HomeMy WebLinkAbout2574 ELDEN AVE - Building Permits 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.O.4 TRACT NO. LOT NO. UNIT NO. •
Project Address tS 2 y �ZOcx, B ` 3 a ff �
Applicant's Mailing Address /g1-167? Oat_ 1-1/74...OaTYPE OF CONSTRUCTION L I NEW Li ADD LI ALTERATION LI REPAIR
Owner's Name r.7-1 her G[N 7-0A/ Phone 4P J"-91(SS ❑ CONVERSION LJ DEMOLISH ❑ OTHER A,P,# Zone
!_et Deter. 1194 DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building:
Arch/Eng. License No. - TYPE OF PERMIT H GRADINGFOUNDATION T
LIU STRUCTURAL Front O
Address El TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N
❑ OTHER I
Contractor's Name__ _ _ Phone Rrj C Right G
Vizi
DESCRIPTION SQ. FT. OCCUPANCY K
Address(mailing)__ _ _ CONSTRUCTION TYPE � VALUATION$ l0 p $ Left
City License No. ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 0
with section 7000) of Division 3 of the Business and Professions Code, and .F
my license is in full force and effect.
License Class - License No. S
Date Signature PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
1 'hereby affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
J00, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow irrigation Sewer Cap Construction Pole Sub. 050+KW
® Certified copy Is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant - _ -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit Is for one hundred ($100)or -
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❑0.1 HP ❑1'A-8
Workers' C¢ ion Laws of Calif orni /y
Date ?/� Signature in
4� _ Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016.15+
NOTICE lf,After making this declaration, you should become subject to the — —
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked- Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
I hereby affirm that there Is a construction lending agency for the performance Devic¢Boxes Pole Light
of the work for which this permit Is Issued (Section 3097 Civ. 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 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.
any structure, prior to its issuance, also requires the applicant for such permit 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
erefrom and the basis for the alleged exemption. Any violation of Section
)31,5 by any applicant for a permit subjects the applicant to a civil — _
Penalty of not more than five hundred dollars($500).
❑ 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 $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an gwner of a property who builds or Improves
thereon, and who does such wo/k himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for
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 of sale). —
leas owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 1 -L.J
tractorsto 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 thatBUILDING PERMIT $ S\ SMTP $ TT
proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration 4/
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING CHECK $$ PERMIT
r— ISSUANCE S
i wF . Heating System& DuctingRegisters
Date Owner _ ENERGY P.C. $
PLAN CHECK 25% $
II here rtify that I have read this application and state that the above ❑Q100,000 BTU 0100,0008Th, ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to nter up n the above-mentioned property for b
inspection pure s.i�A� ?�a___ MECHANICAL $
Signature /1 Date /. TOTAL FEE $ �-
'-Drivers' License or 55# . Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $
S
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor
U1 UUUUbeiY11-UUUUSSY1 1.1J 1 ZS.51.)
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 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 8/.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 _ r
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 ❑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
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace -
3Bf4Final Plumbing
39. Water Service-Final
:40. Gas Service-Final
141. Solar Domestic-Final
I :
42. Backflow Preventer ' .
43. Backflow Irrigation
44. tandsc'ape Irrigation System•
•45. Sound Attenuation
46.'Handicap Regulations /` •
47. FINAL STRUCTURE & BUI LDING P/A1 �® J_ V
48.'Special'Requirements Completed //
•
49. Electric Release to Edison
50. Gas Release to?Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY ;
No. ` Date
-
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n.i,
:EP 114-75- 00 424-
-
. 396M
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIV/ECS_DATE RECEIVED DATE I S D
BADDRESSUILDI NG as_144 oxcvkili7tN\
PERMIT NO.
OWNER .1kalt\1-e VN\no,X-c, S , A.P.NO./4?-•-(7 70 -//
MAIL SW BUILDING
ADDRESS 015-7 f( 70/0vt_
Z 39614
ADDRESS
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- I- LENDER
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OWNER
4 ill ADDRESS
co _i _ • • VALUE
•CO ARCHITECT TEL. USE $.47412---••Ce
OR ENGINEER NO. I
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0-I41 APPROVED ee7- ---- DATE-21(2-C-
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ADDRESS
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TEL.
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Z I-- CITY NO. .
STATE CITY YARDS APPROVED YARDS APPROVED
0 AC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
n o i (FROM C/1_STREET/
SIZE r/ NO.OF BLOCS. -,
OF LOT 3 b Mk) C 7.\ 110• I NOW ON LOT C _FRONT FT. //ei FT.eiriozw7
USE OF 022 lead
EXISTING BLDG. W..)0 R.SIDE FT. FT.
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES _L.SIDE FT. _././ FT. 1711.4477
KC EXTERIOR WALL ROOF ,
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0 COVERING COVERING REAR FT. 45" FT.-I-'74-
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-I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN Az
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CL MAIN BLOCS. ACCESS.SLOGS.
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IP DATE
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APPROVED
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0 I hereby acknowledge that I have read this application and state STATE
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
,..A?TAX 1...
I- any person In violation of the workmen's compensation laws of
CO the State of California.that 1
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— I hereby certify at I am properly licenSQ.FT.
sed as a contractor under ...
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ,•
Chapter 9. and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMG FEE ONLY: a
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am exempt from the provisions of the State of California Business
VALUATION ia:•-•-c. ._____ w
and Professions Code,Division 3,Chapter 9.
0 0 PERMIT FEE $ a2 Cl
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Spelgrnmaitttueree of Tkissz \ vALyna),.._b
--- PLAN CHECK $
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TOTAL FEE $
Authorized Agent
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