HomeMy WebLinkAbout3116 MONROE WAY - Building PermitsI
CIT,�'OF COSTA��A CQ�$UCTI/ON�P�ERMIT ,
�roject Address J_� ��� A� 3��
ApplicanYsMailingAddress ����, ��-�� �-ti±.C���y�N��,
Owner'sName �'��C� �i.��`'— Phone���..
Address ����% �"��� �l
ArchlEng. License No
Address �J . �y��y� Q�� �����
Contiactor's Name��E `nµ�� �'-`3L�•-d��-Phone�'.�--0.� 1t:
Addresslmailing) ����< « � •nla����C1 �
City License No. � ��Z�
LICENSED CONTRACTOR DECLARATION �
1 hereby atfi�m that I am licensetl untler provisions of Charter 9(commencin(
with section 7000) o( Dlvision 3 of the Business antl Professions Cotl¢, anc
my license is in fu�l.ji+Jce ane ettect. ,/t� r,�.1--�
Applicant to fill in all spaces exttpt ihose within neavr bortler Iines antl sign all appropriate tleclarations.
PER N TRACT NO LOT NO Upiir nin
DateJ_/.�.�/_aQ_ Signature L/�b'j�c�%'�yJ�.��
WORK�RS'IOMPEN5AT10N DECLARATION
� M1ereby affirm tha[ I have a certificate of consent to self-insure or a certifica[e
Workers' Compensation Insurance, or a certitietl copy tM1ereof (Section
0, Lab. C.) �
licy No. Company
8 Certifietl copy is hereby fumishetl.
Cer[ifietl copy is filetl wi[h the city Building Division.
Date Applicant
EXEMPTION F.0.0M WORKERS' COMPENSATION DECLARATION
(This section neetl not be tompletetl it the permit i5 for one huntlretl ($100) or
less).
1 certify that in the performance of the work'for which this.�e�mi{ is issuetl, I
shall not emp�'� any person in any m3nntj�s try �ome�subject to tne
Worker' om tion Laws of Calitdil�a/ / GS
Date Signature /✓�A q �
NOTIC : If, ter making this tleclaral�on, you shoultl becom subject to [he
Workers' Compensalion provisions of the Labor Cotle, you must fortM1witM1
comply with such provisions or this pe�mi[ shall be tleemetl revoketl.
CONSTRUGTION LENDING AGENCV
I M1erety affirm that there is a mnstruction lentling a9en[y fo� the perfo�mance
ot the work for which this permit is issuetl (Section 309� Civ. C.j
Lenaer's Name
.Lentler's Atltlress
OWNER BUILOEN �ECLARATION
I bereby affirm that-I zm exemp[ from the Contractor'S License Law tor the
following reason (Se[tion ]03L5 Business antl Pwfessional Cotle: Any city or
munty which reqwres a pe�mit to construct, alter, improve, tlemolish or repair
any structure, P�ior to its issuance, also requireSlM1e applicant fo� such permit
to file a siqnetl statement that he/she is licensetl purzuant to the provisions of
[he Contractor's License Law (Chapter 9(commencing with Section ]000) of
Division 3 of Ihe Business antl Professions Cotle) or tnat he/she a ezempt
' 'efrom antl the basis for the allegetl exemp[ion. Any violation ot Section
.5 by any applicant fo� a permit subjectz Ihe applicant to a civil
ity of�not more lhan five huntlretl tlollars ($500).
�, I, as owner of Me pro0erty or my employee5 with waqes as thei� sole
compensation, will do tne work, antl Ihe structure is not intentletl or offeretl
ior sale (Section �044, Business antl Professional Cotle: The Contractor's
License Law does not apply to an owner of a property who builtls or improves
thereon, antl who tlaes such work himseli/herself or tnrough nis or her own
employees, provitletl that such improvements a�e not intentletl or ofteretl for
sale. If, however, tM1e builtling or imp�ovement iz soltl within one year of com-
pletion, ihe owner will'have the burtlen o( proving he/she tlid not builtl or im-
p�ove for tM1e pur0ose of sale). �
❑ I, as owner of the property, am ezclusively cont�acting witM1 licensetl con-
[ractors to construct me project (Section 7044, Business antl Professions Code:
The�ConVactor's License Law tloes not apply to an owner oi property who
builtls o� im0/oves thereon, antl wno contracts for such projects with a com
tractor(sl ucense pursuant to tne Contractor's �icense Law). I am aware that
proof of their Worker'S Compensation insurance shoultl be p�ovitletl to me.
❑ I am exempt untler Section 8. & P. C. for this reason
. Date � - Owner �
��. 1 hereby certiry that I have reatl this a lication antl state that the above
I iniormation is correct I agree to yo qY �jh all city antl county ortlinances
' antl state laws re�ating to buildi}Yq r ion, antl nereby autho ize repf�
sentatives of tis cit to e Er n above�mentione�l Pr �p/ert //�'�/or
in5pection F��� � L�Y/ S
Signature / Daie
Drivers' Li 5 SS � ���_�
_� .�/993
TVPEOFCONSTRUCTION NEW ADD ALTERATION
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
D�SCRIPTI y(yF WQ RK/USEOF LDG.�'1'{q�� u'�(' � ��"+
DN'�'Z FL4��l'b FIEI. /4'�IU ��t' li
TVPE OF PERMIT GRAOING FOUNDATION STRUCTV
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAI
� OTHER � +
`PROJECT DESCRIP710N SQ. FT. `$� �'�� � oCCUPANC
CON STRUCTION TVPE VALUATION $ �
20NE GRADINGCU.VDS. AC��
qemarks: /� . . . .
P
Sink
cflow Preventer
cflow Irrigation
nubs
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
�OLQfCBPLOfS �
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Strucwral
Duct - Ventilating
Exhaust System � Multiple ❑
Firepi/Fact. BIL ICBO #
Heating System & Ducting
❑0-100,000 BTU O 100,000 BT
Reinspection Fee � $15'
CMF 0865-46, rev. 10/84 White - Builtling; Canary - qppllcanh Pink - qccounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Co1lecJors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heacer
Water Service
A uto-W ash
Isue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteretion
F ire Dampers
Registers
Issue Fee
REPAIR
$ 3
$ 3
A.P. # . .
� Main Buildi
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Plannino Notes:
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Accessory
I Parking Req./Provided
ECECTRICAL. .
Transformer ❑ 15-50 KW
' ❑ 50+KW
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Genereror DO-5 KW �5-15 KW
Meter' Dup to 100 amp5
Meter ❑over 100amps
Sub Panel
Motors DO-1 HP �1 %� 8
Inc.Solar �9-15 HP �i6-15+
Microwave
Pole Light
Range
Sign
Standing Sections .
Trash Compactor
� Rainspection Fee �$15' I I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
Building Approved By
App�IWLIOO luued BY -
BUILDING PERMIT $
PLAN CHECK � $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $�
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
Z
O
N
I
N
G
R
E
Q
M
T
S
FEES
$ 3
ea
SMIP $ •�O
PERMIT
ISSUANCE $ ,
ENERGY P.C. $
GRADING $
MICROFILM $ '�/�,��
TOTAL FEE $ ��+sL
C9NSTRUGTION AND:PLANNING POOL & SPA . , �
APPROVALS 'Permit.# Date Inspector AppROVALS Permit# Date Inspector
1:-Temporary EleCtrical Service or Pole 52. Pool & Equipment Location
t , �,'
2. Soil Pipe-Undrgrnd. i . ' 53. Steel Reinforcement�
3. Eiecv�cai Conduit Utility-Undrgrnd. 54. Forms •
r
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding _ F,:�
5. Steel Reinforcement 56. Rough Plumbing & Pressure,Test '
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE� �
• 7. Footings �� ' 58. Electrlcal Conduit-Undrgrnd.
8. Foundation •- � 59. Gas Pipe, O Undrgrnd.. Test
9: Water Pipe-Undrgmd(,. 60. Backwash Lines, P-Trap, � Undrgrnd. �
r
�r. --
' 10. Structural Floor System � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing �� - 65. Electrical-Final .
75. Rough Electrica6Conduit 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. POOUSPA SYSTEMS KINAL ' ���
19. Rough He2ting & Air Conditioning FIRE DEPT. REQUIREMENT � - . �
20. RougR Faotory Fireplace ; -' APPROVALS Permit # ,, - __
21. Ducts, in 5tructure 70. Underground Hydro � "� � "
22. Ducts, Ventilating� 77. Product Piping OGas OOiI',� • �
23. Gas Pipe-Rough & Test 72. Underground Flush ' '�-. "'
24. Roof Framing . , 73. Undergrnd.StorageTank [}Gas ❑Oil � - � �� �
25. Roof Sheathing � 74. Overhead Hydro S'• �-�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . "
27. Frame and Flashing � 76. Dry Standpipe �- � `
28. Lathing & Siding 77. FIXED SYSTEM FINAL`�'� 1
29. Insulation • 78. FIRE PREV. FINAL '
30. Drywall Nailing HEALTH DEPT`REQUIREMENT �� �' f;
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 . ' � "
.< I.; �:
35. Final Gas PiPe-Test
.
36..Hood or Cflnopy �
37. Final Factory Fireplace � � `'�
:L �
38. Final Plumbing � ��) !
r l .:.
39. WaterService-Final � = ., ;� .-� cj� � � `
40. Gas Service-Final - (�•'� V� t�:
r
/ i
41.�Solar pomesticFinal . }'� ' � /i ' `� �a '
�
�42. Backflow Preventer � . • - �� / �� � �
�:43. Backflow Irrigation •�� � ' �� : . ' - j` �
44.� Landscape Irrigation System � . - 'i, ' • , � - � .
�45., Sound Aitenuation � � ' , ' � �
46. 'Handicap Regulations -� . . - ' � ��
47.'-FINALSTRUCTURE&BUILDING ,N, . � _ " '
/ 1c ``
48.'Special Requirements Completed . �'� ` 4+`.- � -
,.
49. ,Electric Release to Edison �'� ' �."'� �
50. Gas Release to Southern California Gas Co �
51. CERT.IFICATE OF OCCUPANCY -
No. ' Date � ._ � ,
\-
JOB ADDAESS
GENERAL
J,_
Reinf.
Date
DESCRtP1'lON OF WORK
FIRE ZONE VA
SUBCONTRACTOR
;� �3�8� FEE RECEIVED
�COSTA MESA BUILDING-SAFET' DEPARTMENT I�AAR � �9G�J
� P.O. BOX 91] G08TA M66A: CALIFORNIA �INANCE DE�.
CITV OF COSTA MESA
Foi Applieanf !o Fill In Complefely APPLICATION'POR PERMIT ,
TYPE OR aRuvr � BUILDING
• For Oifite Use Only
BUILDIN6 JZ ' ' �
ADDRESS J 116C81'T NO. ' PCqM�T NO.
. COSTA MESA, CqLIFORNIA � �j� g%
R6C[ V6 Y OA 6 N[ rv[O pATe l 9UE
` - 6 'J s
OWNER � ! 4L �
� . BUILOINa
MAIL AD�RE88 D ROC A L
A�DR688 _� O�V Q C y"1�
RIRB T/�/1� _
CO S NO.�. -4 I Z�NB TYPE l� GROUP
cirr .
ARCHITECT + ,(1 1 TEL. � BYPROVED pAT � /
ORENGINEER .l S VHl�(� NO. -- . 6
�J � O ING � �
ADDRE88J/ 7 1i Yi-c�%1i� �
ZO NO.O� U660PN6W
PLANB�' pU1LU1N0
CONTRACTOR '� G� y��. '✓' .
AD�RESS t� d. �� alrtloN �G I � j��s .
CITY .�j � � . . ' A..P. NO. � d
NOTE: NO EAV E OVERHAN6 SHALL BE LESS THAN
STATE . , T�L. �7 _ Z� 90' TO SIDE 9 REAR P. L.
LIC. NO. �I N , F.
EAVES
SIZE � I no.OFe�,n6s. ALLOWBD fU.B.C.REQUIREMENTI
OF LOT U NOW ON lOT
USEOF ] YARD3APPROVED YARD9APPROVED
EXISTING BLD6. �^ S, �,�1 CA.�... - MAIN BUILDING � ACCE55oRY BUILDINR
. f FROM C/L BTRE
. 9ETBACK LINE FROM . ' '+� � FRONT '��
CENTEp OP BTREE! R6AR YAR `•S .
/
SID6YARDI LEFT ' R16HT � R.HID6 � �F9'. Ff•
DESCRIPTION OF WORK �.eioe Fr Fr.
NEW _ ALTERATION ,_I ADDITION REAR . PI'. FT•
DI9TANCE BET. BET. MAIN d
REPAIR MOVIN6 � DHMOLISH MAIN BLDGB. ACGESS.BLDGB.
BUILDIN6 NO.OR VAR.TC �DATE '
SIZE Z ROOMg � g{pR165 C.U.P. APPROVED
EXTERIOR WALL n,ROOF G�u. . OTPROVEO �;
GOVERING � N ' COVERIN6 �
US6 OF BUILDIIiG AND WORK TO.BE PERFORMED
NA,,.._. � S -
�,1.- � � ,_., - 5�., ,�.
.,., - b s4. �. �
m
I HEREBY ACKNOWL OE THAT I NAVE qE�O TXI9 ApPLIGTION THE AMOUNT 9XOWN 11NDeR VALUATIOH IB FOR THE F
�NO eTATE THAT TXC �BOVE 19 CORplCi AND AOREfi TO COM- PURP09E OF 88TABL19HIN6 A P¢RMIT FF¢ ONLY. �
PLY WITH ALL CITY ORDINANC48 ANq gTAT6 UW8 R60ULATINO yALUATION
BUILOINO CONSTRUCTION. � ���� 0
. PERMIT FEE $ �
SIGNATIIRE - /� � ! ,�_ m
PERMITTE — • �A..� • lu • .
S 54-6 s
AUTHORIZED A6Ei`!T �9 �+_yA� � � �`
TOTAL FEE.
�
, ;'!I.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 CPBTA MEBA, GLIFORNIA
For Applieanf fio Fill In Complefely
TYPE OR PRINT
ADO E'ss � 3116 lflonn.o e'fl:u�c¢e CtJa
COSTA MESA CALIFORNIA
OWNER OCC.LSI.�� �LOQR U!1! QIL
MAIL 3225 �la�bo� a.C�d.
ADDRESG
TEL.
2ed fi. fde.�eofzrt
% LiPll¢¢�L.C.f �¢t�0
tj {��4� �4.L.L�U.
' TEL. .... � ,.
� NO. OF 9LDG8.
� 68TBACK LINE FROM �..� __ _ 7�� ��
DESCRIPTIOId OF
BUILDING � NO. OI
6RE ROOM:
PXTERIOR WALL . ROOF
COVERING. COVE
USE OF BUILDING AND WORK TO
i � - ���,�.��v���
EEB 1 0 1963
FINANCE DEPT.
' .,�T„ �r. rn•�p Ar1F�A
AP ICATION FOR� PER'MIT
BUILDIIdG
For Office Use Only
195UED
COSTA MESA. CALIFORNIA
ZONE TYPE (/ GROUP._.�( /
APPROVED
BY DATE
ZONING
zorve rvo. oF ''J use ov rvew s.:,9 �7a�.,
��/ I PLANB [J I BOILpING L`/_�t- �
�ui
LEGAL / �/.%.� T�y y !-3 G
DE9CPIPTION Ld �.� V
(GENTER LINE 8TJ
�/ FT. �
� FT.
s FT.
3 / FT_ �
� f' % 3I�
�- /%7�`' ��l ��� .��E °�
1 HEREBY ACNNOWLEDOE THAT 1 XAVE READ TH�9 APPLIWTION }�{E AMOUNT 6HOWN UNDER VAL ATIOx IB voa iME
ANO BTATE THAT THE ABOVE I6 CORRECi ANO AGREE i0 COM-
PUflP08E OF EBTpBL18HING A PfiqMIT FEE ONLY.
c�v W/rH ALL CITY OHUIN�INGE9 AN� 6TATE LAW9 RE6ULATINa
BUILDINO CON9 ION. VALUATION �/
SIGNATURE O PERMIT FEE $ ']��
PERMITTE $_ //��� � PLAN CHECK $ rL G..
�`
AUTHORIZED'ACENT '
TOTAL FEE
1 '7 �i G