HomeMy WebLinkAbout3257 INDIANA AVE - Building Permits�PP0.IECT PODflESS: �� y 7 —�,�� yAtia yV
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aooeEss:�`.`7N'\���r5?:A�AL'Er•.. �
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'7_4)5:9-0260
ANCNIENCINEEB: 1 HEG.NO.:
a0DNE55:
UNIT:
UNIT:
PENMITTEE:.,�._ t�. V. G�CTai:a�X I%�i.�J"a_O_00
AOOflESS:��j` 7 ��-��a�V+Fi At�
�_C�':A !!=SA CA °�6?5
IICEN5E0 CONiHRLiOfl OECIAHATION:yI �ere6y alli�m �ha� I am Iicen5e0 unGer prmisions ot CAaO�er 9(cammencing vni� Section
7000) ol �rvision 3 0l I�e Business an0 Prolessions Code. anG my license is in �ull force antl eifect.
CITY IIC.: STATE LIC.: CLASS:
Date: Signalure:
WOflKENS' COMPENSATION OECIAHFTION: I here0y allirm t�ai I have a ce�ilicate o� conseni ta sel4insure or a certiticate u� Workers'
Compensalion Insurance. oi a cenilie0 coDY ��ereoi (Seclion 38110. LaU. C�.
POLICY NO.: EXP. ORTE:
COMPRNY:
❑ CetlilieG Copy i5 AereDy �umi5�ed. ❑ Certifiea coDY is lilea vn�h the ciiy Builaing Oivision.
Oale: Applicanl:
EXEMPTION FpOM WUPHEPS' COMPENSAt10N OE0.APRilON: (ihis seclion need no10e complete0 ilihe permit is lor one hunaretl (5f00� or less�.
I cetlily I�al in Ihe periormance al Ihe work lor which Ihis permil is i55ue0. I shall not employ any person'n any manner so as �o become
su0lecl lo IAe Workers Compensalion Laws ol CaAtornia. /, ��
�aie: Signature: ��.�(
NOTICE.II. alt making I�is declaralion. yau shoWd become suElecl to tne Wor ensati n pr�mns ol the Labor
Cod¢. you mu5i �orihwilh tOmply wi�A 5ut� pr9visioCS or I�is permii shall be tleem ewc
CONSiNUCTIDN LENDING AGENCY: I hereby alhqn I�at�there is a conslmction lenaing agency br the pedarmance oi Ihe work for
wAicA inis Oermil is issuee (Section 3W7. Civ. C�.
lENOEfl:
aooeess:
OWNEN BUILOEN OECIABATION: I �ereby atlum Iha� I am exempl imm Ue Contractors' S�ate LicenSe Law for Ihe follawing reason
(Sectian 7031.5 Business antl Prolessional Cotle: Any cily ol county which requires a De�mit �o constmc�, alter, improv¢. Aemoiish, or
repair any simcture, prior lo its issuance. also repuires ine aDDlicant lor such permit to file a signetl statement ihat he/she is Iicense0
nursuanl to ihe piovisions ot ��e Comramors' Stale License Law �Chapier 9(commencing wi�� Semion 7000) ol �ivision 3 ot ��e Business
ana Pralessions Cotle) or Ihat helshe is erempi Iherelmm and ihe basi5 �or �he allege0 eKemption. Any violation oi Section 703L5 by
any applicanl br a permi� suElecls I�e aOD�icanl Io a civil penally oi not more than tive huntlretl Dollars (E500�.
I, as owner ol ��e pmpetly or my emplayees with wages as Iheir sole compensation, will do �he work, antl ihe
❑ slmcWre is nol intentletl or otfere0 for sale (Seclion 70a4, Business an0 Pmiessional Cotle: The Coniractors' State License Law
Ooes nol apPly lo an ownet o� a pmperly w�o Ouiltls or impmve5 ihereon, an0 who Ooes sut� work himselAheRel� or throupti
his on c�i own employees, pmvitled Iha� such improvements are nal inlendetl or offere0 lor sale. II, however �he buil�ing or
impmvement is soltl wi�hin one year oi com0leiion, Ihe owner will have ihe �urden ol pmving helshe tlid not build or impmve
lor ine purpase ol sale).
I, as owner of �Ae pmperry. am ezclusivel9 con�racting wi�h licensed coniraclors lo cons�mc� �he pmlec� (Section 7044, Business
❑ antl Pmlessions Cotle: The Caniraclors' Stale License Law tices not apDly Io an owner ot O�opetly who builds ot improves ��ereon
and who conlracis lor such pmle«s wilh a coniractoqs) license pursuanl �o ihe Coniractors' Stale License Law�. I am aware
Iha� pmol ol Iheir Workefs ComDensation insurance s�oWd �e provide0 �o me.
�0 i am exemo� unAer Sedion:B P 70 4 4 B. 8 P. C.
' mrihisreason: Ai.�:+ :t'OR2C YiY Vih�'L'FR � �
� Date� �� P+vner�
I ao he �y ce ily Ihat I am aware ol ana untlerslanU Ihe requiremenls af Califomia Heall� an de Se n 505, 25533, and
2553d an4 ihal I or any Iuiure builtling occupant will/will no� (circle one) neetl �o comDly wilh 5ai0 ntl the requiremenls tor a
permil for consimclion or mo�ificalion imm I�e Air Oualiiy Managemenl �i5lricL Fesitleniial consimc�ion applica�ions are e�emp� fmm
mese o�avisions.
Date: NpplicanC
I heieby cerlity Ihai I �ave read �his applicaiion and slale Ihal Ihe a�ove in�ormalion is correcl. I agree to comply wi�� all ciry anA counry
oremancesantlsta�elawsrelaling�oDwltlingcongtmciionantl�erebyaut orizereD�esentativesaf�hisciry�aenierupan�hea6ove-mentionetl
pmpetlV �or inspec�ion purposes.
Dare'. Signaiur �
DriverS L¢ense or Social Seanly e: ���-� (� ��- -+
16aLa6 Whpe—Bwlding: G�een—CoEe Enlorcemem: Canary—FpplicanL Pink—Revenue: GOldenroC—Assessor
�
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ti:7i:DING APPRl�V2.D BY : DA:E: . 1!
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TSSIIE FEF
BJI:.:JT_:vG-��IV-> PERM�T :SSIIE PiAN-CHECFi TOTAi PAID DCE
TOTAi,5----> 41.50 0.00 0�.00 4=.SC 9:.50 .G�
5
REVENUE UIV:S�O� TOTAiS--> CULL�ECT.ED: 4i,50 OVER/SriO:�T: .00
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91.00 • - ;� .50
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QTY U E S C R I P: I O• N-
1750 RrROUF HY Ve�LUE RES_DE:;rZAL tiOZONE
E�:L OF FEES
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'_.00 ;,75C.00
01 QD139629-00139630 T4T 42.50
DATE: 0`/21/93 TItIE: 14:23
i� S
CONSTRUCTION ANOPLANNING
APPROVALS Permit �
1. Temporary Electrical Service or Pole
2. Sod Pipe-Undrgrnd.
3. Elcctrical Conduit Ut�l�ty•Undrgrnd.
4 Electrical COndu�t�Undrgrnd.
5. Steel Reinforcement
6. Elecvical UPER Grnd
7. Foot�ngs
B. Foundat�on
9. SNater Pipe-Undrgrnd.
10. Sxructurel Floor SYStBm
11. Property Sewer Line & House Connection
12. Se�ver Cap
73. Roof Oraini
14. Rough piumbmg
15 Rough Eiectriwl-Condurt
16. Ro�gh ElectriclViring
17. Raugh \Y:r�ng S�gn
18. Rough Electrical�T Ba� Ce�l�ng
18. Rough Heat�ng & A�r Cordit�on�ng
Z0. Ro��,gh Factory F�rep;ace
21. DuRs, in Stru[ture
22. DuC.s, Ventilatmg
23. Gas Pipe�Rou�h & Tesc
24. Roof Framing
I 20. Roo` Shcathing
� 26. T�Bar Ceiling (Strutturail & L4onocoat
I 27. Frame and Flashing
� 26. Lath�ng & 9ding
2$. Insula[ion
30. D�y��.a�� Nailmo
31. Plaster 6rown Coat
I32. Electrical Power Meter�F�nal
33. Final Eleciric
34. Fin�l Heat�na & Air Gond;tion�r.r�
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Finai Plumbing
39. VJater Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ,
48. FiNAI PlANN1NG '
49. Electric Release to Ed�son
50. Gas fieleaseto Southern California Gas G
51. CERTIPICATE OF OCCUPANCY
No. Date
Date
0
POOL & SPA
Inspector AppROVALS Permit,",- Dace
52. Pool & Equipmen[ locat�on �_ � ,
53. Steel Reinforcement
54. Forms (
55. Elecbical Bond�ng `
56. Rough Plumbing & P�cssurc Tzst
57. APPROVAI 70 COVFR�GUNi?e
�
58. Electnca! CorE4'rUnd�qm�.
59. Gas Pip¢, � UrUta'^ 7, TeS:
60. [iack�vash L�r.=;. P�Trat,'- U�d�^•r�
67. APPROVAL TO DECK
62. Backr.a;h fi� Reurtcr Fina' • �
� _
� 63. Heater 8: Vent-;'.na'
. 04. PIum6lna SYstem � F�^.:1 ' t�,
' 65. Elecvical-F;ral i �
,
66. Sola� System�Fin,i � : I
-- -----r-----
67. Fencing & Acc•rss Anp�ural
fi$. APPFOVED F07 P�P,STEFI\G �
69. POO:'SPASY57E7,tSFINAL '
_ FiREDEPT.REQUtAEMENT �
APPROVALS Permit �` I
70. Undergro�^c H�,c�o
77. Prod�ct ?:pl'•.9' ; C::� ^' 0��
72. Unde:grou�n Flu;h
73. Undcrgrnr: £tora,� T��,ic �� Gas � 6��
�� 74. vvarrcad F-Varn _�
75. Ory Cnem n i
76. Dry Star.Cp,ue
77. FIXED SrSTE?1 FINAL
� 78. FIRE PREV. PI>J.:L
HFALTI-I DEPT. REQUIREP.iENT
� 79. FI�AL INS'�CT�G'd I
_ a0. FOOD CENTIF��ATE ISSUED �
,��t�s: �/� ��� �--= ps��
�
�
lnspector I
, l��`�:��
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNIA
For Applieanf fo Fill In Complefely
- TYPE OR PRINT
BUILDING
ADORESS 2 7 Indiana Avenue
COSTA MESA. CALIFORNIA
� MAIL
ii2i1SOi1 oC TEL.
TEL.
1 V, n1' NO. OF
OBTBACK LINE FROM
CENTea OP 6TReET 2� REAR YARD 25 �
$IDE VARD ILEFT � IRIGHT �
DESCRIPTION OF WORK
NFW I X II ALTERATION I II ADDITI�N I
WAL4 ROOF
Sttl�'CO COVER❑
IILDlNG AN� WORK TO 6E
BUI
FIRE
ZONE
R-1
LEGAL
��� �����"���
�� MAY 1 b 1960
fINAi;CE DEP�.
cm c� c�s�-a ra�sa
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
RECEIPT NO. I PENtJ{T NO._„�
COSTA MESA. CALIFORNIA
ZONING c;�T,, , _
NO. OP U8H OF NEW
PLAN� BUILDING 4]/ '�],tt g'd,T'.
,
none
eYPROVED W. L. D.
•�
I HERHBY ACKNO`ML¢OG¢ THAT 1 XAVE READ THIB APPUGTION THE AMOUNT BHOWN UNDEP VALU�TION 19 FOR THE
ANO 9TATC THAY THE ABOVE IB COHNECT AN� pGREE TO COM- pUPP08E OF EBTABLIBHING A PEpMIT PEE ONLY.
PLY WITH ALL 61TY OPDINANC£8 AND ST/.TE UW8 REOULATING
BUILDINO CONBYRUGTION. VALUATION
81GNATURE OF C PERMIT FEE $ 3S•
PERMI7TE n
$ 15, 045 • PLAN CHECK $ 1/�SO
AUTXORIZED AGENT D11:8 �. Colegroce� II7C�
TOTAL FEE 52�5�
N
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