HomeMy WebLinkAbout512 BERNARD ST - Building PermitsCosta 1VYesa Building Department �9 APPd.IpCATYON FOR PERMIT
_-- �' 111 EAST 20th STREET p_U-I_L_�.��.N-�G-------9-
'�" COSTA MESA, CALIFORNIA � --"""
FOIi� FIPPLICANa TO FILL IN ` ! �OR OFFICE_ USE ONLY '
� Receipt No. Permit:No. �
Building t, /� ' /� � j = h � �(71 �
Addrcss �J /� — �f:J � /e �� � S7 � / J � -
� ece' d,by. te d. Date Issued ;
Costa Mesa, California � ., � }` �� r
Nearest �, 27� J J —ZS =s �
CroasSt � Building ' � j
� Address si � L� � �
owner '.�'� ' : (iOSt3,'iVI0S8�� California i
Mail /� ���,,�� //// ' '
Address �� y� L(J. ��'_="� r1 � Nea�est � 1
Tel. Cross St. • �
City��� _ No. Zone ; I No. of I Type I Group ;
ArchiteCtor lic. � Plans � :
Englneer No. Approved ; � '
— b ' Date ' �
. Pddress ' ,CLORRECTIONS (
t
ity �fo. � � �
.atractor � •�i !
��
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Address � / . %>'! � ' �'� � � � �
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Descrption � No. I Block I Tra�t � �� �� . �
(AttachMetesandeoundsy�R/����30/—� ' � �� � � I
N ] 1�\//
q q ~ ie%'� 1 \/
�/ X ii� D� I Now oo Lot� nC�► - r •
Size of Lotv - ---' � - �' ' - —
Use oi {� ' No. ot No. af ' /� ��'8 T
Existing 61dg. fy,I,.�,t� � I Families I Roo y /,Cr^ /� �j
�Setback Line from L_ Rwr Yard ♦ "" � 1 ��1.�f1 n
Center oi Street .� Q Side Vard . . `� j
DESCRIPTION OF WORH �
New �� I Alteration I I Add�tion I �
Repair I I Moving I I Demolish I
. Building No. of /
_Size � J � �� Rooms Stories
�rior Wall }- Rooi /p �
erin9 S/ /l �'� Q I Covering C. L�- APP�`7��'
Useoi New Q Foundation Loeation Inspeotor Date
Building /lJ�-W�/���LG .� Forms,MateNals,
Under-Pinning
Frame: Ffre Stopa,
Bracing, Bolts
ere y ac now ge that I ave read this Application
____ __
and state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and 5tate Iaws regulating
buflding construction. Plaster,lnt.
Signature of
Permittee '�01"A Q� �
Plaster, Ext.
Authorized Agt. i'Y)� Masonry Rein}orced
Valwation .p a Permit Fee $ d Bond Beam
\ Plan Check $ '� O
$ � O O Total F�NAL �Gi6 �''�
Fee $ I
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Show Iocation and distances from
' property line and between buildinga. � �
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OWNER GEHLICFI� I'�2'8CI � DATE S-2S�S�
J08ADDRESS 5].2 $gI'flgT(� SL• BUILDINGPERMITNO. 262
GENERALCONTRACTOR Ppm0218 Blli1dBT8 VAWE $ 6��00�00
LOT �� ���301�� BLOCK TRACT �g1d821C@
GROUP I TVPE v ZONE R� FIRE DISTRICT �G69
INSPECTIONB DATE SUBCONTRACTOR I PERMITSISSUED
DATE I NUM6ER
Foundation Forma and Grade to
Wi
Heatl
Plumbina. Final Gas Test
C,
Form 'tl0 0.}i IM1f 1'468
`,:
_ _ _ AVP�icant to flll in all spatts except,those within heavy bortler Ilnas anO sign ali aoD/oDrlate Eeclaratlons.,
' arv UF COSTA MESa CONSTRUCTION PERMITL1 � ""'T ��� T��rT ��� ,� �T ���
Project Address � � �r ��
Applicant's Mailing 1A/d�dress ' � • � ' �/
OwneYs Name � -nE+ yASli%I L�phon ��y
Addreu a��CS �_ /�" 5% • G CeC - �33 .
Arch/Eng. License No.
Address `/ ,
Contractor'sName����GAN �����'�%n�e/��
Address (mailing) -6� ��✓��r�� ' • �.�r •
City License No. 3� 373
LICENSED CONTRACTOR DECLARATION .
I M1ereby af(irm lhal 1 am Ilcensetl untle� provl510n5 0( Chdrt¢r 9(commencing
with section 7000) of Divlsion 3 of tha Business antl Protesslons Cotle, antl
my Ilcense is in full forc� antl effect. � �
�icense �i}�z Ci�o`Z / _, i �cen wo. / 3
Date�d�°'"" Signature � �
WORKEHS' COMPENSATION DECLARATION
'`ereby aftirm that I have a certificato of consent lo seH�insure or a certifi te
Workers' Cjom��pe�nsation Insuranc¢, or a cerH�,fi�e�tl� m--p�y, _the4reof (Sectlon q
� J0� Lab.S�/tK.:>4.� /SJ �'�^�� il�dw•A
Policy No. � Company
�f� rti(ietl copy is hereby /urnishetl.
\y!'Certitietl copY �s filetl with the city Buil ' 9 �sio G�
Date APplicant
`\ EXEMMION�RKERS' COMPENSATION DECLARATION
` (This section ne¢C not �e complete0 I7 tha permll Is fo� one huntl�ed (E300) or
less).
I certify that in tne performance of tne work Por which this perm�t Is Issuetl, 1
shall not employ any OelSon 711 any mdnner So a5 to b¢Coma Subject l0 the
workers' Compensation Laws of GalHomia.
Date 519naWre
NOTICE: If, atter making tnis tleclatation, you ihoultl become subject to lne
Workers' Compensation provisions o( the Labor Cotle, you must lorthwith
comply with SUCh proN5ion5 or [bis perml[ ihall be tlGemetl �evoketl.
CONSTRUCTION LENDING AGENCV
I hereby a(firm Ihat there is a<onstructlon lenaln9 agency tor the performance
o( the work far whicn Inis permlt is Issuetl (SeCtion. 309] CIv. C.)
Lender's Name
Lentler's aaaress `' -
OWNER BUILDER �ECLARATION � �
1 nerebv attirm that Lam exemol irom the Contractor's License Law tor the
sucn
ro me a si9nea statement cna� ne/snc is ricensea pursuanc m ma proviswru o�
the Contractor'S Licens¢ Law (Gnapter 9(commencing with 5¢Ction 7000) o(
'�ivislon 3 of the Business antl Prote55ions Cotle) or lhal he/she is exempt
�.refrom antl [he basis for the alle9e0 exemptlon. Any violatlon of Section
31.5 � by any applicant for a permit sublac(s the ap0�iwnt to a civil
Fe-,nalty of not more than five nuntlretl dollars (5500). . .
LJ I, as owner ot the property or my employees with wages as thelr sole
compensation, will Oo the work, antl the structure Iz not intentletl or ofteretl
for Sal¢ ($ection J044, Buslness antl PrOfGsslonal Cotle: The Cont�acto�'S
License Law tloes not apply to an owner ot a properry wno builtlz or Improves
thereon, antl wno tloe5 such wo�k him5elf/herself o� th�ough his o� he� own
employees, p�oviaetl that such improvements aru not Intentled or offeretl fo�
sale. If, howeveq the bulltlinglor improvemen[ Is soltl within one year of com-
pletion, the owner will hrve the burtlnn of provin9 he/she tlitl not bulltl or Im-
�rove tor the purpose of sale).
1, as'owner of the prOperty, am excluiiv¢ly cont�actlng wi[h IlcenSetl Con-
tractors to coustruc[ the project (Section 7044, BuSiness antl Professions Cotle:
Tite Contractor's License Law doos not apply lo an owner of property who
� builtls or improves Shereon, antl who contracts tor such Drojects with a con-
tractor(5I license pursuant to tlte Contractor'S Licanse Law). I am awar¢ that
D�oof of [heit Wo�ke�'S COmpenSdtlon Insu�ance Shoultl be provltletl to me.
❑ I am exempt unaer $ection , B. & P. C. for tNs reason
Date - Owner
I nereby certi/y that'1 have reatl this apDlitation antl state that the above
informatlon is correct. I agree to <omply wiih all tity antl county ortlinances
ana state laws relating.to builtling-conztrucilon, antl hereby authorixe repre-
sencatives ot this city to enter upo the above- ntlonetl property for
inspectlan purpas . r n'
Signature Dai� �6
Driv¢rs' �iGense or15 �f �
,�3 0 8�3 t� . . _ _
TYPE OF.CONSTRUCTIOf�I' NEW ADD ALTERATION REPAIR
9O❑ SONVERSION � DEMOLISH ❑ OTH R q.p, �S
D�� IP 1 OFyJO��iK/IJS�/E,OF LDG.'
�7El�z S Main Building:
E
TVPE��OFP RMIT GRA ING ❑ FOUNDATION STRUCTURAL T FrOnt
O TENANT ❑ ELECTRICAL ❑ PWMBING O MECHANICAL B Rear �
� � OTHER � . � . . A
i✓-'• 3 C Right .
PROJECT DESCRIPTION �Sa�. FT�.y. � oCCUPnNCv K
.CON�STRVCTIONTVP�TL/-- VALUATION$ I��rfG•�� g Lett �
ZONE � GRADING CU. VDS. ACRE� ping, Ref. #
�1
Remarks: . Planning Notes:
3ar Sink
3ackfltiw Preventer
3�ackftow Irrigation
�
3athtubs � -
Cla[ifiers " '
Dishwasher-
Drinking Fountains
Floor Drains :
FloOr Sinks
Gas Service
Intercepmrs
Kitchen Sink
Lavatories
P—Trap
Roof Drains ' �
ReinspeMion Fee
Showers
JService Sink '
Sewer Cap
Sewer Connection -
Solar Collectors
Solar Piping �
Solar Tank .
Swimmin9 Pool w/Spa
Urinal
Outlets Water Closet
Water Heater �
- Water Service �
. Auto�Wash
laundry Trays
$15
Boiler
Duct - Under Ground
DUCt-$tfuctuf8l '
Duct-Ventilating -
ExhaustSystem_❑ -Multiple❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai o0,60o eTu O i oo,000 eT
qeinspection Fee I $15
CMF OB65-46, rev. 10/84 White - Builtling; Canary - Applican[; Pink - Accounting: Goltlenrotl - Assessor
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Reirigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alt¢retion '
Fire Dampers
Registers •
Issue Fae
Q _':.
�_
,r:�.�,, f�
� ■:��
Automatic Washer
Construction Pole Sub..
Cookin9 Unit
Dishwa5her
Fan
F.A.U.
. W � ' -
��... Zone _. .
Perking Req.IProvided
ELECTRICAL �
� Transformer ❑ 15=50 KW
❑ 50 + KW
Device Boxes .
Oullef5 '
Switches ' ,
Gar6age Disposal ,.,
Generator �0-5 KW �5-15 KW
Meter LJup to 100 amps
Meter �over t00amps
Sub Panel ' �
Motors O47 HP O1 h- 8
Inc. Solar �9-15 HP 016�15+
Microwave �
Pole Li9ht � �
Range
Sign
Standing Sections '
Trash Compactor � �
$ g
Rainspaction Fee $15. luue
FEES .
�DEVELOPMENT SERVICES REQUIREMENTS:
ZoninB Approved By
Building Approved By �/���� �.� �L��� J/����
Application luuad By �"v ✓� ��/ '
$ 3
. � SUMMARV OF
BUILDING PERMIT $, % 7•�
_. PLAN CHECK $ �
PLUMBING $ �
PLAN CHECI( 25% $
ELECTRICAL S
PLAN'CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
SMIP.
PERMIT
ISSUANCE
ENERGY P.C.
GRADING
MICROFILM
-TOTAL FEE
z
O
N
I
N
G
R
E
Q
M
T
S
FEES
$ 3
CONSTRUCTION AND PLANNING � POOL & SPA, ._ _ , - _ ., �
APPROVALS Permit # Date Inspector, qppROVALS Permit # Date` Inspector
t. 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 Gr'rid.� 57. APPROVALTO COVER-GUNITE '., �
7. Footings , ' � , 58. Electrical Conduit-Undrgmd. ; . �
8.Foundation � 59.-Gas�Pipe,OUndrgrnd.,Test . �
9. Water Pipe-Undrgrnd. ' . . . 60. Backwash�, Lines, P-Trap, O Undrgmd. '
70. Structural Floor System 61. APPROVAL�TO DECK �' � ,
11. Property Sewer Line�&;House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap ��,.��a-7 L� 63. Heater & Vent-Final
13. Roof Drains. . 64. �Plumbing System - Final � �
14.� Rough Plumbing . ' � 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 Ba� Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. 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 O Gas ❑ Oil .. • '
23. Gas Pipe-Rough;& Test ' '� � -' � ' � 72. Underground Flush � _ ,
24. Roof Framing J�. Undergrnd.StorageTank OGas -❑Oil �� �
�
25. Roof Sheathing . 7.4. Overhead Hydro � � ��-
�
26. T-Bar Ceiling (Structural) & Monocoat . 75. Dry Chemical ' � - .
27�. Frame and Flashing � - - "JS. 'Dry'Standpipe � -
28. Lathing & Siding � • � � 7�7. " FIXED SYSTEM FINAL . �
29. Insulation ' � 7S. 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 Faaory Fireplace � • ' � , . ' . -
38. Final Plumbing . _ • '
39. Water Service-Final � � ' � ' ',, ' �
�, ,
40. Gas Service-Final - �
41. Solar pomestic-Final - ' � 9 � . � -
' 42. Backflow Preventer � - ' ' .
� 43. Backflow Irrigation • . . � { -
_
44. Landscape Irrigation System � , . ' � . ' � n� �
45. Sound Attenuation � � ' ^ � � "
�)
46. Handicap Regulations . � - _ ' , •
47. FINALSTRUCTURE&BUILDING �(.y..�7 L�D � " �• � � � �' '�
,
�48. Special Requirements Completed . ' � ' �
49. Electric Release to Edison i , ' . " ' � . -; '.
50. Gas Release to Southern California Gas Co � � .' - '
51. CERTIFICATE OF OCCUPANCY � . '
No. Date • � ` � . . " �.. � -