HomeMy WebLinkAbout3325 HARBOR BLVD - Building Permits�_�_. - ' _ _ _ �—
ApD���ant lo Iill in all spaces exce0� ��ose wit�in �eavy borGe� Ilnes anE Si9n all aDD/oD/�ate Oeclarations.
CITY OF COSTA MESA CONSTRUCTIO/N� PERMIT PERMIT NO. _ _ TRACT NO. LOT NO. UNIT N0.
Piklect Address 33 2.r f�.a�raa�r UL ✓Q
1ApplicanvMailingAddress �9�-s��i�ACE.✓Ti�* �✓F
�Owner'sNtne �I�9��✓�6✓F���Srphone7T�T-g9S .
Ay'�ress /¢S �t41/�-` '
Arch/Eng. �� �� License No.
Address �w�.. -- ���
Contractor'sNam r� , hone
Address Imailingl �`ST � L
City�Licenu No.
LICENSED CONTRACTOR DECLARATION
�hereby aHirm that I am Ilcnnsetl untla� provision5 of Chartnt 9(Commentlng
vith sec[ion 7000) of Division 3 of tha Business antl Prolazsions Cotle, antl
my Ilcense is in fu11 force antl eHect. ,
Llcense Ciass License No.
Oate Signature
WORKERS' COMPENSATION DECLARATION
� I h¢reby altirm that I have a cerUticato of consent to seli-insura or a certifiwte
� Workers' Compensation Insurance, Or a cartifietl cOpy Ihereof (SeCtion
100, Lab. CJ
✓oii�y No.G�PP 266 Unna 6 comPa�y T 1 h+
.n�y Cer[HieE copy i5 hereby furnishetl. y,/A
.S Certifietl copY i52iletl with Ihe city_�uiltlinq Qj�iSiOn,_ //�/ �
D'
' EXEMPTION FROM WORKERS' COMPENSATION DECICA)2ATION
( hi55ection neetl nat be complaletl if the permit 1510� one �untl�etl (5300) or
�55). '
I wrlity lhat in [h¢ p¢r(o�man<B Ot Ihe wo�k (o� wM1ich thls p0�m�t is i55u0tl I
Shall nol employ any person in any manner So a5 [o beCOTe subject to t�e
Worker5' Compen5alion Laws oi CalHornia. �
Date Si9naWre �
NOTICE: If,after making [his tleclaration, you shoulC becoma subject to the
Workers' Comp¢nutiOn ptovi5ion5 oi [he Labor Cotle, you mu5t forthwlt�
cOmply wi�h suc� provi5iOn5 or this Dermil Shall DO tl0eme❑ �evoketl.
CONSTRUCTION LENDING AGENCV
I boreby atfirm that thera is a construction Ientlin9 a9ency for tha performance
01 lha work br wMc� Ihis permit is iszuud (Section 309] CIv. CJ
Lnnaer's Name
Lantler's Atltlress
OWNER BUILDEN DECIARATION
I hereby alfirm that 1 am exomp[ irom the Contractor'S Llcense Law for tne
following reazon ($ecelon 1031.5 Businezs antl Professlonal Cotle: Any citY or
Wunty which requires a pe�mit to Cons[�ucQ alt¢r, improve, tlemolisb o� repai�
any structure, prbr to its izsuance, also requires the applicant tor such p¢rmit
to flle a signetl statement Ihat Iw/sbe is Ilcensetl pursuant lo the provisions of
the Convactor's License Law (GhaO�er 9(commencing wllh Section ]000) of
DlviSion 3 of the Business antl Professions Code) or thdt hG/She is exeTpt
'^e�etrOm antl the Da5i5 for the allegetl exemption. Any violatlon ot Section
31.5 by _anY-applicant 7or a Permit SubjG<ts the applicant to a civil
Wlty of not more than five huntlretl tlollars (E500).
J I, a5 owne� of the ptop¢rty o� my employees with wdges as their Sole
compensation, will Oo [he work, antl the structure is not intentletl or offerad
for sale (Seclion ]044, Business antl Professional Cotle: The Contractor'S
LIcenS@ Ldw tloe5 nOl apO�Y �O an own¢r Ot a prop¢rty wno builCS or improves
thereon, antl who aoes such work hlmselt/herseli or tnrou9h hiz or her own
¢mploy ee5, provitl¢tl that such Improvem¢nts are nol IntCntletl or otfered for
sale. It, however, tM1e bulltlin9 or improvement IS Soltl wlthln one year of com-
plotiOn, tne owner will have tho burtlan of proving ha/5h0 tlitl not builtl or Im-
��rove tor [he Ourpose of sale). '
I, a5 Owne� oi [he p�op¢r[y, am oxclusively contraCUng wlth Ilc¢n5e0 con-
'� tractors to construct tnu oroje (So<tlon 7044, Businoss antl Professlons Cotle:
Thu Conlractor's License La oes n0l IY to an Owne� of prOperty who
builtls or improves tnereon, a who co r cts for such orojects with a con-
tractor(s license pursuant to th ontrac r LI�2q se Law). I am aware that
prool o� tnelr Worker's Compa tlon in ur ce�cHoultl bo provitletl to me.
�] 1 am oxempt untler Section �i� 3 P. C, lor this reason
Date
I herCby ce ilyyy that
Intormation �rrec[.
antl state law lating
sentatives ot t s ci�
IOSPection pu�p
Si9na[ure
Drivers' �icense or 55 �
tion an state tbat [he above
all city tl county ortlirtanco5
n, dntl h by authorize r¢Ore-
bove-men 1 netl property tor
TYPE OF CONSTRUCTION ` f2S� NEW LJ ADD LJ ALTERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q p�c
� DESCRIPTION�} F WORK/USE OF BLDG.
�L M/� /yOUS�` `GG� ' S MainBuildi
TVPE OF PERMIT�ADING FOUNDATION STRVCTURAL T Froni
❑ TENANT �ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Reef
❑ OTHER %�
PROJECT DESCRIPTION Sq. F7. 60'd oCCUaaNcv C Right
K Left
CONSTRUCTIONTVPE VALUATION$ $
ZONE GRAOING CU. V�S. aCRES Ping. Ref. �/k
Remarks: Planniny Notes:
Sink
Preventer
Irrigation
Clarifiers
Drinking Fountains
Floor Dreins
Floor $inks
Gas Service - . OuUets
Interceptors,^
Kitchen Sink
Lavatories
Reinspection Fee
515
Ducl-UnAerGround
Duct - Structural
Duct - Ventilating
ExhaustSystem ❑ MWtiple
Firepl/Fact Blt. ICBO �
Heating System & Ducting
❑0-100,000 BTU 0100,000
Reinspection Fee I $75
CMF 0865-46, rev. 10/84 White - Builtling: Canary - AOP��Cdnt; Pink - ACCOunting: Goltlenrotl - ASse55or
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collettors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service -
Auto�Wash .
lasue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑aioo,000eru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
$ 3
S 3
Automatic Washer
Construction Pole
Cooking Uni[
Dishwasher
Dryers OGas ❑
Fan
F.A.U.
Device Boxes
Ouilets
Switches
Garbage Disposal ,
Generator �0-5 KW �5-15
0130730�"L
:. . 2232 � 2�2��Q% _!7,
Zone
Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15�50 KW
� 50+KW
Meter �up to 100 amps -
Meter �over 100 amps
Sub Panel
Motors �0.1 HP �1'h-8
Inc. Solar �9-15 HP 016-15+
Microwdve
Pole Light
Sign
Standing Sections
Trash Compactor
I Reinspection Fee I$15 � � Issue Fee
DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning Approved By
Building Approved By
Applifation laued By
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAI $
PLAN CHECK 25% $
SUMMARY OF
Z
O
N
I
N
G
R
E
Q
M
T
$
FEES
$ 3
G.a
CONS7RUCTION ANDPLANNING POOL&SPA '
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion ,
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. Fo�tings 58. Electrical Conduit-Undrgrnd. -
B.. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water pipe-Undrgrnd. 60. Backwash Lines, P•Trap, 0 Undrgrnd.
10. Struccural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer (;yp . 63. Heater & Vent-Final
13. Roof Dreins 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring � 7. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLAS7ERING
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. Ducta, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil -
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing ' . 73. Undergrnd.StoregeTank OGas ❑Oil
25. Roof Sheathing - • ' - 74, �Overhead Hydro
26. T-Bar Ceiling (Structurai) & Monocoat � - 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe •/ •
28. Lathing & Siding 77. .FIXED SYSTEM FINAL i �
29. Insulation 78. FIRE PREV. FINA� .
30. Drywall Nailing � ' HEALTH DEPT. RE�UIREMENT �
31. Plaster Brown Coat � 9. FINAL INSPECTION � . �
32. Electricai Power Meter-Final : . FOOD CERTIFICATE ISSUED �
33. Final Electric �'y' Not s:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test ' "
36. Hooq or Canopy
,:.
37. Final Factory Fireplace
36. Final plumbing >: ; �
39. Water Service-Final . ' ' "
� .
,40. GasService-Final ' ' " � "
.41. Solar pomestic-Final ' ' � �.
42. Backflow Preventer • �'
'43. Backflow Irrigation . ��'
��
44. Landscape Irrigation System . ' . '�� ;�,
�45. Sound Attenuation � ,� , '
46. Handicap Regulations � . " t,;
;, •� .
47. FINALSTRUCTURE&BUILDING .. � � �t�'i� �
48. Special Requirements Completed • . ` ':
49. Electric Release to Edison �•/
., .� .
50. Gas Release to Southern California Gas Co ' .
51. CER7IFICATE OF OCCUPANCY � ,.� � � �
N0. � Date � �'
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