HomeMy WebLinkAbout3137 VAN BUREN AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMI 0. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA- CONSTRUCTION PERMIT 3398 I
.Project Address 1t 3I37 Y(J� t71.(r r/ :AO / REC--Bin" &,,
Applicant's Mailing •ddress ea 3 'A4 ATYPE OF CONSTRUCTION U NEW LI U ALTERATION REPAIR ^Y ^^)
,♦ -,oreri --Id_ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A P # Zone
Owner's Name A.01 aria Phone rrei.a I DESCRIPTION OF WORK/USE OF BLDG.
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i Mit(
Address e-- — - S Main Building: Accessory Building:
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Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front ni Wont 6 1R-nnnMdi,4 TYlT a 0t
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B N
Address Rear
/1 �(/) N� /� h� ❑ OTHER A
C Right - - N
Contractor's Name �1i , jJg Mr t hj Phone. R.S9"I��/!7
n' 2 Y q ePT /V/7 V PROJECT DESCRIPTION SQ. FT. OCCUPANCY G
Address(mailing) 0-' v P�� K Left
• 0 /2 ' d ► CONSTRUCTION TYPE VALUATION $ s City License No. V ( ZONE GRADING CU.YDS. ACRESR
E
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided
I herebyaffirm that I am licensed under' rovisions of Charter 9 (commencingQ
p Remarks: Planning Notes: M
with section full of Division 3 of the Business and Professions Code, and T
my license is in full fej a d effect. �I S
License I: s `�- A Lc'nse • •. ►I a
Date - MKS Signature nor L . = - PLUMBING FEES
WORKE-S'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
'hereby affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Sects Backflow Preventer Service Sink 300, Lab. C) q �[ 1� Automatic Washer Transformer 0 15.50 KW
Ths Policy No. 7A Ia.5 C1--.6 !7 Company ` _ f W 1 - Backflow Irrigation Sewer Cap — 0 50+ KW
Construction Pole Sub.
erti}ietl copy is hereby furnished.
Gert h of ed with the city B db ivi Bathtubs Sewer Connection . Cooking Unit Meter Cup to 100 amps ,
Date n � - 44 Applicant 4L , / Lk( �+ �z�L _
EXEMPT ON FROM WORKERS'COM SATION DECLARATION Clarifiers Solar Collectors A f Dishwasher - Meter ❑Over 100 amps
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping • a♦ Dryers ❑Gas DElectric Sub Panel
I certify that in the performance of the work for which this permit is issued, I f
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - ' - Fan
Workers' Compensation Laws of California.
�I Motors 00.1 HP ❑1%-B
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 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 Sinks Urinal 14' .
-Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY . Gas Service Outlets Water Closet Device Boxes PoleLight
I hereby affirm that there is a construction lending agency for the performance
rmance9
of the work for which this permit is issued (Section 30971 Civ. C.) interceptors Water Heater r
Lender's Name r p I Outlets Range
Lender's Address Kitchen Sink Water Service - Switches
OWNER BUILDER DECLARATION Sign
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 ❑0.5 KW❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit P
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
•Jtherefrom and the basis for the alleged exemption. Any violation of Section
,:;'031.5 by any applicant for a permit subjects the applicant to a civil T
.E.gj¢nalty of not more than five hundred dollars($500).
❑❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee 111 I $15 Issue Fee $ 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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however,the building or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
platten, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date I
prove 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 of property 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-
tractors) 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
❑ I am exempt under Section B.S. P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire Dampers PLUMBING S S • 1)D 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 00100,000 BTU 0100,000 BTL. ELECTRICAL S GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repre- MICROFILM $
sentatives of this city to enter up n the above mentioned property for PLAN CHECK 50% $ VTL7/1
Inspection pu gggq0000se / C/IN ) • MECHANICAL $ •
Signature i u/2' / •t •
Delo CJI( TOTAL FEE $
Drivers' Licen or S # l/ - - ) Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •
. . . ._ ... ..,.....1
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
1.'Vemporary 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 lest g
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE - -�
$1
•
7. Footings 58. Electrical Conduit-Undrgrnd. • • -
8. Foundaticin 59. Gas Pipe, 0 Undrgrnd., Test - !•�
.1
9. Water Pipg-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69'.9POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning /$;• FIRE DEPT. REQUIREMENT
1 /
20. Rough Factory Fireplace 7 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. IN)
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 s/ 9f LEO -
39. Water Service-Final
40. Gas Service-Final -
41. Solar Domestic-Final
42. Backflow Preventer1.4:if
43. Backflow Irrigation - t1
)
44. Landscape Irrigation System 2i.
45. Sound Attenuation
46. Handicap Regulations �✓)j
47. FINAL STRUCTURE & BUILDING - • iI
48. Special Requirements Completed •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - '
51. CERTIFICATE OF OCCUPANCY - -
No. Date .
90745 FEE RECEIVED
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COSTA MESA BUILDING-SAFETY DEPARTMENT OCT 7 1963
P.O.BOX 317 COSTA MESA.CALIFORNIA rr��TTFIIN��A��NCrrEEn��TTD��EP��gqT..��pp
For Applicant to Fill In Completely AcI CATICIf7FUR'PERMIT
TYPE OR PRINT BUILING
For OfficeUseOnly
BUILDING
ADDRESS 9137 Van 9lzrpn ASA
RECEIPT NO. 20745.
COSTA MESA, CALIFORNIA I(.t
RECEIVE BY DATE RIICHIV D DATE IS U
OWNER Northaate, a Partnership ��� �`� f
MAIL Lrr * BUILDING
ADDRES1ac939 Las Pi ores G4f . ADDRESS
FIRE ./ 9/
TE ZONE TYPE GROUP 1 _
CITY FOUnt9in Valley No`K'�1 (,799
APPROVED
ORFNIGINEER C. Hiller NO Kw5200'2 BY DATE
ZONING
AD,-..fSS Anaheim 7 ISN N,.OF OHH DF N /� I x'x1
PLANSL ( I Ht1ILDl N.
F/T. �•
CONTRACTOR Bopapr (lnns t_ T"n, - .. DF
LEGAL /.../71- J'7 I/ cDO
DEE
ADDRESS iAPRQ T.a RFlnrpR qt
CRIrrION
A.P.NO.
CITY Fn17nt9in Valley
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
LIATE TEL.
C .NO. 215049 NO. 6792c11 30 "TO SIDE8REAR P.L.
/ EAVES
OF LOT 60 I X100 I I NOW ON LOT nnn5 ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. none - -
(FROM C/LSTREET)
SETBACK LINE FROM,/� (� (.--,
CENTER OP STREET 0 I REAR YARD 7 I
FRONT y�`�FT. FT,
SIDE YARD LEFT Yi I I RIGHT c I SIDE l..5----
R. FT. FT.
DESCRIPTION OF WORK L.SIDE S FT. Fr.
2 II
N• X ALTERATION ADDITION REAR FT. JET.
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN BLDGS. _ _ ACCESS.SLOGS._
-
I '1 NO.OF
VAR.# DATE
BUILD
SIZE 34soft ROOMS 6 STORIES 1 C.U.P.# APPROVED
EXTERIOR WALL II ROOF APPR D
COVERING s tIlned COVERING Sh 1 ncrl p BY 4,‘,. � L,tc,1 DATE( '�' 4- 6 T
USE OF BUILDING AND WORK TO BE PERFORMED ll /
single family res . w/attach "\r ------
garage /i3
N
BQ.FT. 4
I HEREBY ACKN• -D•- AT I HAVE -EAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE S
AND STATE TI THE A-• 1- COR-E•, AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH AL CITY OR• AAAAIIII • S• T6 LAWS REGULATING
BUILDING CO =TRUCTIO � VALUATION /_ H
SIGNATURE O i/i , A - PERMIT FEE $ ,,•[T� / m
PERMITTEE • vA+�4� -
$
/� 9L/S— PLAN CHECK S "�/�j^a E
AUTHORIZED AGENT l / TOTAL FEE 5 / Gr5-d 1