HomeMy WebLinkAbout648 19TH ST - Building Permitsl
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PNOJECTROUflESS: 648 W 19TH ST '� f/�
OWNEN'$NPME: CITY OF COSTA MESA
nonRess: TRANSPORTATION DIVISION
77 FIAR DR 4TH �'L
C.M., CA 9262.6
AqCHIENCINEEH:
noosess:
xec.xo.:
uxir:
uxrt:
PENMITTEE: F,J. JOHNSON (714)632-1915
ROOXESS: 11fjS N VAN HORNE WY
ANAHEZM CA 92806
LICENSEO CONTflAtTOfl OECLANATION: I MreUy a11i�m tlwt I am IkenSeE under provisiaas a� CtuO�e� 9(�mmencinp wii� Section
7000) ol Drvision 3 ot Ille Business an0 Prole55ions Code. an0 my license is in full force an� eflect.
cirv uc.:pr sraTe uc.: q g g 3 Z �`}/rs/sO �� p gXP ;
�ate: _1! —�� ` %�� SigreNre: �eLk-.�( ` ��«�^�'�
WOflNEBS' COMPENSRTION DECIABRT10N: I �ereDy aHi�m thai I �ave �oer(fimate at consent ta seli-insure or a ceniliwte ot Workers'
Comoenution Inwrance. or a certilie0 cooY �nereot (Sxtion 3800. Lab. C).
POUCY NO.: PwC 2 4$ 2 2 2 EXP. ORTE: I i/ 1 S/ 9 4
comeaxr: GOLDEN EAGLE
1 Cen4fiea copY is nereCY tumishea. � CertitipA tq9Y�� `n� a7 B�Oivision. � /
�
oaie: Yf /C-9"'� APPlicant //�
EXEMPTION FNOM WOflKEflS' COMPENSRTION OECIAMTION: (ihis s¢�+4o n t 7e mmpkteU ii th peiml a M are �unOreO (5100) or kss�.
I[ertily Itwt in I�e Oedormance ol lhe work tw whz0 IN5 Dermt is isSueG. � slull noi emD�% any p¢rson in any mann¢r so az to hecome
Subleci lo Ihe WOrkeri Com0en5ati0n LaxS of CaliPomia.
Oaie: Sigreture:
NOTICE: I�. atter rtuWng I�iS G¢Claraiion. 7rou SMu10 OeLrome SUEIe[I to ttie Wotkers Compensatqn Dravisions at Ne Lahar
CaEe. you must fonhwith comoN ��� such v�avisions or INs OQ�M� ��� De Eeemetl revokea.
LONSTBUCTION LENDING pGENCY: I �ereGy allirm that t�ere is a construction IenOing a0ency br Ihe pedormance ol Ne wark lar
w�ic� I�is permil is ¢sue0 (Section 3W7. Civ. C�.
LENDEN:
ROUHESS:
OWNEB BWLUEH DECUMTION: I hereCy aflirm tha� I am exempt �wm t�e Comrzaors' State License Law lor t�e fotloxinq reason
(Section 7031.5 Busineu antl Pro�essional fqde: My dty of counN wN�� repuires a p¢rmit to con5imct, atter, imD�ove, tlemolis�. or
repair any 9mcture. prior to its issuance. also r¢quirts the appfiwnt for suc� permit to lile a signeA statemeni ihat �e/slle is Iicense0
pursuam to Ihe O�ovisions ol ��¢ CONractors' Siate littnse Law �CIWO�er 9(cammencinq w�t� S¢ction 7000) oi �ivision 3 of lhe Business
anG Pmlessions Coae) or t�a� �e/she is eKempt thertlmm an0 t�e Dasis lor t�e allepeU exemptian. Any Wolation of Section 7IXi1.5 hy
any aOD�icant for a permil su0jecis t�e app6Wn1 to a GvA ce���Y ol rpt mort tlun 1We �uMreO Uollars (5500).
I. as awnet oi ihe prop¢ny or rtry employew witn +'ages u tAeir 501e compen5a0on, vNl ao ine wOd, an0 tAe
❑ vmciure is not imenaetl or olfereC lor sal¢ (Section 70a4. Buvness anG Professional COAe: The Contractors' Stata License Law
Goes not a0��' to an owner ol a pmperty wtq OmIEs or imP«s tMreon, anC wlio Eou wch work himsell/�erself or I�mup�
�is or �er own employees. OmviAeA ttWl suc� improvemeP�s are not intentletl or offereG lor Sale. If, however lhe buildinp or
imo�%'emenl is so�E vnihin ane year of com0�etion, t�e OW�er witl Iwve Ihe bur0en ol prOvuiO ��s�e Uid nol huilU or improve
� lor the pur0ose ol Sale�.
I, as owner al IAe pm0erty, am ¢aUuSively coniractinq vnt� ii�ensea conuanors m consimct t�e project �Seciion 70A4, Business
❑ antl Prolessions CaEe: t�e Contractors' Stare Lkeme Law does iwt apDN �a an ovmer of Droperry �Mo bmlGs onmprwes therean
ana wno comracis lar such pwiects witn a contractarlsllicense pursuam to me Contracmrs' Slate License law�. I am aware
��ai pm01 0l I�ei� Warker's Campensation i�5urance stqu�d Oe 0��� �0 me.
!I � I am eaempl under Section: B. d P. C.
lor Ihis reaSOn:
Wte: Owner.
I ao nere0y cenily t�at I am aware of anE unCerstan0 t�e repuirem6nts ol Califomu Health anA Salery Cade Sectians 25505, 25533, ana
25534 antl Inat I or any luture builtling occupant wilVwill not (circle one) nee0 to camply with saitl state coaes ane ihe reQuiremenls lor a
permit loi COnSimclion or mo0ilica�ion Irom t�e Air �vatily Manag¢ment Usiritl. flevCentul consimction aDGlicalions are exempi Imm
t�ese D�ovisions '
Oale: Apvticant: _
I nereoy cetlily ihat I have reaa ihis application antl state tlut ihe aWve informalion is correct. I apree to camD�Y ��h all city antl county
ordinances antl slale laws reiating �o OuflGing cons�mction an0 hereby aN�or¢e �epJesenlaiives oi �his city Io enter upon Ihe a�ove-menlioned
pmpeny br ins0ec�ion Durposes- /f� ��
Z�
oaie: tvi�—/L-9'f Signawre: Q�"
Driver's ticense or Sobal Secun�y a: $
16aba6 Whue—Builtling; Green—Cotle EniorcemenC Canary—APOlicam: Pink—Revenue: Galtlenmtl—Assassor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 068489 PLAN CHECK NO; N
CONSTRUCTION TYPE: PERMIT TYPE: ELE
JOB DESCRIPTION : ELECTRICAL METER FOR TRAFFIC LIG[{T
CLAIM VALUE:
CALC—VALUE:
PERM NO: E 06848
GOVT: Y SUPP; N
PURPOSE: OTH
SQ FT;
GROUP OCC: /
COMMENTS: TRAFFIC LIGHT IN FRONT OF DEPT OE MOTOR VEHICLES
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2 O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING RE(� - PROV; PARCEL; 00000000 2NE: AEF NO:
PLANNING NdTES>
7
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D E V E L O P M E N T S'E�R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY
DATE:
DATE:
APPLICATION ISSOED BY: � DATE: �����C(�
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LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECFIANIC FIRE SMIP/RES GRADING
PERMIT 18.50 ,
SOi SMIP/NOIJ—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 0,00 0.00 0.00 0,00 .00 .00
REVENUE DIVISION TOTALS--> COLLECTED: .00 OVER/SF[ORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
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I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50
END OF FEES
01 00165000-0016bOD0 Ti] T
DATE: OS/16/9S TIIfE: 11:40
18.50
.��
CONSTRUCTlON ANO PLANNING ' POOI PA
APPROVALS Permit# Date Inspector APPflOVALS Permii� Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
�.i
2. Soil PiOe�Undrgrnd. .� 53. Steel Rainforcement
3. �lectiical ConduifLl�tility�Undrgrnd.' � � 54. Forms '
`4�'Electoical Conduit�lli�drgrnd. � 55. Electrical Bonding
5$teef Reintorcemeni � -' �� 56. Rough Plumbing & Pressure Test
�6, ElgctricatUFERC�rnd. �- ' S7. APPflOVALTOCOVER•GUNITE
.:7o Footings _ . 58. Eluctrical Conduit•Undrgmd.
'8. Foundation ' � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. � 60. Backwash Lmes, P�Trap, O Undrgrnd.
10. $tructural Floor SVstem ' 61. APPROVAL TO DECK
1+. �Property Sewer l.ine & House Conneciion . 62. Backwash & Receptor�Final
� :
1. Sewer Cap � 63. Heater & Vent-Final
_.
� 3. Roof Drains � - 64. Plumbing System - Final
14, Rough Plumbing. � � 65. Electrical•Final
15, ftough Elecvicat,Conduit 68. Solar 5Ystem-Final
16, Rough Electric Wiring 67. Fencing & Access ARP�ova�
17, flough Wiring Si9n 68. APPRpVEO FOR PLASTERING
18, Rough ElectricahT Bar Ceiling 69. POOU'SPA SYSTEP,7S FINAL
19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
T . A -.
20, �Rough Factory Fireplace r, r, .; y - � . �: APPROVALS� � .6ermit �F ''
, - t x - e ,;
21, Duas, in Structure' � ' ' ? - y'. '� � � ~ ^ � . '�
i :� � a ' - j0. Underground;HyStro
22, Ducis, Ventilating. : � - . ' ' jl. ProducrPipirlg C`GTds rJOil
�
23. Gas�Pipe�Roug�'h &'T,Est � ". . '
� ,, - )2. Undergro�jc(Flusjt�
24. flooi�Framing. � � � �. � : 73. Undergmd.StorageTankOGas ❑ON
25. Roof She�thing � � ' � 74. Overhead Hydro � .
26. T�BaryCeilinq (Str�rcturap & Monocoat � - � - 75. Ory Chemical " ` � �
,
27. �Frame and Flashing'� .� ., � N; i 76:�bry Standpip� .= `; : � �.
28. Lathing � Siding � y : -' � � . • � ' 77. 'FIXED SYSTEM�INAL
29. Insulation - _'" . i � ., 78. FIRE PREV. FINAL •
30. Drywall Nailing �� � k, � HEALTH DEPT�RE�UfREMENT
37, Plaster Br�wn Coa[ '. _ � � ,d FINAI IfVSf?ECTION , -�
32. Electrical.Power Meter¢inal , � g.�jLll�' ; �� �". .'OOD CERT CATE ISSUED
.� �
33. FinalElectric ' g:��?j�jt � .��.es: ; .
'b �"
3q. Finai'He@ting � Air Corld.�tionin9 = , • ' Ir . . ' � � .
35. Finat Gas�Pipe-Tear �- � -� : - _ . �
- t
36. Hood'or CanoPY -... -- n - � . '. � � � : . ; � . •
37, Final,FaCYory Pirepi3ce � � � - • .
' _ .,' -� : , i
�. _ I j �
38. Final Plumbing _ ,� � .. . � �< , . -
3y. Water,Servlce-Final' � � •
40. Gas Service-Final . ! ; ' '
�.r
�qt. Solar pomestirFinal _ � � � � � �
- �
�42. Backflow Preventer.� , , ! � -. . � -
I
43. Backflow Irrigation , � - " �,
i,
44. Landscape Irrigation System - [ � „ - .. . y � '
45. Sound Attenuation � - � � _ '
46. HandicapRegutations � � . � . , • -
�
47. FINAL STRUCTURE & BUILDING i' '
46. FINAL PLANNING , � � ' -�
49. Electric Release to Edison �� - . - �
50. Gas Felease to Southem California Gas Co � , . . -- •
5L CERTIFICA7E OF OCCUPANCY' �
No. Dace