HomeMy WebLinkAbout2437 NORSE AVE - Building PermitsApplican� to fiil In all ipaces except thosa
CITY�Oy ���_�;'�AMESA CONSTRUCTIONPERMIT� .
Froiect-Nl9dress �' 4 3 7 /U(9 JZ J� � � U}�
Applica�nt's Mailing Address a�} �% ��%d�25L� �-wL.7 �✓s.�] �
Owner's Name � mA" "r iYI.'Ph GPA`YY�.S Phone �[_a_G_�z��
Adtlress a44� �f'/ORS6 �fOST/9 7!')t'SI�1 92617•
Arch/Eng � License No. : j
Address �
Contractor's Nam � dW -' � Phone �
Address (mailing) ' � ' � � ' � �
� -x
City License No. � � '
LICENSED CONTRACTOR DECLARATION � .
1 hereby;affirm that I am licensetl;untler provisions ot Charter 9(commencinq
wi[h sectlon 7000) o( Division 3� of tM1e Busine55 antl Professions Cotle, antl .
my license is in full�force antl'effect. , , �
License Class ' License No. '
oate % - � Signature ' .
WORKERS'COMPENSATION DECLARATION � '
�I he�eby aftirm that 1 have a tertifitate of consen[ [o self-insure o� a certiticate
ot Wo�ke�s' Compen5ation Insurance, or a certifietl copy thereof (Section
3800, Lab. C.) � ' . ' ' ' ' '
Policy No. � Company
eCertitietl copy is her¢by turnishetl. � I �
Certifietl copy is filetl with Ine�city Building Division.
Date Applicant �
EXEMPTION FROM WORKERS• COMPENSATION OECLARATION
-(This section neetl not be completetl i! the"permi[ Is tor one huntlretl ($100) or '
less): � � � .
1 ce�tify that in the Oerfo�mance ot the work for which thi5 perm�t is issuetl, I,
sM1all not employ any pe�son in any manner so as to become zubject to tM1e
Workers' Compenzat�on'Laws o� Calitorni.y-7 . � ��,
Date g�� a Signature� yT��Q2L
NOTICE: If, after makinq this tleclara��s; you shoultl � me su�
Workers'I Compensation.provisions ot the Labo� Code, you must_forthwith ,
comply ,with� such p�ovisions or thi5 permit'Shall be.tleem¢tl revoketl.
CONSTRUCTION,LENDING AGENCV' 1
I hereby affirm that there is a construc[ion"lentling agency tor the per}ormance
o( the .work for which this permit is•issuetl (Section 3aW Civ. CJ.
Lentler's, Name -
Lentler's Ailtl�ess �
OWNERBUIIDER DECLARATION - '
I hereby af(Irm that 1 am�exempt from tne Contractor'S License Law Tor'the
followin9 reason (Section ]03L5'Buslness antl�Profeszional Cotle: Any city or �
county which requires a pe�miYto const�uct, altEq improve, tlemoli5h o� repai�
any structure, prior to its issuance, alsa requires the applicant for zucn permit
rto tile a'signetl statement that he/she is licensetl,pursuant to the provisions ot
ithe Gontractor's License Law (Cnapter 9(commencinq with Section �000) of
DiviSion 3 of the Business antl Professions Cotle) or that ne/sne is exempt
therefrom anG the basis for the allegetl exemption. Any violation oi Section
7031.5 by any applicant for a permit subjects the applican[ [o a civil
�e9� Ity of not more than five huntlretl tlollars ($500).
LVS I„ as owner o( the properry or my employeez with wa9es az tM1eir sole
compensation, will tlo the work, antl theSVuctwe is'not intentletl or oHe�etl
i0I Shc2 ($CCSI00 J�94. BU5111¢55 dlltl F(0f255100d1 Cotle: The COOLldCfOl'S
License law tloes not appty to nn own¢r o( a property who builtls Or impwve5
ihereon; antl who tloes such wo�k-himself/he�self br,through his o��he� own
employees, provitletl tM1at such improvements are not intentletl o� ofteretl (o� '
sale. If, howeve�, the builtling or improvement is sOld witM1in one yea� of com-
pletion, the owner wlll have.tha burtlen ot proviBq h¢)she ditl nat build or.im-
�rove tor the purpose of sale). -
I, az owner ot the oroperty, am eKclusivery contractin9 wlth licensetl con-
Vactors ro construct the project (Section 7044, Business antl Professions Gotle:
The Con[ra[tor'S License Law tloes nOt appry to an owne� ot prope�ty who
builtls or improves thereon, ana,who contracts �or such orojects with a con-+
tractor(s� license pu�zuant�[o-[he�Contractor'S Licens¢ Law). I am aware that
proof of their Worker's Compensation insurance shoultl be Provitletl to me.,
❑ I am exempt untler Section � B. & P. C. for ttiis reason ,
�
oate s� � �,(pq. owner ' ,
I hereby certity that I have reatl this application antl stete that the above �
information is correct. 1 agree to comply with all city antl county ortlinances
antl state laws relating'to builtling consVuction, antl hereby authorize repre-
sentatives ot this� ci�[ to entel� upon�1� above-mentionetl property �for �
inspection purpos¢r/� "'�"'// , /'
Si t � tit!/'
Pink - Accounting: Goltlenrotl - A55es5or
' �
' FEES '
�Service Sink -� -
Sewef Cap
Sewer Connection
Solar Collectors
Solar Pipin9 '
Solar Tank
Swimming Pool w/Spa
Urinal .
Water Closet � '
Water Heater
Water Service �
0
0
Issue Fee � . I $�3
Hood or Typel ❑ � -
Canopy Type I I ❑ � �
Refrigeration System
❑0-100,000 BTU ❑ 100,000 BT
System Repair/Alteration
Issue Fee
$ 3
1320 5/31/B4 �
Zone'
� ' � Accessory Building:
.. . ' -
il Parking�Req./Provided
� ' . . '"
8.0� TI:
ELECTRICAL ,
Automatic Washer - Transfarmer �-15-50�KW- '
ConstructionPoleSub. . ❑50+KW �
Cooking Unit ' . � Meter ❑up to 100 amps '
Dishwasher 'Meter �over100amps
Dryere �Gas ❑Electric Sub Panel
Fan � Motors�0-1HP�1`/:-8
F.A.U. InaSolar'�9-15 HP �1645�
Fixtures � � Microwave - �� .
Device Boxes Pole Light
Outlets Range � �
Switches
Garbage Disposal
Generaror �0.5 KW �5-15 KW
0
'Standing Sections
Trash Compactor
2
O
N
I
N
G
R-
E
Q
M
T
S.
I Reinspection fee I$15 I I' luue Fee ' I $ 3 I
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date �
Building Approved By � Date
Application Issued By � Date_ ���__
- ' SUMMARV OF FEES �
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT �
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ �— ENERG� P.C. $
ELECTRICAL $ � lS•W GRADING $
' PLANCHECK 50%i $ ' MICROFILM $ -
MECHANICAL $ TOTAL FEE $ ��OO
PLAN CHECK ,25% $ ,
- CONSTRUCTION�'AND PL'ANNING - POOL & SFA , . ,
Date � Inspector � • . � Date Inspector
� �APPROVALS Permit # , , ' APPROVALS � Permit #
• 7 Temporery Electrical Service or Pole • � _ 52. Pool & Equipment �Location � � � , . ,
"Soil Pipe;Undrgmd.' - � � 53. Steel-Reinforcement � � �
-3. Electrical Conduit Utility-Undrgrnd. � � 54. Forms . . . . � " _ � , � �
4. Electrical Conduit-Undrgmd. . - � 55. Electrical Bonding � . , . '
;�5. Steel Reinforcement . ' . 56. Rough Plumbing�& Pressure Test � � :
. 6.�'Electrical UFER Grnd. �. G Q � -� � -59. APPROVAL�TO COVER-GUNITE � - ' .�
� 7.' Footings � � � � � . 58. �Electrical'Conduit-Undrg�nd. r � .
' 8. Foundation '� 59. Gas Pipe; �� Undrgmd�.,,Test � � �
9. Water Pipe-Undrgrnd. � � 60. Backwash-L'ines, P-Trap, O Undrgmd.' � _
10. Structural Floor System , 61. APPROVALTO DECK�
1�7. 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. RougfiElectrical-TBarCeiling ' �69: POOUSPASYSTEMSFINAL � .
19. Rough Heating & Air Conditioning _ .�FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace � � APPROVALS � Permit # ' . ,
21. Ducts, in Structure� � 70. Underground Hydro � �
� '
�2. Ducts, Ventilating . � 71. Product Piping �Gas' ❑Oil
7. Gas Pipe-Rough & Test � 72. Underground Flush . ,
24. Roof Framing � � . . 73. Undergmd. Stoiage 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 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 . /0 7 • 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 pomestio-Final - � _ � . .
42. Backflow Preventer � � � �
43. Backflow.lrrigation • � . �
44. .l.andscape Irrigation System � .
45. Sound Attenuation � � , � ,
46. Handicap Regulations • , � � . � ,
47. FINAL STRUCTURE & BUILDING � � - � � � �
48. Special Requirements Completed , . � � �
49. Electrie Release to•Edison � - � � . ,
50. Gas Release to Southem Califomia Gas Co ' � " � � � .
51. CERTIFICATE OF OCCUPANCY - - . _,. . .
� No. " Date �' �
CITY OF COSTA MESA
BUILDING DIVISION
O�NNER-BUILDER VERIFICATInN
A city or county, which is required to give notice pursuant to Section 79830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require
the return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and retum this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be
issued until this verification is received.
1. I personally plan to provide� t� major labor and materials for construction of the proposed
property improvement. LYYes ❑ No
2. I(have/have not) signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firml to provide the proposed construction:
Name
Address
Phone (
Contractor's Lic. No
City
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
City
Phone ( 1 Contractor's Lic. No
5 I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
Name
Address
Phone - Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the
State of California Health and Safety Code and have completed the above information to the best of my
personal knowledge, in compliance with this State law.
Signed: 't' Date: s
Name: �?� f 'Yl Pil/ ��' �% � ,� .
(Printed or Typed)
C.D.L. #or S.S. #
754-5273
CMF 3062-46
1
�
Costa Mesa Building Department APPLICATION FOR PERMIT
--- P.O.Box�3!7 ;���5 BUILDING �
� • COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR AP� CANT TO FII.L IN I Receipt No. Permit No.
6ui�diny .� ^�� I
Addresa /
Costa Mesa, California Received by Date Rec'd. � �qate Issued �
Ne�.ve. , . ��o �/ �i� .(%I % 1�1-1•�
Cross St. %/a
Owner ZUCL.E
Mail
Address ^z �i�
egal Lot
:ription No. � � �
ach Metes and BoundsJ
of �ot /o /'�X /3S
0, O(
Costa Mesa, California
Nearest
C Cross St.
'- D'.i%�tl Zone p I No. of I Type �
!'1 Plans �
�-ioo-�s
No. of Bldgs �
Now on Lot
Na.oi � I No.ot �
F.ai..ilim Rnmm�
�
I hereby acknowledge that I have read this Applicatlon
and state thak the abme is correct and agree to comply
with all City Ordinances and State Iaws regulaUng
building construction.
Signatureo��
Permittee
APPROVALS
�n Location Inspecto
Materials,
�inning
'�.re Stops,
Ext.
r, Int
:r. ExL
Valuatlon Permit Fea $ �o(i �—' Masonry Re
3�� n� Plan Check $ ro '' eond Beam
s , � " Total p
Fee Q. � FINAL
xm 2os io�ss o. r. e s.
�1