TENANT 0 ELECTRICAL 0 PLUMBING Cit MECHANICAL PLNG.REF.# BUILDING . _ _ __
Address _ - ❑;BOTHER - - TO BUILDING - - -- erTBACV rti ca-
Address
Contractors Name - • / //yy •/�•��nvs PROPERTY LINE REAR YARD(TO P/L) .
l WA e Phone X17 W+ PROJECT DESCRIPTION SO, FT. OCCUPANCY
/� LEFT SIDE YARD RIGHT SIDE YARD
p ��, CONSTRUCTION TYPE VALUATION§ e&n PKC.SPACE REO. • PROVIDED
Address lmailingl; S
if .
• /'' ('ryC `r-
-J ZONE GRADING CU.YDS. AC RFS License No. __ x -
' LICENSED CONTRACTOR DEC •RATION : Remarks: L")- 7J 7� 6, . STREET WIDTH - PARK FEE$ '
I hereby affirm that I am licensed under provisions of Charter 9(commencing
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: '
my license is In fu force and effect. ( �
License lass %-+ I Lice• No. 201 PLUMBING • -
Date ' C.. -• ' Signature €CS "e Bar Sink Sewer Cap ELECTRICAL •'
WORKERS'COMPENSATION DECLAR•- s - – -- - '
'hereby affirm that I have a certificate of consent to set 4nsure or a certificate Backflow Preventer • Sewer Connection - Automatic Washer • Meter Dover 100 amps . - - .
I Workers' Co,j pensation Insurance, or a certified opy thereof (Section - _ - -
3800, Lab. C.)///,t/q/D Gpj Backf low Irrigation Solar_Collectors " Construction Pole Sub Panel.
Policy No. {''r C- /! Company : Cooking Unit Sub Pole '
I�-I.CertIfled copy Is hereby furnished. , Bathtubs Solar Piping _ :
lq CertiJ(ea filetl with the my B laing durst n. A )jI • Dishwasher 'Motors ❑0-) HP ❑m-s ,
Date //l f� Applicant ate' Jf"Ili Clarifiers • Solar Tank
EXEMPTION FROM WORKERS'COMPENSATI DECLARATION Dishwasher Swimming Pool w/Spa . Dryers •
❑Gal- ❑Electric •
Int.Solar 09-15 HP 016-154-
(This
16-15+
(This section need not be completed if the permit is for one hundred($100)or _—
less) - - • Fan' • Microwave
I certify that in the performance of the work for which this permit is issued I ' Drinking Fountains I Urinal •
shall not employ any person in any manner so as to become subject.to the F.A.U. Pole Light
Workers' Compensation Laws of California. . Floor Drains Water Closet' '
Date Signature ' •
Fixtures
NOTICE:If,after making this declaration,you•should become subject to the Floor Sinks Water Heater - -- Range - - _. .
Workers' Compensation provisions of the Labor Code, you must forthwith) - Device• Boxes
comply with such provisions or this-permit shall be deemed revoked. Gas Service Outlets Water Service - Sign
' CONSTRUCTION.LENDING AGENCY • - Outlets •
I hereby affirm that there is a construction lending agency for the performance Interceptors '- Standing Sections
of the work for %Mich this permit is issued (Section 3097 Civ. C) '
Lender's Name TV
A -- Kitchen Sink •
Switches Trash Compactor
Lender's Address ' ' - Garbage Disposal •
OWNER BUILDER DECLARATION - Lavatories '
• I hereby affirm that I am exempt from the Contractor's License Law for the Generator 00-5 KW 05-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or ' ' - P-Trap - • - ,
county which requires a permit to construct,alter,improve,demolish or-repair - . - Transformer ❑15-50 KW
any structure, prior to Its Issuance, also requires te applicant for such permit . Roof Drains - •
to file a signed statement that he/she Is licensed pursuant to the provisions of _ 050+KW
the Contractor's License Law(Chapter 9(commencing'with Section 7000)of ReinspeCYion Fee $15'
Division 3 of the Business and Professions Code) or that he/she is.exempt , Showers . Reinspection Fee $15
therefrom and the basis for the alleged exemption. Any.violation of Section : • - Meter ❑up to 100 amps ' Issue Fee. .$ 3
7031.5 by-any applicant for a permit subjects,the_applicant to a, civil Service Sink - Issue Fee $ 3
malty of not more than five hundred dollars($500).• JZoning Approved By Date
U I, as owner of the property or'my employees with wages as their sole MECHANICAL - • "
compensation will•do the work,and the-structure Is not intended or offered - • Application Approved By 'nate
for sale (Section 7044, Business'and Professional Code:•The Contractor's
License Law does not apply to an owner of a property who builds or Improves Boiler. . ' ' Refrigeration System �n - /O -/3-.0913thereon,-and who'does:such work himself/herself or through his or her own Application Issued By Date-
employees, provided that such Improvements are not intended or offered for Duct-Under Ground • ❑0-100,000 BTU ❑100,000 BTU ,
• sale. If, however,the building or Improvement Is sold within one year of com- I •SUMMARY OF FEES '
Motion, the owner will have the burden of proving he/she did not build or im- - '
move for the purpose of sale). Duct-Structural System Repair/Alteration BUILDING PERMIT S. SMIP i $ I '
LI 1,as owner of the property,am exclusively contracting with licensed con- Duct.-VentilatingPLAN CHECK $ PERMIT •
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 •PLUMBING $ ISSUANCE ' $ •'
builds or Improves thereon,and who contracts for such projects with a con- • Exhaust System 0 Multiple 0 '
tractor(s) license pursuant to the Contractor's License Law): • PLAN CHECK $ GRADING $
❑ Pam exempt under Section B.& P.C.for this reason Firepl/Fact.BIt.ICBG# •
, $ '
Date - Owner Hhati ng'System&Ducting ELECTRICAL $
I-hereby, certify that I have read this application and state that the above 0,100,000 BTU ❑100,000 BTL - - f oc) PLAN CHECK S.
MICROFILM $
Information Is correct. I agree to comply with all city and county ordinances MECHANICAL $ / TOTAL FEE' $ -
•
and state laws relating to building construction,and hereby authorize repre- Hood or Type I O. OiD
sentatives of this.city to enter on the above-mentioned property for Reinspection Fee $15 'PLAN CHECK $ LESS
Inspection purposes. lo-Al€3 Canopy Type II 0 • +I
Signature Date •o��...JJ! ADVANCED PC $
Drivers' License or SS$ - Registers I I Issue Fee $ 3 •• FINAL FEE $
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
--P. CONSTRUdTION AND.,PL'ANNING-1 c t.",, , W •J _1. ... - - - -POOL&SPA • • - -
° 's c • Date ^ ^Inspector4. . ' - Date ` Inspector
> �APPROVA LS •Permit-#" ; •� - 'APPROVALS- Peimit# - •
_
rr 1_tTe-m5orary iElectrical Service or,-Pole ' ...,' - ' = 527 Pool & Equipment Location -
' :?'i SOH Pipe-Undrgrnd:: '` . ' iti _ '_ S L i 53.'Steel Reinforcement ` - -
1.1
3? Electrical Conduit Utility-Undrgrnd.' l':! J; _- r: '•' 54.: Forms - - - . - - `
�
.r4'. Electrical Conduit-Undrgrnd' : o _ ' L So ° 55.' Electrical Bonding - - •
5; Steel,Reinforcement `- 56.. Rough Plumbing& Pressure Test .'•
6: Electrical UFR Grnd.` z , ' , c n - . - . 57. APPROVAL TO COVER-GUNITE
7. Footings 1 ", ' d -' , - o - •' .:58;.' Electrical Conduit=Undrornd. . - . '
8. Foundation 1 I _ •• c , I.59. Gas Pipe,O Undrgrnd.,Test - -
9. Water Pipe-Undrgrnd. � 1 ,:_ ' ' - 1 ., ,60. Backwash Lines, 0 Undrgrnd. _
10. Structuraltl Floor System - _ •' , 61. APPROVAL TO DECK -
11. Property"Sewer Line & House Connection, _ 7.p r ' , 62. Backwash &"Receptor-Final - _ -'
12. Sewer Cap ' { 1 - *63. Heater & Vent-Final.
•
- 13. Roof'Drains ; 1 I ' '` p„ , 64. Plumbing System - Final ' . _ -
14. Rough Plumbing. : I 1 ' • 65. Electrical-Final -
r
-2 :-5.'iRough'Elect'rical-Conduit-T-- -"r' - - _-' :- 'I' 1 - : -- -- 66:,SolarSystem-Final - '__ . - - --
b ,X16. IRough.Eled ric:Wiring. • i e I i : ;,'� to 1 • L ' -4 '• 67. Fencing & Access Approval . - - - -
"''17:iRough4Wiring Sign{' F '- i . ti I • '' i i ; -' ! 68.E APPROVED FOR PLASTERING - -
18. Rough:ElectricaIT,Bar Ceiling i, , . 1 , i . I ; I 69.E POOL/SPA SYSTEMS FINAL '
t ; 19. iRough:Heating& Air'Conditioning' .j 1 lR j/it7 iffe FIRE DEPT. REQUIREMENT ' ' •
1' 20. Rough Factory Fireplace; 1 I• I I 1 ; I I - ' APPROVALS ' Permit#'AT
,'i 2EDucts,,in Structure ' l j l ; 1, 1 I I 1 1 ; 70.E Underground Hydro
!14`;.22.. Ducts, Ventilating , , , ! •I I. 1 ; 1 ; I 71. Product Piping 0 Gas 0 Oil •
r23. 'Gas-Pipe-Rough&Test 1 1 I ' il. II --I- -f ' _ ' 1 172., Underground Flush ! -
_,C24, 1Roof Framingi I -a : l ' i 1 '; 1 g>, a !-, , ; 73.' Undergrnd.Storage Tank O.Gas 0 Oil, 1
•
;125. .Roof Sheathing ' > ! 1 '= l',',.„ I ;1 ' II,,T i 74., Overhead Hydro
26. 1--Bar Ceiling (Structural).& Monocoaf'' -; "
i i j - ' 75. Dry Chemical -
: .27. ;Frame and'Flashing ' I i ,i 11 i , I ' j • I , X76. Dry Standpipe . ,
' 28`lltething & Siding .� I 1
' 1 1 1 ' 77. FIXED SYSTEM FINAL
_ 29. Insulation '," . `' • I 1 '' II I I I 78: FIRE PREV. FINAL
c ,=30.11 rywal,l Nailing I >"_'' 1 I II i 1 iI I i
Notes: '
,-
31`:!plaster •Brown Coat ; ' I I 11 1 l 1 ,-- I -- 1 � - __ ..
4 32.,Electrical:Power Meter,-Final , :1 ' I ' 1 ' I , i t 4 - . , .
33. Final Electric 1 _ '
34. Final Beating&IAir Conditionin .w ; / r • '
. 1 tn,
35. FinalGas�Pipe=Test ' 1,_, • 2 ' ,•= I • - -
36. Hood 'ortCan'oPy'E j 7 ,a I - 12' •
l L ( . - 1 1 ' - -
37. Final Factory Fireplace - I r I? 1 .. I - . '
38. Final Plumbing I 1 ' -j .
39. Water.Service-Final, I 1 , ' i ' :,
40. Gas Senrvice-Final ! I ' , , ' 1 I
41. Solar Domestic-Final -
42. BackflowPreventer 1 1 ; ', t 1
43. Backflow, Irrigation .- ' I 1 ?• -
44. Landscape Irrigation;Sy"stem ; , 1 J1 ,- : , i • , • .
45. Sound Attenuation ' I.1 r a , I 'i I t • _
46. Handicap Regulations , . m 1 •
t- :H ' 1 i . - - .
47. FINAL STRUCTURE & BUILDING I:; , 1 i`, . ' i I '
.
48. Special Requirements Completed l ! I 2:1 . - rI .
49. Electric Release'to'Edison! I I i._ 1
`t ._� _ i...... '_ . - '
50. Gas Release to Southern California Gas Co i , I '
.
51. CERTIFICATEIOOCCUPANC� !_ i-.-- -i--1l ir I
No .. ' ' I i Date 1 1 . 1 i 1 '
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA - PERMIT NO. •TRACT NO. LOT NO. BLDG.NO. -
CONSTRUCTION PERMIT •
E - 9� 7 / •
// '
Project Address. �n s•� TYPE OF CONSTRUCTION LI NEW ❑ ADD Li ALTERATION U REPAIR oio� • •n ,,„, - - - is
Applicant's Mailing Add�Jress /la N cat (mum I - 1:: CONVERSION F.: DEMOLISH ❑ OTHER A.P.# - Zona-
Owner'S Name v �' v Ph. e DESCRIPTION OF WORK S Main Building: Accessory Building: - Z
Address • - 0
TYPE OF PERMITt'!-lam❑ GRADING U FOUNDATION ❑ STRUCTURAL E Front N
Arch/Eng. License No. • ❑ TENANT I(Q ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear I
Address ❑ OTHER A N
Contractor's Name I, /// l • Il' 9 `-^'''�+' a'Id' ld' - PROJECT DESCRIPTION SQ. FT. - OCCUPANCY - - C Right - - G ,
Address(mailing) ` 1 _ sem, ' � �U CONSTRUCTION TYPE VALUATION$ S Left R
/n(IL
� ,{�/ ZONE GRADING CU.YDS. ACRES Ping. Ref.4 Park.Fees $ O
City License No. IJ\ -• U
LICENSED CONTRACTOR DECLARATION l Remarks: Parking Req./Provided I
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 Co•e a•d - �s� .Y Use of Building: E
my license is in full f• • and -f aa��
License elan 4. —' CSA License N•�� elr1 r PLUMBING FEES Planning Notes: M
Date - aV Signature fly .._ -_-.� flJ=•�r _ E
MOP
WORKERS'COMPENSATION DECLARATION ` , Bar Sink Showers _ N
T
hereby affirm that I have a certificate of consent to self-insure or r HIV to Backflow Preventer Service Sink • S
' Workers' C, mpe tion Insurance, or a certifi d copy roof (Se Ion _� - ��
.800, Lab. {/_I !Or{O2t Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. 14..E 0 /'3 Company --_
Cer fled copy is hereby furnisho _�,011tubs Sewer Connection ' Automatic Washer Transformer / •
15.50 KW
er TIO yo qy Is with the cit
B ll�dhATI Oision. - • ❑ 50+KW
Date_ 1-V'•-4� Applicant �'--•-tf r'-D Clarifiers Solar Collectors - Construction Pole Sub. •
_J
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping - CookingUnit " - - Meter C7u to 100 amps 1
(Thlssection need not be completed if the permit is for one hundred(S1`0 or ` P P
Iecsl• DrinkingFountains ' •
I certify that in the performance of the work for which this permit is issued, I Solar Tank - Dishwasher i 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 w/Spa ' Dryers ❑ L7
Gas Electric / Sub Panel /0 —.
Date Signature —
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal I Fan' • Motors❑41 HP 01K-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. '
Ina Solar 09-15 HP ❑16-15+
CONSTRUCTION LENDING AGENCY -
I hereby affirm that there Is a construction lending agency for the performance Interceptors ,- Water Heater ' D Fixtures / •Microwave 3
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 7 fO
I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap
following reason (Section 7031.5 Business and Professional Code: Any city or P I Switches Sign
county which requires a permit to construct,alter,improve,demolish or repair J I
any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing Sections / —
to file a signed statement that he/she is licensed pursuant to the provisions of
the Contractor's License Law(Chapter 9(commencing with Section 7000)of _ Generator ❑0.5 KW ❑5-15 KW Trash Compactor
Division 3 of the Business and Professions Code) or that he/she is exempt - - P
herefrom and the basis for the alleged exemption. Any violation of Section —
/031.5 by any applicant for a permit subjects the.applicant -to a civil Reinspection Fee 3
malty of not more than five hundred dollars($500). , pe '$25 Issue Fee - ' - $ -
LJ I, as owner of the property or Amy employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered 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 Date '
employees, provided that such Improvements are not intended or offered-for Canopy Type II' ❑
Duct-Under Ground
elation,
l
sale. If, however,wthe t e dof pro i sold within one yearofcorn- Application Approved By Date
prove the owner will have the burden of proving hp/she did not build or Im- g), / / /
6 rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By 7(i J � nate ///e�! �s
I, as owner of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
The Contractor's License Law does not apply.to an owner of property who BUILDING PERMIT $ SMIP
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)- I PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO.4 PLUMBING $ ISSUANCE $ -
Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100.000 BT • GRADING $
Information is correct. t agree to comply with all city and county ordinances • ELECTRICAL $and state I- s relating to building c•r ruc o and hereby authorize repro- PLAN CHECK $ 7i MICROFILM $
sentatives 'o � •is city to ante p•n • =' •ov.,mer •••• • .•.g/ f•
inspection pur•4 —_I � ' / —
Signature -'a•�Is�_ Date "I MECHANICAL $ TOTAL FEE $ 5-6-,AO
Drivers' License or SS
CMF 0865-46 rev. 7/83 white-Building;Canary-Applicant;pink-Accounting:Goldenrod-Assessor - .. . -
. r9
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, D 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 PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final SISril e 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
50. Gas Release to Southern California Gas Co _
51. CERTIFICATE OF OCCUPANCY ' - '
No. Date • ' • •