HomeMy WebLinkAbout810 VICTORIA ST - Building Permits7
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ADD�icant to /ill In ali spaces exceot ihase within neavr eortler lines an0 sign all aDvropriate tleelaratlons.
CITY OF.C�OSTA MESA CONSTRUCTION P.ERMIT PER I�T NO. �TRACT NO. LOT NO. UNIT NO. '
Project Address �� Q .L/ C% m�/ /'� � r ,
Applicant's Mailin ress '
Owner's Name �� M M e O H�9 i`-� phone 'Z' �
Address �/9 M 4 � '
Arch/Eng: License No. �
Address '
Contractoi'sNem ���'� �' 9� �S3�"6s/"'
Address (ma'�'�gl o�-�i�d 5. /✓CLl A/� iii"'.•A'4
City.License No. �� � �� �
�
LICENSED CONTRACTFIR DECLARATION �
I hereby atfi�m that I am IlcenSGtl untler proJislon5 ot Chartlr 9(commentlng �.
witn section 7000) of Division 3 of the Business antl Protession5 Cotle, antl
my Ilcense is in f I for e an0 effero•t. . (�
LicenjE CI�$z ' � ` � � n5j ryo�/ � 6 • -
Date7'b�� 5"9 [ e � �iC
WOf1KER5' COMPENSATION DE�RATION ; .
I hereby aHlrm that I have a certifitate of consent to Se nsure or a�certificate
� Workers' Compensation Insurance, or a.certitietl copY thereof (5¢ction
300, Lab. C.) ' �
Policy No. � ComOany � ! �
❑ Ce�tifietl copy is hereby fu�niSheU. ' .
❑ Certifietl copy is filetl with.the city Builtlinq Division.
Date Applicant �
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION�
(This section neetl not be completed it the Oermit i5 tor one huntlretl (E300) or
less).
I certify that in Ihe pertormance ot the work'tor whiGh thi5 perm�t i5 iSsuetl, I �
snail not employ any person in any man er so a o become s tijecLto th �
Worker�CQinPen�tion Laws of Ca' /' , .
Date �l� F Signature
NOTICE: If, after making this tleclarat on, you shoultl be e subject ro the
Workers' COmpenSation provlsions of [h¢ Labor Cotle, u must torthwi[h
compty with such� O�ovisions o� thi5 permit Shall.be tle¢metl revoke0.
CONSTRUCTION LENDING AGENCV
1 hereby affirm tnat [nere is a construction Ienain9 a9enty for the performance
of Ihe work tor whiCh thiz permit is issuetl (Section 309� Civ. C.)
Lender's Name
Lander's Atltlress �
OWNER BUILDER DECLARATION
1 hereby aftirm that 1 am ezemp[ irom the Contractor's License L.aw for the
followin9 reason (Sectlon �031.5 Buslness antl Professional Cotle: Any tlty or:
county wnich req Wres a permit lo tons[ruct; alter', imOrove, tlemolish or repair
any st�uc�ure,.prlo� to Ils issuanCG, also �equi�e5 [he dppliGant to� such permit
to tile a 5ignetl statement thal he/sne is ii<ensetl pursuant to the prSvisions o(
the Contractor's Lic¢nse Law (ChaO�er 9(commencing witM1 $ec[ion 7000) of
Division 3 of [he�BuSiness antl Prof¢SSiOns Cotle) or that he/She is�exempt
"�eretrom antl the basls tor the allegetl exemption. Any violation ot Se<tion
31.5 by any applicant tOr a petmit Subject5 Ihe applicant t0 a clvil
,nalty of no[ mo�e Ihan fiv¢ huntl�etl tlolla�s (§500).
L� I, a5 owne� of [he prope�ty or my employee5 wi�h wages as their solo
corttp¢nsatiofl, will tl0 the wolk, an0 lhe StfuCtur¢ i5 n0[ Intentletl Or Off@r¢U
for sale (Sectlon 7044, Business antl Protezslonal Cotle: The Contractor's
Licensa Law tloes noLapplY to an owner of a properry who builtls or improves
thereon, antl who tloes sucn work himselt/herselt or tnrouqh his or nar own
' employees, provitletl thal sucM1 ImprOvement5 dre not intentleG Of otfeletl for
,sale.�lf, boweveq the'builtlinq o� Impwv¢ment Is Soltl wlthin one year Of com-
plalion, the Owner will have tba burtlon ot proving he/sne tlitl not builtl ot Im-
'"�rova fOr llte pu�pase ot Sale).
.I, as owner of [he property, am exclusively contracting with licensed con-
tractorsto construct the project (Section 7044, Businesz antl Professions Cotle:
' The Contracfor's License Caw does not appry to an owner ot property who
builas or Imo/oves thereon, ana who contracts for such orojects with a con-
tractor(sl,llcenze�pursuant co the Conira<tor's Llcense Law). I am aware that
, proof of their Worker'S Compensation insuranta shoultl be proviEetl to me.
❑ I am exempt unGer Sec[ion B. & P. C. tor this reason
Date ' - Owner
I hereby certlfy tnat 1 have rea
inforination is mrrect. I agree [o
I�' �ss��
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R
O CONVERSION ❑ DEMOLISH ❑ OTHEFZ q
TVPE OF PERMIT � LJ'GRADING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL' ❑ PLVMBING � MECHANICAL
•� OTHER
PROJECT DESCRIPTION 54. FT. oCCUanivCv_
� CONSTRUCTIONTYPE � VALUATION$
' �20NE GRADINGCU.Y�S. ACRES_
Bar Sink
Backflow Preventer
Backflow Irrigation
7rinking.Fountains
°IoorDrains
=1oor Sinks
3as Service � Outlets '
Interceptors .
Kitchen Sink
Lavatories � � '
?—Trap
Roof Drains . �
Showers '
Service Sink -
Sewer Cap .
Sewer Connection
Solar Collecrors
Solar Piping �
Solar Tank
Swimming Pool w/Spa
Urinal
Water Close[ '
Water Heater �
Water Service
Auto-Wash
A.P. # '
S Main Building:
E
T Front
ARear
C Right
g Left
Ping. Ref. # '
Planning Notes:
� Automatic Washer
Construction Pole Sub.
' Cooking Uni[ . .
Dishwasher
Dryers QGas ❑Electric
Reinspection', Fee $15 � laue Pee a 3
Duct-UnderGround ,
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact, Blt. IC80 #
Heating System,& Ducting
❑ P7 00,000 BTU O 100,000 BT
sentairves ot N�s Uty' [o [er upon e aoove-menuonea propeny ror , , -
' in5pection p . " ' o��Q fiQ ; `
$ignatu�e , �ate b ,
' Orivers' License or SS �
� peinspection Fee
CMF 0865-46, rev. 30/84 White - Buildin9; Canary - Applicanh Pink - Accountin9; Goltlenwtl - Assessor
$15
Hoad or Typel ❑ :
Canopy ' Type I I ❑
Refrigeration System
❑0-100,000 BTU-0700,000
System ftepair/Alteration
Fire Dampers � �
Issue Fee
R
Fan
F.A.U.^
Fixtures •
Device Boxes
$WitCh¢5
Garbage DisUosal
Generator �0.5 KW
Fee
�4147 9/30/86
Zone
Parking Req./Provided
ELECTRICAL � - -
Transformer ❑ 15-50 KW
� 50+KW
Meter ❑up to 700 amp5 .
Meter Oover100amps
Sub Panel " -
Motors �0.1 HP � 1 h� 8
Ina Solar �9-15 HP'� 1645+
Microwave
Pole �ight .
Range
Standing Sections
5-15 KW Trash Compactor
$15 Issue Fee , �
�DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
' 8uilding Approved By � yA�
9.00 TL
FEES
$ 3
' ' SUMMARV OF FEES �
BUILDINGPERMIT $- SMIP' = $ '
PLAN CHECK $ PERMIT '
P�UMBING $ � ISSUANCE ' $•— _
PLAN CHECK 25% $ ENERGY P.C. $ �
ELECTRICAL $ GRAOING $
PLANCHECK .50% $ MICROFILM $
MECHANICAL �$ � TOTAL FEE $ �� .
PLAN CHECK '25% $'
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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. Founda[ion 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 Dreins 64. Plumbing System - Final �
14. Rough Plumbing 65. Electrical�Final
15. Rough Electrical-Conduit 66. Solar System-Final
i 6. 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 # _ / ,
27. Ducts, 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. Storage Tank O 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. F�NAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final 80. FOOD CERTIF�CATE ISSUED
33. Final Electric � Notes: � � :'
� 9 ,G � ,y-; _ -
34. Final Heating & Air Conditioning JO U �
35. Final Gas Pipe-Test /Q F`
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing •
i i
39. Water Service-Final
,�
i
40. Gas Service-Final . .
41. Solar pomestic-Final �
�42. Backflow Preventer � '.
43. Backflow Irrigation
44: Landscape Irrigation SVstem . '
45. Sound Attenuation � '
46. Handicap Regulations � •
. � .
47. FINAL STRUCTURE & BUILDING , � '
• � �
48. Special Requirements Completed . -
49. Electrie Release to Edison 1 ,,
50. Gas Release to Southern California Gas Co , -
51. CERTIFICATE OF OCCUPANCY . �
No. Date