HomeMy WebLinkAbout834 17TH ST - Building Permits' ' i
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iJfST 1'ITH STREET tfj4
129� ' u'3-60 Att. Cnt. $1�0OO.00
129� ' 8-31-61 Warehouse 51�0OO.00
INAISTRIAL N.C.'S �
14753 - 4-17-61 F1ec. :�C (out.;:F1x.)
15a� - 5-26-61 �e�. _tc (Out.uF1.�.)
15159 ^ 6-12-61 Elec. i6 0.(Wt.i: 51a.)
k39$8 � �.�! 7,g'yr install Propane T:.•nk $C00.00,
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CLA�VAL C0:
AP. xo.116-2
INSPECTIONS
OCCUPANCY
DATE
SUBCONTRACTOR
VALUE
10-10-60
OF WORK
Form 210-SM-11-59 5-B P f{QLD FOR SPECIAL REO[1(RF.MFNTR 129C�i
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WOoDETJ F'�IJCE AND 3�
FRoM CHA�n1 �WKFE�(c.E
CIiY OF COSi'A MESA �
PLANNING DEPT.
SUBIER TO BLDG. DEPT. REG.
v�?I. L, V`�`�[✓!•� DAT�L'..�I i�_Z.
' DIRECiORLOF�PLANt
c PERMITS ARF R� -"
:LECTRICAL, P� UM 3�U�r�F
RErRIGERATIO �N� 4��
WORk
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,ALL Ih'SP:C';Orv nE�� ��
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�3�}- INEST 18 T-� STRE�T
CoSTA MESA . ��. J2�2 i
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DRAWN BY- ED BR��A�nl
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bOFDET o CMAN ESST 9,F pN ,I�BTE tJ�!_'y
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y OF p���OSUANCE I, O PRIORT e��_T�M
J T� Bf �� AN� SP �R �RANTI L-�rs
l�1/MINY ( F THf/p F�R,'pR qryNS4S�F1C NaMIT pR APPROV
I��V/SlOA �OF��E AUTNONS OfATH/SOVA[ pF ANy�ONSTq� ql
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f� AS TH k,0 rH/S ��TY Tp ��D£, /y� P ��O(qT��N
THE RH OR �SE �'ti'HICNLL BE �A(l0 R CARMIT �RE.
lT AUT FXCEPC�N !1E
�fCIfICATI7,�uAN�f Of H�R/ZfS r � SO
SAID�ERI AFTERHA�L N0T P�fRMIT g�EO �S �AWf�(.
REV
DIN�P[9<rc A �REPU�R/ryG r�ENTUT�fBU/(pN��NSqNp
..,ury�F ,.atff/ry�-.�,�unS fCTION OFFICIAL
CIJY, rN�S CO�f pRR�ffA�,� 4TH RtUNRfVEN�NCS
B U� �� l-f \-� T NFR OR� NANC-N l
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Applicant to lill in all spaces excev� ihose within heavy EorOer Ilnes ane sign all aoD�ov��ate tleclarations.
Ci7Y oF COS7a pMESA CONSTRUC ION �RMIT
Prolect Address . n 3 � � - � 7/ �k � � 2 «�
Applicant'sMailingAddrness �70/ �^/ �iG.��%%/�i
Owner's Name `� Q — V�T � Phyone
Address ��� P.(n�c e,�Ti� �OJ/ �{ ���1 �'
Arth/Eng. �pG—� W 10 �Le � License No. -��Z / 03
Address P�• � �X-� /.3.S�ei3 � �'AN%�i rt% �ciZ'�/ti�+-J
Contractor�'y!�Vnam�'��r ��' �h� F�`�� P�6'� -0't�q
Address IMeiiiTig) � Ox —•3�•7.3 - � �N% �i l�,E .$'�/(I� 9ac�s
City License No. 6 0� y�,%-3
LICENSED CONTRACTOR DECLARATION
I he�eby aHi�m [bat 1 am licensetl untler provisions oi C�arter 9(commencing
with section ]000) of Dlvision 3 of the Business antl Vrofessions Cotle, antl
my iicense is In tuu forceGana e�ct. � a,,j, /O�
�icense Clasj __License
�ale �� i —�z $ignature
WORKERS' COMPENSATION DECLARA ION '
nereEy aHirm tnat 1 have a certiticate ot mnsent to self-insure or a tertiticate
f Wo�ker5' Compen5ation CIns/u��a)nce, or a cerNfletl copy tnereof (SOCtlon
PoIOIc�Y Ndo.xW/✓ O 00 p J/OTnimPanY �✓S% ��r/'r/ •`
f�'I,,.`rtifietl copy is hereby furnishetl.
L7 Cert ietl copy�f�tl with the city i1QRig Dlvisio� ,
�ate � � APPlican[
EXEMPTION F0.0M WORKERS' CO NSATI N DECLARAT N
(This seclion neetl not be complete0 i1 the permlt i5 to� One huntl� ($100) or
Iess).
I cerlHy thal In the pertormance of the work tor which this perm�t i5 issuetl, 1
shall no[ employ any person In any manner so as to become subject to the
Workers' Compenzatlon Laws ot Calitomia.
Date Si9nature
-NOTICE: If, atte� making thl5 tlecla�atlon, you Shoultl become subject to lhe
Workers' Compensation provisions ot the Labor Cotle, you must torthwith
comply with such provisions or this permit snall be deematl revokeC.
CONSTRUCTION LENDING AGENCV
I hereby afflrm that there is a construction lentling agenty tor th0 perfo�mance
of [he work far wMch this permit is -issuetl (Sec[ion 3097 Civ. C.)
tPntler's Name
Lenaer's Atltlress
OWNER'BVILDER DECLARATION
I hereby�afflrm that I am exempt trom the Contractor's License Law for the
following redson (Section ]031.5 Buslness antl P�ote55iOnal Cotle: Any city o�
counly which �equi�es a pe�mlt to construct, alte�, improve, tlemolish'o� �epair
any Structur¢, p�ior IO i[5 is5uance, also �equire5 the applicant for such pe�mi[
to tile a si9netl Statament that he/she I5 licensetl pur5uant to the p�ovislOns ot
me Contractor�s License Law (Chapter 9(commencing wlth SecHon 7000) of
� Division 3 of the Bu5ine55 antl Professlons Cotle) or that he/she is exempt
here(rom antl tbe basls fo� the allegetl exemption. Any violation Of $ectlon
/031.5 by any applicant for a permit subjects the applicant to a civil
�nalty of not more than five hunOretl tlollars (5500).
LJ I, as owner of the property or my employees with wages as thelr iole
compensation, will tlo the work, antl the structure is not intentletl or offeretl
for sale (Settion 7044, Business antl Professional Cotle: T�e Contrac[or'z
License Law aoes not apo�Y to an owner oi a property who builtlz or Imorovez
thereon, anC who aoes such work hlmself/herself or throu9h his or her own
employees, provitleG that such improvements are not intentled or otieretl for
sdle. If, �owever, lhe bulltling or improvement is soltl wit�in one year ol com-
pletlon, the own¢r wlll have Ihe bu�tlen of proving he/Sh¢ Ei0 not builtl Or Im-
P/Ova 10f Ibe purpo5a Of sale).
❑ I, as owner ot tne property, am exUusively contracting with IicenseC con-
tracto�s to const�uct lhe project (Section 7044, Business antl Pro�esslons COtle:
The Contractor's License law does not apply to an owner o/ property who
builtls or improvet thereon, antl wno conVacts tor such orojects witn a mn-
Vactor�s) licanse pursuant to the Contractor's License Law). 1 am awara that
proOf of thei� WorkEr'S Comp¢nsation insurance shoultl be provid¢tl [o me.
❑ I am exempt untler Section B. & P. C. lor this reason
Date Owner
I hereby certiry, [ha[ I have reatl this appl
information is correcL I a9ree to compty wi
antl state laws relating to builtling construci
sentalives Oi this �SD ente� upOn the
519nature
Drivers' L
abOve
E 3 0 4 4- d. ,
TYPE OFCONSTflUCTION NEW. ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q.p. �, .
DESCRIPTION OF WORK/USE�,1 F BI.DG.�
CO✓� �QLtiO/� � S MainBuildin9:
E
TVPE OF PERMIT GRFlDING FOurvDnT�ON ❑ STRUCTUHAL 'T Fmnt
❑ TENANT �ELECTRICAL ❑ PWMBING ❑ MECHANICAL A Reaf
❑ OTHER .
PROJECT DESCRIPTION 5q. FT. � oCCUPArvcv C Right
K �Left
CONSTRUCTION TVPE VALUATION 3 $
20NE GRADING CV. VDS. ACRES P�pg, Ref. #
Remarks: y. ,�% `��%� l�q�OJ�JI/j� _ Planning NOtes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink �
Fee � $15
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System � Multiple
Firepl/FacL Blt. ICBO #
Heating System & ting
❑0.100,000 B ❑ 100,000
pefnspection Fee � $15
CMF 0865-46, rev. 30/84 White - BWltling; Canary - Applicant; Plnk - Accounting; Goldenrotl - Assessor
ServiceSink '
Sewer Cap `
Sewer Connection
Solar Collector5
Solar Piping
Solar Tank
Swimmi Pool w/Spa
Wa[er CIOSEL
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Typell�l
iefrige n System
�t00,0008TU ❑100,000
System Repair/AI[eration
Fire Dampers
Registers
Issue Fee
FEES
6i i.i. 9i2eie�
Zone
Actessory Buildin9:
Parking Req./Provided
ELECTRICAL ,
Au[omatit Washer ' Transformer ❑ 15�50 KW
Conslruction Pole Sub. � 50 + KW
Cooking Unit Meter ❑up to 100 amps�
Dishwasher ' Meter over 100amps -
Dryers ❑Gas ❑Electric Sub Panel
Fan � Motors�0.lHP�tYh-8
F�%��U. InaSolar 09�15�HP, �16�1
Fixtures Microwave •
Device Boxes • Pole Light
Outlets Range �
Switches ' ' Sign '
Garbage Disposal Standing Sections
Generator �0.5 KW 05-75 KW Trash Compactoc ,
$� Reinspection fee $15 laue Fee
FEES
DEVELOPMENTSERVICESREQUIREMENTS�
� Zoning Approvad By -
Building Approved By
Apaliwtion Issued Bv 7��
$ 3
5+
3Q,50 TL
FEES
$ 3
Z
O
N
I
N
G
R
E
Q
M
T
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $ �
PLAN CHECK $ PERMIT .
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ � . ENERGV P.C. $
ELECTRICAL $ ,i0. SO GRADING $
PLANCHECK 50% $ - MICROFILM $
MECHANICAI $ TOTALFEE $ __..ia-.SD
PLAN CHECK 25% $
� CONSTRUCTION AND f'CANNING � ' '��', � " POOL & SPA -
� Date Inspector Date Inspector
APPROVALS Permit # � AVPROVALS Permit #
1..' Temporary Electrical�Seivice or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd.� � 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. �'. 54. Forms �
4. Electrical Conduit-Uridrg 55. Electrical Bonding
5. Steel ReinforcemenY ( `� 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPfiOVAL TO COVER-GUNITE.
7. Fodii�gs (�;, � �-i 58. Electrical Conduit-Undrgrnd.
8. Foyndation � i 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ;,�. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural FloorSystem� � 61. APPROVALTO.DECK
11. Property�Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Dreins 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Elecvica6Conduit � 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 $YSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE,DEPT. REQUIREMENT
r
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts,in Structure 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil1 �
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. Frame and Flash�ing . 76. Dry S[andpipe ' �' .
� %.
28. lathing & Siding ' , 77. FIXED SYSTEM FINAL � '
29. Insulation' � 78.�. FIRE PREV. FINAL ��7 � �
30. Drywalf Nailing '� HEALTH DEPT. FjEQUIREMENT �° �
31. Plaster Brown Coat 79. FINAL INSPECTION �� . �
.y
32. Electriral Power Meter-Final 80. FOOD CERTIFICAT ISSUED
33.FinalElectric . 1,� Notes: �,�
34. Final Heating & Air Conditioning .� ,, .
�1
35. Final Gas Pipe-Test
36� Hood or Canopy � i -•
3�. Final Factory Fireplace � ,� � '
38. Final Plumbing : `'j '� ' ' � � � �
- 1 �
39.' Water Service-Final � • � ^ i �, ' • � . ' ,- : .
. � - i, '
40. Gas Service-Final 'r � �'.�- , , . �
41. Solar pomestic-Final ' � ` � �.
i ;j • �
42. Backflow Preventer � � ' � �� � - � ' '. � ? � . '
I 43. Backflow Irrigation � ) ? `: � �� ,� ' -, '
44. Landscape Irrigation System �' f_ ,. � � , t • ' -- • .
: �,
45. Sound Attenuation ' ' ' � _ � � - •
� Y
46. I�andicap Regulations ' �' - � ' '
47. FINAL STRUCTURE & BUILDING ,I i�' r' _� %•'
� ,
48%Special Requirements Completed ; (. ' '
49. Electric Release to Edison � .„- - ;
50. Gas Release to Southern California Gas Co �'�' ,, "
51. CERTIFICATE OF OCCUPANCY _
� ,.
No. Date . . `•
� .�
� t. ^.
.
' �+ 1_29�2
;�-_�_
COSTA MESA BUILDING-SAFETY DEPARTMENT
„ r. o. eox an C08TA M68A. CA�IFORNIA
For Applieanf fo Fill In Compleiely
TYPE OR PRINT
COSTA MESh GALIFORNIA
NO. OP lLOO/.
� 86ie�CK LINt FROM
DESCRIPTION OF WORK
WALL /' _� .. I ROOP
t XtlilGY ACKNOWIdD06 TXAT 1 HAVB NtAD TF18 APPLlGT10N
AND BTATB TXAT TH8 AlOVQ IB CONRBCT ANO AOR88 TO COM�
PLY WITX ALL WTY O!lDINANCHB AND 9TATi U1W9 P8011LATN0
IGUIlDINO CONlTRUGTION. .
81GNATURE OP .• _
m� '� {.tJ t
AGEM
� �• ,d,,,«�.. w✓,o a = c o
FEE RECEIVED
m��. ����o �
FINANCE DEPT.
APPI�Q�T(pDN�6mTA f(A�6AT
BUILDING
For Office Use Only
RECEIPT NO. �CflMIT
COSTA MESA. CALIFORNIA
RIRE
/I1 � / I PUNB � I OUILDINOHW�/1/
r u
L80AL � LO� � 1�D I�I I
OHBCRIPTION n - i ��
. � .._ / / � . � 1 � � � �
(CHNTHR LIN6 BT.)
L. SIDE l/ •FT. /(� /// � �
'
REAR / � �I ,O OFT. � �
APPROVED l/i Y .� I _
TH6 AMOUNT BXOWN IINDBR VALUATION 18 FOR TXH
PUIiP086 OP HBTAELIBHINO ♦ PBRMIT F¢8 ONLY.
VALUA710N � �n
ffrrjj O � PERMIT FEE S G/ l_
S ` //� � PLAN CHECK $ •_}'� '�'
/n t =
�
� 12�66
COSTA MESA BUILDING-SAFETY DEPARTMENT
� P. O. BOX 917 COSTA M88A. CALIPORNIA
Fo� Applleanf fo Fill In Compleiely
TYPE OR PR/INT ,-, �
BUILCING . �`� H L7/ / // �� /�
ADORE88 (
I CpSTA ME6h CALIFORNIA '
�
TEL.
OP lLDOB.
U8H OF
EXISTING BLD
6HT6ALK LIN[ FNOM
aNiHR OI BTReHT REAR YARf
BIDE YARD I LBPY I RIGNT
DESCRIPTION OF WORK
NE`
EXTERIOR WALL ROOF
COVERING GOVERII
U6E OP BUILDING AND WORK TO BE
FEE, RECEIUED
��� o--(��=�-Q�,
FINANCE DE?T.
APPLICATI�tJ FbkTPERMsT
BUILDING
For Office Use Only
COSTA MESA. CALIFORNIA
i
FIRE
ZONE TYPE � GROUP,
BYPROVED �� OATE/O d � D
v
� NING
ZON¢ I NO. OF - I I18E OP N
�LANB sU1LD�N
�eo„� �-oTS Si o 7-+— t a�
oeocrtirr�an
A. P. NO. /I 4' — �_� —_�
VAflOS EVES
APPROVED ALLOWED
(CBNi[H LIN6 BT.1 ,����_�y�y7—
FRONT �♦�FL � —/ " ' IN.
R.61DE i1+v !Ys'.b� �FT WrtYfY`! IN.
L. 81DE / O� FT. Q�L KJ I/ J�
REAR i -) FT, ��L(LLV11a�fA-L� IN.p�''
APPROVED �1�1� D, � DA7E ) d /In /•
6Y 6 r � -r�
/I � (Y�ii %
/"
H .n 1'C1r C'�T"'•r1. Rr lTTRFAAFhITC
..v� .i'1 / .� .�
nexxer w TH8 AMOUNT BXOWN UND¢P V�LUATION 19 FOq THE
M!D BTATB THAT TMH ABOVB 19'CARRHCT ANO AORBH TO COM-
PUPP098 OP H9TABLIBHING A PERMIT FHE ONLY.
PLY WITH ALL EITY Q�INANCHB IWD HTATB LAWB q[OUlATNO
Bu1LDINa coHeTrtVR1oN. VALUATION
BIGNATURB OR /O�i' � PERMIT FEE $ ��•
PERMITTB (/
, ��, S � PLAN CHECK $
AUTHORIZED AGEN � ��
TOTAL FEH
/
. -� �3956
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING � ��/Fr � �
ADDRESS VV d
OWNER N�Iy O T T DIV C
ADDRESS S�� J D�
CITV r�STA M�'�i'i4 N�L(�7'YO i
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BFANCM
ADORESS
ARCHITECT
OR ENGINEER
ADDRESS
CONTRACTOR PL
ADDRESS
CITV�(,%�%�
STATE /� �� O
IIC. NO. e�
SIZE
OF LOT
USE OF
TEL.
NO.
��`�/� �G
T
L f} �/E
NOLy� �
CITV
IIC. NO.
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
elec[ric, plumbing and heating work.
UILDING AND WORK TO BE PERFORMED
r�
.,�r, �-„����=on sss �� �:._. _ ��.�c.
FOR STRUCI'URAL PERMIT
A.P. NO. I I lY � l I`— Z
BUILDING
ADORESS �
TRA TI
W A P
OWNER
S I� �IM
FIRE
20NE PE
APPROVED
BV
20NE NO.OF�J l
PLANS L fi
VARDSAPPROVED
DISTANCE
MAIN BLD
VAR. �
C.U.P. �
`.� ��'
PEFMIT NO.
DATE � �
E OF NEW
ILDING
VARDSAPPROVED
ACESSOFV BUILDING
F
�
FT �'
1 �
FT. O
VFT.✓
T. MAIN &
DATE
APPROVED
�%�� � –
I heraby acknowlatlpa that I heve �aetl this appllcetion entl atata
thet tha ebove Information i� correct entl eprae to comply with
ell law� repuletinp buildlnB consttuction, end 1 chell nat employ
any parson In vlalation of the workmen'e compansatlan lews of
me state of colifornle.
I hereby cartify thet 1 em properly Iicansatl as a contractor untler SQ. FT.
Me Stete of Celifornie Buflneu antl Profeulons Cotla, Dlvislon 3, - THE AMOUNT SHOWN UNDER VALU
C�epter 9, entl that sueh Ileansas ara (n full force anC Nfect, or I THE PURPO6E OF ESTABLISHING A PERI
em exampt }rom the vrovialons of the Stete of Celifornia Buainass VALUATION � PERMIT FEE E
end Profasalone CoCa, s 3, Chapter —
PLAN CHECK E
Sipneture of � � � �
Parmlrtee /�•��+ • � S TAX E
Authorized A9e�t TOTAL PAID E
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