HomeMy WebLinkAbout640 JOANN ST - Building Permits� �19 4'1 / �-� aT
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AVD�I[ant to fill In all ipaces except l�ase wit�in �eavy Oortler Iines anC sign all appropriate tleclarations.
CITY oF COS7A MESA CONSTRUCTION PERMIT
r Project Address � �
Applifant'S Mailina Addrrn �
��� 1 � `
Owner's Name '�F 1 G. `�'�i�. Pho♦ne� ,� A��
Address � `���`-�N S��e�—I�11���
Arch/Eng. License No.
Address v ,� ' `,'., . ( �
Contracmr's NamP ��,����,-�F��.��`� Phonr�i
Addresilmailingl-L���L' �+�U Y - 1��� ��
City License No. �� '�'����
LICENSED CONTRACTOR DECIARATION � �
I hereby allirm thal I am IicenSetl untlBr provi510n501 Charter 9(Comm¢nCin9
with section ]000) of Divislon 3 of t�e Business antl Prof¢SSiont Cotla, a tl
my license is in (WI (orceanQsttect. 553.�
License Clas Lv License` N1p,
Date '2-'�- '�`J 5'ana� .e � yy
WORKERS'COMPENSATION DEC RATION
'ereby afiirm that I have a certificate of cons¢ne to S¢tltinzure or a certi/1Cate
Workers' Compensation Insurance, or a certifietl coOY lne�eof (Se<tion
.,d00, 12b. C.)
Policy No.�L����J Company ��������-�
Certilietl capy is here�y furnisnetl. (�
Certitietl copy is (iletl wit� [he city� i[ �i 9�Division. ' 1
Date i' h-%?T-. APPtican� � 1�•m-=-- L�
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This seclion neetl noFbe.completetl it the p<rmlt i5 fOr One huntlr¢tl (E300j o�
less�.
I certify tM1at in the pe�lo�mance of Ue work fOr which [bis pCrm�t i51s5u¢tl, I
shall no[ employ any person in any manner so as to become subject to lhe
Workers' Cortipen5a[ion, Laws ot Callfomia.
Date Stgnature
`NOTICE: It, a/ter makin9 tnis tleclaration, you shoultl become sub�ect to the
Workers' CompenSalion provisioni ol the LdDor Cotle, you must (ortttwith
compty wilh� suc� prOvisions or this Oe/mR sball be tlaemetl' ravoketl.
CONSTRVCTION LENDING AGENCV
I hereby aftirm Ihat Nere is a'const�uclion lentlin9 agency fOr Iho pertormance
of the work far wnich inis permit iz issuetl (Section 309� Civ. C.)
Lenaer's Name
L¢ntlet's Atldress
OWNER BUILOER OECLARHTION
I hereby alflrm that I am ezempt from tho Contractor's Li<onsa Law for tha
tollowin9 reason (Section ]031.5 Business antl Profeisional Cotln: Any cl[y or
county which r¢quires a pe�mit lo coniVUCt, alter, Improve, tlemOlish or �epair
any strutture, prior to its issuance, also reqWres the applicant for sucn pormit
to tile a 5i9netl statement that ne/ihe is Ilcensotl pursuant to tho proWsions of
the Contractor's License Law (Chapter 9(commencing with Soclion 7000) of
Oiviiion 3 of lhe BuSiness antl Prolessioni COGC) or lM1al ne/Sha is e%ompt
hcre/rom antl [he Uasis for lho allegetl ¢xam0��on. Any viOlation ol SOC�iOn
/031.5 by any ap0���ant for a permlt subjetts t�n appllcant to a civil
�enalry of not more than five huntlretl tlollars (E500).
LJ I, as ownor oi the property or my emD�oyees wilh wa9os as tnelr sola
compensation, witl ao tno work, antl lhe structure is not intentletl or oHerotl
for sale (Section 7044, Business antl Protesslonai Coaa: Tna Contractor's
LicenSe l.aw tloe5 not apPry to an own¢r Ot a pwperty wli0 builtls ar ImprOv¢s
lhcreon, antl wh0 tloes such wo�k M1imsetl/hCrsCtl o� lhmugh h15 or hor own
employces, provitletl lha[ zuch ImprOvem¢nts a�e not intentlatl o� oiteretl for
sdl0. It, nowev¢r, th¢ Dulltling or ImO�Ovament i5 soltl within ono yaar oi com-
pletion, thc owner will have tna burtlen Of proving he/sha tli0 not Dulltl or im-
, prova for lhe purpose ot sale�.
'� ❑ 1, as owner OI the property, am ¢xclusivety con[racting with Iicensetl con-
[rac[ors to mnstruct lhe project (Se<Hon ]044, Bu5ine55 antl PrOle551on5 COGe:
The Conlracfor's license Law dOes not apply IO an owner o1 property wlto
builtls or imo�o�es thereon, and who contracts for such orojects with a<on-
tracior(s� Ilcense pursuant�to tne�Contractor's License Law).,I am awara tnat
proof o Iheir Worker'S Comp¢nsatlon insurance ihaultl b¢ prOvltleC l0 mn.
❑ I am exempt untler Seciion B. 8 P. C. �Or Ibis reason
Dale Owner
I hereby certi(y that I nave rea
intormation is correcL 1 a9ree to
antl state laws relating to ouiltlir
sentatives of 'ty to enter
insvection oses.
Signature
Drivers' Licenz¢ or 55 �
p�o0erty
TVPE OF CONSTRUCTION IJ NEW 'LJ ADD LI ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOL�SH ❑ OTHER A p �6
DESCRIPTION OF WORK/USE OF BLDG.
S Main Buildi
E
TYPEOFPERMIT GRADING FOUrvDaTiorv S7auCTVRaL T Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING .�lYMECHANICAL B Reaf
❑ OTHER %�
PROJECT DESCRIPTION 50. FT. OCCVPANGV C A�9ht
CONSTRUCTION TVPE VALUATION 5 S Left
ZONE GRADING GU.YDS. ACRES Ping. Ref. #
Remarks: �!/��� /�jAA1�.-�C /11�C PlanninqNores:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitthen Sink
Lavatories
P-Trap
Roo( Drains -
Reinspection Foe � $15
Dut� - Under GrounA
Duct - SVUCtUrel
Duct � Ventilating
Enhaust System ❑ Multiple ❑
Firepl/FecL BI�. ICBO ak
H�e �^ 9 System & Ducting
YJ6100,000 BTU O 100,000 BT
Reinspection Fae � $15
CMF 0865-46, rev. 30/84 Wnite - Bvilding; Canary - ApOi�wnt; Pink - ACCountinq; GolaenrOtl - AS5e550r
$howers
Service Sink
Sewer Cap
Sewer Connection
$olar Collxtars
Solar Pipin9
Solar Tank
Swimming Pool wlSpa
Urinal
Water Closet
Water Heater
water Service
Auto�Wesh
Issue Fea
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
❑aioo,000sru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
S 3
$ 3
Automatic Washer
Construction Pole Sub.
CAoking Unit
Dishwasher
Dryers �Gas ❑Electtic
Fan
F.A.U.
Fixtures
Device Boxes
Outle[s
Switches
Garbage Dispoul
Generamr �65 KW �5-'
Reinspection Fea
2116 2/10/87
2one
Accessory B
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Morors � a 1 HP � 1:5 - 8
Inc.Solar �9�15 HP �tE15+
Microwave '
Pole Light '
Ran9e
; Standing $ections
5 KW Trash Compactor
$75 Iszue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approvad By
Building Approved 8y _�
7.00 TL
FEES
$ 3
Z
O
N
I
N
G
R
E
Q
M
T
S
SUMMARV OF FEES ,
' BUILDINGPERMIT 5 SMIP 5
PLAN CHECK $ PERMIT • �
• PLUMBING $ ISSUANCE S
PLAN CHECK 25% $ ENERGV P.C. 5
ELECTRICAL § GRADING 5
PLANCHECK 50% $ AC�CROFILM S
MECHANICAL $ �`�`OTALPEE $ �EO
PLAN CHECK Z5% $ -
, CONSTRUCTION AND PLANNING PO(., .� SPA
APPROVALS - Permit# Date Inspector AppROVALS Permit# Date Inspecror
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. Elettrical Conduii-Undrgrnd. 55. Electrical Bonding ,
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �
Z Footings 58. Electrical Condui(-Undrgmd. .
8' Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structural Floor SYsrem 67. APPROVA� TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
73. 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. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rou9h Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
� 20. Rough Factory Fireplace APPROVALS. Permit #
21. Ducis, 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 ❑Oil
25. Roof Sheathing 74. Overhead Hydro '
26. T-Bar Ceiling (Structurel) & 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. Plasrer Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: � J �' ��
34. Final Heating & Air Condi[ioning �/�y �� C,qy��, � p,� 3 �3 D UMG („Fc,p
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final
40. Gas 5ervice-Final •'.7
41. Solar pomesticFinal i ���
42. Backflow Preventer �-.� �
43.Backflowirrigation :��
44. Landscape Irrigation Syste'm
45. Sound Attenuation ��
46. Handicap Regulations "
47. FINALSTRUCTURE&,BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Felease to Southern Califomia Gas Co � �
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER
AP. No.
7
DATE
F7, Joann Street
�7 �T.�.�
TYPE V ZONE R�.i PLAN NO.
?ECTIONS I DATE I SUBCONTRACTOR
and
coat
i4,526:00
Res. Att. Gar.
MITS ISSUED
✓
✓�
,� '�F��.L
COSTA MESA BUILDING DEPARTMENT
P.O. BO% 31�
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
ADDRE155 W� UOaIISI S'fi•
COSTA MESA. CALIFORNIA
OWNER ud+lYG'. tLL1A •�6tlOYSOS
ADDRE55�9 E• 17th St•
�a� TEL. T.t
CITV CO3f'i'd M8S8� C�11• NO. ..r
ARCHITECT CaS1S � LIC.
OR EN^-�NEER �(1 e�OO�L NO.
ApDh..,d dpnp� Grove
CONTRACTOR ��eCV18ETOVe• �yWJO.
ADDRE55
IEGPL
DESCRIPTION
A.P. NO.
60 x l00
USE OF �
E%ISTING BLDG.
$ETB�CN LINE FROM �O�
CENTEN OF S1PEEt
NEW
REPAI,.
BUILDI
TEL.
NU.
�+o. ov e�ocs.
NOW ON LOT IIORB
REAR YnRD 21�
5' S'
RIGHT LEFT
DESCRIPTION OF WORK
� ALTERATION AODITION
MOVING OEMOLISH
��O `9Q 1Y200M5 o STORIES 1
E%TERIOR WALL ROOF
COVERING C+��nnn COVERING C���
USE OF NEW ^,
BU�LDING SjpajP��� SP9lfjAil -
.i1L ...L1�.�L..�ii �nwnw�
�-'i�� RECEBUED
q-3o-s�
FlNANCE DEPt.
c�rv Q� c�sm r�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. ��If�1�Q
J
MECEIVlO BV �'E RE�CEIVSED ��E ISSOUE
�• 3
UILDING
DDRE55
COSTA MESA. CALIFORNIA
IRE
DATE
CORRECTIONS
I HEREBV ACNNOWLEOGE TM�T 1 X�VE FE40 TMIS FPP�IC�TIOfI 1f�D
ST�TE TM�T THE �BOVE IS CORAECT �NO �GHEE TO COMPLV WITH �LL
CITY ORDINANCES ANO STATE 5 PEGULITING BUILOING CON6TRVC�
TION. VALUATION
SIGNATURE OF PERM�T FEE 53[i��
PERMITTEE
T_ s7.4,526�W PLANCHECK 51'�QQ
AUTHORIZED AGENTMke & Colegrove, 111C• TOTAL FEE $Sl��/�/
O\VNER �1.T�� JAMES G. DATE 6'2'S9
JOB ADDftESS 6�10 J08I1[1 BUILDING PER6SIT NO. ��—�
GENERAL CONTRACTOR Owner-Huilder VALUE S 1�.��
AP. No. LOT 3 TRACT 221 PIRE ZONE DESCRIPTION OF WORK B10Ck Wall
INSPECTIONS DATE _I GROUP �
� �rground Soil U.G. Watcr _I
SU6CONTRACTOR
. " � 9`��0 . � �E �ECtI�ED
COSTA MESA BUILDING-SAFETY DEPARTMENT / 2- S`� v�
P.O. BOX 31] COSTA MESA, CALIFORNIA `�'�
FINANCE DEPT.
FOR APPL/CANT TO F/LC /N COMPLETELY APPL iCA� IONThFO�R��PERMIT
� TYPE OR PRINT . BUILDING
BUILDING
ADDRE55 O TT ^`
COSTA M SA. CALIF'ORNIA FOR OFFIK USE ONLY
I NECEIPT NO. I PERM NO.
OWNER '� OR�� � I.�
MAIL 1 EIVED BY I pATE RECEIVED pATE ISSUE[
AODRE55 (, /D T"� � bi �- —% (p _,�$
CITY Tf% `/' TNO.�p //V qDDRE55 i )
AOR�CHITENEER ND uG N�o. COSTA ME A. CALIFORNIA
ADDeE55 �V N FIRE �e Group
ZONE
STATE qppppyED
CONTRACTOR LIC.NO. BY DATE
ADDRE55 ZONING
LEGAL I LOT �'. I� I��I y ZONE NO.OF USE OF NEW
OESCRIPTION NO. BLOCK TRACT I>�ANS LI BUILDING �
� /W
A.P. NO. � APPROVED •�/ 1 _� C
BV l�I'p�, I-• D�ATE.. \O J
SIZE % rvo.oF a�ocs. YARDS �E=VES
OF LOT {QO / X�O / NOW ON �oi REQUIRED ALLOWE_ 'D
USE OF ICENTER LINE ST.)
E%ISTING BLDG. D N ji FRONT _� Ff. IN.
SETBACN LINE FROM ¢ �
c[HiEa oF STRe[i �Q REAR VARD R. SIDE FT. C�N.
i /
SIDE YARD I LEFT � RIGHT S� L. SIDE FT. '�^ IN.
DESCRIPTION- OF WORK �—
REAR FT. IN.
NE' I ALTERATION I II ADDITION I
REPAIR ( IIMOVING I IIDEMOLISH I �
9UILDING NO.OF
SIZE ' ROOMS STORIES
EXTERIOR WALL IROOF
COVERING COVERING
� CU 1
���/ _ c�-,- � a- �
I HEREBY ACKNOWLEOGE THAT 1 HAVE REqO TMIS iIPPLIC�TION THE AMOUNT SHOWN UNOER VALURTION IS FOH THE
RND STRTE THhT THE ABOVE I6 CORRECT qryO AGREE TO COM�
PLV WITX >LL CITY ORDINANCES RND STATE LRW9 REGVL�(�TING PUflPO6E OF ESTABLISHING P PEflMIT FEE ONLY.
BUILDING CONSTRUCTION.
VALUATION /J�-/\
SIGNATURE OF .� PERMIT FEE $ �; ' v
PERMITTEE
• . $ �+ � PLAN CHECK $
AUTHORIZED AGENT a ✓p/
/Q 6 � TOTAL FEE S ,� ;
OWNER F1L
JOB ADDRESS bI10 J03t1i1 St
BUILDING PERnSIT�
GENERAL CONTRACTOR owner-bui.lder VALUE s 563.�
AP. No. LOT TRACT FIRE ZONE DESCItIPTION OF WORK hl nek vall
INSPECTIONS DATE I GROUP TYPE
� rground Soil U.G. Nater —I SUBCONTRACTOR I—
Form 21
. : � ���4
COSTA M�SA BU�LDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. GALIFORNIA
fOR APPL/CANT TO F/LC /N COMPCETELY
TYPE OR PRINT
BUILDING �� /_i •1
ADDRE55 i
COSTA MESA. CALIFORNIA
�]llCi�:1
�
■ ARCH ITECT
A OR � :INEER
TEL.� /
NO. �
STATE
LIC. NO.
ADDRE55
EscairTioH I NO. � I BLOCK I�'R!
A.P. NO.
SIZE /) / �//�/ � I NO.OF BLDC
OF LOT �+ `" rvow orv �O'
USE OF
EXISTING BLDG. C
SEIBACK LINE FROM `� /� /
CENTEfl OF STREET (� �T} REAR YARD
SIDE YARD ILEFT , IRIGHT `/
DESCRIPTION OF WORK
NF\' I X II ALTERATION I II ADDITION
BUILDING ' NO.OF
SRE ROOM,
EXTERIOR WALL IROOF
COVERING COVER
���� R*�C�i���
�-- �i-s���
FINANCE OEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
fo,e aFficF usF aNcy
I RECEIPT NO. I �R� No`
J
RECEIVE� I DATE RECEIVED ATE IS U
`� 7._7,j-s4 �-.Zr �
,
BUILDING
APPROVED
BY
�y ZONE �
COSTA MESA. CALIFORNIA
ZONING
lISE OF NEW
�� UILDINO
fCENTER LINE 8T.) ^� /� '
FRONT �J �/ FT. �N.
R.SIDE �� FT. IN.
L. SIDE FT. IN.
REAR FT. � IN.
��
V1/ G. L. " � '� C' X,
1 HEREBY ACKNOWLE�GE THAT 1 HAVE FEAD THIS A PLICATION
RNO STATE THAT THE /BOVE IS COitfiECT ANO pGPEE TO COM� THE AMOUNT 6HOWN UNDER VALUATION IS FOR TNE
PLY WITH ALL CITY OflOINANCES NNO STATE LhW3 REGIILATING �'UFPOSE OF ESTABLI6H�NG P PEHMIT FEE ONLY.
BUILOING CONSTRIIC.T!I�ON. �� � �// q � VALUATION
SIGNATURE OF SI�f N., ` SG/ �//� PERMIT FEE $ �r
PERMITTEE jyry I..Y � ��� � '�
VG
Y $ ��%� � PLAN CHECK $
AUTHORIZE� AGENT TOTAL FEE $ .�