The URL can be used to link to this page

Home My WebLink About584 19TH ST - Building PermitsADP��ant to fill in all spaces except tltoze wit�in heavy Gortler Ilnes anE si9n all appropriate Eecla�ationi. CITY OF COSTA MESA CONSTRUCTION PERMIT PFwRMLT Ix0` '� w TRACT NO. ^ LOT f,QQ. � UNIT NO. Project Address '.��-1 �✓�S� /rn C`Qdi i c,J E Fb ApplicanYSMailingAddre55 _(�� o 'RlLQ ' Owner'sName ��AQY C�� Phone Address 'TSl—LL�tT (i?6 T�- �'pSTA ,v�25H Arch/Eng. License No. Address Contractor's Namel�t��7 Cow�j (/M7alt�L Phone r+��-nSISI Addresslmailing) (96� %IDO.�..f�/.li� AUr City License No. g LICENSE� CONTRACTO DECLARATION � I hereby affirm that I am licensetl uPtler provisions of Charter 9(commenclnq with section 7000) of Division 3 of �he Bu5ine55 antl P�o(e55iOn5 Cotle, antl my license is in fwi toroe and efiect. - ya �� License Class - b� Lic o. oate �- � � -ti1 Si9nature _ 'i, WpRKERS' COMPENSATION DEG�RATION I hereby aitirm that I have a certi(icate of consent to zelt-insure or a terti/icate ��t Workers' Compensation �Insuranoe, or a certifietl coOY thereof (Sectlon 00, lab. C.) ' /y J/� ��. iicy no.XWO.ribCIUDUu Company C./b4 la Iy,/` Cer[ifietl copy is hereby furntshed. LII Certifietl co y a fileG ivith the citY Builtlin9 Divizion. 1 � Date �� AOP��anC . EXEMPTION FROM'WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl i1 the pErmit i5 tor one huntlretl ($300) o� Iess). �I I certity that in tlte perto�mance ot Ihe wo�k tor which this pe�m�t is issuetl 1 Shall not employ any;perzon in any manner so as to become subjeGt to [(�e Workers' Compensation-laws of CaUtornia. Date �• Si9nature ' NOTICE: If, aiter makin9 this tleclaration, you shoultl become subject to.tne Workers' Compensatlon Orovisions of'lhe Labor Cotle, you musl forthwith comply wlth such, provizions or this permit shall be tleemetl revoketl. CONSTRVCTION LENDING AGENCY I hereby aftirm that [here is a constr�«�on IenGing agency for tne pe�fo�mance Of [he work fOr w�icn this permit is iszuetl (Sectlon 309] Civ. CJ I..ender•s Name - -Lentler'S'Atltlress � OWNER BUILDER �ECLARATION I hereby at(irm that I am exempt flom Ne ConVactor's License Law for the following reason (Sectlon 7031.5 Business antl Professlonal Cotle: Any ciry or county which requires a permit to conztruct, alteq improve, tlemolisn or repair any ztructure, prlor to Its Issuance, also requires the applicant tor such permlt t0 file a SI9nOtl statement that ne/spe �s licensetl pu�5uant to Ih¢ prOvisions of the Contractor's License Law (Chapter 9(commencin9 with Sectlon ]000) oi Olvision 3 of th¢ Business antl Pro�essrons Cotle) or tha[ he/sne Is exempl [herefrOm antl the ba5i5 for Ihe aIIC9etl ex¢mptlon. Any violalion of Sectlon '131.5 by any applican[ for a permit subjects tha applitant to a civil nafty of not more man'five huntlrRtl tlolla�s (E500). J I, as owner of the oroperty oi my employens with wa9es as their sole com0ensation, will tlo the work, antl the structure Is not intentletl or offeretl tor sale (Section �044, Business 0ntl Protessional Cotle: The Contractor4 Licen58 12w tlo¢5 not apply t0 an oW�er Of a p�ope�ty who builtl5 Or Imptoves thereon, antl who tloes such work himself/M1erseH or throu9h his or ner own employees, provitletl that such improvement5 are n0[ Intentletl or ofleretl to� sd10. Il, however, tne bull�in9 0� ImP�ovement I5 soltl within Ono year of com- pletlon, th¢ owner will have Ne buftlen ot provin9 he/Sne �IE not bulltl Or Im- proVa Por[he purpose of Sale). ❑ I, as owner of [he prop¢rty, am extlusively con(racting with Iicensetl con- tractor5to construct tho project (SeGtion ]044, Businessantl Protassions Cotle: The Conlra<to�'s License Law tlOeS not appry to an owner of property who builds or improves enereon, Snd wno contracts tor such projeccs with a con- tractor(s) ucense pursuant to tne Contractor's LiCee15¢ Law). 1 am aware that proot o( their Wo�ker'S�ComPensa<Ion in5urance Shoultl be provltletl to me. ❑ 1 am exempt un0er.$ection _ B. & P. C. for this reason Date _ Owner _ have reatl tnis Si9nature ". lev� Drivers' License or 55 �� aplicatton antl ziate that tne above with al city antl county ortlinances �uctio antl hereby authorize repre- Ihe a ve-mentionetl property for Date �f t �'-�S� � TVPE OF CONSTRUCTION Li�PlEW I_I ADD LI ALTERATION L.I REPAIR ❑ CONVERSION ❑.DEMOLISH ❑ OTHER q p # DESCRIPTIONOFWORK/USEOFBLDG. �✓A-' (�� S Main Building: TVPEOFPERMIT GRADING FOUNDATION STRUCTVRAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION 5Q. F OCCUa.arvCV C Right� - K Left CONSTRUCTIONTVPE VALVATION$ $ 20NE GRADING CU.YDS. ACRES p�ng. Ref. # Remarks: Q��' 79'� ' Planning Notes: Sink low ing Fountains Drains Gas Service I n teicepmrs Kitchen Sink Lavamries P-Trap Roof Drains Reinspection Fee Outlets 0 Shawers Service Sink � Sewer Cap Sewer Connection Solar Collectors- � � Solar Piping : � Solar Tank Swimming Pool w/Spa Urinal Water Cloret Water Heater Water Service � - - - Auto�Wash � Laundry Trays ' $75 Issue Fee Boiler Duct � Under Ground Duct - Structurel Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ ai ao,000 sru � i p,000 er Reinspaction Fee � $15 CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicdnh Pink - Accounting; Goltlenrotl - Assesso� FEES $ 3 Hood or � Type I ❑ , Canopy Typell ❑ � Refrigeration Syste : ❑0.100,000 ❑700,OOOBTU � � Sys epair/AI[eration Fire Dampers Registers lyf'�RnlrTr I�15( CtlOf Oate � � - Si , � Issue Fee - $ 3 Automa[ic.Washer Construction Pol¢ Cooking Unit Dryers L1Gas L Fan F.A.U. Fixtures Device Boxes Outlets Switche5 - Garbage Disposal Generator �0-5 s:��a eia �i�� Accessory Building: Parking Req./Provided i��,r. �� Zone � ,ECECTRICAL . � � Transformer ❑ 15-50 KW � 50+KW � � Meter ❑up to 100amps � � . Meter ❑over 100 amps 75 KW Sub Panel Motors 00.1 ❑ i'F, - 8 Inc.Sola 9-15 HP �16-15+ My wave �Pale Light Range Sign Standing Sections � Trash Compactor FEES � Reinspactian Fee �$15 � � luue Fee ' I $ 3 DEVELOPMENT SERVICES REQUIREMENTS: • Zoning Appraved By � - Date Building Approved By T/�y�� ' Date ' Appliwtion Issued BY� `� ��*�- � Datei{"'��'�! �SUMMARV OF F r BUILDING PERMIT $ � PLAN CHECK $ PLUMBING $ � PLAN CHECK _ 25k $ 3.• D ELECTPICAL $ PLAN CHECK 50% $. MECHANICAL $ , PLAN CHECK 25% $ 2 O N I N G R E � M T S SMIP $ PERMIT ISSUANCE S ENERGY P.C. 5 . GRADING S " - MICROFILM� 5 � TOTALFEE $ /73.� �—_ CONSTRUCTION AND PLANNING � , POOL & SPA APPROVALS Permit # Date Inspector qppROVAIS 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, O Undrgrnd., Test � 9. Water Pipe: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 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 S�9n '„ 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 Struaure 70. Underground Hydro 22. Ducu �Ventilating ' 71. Product Piping O Gas ❑ Oil ! 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil , 25. f�oof Sheathing 74. Overhead Hydro ' "26. T-Bar Ceiling (S�ructural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing , r. ` 76. Dry Standpipe 28. Lathing & Siding 77. �FIXED SYSTEM FINAL �� i ` 29. Insulation 78. FIRE PREV. FINAL - 30. Drywall Naiiing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � �"� -' 32. Electrical Power Meter-Final , 80. FOOD CERTIFICATE ISSUED , 33. Final Electric Notes: � '� � i 34. Final Heating & Air Conditioning �' n 35. Final Gas Pipe-7est �'.7� ' � f" 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � - , _ � 39. Water Service-Final 40. Gas Service-Final ' - 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System ' ' . - 45. Sound Attenuation ' � ections � 46. Handicap Regulations ."' ' 47. FINAL STRUC7URE & BUILDING A8t8 _.,.._ �. 48. Special Requirements Completed . • � � +� 49. Electric Release to Edison • . 50. Gas Release to Southern California Gas Co -• 51. CERTIFICATE pF OCCUPANCY . � No. Date � � , � \� tl CirY OF COSTA MESA CONSTRUCTION PERMIT Project Address Sf��4 ��Es� �y j�. s;,(Hf f.�� ApplicanYSMailingAddress :DbON iitoo.i.�L-IL� i]�+& <o6.KR Owner's Name � pQ K � µ� Phone Address '�1So�. /.i&,Sj /5f� RT CoSTA MfjA Arch/Eng. Licenu No. Address Contracror's Name w�� OhGT �/Jwn/3LL�Ir Phone � O{� � Address Imailing) � � O City License�No: y � 3 � LICENSED CONTRACTOR DECLARATION I nereby affitm lhal I am licensetl untlGr provl5ions oi Charter 9(commenCin9 with seclion 7000) ot Divislon 3 ot the Buslness antl Professions Cotle, antl my license is in full force antl eftect. ' License Class - 6' Licens Date Signa[ure WORK RS'�SATION DECLARATION I hereby affirm that I nava a certititate of consent to self-Insure or a certificate ` Wo�ke�s' Compensatlon Insu�ante, Or d,te�tlfletl copY the�eof (Section 00, Lab. CJ `O /_ i�0' o iCY No.K�O �� ComPanY lrV`Y Certifietl copy is hereby Jumishetl. Cert�i�ffe��=py�s flletl�with the tlty Builtling Division. ' Oate�- ST qpplicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl it the permit is for one huntlretl (E100) or less). . I cerhty Ihat in the perfOf.mance o( Ihe wOrk fOt which this pe�m�t i5 i55uetl, I shall not employ any pe�son in any manne� so as to bGComO subject to tne Workerz'�COmpensation''LawS of California. , Dafe � S9�ature NOTICE: 1f, afte� making this decla�ation, you shOultl become subje<t to lhE Wo�kers' CampensdtiOn Pwvisions o/ th¢ Ldbo� Cotle, you mu5t torthwith comply with such provisions or this permlt sha11 ba tleemetl revoketl. CONSTRUGTION LENDING AGENCV I hereby aiflrm tnat tnere is a consVuction lentling agency for the parformance of the work tor whic� ttiis Oermit is issuetl (Sectlon 309] Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUILDER PECLARATION I hereby affirm that I am oxompt from the ConVactor's License Law for the followin9 reason (Seciion 7�31.5 Business antl Profezsional Cotle: Any city or I county which requires a permit to construct, alter, Improve, tlemolish or repalr '� any structure, prior to Its issuance, also requlres tho applicant for sucn permit �i to file a Signetl statemenf [M1at he/Sh¢ I5 IicenSetl pursuant to Ihe provisions of Ithe Contractor'z License Law (Chapter 9(mmmencing with Sectlon ]000) of Dlvision 3 of tne Business antl Professions Cotle) or that he/she is exempt 'M1eretrom antl the basis Por [he allegetl ex¢mPtion. Any violation of Section 'I31.5 by any applican[ for a permlt subjects the applicant to a civil ;nalty of not mote than five huntlretl tlollar5 ($500). - � I, ai owner o/ tho property or my emPloyee5 with wage5 a5 Ihelr sole compensation, will tlo the work, antl the structura Is not intentletl or ofieretl for sale (Section �oa4, Business �antl Professional Cotla: The Contractor's ' License Law tloes not apply to an owner of a proparty who builtls or improves [bereon, antl wbo does such work himself/horsalf or throu9h his or her own employee5, 0/ovitletl that Such imprOvemen[s are not Intentletl or off¢retl for Sale. It, howev2r, tne bulltling or Improvemen[ Is Soltl wlthin one yea� of cOm- pletion, the owner wlll have the burtlen of provinq M1e/sho tlIC not Culltl or Im- p�ov0 �or the purpose Of sale). ❑"I, as owner of the property, am exclusively contractin9 with Ilcensetl con- tractorsto constructtbe projett ($ection 7044, BuSin¢zs antl P�ofessionz Cotle: The Contractar's License law tloes not apply to an owner ot prooerty who builtls or imoroves thereon, antl who contracts lor such pro�ectz with a mn- tractor(s) IiCense pursuant to th¢ COntraCtor'S Licanse Law). I am aware that proof of tbei� Work¢�'s CompenSaHon inzu�anCe Shoultl be provltletl to me. ❑ 1 am exempt un0er Section B. 6 P. C. for tnis reason ApP��ant [o fill in all ipaces except tnose within heavy Gortler lines anE si9n all a0D/opria�e Oeclarations. P �NO�� TRACT NO. LOT NO. I�N� 0 �E OF CONSTRUCTION NEW A�D ALTERATION REPAIR Date Owner I hereby certify that I have rea this application antl s[ate that tne above information Is mrrect. 1 a9ree to mply with all Gty ntl county ortlinances antl state laws r ing to b Itli g conslr lon, antl ereby authorize repre- sentatives ot is ity t en pon h above- entione� property tor inspeGtion pu� ose �� / f_ g� Si9ndture Ddle Drivers' License or 55 � ,T ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. �.iFLL/� (. TVPE OF PERMIT LJ GRADING �LyJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL 1751 PlVM81NG ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 'Sa.FT. oCCUPArvGv �A' C O N ST RUCTI ON TYPE V ALUATI ON $ ZONE GRADINGCU.VDS. ACRES_ Remarks: Bar Sink Backtlow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains - Floor Sinks Gas Service Lavatories Roof Orains Showers Service Sink $ewer Cap Sewer Connection � Solar Collectors Solar Piping Solar Tank � � Pool w/Spa Urinal Water Closet Water Heater Watec Seivice Auto-Wash Reinspection Fee� � $75 I I Issue Fae $ 3 Duct - Under Ground Duct - Sttuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact BIL ICBO # Heating System & Du � g - ❑6100,OOOB 100,000BT Rainspection Fee I $15 CMF 0865-46, rev. 10/84 White - Builtling: Canary - Applicant; Plnk - Actounting; Goltlenrotl - Assessor A.P. # S Main Building: E T Front ARear C Ri9ht g Left Ping. Ref. # Planning Notes: Aummatic Washer • Construttion Pole Sub. Cobking Unit � Dishwasher Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposa Generator �65 KW 3364 8/i(/�7 2one Accessory Building: Parking Req./Provided ELECTRICAL . . Tronsformer ❑ 15-50 KW -0 50+KW Meter ❑up ro 100 amps Meter ❑over700amps 5KW Su6 Panel - Motors�0- P01Yh-8 Inc.S r 09-75 HP 016-15+ icrowave Pole Light Range Sign' Standing Sections � Trash Compactor Reinspection Fea $15 Issue Fee IANICAL FEES Hood or T DEVELOPMENT SERVICES REQUIREMENTS: YPeI ❑ Zanin9 APProved By Canopy Type II ❑ Building Approved By Refriaeration Svstem Aooliotion laued Bv � __! 70.70�TU ❑100,OOOBTU stem Repair/Alteratio�p � - Pire Dampers �� Ct Registers '� ^ ' SI py Iwue Fee $ 3 SUMMARVOF BUILDING PERMIT 3 PLAN CHECK 5 PLUMBING $ �.� PLANCHECK 25% S �C%•!S ELECTRICAL ^� PLAN CHECK 50% $ MECHANICAI $ P,LAN CHECK 25% $ 56075 7L Z O N 1 N G R E Q M T S FEES $ 3 SMIP $ PERMIT ISSUANCE $ ENERGY P.C. S GRADING $ MICROFILM 5 L�,(��—�/� TOTAL FEE $ `� '�" � � CONSTRUCTION AND�PLANNING . POOL & SPA APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspecto� � 1.c:Temporary Electrical.Service or Pole 52. Pool & Equipment Location . � 2. Soil Pipe-Undrgmd. 53. Sree7 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. Foundatiofi 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 & fleceptor-Fina! 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 Ele�ric Wiring 67. Fencing & Access Approval , 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Ele�rical-T Bar Ceiling . , i; . 69. POOU$PA SYSTEMS FINAL 19. Rough He�ting & Air Conditioning , � FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro . ' 22. Ducts, Ventilating 71. Product Piping �Gas DOiI 23. Gas Pipe-Rough &� est ' 72. Underground Flush 24. Roof � ming 73. Undergrnd. Storage Tank 0 Gas ❑ Oil �� 25rRoof Sheathing 74. Overhead Hydro , 26.. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical 27. Frame and Flashing � ' . 76. Dry Standpipe � 28. Lathing&Siding 77. FIXEDSYSTEMFINAL � � � 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing HEALT�H DEPT. REQUIREMENT 31. Plaster Brqwn Coat 79. FINAL INSPECTION 32. Electrical power Meter-Final 80. FOOD CERTIFICA7E ISSUED �� 33. Final Electric � Notes: . � � 34. Final Heating & A(r Conditioning � y 35. Final Gas Pipe-Test ' � 36. Hood or Cynopy . 37. Final Factory Fireplace � " 38. Final Plumbing - ' - " 39. Water Service-Final � � 40. Gas Service-Final ' . - 41�. Solar pomesticFinal • . 42. Backflow Preventer � . � 43.• Backflow Irrigation •�, ` 44. Landscape Irrigation System �,F �) . '45. Sound At[enuation r � Incom lete Inspections .; 46. Handicap Regulations � � 47. FINALSTRUCTURE&BUILDING a " � 48. Special Requirements Completed - - .. 49. Electric Release to Edison �`-' '�. � 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY _ . No. Date _ . ' " �