HomeMy WebLinkAbout2737 FREMONT LN - Building PermitsApplicant to fill in all spaees exceo� those within heavy Doraer lines ana sign all apvrovriate declarations.
G7Y.OF COS7A nnE//S/A� C(%���STRUCTION PERMIT
Froject Address �%s! � /"�L���% L�
Applicant'sMailingAd ress � � ^'���C��Lj� ��� �7
Owner's Name . 1 � A � � PhoneG.,2[" �LL-C
Address
Arch/Eng. License No. .
Address .
Contractor-s Name �2 Phone7��-3.
Address (m�'i���l �J .'� J r./(�• �2ii��L 1�
Ciry Licensr No ' � .� d
LICENSED CONTRACTOR DECLARATION � '
I.hereby a/firm that I' am licensetl untler provi5ion5 of�Charter 9(commencinq
with section ]000) oi Division 3 of the Business antl Protessions cotle, antl
my license is in full for$� an fecL 9W '
l:icen I � I"� i�—�-Tl.�c CY-C o.�
Date �� 5'9 t � r � ���
WOfiKERS'COMVENSATION DECLARATION �
�_l hereby affirm [nal I have a certiticate ot consent to self-insure or a certificate
s-s! Workers' Com�pe/n(sz/ti/on Insurance, or a certnifietl copy thereof (Section .-
�,,""800, Lab. C.) V't 0 `I � � • /JC/��%C� ��S
�Poli<y No. Company
M � Certitietl copy is hereby furnisneC.
`^V Certitietl c y is f etl " h the city /i)�� n DI isibn y/��+ �
� pplicant �-�\ ��� �L'L]
I XEMPTIO ROM WORKERS' COMPENSATION.DECLARATION "
.` eetl nat be completetl if the permit is /or One huntl�etl ($100) o� '
less •
� ertify Ihat in Ihe per o k for whichthis pe�m�t is issuetl, I
� zhall not employ any person in any manner t to tne
� Workers' o p ns i Laws of Califor ' .
NOTICE:If, after making this tleclaration, you s ou ct to the '
Workers' Compensation provisions o( the Labor Cotle, you must fort�with
comply with such provisions or Ihis permit shall be�tleem¢tl revoketl.
CONSTRUCTION LENDING AGENCV ' ' �
I he�eby af(irm that [here is a conSlruction lentling agency for the performdnCC
ot [he wotk for which- this permit is Issuetl (Section 3097 Civ. CJ '
Lentler's Name
Lentler's AtltlieSs � �� -
OWNER BUILDER DECLARATION � ' ' '
I hereby atfirm that I 5m exempt �rom the Contractor's License,Law for the -
wunry whicM1 reqWres a permlt to const�ucq alter,.imprave, aemousn o� �epai�
any structure, prior to its issuance, also requires the applicant for such permit
to file a signetl statement tnat he/she is litensetl pu�suant to ihe provisions of
the Contractor's License Law (Chapter 9(commencing with Section ]000)pt
Division 3 of tM1e Bu5ine55 antl Professions Cotle) o� that he/she is exempt
therefrom antl the basis for the alleqetl exemption. Any violation of Sectlon
?031.5 by any applicant for a permit subjects the applicant to a civil
'palty of not more tnan five huntlretl tlollars (E500).
`" I, as owne� of the D�operty o� my employees wi[h wa9es as their sole
mmpen5ation, will tlo the work, antl the structure is not intentletl o� otteretl
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
LicenSe Law tloes not apo�Y to an owner o( a property who builtls or improves
thereon, antl who tloe5 such work himself/hetselt�or Ihrough his o� ber own
employees, provltletl [hat suclt impiovements are not intentletl or ofteretl for
sal¢. It, howeve�, tne builtling or improvemenl is Soltl wlthin one year of com-
oletion,'the owner will: nave the burden ot proving he/she tlitl not builtl or Im-
�rove for the purpose ot sale).
I, as owner Of the pro0erty, am exUusively contraCting with litensetl Con-
tractors to consiruct the project (Section ]044, Business and Professions Cotle:
. The Contractor's License Law.tloes not apply to an owner_ of praperty who
builtls or improves thereon, and who contracts tor such projects witn a con-'
tracto�(31 license pursuant�to the,Contractor's License Law). I am aware that
proot of their Wo�ker's Compen5ation insurance sM1oultl be P/ovltletl to me.
❑ I am exempt unaer Section B. & P. C. for this reason
Date Owner
I hereby certify that I have reatl this application and state that the above
iniormation is correct. I agree to comply with all city antl county ortlinan<es
antl state Iaws relating to builtling construction, antl hereby avthorize repre-
sentatives of tbis city to ent r upon the above-rtientionetl'propert fOr
in5pec[lon purpo sJ�
Signature .YI. ! Date �
Drivers' License Or 55 � - � �
TYPE OF CONSTRUCTION LJ NEW � LJ ADD. LJ ALTERATION LJ REPAIR �
-❑ CONVERSION ❑ DEMOLISH ❑ OTHER Ap # '
.DESCRIPTION OF, WORK/USE OF BLDG�.
' � � S Main Building:
E
TVPE OF PERMIT ❑ GRADING FOUNDATION �_STRUCTURAL T front
❑ TENANT ❑ ELEGTRIGAL ❑ PLUMBING ❑ MECHANICAL A Rear '
❑ �OTHER � � .l
PROJECT DESCRIPTION Sa.FT. OCCUPANGv C Right
K Left
CONSTRUCTIONTVPE VALUATION$ S
20NE GRADING CV. VDS. ACRES Ping. Ref. #
Rema'rks: . ' , ' - � Planninp Notes:
Backflow'Preventer
Backflow Irrigation
Bathtubs
....� ���., �
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks-
Gas Service ' Outlets
Interceptors
Lavatories ��' "
P-Trap '
Roof Drains '-
1
Reinspection' Fee '. $15
- M
Duct-UnderGround
Duct-Strucmral '
Duct - Ventilatin9
Ezhaust System ❑ Multiple ❑
FirepVFact.,Blt. ICBO #
Heating System & Ducting
❑ 0.100,000 BTU � 7 00,000 BT
Reinspection Fee � �$15
CMF 0865-46, rev. 4/84 White - Builtlinq; Canary - APPlicant; Pink - Accounting; Goltlenrotl - Assessor
NBING . .
Showers
ServiceSink -
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank � �
Swimming Pool w/Spa
Urinal '
Water Closet
Water Heater
Water Service
4. �
Issue Fee
$ 3
Automatic Wa
Consttuctior
Cooking Unit
D ishwasher
Dryers ❑Ga�
Fan
F.A.U.
Fixtures'
Device Boxes
Outlets
io%� i_2iiiie�
• Zone
Accessory.Building:
Parking Req./Provided
R�CE�VED Id
(���F�VED DEC ' �
� ELECTRICAL i
�. -- " ' Trensformer � 15=50 KW '
Sub. � � 50+KW
� Meter LJup to 100 amps �
Meter ❑over700amps�
lectric Sub Panel
Motors00-1 HP�1'/:=8
Inc.Solar �9-15 HP �i6-15+
Microwave ' - �
Pole Light
Range
' Sign
Garbage Disposal � ' I' �' Standing Sectiom.
Generamr O0.5 KW 05-15 KW �—+rash Compacmr
� Reinspection Fee . �' $15 Issue Fea
IANICAL FEES
Hoodor Typel ❑ DEVELOPMENTSERVICESRE�UIREMENTS:
Canopy Type I I ❑ � Zoning Approved By
' Building APProved By
?efriaeretion Svstem . APoliwtion Issued Bv
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Issue Fee � $ 3
5.00 T�
FEES
$ 3
• SUMMARV OF FEES •
BUILDING PERMIT $ ' SMIP $ ,
PLAN,CHECK $ PERMIT
PLUMBING � :�LiD ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $ '
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ � MICROFILM $ �j�
MECHANICAL $ TOTALFEE $ �Cil./
PLAN CHECK 25% $
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' ! CONSTRUCTION AND PLANNING • - POOL _ A . .
Date Inspector � Date Inspector
APPROVALS Permit # ' - APPROVALS Permit #
• 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location� . "
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement -• � -
3: Electrical Conduit Utility-Undrgrncl. 54. Forms . -, -
4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding "
5. Steel Reinforcement - ' 56. Rough Plumbing & Pressure Test
-6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings . 58. Electrical Conduit-Undrgmd. �
, 8. Foundation � � � 59. Gas Pipe, O Undrgmd., Test�
'9. Water Pipe-Undrgrnd. - � • 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor System 61. APPROVACTO 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 � ,- �•
i 6. Rough Electric Wiring _- . - 67. Fencing & Access Approval _
':'1,7.'Rough Wiring'Sign � - 68. APPROVED FOR PLASTERWG �
18: Rough Electrical-T'Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
1
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT .�
2G:�Rough Factory Fireplace APPROVALS Permit# �
2L� Ducts, 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. Storage Tank O Gas ❑ Oil .
25. Roof Sheathing 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 HEALTH DEPT. REQUIREMENT ,
31. Plaster Brown Coat � ' 79. FINAL INSPECTION � � ��
32. Electrical Power Meter-Final 80. F000 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 - �2��,.87 (� E�� ' . ' '
39. Water Service-Final � ,
40. Gas Service-Final � �
r--
41. Solar pomestic-Final f'1 �.- _
42. BackflowPreventer ,j�r�� . �. ' -4�
43. Backflow Jrrigation , m . � , � ' ��
1ri_
44. .Landscape Irrigation System�;T( .
i
r� `-'
45. Sound Attenuation �.� . �
,^
46. Handicap Regulations t,� , � , _ . "
47. FINAL STRUCTURE & BUILDING �
48. Special Requirements Complete`d . � - �
49. Elecirie Release io Edison ' - , , - -� , . . -
50. Gas Release to Southern California Gas Co . '
51. CERTIFICATE OF OCCUPANCY : . �
_ i ,
No. Date � � � t '
����o)
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COHTA MHBA. CALIPORNIA �'
For Applicant fo Ftll In Complefely
' TYPE OR PRIN7 -
COSTA MESA, CALIFORNIA
OWNER Mesa Del Mar Developme
ADORESS 3800 E. Coast Hi hwa.
. TEI
TEL.
e
cin Corona del Mar
uc No. 98808-SB-1 No:Oriole 3-4220
SIZE ___ I NO. O■. BLDGB.
EXISTING BLDG. RORG.
86TBACK LIN6 PAOM
GeNiER oF BiReeT 49 � REAR YARI
SIDE YARD I LEFT S�3�� I RIGHT
DESCRIPTION OF WORK
.��... I X II er rrcer�nra I II ennrr�..
NO, OF
�Q��X SO�ROOMS Ct STORIEI
� Wood IROOF Comp. and
S�uCCO COVERIN6 Crn�rol
NG AND WORK TO BE PHRFORMED .
Lot29 Tract 428��I�� n����VED
C
�' SEP 6 1969
� FINANCE DEPT.
CITY OF C�StA MESA
APPLICATION FOR PERMIT
BUILDING
For Offlce Use Only
' nsce�Pi xo. PepM�LNo.
BY I O�.l¢ RQCl�V� / I DATH IBBUSD
X /CL
COSTA MESA, CALIFORNIA
APPAOVED
ZONING
f INO. OF � I uee or xew
PLqNB BUILDINO
'�a�e�e.,,,.. Y!7_ L�...Z� � ��`�7 �
� (G6MCR LJNB 9T.)
24 FRON7 �� FT. ��— IN.
5 � �_
R. SIDE -� Fi. IN.
L. SIDE -� F7. 3 IN.
i REAR � � FT. ^- ^� IN.
APPROVED W�A �� .i�iS/G/
�1 H6REBY ACKNOWLED6E THAT 1 HAVE R6AD TH�9 APPLIGTION
ANO 9TAT8 TNAT THQ ABOVH I6 COPR¢CT ANC A6ReE TO COM•
PLY WITH ALL CITY OIiDINANCEB AND BTATH LAW6 RSOULATINO
BUILDINO CONBTiUGT�ON.
IAU HORIZE�
OCC. . - HIe3 JL Jr
THE AMOUNT BNOWN UNDlR VALUATION 1! POR TH8
PURPOB¢ OF 66TABLIBHING A PERMIT FEE .ONLY.
VAWATION � "{,
PERMITFEE $ �✓ �
$ LS,326.00 PLAN CHECK $ ���� �
___" ___ _5Z.50
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.,42895
COSTA MESA BUILDING-SAFETY DEPAflTMENT
p.O.80X1200 COSTAMESA,CALIFORNIA92626
For Applicant [o Fill in Com etel U� Ink Only
BVI�DING 2737 F+..emont Costa Mesa, Calif
ADDRESS
OWNER Richard l9illson
ADDPESS 2218 Aralia Newport Bch, Calif.
CITY Newport Bch N�L' 64�l—�.aj
BRANCH
ADDRESS
ARCHITECT ' .TEL.
CONYRACTOR
ADDRESS
TEL.
GTV NO.
STATE CITY
LIC. NO. LIC. NO.
SIZE ' 6O X- LOO NO.OF BLDGS. 1
OF LOT I NOW ON LOT
USE OF Residence
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work. .
USE OF BSIIlj21NG A D WORK TO BE PERFORMED
tlOri
1 heraby acknowletl8a ihat I have read this application and stare
that tha above information is corract antl aprae to comply with
all laws reguiaiing buildin8 construction, entl I shall not employ
any person in violation af ihe workman's comp¢nsation laws of
the State of Celifornia.
I hereby certity Shet I am properly Iicensetl as a contractor under
tha State ot Californla Business antl Professions Cotle, Dlvision 3,
Chapter 9, antl that such licenses ara in full force and eitect, or I
em axempt from the pravisions of the State of Cellfornia Busi�ess
antl Professlons Code� Oivision 3, Chapter 9.
SlBnature of / G�/' /
PermlRee �A�1� �. 'C..G/{'��i� ^:
Autho��ied Aqent � '
. �
�r.7 1 R-7�,�-''..L (i41 �36'� '�,: t':1 t?.50
�„
A.P. NO. —
ADIDRESS 2�3�
FIRE
ZONE
APPROVED
FOR STRUCTURAL PERMIT
�ATE EiElj� DATE I55 ER
a" � 6-l�'
�o �" z
FSrem n� osta Mesa
.aS LOT 29 BLOCK
R PA
ard Willson
VALUE
$
T�'PE - GROUP v/
�� � ' nn�rc///i� iI
NO.OF USE OF NEW
PLANS BUILDING
DSAPPROVED VARDSAf
IN BVILDWG ACCESSOR'
C/LSTREET)
^��
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DI5TANCE BET: MAIN &
MAIN BLDGS. CCESS. BLDi
VAR.# DATE
C.U.P.# APPF70VED
THE AMOUNT SHOWN UNOER VAIUA
THE PURP�E OF ESTABLISHING A PERMI
VALUATION PERMIT FEE �$ �
� PLAN CHECK $r
5� ��
$ TAX $
TOTALPAID $
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