HomeMy WebLinkAbout1201 HYLAND AVE - Building Permits /
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF.4eSTA MESA CONSTRUCTION PERMIT - 1 PEAR NO . _/� TRACT NO. LOT NO. UNIT NO. .
1N-' O��(D.I 9619. .2/ 19/86 700 TL
Pr�wr,-Address I 10/ F//�r(1L0:,pn/ 2).01f ,
Applicant's Mailing Address 302 2-Kn-({� e'i'%G.v n fa/ rein/ TYPE OF CONSTRUCTION LI NEW LI ADD Li ALTERATION W REPAIR
❑ CONVERSION ❑ DEMOLISH SI OTHER L 'coved A.P.# - I Zone
Owner's Name t,rQ�ra*aa'�i� .�o.YZ 3�Phone j� DESCRIPTION OF WORK/USE OF BLDG. •
Address 5 Ve - - • S Main Building: • Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING UFOUNDATION ❑ STRUCTURAL • T Front. . . - - - ZO
Address Aft-4-/�..� ❑ TENANT -❑ ELECTRICAL ❑ PLUMBING g MECHANICAL B Rear • - • N
Contractor's Name a mt/e a 'phone f•f'(�Z 7T
.0 OTHER - C Right •
. . N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) 30L L Ko.•H�S�oerinq•a' at Ary K G
CONSTRUCTION TYPE • VALUATION$ S Left
City License No. �g R �'� - ZONE GRADI NG CU.YDS. ACRES R
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: Q
with section 7000) of,Division 3 of the Business and Professions Cod and _ . ' M
my license is in full force and feel, T
License Class L'-7 License No 6 • • S
�\ Date 2,//9/&C Signature,• PLUMBING1 ` FEES / i • '
1�
WORKERS' COMPENSATION DEG to RAT Bar Sink dowers ELECTRICAL FEES
hereby affirm that I have a certificate of consent to self-insure or a certificate 1 is
Workers'-Compensation Insurance, or a certified copy thereof (Section • Backflow Preventer Service Sink 1v(' `\
..800, Lab. 4 ' �j Automatic Washer Transformer 0 15-50 KW
Policy No. `1t"eio(.3g2 Company +/Uicq Backf low irrigation S YL` �nn`1 0 50+ KW\ / V aP Yti Construction •Pole Sub,
1 Certified copy is hereby furnished. Yti
1 B'Cer'pegs'titied<o} is filed with the city Building Di ' Bathtubs ewer Connecti - Cooking Unit Meter ❑up to 100 amps
\ Date N FRO 26 Applicant • { ,
-EXEMio FROM WORKERS'COMPENSpe ECe hundred
RATION Clarifiers - Solar Collectors .- 'Dishwasher - - Meter .0over'100 amps, - -
(This section need not be completed if the p mit is for one h ($100)or
less). Dishwasher I ,� Solar Pip' g - Dryers ❑Gas ❑Electric Sub'Panel •
I certify that in the performance of the work for which this permit is issued, 1 ?{!+/( ;
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar nit Fan
Workers' Compensation Laws of California. Motors❑0-1 HP 01%-8
Date Signature Floor Drains / Sw Ing P I w/Spa • F.A.U.
'NOTICE: If,after making this declaration, you should become subject to the / Inc.Solar 09-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you-must forthwith Floor Sinks nal
comply with such provisions or this permit shall be deemed revoked. - r Fixtures Microwave
CONSTRUCTION LENDING AGENCY - - Gas Service ' Outlets Water Closet Device Boxes -
I hereby affirm that there Is a construction lending agency for the performance _ I Pole Light
of the work 'for which this permit is issued (Section 3097 Cie. C.) Interceptors 'Water Heater ' ' •• Outlets
Lender's Name- •
Range
Lender's Address - Kitchen Sink " - Water Service ,, Switches • Sign '
OWNER BUILDER DECLARATION - - - -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories, •
following reason (Section 7031.5 Business and Professional Code: Any city or 'Auto-Wash Garbage Disposal ;Standing Sections - • ,
county which requires a permit to construct;alter,improve,demolish or repair ' ' P—Trap Laundry Trays , Generator ❑0-5 KW ❑5-15 KW ' •
any structure, prior to its Issuance, also requires the applicant for such permit 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
Thvision 3 of the Business and Professions Code) or .that he/she is exempt - -
•
erefrom and the basis for the alleged exemption. Any violation of Section - - - ,
131.5 by any applicant for a permit subjects the-applicant to a civil . - .
penalty-of not more than five hundred dollars($500). • . ' ' - ;
O I, as owner of the property or my employees with wages as their sole Reinspection'Fee I $15 Issue Feet: $ 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 ' MECHANICALFEES
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 DEVELOPMENT SERVICES REQUIREMENTS: '
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. 1f, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ I Zoning Approved By nate
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • •
Building Approved By - Date
prove for the purpose of sale). • - - - (y/
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date -1-5 069
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 Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU '
builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT
0 I am'exempt under Section B.& P.C.for this reason . Firepl/Fact.Bit. ICBO# • Fire Dampers PLUMBING $ ISSUANCE $
T• DV Date dwner Heating System& Ducting Registers
PLAN CHECK 25% $
I hereby certify that I-have-read this application-and state that the above ( 00-108000 BTU F100,000BTL : GRADING $
Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- 1 MICROFILM $
sentatives of this city to enter upon the above-mentioned properly for PLAN CHECK 50%' $
inspection purposes. O
Signature Date 3/4 MECHANICAL $ -�.0 V TOTAL FEE I $ .0
Drivers' License or - _ / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building: Canary - Applicant: Pink -Accounting; Goldenrod - Assessor .
CONSTRUCTION AND PLANNING - POO. ;PA
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. Waver Pipe-Undrgrnd. Vi • 60. Backwash Lines, P-Trap, ❑ 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. .. H' 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 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
'V •• 7
3
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. '
i C
CITY Of COSTA MESA CONSTRUCTION PERMIT — PERMIT NO. (y('� TRACT NO. LOT NO. UNIT NO.
•
Project Address /Zt"/ Al rr-tie r...Lc/ /,ia
1 �TU/ 21- .,i r ` s /o. . I.
7 iZ ., yr,,;, ��e c' � . TYPE OF CONSTRUCTION 0 NEW U ADD U ALTERATION F1 REPAIR
Applicant's Mailing Address _ 'v"/ �•�l Jjtg.—Z [ rAU
,r//Y 14:,‘•/• ❑ CONVERSION --❑ DEMOLISH /CJ OTHER A.P.# • Zone
Owner's Name - J'• Phone C.VZ-ate DESCRIPTION OF WORK/USE OF BLDG.
Address /G -''" - S Main Building: Accessory Building:
Arch/Eng. License No. `t v/'! TYPE OF PERMIT 0 GRADING U FOUNDATION 0 STRUCTURAL E Front 0
Address --9/.--9/.• " 0 TENANT 0 ELECTRICAL 0 PLUMBING •® MECHANICAL B Rear N
/ /!•s-• ❑ OTHER A 1
Contractor's Name nes''4---'‘-'' N"�^^•='G "�--_�hone5'9i'
Addresslmailing) -Y'''L2 /u,-• Nr_i -. u•. /
PROJECT DESCRIPTION SQ. FT. • Of/ UP• • CV C Right N
rCT �-.
CONSTRUCTION TYPE W1L ATI.\ - S Left R
City License No. `J ZONE GRADING CU.YDS. ACRES
N
LICESED CONTRACTOR DECLARATION 1 Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 0
with section 7000) of Division 3 of the Business and Professions Code,and
my license is in lull f ce and,effect. 4y y.� a T
License Class - License No. -1 S
Date 2/0.4-$C-•' Signature 7- e••�"`� PLUMBING , FEES f
i
WORKERS' COMPENSATION DECLARATION Bar Sink Wer
(
I hereby affirm that I nave a certificate of consent to self-insure or a certificate ELECTRICAL FEES
'i p Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Prevent r e Sink •
�J00, Lab. C.) Automatic Washer Transformer 0 15.50 KW
Policy No.Pe-4 C/.1929 Company �e../�t6� ' Backf wiry atio Se Cap j Construction Pole Sub. ❑ 50+KW
'
1 S 1 8 Certified copy Is hereby furnished.
1 Certified copy Is filed with the city Building Division:— r Batht bs onnection Cooking Unit Meter Dup to 100 amps
�1. Date 21', L. Applicant T•`•it+'�->a� - ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Ciarifi rs Solar Ilectors Dishwasher .I. Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). Dish her Solar Piping Dryers OGas ❑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 Drinkin Fou t - Solar Tank Fan
Workers' Compensation Laws of California. - ti_ . - • Motors 00-1 HP Ell h-B
-Date Signature Floor Dr Swimming Pool w/Spa F.A.U. '
NOTICE: If,after making this declaration,you should become subject to the Inc.Solar 09-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water ClosetDevice Boxes -•
1 hereby affirm that there is a construction lending agency for the performance Pole Light
• of the work for which this permit is issued (Section 3097 Clv. C.) -
Interceptors Water Heater Outlets Range
Lender's Name
{Lender's Address • Kitchen 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 Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00.5 KW ❑5-15 KW
any structure, prior to its Issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to theprovisionsof 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
erefrom and the basis for the alleged exemption. Any violation of Section it
31.5 by any applicant for a permit subjects the applicant to a civil - _
nasty of not more than five hundred dollars($500).
U 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 $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 Boiler Hood or Type I ID
SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for
sale. If, however, the building or'improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By
prove for the purpose of sale). Date
0 I, as owner of the property, am exclusively contracting with licensed con- Duct•Structural Refrigeration System Application Issued By 1 - (/• Date 44-11-`t'
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 Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System D Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bl 1. ICBO# Fire Dampers- PLUMBING $ ISSUANCE $
Date Owner • Heating System& Ducting Registers -I{. ;..1 ENERGY P.C. $
I PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above 00100,000 BTU E100,000BT GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter upon the above-mentioned property for -
inspection purposes. 24•24/lF MECHANICAL $ -. i' i-' 'J TOTAL FEE $ t /✓ `�
Signature 7 an
Date24•24/4C
^/, / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or.SS _
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. 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 ❑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:
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