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1618 NEWPORT BLVD - Building Permits
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 5297 I/09/65 19000 TL- WY OF COSTA MESA' -yCJONSnTRR UCTIO RRMIT PERMIT i0�'�O TRACT NO. LOT NO. UNIT NO. Project Address /Pa !((irfr�t' :� ���� ''IIVV.•,, I KI ' Applicant's Mailing Address - 4') /if. : i x TYPE OF CONSTRUCTION LI NEW ICI ADO IJ ALTERATION Li REPAIR l .-A[f $3J y2 A-9 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#s I Zone Owner's Name •C -----yy�����I. -���/// d,/(L/��� / Phone DESCRIPTION OF WORK/USE OF BLDG. Address add , yOL4 We/At . - - S Main Building: • Accessory Building:• / r� E Z Arch/Eng. License No. TYPE OF PERMITrr''ll U GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front - 0 Address ' ❑ TENANT U ELECTRICAL ❑ PLUMBING © MECHANICAL B _ N • y,�/ ❑ OTHER A Rear l Contractor's Name d //Jgrie Phone d�p� �_�259n�� C Ri ht N r� Address(mailing) � n fA 2,[2.4 .x to LL nd jezte ) PROJECT DESCRIPTION SQ. FT. SSZO OCCUPANCY . eC K g G �7`r .5��� C ON Si-RUCTION TYPE VALUATION$ Q r4 Left City License No. O.{ R _ ( LICENSED CONTRACTOR DECLARATION ZONE GRADING CU.YDS. ACRES - Ping. Ref.# • Parking Req,/Provided E ' I hereby affirm that I am licensed under provislohs of Charter 9 (commencing Remarks: Planning Notes: • - 0 with •section 7000) of Division 3 of the Business and Professldns Code,and • --,.., my license is in full,{orce and effect. T • l License Class, 6 - �� icense No. '.�a/ - S Date /`7-rS Signature iA nM A154 PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers A T - 'ereby affirm that I have a certificate of consent to se -insure or a certificate ELECTRICAL ' • ' FEES Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink a800, Lab. CJ / / yn � - Automatic Washer � Transformer 0 15-50 KW Policy No. C La 3 ci Company y 7! /A/YX/.4A,td • Backflow Irrigation Sewer Cap - - 0 50+ KW ® Certified copy is hereby furnished. / _ _ Construction Pole Sub. • Certified copy is filed with the city Builpin Division. l 'w Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps • Date /e 7 - 8.r Applicant / (n.i-!2 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION • Clarifiers Solar Collectors ' Dishwasher Meter Myer 100 amps (This section need not be completed if the permit is for one hundred ($100) or • - iess). Dishwasher Solar Piping I Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is issued I - snail not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan' Motors❑0-1 HP 01%-B Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/SpaF,A.U. 'NOTICE:If,after making this declaration,you should become subject to the _ Inc.Solar 09-15 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 1 hereby affirm that there is a construction lending agency for the performance Device Boxes Pole'Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets Lender's Name - Range r Lender's Address Kitchen Sink Water Service Switches Sin OWNER BUILDER DECLARATION 9 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash e. 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-Trap Laundry Trays Generator ❑0-5 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 tne 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 forthe alleged exemption. Any violation of Section v 0031.5 by any applicant for a permit subjects tne 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 S 3 compensation, will do the work,and the structure is not intended or offered I ' - 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 DEVELOPMENT SERVICES REQUIREMENTS:, • employees, provided that such improvements are not Intended or offered•for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of corn- • Canopy Type I I ❑ 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 tne purpose of sale). - - {� ❑ I, as owner of the property, am exclusively contracting with licensed con- • Duct-Structural Refrigeration System Application Issued By �`l nat. /'9-85— tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to en owner of property who Duct-Ventilating JZ J'0-100,000 BTU ❑100,000 BTU builds or improves thereon,and who contracts for such projects with a con- tractor(s) (/` SUMMARY OF FEES license pursuant to the Contractor's License Law). I am aware that Exhaust System D Multiple 0 System Repair/Alteration - BUILDING PERMIT $ SMIP • $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT i ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# ' Fire Dampers PLUMBING ISSUANCE $ Date Owner. Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify •that b have read this application and state-that the above [30-100,000 BTU 0100,000 BT v GRADING $ information is correct. I agree to comply with all city and county ordinances / o O ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- , - PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon t above-mentioned property for • Inspection purpose ; Signature 9-LC. Pink -Accounting; Goldenrod - Assessor r - ... . .. _ '• - ' CONSTRUCTION AND PLANNING - . POG�9';PA . • APPROVALS - Permit#_ Date Inspector APPROVALS Pe # 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 • , 5Y 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 Uidrgnd. . 10:Structural Floor System - 61. APPROVAL TO DECK I11. Property Sewer Line& House Connection 62. Backwash& Receptor-Final 12. Sewer,Cap 63. Heater& Vent-Final 64. Plumbing System•Final 13. Roof;Drains • • �� 14. Rough Plumbing 65. Electrics!-Pinel 15. Rough Electrical-Conduit 66. Solar System-Final I 16. Rough Electric Wiring 67. Fencing&Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING I . 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 9 FIRE DEPT. REQUIREMENT . I I 20. Rough Factory Fireplace APPROVALS Permit# 1 y l ' • 21. Ducts, in Structure 70. Underground Hydro it , '22. Ducts, Ventilating • 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough&yest 72. Underground Flush • • 24. Roof Framing • _ 73. Undergrnd.StorageTank 0 Gas 0Oil• . _ • 25.-Roof Sheathing _ 74. Overhead Hydro - ;, 26. 7-Bar Ceiling (Structural) & Monocoat 75. bry 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 • a 80', FOOD CERTIFICATE-ISSUED -33. Final ElectricNotes:JO•T74III ..csrei As pe Spat UMC G..E.b 34. Final Heating& Air Conditioning 35.-Final'Gas PipeTest - _ • 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 Requirerrients Completed - 49. Electric Release to Edison , .- - +- - i , 50. Gas Release to Southern California Gas Co • , . . . . - 51. CERTIFICATE OF OCCUPANCY - . No. Date - . • .