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Home My WebLink About2616 WILLO LN - Building Permits • PROJECT ADDRESS: 2616 WILLO LN 0X17` CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 045414 • -OWNER'S NAME: GARY DUBACI4 • ADDRESS: 2616 WILLO LNt • PERMIT •NO: P 045414 PLAN CHECK NO: . N GOVT: N SUPP : N •' COSTA MESA CA 92627 ' ' CONSTRUCTION TYPE: 5-N • PERMIT TYPE: PLU PURPOSE: REP ( 714 ) 646-3358 JOB DESCRIPTION : REPLACE SEWER LINE (SEPTIC TANK TO CURB ) SQ FT: ARCH/ENGINEER: • flEG.NO.: -• - ADDRESS: . UNIT: ' CLAIM VALUE: CALC—VALUE: GROUP USC: R-3 I' PERMITTEE: DOUG DUBACH ( 714 ) 646-3358 . . • - ADDRESS: 2616 WILLO LN COMMENTS : NO 'B ' PERMIT. SEWER REPLACEMENT ONLY! • _ • • . COSTA MESA CA 92627 ***N-*vE+EseaE***( -cif* N-icNK*ee,'kiErtaF***+E*staE+r** -**+e;'E+e>fit+title+Est***>F*ie******sr+txst**i<>t*iex **fe*+fmY • LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section - L ON INC R E Q 'U I R E. M ,E N T S - • 7000)of Division 3•of the Business and Professions Code.and my license is in full force and effect. • _ S E T• B A C K S. CITY LIC.: STATE IX: CLASS: Dae: Signatue: • MAIN BUILDING • ---'--- --- ACCESSORY BUILDING- - WORKERS'COMPENSATION DECLARATION: Ihereby affirmthat lhave acertificate ofconsent toself-insure or a certificate of Workers' `I•RNT: FT IN REAR: FT IN ' FENT: 'FT• IN REAR : • FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). ' LEFT: FT IN RGHT': LET IN L F IN RGHT: . .. FT ' IN . POLICY NO.: EXP.DATE: . . COMPANY: 1 PARKING REQ: PROV: • - •CEL: 00000000 ZNE: REF NO: , " Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANN ING NOTES> • pare: Applicant: ********IE***********************.' a1< ********************************-***Xie EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed g the permit is lar one hundred 0100)or less). D E V E L O' P M E N "I' S E R V I C E S ' REQUIREMENTS I certify that In the performance of the work for which this permit is issued.I shag not employ any person in arty manner so as to become i subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • f DATE: Dam: - ' Signature: - .. _I. . NOTICE:If,atter making this declaration,you should become subject to the Workers Compensation provisions of de Labor BUILDING APPROVEDB Y : _ DATE: •Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. i .. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: - • - DATE: (. 2./!45-9 which this permit is issued(Section 3097.Civ.C). - ***-******************* *iE*****et * •T; 'iF '# tw.s3 • TF7FFF**********1Fw"yt=1F'(F* i�it(,t N • . LENDER: *************#ink*##**#*****#**********ee{t****** RPI ************************X***** . ADDRESS: - LEGALIZATION: N . F E E- S rO M M A R Y STRUCTURAL SEGMENT : N ' , • _ -I • OWNER GUILDER DECLARATION: I hereby affirm Mat I am exempt from the Contractors'State License Law for the following reason ' BLDG PMT PLUMBING EL EC Ttf•I C I MECHANIC FIRE SM I P/RES GRAD INC (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to constnbt,alter,Improve,demolish.of PERMIT 5 , 00 - - T repair any structure,prior to its Issuance.also requires the applicant foi such permit to file a signed statement that he/she is licensed , • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25%- S M I P/NON-R E S and Professions Code)or that he/she Is exempt therefrom and the basis for the aneged exemption.My violation of Section 7031.5 by .p L AN . • , , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 00 I, as owner of the property or my em oyees with wages as their sole compensation, wit do-the work, and the BUILDING-DIV-->' PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE ❑ structure is not Intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S---->. 5 . 00 3 . 00 '• • 0 . 00 8 . 00 8 . 00 . 00 does not apply to an owner of a property who builds or Improves thereon,and who does such work himself/herself or throughz-. . • his or her own employees,provided that such Improvements are not intended or offered for sale.If,however the building or • Improvement Is sold within one year of completion.the owner-wit have the burden of proving he/she did not build or Improve REVENUE DIVISION TOTALS---> COLLECTED: 8 . 00' OVER/SHORT: 00 ( for the purpose of safe). 1 DLDG PMT PLUMBING ELECTRIC- MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK •, I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 8 - 00 •. ❑ and Professions Code: The Contractors'Sate License Law does not apply to an owner of properly who builds or Improves thereon A and who contracts for such projectswith aconuactor(s)licensepbrsuanl to the Contactors State License Law).l am aware r***it**.N**r,*W*******st*****************************le **************************** that proof of their Worker's Compensation insurance should be provided to me. - INDIVIDUAL' F' E E• BREAKDOWN RC1 lam exempt under Section:7 0 4 4 B.a P.C. r -• !or this rred/son: D CODES/EXEMP• % • TYPE QTY; DESCRIPTION UNIT COST TOTAL COST / Date: • 1 h / !�._�' I do hereby certify tlatIam aware of and understand the requirements of eatt• .>�.lery •�• - tions 25505,25533,aM PLU 1 BUILDING SEWER / TRAILER PARK SEWER 5 . 00 5 . 00 END OF FEE S 25534 and that I or any futOre building occupant wIMnT not(code one) r•to corn' ..- said .•'.•.es and the requirements for a permit for construction or modification from the Air-G ality Management District. '- lentul construction applications are exempt from ,-1 these provisions. • - • - • T , Date: Applicant: I • I hereby certify that I have read this application and state that the above: correct.I a. : •comp • all city and county ' . . ordinances and state laws relating to building ronsiroctian and hereby authorise represma' of city to enter •.n the above-mentioned ' • property for inspectio/n purposes. t Date: G�i--[ Signature: -_+ ,�� • - U, U6B49E5]Care TOT• S Pr.. gravers License or Social Security x: �`� • DATE: 12/15/89 TIflE: 14:0• 8. 8.00 1641746 White-Building:Green-Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor "- • — - ' CONSTRUCTION AND PLANNING' - POOI 'PA - APPROVALS Permit _ Date Inspector APPROVALS - Permit# Date Insp`ctor , ' , 1:•Temporary Electrical Service or Pole - 52. Pool & Equipment Location (-4 I*" 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . ` 8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,Test I 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 UndrgThd. 10. Structural Floor System 61. APPROVAL TO DECK r 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 1 / II' 12. Sewer Cap 63. Heater & Vent-Final .` 1- I 13. Roof Drains - 64. Plumbing System - Final - • • 1', 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final I j 16. Rough Electric Wiring 67. Fencing & Access Approval .--11 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 • '6 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final - • • ,_'•. 80. FOOD CERTIFICATE ISSUED 33. Final Electric - ' Notes: Z_1-4O ' N,or- 6€A' ' - L. e.D ' 34. Final Heating & Air Conditioning ' "'-' 37.3/qo FUcwuT Cianv qb Psi 20.9 u. G 35. Final Gas Pipe-Test (,,, . 36. Hood or Canopy _ - 37. Final Factory Fireplace ••38. Final Plumbing l - • 39. Water Service-Final I 1 40. Gas Service-Final ' 41. Solar Domestic-Final v• '• 42. Backflow Preventer � s 1 43. Backflow Irrigation 44. Landscape Irrigation System d 45. Sound Attenuation . 0 . 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING k,r '' 48. FINAL PLANNING " .• • 49. Electric Release to Edison i- r ' • 50-Gas Release to Southern California Gas Co „vim.. Q 51. CERTIFICATE OF OCCUPANCY ': No. - Date _