The URL can be used to link to this page

Home My WebLink About621 ANTON BLVD - Building PermitsAppllcant to CITY OF COSTA MESA CONSTRUCTION PERMIT in all sp><es within heavy bortivr Iines ana sign� Oroo��ate tlaelaratlon ;NO. TRACT NO. LOT NO. BLDG. NO. � �� ..io ..,....�.... / /VV Owner (�V ��r� �, Phone Addrea Arch/Eng. License No. Address Contracror ['. G. , �< < � , Phone Address , r1 .C.'L,"w (;.�..'f /l.t��i I hereDy affirm that 1 am Ilcansetl untler provlsloni of Chartar 9(tom- mencing wlth section 7000) of Dlvlsion 3 of tha Business antl A01¢SSIOnS COtlB, dntl Ty IICen50 IS In full (OfCe dntl BIIBCt. License Class Liconse No. Date S�9�ature WORKERS'COMPENSATION DECLARATION I hereDy affl�m that I nave a mrtlncate ot consent to sali-Insum or a tertitiwte ol Workers' Compensatlon Insurance, or a tartlfieE copy W7•�eot (Sectlon 3800, Lab. C.). f No. Campany � .tifietl copy I5 hareby furni5hetl. �J Certlfietl cOpy IS tilatl with tha city Builtlin9 DlviilOn. EXEMPTION F0.0M WORKERS' COMPENSATION DECLARATION (Thls uction neetl not be complatatl if tha permll 15 for ona huntlratl (51001 or leu). I tert(ty that in t�e pertOrmance 01 tht work tor whlC� tnis permit IS Issuetl, 1 shall not amPtoy any person In any mdnner so as to become zuE�Ott t0Ih8 WOfkBR CompenSdtlOn Ldws O7 CdI1tOfNd. Data Si9nature NOTICE: If aft¢t making this tletlaratlOn, you snoUltl betome subjeCt lo the Workers' Compensatlan provislons ot tha Labar Cotla, you must to�thwith COTpIy wit� suth p�ovl51on5 O/ Ihis pe�mit s�all be tletmatl revoketl. CONSTRUCTION LENOING AGENCV � 1 hereby aftirm that there Is a constructlon landinq a9ency lor the per- formance of Ihe work for whith thls permlt Is i5suatl (Sectlon 3097 Civ. C.). LlOtlBr'S NdTO Lentler'S Atltlress U I, d5 ownaf of tha pro0orty, or my amployee5 with wd905 d5 Ih¢if sol0 COIIIpBnSdtlOn, will tlo th8 wOrk, d�tl t110 StluCturO i5 nOt Inlantlad or ofteretl for zale. (Section 7044, Buslness antl Aofeislons Cotle: The Contractor's Ucnnse L.aw tloes not apply to an owner ol a Droperty wh0 bu11tl5 or ImprOveS th¢r80n, dntl wh0 tlOat Suth wOrk hlmsell OI th�0ugh hls Own employea5, p�ovidotl tltdt suGh IRfprOvomentt a�a not intentlea or ofleretl tor sale. It, however, tna bulltling or Improvemonl IS SDItl wlthin OnC yeaf ot COmplption, thB Owntl wlll havB Itla bUltlen ot proving he tlitl not bulltl or improve for t�e purposa ol sale). ❑ I, d5 Ownel ot tFle pfOptfty, aT OxUUSlvely colltlaCting wltll Iicensed contractort to construct tne project ($actlon �044, Business antl Profe551on5 Cotle: The Contractor's Llcanse law tloes not apply to an owner o/ property w�o Dulltls or Improvez ihereon, antl who con- tYaGts ttom SucM1 plo�ects wlth d COntrattOl(s) Ilc¢SnOd pursuant lo the Contractor'S License Law). ❑ I am ¢xempt UnEer Settion 8. & P. C. fOr thii reason Date Owner I h¢roby cerlify lhat I hdvG r¢dtl thi5 appllcdllon antl StdtOlnat Ih¢ above iMOrmation IS wrreGl. I d9rG! to comply with dll City antl Coun[y orElnances antl state laws relaHnq to construction, antl nereby authorize repre5entatives o Ihis city to,1enter u0on tha above mentionetl property ectlon p Cs. Signature Date 8,l1/LBI Drivers' License or 55 � �%� CMF 0865-46 White-Builtling; Gnary-Appliwn[; Pink-Accounting: G TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER OESCRIPTION OF W RK v e f�e.,�,i.c � �,u>s�., r i., raa,�. ❑GRADING ❑ FOUNDATION ❑STRUCTVRAC ❑ TENANT ❑ ELECTRICAL OPLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCVPANCV CONSTRUCTIONTVPE� VAIUATION 0 a ZONE GRADING CU. VDS. ACRES PLUMBI NG TOILETS LAVATORIES KIT. SINKS SERVICE SINKS FLOOR SINKS DRINKING FOUNTAINS INTERCEPTORS SWIMMING POOL ' wATER SERVICE GASSERVICE WATER HEATERS SEWER CONNECTIONS SOLARTANK SOLAR PIPING SVS. ISSUE FEE PLAN CHECK � SHOWERS V R I NALS DOVBLE LAVS DISHWASHE0.5 SUMPS " FLOOR ORAINS �CLARIFIERS PTRAP ALTERATION OVTlETS BTU OUTPUT COLLECTORS MECHANICAL PLAN cHECK HEATING SVSTEM 0-300,000 BTU. AND DUCTING 700,000 + BTU _ REFRIGERATION 0-300,000 BTU_ SvSTEM � t100,000.BTU_ BOILERS BTV SVSTEM REPAIR,ALTERATION E%HAUSTSVSTEM MVITIPLE ISSUE FEE A.0. $ ZONE REAR VARD (TO PKG.SPACE REQ. STREET WIDTH SPECIAL CONDITI ELECTRICAL 3428 7/OB/81 NING REGULATIONS DED FEE S PLAN CHECK TRANSFORMER 0-1 KW_ 1-30 KW _ APPLIANCE 30-SOKW_SO+KW_ MOTORS 0-1 HP_1-30 HP _ (INC.SOLAR) 10-SOHP SO+Hp_ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS - MAIN SERVICE ISSUE FEE APPLICATION OF FEES PERM�IT G 51� �. PLAN CHECK 5 �' �.�._gr 7LVMBING b PLAN CHECK E ELECTRICAL S PLAN CHECK § MECHHNICAL 'S PLANCHECK E 2416.23 TL DATE SMIP E�.}_�O PERMIT ISSUANCE S GRADING E b � MICROFILM $ ' TOTAL FEE E...�/� LE55 AD- VANCE'PC`$_ FINALFEE 5�,..y� �� CONSTRUCTION AND PLANNING POOL & SPA _. APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service o� Pote 43. Pool & Equipment Location � � Soil ipe-Undrgrn 44. Steel Reinforcement � 3. Electrical Conduit"Utility=Undrgm - �- � ' 45. Forms 4. Electrical Conduit-Undrgrn _ �� • . 46. Electrical Bonding . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn - - 48. APPROVALTO COVER-GUNITE 7. Footings ' 49. Electrical Conduit-Undr rn 8. Foundation ', �' 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe�Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor System 52. APPROVALTO DECK 11. ' Propert� Sewer Line.&,House Connection 53... Backwash & Rece tor-Final 12. Street Sewer Connection. 54. Heater & Vent•Final ' , 13. Rough Plumbing 14. Rough Eiectric-Conduit � �56. Electrical-Final 15. Rou h Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning � encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAI 20. Roof Framing 21. Roof Sheathin 22. Frame and Flashin NOTES: 23. Insulation � 24. lathing & Siding 25. Drywall Nailing 26. Plaster grown Coat 27. Electrical Power Meter-Final 28. Final Eiectric ' 29. Final Heating & Air Cohditioning 30. Final Gas Pipe-Test 31. Final Plumbing - � 32. Water $ervice-Final • 33. � Gas Service-Final 34. Solar pomestic-Final 35. �Landsca e S rinklin S stem 36. Sound Attenuation 37. Handicap qegulations 38. FINAL STRUCTURE & BUILDING /a S� 39. Special Requirements Completed 40.� �Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date � F � W a Q : � s F G F Q � 3 a > r .� x w a O a z � .Z' 3 ' ' ,— COSTA MESA BUILDING-SA Y DEPARTMENT P.O. BOX 1200 COS7A MESA; �.ALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only nooa°e"ss ANTON BOULEVARD �EryqryTOR TWO 70WN CENTER ADDRE 5 3315 FAIRVIEW ROAD � aTv COSTA MESA No' 546-01 BRANCH AODRESS � ARCNITECT . _ , --- APPLICATION R �+1'jtUCr'TURp�L PERMIT �� 75 �p CEIVEDB PERMIT. ��'�^ �� •55 TC A.P. NO. I BUILDING ADDRE55 VNIT OR SPACE NO. TR.NO. N� OWNER USE � `.�6a�-�qnn ZONE APPROVED CONTRACTOR (; L. ftCK ADORESS 620 ANTON BOULEVARD ��T� COSTA MESA No`546-22 uc No. 182753 �ic�No.00591 512E NO.OF BLDGS OF LOT NOW ON LOT ezs°iNcs�oc. NOT APPLICABLE Separate permits are required for electric, plumbing and heating work: USE OF BUILDING AND WORK TO BE PEFFORMED SCULPTURE GARDEN INSTALLATION 1 hereby acknowledpe thet I heve reatl this applicetion entl state that the above Information is corract antl agrae to comply with ell lews repulatln0 b�ilding consttuction, antl 1 shell not employ eny pefson in vlolallon of the workman's compenzat{on lawa of Me Stete of Californis. i hereby cartify that I em pro0erly licensed as a contractor un0er tha Steta of California 9usiness antl Professions Cotle, Division 3, Chapter 9, and Mat cucn licanses are in full forca and effact, or I em exemOt from tha pr0��sions of the State of Californle Business antl Profess(ons Cotle, Dl��sion 3, C�apter 9. Sipneture of � ' Permittee � or AuMorized Agent DaYe n ROM PLANNING ACTION �� m �-o / ' � - / — BLK. REPAIR MOVING DEMOLISF %t.Cd� �'.e.YrkY �/ VALUE . / � S u� OOJ.� r`'^ 4' / —/ E .Y�"IV GROUP OATE � -� _ �% _ _ _ V m � > a . SQ. FT. SO � '�— N � ' THE AMOUNT SHOWN UNDER VALUATION IS FOR m � TNE PURP06E OF ESTABLISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE § � q N $^ y��p •� PLAN CHECK E •�p LL �+ TAK $ /. � � u TOTALPAID § �� • S