HomeMy WebLinkAbout289 PALMER ST - Building PermitsCi7Y oF coST�,aq-nnpEsn—CONSTrRUCTIO{N PERMIT
ProjectAddress T�Q9� ����—MC�� f .
ApplicanYsMailingAddress� � S��{�EQ���.
Owner's Namer� ���� ^ �� Phone � (
Address Lr>Q � /�
Arch/Eng. License No. �
Address
Contractor's Name—��E C-Q�--�S ' Phone 54 -
Addresslmailin9l—�-I�rO�p �S�iP��� _ _
City�License No. —�L.7 � lJ
LICENSED CONTRACTOR DECLARATION �
1 hereby aftirm that 1 am licensetl untler provisions of Charter 9(commencing �
wi[h section ]000) of Division 3 ot the Business antl Prote55lons Cotle, antl
. my license is in ( II fOr antl etfect. ��r�
� LJCCOSCCId55' LI Pp5 NO C��
Date Q ��R Signahre
I WORKERS'COMPENSATION DE RAT.ION � .
I nereby attirm that 1 have a certifi e ot consent lo sel/-insure or a certificate
o( Workers' Compenzation Insurance, or a certifietl copy thereot (Section �
� 3800,�Lab.�F{ ^,.,� '`
Policy No. t��� Company���'�`QNj ��(
1 e Certifietl coOY is hereby fumishetl. � � � .
,� Ce�tifi ' tl with [he city Bui ng Oivision
�y Date Applicant
EXE PTI N FROM WORKERS' CO P ATION DECLA ATION •
(TM1issection neeG not be completetl i� th ermit is for one huntlretl ($100) or
less)'
I certity [hat in the pe�to�mance ot the ork to� whicM1 tM1is petm�t is issuetl I
shall nat employ any person in any manner so as to become subject to t{�e
Workers' Compensation Laws of Califomia. , , - ' '
, Date ' Signature � � �
'NOTI[E: It, atier makin9 this tleclaration, you shoultl bemme subject to the
Wo�ke�s' Compensation ptovisions of �the labo� Cotle, you must forthwith
comply with zuch provisions or this permit shall be tleemetl revoked. '
GONSTRUCTION LENDING AGENCV�' ' ' ''
I hereGy atfirm that Ifiere i5 a'constru[tion lentling a9enq to� the performance
ot tfie �work far which this permit is i55uetl .(Section 309] Civ. C.)
Lentler's Name '
Lentler's Atltlress � -
OWNER BUILpER DECLARATION ' " '
I hereGy afiirm that I am ezemp[ from the ConVactor'S License �aw for the
following reason (Section 703L5 Business antl Professional Cotle: Any city or
munty which requires a Oermit to con5truct, alte�, improve, tlemolish or re0ai�
any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he/she is licensetl pursuant to the provisions of
the Contractor's LicenSe law (Chapter 9(rommencin9 with SeCtion �000) of
Division' 3 0( the,Business antl Professions Cotle) or that he/she is exempt
theretrom antl the basis for the allegetl exemption. Any violation ot Section
� ]031.5 by any applicant for a' permit subjects the� applicant to ,a civil
�enalty of not more than five huntlretl tlollars ($500). '
I,�as owner o( the' property or my� emplayees with wages as fheir sole .
mmpensation, will tlo the work, antl the structu�e is not intentletl o� ofteretl •
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
License Law aoes not apply to an owner ot a property who,builtls or improves �
theleon,-antl who tloes such work himsel(/hersel( Or lM1rough M1is or her own
employees, O�oviGeO that such improvements are not intentletl o� ofteretl for
sale. It, however, [he builtling or imp�ovement is Soltl within one year of com-
o�etioq the owner will have the burtlen of provin9 he/she tlitl not builtl or,im-
p�ovG for the purpose ot sale). �
❑ 1, as own¢r ot the property, am exclusively mntracting with licensetl con-
tractorsto constructthe project (Section 7044, Business antl Protessions Cotle:
The coMractor's License Law does mt apply to an owner ot property who
builtls or imDroves thereon,:antl who contracts fo� such projects with a con-
Iractor(s} li<ense pursuant to the Contractor's License Law). I am aware that
� D�mf ot their WorkeYs Compensation insurance shouitl be provltletl to me.
❑ 1 am exempt untler Section B. S P. C. for this reason
Date Owner
I hereby: certify thaf I have rea�
intormaiion is correct. I agree to
Drivers' Lice Or 55
CMF 0865-46,re 0/84
upon
nt to fill in all spaces exceo< <hose within heavy eortlei lines ane sign all aOProo/iate tleelarations.
.�,.,35:43� I ,,. I��, ,..,. I ���,, ���. ,
TYPE OFCONSTRUCTION � NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TYPE OF PERMIT LJ GRADIN�
� ❑ TENANT ❑ ELECTRICAL
O OTHER
PROJECT DESCRIPTION SQ. FT._
I-FOUNDATION LJ STRUCTURAL
PLUMBING ❑ MECHANICAL
CONSTRUCTION TYPE VALUATION $
ZONE _ GRADINGCU.VDS. �A(
Remarks: - � , � •
Bar Sink .
Backflow Preventer
Backflow Irrigation '
Bathtu6s ' �
Clarifiers
Dishwasher .
Orinking Fountains
Floor Drains
Floor Sinks -
Gas Service ' Outlets
<icehen Sink - '
Lavatories
'-Trep '
Roof Drains �
Reinspeition Fee' $15
Boiler
Duct- Under Ground � •
Duct-Svuctural �
Duct -_Ventilating _ . .
Exhaust System ❑ Multiple
Firepl/FacLBIt.ICBO# �
Heating System & Ducting
❑0-100,OOO�BTU 0100,000
� I Reinspection Fee
Builtlinq; Canary - AppliCant: P�nk - Acmunting; Goltlenrotl - Assessor
FEES
$hOW¢f5
Service Sink - `
Sewer Cap� , . �
Sewer Connection
Solar Collectors �
Solar PipingT �
Solar Tank � '
Swimming Pool w/Spa
Urinal
W222I CIOSEI
Water Heater �
Water Service
Auto-Wash `
laue Fee � - . $ 3
IANICAL FEE
Hoodor Typel ❑
Canopy Type I I ❑ .
Refrigeration System '
Oaioo,000sru ❑ioo,000
❑ System flepair/Alteration
Fire Dampers
Registets � �,
$15 � � � Isue Fee
$ 3
A.P. #
S Main Building:
E
T front
ARear
C Right
gLeft
Ping. Ref. #
Planning Notes:
Unit
Electric
F.A.U.
Fixtures
Device Boxes
Outlets
$witch¢5
Gar6age Disposal
Generaior �0-5 KW �5-15
� Zone .
Accessory Building: . '
i
Parking Req./Provided' '-
ELEC7RICAL .
Transformer ❑ 15-50 KW �
' 050+KW
Meter ❑uptot00amps
� Metec Dovec 100 amps . _
Sub Panel
Motors �47 HP
Ina Solar �9-15
Microwave
Pole Light -
Range
! Standing Sections
Trash Compacror
� Reinspection Fae �$15 � . � Issue Fee
DEVELOPMENT SERVICES NEQUIREMENTS:
Zoning Approved By
Building Approved By �
Application Isued By
8
5+
$ 3
' SUMMARV OF FEES ,
BUILDINGPERMIT $ SMIP $
PLAN CHECK $ PERMIT
, PLUMBING ' $ � � • �D �ISSUANCE � $ `
�� PLAN CHECK 25% �$ ENERGV P.C. �$
ELECTRICAL $ � GRADING $
PLAN CHECK 50% $ MICROFILM $
� MECHANICAL $ TOTAL FEE ' $ � `� �
P�AN CHECK 25% $ �
.. �. . .� - . . _. " � __ .... , y. . ' `. �
i . " , \
\ . . , .. __
- CONSTRUCTION�AND PLANNING ' , � POOL & SPA .
• APPROVALS Permit # �� Date � Inspector � AppROVALS �'- Permit # Date Inspecr�r
��,1. TemporarY�Electrical Service or Pole � _ - " 52. Pool'& Equipment Location '
(2.� Soil Pipe-Undrgrnd. � - , � : 53. �Steel Reinforcemeni _ , '
', �. �Electrical Conduit Utility-Undrgrnd. ' � .54. Forms- . '
I�lectrical Conduii-Undrgrnd. � ' � ' � -55. Electrical Bonding ' �
I�.a �� ,
��Steel Reinforcement _ 56. Rough Plumbing & Pressure Test ' '
i .
.�,61ElectricalUFERGrnd. ' 57. APPROVALTOCOVER-GUNITE . ,
.r i
, ,7�Footings -- -� - ,58. Electrical Conduit-Undrgmd. � .
�8. Foundation � � � � � 59. Gas Pipe, O Undrgmd., Test � I
9. �Water Pipe-Undrgmd. ' ' ' ' 60. Backwash L`ines, P_Trap, O.Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL TO 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-Fihal " � - " -
16- Rough Electric Wiring � ' , - - - � 67. Fencing & Access Approval � . "� � ' .
17�.�Rough Wiring Sign' ' . ' ' 68. AFPROVED FOR PLASTERING ,�
� 18� Rough Electrical T Bar Ceiling ., ' 69. POOUSPA SYSTEMS FINAL
19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' �
i
20: Rough Factory Fireplace . - . APPROVALS Permit # � �
21. 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 . . 73. Undergrnd.StorageTank OGas� OOiI �
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 Facxbry Fireplace • ' �
38. Final Plumbing • � � � -
39. Water Service=Final � - ' � �
40. Gas Service-Final , • �
41. Solar pomesticFinal � . . . , _. '
42. Backflow Preventer , ' , , � � ' ',
43. Backflow Irrigation ' � � •�
44. .Landscapa Irrigafion SYstem � � ' � � -
45. Sound ATtenuation - � � � � - � �
46. Handicap Regulations � , , . � - • �
!,
47. FINAL S7RUCTURE & BUILDING ' { � ' • •
- i ,
48. Special Requirements Completed � . ' . � � - �
; �
49. ElectrieReleasetoEdison - --� - . . � � �- � ' -'-' �
t �i.
50. Gas ReleaSe to Soutliern California Gas Cn • ' ' ��� "
51. CERTIFICAT�E OF.00CUPANCY , _ � _ __ . ' _ _ . . _ � .. �� .
Nn. - � � Date � � � ' � . : � • _ _
..� .
! . . �.. ... _.. . �, .. M � -. -. � . . _ ....- �
J OWNER SKOK� A. � � DATE rj—].Z-5S.
�� JOBADDRESS 289 Pal.mer ' BUILDINGPERMITNO. �.3Oµ
GENERALCONTRACTOR J2C}( COMIBiT VAWE $ <J�'j�L��OO
LOT /�� ].l']—],al—'ZF} BLOCK TRACT R.esidence & GaraQe
GROUP I TYPE v ZONE i`�+ FIRE DISTRICT 1319
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench � �+ "lQ' S
Foundation Forms and Grade to G ra �0'
Rough Framing � z `
Piumbing, Rough to Slab �LG/ — .J � / O %0 .i5 c� � i i
Plumbin4. Rouah Complek �O',' �)f- � � �`� __ . .i,k �,_� S /L _c— /f%C— lL
, Heating, Rough
Heating, Final e
.Sewer, House ' Sewer, St.
Septio Tank or Cesspool /j/
Lathing, In v Out
Plastering
Plumbing, Final, Fixtures Comple�
Plumbing, Fin.al Gas Test /�/g _
Wirinq, Final �
a
,��esa Building Departmentl�' APPLdCA�`ION FOR PERMIT
1��111 EAST 20th STREET �349 B lJ I L D�,� N G �
�� � COSTA MESA, CALIFORNIA 1
� FOI� APPLICANT TO FILL IN FOR O�'&'ICE USE ONLY :
� � _, .,_Receipt No.. Bermft No. `
Building - � , ' / 3(� :
Addreu '" '
Costa Mesa, i�'ia,I1fOPI113� Receive y oate Rec'd. Date Issued
Nearest � `S�/�-.�,j'��AY i z.�ss�
Cross St. Buildin
Address �
Owner Costa Mesa, California
Mail
Address — Nearest
Tel. Cross St.
City �p�SYA�'1.,rA'A No. Zone I No.of I Type I Group
Arch iteet or Lic. Plans
Engineer� No. Approv d� � `
by Data
Address CORRECTIONS
/� City Lic.
Contractor�� ( p,�+,t/,4�p No.
Address %%S� �i .s2��� C i ��i�,
LegPl I Lot � I I,y,/� ,pif -
Descri tion No._ 81ock Trac�_ _ _ ,�ti
> �p�� 7-/�/- a�` �._„-- _
(Attach Metes and Bounds ��"--
No. of Bldgs. l
Size of Lot Naw ort Lot i`' O
Useof �gq�pgNfF No.oT No.of - �' " �
Existing Bldg. y� . I Familles�I Rooms .j . y�
Setback Linefrom /['� Rear Vard
Center oi Strcet �� /t Side Vard � - - j
DESCRIP'1`ION OF WORH �
New I�I I Alteratfon I I Atldition I - ' �
Repair I I Moving I I Demolish I � � °i �
Building No. of �
Size Rooms Stories
Exterior Wall Roof
Covering �Y!/fCG I Covering CpyJ�O APPROVALS
Use oT New �Foundation Lxatian Ins eetor D.ate
Building �lYS /At�'1✓G�` P
Forms, Materials,
�` Under-Pinning
Frame: Fi re Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is rnrrect and agree to comply
with all City Ordinances and State Laws regulating. Lath. Ext.
building construction.
Signatureof �� � ,. �_ _/
Plaster, Int.
Permittee Ahv,L'eI/
� - Plaster, Ext.
Authorized Agt. � �
�,� � / � � � Masonry Reinforced
Valwati T Permit Fee $
Q� Plan Check $ Bond Beam
$'�- Total �f
Fee $ pc � FINAL
COHM 206 G-H 2M 5-Sd I �- -
t
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PLOT PLAN
Show locatlon and distances from
property line and between buildings.
1 .
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h'AY 1 2-55 cosra � r at�*�
PD�ESA 374a Z�.QQ
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