HomeMy WebLinkAbout412 18TH ST - Building Permits''^ Applicant to till In all soaces exceot inosa wlthin heavy Gortler Ilnes antl sign all appropriate tleclaralions.
CITV F�COSTA MESA CONSTRUC�T�ION P.F>RIVjIT� PERMIT O. TRACT NO. LOT NO. UNIT NO.
Project ,4ddress "��� � ��. p� ��j ,s/�/S[t�/7 �aS A%///i'C/)
Applicant'sMa�ili/ng�AddreJs vI//_��-�q��f�,��l//(_r'�f�i�Ft/9
Owner's NameVd fTAl���42./Y/�--Phone�j,�`�.�
Addres=;s,��2_si�rh .Sy��,�t� t�lf�
Arch/Eng. License No.
Address
Contractor's Name Phone
Address (maiiingl ' �
City License No.
LICENSED CONTRHCTOR DECLARATION
I heraby a(firm that I am licensetl untler provisions oi Charter 9(commencln9
with section �000) of �Ivislon 3 of the BuSiness antl Grofessions Cotle, antl.
my license is in full force antl effect.
�%<eqse Class License No.
. Si9nature �
RKERS'COMPENSATION DECLARATION �
� nereby aHirm tllat I have a cartificate ot consent to self-insure or a certltiwte �
of Workers' Compensation Insurance, or a cortiilatl copy thereof (Section�,
3800, t_ab. C.) �
Policy No. Company �
8 Certifietl copy is hereby furnishea. ��
Certlfied CapY i5 til¢a with the dty Builtling DiWslan.
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -
(This section neea not be completed if the permit Is ior one hunGred (g100) or� �
less).
I cerp{y tha[ in tM1e pertormance of the wOrl Po� whiGh tM1ls Oe�m�t iz Issuetl, I•
shall not emO�Dy any person ip any nn so to beco suEject to Itie
Worl�a�5 o en io LawSofCali Y � ��
Date' $i9natute
NOT��E: t, aiter makin9 this tlec tion, you shoultl be ome ub7 c to lhe
Workers' COmpensation prOvision Of ihe Labor Cotle, you mu5t fortnwith
comp�y w'it❑ such prOvision5 or this permit Sball be de¢metl revOketl.
CONSTRUCTION LENOING AGENCV
1 herqby afll�m that there is a Const�uction lentling agenCy for the performxnce
of tne work for which this Oermit is issuetl (Section 309�_Civ.- CJ
lEnq¢r's Name
I- LenQer'S Atltlress
OWNER BUIIDER DECLARATION '
1 he�¢by aHi�m that I'am exOmPt �rom the Conl�aclo�'s License Law foi.the
n
the/efrom an0 the bas(s fo� [he allegetl exemptlon. Any violation O( SeC[ion
]031.5 by any applicant fOr a permit Subject5 Ine applicant to d civil
pe�8lty o( not mo�e than five huntlretl tlolla�s ($500).
��9 �, as owner ot the oroperty or my employees with wages as tneir sole
�compensatlon, will tlo the work, antl the structure is not intentletl or offeretl
tor sale (Section 7044, Business antl Protessional Cotle: The Contractor's
LiC@nie law CoeS not apply lo an owne� Of a p�op¢rry whD bwltls p� Improve5
ther¢on, antl who does such work himself/nerself or through hiz or her own
employees, provitletl that such improvemenis are not Intentletl or ofieretl for
sdle, If, however, the bulltling or Imptovement IS Sold Wi[hIn one yea� of com-
ple40n, Ihe owne( will hav¢ [ha bu�tlen Ot prOving h¢/she tlitl nOt builtl o� im-
fLoye tor the purpose of zale). _
U I, as owne� O/;the property, am exclusively cont�acting witb IicenS¢tl con-
traCtorsto constructthe Project ($ection 7044, BuslneSs antl Professions Cotle:
�e Contractor'z License t1w does not apO�Y �o an owner of D�opmty wbo
uqtls or Improves;tnereon, antl wM10 contracts for such projects with a con-
! 3Ctor(5 Imense pursuant to Ihe Con[�atto�'s Lic¢niC L.aw). 1 am aware tha[
P�ooi o� lheir Wotker'S COmp n5ation insurance shoultl be p�ovidetl l0 me.
� I am exempt untler Secfion ���� S B. & P. C. for thiz reason
Date - Owne
1 hereby certity that I have r this application antl state that t a above
infGrmation I5 correcf. I ag�ee to comply wiin dll tlty antl county ortlinanc¢s
antl state laws relating to builtlin9 construction, ana hereby authorize repre-
sentaliv¢s o( thy� city�tp enter ybon the abova-men[ionetl prope4ty for
55
4f�o3 �I54 1 �
TVPE OF CONSTRUCTION NEW ADO ALTERATION REPAIR
� CONVERSION ❑ DEMOLISH ❑ OTHER
DESCFIPTION OF WORK/USE OF BLDG.
TYVE OF PERMIT LJ GRADING I'J� FOUNDATION ILy STRUCTURAL
O TENANT � ELECTRICAL � PLUM9ING ❑ MECHANICAL
l
O OTHER SI/1
PROJECT DESCRIPTION SGl. FT.��l1 oCCVaa�N}C�v�
CON STRUCTION TVPE VALVATION 5—Z.�
ZONE GRADING GU. VDS. ACRES �
i . `- rr-
/ l
Bar Sink
Backflow Preventer
Backflow Irrigation
Bath W bs
' Clarifiers
- Dishv�asher
� Orinking Fountains
2 Floor Orains
Floar Sinks
Gas Service Outiets
Interceprors
Kitchen Sink
Lavatories
' P-Trap
' Root Drains
ReinSpeMion Fee $75
Boiler
Dutt- Under Ground
Duct - StrucW ral
Duct • Ven[ila[ing
ystem ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
X�0-100,000 BTU O 100 000 BTI
Reinspection Fee $75
3ol�enrotl - A5se55or
Showers f
Service Sink '
Sewer Cap ;�
Sewer Connection '�
Solar Collectors
Solar Piping
Solar Tank �
Swimming Pool w/Spa
Urinal
Water Closet '�
Water Hea[er
Water Service
Auto-Wash '
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration Systam
�0.700,OOOBTU ❑100,000
System RepaidAlteration
Fire Dapipers
Register5
laue Fee
FEES
i
$ 3
$
GSn IZS'�
A.P. ;1� ' - -
S Main Building:
TFront � (� ��
ARear ��� ��
/C Right � �/
K �eft /
S
Ping, Ref. #
Plannin4 No[es: �'n �,,,, �1, . rr
Auromatic Washer
Construction Pole Si
Cooking Unit
Dishwasher
Dryers �Gas ❑EI
Fan
F.A.U.
Fixtures
DCVICQ B0X25
Outlets
Switches
Garbage Disposal
Genereror C]0-5 KW
13t OGUt1G,i47-tlllEi063:,1 'i'id'Y
Zone
./PrOvided
ELECTRICAL
Transformer 0 15-50 KW
❑ 50+KW
� Meter up to 100 amps
Meter �over100amps
Sub Panet
Motors O0.7 HP O1 X- 8
Inc. Solar Og�15 HP �16-�
Microwave .
Poie Light
$ign
Standing $e�tions
15 KW Trash Compactor
� Reinspection fee � S75 � � luue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
Building Approved By
Application luued BV
44?D, 31
FEES
5
2
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G
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�
M
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S
SUMMARYOFFEFS �
BUILDING PERMIT $ �J I iJ. SO SMIP $ �•� Z
PLAN CHECK $ " PERMIT
PLUMBING $ 7.O � C B ISSUANCE $
PlAN CHECK 25% $ �� ENERGV P.C. $
ELECTRICAL $ -'-�•J V GRADING . $
PLAN CHECK 50% $ � MICROFILM $ �
MECHANICAL $ `�J TOTALFEE $ �
FLAN CHECK 25% $ -^
CONSTRUCTION AND PLANNING' ," �, POOL & SPA
�APPROVALS ' Permit #'' Date Inspector , AppROVALS Permit # Date Inspector
i i - -+
1'*Temporary Electrical Service-or Pole 52. Pool & Equipment Location '� ��
2. Soil Pipe-Undrgrnd. ' !„ 53. Steel Reinforcement '
3. Electrical Conduit UtilitY-Undrgmd. 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-7rap, O Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK - -
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � �
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains 64. Plumbing SYstem - Final � , .
14. Rough Plumbing 65. Electrical-Final
75. Rough Electrical-Conduit 66. Solar System-Final
76. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring S(gn ., , ,68. APPROVED FOR PLASTERING �
.j8, Rough Electrical-T Bar Ceiling � _�. „69. POOUSPA SYSTEMS FINAL '' '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ;'i"''
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro � �
22. Ducts, Ventilating 77. Product-Piping OGas ❑Oil'
23. Gas Pipe-Rough & Test - 72. Underground Flusp� � � �� '
24. Roof Framing 73. Undergrnd.Storage7ank �Gas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro - � �
26. T-Bar Ceiling (Structurall & Monocoat 75. Ory 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. Fiqal Electric �� �2Z� _ Notes:
34. Fina�'.Heating,� Air Conditioning �y �Tl� (�� � sff -�,yRL £L�Gi" ��-
35. Final Gas�Pipe-Test �frf( (�� ;7 Gu �� ,
36.' Hood or Canopy G /6 �, � / �.r. �Q` ��
C.
37:� Final Factory Fireplace G �Z �(,(� ' '
r: I�.
38. Final P,lumbing (o � � � . �
39. Water $ervice-Final O :' .
� . �
' 40. Gas Se�vice-Final ' � -
' 41. Solar pomestic-Final � ' �
I � i! � � "
"42. Backflow Preventer ;� �, .+' .
i
� 43. Backflow I�rigation � 1 � �' -
�
44. LandscaPe��irrigation System � ' - ' '�, : q
; 45. Sound Att'enuation � . �' , �, • ;.
' 46. Handicap Regulations i -�
' - %i
47. FINAL STRUC7URE & BUILDING 3 r ' �.. �
48.,Special Requirements Completed ' - ' ' ,
i
� � i..
9. Electric Release to Edison � � � f
.�50. Gas Release to Sc�uthern California Gas Co � ''� �
51. CERTIFICATE OF OCCUPANCY
- �.r
No. '' Date '
. _
`, _ ... .
-,
"" • 297'Z3 FE811-69PpIo00 252+� *�**18.00
CNSA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BpX 1200 COS7A MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECEI V� BV DATE RECEIVED DATE ISSUED
ADDRESS � � ' �J �'/a'-� ��//-�`
9 PER IT NO.
OWNER � V A.P. NO. ' '
MAI �/ BUILDING / �
ADD 55 �'�/ ADDRESS a �
Z . �j �
d U CIT NQ�� � TRACT � LOT Q BLOCK
ZZ W ADD
Q CA RVCT�ON
ON LENDER _
am
J � BRANCH
J N OWNEF
m J ADDRESS VALUE �
m ARCHITEC7 TEL. S $
J a OR ENGINE R N
U N �
w¢ ADDRESS ZONE TVPE/�J GROUP �
a w APPROVED �%� DATE Z/�—(JC �
w Z CONTRAC7p BV
J Q ' (�
m Z �Y
J � ADOFESS �'
w W �� 20N NO.OF VSE OF NEW � �
Z� CITY NO. � P�� � BUILDING
� STATE CITV �'ARDSAPPROVED VARDSAPPqOVED
y� LIQ NO. �!.` 'g ��'� LIC. NO. �7j MAIN BUILDING ACCESSOflV BVILOING �
�� SIZE NO.OF8LDG5. (FROMC/LSTREET)
OF l0T � g NOW ON LOT qONT FT. � FT �
USE OF
E%ISTING BLDG. S T
H $12E OF � n N . OF ��
Z NEW BLDG. ROOMS STORIES L. SIDE FT, FT,
V EXTERIOR Wq � ROOF �' `
COVERING COV6RING REAR FT, FT.
' J VSE OF BUILOING AND WORK TO BE PEflFORME ' DI5TANCE BET. BET. MAIN &
a MAIN BLOGS. ACC65. BLDGS.
a
Q ` VAR.�W OATE
O C.U.P.qW APPROVED
F � APPROVED /
tn ' V
� 4
VI heraby acknowled8a thai I hava reetl this appllcation antl state
� [hat tha abpvo Informotion is corract antl apree to comply wIN \
� oll lews rap�tating builtling construcilon, and 1 shall not employ
� ony person �� ��oletion of the workman's compansation lews o(
5 �
y the Steta o( Celifornie. D
? I �ereby tertryy that I em properly Iicensetl as a controctor untlar SQ. FT. o
[he State of Callfornia Businass and Protessions Cotle, Divisicn 3, THE AMOUNTSHOWN VNDEP VALUATION IS FOR �
Chepter 9, antl that such licanus ere In full torca entl eftact, or I THE PUFiP06E OF ESTABLISHING A PERMIT PEE ONLV: Q
am e.empt from tha provisions ot tha Stat¢ ot California Business VALUATION
antl Professions Cotla, Division 3, Cheoter 9. �
od PERMIT FEE S ��O O j
SIO�aiura ot((('��� �/�'��� p fj�/�/— / m
Pormittee ��-\ h11QA�'.1�� 5/ �j PL4N CHECK 5 W� O O E
a`
A�thorizatl qgent . QQ LL
TOTAL FEE ^a / �
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
AP
For Applicant to Fill in Completely
RECEI\
BUILDING li,�.� ....T� n�+_ 1 /Z1. /
OWNER
MAIL
ADDRE:
CITV �
BRANCH
ADDRE55 �
ARCHITECT
OR ENGINEEF
ADDRESS
/1�£Ss� N��l//,I �s.
; . /`'A/i� / rr/1/�/i�H�t� /,�n �
� - �-
s f ��'�� �/� r�P�t,� t L
/ l✓`G.' S �P �/ � E/L�/�d 2�T
Sf �. i TEL.
NO.
�—�_
ADDRESS �.�.---�
TEL.
CITV -- NO. �—
STATE CITV
LIQ NO. �'[ '� �� 4� LIG NO.
51 Z E � NO. OF BLOGS.
OF LOT I NOW ON LOT
USE OF �/�Urn C
EXISTING BLDG. G
512E OF NO. OF q
NEWBLOG. ROOMS N STOFIE:
EXTERIORWALLA/._1 ROOF �iDi/NULF ,
,.
'��� 11-75rat�OO 602:a r=�-{==Z�a.63
CMSl�
ON FOR BUILDING PERMIT
ATf�E�RE�VED D�'E IS�SI�ED�
1( / I�
A.P.NO.I I�-332-3F�� PERMITNO. e
BUILDING I/ (� �/ „�/
ADORESS ry�'� £ / s/ � �.�/,P. /;///
VARDS APPROVEO
MAIN BUILOING
(FROM C/L STREET)
f 4
REAR 2' F�
DISTANCE BET.
MAIN BLDGS.
VAR. sk
�
USE OF NEW r'�YY
BUILDING M
VARDS APPROVED
DATE
/1PGROVED
2
I hereby acknowl¢tlpe thet I have raetl this application entl rtete �(�
that tha abO�e information is correct entl apree [o comply wlth
all laws regulatlnp builtlinB conatruction, antl I shell nOt amploy O
any parson in violatlon of the workmen's compensaHon laws of �
the State of Celifomla. m �
500 5a. FT. a �
1 hereby certity that I am D�oparly Iicensatl es a contrector untlar �
the Stete of Cellfornia Businezz entl Profeasions Code, Dlvlsicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl thet such licensas ara in full torce entl effect, ot I THE PURPO6E OF ESTABLISHING A PERMIT FEE ONLV: Q
em exempi from tha provisions of the State of California Businass VALUATION
antl Profassion e, Div �9on 3, �ter 9. H �
` � PERMIT FEE $
SIB�eture of / I//� / U m �j�
tl
Parmittee � V $ �aD� P�AN CHECK $ r� _ E RYl
/ ! o nl
LL
'�ithorizadl�pont TOTALFEE $
� . -