HomeMy WebLinkAbout721 17TH ST - Building Permits0
Applicant to till in all spaces xcev� those within heavr eortle� Ilnes ane sign ail avo�eo��ate tleclarations.
........ ..... __. .'_" _...
CITY OF COSTA MESA ,. CON TR --�• ��yy �
PrOlect Address �� Z� I � ` 5 1 ' . � " ' ' � ^
Applicant's Mailing Address ��"'� � - P 171� � TVPE OF CONSTRUCTION ' rvEW aDD aLTERATION'l
❑ CONVERSION ❑ DEMOLISH ❑ OT ER- • �
Owner'sName �"AS��'< <=��'�"""��one � � �<or// ,C�
� - - DESCRIPTION OF WORKNSE OF, BLDG. � '
Address � Z l, ` '' �'�Tra . G''r� �t . � �.✓/��' / i 5.�.�17 %3Gd� /�1
Arch/Eng. ��= License No. '�Z3 �� TVPE OF PEflM1T GRADING FOVN� TION ❑ STRUCTU
Addre55 ZL�� La ����- G� ❑�TENANT, � ELECT.RICAL ❑ PCVMBING ❑�MECHANICAL
Contractor'sNama-�h�t �e�• �iLc S�phone `"'-SZ"5�6 �7~ER � �2G s'��i^i/ILtrC' .
REPAIR
PROJECT DESCRIPTION SD.FT. - oCCUPANCv
Addreu (mailing) �-� � �-o� �� �"�_ _C�'�+-� '� %
q . - � CONSTRVCTION TVPE VALVATION $ � ��J
Cify LiC¢nSeNO. ���/� � � ZpNE ' GRADING CU. VDS. ACRES _
LIGENSED CONTRACTOR DECLARATION
I hereby affirm tbat I am licensetl untler provislons of Charter 9(cOmmenCin9 RFinarks: , � '�
. with section ]000) of Division 3 oi the Busin¢ss antl Profezslons COGe, antl
my license is in fu jar e nq ¢tfect.
' IJcense lass �� � LiC¢nse No. ��� ��
Date�. Si9nature '
� WOR�(ERS' COMPENSATION DEO� TIO �G�w ^-��'vr' � �
' I hereby affirm that 1 have a certifi e of mnsent to selLinsure or a certifiwte Bar Sink
ot Workers' Compensation Insurance, or a certl(ietl coOY ��ereof (Sectlon gackflow PreveM2r �
saoo. ub. c.�/ � qaz7/7ay3� .
"+olicy N�� E�6y rompany � Backflowlrrigation
Tetl coOY is he�eby �urnishetl.
�i�ecopyji Bletl with the tlty Builtlin � _ ' Bathtubs �
Date �� '�� Applicant � '
EXEMPTION FROM WORKERS' COMGENSA ON DEGLARATION' ' Clarifi¢rs�
'(This sectlon neetl nat be completetl if [he pe it Is for one huntlretl (E300) or. � Di5hwa5hCr �
rless). ' � � '
I certifY Iha[ in the OerforTance of thE k for which thls pe�m�t is ISSueQ I
shall noi �employ any person in any mannei so as to become subject to the Drinking FOunta� �
Workers' Compensallon l.awz,of Gali(ornia. � �
Date Signature - Floor Drains
'NOTICE: If, atier making this tleclaration, you shoultl become subjecl to tne
Workers' Compenzatlon provisions of [he Labor Coae, you must tor[hwitn . FloorSin •
Comply with- such provisiOns or this � permit shall be tleemetl �evoketl.
CONSTRUCTION IENDING AGENCV � GasSer ice ' ets �
I nereby affirm that [here is a cons[ructiomlentling�agency for the performance � -
of the work for � which [his Oermit is issuetl (Sectlon 3097 -Civ. CJ � In[er eptOrs
Lentler's Name
Le�tler's ACtlress Kit hen Sink ,�
OWNER BUILDER OECLARAT,ION ' � ' ' .
1 hereby affirm that I am exempt from the Contractoi'i License Law for the La toties .
.'following reason (Section 7031.5 Business and Professional Cotle: Any ciry or -
County which requlres a Permit to con5truct, all¢r, Improve, tlemoli5h o� �epair P- .
' any structure, prlor to Its issuance, also requires the applicant tor sucn parmit
to (ile a 5igne0 stat¢ment that he/She is licensetl Dursuant to the provl5iOn5 ot ROOf�DlBi05
the Contractor's License LaW (Chapter 9(commencing with Seclion.]000) Of
Division 3 ot:the Business antl Protessions Cotle) or that he/she is exempt � �
[heretrom antl the�ba5i5 foY the allegetl exemptlon. Any violat�on of Section
7031.5 by any appllcant for a Permit Subjects 4he appliGant to, a clvll - -
penalty ot not more than tive buntlretl tlollars (§500). ' �'
I, as owner of�the prop¢r(y oriny employee5 with�wages as thel� Sole �ReinSpaction F@e �
ipensation, will tlo tne work, antl the sGucturo is not intentletl or.ofterad �
. sale '(Section 7044, BUsinesz antl Professlonal Cotle: The Contractor's ' . � p
� License l.aw aoes nol aoa�v to an owner of a oroperly who builtls or improves '
' thereOn, antl who tlaes SUCh work nimself/barSelf or throu9h his or hm own BOiI¢� -
employees, oroviaetl that sUch Imorovements are not Intentletl or otieretl tor �
sdlG. H, howeveq the builtling or improvement Is Soltl within One year of com- . �
� pletlon, the owne� wlll hav¢ the burtlen o( proving h¢/She tlIC not bulltl or Im- DuCt - Und¢� i�ii0und�
�rova ror the purpose o1 sale). ' -
I, as owne� of the propQrty, am exUusivety contractin9 wi[h lic¢nietl con- DuCt-$t�uCtU�dl �
Vactor5 to construct Ihe O�Ojecl (Section 7044, Busine55 antl Profe55lon5 COOe: '
The Con[ractor's License �yw does not apply to an owner of p�operty who Duct - Ventilating
builtls or improves, thereon, antl who contracts for sucn orojects with a com _ '
tractor(s)�license pursuant [o tne Contractor's License Law). I am aware tnat Exhaust System ❑ Multiple ❑
proof of [heir WorkeYs Crympensation insurance shoultl be provitled to me.
, �] I am exempt untler Sectipn 8: & P. C. for tM1is reason Firepl/FaCt. BIL. ICBO #
�ate � Owner Heating System & Duc[ing �
�I nereby certiry tnat I have reaa tnis applicatlon antl state that the above ❑6100,OOOBTU �100.00OBTL'
' informatio -
antl'state I
sentalives
inspeGtlon
Signature ,
I� prlveR' Li
AF 0865-46,
Wh�te - Bulltling;-Canary
antl county ortllnances
ereby authorize repre-
ntlonetl properry tor
.[z._._ !<-� —is—
Pink
IReinspection Fee I $15
GOltlenroE - qssesso� �
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9 �
Solar Tank
Swimming Pool w.
0
Water Service � � -
Auto-Wash � . -
Laundry T
; t
� Issue Fee ; �
Hood or Typel ❑ '.,
Canopy � Type I I � '
Refrigeration SysSem ,
❑0.100,000 BTU ❑ 100,000 BT
System Repair/Alteration
Fire Dampers
Registers ,
FE
A.P. #
S Main Building:
E
7 Front
B Rear
A -
C Right .
gLeft
Ping. Ref. •,W �
Plannin9 Notes:
�
���� aino�:5
-
Accessory Building:
Zone
� .
Parking Req./Provided '
ELEC7RICAL
Automatic Washer - . Transformer ❑ 15-50 KW
Construction Pole Su6. � ❑ 50+ KW
Cooking Unit , Merer ❑up ro�100amps
Dishwasher - � , Meter ❑over100amps �
Dryers �Gas ❑Electric
Fan '
F.A.U.
FixWres
Device Boxes , .
Outlets
Switches ' �
Garbage Dispoul
Generator �0.5 KW OS-15 KW
15o4i Tl
�_
Sub Panel � -
Motors�0.1 HP�1h-8
Inc.Solar �9-15 HP �16-15+
Microwave . .
Pole Light � �
Sign •
; Standing Sections
Trasli Compactor
i '
$ 3 �
Reinspection Fae � $15 Iuue�Fee
FEES�
DEVELOPMENTSERVICESREUUIREMENTS:
Zoning Approved By_
. ' Buildin9 APProved 8v �r �
laue Fee $ 3
, Z
O
_ N
1
N
G
R
E
Q
M
T
S
FEES
$ 3
� SUMMARY OF FEES � G�7j
BUILDING PERMIT $ �� �r7J SMIP '$ � � .�{�—
PLAN CHECK , $ Z—�f � PERMIT �
PWMBING $ � � �SSUANCE $
PIAN CHECK 25% $ ' ENERGY P.C. �$
E�ECTRICAL -$ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAI $ , TOTALFEE �$ �, , /
PLAN CHECK 25% $
. . . . . . . . _ . _ .L .' _ _ ' '
CONSTRUCTION AND PLANNING • � ' POOL & -
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-Undrgind. �� � ' 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. ,
r10. Structural Floor System 67. APPROVAL TO DECK �
� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
' 12. Sewer Cap 63: Heate� & Vent-Final -
13. Roof Drains 64. Plumbing System - Final . �
14. Rough Plumbiag 65. Electrical-Fioal
15. Rough Electrical-Conduit 66. Solar System-Final
1�6. 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 -
79: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating. � � 71. Product Piping OGas ❑Oil . �
23: Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � - 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
. 26. T-Bar Ceiling (Structurel) & Monocoat � 75. Dry Chemical
27. Frame and Flashing , � ' 76. Dry $tandpipe �
28. Lathinq & 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-Tesf " • � '
36. Hood or Canopy
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 � � . .
45. Sound �Attenuation � � � � . '
46. Handicap Regulations ' � � � ' �
47. FINALSTRUCTURE&BUILDING � � � ' , � �
48. Special Requirements Completed � � �, • ' �
49. Electric Release to Edison � . � � . � '
50. Gas Release to Southern California Gas Co � � '
�
51. CERTIFICATE OF OCCUPANCY - � � - � �
No. Date . ' . _ -' . --- . �