HomeMy WebLinkAbout1747 IOWA ST - Building Permits _ Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations.
CITY OF COSTA MESA P MIT NO. TRACT NOl LOT NO.. •BLDG.NO. 1 - -
CONSTRUCTION PERMIT . f—A; c2 4a' , 1p ! •
Project Address /14 7 ��/-d• S� TYPE OF CONSTRUCTION ; p NEW ❑ ADD Li ALTERATION Li REPAIR 7030 3/23/84 I rt.",n Ti
Applicant's Mailing Addressdr/�� , rSAME •
❑ CONVERSION ❑ OEMOLySH ❑Js1THR. A,p,# Zone •
PA at V Qh/452A,/ !�5(q"35/8 `DESCRIPTION OF WORK Xe--/COOS
Owner's Name �t G Phone .S Main Building: Accessory Building: ' Z ,
o
Address SAM` TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION LI STRUCTURAL T •Front N
Arch/Eng. r License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B hear I
Address ����pppp �l�/1/'� .❑ OTHER - A . N
Contractor's Name o /- / i Phone PROJECT DESCRIPTION SQ. FT. �Do SltwA45S OCCUPANCY C Right G
v pci K R
Address(mailing/ CON ST RUCTION TYPE VALUATION$ 5135 -- S Left E
• ZONE GRADING CU.YDS. ACRES .PIng. Ref.# Park.Fees $ Q
City License No. '
LICENSED CONTRACTOR dECLA RATION - Remarks: . • Parking Req./Provided U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and Use of Building:
my license is in full force and effect. . E
- E
License Class License No.• - ' PLUMBING ' FEES Planning Notes:
rtitE
Date Signature LN
WORKERS'COMPENSATION DECLARATION Bar Sink Showers T
I hereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer - Service Sink S
of Workers' Compensation Insurance„ or a certified copy thereof (Section
3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. Company
8 Certified copy Is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50KW
Certified copy is filed with the city Building Division. ❑ 50+KW
Date Applicant Clarifiers Solar Collectors Construction Pole Sub. ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION in Dishwasher Solar Pi
(This section need not be completed if the permit is for one hundred ($100)or Piping Cooking Unit Meter up to 100 amps
less).
I certify that In the performance of the work for which this permit is issued I Drinking Fountains Solar Tank Dishwasher Meter Cover 100 amps
shall not employ any person In any manner so as to bec a subject to the
Workers ensptLon Laws of Callfor1a �to . Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
Date 7" O V" Signature }��.- � ,
NOTICE:If,iafter making this declaration,you s d become subject to the Floor Sinks Urinal Fan Motors 00-1 HP 01%-8 -
Workers' Compensation provisions of the Labo ode, you must forthwith — -
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. - Inc.Solar 09-15 HP 016-15+
CONSTRUCTION LENDING AGENCY .
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address - -
Lavatories •
OWNER BUILDER DECLARATION Outlets Range
1 hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign
county which requires a permit to construct,alter,improve,demolish or repair
-
any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains Garbage Disposal • Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of
the Contractor's License Law(Chapter 9(commencing with Section 7000) of Generator 00-5 KW ❑5-15 KW Trash Compactor
Division 3 of the Business and Professions Code)"or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee $ 3
penalty of not more than five hundred dollars($500). pe $25 Issue Fee
DC I, as owner of the property or my employees with wages as their sole - Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES
for sale (Section 7044, Business and Professional Code: The Contractor's _ PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I
thereon, and who does such work himself/herself or through his or her own
employees, provided that such Improvements are not Intended or offered for Canopy Type II ❑ Zoning Approved By - Date
Duct-Under Ground
sale. If, thwon, the building dopro i sold within one yearofcom- Building Approved By Date
prone the owner sewill hal¢ the burden of proving he/she did not build or Im- 1v 1, / { Sir
rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By 1L7 � Date
LiI, as owner of the property, am exclusively contracting with licensed con- ❑0100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMA Y F FEES
The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT S /ori V SMIP $ i :SQ
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration
tractors) license pursuant to the Contc o7)s cense Law). PLAN CHECK $ PERMIT
j79.J am exempt unde''``rSection `'` ' B.& P/.for this reason Firepl/Fact.Blt. ICBG 4PLUMBING $ ISSUANCE $
Date 7- ar'X`� owner ' /re^'4 - -l. Heating System& Ducting - PLAN CHECK 25% $ ENERGY P.C. '$
. I hereby certify that I have read this applicati. and state that the above 00100,000 BTU 0100,000 BT - GRADING $
information is correct. I agree to comply with a ity and county ordinances ELECTRICAL $
and state laws relating to building co. truction,and hereby authorize repre- PLAN CHECK 50% MICROFILM $
sentatives of this city to ent.' the above-mentioned property for $
inspection purygse�J -- • MECHANICAL $ i
Signature fC f'z«^"P �
76Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 25% $ •
Drivers' License or 55 1# -
CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting:Goldenrod-Assessor - - - - -
c- ' CONSTRUCTION AND PLANNING • POOL&SPA, _ -
:APPROVALS Permit# Date Inspector APPROVALS 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. 'Electkcal UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. •
8. Foundation i 59. Gas Pipe, 0 Undrgrnd., Test.
9. Water Pipe-Undrgrnd. t 60. Backwash Lines, P-Trap, 0 Undrgrnd. •
10. Structural Floor System 61. APPROVAL TO DECK •
11. 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.t 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. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil .
23. Gas Pipe-Rough& Test 72. Underground Flush
N'. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing - , . 74. Overhead Hydro
'16. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemicali
27. Frame and Flashing 76. Dry Standpipe -
' 28. Lathing & Siding i t 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 ElectricNotes:
34. Final Heating& Air•Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace - - -
38. Final Plumbing II -
39. Water Service-Final - -
40. Gas Service-Final i
41. Solar Domestic-Final . i .
•
42. Backflow Preventer • ..
43. Backflow Irrigation ,
44. ,Landscape Irrigation System
45. Sound Attenuation '
46. Handicap Regulations .
47. FINAL STRUCTURE& BUILDING 3-26-0 1P.
48. Special Requirements Completed
49. Electric Release to Edison - .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY - -
No. . Date' - - -- - _ _ _ _
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, 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 return 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�y the major labor and materials for construction of the proposed
IQ`
property improvement. Yes 0 No
2. I (have/have not) /-"AVS signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone ( ) Contractor's Lic. No.
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 ( ) - - - 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 wi th' ate law. c`��
Signed: �, 9 �7� Date: 2g -
Name: 7'c PAzi V o i so,o
(Printed or
Typed) �
•
7545273
CMF 1042-46
uy nks CITY OF COSTA MESA
9
it, .4. . A. CALIFORNIA 92626 P.O. BOX 1200
> i , Ie
:F
V. •• FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY
Sea to
Project Address /1i) 42C h - Permit # AilJ9l0, 7835
Project Name /� Type ,er, Ate" q
Owners Name _�'",.......2.4;,21 FL,
2:1•4144-07v
O
Owners Address ' FJ City Use Only
Owners Telephone c` 7- -3 7/5
AO
I e , t' "P" as Owner, Contr ,r, Age 4t (strike out all
except one) •. hereby attest that employment of any person, or persons, is not
anticipated .t the time of seeking the above-referenced permit. In the event that
any person, or persons, are employed under the provisions of this permit, I shall
immediately cause a valid Certificate of workmen Compensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own oast, and to indemnify and hold harmless, the City,
its officers, agents and/or employees, frau and against, any and all liability,
damage, costs, losses, claims and expenses, howsoever caused, resulting directly
or indirectly frau, or connected with the improvement under this permit.
I further state that I have read and fully understand the implications and re-
sponsibilities of the above statements, and will canply with all provisions of the
Contractors State License Law found under the Business and Professions Code,
Division 3, Chapter 9, of the State of California.
.� ,gq e -,70<'ISOs/
print Name
,e.,Za� 7-29-go
Signa Date
•
CMF 0777-46
Lor 45
TR 3722 [ 13149 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 4 OCT 21t1980
P. O. BOX 917 COSTA MESA. CALIFORNIA fill FINANCE DEPT.
���e
For" Applicant to Fill In Completely APPLI (CSU IQTPEM&
TYPE OR PRINT
BUILDING 11 BUILDING
ADDRESS 1747 IOWA STREET
COSTA MESA. CALIFORNIA For Office Use Only
` RECEIPT NO. I 1Vl-J�,Xl./Y, eLTY.eI
BL
OWNER K E DEVELOPMENT Co., INC. VI
MAILRECEI ED BY I DA EWIYEDD DATE ISSUED
ADDRESS _ tad(J eel OCT 2 7 1860
TEL. BUILDING
CITY NFWPORT RFA CH NOMI 6-32 ADDRESS
ARCHITECT TEL. COSTA MESA, CALIFORNIA
OR ENGINEER NO.
FIRE
ADDRESS ADDRESS ZONE TYPE GROUP... oe
CONTRACTOR K.W. KOLL APPROVEDBY DATE
ADDRESS I ACENTIA A ZONING
ZONE NO.OF USE OF NEW sLligl 2• .
CITY NFWPORT BFA C R-1 I PLANS 2 I BUILDING W. Att gar.
STATE TEL. LEGAL
LIC.NO. • • NO. M •- DESCRIPTION • 4 act
SIZE 62,83X100 IRREG I NO. OF SLOGS. 0
OF LOT NOW ON LOT A.P.NO. none
USE OF YARDS EVES
EXISTING BLDG
1 ♦ APPROVED ALLOWED
SETBACK LINE FROM 501 241 (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT r FT. IN.
SIDE YARD I LEFT (/I / I RIGHT ‘i R.SIDE ( FT. IN.
DESCRIPTION OF WORKFT. IN.
L.SIDE
NEW I II ALTERATION I II ADDITION I REAR . FT. IN.
/,�
REPAIR I s� II MOVING I /
SIZE -GAN 4
15771 5-
V DEMOLISH I ABY PPROVED , DATE 10-21-60
BUILDINGNO. OF
551 .5 HSF ROOMS O STORIES I
EXTERIOR WALL (ROOF WOOD SHAKES
COVERING TUCCO COVERIN '
USE OF BUILDING AND WORK TO BE PERFORMED
L _.. . • I
AND ATTACHED GARAGE
PLAN 2-A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AN GREE TO.COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CIT' ORDINANCES ATE S REGULATING .
BUILDING CONBtRJT�O 4
ALUATION N
SIGNATURE OF (/ ERMIT FEE $ ?(Q — N
PERMIT-FIEF4 //�,/,
$ +}��/ PLAN CHECK $ 1%J
/
AUTHORIZED AGENT L Fe
TOTAL FEE - _7 a