HomeMy WebLinkAbout2531 BACK BAY LOOP - Building Permits' /
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
/ PERMIT NO. TRACT NO. LOT NO. UN NO. OB69 4/09/85 Bo00 TU
CITY OF COSTA MESA CONST UCZION . RMIT t R31 1 •
- Jj -7Z
Project Address Z..�.�I q ' I ' _I r V-� .
f J�O , tQ-f • 4- e TYPE OF CONSTRUCTION KNEW U ADD U ALTERATION U REPAIR
Applicant's Mailing Address r ❑ CONVERSION ❑ DEMOLISH El OTHER A:P:3W Zone
Owner's Name e ?+ •S. r�_ 7••7F A e>' �.Tn�'pA'Q d P•OnedS 2-2 DESCRIPTION OF WORK/USE OF BLDG.
Address S - uL • S Main Building: Accessory-Building:
Arch/Eng. - License No. - TYPE OF PERMIT -LI GRADING U FOUNDATION 0 STRUCTURAL E Front - O
Address 0 TENANT ❑ ELECTRICAL 0 PLUMBING tMECHANICAL . B Rear N
/ a (.J._ '-' l /� . "i/I ❑ OTHER 5'. s A - I
Contractor's Nam v.. Phone��l—`(J' /[.6 -L C Right • N
Address(mailing)��J LYMOW —Y�� �.(�f. PROJECT DESCRIPTION. SO. FT. OCCUPANCY' K f,
�� CON STRUCTION TYPE VALUATION s Left R
City License No. O 1- • ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm than am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
•
with section 7000) of Division 3 of the Bpsiness and Profession Co•e, and I ,
my license is in f force and effect. 3-�- Z • • - T
Ucense Cldss/.�_l,(1 c'p5' ern�•� S
Date -5-1 L X05• Signature r��� "—s PLUMBING ' FEES
WORKERS'COMPENSATION DECLARATION, ` ! ' Bar Sink Showers ' •
I hereby affirm that I have a certificate of consent to selftinsure or a certificate • - ELECTRICAL FEES
Workers' Compensation Insurance, or a certified'copy fher of (Section - - Backflow Preventer - Service Sink - • - - -- -- -- -
00, Lab. C.) (// I I ^ r� Automatic Washes . - Transformer 0 15-50 KW
rolicy No. -,3 7 `�F sc Company ' yy - Backflow Irrigation - 0 50+KW
9 Sewer Cap Construction •Pole Sub.
fl Certified copy is hereby furnished.
`Ia.Certjjie Zc9 py'S fled with the city Buil Ing IvISJ OA Bathtubs •
Sewer Connection Cooking Unit Meter ❑up to 100 ampi
Date S Applicant •�,(1�Y
EXEMPTION FROM WORKERS'COMP NSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps _
(This section need not be completed'il the permits for one hundred (5100) or — -- - - - •
less). Dishwasher i I Solar Piping , Dryers ❑Gas ❑Electric • Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person In any manner so as to become subject to the Drinking Fountains - Solar Tank ' Fan ' Motors❑0.1 HP 0i'r5-8 '
Workers' CompensationLaws of California.
. Date Signature i Floor Drains • Swimming Pool w/Spa F.A.U. • Inc.Solar❑9-15 HP 016.15+
'NOTICE: If,after making this declaration, you should.become subject to the •
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks. .Urinal ' - - Fixtures- ' - Microwave
comply 'with such provisions or this permit shall be deemed revoked. .
CONSTRUCTION LENDING AGENCY - Gas Service .Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance . _ ,Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - - Outlets Range '
Lender's Name. - -
'
Lender's Address r 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 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections
•
county which requires a permlt'to construct,alter,improve,demolish or repair 1 P—Trap - Laundry Trays • Generator ❑0-5 KW❑5-15 KW Trash Compactor
any structure, prior to Its Issuance, also requires the applicant for such permit p
;to file a signed statement that he/she is licensed pursuant to the provisions ofRoof. 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 , I -
''erefrom and the basis for the alleged exemption. Any violation.of Section ' . . r
31.5 by any applicant for a permit subjects the applicant to a. civil - •
dally of not more than five hundred dollars(S500).
Li I,'as.owner of the, property or my employees with wages as their sole Reinspection.Fee " I $15 Issue Fee . - $ 3 '
compensation, will do the work,and the structure Is not Intended or offered - - Reinspection Fee f $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The' Contractor's ' MECHANICAL , FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or tnrough his or her own • Hood or Type ` DEVELOPMENT SERVICES REQUIREMENTS:
Boiler employees, provided that Such improvements are not intended or offered for I 0 -
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 . Zoning Approved By Date •
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale). -
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By
Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU
builds or Improves thereon,and who contracts for-such projects with a con- . - - SUMM V OF FEES
tractor(s) license pursuant to the Contractor's License Law). am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration - BUILDING PERMIT ' $ SMIP • $
proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ - PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG+ Fire Dampers PLUMBING $ ISSUANCE $
Date - owner �,�He/yting System& Ducting Registers I • PLAN CHECK 25% $ ENERGY P.C. 1 $
I hereby certify that I have read this application and state that .the above100,000 BTU ❑q 00,000BTL - GRADING $
Information is correct. I agree to comply with all city and county ordinances • / 00 ELECTRICAL $
sentataeS laws relating to building construction,and hereby authorize repre-yfor ! MICROFILM $
sentatives of this city to ante j yPon the above-mentioned property for - l_is6`-K.-d/ ( (� PLAN CHECK 50% '$
Inspection puns)! DJ r7 / _ 3_���s ` Po MECHANICAL $ :Oo • TOTAL FEE $ •�� •
' Signature Y .Jl�/ l.".-� Date ,
Drivers' License or SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 1
CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 9, Ob
CONSTRUCTION AND PLANNING . POOL .PA
APPROVALS Permit# Date Inspector •APPROVALS Permit# - Date Inspector
-
1.-Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ti 53. Steel Reinforcement
.3. Electrical Conduit Utility-Undrgrnd. �: 54. Forms
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding -
5. Steel Reinforcements, 56. Rough Plumbing & Pressure Test ,
Electrical UFER Grnd. - • 57. APPROVAL TO COVE R-GUNITE
• 7.. Footings •• - - 58. Electrical Conduit-Undrgrnd. -
.8. Foundation • . 59. Gas Pipe, 0 Undrgrnd., Test
9: Wates Pipe-Undrgrnd. - - 60. Backwash Lines,P-Trap, 0 Undrgrnd.
'107.S[ructural 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 Plumbing , 65. Electrical-Final '
15. Rough Electrical-Conduit 66. Solar System-Final
"16. Rough Electric Wiring 67. Fencing & Access Approval s_
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#
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 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 i
33. Final Electric Notes:
34. Final Heating & Air Conditioning 44/ .f CrrA
35. Final Gas Pipe-Test
36. Hood or Canopy •
37.,Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final -
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
,50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY • - -
No. Date
•