HomeMy WebLinkAbout2666 ELDEN AVE - Building Permits •
lipApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. '
ITYa0 COSTA MEJ��'pp//•• SONSTRUCTIQN PERMIT PERMIT NO. ,TRACT NO. LOT NO. UNIT NO. -
Project Address ZG1� [� n1�Pp1`r -2-3 2- •;
Applicant's MailingAddress `(7 � TYPE OF CONSTRUCTION EW 0 ADD 0 ALTERATION 0 REPAIR • -
♦
v� •r' 1t• ' � 0 CONVERSION 0 DEMOLISH ❑ OTHER A.P.0 ,re, i5 (•cQna
Owner's Name `` �,t`"�t/T far(
,�� ��q DESCRIPTION OF WORK/USE OF BLDG. • t7
Address ��D • Z'0" '� �7 1 t���l/JT �FT - riT/+-�T.y+ - S Main Building: Acrossory Building: ; `/
Arch/Eng. License No. TYPE OF PERMIT •• U GRADING U FOUNDATION U STRUCTURAL T Front / �IU IlSY17 - O
Address • ,��•� I 0 TENANT 0 ELECTRICAL ❑ PLUMBING ❑'MECHANICAL B Rear . • �• • / , N
Contractor's Name UNI 1Z1/ - A-4 r.. G Phot A. • 2' ❑ 'OTHER A ��
i P PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right .mq tACC4, N
'Address(mailing) -./l• �//• :Sal I" ' _ _�I '1'q 1;41
City License No. �.AWL- 37j74 . - S/ '/ CONSTRUCTION TYPE - VALUATION 5 • S Left �gp` lJ$7 VrNK'FY I`14-VI• i C'
ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION -a aiff- _ Ping. Ref.# Putkioo Req,/ProYided: E
t^'n p...: - E
I hereby affirm that I am licensed under provisions of Charter (commencing Remarks: /r/rfArf f bt/.2/\ Planning Notes: - f. NI •
'with section 7000) of Diyyy ision 3 of the Business and Professions Code, and L - '
my license in full f.rce fy• effect. r...r/, 7 .
_ - S
Licens- C: /I7 , cense NoX0Jli4
0., Date 4 =e Signature nir a PLUMBING FEES •
-
WORKERS'COMPENSATION 0c LARATI•N
I hereby affirm that I have a certificate of co sent to self-insure or a certificate Bar Sink' Showers ELECTRICAL FEES
' 'of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer _ Service Sink
3800, Lab. e) .Z - - Automatic Washer - Transformer 0'15-50 KW - - -
'Policy No.w(�I 34a/ Company N t"� I)N[0 �'� Backflow Irrigation Sewer Cip
e• Construction Pole Sub. 0 50+KW
ertified'copy is hereby furnished. ,
erY fed 9qgqy��ra filed with the city (ding WI on. Bathtubs •
Sewer Connection - Cooking Unit / Meter ❑up to 100 amps S'�
•
'Date `b Applicant A/l�^--
EXEMPTION FROM WORKERS'CO PENSATI N DECLARATION ' Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need.not be completed if the permi is for one hundred(5100)or '
'less). . Dishwasher Solar Piping I Dryers OGas ❑Electric Sub Panel'
.1 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 te Drinking Fountains Solar Tank FanI Motors❑0.1 HP ❑1 h-8 •
Workers' Compensation Laws•of California.
. Date Signature Floor Drains ' Swimming Pool w/Spa - F.A.U.
'NOTICE: II,after making this declaration, you should become subject to the Inc.SOlar ❑B-15 HP 016-15+ ,
'Workers' Compensation.provisions of the Labor Code, you must forthwith Floor Sinks • Urinal
comply with such provisions or this permit' shall• be deemed revoked. Fixtures - Microwave - - •-
CONSTRUCTION LENDING AGENCY- Gas Service- Outlets Water Closet Device Boxes '
I hereby affirm that there is a construction lending agency for the performance - • • - POIe Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets "
Lender's Name - Range
Lender's Address- • Kitchen Sink Water Service SwitchesSign
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ;Standing Sections
' following reason (Section 7031.5 Business.and Professional Code: Any city or
county which requires a permlt•to construct,alter,Improve,demolish or repair P—Trap Laundry Trays • Generator ❑O.5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) oftv1i . •
Division 3 of the Business and Professions Code) or•that he/she is exempt - - •'
therefrom and the basis for the alleged exemption. Any violation of Section Q �N
7031.5 by any applicant for a permit subjects the applicant to a civil • I`'^
aenalty of not more than five hundred dollars($500). {{{}}���
O I,•as owner of the property or.my employees with wages as their sole Reinspection Fee I $15 . Issue Fee $ 3 c2_`_` C 6
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business,and Professional Code: The Contractor's . MECHANICAL I 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 through his or her own ' DEVELOPMENTSERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 ,
sale- If, however, the building or improvement Is Sold within one year of com- Canopy Type 11 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 L�
prove for the purpose of sale). - • d•
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
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 00.100,000 BTU 0100,000 BTU • SUMMARY OF FEES -
builds or improves thereon,and who contracts for such projects with a con-
tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $ - SMIP . $ '
proof of their worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
•
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BI t. ICBO# Fire Dampers PLUMBING $ • ISSUANCE $
Date ' Owner ' Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ '
I hereby certify that I have read this application and state that the above _ ❑o-i00000 BTU 0100,000 BTL. ELECTRICAL $ I O-D GRADING $
information is correct. 1'agr e to comply with all city and county ordinances - -
and state laws acing to •uilding construction,and hereby autryor a repro- PLAN CHECK 50% $ 5-; 1-1) MICROFILM $
sentatives of s city • enter the above-mentioned o erty for (f
inspection p p•ses. / L�• MECHANICAL $ TOTAL FEE $ e
Signature Date ,
Drivers' Lic nse or 55 _ Reinspection Fee $15 Issue Fee $ 3 ' PLAN CHECK 25% '$
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor -.
CONSTRUCTION AND PLANNING " POOL sY SPA
tw APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 67+67 7 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
7...5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. _ 57. APPROVAL TO COVER-GUNITE
7: Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation •- 59. Gas Pipe, 0 Undrgrnd., Test •
. 9. Water Pipe-Undrgrnd'C • 60. Backwash Lines, P-Trap, O Undrgrnd.
•10: Structural 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
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 El Oil
23: Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank D Gas D 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 6/{ / �'y/' 80. FOOD CERTIFICATE ISSUED
33.-Final Electric I/'17_ {�/J/.�-] Notes:
34. Final Heating & Air Conditioning
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 i
49. Electric Release to Edison
\50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY -
No. • - Date - .
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTIONCTION PERMIT •
IPERMIT NO, TRACT NO. LOTO, UNIO.
-
Project Address "1IMrC Elete.t E- &7i� Qso • A.P,#Lp,q r, a I - [y - Izone- "4„Q
2.46-4.-C Zites/ �� TYPE OF CONSTRUCTION LINEA.' ® ADD S Main Building: '� Accessory Building:
•
❑ ALTERATION REPAIR I, , I1� �
Applicant's Mailin Ad��VVess ❑ CONVERSION ❑ DEMOLISH. ❑ OTHER T Front L6144-w; Z
•• Obe-T �rrad-km-2T✓IPhoneGY�-070 Q
Owner's NameDESCRIPTION OFAIORK/USE OF BUG.ArAd el'a-�P1Z--Fa^ B Rear • �+ N
1 Address ,ZG(L-C- et des, 14ve _. Ja c 5t _• // es/then . . . _ _ A - - n P Q n !� • 1
Arch/Eng. . . . License No. - '^"-`TYPE OF PERMIT II GRADING U FOUNDATION a STRUCTURAL K Right - /^� _ 3 ,yy N
• Address •r�-� ❑I�, TENANT'$.ELECTRICAL ❑ PLUMBING •❑ MECHANICAL I S ' t .ria 1 • ( n•n (d/y., R
Contractor's Name l J� Phone IX OTHER .�•P.¢-QOrTA.L�e - - • - Ping.-Ref.# Parking Req./Provided E
PROJECT DESCRIPTION 'SQ. FT. Ire tJ OCCUPANCY - " PlanningNotes: • - 0
Address(mailing) Ni
g - _ CONSTRUCTION TYPE VALUATION 4 000 , ,�,I ��S� ��y. � '�, -h T
City License No. ZONE GRADING CU,YDS. • ACRES elLa a-el `}'� ,�,ts. PA!U1_14 S.
LICENSED CONTRACTOR DECLARATION •
` II -
1 h affirm that I am licensed under provisions of Charter 9 (commencing Remarks: A)Q e h' t p,O�..M e V - w
with sec .• 000) of'Division 3 of the Business and Professions Code, and //-_ •
my license is in I •• • ELECTRICAL . 'FEES
License Class - i ' -
Date ' - SignaturePLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION Pole Sub. '❑ 50+ KW
I hereby affirm that have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter pup to 100 amps
3800,Lab. C.) - - - - Backflow Preventer - Service Sink - - - - - - _ - - - - - - - - - -
d Policy No. Company Backflow Irrigation Sewer Cap - Dishwasher - Meter Dover 100 amps '
Certified copy is hereby furnished. ' Dryers DGas DElectric Sub Panel '
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection .
Date Applicant Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - Motors�(J;1 HP ❑1'/x-8 , ;
essis section need not be completed if the permit is for one hundred ($100) orlDishwasher Solar Piping F'A'D' Inc,Solar d9-15 HP ❑16-15.1
I certify that in the performance of the work for which this permit'- sued• I ' •'- - ' •
shall•not employ any person in any manner so as to become sub t to the . Drinking Fountains - Solar Tank FixturesMicrowaves`
Workers' CorPpenjoy Laws of Cali NQ;I •
Device poxes Date •LO/lf ( rT� Signature's"<rr t-•i/�,r -Wt Floor Drains 1 Swimming Pool w/Spa f 'Pole Light, Z�
NOTICE:If,after making this declaration, you should become su• e to the • Outlets 'Range - /,
Workers' Compensation provisions of the Labor Code, you mus orthwith Floor Sinks Urinal . . . - g - - - .- _..-_
comply -with such provisions or this permit shall be deemed 'revoked.
CONSTRUCTION LENDING AGENCY Gas Service- Outlets Water Closet Switches -$ign "1
I hereby affirm that there is a construction lending agency for the performance - - -
of the work for which this permit is issued (Section 3097 Ciy..C.) Garbage-Disposal -• "$tanding_Sections
Lender's 'Name Interceptors ater Heater.
Lenders Address - Kitchen Sink Water Service• Generator ❑0-5 KW❑5-15 KW 'm •
�. 1 T{ash Compactor
OWNER BUILDER DECLARATION - 2.:5-rt''''
J,•-/� e ./�
I hereby affirm that I am exempt from the Contractor's License Law for the . - Lavatories Auto-Wash (J �dafk•A A.et(/ s - '
following.reason (Section-7031.5 Business and Professional Code: Any city or q�os....,�. __-- � cc
county which requires a permit to construct,alter,Improve,demolish or repair' P-Trap • Laundry Trays - • sThe 'G►++•,,&. r-'eaI , I/ (7 ti
,any structure, prior to its issuance, also requires the applicant for such permit i ,
' .to file a signed statement that he/she is licensed pursuant to the provisions of. Roof Drains 1•
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 - • Reinspection Fee $15 Issue Fee : $'
therefrom.and the basis for the alleged exemption. Any violation of Section . . '
031.5 by any applicant for a permit subjects the applicant to a civil -.A.....
enalty of not more than five hundred dollars($500). - DEVELOPMENT SERVICES REQUIRE/p4y� T : s«:ia J�(Jp1
, I, as owner of the property.or my,employees with wages as their sole- Reinspection Fee , , I $15 . Issue Fee •
S.3 Zoning'Approved By '^^- ` Date bI 7/t-'`-"'
compensation,sale will do the work,and the structure Is not intended etl or offered '�L
for sale (Section 7044, Business and Professional Code:•The Contractor's MECHANICAL FEES Building Approved By +11 Date• 999r
ins-
License Law does not apply to an owner of a property who builds or improves ����
thereon, and'who does such work himself/herself or through his or her own Application Issued ByeU—/.eia'.�__:_� Date
employees, provided that such-improvements are not Intended or offered for Boiler Hood or Type I ❑ _ el
sale. If, however, the building or improvement is sold within one year of tom- ' Canopy Type II 0 SUMMARY OF FEE
p , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground . P .
prove for the purpose of sale). - BUILDING PERMIT $ SMIP $
0 I• as!owner of'the property, am exclusively contracting with licensed con- • Duct-Structural Refrigeration System
tractorsPLAN CHECK to construct the project (Section 7044,Business and Professions Code:• $ PERMIT-
The
ERMITThe Contractor's License Law does not apply to an owner of property who Duct-Ventilating : ❑0-100,000 BTU 0100,000. BTU PLUMBING $ ISSUANCE ' $'
'builds or'improves thereon.and who'contracts'for such oro iects with a tori- -- - ENERGY P.C. $
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ Sys Repair/Alteration PLAN CHECK 25% $
pr of of their Worker's Compri n Ins.ra rice should be provided t is to me. ELECTRICAL $ GRADING $
I am exempt under Section • Q.- • B.& P. for t•is reason Firepl/Fact.BIL ICBG* • Fire Dampers
/ / PLAN CHECK 50% $ r ' MICROFILM $ ' •
r
Date 1 nf!l l2" ' owner r -•t ,a - - - - ..1:4 Heating System &Ducting Registers• MECHANICAL $ . • 'TOTAL FEE ' $.32-. 1D3
I hereby certify-that I have read this application and state that rabove • ❑O-100.000 BTU 0100.00067 • - _ '- - ' PLAN CHECK 25%
Information is correct.-1 agree to-comply with all city and county ordinances • - - $ 1 •
and state laws relating to building cppp���lstructlon,and eby authorize repre- .
sentatives of this sr to enter the ab ntioned p per y for . • '
inspection poses (p (- D1 00016802-000016803 TOT' ' 32.63
Signature 7r Date •
Drivers' License or.SS 1# Reinspection Fee $15 Issue Fee $ 3 DATE: 10/11/88 TIME: 15748 •
0865-46,rev.5/88 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod -Assessor
v ,". a e
} ' POOL PA
CONSTRUCTION AND PLANNING
• APPROVALS Permit# s Date Inspector APPROVALS Permit# `Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • J
3. Electrical Conduit Utility-Undgrnd. 54. Forms .-' c:
4. Electrical Condiiii-Undrgrnd. ! 55. Electrical Bonding
5. Steel Reinforcernfnt 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE , -
i
7. Footings -- ' 58. Electrical Conduit-Undrgrnd. ,,
8. Foundation . 59. Gas Pipe, 0 Undrgrnd.,Test _ .
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,0 Undrgrnd. 1,: { i
10. Structural Floor System S 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap I
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
(IIIRough Eldbtric Wiring "67. Fencing & Access Approval
t
1711. Rough Wiring Sign 68. APPROVED FOR PLASTERING
tr;
18': Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
'1.9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
i •;
2�. Rough Factor'/Fireplace APPROVALS Permit#
12,1/Ducts, in Structure r 70. Underground Hydro
22. Ducts,•Ventilatin �'
9 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 wl 74. Overhead Hydro
26. T-Bar Ceiling (Structural) &4Monocoat 75. Dry Chemical
27. Frame and Flashing i • 76. Dry Standpipe
28. Lathing & Siding ,tit' 77. FIXED SYSTEM FINAL
29. Insulation 7 78. FIRE PREY. FINAL
30. Drywall Nailing t-;'. A- HEALTH DEPT. REQUIREMENT
-31! Plaster Brown Coat .- 79. FINAL INSPECTION
32. Electrical Power Met-el-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: Ø' /.g'_9/ 7
34. Final Heating & Air Conditioning 7
35. Final Gas Pipe-Test
3g. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final I
40. Gas Service-Final 1. i}
41. Solar Domestic-Final I - I 2--1-' ;, i f
42. Backflow Preventer - : --'
ttt • Ili
43. Backflow Irrigation EXIHE . . , ,
tO ;yr.--
44. Landscapellrrigation System ►twr]
45. Sound Attenuation Date > > big%ps{teCt - •c
d: •
46. Handicap Regulations ` S '"
1 47. FINAL STRUCTURE &;BUILDING 1.
48. Soecial Reduirements Completed r ' ,a
49. ElectricrRelease to Edison - • :i
50. Gas Release to Southern California Gas Co - -• r
51. CERTIFICATE OF OCCUPANCY ^' =1l ,''v
Date
-- v f ' ' '.. Ls
.7
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 0307 I 1 /25/67 34033 TL
ITV* COSTA MESA CONST CTION PERMIT - PERMIT NO. TRACT NO. LOT NO. UNIT NO.
Project Address 066G € B 3 c `-1- 14 -- _
Applicant's Mailing
tAdd'ess O �t/(I / TYPE OF CONSTRUCTION NEW LI ADD U ALTERATION U REPAIR )
Owner's Name ` -.Mtn t —Al hone(/7JJ$ .3777
CI CONVERSION El DEMOLISH ❑ OTHER / A.P.# - Zone
.SIO Sot �. g/1) one DESCRIPTION OF WORK/USE OF BLDG. –��4/1- aid2 –
Addreu r - ,,��..�� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT IJ GRADING U FOUNDATION a TRUCTU RAL E Front D
Address 1:1 TENANT 0 ELECTRICAL El PLUMBING 0 MECHANICAL A Rear N
Contractor's Nam¢ est Phone LI OTHER - C Right - N
Address(mailing) PROJECT DESCRIPTION SD. FT. OCCUPANCYK
CONSTRUCTION TYPE ` .VALUATION$ /"� •V"U-S7� s Left G
City License No. 3,57 4k# ZONE GRADING CV.YDS. I
ACRESR
N
LICESED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: r_ `r' /j7 (f,�, Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and �`r141`el,c_C �e.� V`� 1 Re• �� ^/
my license is in full force • effect. y `` ��70 rl S
License Cla s = 7 Licen e Np,i jJ p V7O •f- -
Date Signature WA . f! - PLUMBING FEES .
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
i hereby affirm that I have a certificate of consent to self-insure or a certificate - ELECTRICAL FEES
Or N Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
Q 900, Lab. C.) , Automatic Washer Transformer 0 15-50 KW
\ Policy No. qo 3Co.''36O/-Company R�tQ Fr r04 Backflow Irrigation Sewer Ca 0 50+KW -
9 P Construction Pole Sub. .
Vertified copy is hereby furnished. l
Certified copy is filed with the city 'Id' Di ion Bathtubs Sewer Connection Cooking Unit Meter Oup to 100 amps
••N(1), Date fl—�S$7 Applicant
EXEMPTION FROM WORKERS'CO E SATION DECLARATION Clarifiers Solar Collectors Dishwasher •
Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
t4\ less). Dishwasher 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 00-1 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa - F.A.U. Inc.Solar ❑9-15 HP 01615+
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 POI¢ Li ht
I hereby affirm that there Is a construction lending agency for the performance 9
of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors Water Heater
Lender's Name p Outlets Range
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that ram exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ,
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
countywhich requires-a permit to construct,alter,improve,demolish or repair s
any stucture, prior to Its issuance, also requires the applicant for such permit P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor
to file a Signed statement that he/she is licensed pursuant to the provisions of Roof 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
-herefrom and the basis for the alleged exemption. Any violation of Section
131.5 by any applicant for a permit subjects the applicant to a civil
Welty of not more than five hundred dollars($500). $ 3
o I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not Intended or offered j Reinspection Fee I $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 through his or her ownDEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletlon, 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 the f oe). //_.y 5,
❑ as owner the property, Se tion 7 44, contracting with of licensed con- Duct-Structural Refrigeration System Application Issued By Data i
The tractors to actor'construct the project e 7044,Business and of propertsy
Code: .
The Contractor's License Law does not apply to an owner of who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SU MARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- r�
P
con-
tractor(s) rse pursuantrkr'so thetion Contractor's License be lam aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ (3 - 3'4 PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting RegistersPLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00.100.000 BTU 0100,000 BTU GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city a er upon the above-mentioned Property for 34. 33
inspection purposys.SiMECHANICAL $ TOTAL FEE $
Drivers'gnerl(//
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor •
•
CONSTRUCTION AND PLANNING • POOL& SPA. - .
APPROVALS Permit# Date Inspector • APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2
`
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical,Bonding I
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, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines„P-Trap, 0 Undrgrnd.
10. Structural 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 •
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# ' _ I-'
21. Ducts, in Structure 70. Underground Hydro • - "
22. Ducts, Ventilating 71. Product Piping 0 Gas 'El Oil '
23. Gas Pipe-Rough & Test 72. Underground Flush
1,
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
J
'�
i
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical - • .
27. Frame and Flashing76. Dry Standpipe
- •
28. Lathing & Siding 77. FIXED SYSTEM FINAL I •
29. Insulation . 78• . FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT .
•
31. Plaster Brown Coat - 79. FINAL INSPECTION i -
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 Factory Fireplace ...<n
'36: Final Plumbing ^% _
•39: Water Service-Final 1'
.•
i
/40. Gas Service-Final ! r , - ;:::
••'41. Solar Domestic-Final
�"
42. Backflow Preventer . /' - to
�1 r,
x.,43. Backflow Irrigation • ;i %�'
(4/1.:-.Landscape Irrigation System .. y f
.tv.
,95-: Sound Attenuation '' - ' / •
• L.
46 Handicap Regulations . `i : t�
y
47.6•FINA LSTRUCTURE & BUILDING
1/13e181 fJ .
r•
48? Special Requirements Completed • ' `
49. Electric Release to Edison
r
50. Gas Release to Southern California Gas Co •
• 1 I
51. CERTIFICATE OF OCCUPANCY - _
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. j TRACT NO. LOT NO.S UNIT NO. .
Project Address 2656-46-?P- Elden, Costa Mesa. , S2 0 0 L7�
•Applicant's Mailing Address 510 30th St. Newport Bch. TYPE OF CONSTRUCTION NEW LI ADO LI ALTERATIONLTL REPAIR �J
Owner's Name "A1 Ire Steiner/Russ F71)1 �- 673-3777 ❑ CONVERSION ❑ DEMOLISH V�OTHER Ee As'V/-7 CCW/�- A.P. d-.zg - Zc_/ - /7 /R IZone La.
DESCRIPTION OF WORK/USE OF BLDG. - d T `� L .1
Address -{S10 30 h St. Newport Bch, q 92663 - s Main Building: cessorY Building:
Arch/Eng.r/heK 30th
License No. c 8"5 781 TYPE OF PERMIT ❑ GRADING LSI FOUNDATION L4' RUCTURAL T Front �Z }. O
Address • .O ' W e r a.)at gm , 4'.Jr. ',_.-do 0 TENANT ❑ ELECTRICAL 0 PLUMBING O MECHANICAL B Rear GGi•��� ' I N
. Contractor's Name Paas F Fluter Phone 673•-3777 • ' 0 OTHER QS.'�'�''�'jy
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right ✓ ay �� , - N
Address(mailing) E1 ln4h St Newport Beach. Ca: K ",� yy - - G
/�}/r q / C O N ST RUCTION TYPE VALUATIONS 0i SSSDO $ Left "I (� t ,, -- ...,.CQ R
City License No. ()di of 4 ZONE' GRADING CU.YDS. ACRES �' p r� ,"`.
Ping. Ref. # it iirUs Sd llProvided E
LICENSED CONTRACTOR DECLARATION an' t`4 `� (s _
I hereby affirm that I am IIsion 3 under provisions of Charter 9 (commencing Remarks: x,/5+1 !O si i`N- RET. w Il vs� r E.L Planning Notes: •�• / / tuz/z(J M
with section 7000) of Division 3 of the Business and Professions Code,and -Q-04 e7 1. �' J YW �" """moi
aGp� �hs � On T
my license is irs1y14fpr an •••- 351.470; • loc.-4 '24 -8'\ �'rV 1140 717-e_ /..-, /I Z/ � $
License Class 1l..Qa ll ll lI..00tI yen o �' �,�,I s
r. Date r f ZO-_�v Signature - -:".2 PLUMBING FEES /u�r- -(_ LAPP•u- Wic z l0/ S-•*+'•-` -C
,b WORKERS' COMPENSATION D CLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate. • ' ELECTRICAL FEES
' 'of Workers' Compensation Insurance, or a certified copy thereof (Section• -
3800, Lab. C.). - Backflow Preventer Service Sink Automatic Washer Transformer 0 15.50 KW
2 3STATF. FARM
4 Policy rvo.97-R1 furnished.
Company - Backflow Irrigation . . Sewer Cap - Construction Pole Sub. 0 50+KW •
1 ❑ Certified copy is hereby furnished. , •
LC) [�, Certified copyJs filed with the city�uilding,DivAl - Bathtubs Sewer Connection Cooking Unit . Meter Oup to 100 amps
Date .14 / APPlicant� -4v-4-"- rr L• - ..
EXEMPTION FROM WORKERS'COMPENSATION ECLARATION 'x - Clarifiers Solar Collectors Dishwasher - Meter ❑over 100 am
(This section need not be completed if the permit is for one hundred($100)ort
less). - Dishwasher Solar Piping - Dryers'OGas ❑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 LDrinking Fountains Solar Tank Fan Motors 00- P 01)5-8
Workers' Compensation Laws of California. - -
Date Signature Floor Drains, Swimmin• '••I w/Spa F.A.U. Inc.Sol 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 Urin. Fixtures
Comply with such provisions or this permit shall be deemed revoked. _ - Mi wave
CONSTRUCTION LENDING AGENCY -Gas Service Outlets , .ter Closet Device Boxes
1 hereby affirm that tMhepr1e/�is,,a construction lending agency for the performance ole Light
of the work for 1.1 l zlh �RerroJ xflsuplALS?\tion 3097 Civ. C.) Interceptors : Water Heater Outlets Range Lender's Name 11 t51 V /il Lel l 9 -
Lender's Address -4.Q9-.N-.—Roxbury Beverly ming 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 permit to construct,alter,Improve,demolish or repair ' P-Tra
any structure, prior to its Issuance, also requires the applicant for such permit P Laundry Trays Generator 00-5 05-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof 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 '
therefrom and the basis for the alleged exemption. Any violation of Section
131.5 by any applicant for a permit subjects the applicant to a civil
nalty of not more than five hundred dollars($500). •
$ 3
J I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $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 through his or her own I DEVELOPMENT SERVICES REOUI EMENTS:
employees, provided that such improvements are not Intended or offered for Boiler • Hood' or TypeZoningApproved By �'�� �
sale, If, however, the building or Improvement is sold within one year of com- Canopy Type II pP /�/, Date / I
pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By y( � Dates{ ¢
prove for the purpose of sale). F•�V' W1 (.�LI� '
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeratio ystem Application Issued By Date
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 0010 , 00 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon,and who contracts for such projects with a con- ��yy/��
tractorl/s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 tem Repair/Alteration BUILDING PERMIT $ 102.7sSMTP $ _ •�
proof of their Worker's Compensation Insurance should be provided to me. _ PLAN CHECK $ ct110 6'I. PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers— PLUMBING $ ISSUANCE $
Date Ownei - Heating System& Ducting Registers PLAN CHECK .25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100 0 B GRADING $
information is Correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this c o enter u•on the a•ove-mentioned property for •
inspection p rpo _dr i4
fa7' TOTAL FEE $ (73
MECHANICAL $ 1 .6 `
Signature , - ` •. •/---
Reinspect n Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 white - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
. 'CONSTRUCTION AND PLANNING ' • POOL &SPA
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-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grndr- 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. •
8. Foundation. • 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural 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
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.StorageTank DGas 0Oi1
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 ERTIFICATE ISSUED
33. Final Electric Notes: i `- r
34. Final Heating& Air Conditioning L9 8 l " - ad'
35. Final Gas Pipe-Test S -V l8i laci- ", 1 .
36. Hood or Canopy 7/r7 400r 4114011 a 6,60,),- 04
.37. Final Factory Fireplace 11187 DC T <emir Da-
38. Final Plumbing w
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42•. Backflow Preventer
43. Backflow Irrigation
_44. Landscape Irrigation System j
•
45. Sound Attenuation
'46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 1/45--
48.
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY •
No. Date 4 _ • .