HomeMy WebLinkAbout1543 LUCKUP LN - Building Permits - •I 4 LuK. Applicant to fill in all spaces except those within heavy border lines and sign all a •- .rations. 1656 14/23/85 =c 1 _
CITY OF COSTA MESA CONSTRUCTION PERMIT! PERMITrNNO, TRACT NO. LOT NO. nUNIT NO.
d
Project Address Tom-- Laundry Bldg XXX Air 1 U✓`O O n'�'; &-, let a kit tj yl'fj�
Applicant's Mailing Address 7633 Woodsboro Ave. ,Anaheim,Ca TYPE OF CONSTRUCTION [XI NEW —I ADD U ALT' -ATION u REPAIR
Owner's Name Fairview Management C°111PR e714/863-15)0 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Li(�-_01�-/o •
I Zone /��
Address 1176 Main St. , Irvine, Ca. 92714 DESCRIPTION OF WORK/USE OF BLDG. t
I;� rr���� S Main Building: Accessory Building:,
Arch/Eng. Gilbert Aja & Assoc. License No. CO08038 TYPE OF PERMIT U GRADING LRI FOUNDATION A.A STRUCTURAL T Fron 41r/ ' '4 *s / 0
Address 3117 Paa7�a PO me Ste. 100 CI TENANT CI ELECTRICAL CI PLUMBING El MECHANICAL R Rear / N
.P3 ,�'___�, Cc.-J X653 A r�o-A#- 5 ra neo rapt cu�Oo.�' 1
0 OTHER
Contractor's Name DMH Bull dors. _TDC. phone 714/777-4666 C Right,y�(o„,„ffe-,, , lb/ .74, nfl4,44i- bidt4 G
PROJECT DESCRIPTION 50. FT. 238 OCCUPANCY
Address(mailing) 7633 WOOd,sboro AYQ• .Anahei m.C'a.92807 K Left
_34704 •
ZONSTRVCTIONTYPE VALUATION $ E 3AQ $ —
'1 City .!cense No: ZONE GRADING CU. ACRES
R
LICENSED CONTRACTOR DECLARATION _ Ping. R¢(.# �. �/-/,)^ Parking R¢q./Provided E
II I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
tp with section 7000) of Division 3 of the B slows and Professions Code,and • T
N my license is In full force and effect.
�� ' HOLD FOR SPECIAL REQUIPEMENTs s,
C License No. 468985
I\ Date Cr_I -.Y� SignatuBre -'rr PLUMBING FEES
0 WORKERS' COMPENSATION DECLARATION' Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, pr a certifiedcopy thereof (Section Backflow Preventer Service Sink
3800,-Lab. C.) 16-1 N9S2,3,�2 /0 Automatic Washer Transformer 0 15-50 KW
^' 0 50+ KW Policy No. XX Company 1 Backflow Irrigation Sewer Cap •• Construction Pole Sub. '
8 Certified copy is hereby furnished. n t-1'Yth.tn ,
Certified copy is filed with the city Builtlin/y�DivisioR..� s ll Bathtubs Sewer Connection Cooking Unit Meter Cup t0 100 amps
Date Applicant ' ••01 "'-t Situ I,Ao'S •
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers • Solar Collectors - Dishwasher Meter ❑over'100 amps •
(This sectionneed not be completed if the permit is for one hundred($100) or
less). Dishwasher Solar Piping . Dryers ❑Gas ❑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 Drinking Fountains Solar Tank Fan Motors 00.1 HP ❑1'/a-8 '•
Workers' Compensation Laws of California. '„
-
Dale Signature - Floor Drains Swimming Pool w/SpaF,A,U, Inc.Solar 09-15 HP❑16:15+
'NOTICE: If,after making this declaration, you should become subject to the '
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. Microwev¢
CONSTRUCTION LENDING AGENCY Gas Service 'Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there Is a construction lending agency for the performance -
of the work for Mach Ahis permit is,Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name 13anK. OT __erica
• Lender's Address ROT N t1ai n St. ,Santa Ana,Ca -99702 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 ;Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays •. - Generator 00-5 KW 05-15 KW Trash Compactor
any'structure, prior to its issuance, also requires the applicant for such permit' ,
I
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 -
.Division 3 of the Business and Professions Code) or that he/she Is exempt - -
jy'3,therefrom and the basis for the alleged exemption. Any violation of Section
=:,7031.5 by any applicant for a permit subjects the applicant to a civil . . '
'unalty 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 S 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 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 0 DEVELOPMENT SERVICES`R'EOUj FjEMENTS: p��
employees, provided that such improvements are not intended or offered forZoning'Approved By JII�-`"' JC.•�, Date '0-1.2/-6.a
sale- If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 // / -Q r�
pletien, the owner will have the burden of proving he/she did not build or im- • Duct-Under Ground Building Approved By IN Date 4- 19 v i
rove for the purpose of sale). - /ys,f
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By \r 1l"t Dat f Ia
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 ❑o-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon, and who contracts for such projects with a con- CO
tractor(s) license pursuant to the Contractor's License Law). I am aware that 0 Multi le 0 System Repair/Alteration BUILDING PERMIT $ , SO SMIP $ v J
proof of their Worker's Compensation insurance should be provided to me. Exhaust SystempY p ,•
•
PLAN CHECK $ Z 5.65 PERMIT
❑ I am exempt under Section B.6 P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑O-100,000 BTU ❑100,000BTL—
Information is correct. I agree to comply with all city and county ordinances
and state laws I atip to building construction,and hereby authorize repro- ,PLAN CHECK 50% $ - MICROFILM $
sentatives of nicto enter upon the above-mentioned property for /
I inspection pu o 0� `' MECHANICAL $ TOTAL FEE $ / q,•°3
Signature Date ,Z_y
Drivers' License orrSS g2 • -- ` ` " ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ -
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Plnk -Accounting; Goldenrod - Assessor
/j CONSTRUCTION AND PLANNING POG_ 4 SPA
lr 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 LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings •
Shlk.cDs 58. Electrical Conduit-Undrgrnd.
• 8. Foundation s2Afa 5h- '/ tcS 59. Gas Pipe, (] Undrgrnd.,Test
9. Water Pipe-Undrgrnd. . /a 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVALTODECK .
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 ❑Oil
-23. Gas Pipe-Rough& Test , 72. Underground Rush
24.;Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing q/l/rg �S 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat �F" 75. Dry Chemical
27. Frame and Flashing�j'c / f 76. Dry Standpipe
28.. Lathing& Siding ��o �` r '�'� 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat p1/5'S 93
79. FINAL INSPECTION
32.,Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33.. Final Electric Notes: jf r Q . _d A,c3-4- et ,oQ
34. Final Heating& Air ConditioningG Tr_ L'�j/ �
' 35. Final Gas Pipe-Test - rz,,,-- at 6 4
36. Hood or Canopy , - !!!"""""""���°°° ___
37. Final Factory Fireplace
38. Final-Plumbing
39. Water-Service-Final ,
•
40. Gas Service-Final
41. Solar Domestic-Final t' •
42. Backflow Preventers
43. Backflow Irrigation fl
44. Landscape Irrigation System -'t •
45. Sound Attenuation . -
46. Handicap Regulations: oz.
47. FINAL STRUCTURE & BUILD$VG Iali-3hlc 0 5
48. Special Requirements Completed. 12-26-
49. Electric Release to Edison . . -
50. Gas-Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY 1l
No. Date -
411;-AP", , $LDC, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ,..------- 2169 55/02/85 16.00 IL
PERWT NO. • ,TRACT NO. .LOT NO. UNIT O. 1 -
ICITY OFcoSTAME h CONSTRU/CTION/PERMIT : WTN&) 7 " •
-
i '.PfbjectAddress /5313. , I�, (may( ( `//{),ap�/ r l f I' _ ." .
Applicant's Mailing Address W{7 N:I3✓f+TI1�tA ` ttJl4 1/ 144
YPE OF CONSTRUCTION .LJ NEW IJ ADD L� ALTERATION U REPAIR- - '
ANh4FAE • ❑ CONVERSION '❑ DEMOLISH ❑ OTHER
Owner's Name FAIRVI�W �TPhon_e�'I7� 'SOS! A.P.# I Zone'
DESCRIPTION OF WORK/USE OF BLDG. -- -
Addressb SHc L�� CI�� . C0��1 IubSA - S Main Building: _ Accessory.Building: -
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING H FOUNDATION ❑ STRUCTURAL E Front - . • - ' i• 0
Address .,/ ❑ TENANT ❑ ELECTRICAL `❑ PLUMBING ❑ MECHANICAL BA Rear - •
. , N
Contractor's Nem:4047E WSr pu$& Wt. - PhoneI47-gticI - _
PROJECT DESCRIPTION SQ. FT. •
OCCUPANCY C Right N
Address(mailing) Ii-ill 1'•I De.TA✓IQ pQ-AWOE CA 42-6(2q •
_ K _ •
-S13 ( 1 / CON STRUCTION'TVPE •• • 'VALUATION - S Left • • R
I City NSED¢No. : •OW R - • ZONE ' GRADING CU.YDS. ' 'ACRES
\y^J LICENSED CONTRACTOR DECLARATION I Ping. Ref.# Parking Req:/Provided
CI
hereby affirm that I am licensetl under provisions of'Charter 9 (commencing Remarks: I bibs-50 Planning Notes: . - MI
00 with section 7000) of Division 3 of the Business and Professions Code, and T
my license is in full force an of ecf. _ . • _ -
Gfcense class -G- Licen rv99[�!� 31 �2 i - _•
S,
1 date • • Signature - PLUMBING _ • FEES • '
WORKERS' COMPENSATION D RATION' Bar Sink Showers ' ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate
'- of Workers' Compensation Insurance,-or a certified.copy.thereof (Section Backflow Preventer Service$ink' - '
3800, Lab. ,CJ nutomatic Washer- Transformer ❑ 15-50 KW
P lic No. U11Q40,5C�b 1j. Company 1/g�`y�� I�S : co� Backflow Irri anon Sewer Ca ❑ 50+KW I
Y 9 p 'Construction Pole Sub.
Certified copy is hereby furnished. , ' - ' -
Certif'�i99tltl copy is flleif with thecity qq ltlipy ql lsl Bathtubs 1 Sewer Connection Cooking Unit . 'Meter ❑up to 10damps
Date b Applicant W�K.1t�1'1J 1 ` Me• `'•7 Clarifiers Solar Collec •
tors Dishwasher Meter_ Dover 100 amps:EXEMPTION FROM WORKERS'COMPENSATION DECLARATION() ._ _ __ - . - .. p --•
(This section need not be completed if the permit is for one hundred (S 00) or - - '
less) - Dishwasher Solar Piping Dryers ❑Gas ❑Electric .Sub Panel '
1 certify,that in.the performance of the work forWhich this permit is issuetl 'I -
shall.not employ any person in any manner so as'to become subject to the' Drinking Fountains ' Solar Tank , Fan 'Motors 00.1 HP ❑1'h-8
Workers'.Compensation Laws of California.: -
Date - ' Signature ' • ` Floor Drains' Swimming Pool w/Spa O, pp F,A.U. - Inc.Solar ❑9-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the -
Workers' Compensation provisions,of,the Labor Code,.you must forthwith '. Floor SinksI ' Urinal -.-- • ' , ' •-- Fixtures Microwave
comply ,with such provisions or this permit'shall be'deemed reyoked. • •
CONSTRUCTION LENDING 'AGENCY- : _ _ ' •' I - 1 Gas Service ' ;Outlets Water Closet Device Boxes •
I 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 Cie. C.) Interceptors / .Water'Heaier !Jfl Outlets
Lender's' Name' - [ • l Range ' •
Leneer's.Address • ' ' ' ' - •. - • . .• Kitchen Sink 'f Water Service . • - I
OWNER BUILDER DECLARATION - - ��)D— Switches - Sign • •
I hereby affirm:that I am exempt from the Contractor's License Law for'the Lavatories, 3 Auto-Wash d OP Garbage Disposal
following reason (Section'7031.51Buslness and Professional Code: Any city or 9 p Standing.Sections ,
county which requires a permit to construct,alter,improve,demolish or repair - P-Trap _ - Laundr Trays- , • - ' -
,,any structure, prior to its issuance,-also requires the applicant'for such permit . - . . . - - y y . - Generator ❑65 KW❑5-15 KW 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 . -
Division' 3 of the Business and Professions Code) or that he/she is exempt . , .
•
therefrom and the basis for'the alleged exemption:Any violation of Section ' ' -_ - ,/a CO .
7031.5 by_anyapplicant for.a permit subjects the applicant to a civil ' ' - ' -' - '
.penalty of not more than five hundred dollars($500). - ' - - _
• LJ I, as owner of the property or my employees with wages as their sole 'Reinspection v �� •$15 Issue Fee • $ '3 1
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 - • 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 - Hood or Type I : ❑ DEVELOPMENT SERVICES REQUIREMENTS: 1
employees, provided that such improvements are not intended or offered for Boiler : - -J
sale, If, however, the building or Improvement is'sold within one year of com- - -- Canopy Type I• ❑ Zoning Approved By Date
pletlon, 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). i ,
❑ I, az owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System : Application Issued By - Date
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 -_ 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). am aware that Exhaust System ❑ Multiple❑, System Repair/Alteration BUILDING PERMIT $ SMIP ' $
proof off their Worker's Compensation insurance should be provided to.me.' PLAN CHECK • $ PERMIT
I am exempt under Section • B. & P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers - /rj .00ISSUANCE $
' PLUMBING' $ •
Date • Owner Heating-System&Ducting Registers• PLAN CHECK 25% $ • �� ENERGY P.C. $
I hereby certify that I have read this application and state that the above " - 00100,000 BTU 0100,000 BTL - - - _ 1 • 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- • PLAN CHECK 50% $ MICROFILM : $
sentatives of is city to enter up.n the above-mentioned property fo
inspection our.. a '1MECHANICAL $ TOTAL FEE $ pane
Signature �' " - 4 -- 0-4-1 7 . •
Drivers' Lira or SS# ' • - Dae - 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
POOL & SPA •
.APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
rel. Temporary Electrical Service or Pole 52. Pool & Equipment Location
r2. Soil Pipe-Undrgrnd. - -£$4r 6E4 53. Steel Reinforcement -
j 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4. Electrical Conduit-Undrgrnd. -55..Electrical Bonding .
F 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
:6. ElectricalUFERGrnd. 57. APPROVAL TO COVER-GUNITE
'7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 572. /d5_LeO • 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 ?Has C 65. Electrical-Final - •
15. Rough Electrical-Conduit r 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 0Oil
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 PREY. 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 1117/15 C.F.t7
36. Hood or Canopy
•
37. Final Factory Fireplace
38. Final Plumbing • 111i-1/45- 6,69
.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 • -
r- i
r
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 379.0 5/30/85 -, 5950: 11
CITY OF COSTA MESA . CONSTRUCTION PERMIT IrE T NO. I( TRACT NO. LOT NO. UNIT NO.
Project Address 1543 Luku Lane (Laundry Bld #1) �� I I '
5 2 N. Shelley C Irl* TYPE OF CONSTRUCTION IXI NEW U ADD U ALTERATION U REPAIR 1 - !
A)Splidant's Mailing Address (TIC1-A Mega, A. 9404 ' I - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
, Owner's Name Fairview Management COm 91k. e714/863-1500 A.P.1W Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address - 1176 Main St. , Irvine, Ca. 92714 • S Main Building: Accessory Building: •
'Arch/Eng. Gilbert Aja & Assoc. License No. C008038 TYPE OF PERMIT U GRADING 0 FOUNDATION U STRUCTURAL E Front O
9- Address AD1177aP a Po nt t)r45_3Ste. 100 0TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B N
Lh g2Rear
`� •Contractor's Name DMH Bui ders, Inc. phone 714/979-5057 Q OTHER A I
I 2512 N. Shelley Circle,Costa Mesa,Ca PROJECT DESCRIPTION SQ. FT: 238 OCCUPANCY C Right N
‘...0 .Address(mailing)City License No._ 34704 92626 - CON STRUCTION TYPE - - VALUATION$ 2.380 S Left G
R
ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
CO LICENSED CONTRACTOR DECLARATION n O
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: q ) 4s'y.{.)� • Planning Notes: -_ M
1 -with section 7000) of Division'3 of the Bus ess and Professions Code,and �✓ . T
/4 my license is in full force and effect. , • •-
\IU\ $
License Class a► 1.( / License No. 468385 PLUMBING FEES
Date -» Signator QEJ/L
WORKERS'COMPENSATION Decca ION Bar ShowersELECTRICAL I FEES
hereby affirm that I have a certificate of consent to self-insure-or a certificate . .
of Workers' Compensation Insurance, or a certified copy thereof (Section, Backflow Preventer - Service Sink - - ' •--- - - - - -
3800, Lab. C.) Automatic Washer Transformer 10 15-50 KW'
Policy No.WS 85-332.344-01 company Fr_ emorit Backflow liri anon Sewer Cap0 50+KW
- 9 Construction Pole Sub.
Certified copy is hereby furnished. I '
Certified copy is filed with the city Building Division. 1 - - Bathtubs . Sewer Connection 2 00 Cooking Unit Meter Cup to 100 amps '
Date . Applicant TIMH Rltl lrlers,. Inc- ' - •,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION • Clarifiers Solar Collectors Dishwasher • Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel .
I certify that in the performance of the work for which this permit is issued I
I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank ' • Fan Motors 00-1 HP 01'A-8
Workers' Compensation Laws of California. ,
. Date Signature Floor Drains . Swimming Pool w/Spa F.A.U. Ind.Solar 09-15 HP 016-15+ 1
. 'NOTICE:If,after making this declaration,you Should become subject to the • ,
Workers' .Compensation provisions.of the Labor Code, you must forthwith - Floor Sinks - , Urinal - - Fixtures • - - - Microwave - - '
comply with such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY Gas.Service Outlets Water Closet . Device Boxes
I hereby affirm that there is a construction lending agency for the performance - Pole Light .
of the work for ryrya[{! tn iF• m .is issued (Section 3097• Civ. C.) I Interco Lori - Water Heater
Lender's Name an^ Oi lC ic3 - - P Outlets Range •
Lender's Address -8.0LNiMain St. .Santa A_n' C-. 92702 Kitchen Sink - . Water Service' Switches Sign
OWNER BUILDER DECLARATION - -
I hereby affirm that I am exempt from the•CohtractOr's'License Law for the . Lavatories - _ Auto-Wash - Garbage Disposal - ;Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or .
county which requires a permit to construct,alter,improve,demolish or repair P-Trap . . Laundry Trays • - Generator 00-5 KW 05.15 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 . • I
Division 3 of the Business and Professions Code) or that he/she Is exempt I , •
therefrom and the basis for the alleged exemption. Any violation of Section - - ,
7031.5 by any applicant for •a, permit sdbjects the applicant to a civil - '
penalty of not more than five hundred dollars(tsoo). .- I •
,
LJ I, as owner of the property or•my employees with wages as their sole Reinspection'Fee 1 $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered 1 • Reinspection Fee- I $15 Issue Fee $ 3
for'sale (Section 7044, Business and Professional Code: The Contractor'sMECHANICAL 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 •
- DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler
sale, If, however, the building or Improvement is sold within one year of com- Canopy Type II
0 Zoning Approved By Date
pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground ' Building Approved By Date _
Trove for the purpose of sale). • ,
LJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural , Application Issued By Date 5 L`
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 a a s 1 a a ' �'� a a ' SUMMARY 0 FEES •
builds or Improves thereon, and who contracts for such projects with a con-
tractor(s) license pursue ht to the Contractor's License Law). I am aware that ' stem 0 � , 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' :• - Dampers
PLUMBING § 5.00 ISSUANCE $
Date • Owner Heating System& Ducting II- �PLAN CHECK 25% $ .50 ENERGY P.C. $ •
I hereby certify that I have read this application and state that the above - 00-100,000 BTU 010Q000BT - ELECTRICAL $ GRADING $
Information is correct. I agree to amply with all city and county ordinances I
and state laws relatin• Itli,• construction, and hereby authorize repro- PLAN CHECK 50% § MICROFILM $
sentatives of this cit, os ' upon the abve-mentioned property for • •
inspection purposes L-� �_..C��� _ MECHANICAL $ TOTAL FEE $ 5.50
Signature "%-'�� - Date , v-/
Drivers' License or 55 qt
CMF 0865-46.rev.10/84 White - uilding; Canary . Applica ; Pink -Accounting;Goldenrod - Assessor
CONSTRUCTION ANDPLANNING POI .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, 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 •��730b - Lr� 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 OOil
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 •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 312`5 5/1 6 65 iEe Gil.^'!
CITY OF COSTA MESA CONSTRUCTION/ P RMIT r PERMIT NO. TRACT NO. LOT NO. ' UNIDO., pC ' •
_ �r Project/ )rens /323 LI�A e/P 41-Ale. 1 C/ -2l' 7 /� --E�'. 1
( Applicant's Mailini 'ddress � ,Syr TYPE OF CONSTRUCTION ?NEW U ADD LJ ALTERATION H-REPAIR '
/ ❑ CONVERSION 0 DEMOLISH ❑ OTHER A.P.# - Zone
Owner's Nar/re - �. /, 4 Phon�a�/G/J� DESCRIPTION OF WORK/USE OF BLDG.
Address V69/ a,"- ej/V4 `3T- V�-///We $ Main Building: - Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING- 0 FOUNDATION 0 STRUCTURAL E Front - O
Address ' - - O TENANT p ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear - N
r Sr 7jyjyjo ❑ OTHER •
Contractor's Nam �•a0 '�/�1E� ��/�phone - - K Right G
//'U / •
PROJECT DESCRIPTION SQ. FT. - _ OCCUPANCY
Address(nse N gll4Tv ��r� E '5r- 612.a/V� Left
'/�' CONSTRUCTION TYPE VALUATION $ $ _
City License No. One/ ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION • _ Ping. •R¢f. # 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 Code, and • M
my license is in full forcVn �yffect, r • • T
Licens s y�`� L' nse a/ I /��`-a^� S.
)
Date__ Signature _�G: • PLUMBING FEES • ..
YORKERS COMPENSATFON DECLARATION ' Bar Sink Showers «
!y\((V`V`, �aereby affirm that I tiave a"certificate of consent to self-Insure or a certificate ELECTRICAL FEES
,f Workers' Compensation Insurance, or a certified copy thgyeof (Section • 'Backflow Preventer -Service Sink -
3800, Lab. C. •/l/ I ' Automatic Washer Transformer' ❑-15-50 KW
) Policy No. y4Z/Yg7o373 Company 1 �T' L 1,Backflow Irrigation Sewer Ca • 0 50+KW
P Construction Pole Sub.
jiCertified copy is hereby furnished- r
Ce"ryJr/( o d with the cIty;Bu" Divis J •/(/A/_; Bathtubs 1 Sewer Connection = Cooking Unit Meter pup to 100 amps •
Date_ /�n� APPlicant'; � f 1 a[/ �l/
EXEM T10 FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter rover 100 amps "7
(This section need not be completed if the permit is for one hundred ($100) or L
(•• less). ;1 Dishwasher , Solar Piping. Dryers ❑Gas ❑Electric -Sub Panei •
I certify that in the performance of the work for which this permit is issued
shall not employ any person in any'manner so as to become subject to fire Drinking Fountains Solar Tank _ Fan Motors❑0-1 HP ❑i%-8
Workers'Compensation Laws of California.
Date - Signature ' Floor Drains Swimming Pool w/Spa
F• .A.U. Ina Solar ❑9-15 HP ❑16-151
NOTICE: If,after making this declaration, you should become subject to the -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - - . Urinal - - /� Fixtures - . - 3
comply with such provisions or this permit shall be deemed revoked. w Microwave 1
CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet 7 Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - �,% 9 60
of the work for which, this permit is issued (Section 3097 Clv. C.) 1 Interceptors, Water Heater /7 Outlets Range
Lender's Name - _ —
Lender's Andress . Kitchen Sink I ' Water Service . - - / Switches, - Sign Z
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 - Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P=Trap . - - —
any structure, prior to its issuance, also requires'the applicant for such permit . - - Generator ❑0-5 KW❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of . Roof Drains ' - _- .aG 'v
the Contractor's License Law (Chapter,9 (commencing with Section 7000) of -, ` Ti�iG c� S r •
31vision' 3 of the Business and Professions Code) or that he/she is exempt - - '
herefrom and the basis for the alleged exemption. Any.vlolation.of Section ,
7031.5 by any applicant for a permit subjects the applicant:to a civil , - - °., '
penalty of not more than five hundred dollars($500). - 3
LJpropertymy Issue Fee $
compensation,(Section
ec, will 7044,the work, and the ProfessionaloIsnot Intended Contractor's oofferr's
for I,nsee aw ddos plaw er oh property
ro ert Code:
through or hr on p ttion Fee $15 MECHANICAL slue Fee $ 3
Reinspection
L
ereon taw does not apply to anowner if a prose or who builds s or improves , - - - -DEVELOPMENT SERVICES REQUIREMENTS:
thereon,mpland / 9 ._
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ -
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ - Zoning ApprovedBy Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground -• Building Approved By Date
L.rove for the purpose of sale). - _
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner 'propertyof who . Duct-Ventilating • 00-100,000 BTU 0100,000 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 ❑ Multiple ❑ System Repair/Alteration - - BUILDING PERMIT $ SMIP - $ -
proof off their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
o I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICRO# . , "/ ISSUANCE $
S PLUMBING $
Date Owner, - Heating System& Ducting
- PLAN CHECK 25%. $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU ❑100,000 BTL - ELECTRICAL $ )--(0. (� GRADING $
information is correct. I agree to'comply with all city and county ordinances
and'state laws relating to building c• struction,and hereby authorize repre- - PLAN CHECK 50% $ ( a . SS MICROFILM $
sentatives of this city to enter •'•n t above-mentioned pro rty for Q
ighat re sur/ GMECHANICAL $ Se ,(pS
Signature p _/ �� Date TOTAL FEE $
Drivers' License or SS# •
_ - / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
rev.4/84 `�
CMF 0865-46, White-Building:Canary-Applicant;Pink-Accounting:Goldenrod -Assessor -
CON;TRUCTION AND PLANNING POC. 4 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:ConduitvCtility-Undrgrnd. -k- ••: 54. Forms
4.iElectrica6Conduit;Undrgrnd. .. 55. Electrical Bonding
5.:Steel Reinforcementj'.: , 56. Rough Plumbing & Pressure Test
6. Electrical;UFER Grnil.:' Sj.i � 1 G 57. APPROVAL TO COVER-GUNITE
7. Footings' 58. Electrical Conduit-Undrgrnd.
8.'Foundation %" 59. Gas Pipe, 0 Undrgrnd.,Test
9..Water.tipe-Undrgrnd. 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 ' �i 63. Heater & Vent-Final
13: Rbof L?r"ains 64. Plumbing System - Final
14. Rough Plumbing',, 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final •
16. Rough Electric Wiring 94k6-4 A-.. 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 /j/ 80. FOOD CERTIFICATE ISSUED
33. Final Electric ( ee..2 Notes: sJ i �f,,� �p4/4.„7-
4-2P .r7 c u N A ro e c
34. Final Heating& Air Conditioning c% . A/ e?
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. Backf low 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