HomeMy WebLinkAbout289 19TH ST - Building PermitsIApplicant to fill In all spaces except those within heavy border lines and sign.all appropriate declarations.
CITE GP cosi-47A CONSTRUCTION PERMIT PERMIT NO. TRA TNq LOT NO. UNIT NO.
4-, P-i.S7 • 8 332 d-] 0 . o'j. o2 9286 ;4/25/8D. 54p95 TL
APrg}ect Address [� ff �
Applicant's Mailing Address 0 ,if ." _ . TYPE OF CONSTRUCTION NEW L i ADD, LI ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT R 4 I ',f')/
Owner's Name i./•/' :4 i //�/ •hone '` '016/ P - .'- _ A.P.# J�7—aI J,� Zone [7C.
TrJ� q DESCRIPTION OF WORK/USE OF BLDG. ` ( � / I
Address ,,J6 e "/CLO Sr • L. '/ v 12.-FOUNDATION
-�� eve_ , c S Main Building: Accessory Building:
License No. TVPE OF PERMIT ID GRADING IJ FOUNDATION IJ STRUCTURAL E Front /0' Z
Arch/Eng. 7//f ,ry��'CEE T 0
Address -' L.'
ORS KI OTHER RT III ElPLUMBING III BA Rear /�� N
Contractor's Name Phone - C Right U / N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY 04 t
Address(mailing) K L t / G
i CONSTRUCTION TYPE • VALUATION$ IS Cr 11 s �1 R
City License No. • _ ZONE GRADING CU.YDS. ACRES ,
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing Remarks: / �` 979. gj,p Planning Notes: /,,5( ^ I J / L - • M
0
with section 7000) of Division 3 of the Business and Professions Code,and Lt eJO_Sti L11 JU t-t�- t/`{4M
my license is in fu f0 ce alis effect, ' /c U T
License Cl.ss < t•••• --- �tJY `S
•. __ _ • a ure 1.-n...11./ U a PLUMBING FEES I
WORK RS'COMPE NSAT.ION • CLARATION Bar Sink Showers
' 1 hereby affirm that I have a ee ificate of consent to self-insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a • ti led cop- .• •• -ction Backflow Preventer Service Sink
0, Lab. C.) • — /' Automatic Washer Transformer D 15-50 KW
Policy No. /1. •.y V•—.�. ompany it• e C.v',y. S. Backflow Irrigation Sewer Cap - D 50+ KW
Certified copy Is hereby-furnished. _ DOpsI1UCLl0n Pola Sub. . •
_ Certified copy is flied-with the city Building Division. Bathtubs Sewer Connection Cooking Unit - Meter Duo to 100 amps
Date - Applicant
• EXEMPTION FROM WORKERS'COMPEN ,, ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if then one hundred ($100) or
less). a Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel '
I certify that in the performance of the`p for w permit is issued, I '
shall not ploy any,person in any a 50 a co e subject to the Drinking Fountains Solar Tank Fan
Workers' ompensalion Laws of Calif. �_ Motors c.Sol❑0-1 HP ❑iX-$
Date • ' Signature ' _ Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑g-15 HP ❑16-15+
NOTICE: If,after making this declar,� , sho • beco bject to the
Workers' Compensation provisions of the .:.r ode, you p st forthwith Floor Sinks Urinal
comply with such provisions or this p, mit shall be d••med revoked. • Fixtures Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
' I hereby affirm that there is a construction? nding agency for the performance Device Boxes Pole Light ,
of the work for which this permit • issued (Section 3097 Civ. C.) Interceptors Water Heater e Outlets Ran
Lender's Name 9
Lender.'s Address 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
following reason (Section 7031.5 Elusiness and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry•
Trays
any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0-5 KW ❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of R •
oof 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 - - - -
' -efrom and the basis for the alleged exemption. Any violation of Section
• 5 by any applicant for a permit subjects the applicant to a civil
Ity of not more than five hundred dollars�� ((5500).
I, as owner of the•property or my S131p4"t.ee with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
co pensation, will do the work, and the structure is not Intended or offered -
for ale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee $ 3
FEES ,
Lice Law does'not apply to an owner of a property who builds or improves
thereo and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENT 7 7 q7„ J/...2/ q
employees, provided that such improvements are not intended or offered for Boiler Hood or Type 1 ❑ (..CX.Jt•e_ "70
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion,-the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground '
prove for the purpose of sale). • Building Approved By ,g Date �y(
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 4—.2-C-6-&O
tractors to-construct the project ($ection'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 -OF FEES
builds or improves thereon, and who cont ,cts for such projects with a con- 2
tractor(s) lice se pursuant to the Contr. s License L. ). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ 3' OD SMIP $ a ,�
proof of the' Worker's Co mpensatio rance shou • b• provided to me. PLAN CHECK ' - $ in 5,
4S .PERMIT '
0 I am : pt u • Section la / C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date✓ - 41 F owneri�//�/� �__ 111 � Heating System& Ducting Registers ENERGY P.C. $ •
I ❑0-100,000 BTU ❑100,000 BT PLAN CHECK 25% $
hernia certify • ct I have read is application nd state that the above GRADING $ - -
inforeb on .mein. agree to compl with all -y and county above
ELECTRICAL $
and stat laws el ting to building ruction, a . hereby author e repr - MICROFILM $ '
sentatives of cit .,,enter the above-mentioned p erty PLAN CHECK 50%. $ _ �{ -
inspection pur VM •ECHANICAL $ TOTAL FEE $ car, QC
Signature . • Dat` Reinspection Fee $15 Issue Fee $
p $ 3 • PLAN CHECK 25%
Drivers' Licens or S$#
CMF 0865-46,rev.10/84 White - Building: C nary - Applicant; Pink -Accounting: Goldenrod - Assessor '
CONSTRUCTION AND PLANNING POOL& SPA
Fr,.\
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 62. Backwash & Receptor-Final' .
12. Sewer Cap 63. Heater & Vent-Final .
13. Roof Drains 64. Plumbing System -Final '
14. Rough PlumbingL 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# ' _ _ t .
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 i 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 .
I
36-.Hood or Canopy
37. Final Factory Fireplace
I
38' Final Plumbing -
39. Water Service-Final . . .
40. Gas Service-Final
41. Solar Domestic-Final i r
i
42; Backflow Preventer .
•
-43 Backflow Irrigation • - • 1
• • 7i
,-...44.. Landscape Irrigation System • ,; • I ' ' •
'1.,,45 Sound Attenuation - • - -
46:` Handicap Regulations ��O a
&INCL.
47. FINAL STRUCTURE & BUILDINGt,� ie -etSl .303 fate oQ
48.4Special Requirements Completed 1' ���l�Y"" .,
_
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -j
51. CERTIFICATE OF OCCUPANCY - -
No. Date - j'.-
•
• 10340tr
EE RECE��E®
COSTA MESA BUILDING-SAFETY DEPARTMENT .L SII`q 5S I
P.O.BOX 317 COSTA MESA. CALIFORNIA F1NANCr�?�Cn�C¢��r1•
EOR APPLICANT TO f/LL IN COMPLETELY APPLICA910FOR''PERM
L7IT
TYPE OR PRINT BUILDING
woDREss
BU ILDINGC I9 p i9 ad a yam.
COSTA MESA, CALIFORNIA
foR officE USE ONLY
Ws RECEIPT NO. PERMIT NO.
OWNER�e� r I �l ''/v
MAIL RECEIVED BY • TE RECEIVED D g 1fi9UED
ADDRESS y�/ �i I i di -J -/
CITY £p 'ff�f�(,`, TN(]/�(•d 3io k BUILDING
ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA (�/�
OR ' -•.INFER NO. `- \
FIRE /�
ADDnc55 �Q//(�� drat
(� �/ /� ZONE TYPE !/ GROUP �.j0/ Y
CONTRACTOJ4.7 C ,'`Y'at y& A.( LL C NaO1.0) L"?l APBY DATE
DATE \
ADDRESS/2Q2J yyestin:A(.sfps- A8LL -Si+, ZONING
LEGAL LOT ZONE I NO.OF USE OF NEW /'//�,. _
DESCRIPTION NO. BLOCK 'TRACT 7 (.7 PLANS �. IBUILDING r V \ .
/l ^J ^ APPROVED ���/ .�+ �-
A.P.NO. / I / 27 ‘"/ �- �Y� BY DATE 9///��y
SIZE /{/� NO.OF BLDGB. YARDS EVES , /
OF LOT.,53 /�� I NOW ON LOT / REQUIRED ALLOWED !
USE OF {q/� �� �� � (CENTER LINE ST.) JJ��
EXISTING BLDG. .`FK�C.r FRONT G� 0 FT. •
IN:
V
SETBACK LINE FROM �'�A t / !
CENTER OF STREET .J (/ REAR YARD y/ R.SIDE t{,�
FT• IN.
SIDE YARD I LEFT 7 I RIGHT L.SIDE .f� FT. IN.
DESCRIPTION( / OF WORK RE{A,R�>��/C/ C.X.T.(Cr_ N.
NE'" • I I ALTERATION I II ADDITION I ;\/ lam( ��U `•
REPAIR �j�j I II MOVING L,II DEMOLISH /IBC /
SIZEIDINoGg�7�/P^qAM(' /I( ROOM$ S STORIES
EXTERIOR WAil- C I ROOF
COVERING NGC�O COVERING
USEOFOF�UILWORK TO BE PERFORM —
02 V
l'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONTHE NTnSHOW DER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTAB I6HING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
VALUATION _
SIGNATURE OP� ' 1 /2/ N� PERMIT FEE $ a SL
PERMITTEE //
• $ 9; S /2 — PLAN CHECK 5 /ot.
AUTHORIZED AGENT TOTAL FEE $ 3 6