HomeMy WebLinkAbout749 HUDSON AVE - Building PermitsL .
��� Q�2 �� AOClicant to fill in all s0aces except thase wilhin �eavy OorEer Iines anG sign all aporo0�iate tleclarations.
CITY OF COSTA eM-�E�S(A[� �([�_N�S�TR UCTI N PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
Project Addresz �L� T�tLI� � • ,
�
Applicant's Mail'r�g ddress �7
Owner's Name ���1 D�1/Q� � nnnd�"_���
Address �� ���'r ��-
Arch/Eng. License No.
Address
Convactor'sNa Phone1 /g�—��
Addresslma����� ��'�' L �a�ci�..�o� —�.51
City License No. "'[2��—
LICENSED CONTRACTOR OECLARATION
1 h¢r¢by aifirm [ha[ I am IlcensBtl untler p�ovi5lon5 of Charte� 9(cOmmencing
with 5ection 700 f DIVISion 3 of the Business antl PrOfesslons CotlC, antl
my Iicense Is in f I fo efi¢�L QLL� �
Li< 4�la � : e No.�'�' • �
DatPe�"—!�_ ._ 519nature _
WORKERS' COMPENSATION qECLARATION
�reby alli�m that I have a Ce�qticate of conseni t If-in5ure Ot a Ce�qflcate
Workers' Compensatlon Insyrance, or a certitietl copy thereof (SecHon
..a00, Lab C.� ��y�� Ty.,��
Golicy No.�� �� �"-� ^��—��mp - ` �
n�-y —Ccr�.i,�fi' tl cop is hereby (umizhea.
}�x�yl � letl wlth the <ity B i i.(j5�on.
�Date �� ApPli�an[ � �
E%EMPTI N F OM WORKER$' COMPENSATION DE L RATION
(Tnis section neetl not be completetl it the permit is for O untlred ($300) or
less).
I c¢rlity Ihal in tbe pe�fOrmancg of Ih¢ wotk to� whi[h this p¢�m�t is ISSu¢tl, 1
shall not employ any person in any Tanne� so a5 [o become subj¢<t to the
WOrkers' Com0en5aliOn LawS ot California.
Date Si9na�ure
NOTICE: 11, afte� making this tl8claratiOn, you shoultl become SubjlCt to tna
Workers' Compensation Provisi0n5 of tbe Labor Code, you musf foRnwl(h
comply wilh Such p�ovlslon5 Ot this p¢rmi[ shall be tleemeU �avok¢tl.
� CONSTRUCTION LENDING AGENCV
' I hereby altirm that there Is a construction lentlin9 a9ency tor the performance
I of [he work br wnlch this p¢rmit is i55ueA (SettiOn 3097 CIv. C.)
I LPntleYz Name
l.entler's Atltlress
OWNER BUILDER DECLARA710N
I hereby aflirm lhat I am exempt from lhe Contractor's License Law for lhe
following reason (Section 7031,5 Business antl Professional Cotle: Any city or
counry whith require5 a permit to con5[ruct, alt¢r, Improve, tlemOlish Or repair
any structure, prlor to its iszuance, alzo requires the applicant tor such permit
to lile a Signetl Slalernent Ihat he/She ls IicenSe� pursuan[ to the provl5ion5 0}
'^e Contractor'S License Law (Chapter 9(mmmencin9 w��h Section 7000) of
�ision 3 of lhc Business anq Professions Cotle) or tbat he/she is exempt
refrom antl the basi5 fot M� dllegetl ¢zemption. AnY violdtlon of $ection
�31.5 by any applican[ tor a permi[ subjects the applicant [o a civil
penalty oi noi more than five h�nared tlollars (E500).
❑ I, as owne� of the p�oper[y or my emplOyees witit wage5 as their sole
mmvensation, will tlo tne work, antl the structure iz not intentletl or otferetl
ior sale;/(x<tion 7044, Business antl Professional Cotle: The Contrattor's
License Law tloes not apply to 8n owner of a property v+ho builtls or improves
thereon, antl who does such wp�k himself/he�self or Inrough his o� 0¢� own
employees, provitletl Ihat sucM1 improvements are not Intentlocl or ofiCretl for
sal4>.1.,(� hOwevet, thG bUiltling 0� irtfP�ovement i5 soltl wilhin one y¢ar of com-
pletiOn,�]�� owner will bave tne bu�tlen of provin9 he/Sh¢ tlitl not bulltl or Im-
prov< for the purpose of sale).
❑ I, as owner oi the oroperty, am ezclusively contractln9 with Ilcensetl con-
VattOrsto COnstrucl [he project ($ectiOn ]064, Business antl PrOfe55io05 Cotle:
The ConVactor's License ldw does not a001y to an owner Ot OrOPer[y wh0
Duiltls or improv¢s thereon. antl who conVacts for such oroiacts wlt0 a r.on-
tractor(s) I¢ense pursuant m ihe ConVactorY License Law). I am aware tha[
proof o( Iheir WorkeYS Comp¢nsation Insu�anGe shoultl be provitletl t0 me.
❑ I am exem0� untler $e<tlon B. 6 P. C. tor thii reason
Date Owner
1 hereby cer[iry lM1a[ ave reai
inlo/mation i5 Correct I 9ree to
antl state laws relati t ilqjn
s¢ntatives o/ this c' ntj
inspec[ian purpo .
Signature
Drivers' License or 55 �
thi5
a
� ����
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ O ER _
ESC IPTIp O WORK/U•SEOF�8 LQG. �
� � Z��I lGi C'0'�ML1�S2'{�t�.'�
�VPEOF ERMIT GRADING FOUN ATION STRUCTURAL
❑ TENANT ❑ EIECTRICAL ❑ PLVMBING ❑ MECHANIGAL
❑ OTHER
PROJECT DESCRIPTION Sq. FT. oCCUaaN���_
CONSTRUCTION TYPE VALUATION S
ZONE GRAOI(VG GU. YDS. ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Orains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Dutt-UnderGround
Duct � Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFact. Blt �CBO #
Heating System & Ducting
❑0.700,000 BTU 0700,OOOBTi
peinspeMion Fee � $15
0865-4fi, rev. 5/BB White - guiltling; Canary - APOIIcanL Pink - Accountin9; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
$wimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Leundry Trays
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Re(rigeration System
❑0.700,OOOBTU ❑100,000BT
Sysrem Repair/Alteretion
F ire Da mpers
Registers
Issue Fee
A.P. 51E
5
S Main Building:
T ront
C A�ght
SLeft
Ping. Ref. #
Planning Notes:
FEES .4uwmetic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electtic
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator DO-5 KW 05-15
•
Zone
Accessory Building:
Z
O
N
I
N
G
R
Parking Req./Provided E
Q
M
T
S.
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up ro 100 amps
Meter ❑over100ainps�
Sub Panel �-
Motors 00.7 HP O1 :4 - 8
Inc.Solar �9-15 HP �16-15+
Microwave "
Pale Light
Range
Sign
Sianding Sections
� Trash Compactor
Fee �$75 � � Issue Fee
$ 3 DEVELOPMENTSEHVICESREQUIREMENTS:
Zoning Approvad By
FEES Building Approved By �
��' Appliption luuad By
$ 3
FEES
$ 3
SUMMARy QF EES Cp
BUILDING PERMIT § ��-•l_`�.-'F SMIP � $ b �
PLAN CHECK $ PEFMIT
PLUMBING S ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL 5 GRADING ' 8
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PIAN CHECK 25% $
['_ ^�:n��n1t-C^.743^A" Z":: 3 ' .
DAlE: u9i21/:U ''I:ic: uS:•.(� -
. � . ' �' - � - VA� . . . ..
�l
CONSTRUCTION AND PIANNING ;� POC SPA
APPROVALS Permit # '" Date Inspector AppROVALS Permit # Date Inspector
�
i. Temporar.y Electrical Service or Pole. _ - 52. Pool & Equipment Locati�4i .�l
2. Soil Pipe;Undrgrnd. ,.�'I� ,`' -- 53. Sieel Reinforcement
3. Electn`cal Condui(Utility-Undrgrnd. r �• 54. Forms ./
,
4_Electrical ConduitrUndrgrnd. � -� 55. Electrical Bonding �•
5..Steel'Reinforcement. �. I 56. Rough Plumbing & Pressure Test �i
- � '
6.�Electrical UFER Grnd � v 57. APPROVALTO COVER�GUNITE �
7��Fo"otings� � �'• ,� ,.�s 5S. Electrical ConduibUndrgmd. '
8., Fdundation , .� ^�' ���� . 59. Gas Pipe, O Undrgrnd., Test �'
J
9' �Water Pipe-Undrgrnd. �y� � '' �� 60. Backwash Lines, P-Trap, � Undrgmd.
70. Structural Floor System ' �- - 67. APPROVAL TO DECK '
11. Property Sewer Line & House Connection � I 62. Backwash & Receptor-Final
�
72. Sewer Cap -- t�_' ♦ 63. Heater & Vent-Final -'
i� -�
13. Roof �Drains �� 64. Plumbing System - Final
14. Rough Plumbing� 65. Electrical-Final r%
15. Rough Electrical'Conduit 66. Solar SYstem-Final
i6� 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. Duc[s,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. Undergmd.StorageTank OGas ❑Oil
25. Roof•Sheathing �r 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 r HEALTH DEPT. REQUIREMENT
31. Plaste[ 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 Factory Fireplace ,
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final
42. Backflow Preventer
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 ".
Y
No. Date �
OWNER nc�ve��� iv�iunniv. DATE ' '�••- '
JOB ADDRESS 7 9 Hudson Ave. BUILDING PERMIT N0,
�AP No.141-533-�6 LOT
•� �ECTIONS
Y
G! 5`
� WATER
� ROUGH PLUMBING
SPRINKLING SVSTEM
M ISCELLANEOl15
ROUGH HEATING AN� AIF CONOITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUND � POwER �
FOUGH WIRING
TRENCHES � FORMS Q STEEL REINF.
FLOOR SVSTEM
BON� BEAM � STEEL REINFORCE �
SHEATHING
FRAME ANO FLASHING
�..�,���.� - ��. � i ..,.
PLASTER, BROWN COAT
STP��CTURPL, FINAL
H G, VENT., REFRIG.
SUBCONTRACTOR
� 'l� 3828� APi 16-7���a�u�� 64�:t t�a:,�.SQ
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fip in Completely
REC,j,�I,�(.[D BY O9T�REQEIV D pqTE I�S�UE
BUILDING y � T G T/
ADDRE55
/ PE
OWNEF A.P. NO. + —
MAIL BUILDING �
Z . 7
ADDRESS ADDRESS /
W� U TEL. TRACT J�� LOT � BLOCK
CITV NO.
~ Z �A •—, ' / W AD A
Z Q CONSTRUCTION
ON LENDER /�i��«� �
2 (n
J � BRANCH
OWNEF
m _ ADDRE55 VALUE D (JU
ARCHITECT TEL. p ,�y S � S O D
J� OR ENGINEER N o'Jd/
V Q FIRE
W 2 ADDRE55 ZONE TV E" GROU
a W /�� APPROVED
WZ CONTRACTOR �(.C/� C BV DAT �
J Q
w w ADDRESS � TEL. , Z� E NO.OF VSE OF N ^�
Z� CITY � NO �SI P�� BUILDING a OC�
G
w � STATE � CITY VARDS APPROVED VARDS APPROVED
N� LIQ NO. J LIC. NO. MAIN BUILDING ACCESSORV BUILDING
_� SIZE NO.OF BIDC.S. (FROM C/L 5 ET) /�
OF LOT NOW ON LOT FRONT / FT.
USE OF y� /.�
EXISTING BLDG. /� / y/ 5 FT FT
F SIZE OF /� NO. OF
Z NEWBLDG. oi ROOMS STORIES L.SIDE T FT.
aEXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT.
VSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN &
a MAIN BLOGS. ACCESS. BLOGS.
O �� X�/ � CURP � APPROVED
F AR'FOVED
y —
Z
O c-.• _\
UI hereby acknowletl8e that I have reatl this application antl state
� ffiat tho ebove into�mntion is tOrrett nntl agreu ro comply with
� all laws regula[inp builtlinp construction, antl I shall not employ �
r ony person in violntion 0� the workman'z comp¢nsation laws af '
the Srote of Caliiomla. �
N e
ZI hereby cerUfy thot I orr� properly Iicansetl as a contracror untler SQ. FT. o
the State of Californie Bi+sinoss antl Professions Cotle, DivisiGn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
' Chapter 9, nntl that such iicanzes ure in (ull tOrce antl affect, or � THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
om exempt trOm tl'.e provisions of Ihe SroID Ot Cali�Omla Buslnass ¢
antlProtessionsCr��yg, Oiv�sio7 3,Chopter9. VALUATION m
� �� �� � � PERMIT FEE $ • O�D �
J
Sipnature oi ���jjj Q � m
Permittae � � «� � 5�QD� PLAN CHECK $ E
0
LL
Authorizetl Agent TOTAL FEE 5 •�
Lot 8_„Tr. 00
p �� � �?. /L i e
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 C08TA MEBA. CALIFORNIA
Fo� Applicant fo Fill In Completely
TYPE OR PRINT
BUILDING �
ADDRHSB $�SOII A
COSTA MESA. CALIFORNIA
� MAIL
;
FE� RECEfVED
�' &!AY 171So1
FINANCE OEPT.
CITr Of COStA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
aeceirr no. ,�r¢qa+,lj po�q
�� � S'+'L� o
RECEI�V6�,lY I DATE �C�81VEq I D.�TH ��UED�/
(/!/ -� / v / i G
rE�. COSTA MESA. CALIFORNIA
NO.
FIRE �
ZONE TYPE GROUP
APPROVED
61195 No: MI 6-�227
/I ��/ � 1 O/ � I NO. OP BLD66.
�)� i5 .l V NOW ON LOT
ZONING �a _�, Q�T
20NEn-� I PLA BP Z I BUILDIN�J/ StY g8T •
f\
LH6AL _ . n � .. ...-....
EVES
BeTBAIX LINH PPOM / // (CeNTen LINH BT.1
ceNT¢R oP eTReET D REAR YARD FRONT
SIDE YARD LEFT �J / IRIGHT /�/ R.SIDE U
DESCRIPTION OF WORK _ _ ,�
NO.
`"A34ucco �co°Er���d shingle
IILDING AND WORK TO BE PERFORMED
I X8R6BV ACKNOWL8DG6 TXAT I NAVB ReAD TNIB APPLIGTION
ANO 9TAT8 TH�T TH8 ABOVE IB LOHRHGT AND A6P6H TO CON-
P1.Y WITN ALL CItY ORDINANCE9 AND 8i�T8 LAWB i[HOULATN6
BUILDINO CONlTpMUGTION.
SIGNATURE Op 1^ ^ /�. ( .`��C�
PERMITfE —Y1E (
AUTHORIZED AGENT \
/7�
TXE AMOUNT BHOWN UNDER VALUATION �B IOq THH
PYRPOSE OF EBTABLIBHIN6 M1 PeqMIT REe ONLY.
VALUATION �
PERMIT FEE $
S -� PLAN CHECK S�— I
/ �� � TOTAL FEE �