HomeMy WebLinkAbout1144 BUCKINGHAM DR - Building Permits„,/
` - Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTAIVIESA--• - - ' - - - PERMIT NO. • TRAC 4'4 LOT NO. ' BLDG.N . - • - - -
CONSTRUCTION PE'MIT $-1//120_ • • //y •
Project Address s c Sr - I I . I as TYPE OF CONSTRUCTION D NEW H ADD ALTERATION 0 REPAIR _ ,Ya! y
Applicant's Mailing Address 4 1 n . • s - • • - I 0 CONVERSION 0 DEMOLISH 0 OTHER _ - A.P.�E l 1/ l-OSC..r- /
Owner's Name MCLa1n Deve10 ment CO. •Phone fi40-DQDD DESCRIPTION OF WORK
LA
U�D�y r• T i
P r-1 / S Main Building: ccessorL BuiII]din Z
ff � wry,/ E '
erg A f qR 0
Address SdI11P TYPE OF PERMIT 0 GRADING L I FOUNDATION L7 STRUCTURAL _ T Front 1984 N
Arch/Eng.COrhin-Yamafuji License No.C-6832 ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL ' BRear / I
Address 17992 Mitrhell So. , 4700, -Trvine 92714 111 OTHER A N
• C Right 7� �aT hh(y�7
Contractor's NamPMrl Bin OPVP1npnent Co Phont14O-6800 PROJECT DESCRIPTION SQ. FT L O OCCUPANC�y7' 'g.'I K �V� tYLNW7A MESA G
CONSTRUCTION TYPE �/ VALUATION$ 4• Zoo S t - nd _ E
Address(mailing) '4 Cnrpnrate Pl.d7B , Suite 101 J E
ZONE GRADING CU.VDS. ACRES r. �1 O
\�1I�1� City License No. 1 RR73 _as. I Ping. Ref.# Z(j-8L� -�O 'I'?'T Park.Fees $
LICENSED CONTRACTOR DECLARATION Remarks: rC:f+ (-7a'-83 Parking Req./Provided • U
\\t.1 `I hereby affirm that I am licensed under provisions of Charter 9 (commencing r•n R
with section 7000) of Division 3 of the Business and Professions Code, and ,t at. 1�' . 2 S o• , • , Use of Building:� ail,nd,�- 1Wm'
my license Is irbfu force and effect. _ ( !” //��
' •
\ censelClass D � / tea a. �' _ PLUMBING FEES Planning Notes: ,�-- _ - M
/1��. .i .--u E
rete 11-71'-R4 - Signature . // /� i /moi 1 HOLT? FOR $f@`([AI, kk.!IUIKCInC ?G • N
%pi/ Bar Sink Showers
WORKERS' COMPENSATION') t T •
I herebyaffirm that I have a certificate of consent to self-insure ora certificate861-vice • •
of-Worers''Compensation -Insurance, or a certified copy thereof (Section •
Backflow Pfev¢nt¢r -- Sink , S
3800, Lab. G.A 83-112589 James Econn Backflow Irrigation I j Sewer Cap . . 1 ELECTRICAL I - , ' FEES - V
�Pllcy No. JY Company • ,
pit Certified copy is hereby furnished. - Bathtubs 1 Sewer Connection , - Automatic Washer Transformer 0 15-50 KW,, .
666555 •
Ce tfie o filed with the Nty gull• 5 ��� �'
Date ii-2i`oaApphcant X �/� Clarifiers - • , I Solar.Collector''s �s Construction Pole Sub. ❑ 50+KW ...
EXEMPTION FROM WORKERS'COM6ENSATION1DECL- •ATION. 1 - '' Dishwasher . , Sola(Piping' - -- --"- ' "- Cooking Unit Meter ❑yup to 100amps --
(This section need not be completed if the permit is for one hundred ($100) or , -I
less). I + 1 - DrinkingFountains - - ' - - - .
I certify that In the performance of the work forwhich this permit is issued, i , Solar Tank ' Dishwasher 1 •Meter Dover 100 amps to
shall.not employ any person in any manner so,as to become subject to the - •- - ' •
Workers; Compensation Laws of California. + t Floor Drains. { Swimming Pool w/Spa I Dryers OGas ❑Electric Sub Panel '
Date Signature - - 1'
•
NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal 1Fan• 'Motors❑0.1 HP 01%-8
Workers' Compensation provisions of the-Labor Code, you must forthwith •- ' - -- - - - -
•
comply with such provisions or this permit shall be deemed revoked. ; Gas Service- Outlets' Water Closet F.A.U. Inc. •Solar❑915 HP 016-15+ •
CONSTRUCTION LENDING AGENCY _ - - -
I hereby affirm that there Is a construction lending agency for the performance - Interce tors I I t, 1
of the work •for ss ,y m 3097 Civ. CJ - p Water Heater Fixtures Microwave
Lender's Name w� ��h � T ���Il"-f� Kitchen Sink Water Service ,
Device Boxes Pole Light -
Lender's Address • .1 11 . 2 . 1 . . u. 1 . 1• _ -
OWNER BUILDER DECLARATION pp((1tgqpp77 • Lavatories - Outlets Range ' '
•
I hereby affirm that I am exempt from the Contractor's License9 Z�fbr theP—Tra
- Ilowing reason (Section 7031.5 Business and Professional Code: Any city or p - • - Switches. Sign
c,. ynst!structure, priiorwhich res to Its issuance,also to construct,
requiresethe applicantimprove,
molish or such permit! . Roof Drains! - t . .
-'"sb file a-signed statement that he/she is licensed pursuant to4the provisions of , 1 Garbage Disposal •Standing Sections . -the Contractor's License Law (Chapter 9(commencing with Section 7000)of ' - - ' • Generator ❑05 KW❑5-15 KW ,Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exempt ' - -' pa
therefrom and the basis for the alleged exemption', Any violation of Section . - - '
7031.5 by any applicant for a permit,subjects the applicant to a civil • 3 ,
enalty ofnot more than five hundred dollars($500). Reinspection-Fee . •$25 • Issue Fee + $
I, as owner of the property or my employees with wages as their sole . Reinspection Fee $25 Issue Fee' - $ 3
compensation, will do the work, and the structure is not intended or offered ' MECHANICAL - FEES •
for sale (Section 7044, Business and Professional Code: The Contractor's - - - - --- --- -- -- ------ -- .--- - PUBLIC SERVICES REQUIREMENTS:
License-Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 J I . 1
thereon, and who does such work Himself/herself or through his or her own Zoning Approved By W Date
employees, provided that such Improvements are not intended or offered for - Canopy Type II ❑
Duct-Under Ground /G/r
plsale.ti If, the own, the dimprovement i g within one yearofcom- Application Approved By Date
p move
the owner will havele the burden of proving he/she did not build or im- - ��li ,
Rrove for the purpose of sale). ' Duct-Structural Refrigeration System Application Issued By Dat
DU I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES
-The Contractor's License Law does not apply to an owner of property who - - - BUILDING PERMIT $ 3 .SQ SMIP $ a Co
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
0 lam'exem pt under Section B.& P.C.for this reason • Firepl/Fact.BIt. ICBO# PLUMBING $ ISSUANCE $ '
•
Dat41-21-83 • qwner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ •
I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000BT� ELECTRICAL $ • GRADING $
information Is correct. I agree to comply with all city and county ordinances - - ' -
and state laws relatin• to buildin• construction,a ereby authorize repre- • PLAN CHECK $ MICROFILM $ '
sentatives of, thi o- , �'•- a ention d-property for • ,
inspection purpor-- //� //, 11-21-83 I MECHANICAL ' $ ' TOTAL FEE $ 5940 (D
Signature e`' Date
Drivers' License or SS 5F * Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $
•CMF 0865-46 rev. 7/83 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - • - . . I _ _. _ -
•
'CONSTRUCTION AND PLANNIN., ' 'e•;; , - . . JOL&SPA ,,APPROVALS Permit ' Date Inspector _ APPROVALS Permit Date. Inspector
- 15 Temporary.Electrical Service or'Pole _ .52. Pool & Equipment Location '
2. Soil Pipe:Undrgrnd. .
• - 53.-Steel Reinforcement - _
r ' 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. `t/ '/Q1' US 57. APPROVAL TO COVER-GUNITE
7. Footings - .58. Electrical Conduit-Undrgrnd.
8; Foundation_ = •c._!. ' . 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. Root: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,yentilating 1_, 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test 72. Underground Flush ,
-24. Roof Framing ;..., . ' . i 73. Undergrnd.StorageTank 0 Gas 0 Oil
25. Roof Sheathing ' s 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical '
27. Frame and Flashing 94/17:-cf"�S 76. Dry.Stand pipe - - •
28. Lathing.;& Siding C /7- , 77. FIXED SYSTEM FINAL
29. Insulation J • •� 78. FIRE PREY. FINAL '
•
30. DrywallNailing �„ • 99 (,6< C HEALTH DEPT.:REQUIREMENT
31: Plaster Brown Coat` i tj . S 79. FINAL INSPECTION .
"32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED
33. Final ElectricNotes: i
34. Final Heating & Air Conditioning i '
35. Final Gas Pipe-Test _ '
t . .
36. Hood or Canopy - . , • ' w -
- -
37. Final Factory Fireplace : . - , I
,
38. Final Plumbing - . • , - ' -
39. Water Service-Final . ' i ,
40. Ga Service-Final -�' •• _ '
41. Solar Domestic-Final ° ' -_ _ . _ ' .. ,
42. Backflow Preventer , . '
43. BackfIcw2lrngation -
, -
44. it‘iildscarie Irrigation.Systemi , $ •• ` - ,
45. Sound (Attenuation .
46441Ndicap;Regulations ' • , • 1
47^FINALSTRL{Cr,FJRE & BUILDING - /bs77s .�s
48.,.Special Requirerlients Completed tofrsip ee ,
49. 1I�e'_cne Rele se'Lo Edison - - -
50. Gas'`tRN4e�sre to Southern California Gas Co - '
51. CERTIFICAAE OF OCCUPANCY �/
No. - �7 Date /H d S /'- L �•(p�,c I '
.
City of Costa Mesa
Development Services Department CERTIFICATE OF OCCUPANCY No. 000907
Building Safety Division
P.O.Box 1200
Costa Mesa,California
The Building located at 11 d4 1u,rgT,\i(.1471tv1 fPTlrb`
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
fora Group R-1 Occupancy.
Use of Building TATIMIRY Rf1C181
Legal Description 412—f1R4—f11
(See reverse side for Metes and Bounds)
Building Permit No A._i11 nn Electrical Permit No. R1 SFQQ t:'1 Pan lumblog Permit No. P—i 91147
Mechanical Permit No. Number of apartments ./� and/or guest rooms
ISSUED TO: Building Official i . tit/, eter-21
MC LAIN DEVE DPMLNT COMPANY C Yl OccrZ—t,--
4 CORPORATE PLAZA ##101, NEWPORT BEACH, CA.
Date / .4 (lent ( /?Up S
This Certificate of Occupancy SHALL BE posted in a conspicuous place on th premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C.
•
CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File
•
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA - • ��� P •MIT NO. TRACT NO. LOT NO. BLDG.NO. -
I
•
CONST CTION PERMIt ✓ /� — 0 ,
H 'j('1 ;, ICU •f„ ; , .-_ 6784 3/20/84 22.00 TL
Project M'ddre5 --" • - • TYPE OF CONSTRUCTION' es NEW NI ADD NVALTERATION NI REPAIR '
Applicant's Mailing Address P.O. Box 536 Sante Ana, 'Ca; ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.5r' I Zone •
Owner's Name MC Lain Dm CoPhone 640FiROO DESCRIPTION OF WORK SEA
L S Main Building: Accessory Building: izAddress ! ••• E••• -• - -• - - TYPE OF PERMIT ❑ GRADING LJ FOUNDATION U STRUCTURAL T Front Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL B Rear .A Address OTHER - p Right Contractor's Name• P2urn6.U'tg Cont. Inc. Phone- 531-0'240 PROJECT DESCRIPTION SQ. FT. OCCUPANCY • K '
Address(mailing) P.O. Box 536 Santa. Ana, Ca. C ONSTRUCTION TYPE Ptum6.ing VALUATIONS S Left •18996 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park,Fees $'City License No.LICENSED CONTRACTOR DECLARATION Remarks: 6//!OO - • Parking Req./Provided . . .1 hereby affirm that I am licensed under provisions of Charter 9(commencing •
with section 7000) of Division 3 of the Business and Professions Code,and , - , Use of Building:my license is in full force and effect. • .License Clasp,,._, C_36 u • se N424734- PLUMBING I FEES Planning Notes: •+ate /9>! SignatureIo WORKERS'COMPENSATION DECLARATION - , Bai$ink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers''Compensation Insurance, or a certified copy thereor(Section BackflDw Preventer _ _ ' _ Service Sin �AM�a•. n _ a OQ
3800, Lab. L) I - Backflow Irrigation ((
04324 Chubb - g Sewer Cap O_. vs --. ELECTRICAL FEES
\ Policy No. Company ' ,
Certified copy is hereby furnished. Bathtubs • / Sewer Connection s nO,, Automatic Washer Transformer ❑ 15-50 KW
filcCertified aqv z fy'Igtl with the city gy�Itliny Division. I - ❑ •50+ KW '
ate f-15-64 Applicant t'•�J1111D•(.reg cont. Int. Clarifiers Solar Collectors Construction Pole Sub. -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Dishwasher - Piping - -
(This section need not be completed if the permit is for one hundred ($100) :51r Solar . Cooking Unit Meter ❑uii to 100 amps
less) - ' DrinkingFountains
I certify that in the per performance of the work for which this permit IsIssued,t I , Solar Tank Dishwasher Meter Dover 100 amps'
shall'not employ any person In any manner so as to become subject to'te •
Workers' Compensation Laws of California. , • / Floor Drains Swimming Pool w/Spa -; OC/ Dryers ❑Gas ❑ElectricSub Panel ,
Date - Signature '
NOTICE: If,atter making this declaration,you should become subject to the ' Floor Sinks , Urinal , _ - _ Fan . 'Motors❑0.1 HP ❑1'h•6 .
Workers' Compensation provisions of the Labor Code, you must forthwith �• --
comply with such provisions or this, permit shall be deemed revoked. , :/ Gas Service ' S ,Outlets - ' Water Closet • ..2 00- F.A.U. Inc.Solar 09-15 HP 016-15+
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors ' , Water Heater a OO Fixtures •Microwave
of the work for which this permit Is issued (Section 3097 Civ. C.) :
Lender's Name' - - - . Kitchen Sink - Water Service
. . ' e. pO • Device Boxes Pole Light
Lender's Address '
OWNER BUILDER DECLARATION • Lavatories , 4 IN)C ..P 1T ���0 $,0Q Outlets Range
I hereby affirm that I am exempt from the Cdnlraclsr'S License Law for the V
following reason (Section 7031.5 Business and Professional Code: Any city or P—Trap - Switches ' Sign
-ounty which requires a permit to construct,alter,Improve,demolish or repair
y structure, prior to its issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing Sections
file a signed statement that he/she is licensed pursuant to the provisions of -
.ne Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW❑5-15 KW Trash Compactor
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 -
7031.5 by any applicant for a permit subjects the applicant to 'a civil Reinspection Fee I $ 3
Cenalty of not more than five hundred dollars(8500). - pB $25 Issue Fee
I, as owner of the.property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES l 7
for sale (Section 7044, Business and Professional Code: The Contractor's - - — PUBLICSERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or Improves ' ' Boiler - Hood or Type I ❑ • •
thereon, and who does such work himself/herself or through his or her own - Zoning Approved By nate
employees, provided that such improvements are not intended or offered for Canopy Type II ❑
sale. If, however, the building or Improvement Is sold within one year of corn- Duct-Under Ground Application Approved By ' Date
pletion, the owner will have the burden of proving he/she did not build or Im- —
rve for the purpose of sale). Duct-Structural Refrigeration System Application Issued By - � DateR
oI, as owner of the property, am exclusively contracting with licensed con- '
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating , 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES .
The Contractor's License Law does not apply to an owner of property who
builds or Improves thereon,and who contracts for such projects with a con- - Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
tractor(s)license pursuant to the Contractors License Law). -
PLAN CHECK $ PERMIT
❑•I am exempt under Section - - - B.& P.C.for this reason Firepi/Fact.BIL ^�ICBG 4 PLUMBING $ 0 ISSUANCE r $ "Y'"-
Date Owner • i Heating System&Ducting PLAN CHECK $ c Od ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,00067E _ • 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 • $ MICROFILM $
sentativez of this city to'enter upon the above-mentioned .property for
Inspection purposes. MECHANICAL $ ' • TOTAL FEE $ Qr:400
Signature .- +� _ Date/ +
Drivers'license or 55 '1hYv' C A>-c t ,•'•/ Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ •
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-'Assessor- - ' ' - - - -. - -— -- - - - - - _
r, .. .. .
CONSTRUCTION AND PLANNING , - L& SPA
DateInspector Date Inspector
APPROVALS Permit# - APPROVALS Permit#
4
1'..Temporar�y, Electrical Service or Pole _ 52. Pool & Equipment Location
' 2. Poll PipeiOndrgrnd. ry `%rddi% GfO 53. Steel Reinforcement
3.'wrrRElectri€cbl ConduiyUdJity-Undrgrrii. oc 54. Forms
.... . Fw
4.1 Electri6bl Gonduit:JOrefnd. A 55. Electrical Bonding •
5,E3te l i jorcem nt•3 56. Rough Plumbing & Pressure Test
6.EIe�trryal4FERc3rnd. 57. APPROVAL TO COVER-GUNITE
7. o$tings tai v
. .A 58. Electrical'Conduit-Undrgrnd.
� B.�Fo�ndati`n co
59. Gas Pipe, 0 Undrgrnd.,Test
9. Weider Pipe-Undrgmd'4 1747/779:e (/J 60. Backwash'Lines, P-Trap, 0 Undrgrnd.
;seti. a, , -. -, 4,
10. StrGcturalirloor System -o 0 61. APPROVAL TO DECK
11. Property Sewer Line &House Coa`,ection y//n/f �O 62. Backwash & Receptor-Final
n I.-
12. Sewer-Car) :� a 63. Heater & Vent-Final
ci4- g w c5
13. Roof 1.-- .1: , 64. Plumbing System - Final
14. RoUgiklumbingo WHIP( CAD 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 o5 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72.-Underground Flush
24. Roof Framing i-' 73. Undergrnd.Storage Tank 0 Gas OOil
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 i 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
35. Final Gas Pipe-Test j/jw/,y air
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing /2/ZIP( LE
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer •
- )t)
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
(--61214A•eL4L.,- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 9917 10/11 /84 16.60 TL
CITY OF COSTA MES C(?NS RUCTION?�ERMIT� - PERM/IT^NO` /]Q TRACT NO. LOT NO. UNIT NO.
, Project Address • I ( I r qq�V UUP %�Kl ^ ,'LSC- C> Vi/)`I 1 f
Applicant's Mailing Address 4vsZ I �kQ,dmd TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION U REPAIR
Owner's Name AI C.�^ O�t� aPP_h_one ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# .g Zane
�sfr. t/ n Iv- ter, DESCRIPTION OF WORK/USE OF BLDG.
Address �.�3.e0,(. .G(-U;ul+� S Main Building: Accessory Building:
Z
Arch/Eng. - ._ License No. U TYPE OF PERMIT U GRADING U FOUNDATION Li STRUCTURAL E Front - O
Address ❑ TENANT ❑ ELECTRICAL El PLUMBING ❑ MECHANICAL B Rear - N
A I
Contractor's Name ' s' a-' /' - Phone g Q ❑ OTHER C Right N
0 /, PROJECT DESCRIPTION SO:Fr. OCCUPANCY K G
Address(mailing) 2:047--( al APC- d!L- Left
,fs CONSTRUCTION TYPE VALUATION$ $
�-J City License No. R
ZONE .. GRADING CU.YDS. ACRES - E
I LICENSED CONTRACTOR DECLARATION _ - Ping. Ref.# Parking Req./Provided
i �GC./ Q
I hereby affirm that I-am licensed-under provislonS of Charter 9 (commencing . Remarks: Planning Notes: - M
with section 7000) of Division 3 of the Business and Professions Code,and
my license is in full force and effect. LA, T
License Class G `l License / I - S-
latea Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATION •
I hereby affirm that I have a certificate of consent 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. C.p 71-
Q nq,�t Q - Automatic Washer. Transformer 0.15-50 KW 3
PolicyNo. '�Q 51t/�+-1751 Company `i' �IY\ r/ Backflow Irrigation • Sewer Ca 0 50+ KW
P Y 9 P Construction Pole Sub.
8 Certified copy is hereby furnished.
CertIllcd yrd with the city Byi n Ion. cQe'tj. Bathtubs Sewer Connection CookingUnit Meter Dupto 100 amps
Date 1 -- = Applicant `v`r ""�
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers , I Solar Collectors • Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit Is for one hundred ($100)or Dishwasher
less). 1 _ Solar Piping Dryers ❑Gas ❑Electric ( Sub Panel S
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 ❑1%-'B
Workers' Compensation,Laws of California. .
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. - 09-15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to the - - �I '
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal 2 Fixtures
comply with such provisions or this permit shall be deemed revoked. - Microwave `1�
'`
CONSTRUCTION LENDING AGENCY - Gas Service ;,Outlets Water Closet (a Device Boxes • Pole Light
I hereby affirm that there is a construction lending agency for the performance • - -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater
Lender's Name P 2---Outlets Range +C
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 --
Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or -
'ounty which requires a permit to construct,alter,Improve,demolish or repair P-Trap
ay structure, prior to its issuance, also requires the applicant for suchpermit - Generator 00-5 KW 05-15 KW Trash Compactor
o file a signed statement that he/she is Iicensed'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 - '
7031.5 by any applicant for a permit subjects the applicant .to a civil •
enalty 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 I $15 Issue Fee i $ 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 (7
sale. if, however, the building or improvement is sold within one year of com- Canopy Type II ❑ t 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
Grove for the purpose the of pope). \ I rC. %
r t'as owner tr the property, Se exclusively contracting ing with licensed con- Duct-$Iructural Refrigeration System Application Issued By (J ) Date—TI l
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-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration - BUILDING PERMIT $ $MIP $
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.Bit. ICBG# — PLUMBING $ PERMIT
ISSUANCE $
Date Owner Heating System& Ducting PLAN CHECK 25% $ - �/ ENERGY P.C., $
I hereby certify that I have read this application and state that -the above 0o-100,000 BTU 0100,000 BTL ELECTRICAL $ I'1.Y'U 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- - PLAN CHECK 50% $ S. 7 O MICROFILM $
sentatives of this city to enter upon the above-mentioned property for . - - f�
inspection purapgsei�{{. ee� / 01-.(0.-rr"ct MECHANICAL $ TOTAL FEE $ I S .(gOi
Signature /YLC/•w.Ct �l7Wt•�^ Date
Drivers' License or SS / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ '
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - _ ---
CONSTRUCTION AND PLANNING•
• JQL & 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!ElectricalConduit-Undrgrnd. 55. Electrical Bonding
5: Steel Reinforcement 56. Rough'Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
1. 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 4( ril/L -�f�i 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.0Gas ❑Oil
•
23. Gas Pipe-Rough&Test - 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank ❑Gas ❑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 PREY. FINAL
•
30. Drywall Nailing i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric )%s
/9
Not": fg,Le.,
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 I -
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
t--(Au .5 - L. til 1 9 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 5300 1109/65 I X10.25 TL
CITY OF COSTA MESA . COp $ST�R U/C_T•,ION�IPERM1.T /� PERMIT NO. TRACT NO. LOT NO. UNIT NO. •
-
Projegt Address iI J N- 44, I'� ^ JJ r I
Applicant's Mailing Addressl .2.�LI /�L`2ate/tett TYPE OF CONSTRUCTION U ADD U ALTERATION U REPAIR - Ar
Owner's Nam `- �^ Phone III CONVERSION El 'DEMOLISH III OTHER A,P.# I Zone
y� q' ,d DESCRIPTION OF WORK/USE OF BLDG.
Address -- r IA `— t V - S Main Building: Accessory Building: -
IV) Arch/Eng. - License Na. TYPE OF PERMIT El GRADING El FOUNDATION ❑ STRUCTURALT Front . Z0
-.�..�y Address ,,/ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear _ N
Ole Contractor's Name We Phone ❑OTHER C Right - N
,` PROJECT DESCRIPTION SQ. FT. OCCUPANCY
I Address(mailing) 2-6 42-4 "r^'c �� K G
CONSTRUCTION TYPE VALUATION $ _ $ Left •
City License No. • R
1 ZONE GRADING CU.YDS. ACRES Ping. Ref, #
LICENSED CONTRACTOR DECLARATIONParking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: a/ cq 9 Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and l
my license is in fu farce and effect. _ T '
License Class —(l) License No-��31�� - • S
Date I—'elc-""76 " Signature A.p Lai) cfidare--e--i-- PLUMBING FEES _ -
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-Insure ora certificate '
of Workers' Compensation Insurance, or a certified copy thereof ( coon Backflow Preventer Service Sink - - •
3800, Lab. c.) ^-7--+{� I,f �JfI Automatic Washer Transformer 0 15-50 KW
Policy No. was MA-1 gS6 Company ---f--1V I`"` rl • Backflow Irrigation Sewer Ca - 0 50+ KW ' • '
8 Certified copy is hereby furnished. - - p Construction Pole Sub.
Certified£opy;44il¢tl with the city Builtlin on. /`� Bathtubs • Sewer Connection
Date 1� b YJ Applicant ,M../ i •
Cooking Unit •
Meter Sliver
to 100 amps '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Over 100 amps - C/�
(This section need not be completed if the permit is for one hundred ($100)or J`-•
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%-8
Workers' Compensation Laws of California. •
-
. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
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 --
comply with such provisions or this permit shall be deemed revoked. _ Microwave
CONSTRUCTION LENDING AGENCYGas 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, Outlets
Lender's Name 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 • Garbage Disposal •
following reason (Section]031.5 Business and Professional Code: Any city or 9 P ;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 ,
o file a signed statement that he/she is licensed pursuant to the provisions ofRoof Drains -.— - --
.he Contractor's License Law(Chapter 9(commencing with Section 7000)of • - -
Division 3 of the Business and Professions Code) or that he/she..
exempt , , - . - _
therefrom and the basis for the alleged exemption. Any violation of Section , '
. 7031.5 by any applicant for_ a permit subjects the applicant to a civil •
- ,
malty 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 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 .
employees, provided that such improvements are not intended or offered for . ' Boiler _thereon, and who does such work hlmself/herself or through his or her own ' DEVELOPMENT SERVICES REQUIREMENTS: -Hood or Type I 0 '
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ 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). - - -
El � n
I as owner of the property,am exclusively contracting with licensed con- • Duct-Structural Refrigeration System Application Issued By I,s� 1l
Date I 'IIc—
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 ❑100,000 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 _
of Exhaust System 0 Multiple 0 System Repair/Alteration $ $
proof their 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 Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BT ELECTRICAL $ �OJPO 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- •
PLAN CHECK 50% �.7'' • MICROFILM $ - _
sentatives of this city to enter upon the above-mentioned property for $
inspection purp• es f/��%7„ /"O_.P� , I
W ______!_7 0 G MECHANICAL $ _ • TOTAL FEE $ �T •is
Drivers'riverure 44 Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25%
License or 55 {� pe $
CMF 0865-46,rev.10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor T -�—
CONSTRUCTION AND PLANNING . - . _JL &SPA
APPROVALS . Permit# Date Inspector APPROVALS, Permit# Date Inspector
, .i . - _
•
-1. Temporary Electrical Service or Pole52. Pool & Equipment Location
'2. -Soil Pipe-Undrgrnd. ' . 53. Steel Reinforcement - . '
.3: Electrical Conduit Utility-Undrgrnd. < - . ' ' 54. Forms -
/ I 41 Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' .
• • 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. • 60. Backwash Lines,P-Trap,0 Undd
rgr .
• 10:,Structural Floor System - 61. APPROVAL TO DECK
. 11. Property Sewer.Line& House Connection 62. Backwash& Receptor-Final
1211 Sewer Cap '• 63. Heater&Vent-Final
I3.'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 _ 71 Undergrnd.storage Tank 0 Gas 0 Oil, .
25.moof Sheathing - 74. Overhead Hydro - -
_ 26. J-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 //yla 406 801 FOOD CERTIFICATE-ISSUED
33. Final Electric - j Notes: - - -
//9 4
34. Final Heating& Air Conditioning 111111 _
. 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 : 1
48. Special.Requirements Completed -
49. Electric Release to Edison . - -
50. Gas Release to Southerri California Gas Co' - ' 1
51. CERTIFICATE OF OCCUPANCY - • _ , _ . . _ ,
No. Date _ __ . - _ .