HomeMy WebLinkAbout725 19TH ST - Building Permits� •. 2
COSTA MESA BUILDING-SAFETY DEPARTMENf
P.O. BOX 1200 COSTA MESA� CALIFORNIA 02820
For ApplimM to Flil In Comp/aNly
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COSTA MESA, CALIFORNIA
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DEC-6-67�psA00 290 �*****3.00 I
AIPLICATION FOR PERMR
BUIIDING
For Offln Us� Only
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AVV��cant lo fi11 in au spaces except those witnin heavy Gottler linez anG si9n all aporoDriate Geclantions.
PERMIT NO. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTn MESa CONSTRUCTION PERMIT G _,—�
Proie[tAddress 2r v � �
9
Applitant`s Mailing Address I!o� yl'�haH/� r., i� ii O . e 7VPE OF CONSTRUCTION U NEw U ADD LI ALTERATION LI RE�AIR
OvenCr'S Name Le�-rh V F. �/h/�T/: ohone ��v_.. RUl'f�y � CONVERSION ❑ DEMOLISH ❑ OTHER
S.Q �� _ � DESCRIPTION OF WORK/USE OF BLDG.
Adtlrea •
AfGh/Eng: Litense No. TYPE OF PERMIT GRADING FOUNDATION STRUCTVRAL
Adtlress � ❑ TENAIVT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ,
❑ �OTHER � ' '
Convanor's Nam � � hone
PROJECT DESCRIPTION Sq. FT. OCCUaANCv
Adtlf2u(mailing) �� CONSTRVCTIONTYPE � VALUATION$ �
City License No. ZONE GRADING CU. VDS. ACR@5
. LICENSED CONTRACTOR DEGLARATION �
I.hpre�y at�i�m that I am lit<nzetl untl � p�ovl51on5 01 Cha�te� 9(commen<in9 Rema�ks:
w��h seclion 7000) of Division �Oj �uslness antl Prolessions Gotle, antl
my �icense is in fullNorce antl eftd�,J
LJcense C1ass ' License No. aA ��va
Oate Si9nature
W00.KER5' COMPENSATION DECLARATION BarSink
'@reby al(i�m lha� I have d'certiflca[e Of consent lo selHnSuro o� a C¢rtlfiCate �
Workers'_Componsation Insurante,�or a<ertifietl copY.�hereof (Settion gackOowPreventer
_ep0, Lab. C.) ,
Poqcy No. Company Backflow Irrigation
8 Cortifietl copy is hereby IprniSh¢tl. � , _
Certifietl copy is /IIeC wilh tne city Builtlin9 Division. BathNbs
Data � AOPlican[ ' . •
EXEMVTION,FROM WORKERS' COMPENSATION OECLARATION Clari(i2f5
(Thi55ection neeC not be completetl it Ihe permit is for one huntlretl ($100) or DiShwdsh¢r
Iess)
I c@rti(y that in the performance of Ihe work tor whicp tnis perm�t is issuetl, I - -
Shall n0[ employ any p¢r5on in dny manner to become �bj¢<t to thB Drinking Fountains
Workers'�p�➢y¢ nsatlon� Laws of Calitornia. �/�
Dato =J �1.(._Sl9nature �� Floor Drains �
NOTICE: 1(, after making this declara[lon, you shoul ecome subject to the
Wohkers' Compens�tlon provisions ot tha Labor Cotla, you must forthwith floOrSinks
coTply �with suc� p�ovlsions or thl5 pOrmit Shall b0 Gu¢metl �evokatl.
CONSTRVCTION LENDING AGENCV ' Ga55¢rviC2
I nereby al(Irm that thero Is a conscruction Icntlin9 agency for the performanca
ol tho work fOr which thi5 permit Is,iSsuetl (Section� 3097 Civ. C.) InterCeptOfi
LOnaer's' Name
Lentler's Aatlress � Kitchen Sink �
OWNER BUILDER DECLARATION ' ' ' - �
� har¢by dttirm that I am exeTPt from th¢ Contracior's Lit¢nze l.zw for th¢ LavdtOri¢S '
following reason (Settion 7031.5 BuSiness antl Professional Coae: Any Nty or
<o�nty which reqWres a permk to construcq'alter, improve, demolish or repair P—Tiep
any structure, pdor to Its Issuan<e, also requires the applicant far =uch permit
to tile a Si9n¢U statem¢nt [hdt he/ihe Is Ilt¢n5e0�pu�sUant to the P�ovision5 0l qoof Drains
th4 Contractor'S License Lnw (Chapler 9(�ommencing with SecHon 7000) of
1�V15iOn 3 O/ the Bu5in055 antl Pro/e55iOns COUe) or �hdt h2/S�e is exempt
eretrom and tbe basls for the alle9etl Cxomption. Any violatlon ot Sectlon
�31.5 by any applicant Ior a permit subjetts t�e applicanl to a civil
�alty of not moro [han (ive huntlretl tlollars (5500�. ; �
I, as owner of the property o� my omplOyees witb wage5 as thei� Solo Rel�SpettiOn FBB
co pensation, will tlo the work, antl the structure Is nol IntenOea or oiteretl
for �lo (Section 7044, Business antl Pro(essional COGe: The Contractor's �
LlcenS¢ Law tloes no[ apply to an owner ot a property who builGs or improvls
tnereon, antl wno tloes such work hlmselt/herself or thwugh hfs or her own
emp�oyeez, proviCetl tha[ such improvements are not in[enAetl or ot(eretl tar Boiler
sxi0. I1, however, Ihe builtling •Gr improvement ii soltl witM1in one y¢ar of com-
t
OuUe[s
$15
Dletion, Ihe owner wlll have the burtlen ot provin9 he/she tlitl not Ouiltl or Im- Duct - Under Ground
�Ov! 10� the p4rpo5a ot sale). �
�-� I, as owner Oi tha pro0erty, am exclusivoly Contra�tlng with IiCCn5e0 con- DuCt -$VUCLu�LI
trartors to construct tho oroject (Section 7044, Business antl Professlons Cotle:
T(�e Contrac[or's Litanm Law does nol apply to an owner o1 properry who Duct- Ventilating
bulltls o� improves the�eon, antl wbo conbaCts to� ipcb O�OjGGts wlt� a Con-
tra��w�s Ocense pursuant'[o�tne�Contractoi's �icensd L.aw). I am awaro that
P�oof o� tneir Worker's Com ensation insurance zhoultl oo Exhaust System ❑ MW[iple
p praviAetl to� me.
❑ I am exempt untler SeCtiOn 8. y P. C. to� th6 reason FiRpl/F2GL. 91t. ICBO i�
� Date owner Heating Sysrem & Ducting
I hereby C tity tbat 1 havB �ead [his app ation antl Stdte Ihat the above - QP70Q,D�OBTU �100,��
InfOrmation is correct. 1 aqree to comply wlth all tity antl county ortlinancas
anq state lawi relating to bulltling <onsbuctlon, antl hereDy authorize repre-
sen�ativus of t0i5 tlty to En[er upon t�e above-mentione0 property for
InipeCllon pufpo5¢5.��'y� /% _ �. ��/
Signature ��l�l�� Date
Dri�ers' LJtense or 55 � ReinSpBe[ion Fee
CMF 0865-46, rev. 4/B4 W��te - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Asmssor
$15
ShowCrs
Service Sink
Sewer Cap
Sewer Conneccion �
Solar Collectors '
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Waler Closet
Water Heater
Water Service
Isua Fee $ 3
A.P. ;1�
S Main Building;
E
T Front
A Rear
C Right
SLeh
Ping. Ref. dh
✓
6711 B/21/Q4
Accessory Buildin9:.
Parking Req./Provided
9oC�' TL
2one
2 '
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. . S. �
. � ELECTRICAL , ' �FEES
Autometic Washer ' Trnnsformer ❑ 15�50 KW '
Construction Po1e Sub. ❑ 50+ KW
Cooking Unit �� Meter ❑up to 100 amUs �
Dishwasher ' � Meter ❑over700amps
Dryers �Gas �Electric
Fan
F.A.U.
Fixtures - -- -
Device Boxes
�UL12L5
Switches
Garbage Disposal
Generator �0.5 KW �5-15 KW
Sub Panel
MOtois�Pl HP01h-6
Inc.Solar �9-15 HP �16�15+
Microwave - �
Pole Light
Sign
Standing Sections
Trash Compactor
IANICAL FEES Reinspection Fee $15 luue Fee
Hoodor Type! ❑ DEVELOPMENTSERVICESREQUIREMENTS:
Canopy Type �I ❑ Zoning Approved By
Building Approved By
Refrigeretion System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
laue Fee � $ 3
SUMMISRV OF FEES
BUIL�ING PERMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING § .ISSUANCE
PLAN CHECK 25% S �— ENERGY'P.C.
ELECTRICAL $ df% � GRADING
PLANCHECK 50% $ MICROFILM
MECHANICAL S TOTAL FEE
PLAN CHECK 25% $
$ 3
$
CONSTRUCTION ANDPLANNING POO �PA .
, APPROVALS Permit # Date Inspector � qppROVALS Permit #' Date Inspeccor
1. Temporary Electri�cal �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, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK �
71. 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. SolarSystem-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
2p. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Structure ' 70. Underground Hydro
32. Ducts, Ventilating 71. Product Piping 0 Gas ❑ 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.�FrameandFlashing � 76. DryStandpipe ,
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 pomestic-Final
42. Backflow Preventer '
43. Backflow Irrigation ,_ . . � .
44. .landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations �
47. F.INALSTRUCTURE&BUILDING
46. Special Requirements Completed � .
49. Electrie Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATEOF, OCCUPANCY .
No. Date