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Home My WebLink About2257 FOUNTAIN WAY - Building Permits�L N (`S.� 6r-�L�.-e - A pTs • lr ' AVDlicant to fill in au spaees except those within heavy borde� CITY Of COSTA MESA CONSTRUCTION PERMIT Project nddress �, i' ZZ.�% FO(ii/�/bi G1j/% Applicant'�Mailing Address ��7 t, Owri'�Ps Name �( I�`ti TC:li� Q'.rR"�. C�}/�kPR�ne d7f vq r,U Address Arch/Eng. License No. Address City License No. � 7'd7J�% ��•m � LICENSEO CONTRACTOR DECLFf1ATION I hereby affirm that 1 am licensetl untler provislons of Charter 9(commencing with section ]000) of DiviSion 3 ot the Business antl ProfesSiOns Cotle, and my license is in full force antl effect. .�, License CI ss � Licen No. Oa[e � ' Signature WORKERS'COMPENSATION DECLARATION� ' �.hereby ai(irm that 1 have a certificate of consent to selt-insure or a certificate ' Workers' Compensation Insurance, or a certitietl copY th�eyr�eof (.Sectlon ,00. lab. C.L �,C� [ �� YY'\O�1 _i.K S ' Nolicy No. �� Company eCertifietl copy is hereby furnishetl. Ce�tif�etl o �5 tiletl with the city Bu' n� Divisia �/ /�� Date_ APplicant � p�p ��✓ � EXEMPTI N F O WORKERS' COMP SATION DECLARATION (Thissection neetl not be completetl it the permit is for one huntlretl ($300) or lezs). I certify tha[ in the Perfo�mance of th¢ work fo� wnich this pe�mk i5 i55uetl, I shail not employ any person in any manner so as to betome subject to tne Workers' ComOensation Laws ot Calitornia. Date Si9nature NOTICE: If, after making this declaration, you shoultl become subject to the Workers' Compensation provisions of the Labo� Cotle, you must forthwith comply with such provisions ot this permit shall be tleemetl �evoked. CONSTRUCTION LENDING AGENCV I hereby affirm Ihat there is a construction lentlin9 agency for the performance of the work tor whicM1 tltis permit is issuetl (Settion 309] Giv. C.) Lender's Name . Lender's Atltlress OWNER BUILDER �ECLARATION ' � I hereby affirm that I am exempt from IM1e Contractor's LlcenSe Law for the following reason (Section ]031.5 Business antl Protessional Cotle: Any city or counly which requi�es a permit to con5truct, alte�, improv¢. tlemolish or repai� any sVucture, prior to its issuance, also requires the apolicant for such permlt to tile a siqne� slatement thdt he/she is licenzetl pursuant [o the provisions ot the Contractor's License Law (Chapler 9.(commencing with Seclion ]000) oi Division 3 of the Business antl Profe55ions Cotle) or that ne/she is exempt 'herefrom antl the bazis fo� the all¢getl ezemption. Any violatlon of Sectlon 031.5 by any ap0�icant for a petmit subjects the applicant to a Civil Lnalty of not more than five huntlred tlollars ($500). d I, as owner of Ihe property or my employees with wages as their sole comDensation, will tl0 the work, antl the stru[ture I5 not intenGetl o� offeretl for sale ($ection �OC4, Business ana Protessional Cotle: The Contractor's l.icense Law tices not appry to an owner of a properry wno builtls or improves thereon. antl who tloes SucM1 work himself/hersel( o� throu9h bis or h¢r own employee5, provitletl tM1ai such improvements are not in[entletl or offereC for sale. If, howeve�, tne builtlinq o� improvement is soltl within one year of Com- pletion. the owner will have the burtlen of proving he/she tlitl not builtl o� Im- prov0 torthe purpose of sale). ❑� I, as owner of the proper[y, am exGusivery contracting with licensetl con- t�actors to const�uct the project (Section 7044, Business antl P�ofessions Cotle: The Contractor's License Law tloes not apply to an owner of property who DuiltlS or improves thereon, an0 who cont�acts for such projects with a con- tractor(s) iicense pursuant to tne Contractor's License Law). 1 am aware that proof ot their Worker'S Compenzation Insurance Shoultl be provitletl to me. ❑ I am ezempt untler Section B. & P. C. Por this reason Date Owner I tiereby certify tnat I have reatl this application antl sta[e that the above information is correct. I agree [o comply with all city antl county ortlinance5 antl state Iaws relatin9 to buiiding construction, antl hereby authorize reDre; senta[ives of t 5 city to en er u pp the above-mentionetl p� pert for inspection pur see. � Date 1�%% Signature drivers' License or,55 � si9n all approp�iate tleclaralions. UNIT NO. TYPE OF CONSTRUCTION L4'NEW U ADD LJ ALTERATION LJ REPAIR ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIO[J OF WOFK/USE OF BLDG. A�•'^�� K�3'< TVPEOFPERMIT GRADING LJFOVNDATION LJSTftUCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5a. FT. ocCuaANCv— CONSTRUCTION TVPE VALUATION $ ZONE - GRADINGCU.YDS. ACRES_ Remarks: Bar Sink Backflow Preventer Backflow Irrigation Baihtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Sink P—Trep _ Roof"Drains Reinspection Fee .� $15 Boiler ' Duct- UnderGround Duct - Structural Duct- Ventilating Exhaust System ❑ Multiple ❑ FirepVFact. Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU � 100,000 BT Reinspectionfae �' $15 CMF 0865-46, rev. 10/84 White - Buiitling: Canary - Applicant; Pink - Accountinq; Goltlenwtl - Asse55o� SFIOWQIS SerWce Sink Sewer Cap Sewer Connection � Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service A uto-W ash Issue Fee Hood or Typel ❑ Canopy Type I I ❑ , Refrigeration System ❑aioo,000eru ❑iao,aoo System Repair/Alteration Fire Dampers Registers - Issue Fee FEES A.P. # S Main Building: E T Front B Rear A C Right K 5 Lett Ping. Ref. # Planning Notes: 7635 10/i'9/87 7635 ' Accessory Building: ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW Construction Pole Su6. ❑ 50 + KW Cooking Unit D ishwasher Dryers ❑Gas ❑Electric Fan F.A.U. PixWres Device 8oxes Outlets Switches Garbage Disposal Generator �0-5 KW �545 KW Zone Meter ❑up to 100 amps Merer ❑over 100amps Sub Panel Morors �0-1 HP �1 %- 8 Inc.Solar 09-15 HP �16-15+ Microwave Pole Light Range Sign Standing Sections � Trash Compactor $ 3 Reinspection Fee $15 Issue Fee FEES DEVELOPMENTSERVICESREQUIREMENTS: Zonin9 Approved By Building Approved By Aoolication Iwued Bv � ` $ 3 Be00 TL Bo00 TL 2 O N I N G R E Q M T $ FEES $ 3 SUMMARV OF FEES BUIIDING PEFMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ g�� GRADING $ PLAN CHECK 50% $ MICROFILM $ Q' MECHANICAL $ TOTALFEE $ V ��O PLAN CHECK 25% $ 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 ConduibUndrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement �' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.` 57. APPROVALTO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation � � 59. Gas Pipe,.O Undrgrnd., Test 9. Water Pipe�Undrgrnd.� 60. Backwash Lines, P-Trap,.O 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. 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 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 (Structural� & Monocoat � 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe r 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 �QIa.� 80. FOOD CERTIFICATE ISSUED .- 33. Final ElecVic Notes: � • � 34. Final Heating & Air Conditioning '- 35. Final Gas Pipe-Test 36. Hood or Canopy • �, 3ZiFinal Factory Fireplace , �� - i � " . 38: Final Plumbing . ' . " � �� .; 39. Water Service-Final ' - ' i' � : , , r . 40. Gas Service-Final . ' _ . � �' 41. Solar pomestic-Final� � • � ' �_' : '� , ' fd•r r .'42. BackflowPreventer�� " � %(�' � � •�, ' � � . 43. Backflow Irrigation � � �� • : t : 44.��Landscape Irrigation SYstem � "' . ' � � . �, - - 45. Sound Attenuation "� . ' � ,. , 46. IlandicapRegulations �� " Jf I 47. FiNAL STROCTURE & BUILDING � 4. '. ,' � `�,± 4 48. Special Requirements Completed � � �•, , : � 49. Electric Release to Edison , �� ': i - 50. Gas Release to Southern California Gas Co � ,' •� � - 51. CERTIFICATE OF OCCUPANCY ._ No. Date _ � � . - ;i .