HomeMy WebLinkAbout3253 NEBRASKA LN - Building PermitsApplicant to fill In all SDaces except those within �eavy bortler Iines antl sl9n all aOP�opriate tleela�ations.
CITV OF COSTA MESA '� PERMIT NO. TRACT NO. LOT NO. BLD . . ' SI-i i I i Ii^.�/ � � % o�: •� i
C(JF7&TRUCTION PERMIT � — 9 % � � ' , . _
� ProjectAddrMs e L85 8 II, ' TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR �
AppliCenl'SMailingAddl255 10422 Trask.Ave. Garden (�iiOV ❑CONVERSION ❑DE OLI H❑OTHER p�.p�6 Zp�q
�e l�acement of AU BTU
Owner's��Name ML. Allen chone54S-1911 DESCRIPTION,OFWORK P � _ �
Rheem S Main Building:. Accessory Building: Z
Address 3253 Nebraska Ln. E , o
TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL T Ffont � N
ArCh/En9. LlCense No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING � MECHANICAL B Reaf ' �
Address ' - ❑ �oTHER � A N
Contractor'sNam�A'�=S PLUmbing-Htg. Phone 530-2440 PROJECTDESCRIPTION SQ.FT.� � oCCUPANCv C Right G
K Left R
Address�mailing) 10422 Trask Ave. Garden Grove CONSTRVGTIONTVPE VALUATION$ S � ' E
City License No. 6664 � ' - zOnE GRADING CV. VDS. ACRES ping. Ref. �' � P2rk.FeCS $ . � � n
U '
UCENSED CONTRACTOR DECLARATION Remarks: Parking Raq./Provided � � . . �
I hereby attlrm that I am Ilcensetl untler isions ot harter 9(co m cing - R
wlth section 7000) ot Dlvision ot Business a Prof Co e, antl , Uie of Building: � ' • E
my Iicense is in full fOrce antl efte . . .
Licen a CI icense No. � � PLUMBING � FEES Planning Notes: � '- M
Date�l���� ' Slgnature � E
WORKERS' COMPENSATION RATION � Baf Sink � Showel5 '
' N
T
I hereby afflrm that I have a rertificate of mnsenY t self-insure or a certificate Backflow Preventer Service Sink ' - � � S
ol Workers' Compensation •Insurance, or a c¢rtiLetl copy thereof (Sectlon
3800, Lab. C.) � ' ' Backflow Irrigation Sewer Cap ELECTRICAL ' FEES
Policy No. [�Cg���G1Q Company Fremont � � �
Lf certlfiea copy is nereby fumishea. . . Bathtubs Sewer Connection : Auromatic Washer 'Transformer � 15-50 KW
CJ Cer etl p iilea witn the tlty uil �v' �
oate Yy'��4�'� nppiicant �'"��g �pd�bing-Heating Clarifiers � � SolarCollectors � ConstructionPoleSub. � ❑SO+KW
-EXEMiT10N FROM WORKERS'.COMPENSATION DECLARATION Dishwash2� � "' ' � Solar Pipin " ' -
(Thi55¢CtiOn neetl na[ be coTple[etl if tlte pe�mit is fo� One huntlr¢tl (5100) o� 9 Cooking Unit Meter Oup to 700 amps'
less). Drinkin FOuntains ' ' '
1 certify [hat �in lh¢ p¢rformance of the work fo! which this perfO�t i51s5ueQ I' 9 SOId! T2pk Di5hwd5h¢� � M¢tE! ❑OVC! 100 2Tp5
ihall not employ any person In any manner so as to become subject to'the
Workers' Comoensalion Laws of California.� Floor Drains Swimming Pool w/Spa Dryers �Gas �Electric • �Sub Panel . �
Da[e Si9nature
NOTICE: II, atter making IhiS tl¢clara[iOn, you shoultl becOme subject to tne FI00� $ink5 Urinal Fdn 'MOt0�5 00-7 HP �1 h- 8
Workers' Compenzation provisions ot tne Cabor CoOe, you'must torthwith . ' -
compry witn such orovisions or this permit sha11 be tleemetl revoketl. GasService Outlets Water Closet � ' � F.A.U. InaSolar 09-15 HP �16-15+
CONSTRUCTION LENDING AGENCV .
I hereby affirm that lhere is a conztruttion lentlin9 agenty tor the perTormance Interctpro�s Wate� Heater Fix[ures � MicrOwav2
o( thB wOrk tOr which this permit is ISsuetl ($ection 3097 Civ. C.) ,
Lentler's Name Kitchen Sink Water Service .� _ Device Boxes Pole Light
Lenaer's Atldress Lavatories
OWNER BUILDER DECLARATION . - OuLICtS flange ' .
1 hereby aiiirm that 1 am exempi from the ConVactor's License L.aw for t�e p_Tra
tollowing reason (Section 7031.5 Business antl Protessional Cotle: Any city or P Switches Sign �
toun[y whiGfi rGquires d p¢rmit t0 <onSVuct, alter, im0�ove, tler+�Olish or r¢palr _
any structme, prbr to its Issuance, also requires the applicant tor such permit Rooi Drains - Garbage Disposal . Standing Sections
to file a si9netl statement that he/she is licensetl pursuant to the provisions of '
tne Contractor's U<enze Law (Cnapter 9(commencinq witn Sectlon ]000) ot Generator �0.5 KW �5-15 KW Trash Com actor �
DlviSion 3 of the Business antl ProtessiOns Cotl¢) ot that he/She is exempt ' � ' P
the�efrom and the basis fOr the allegetl exemption. Any v101atlon oi SectiOn •
7031.5 by any applicanl for a permit subjects the aOPlicant to a civil R¢ins ctiOn Fee � $ 3
�enalty of not more than five huntlretl tlollars (5500). . PB ,$25 . � laue Fee
I, a5 Owner ot the prope�ty or my employees witlt wagEs as their Sole RBinSpectiOn F¢B $25 ISSUB FBe '$ 3
compensation, will tlo the work, antl the structure is not inientletl or offerea ' ' �MECHANICAL ��ES
for sale (Section 7044, Business antl 7rofessional Cotle: The Conbactor's - PUBLIC SERVICES RE�UIREMENTS:
License law tloes not apply to an owner of a property who bulltls or improves BOile� Hood or Type I ❑ �
thereon, antl who tloos sucM1 work hlmselt/herself or through his or her own � Zoning Approved By Date
employee5, provltletl that such Imp�ovements a�e not'Intendetl or olfereJ for � C2nOpy � Typ2 II ❑ -
sal0. If, hOwever, the bUiltlin o� Imp�ovement i5,5oltl wlthin one ea� of com- DuCt - UOd¢� �iroUnd �
9 Y Applieation Approved By Date
pletion, the ownor will have tna burtlen of proving he/she tlitl not builtl or im-
��ova fo� the pu�pose ot Sale). � Duct - StfuCtU�al Refrigeration System • Application luued By Det
I, as owner of the property, am exclusively mntractin9 wim Iicensetl con- ' ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Sectlon 7044, Business antl Professions Cotle: Duct - Ventilating , SUMMARV OF FEES
The Con[rdcto�'S Llcense Law tlOes mf apply fo an owner of pro0erty wh0 � '
Euiltls or improves thereon, antl wno contracts for suth projects with a con- Exhaust System ❑ MWtiple ❑ System Repair/Alteration � . BUILDING PERMIT $ SMIP $
tractor(s) Ilcense oursuant to the Contractor's License Law). �PLAN CHECK $ PERMIT
❑ I am exemo� untler Section B. & P. C. for this reason Firepl/Fact. Blt. ICBO # ISSUANCE $ �
, ��PLUMBING $
Oate Owner � ' Heating System & Ducting � pLAN CHECK $ ENERGY P.C. $
i hereby certify th reatl this app�i tion antl state that the above 1 QO-100,OOOBTU �700,000BT r1� t—__ �1. � ELECTRICAL $ GfiADING $
Inlormation Is co tt. I agre to comply w city and county orUlnances i� � u l�em
ana state I ws at iltling tl , antl hereby authorlie repre- ,�, 1 MICROFILM $
sentaHves f is to enter u n bo m ntionetl ro,Q �rW �rTM r MECHAN CAL $� TOTAL FEE $ ].�Q
InSPeGtlon �.//'. r
5�9nature ' D ���� '
Orivers' L cense or 55 � Reinspaction Fea $25 Issue Pee § 3 • PLAN CHECK $ � �
CMF 0865-46 rev. J/83 hite - Builtling; Canary - ApO�icanh Pink - ACCountlp9: Goltlemotl - ASsessOr - ' .
'CONSTRUCTION AND PLANIVING ^ POOL & SPA .
� APPROVALS Permit# Date Inspector qppROVALS 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�UFERGrnd. � , 57. APPROVALTOCOVER-GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd.
8:'Foundation �, • � � 59. Gas Pipe, O Undrgmd., Test - �
9. Water Pipe-Undrgrnd. � � - � 60. Backwash Cines, P-Trap, O Undrgmd. . .
10. Structural Floor System ' � _ -' 61. APPROVAL TO DECK .
11. Property Sewer Line & House Connection �- " 62. Backwash & Receptor-Final
� 12. Sewer Cap . �.� � 63.. Heater & VenDFinal
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 CondRioning � � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace �- � APPROVALS Permit #
27. DuCts, in Structure +" ' 70. Underground Hydro
�. ,� �
22. Ducts, Ventilating �� ' 71. Product Piping O Gas ❑ Oil '
23. Gas Pipe-Rough & Test � , 72. Underground Flush
24. Roof Framing �t,� � 73. � Undergrnd. Storage Tank�O Gas ❑ Oil
25. Roof.Sheathing },,,'', 74, Overhead Hydro
26. T-Bar Ceiling (Structuraq �&: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 MeterFinal � 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �Q�2��,3 �j�J-�,�Qf�.f� �(z
34. Final Heating & Air Conditioning Y���'� N.0 O�/��t, kl�N,v�
35. Final Gas Pipe-Test �C. p�SPrt/C ZA•i U MG.
36. Hood or Canopy , ' ' "
37. Final Factory Fireplace
3S. Final Plumbing � � �
39. Water Service-Final
� .
40. Gas Service-Final ,
41. Solar pomestic-Final
42. Backflow P�eventer . � �
43. Backflow Irrigation �� ' � • .
44. �Landscape Irrigation System �. •
45. Sound Attenuation '
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING �
48. Special Requirements Completed �
49. Electric Release to Edison �- - , ,
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Date
Lor 12
TR 3722 �
. � j�.��
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX �17 COHTA MHBA. CALIFORNIA
For Applicant fo Fill In Complefiely
TYPE OR PRINT
BUILDING 3253 NEBRASKA LANE
ADDRE68
COSTA MESA. CALIFORNIA
OWNER K 8c E DEVELOPMENT CO.�INC.
MAIL
TEL.
SIZE No, ov B�GB.
__ __ 70X�OO IRREG .._... __.. _
FEE RECEIVED
`_� OCT 241960
�'�fINANCE DEPT.
CfTY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. YEAMfT NO.
aecelyco er I o� � e
�''�'� �
BUILDING
ADDRE65
COSTA MESA.
FIRE
ZONE TVPE
APPROVED
ZONING
20HC I NO.OF I U8H OP NeW
R-1 PLANB �Tl 9UILDIN6 W
6
LEGAL
6VE5
BHiBACK 4NH FPON �j � � <CENTBR IINH 6T.1
cepieq OP ern¢sr J� REAR YARD Z� FRONT
� �
31DE YARD I �EF'� U RIGHT D R. SIDE
DESCRIPTION OF WORK ___
�BUILDING : -`��"� NO. OF
ROOF n��(
COVERI G
WORK TO BE PERFORMED
�
1 H8R8BY ACKNOW�008 THAT � HAVH ReAO 1H18 APPLIGTION }X6 AMOUNT BHOWN UNDeN VALUATION IB /OF THE
AND BT/�TC THAT TN8 ABOV¢ IB COPRBCT AND AGHEB TO CON• pUPP088 OP BBTABLIBHINO � PBHMIT FEH ONLY.
PLY WITN �LL CIYY GPCIN/.NCHB AND HTA L�WB Ii80U4TN0
BUILDINo CONeTRUCTIo �VALUATION /
81GNATURH OP
/���� � PERMIT FEE $ �!O �
PERMITTE D
S PLAN CNECK 3 I �! �
� AUTHORIZED AGBNT