HomeMy WebLinkAbout2272 FOUNTAIN WAY - Building PermitsAppiicant to /ill In ail spaces wilhln
CITY OF COSTA MESA vE$MIT�(� ��
CONSTRUCTIONPERMIT �r'
Addrea� �1��!} N. (;rand� Aanta Ana. �
ArchlEng. ' ' � License Na.
Address � � � - � "
Convacmr TnVerde R Tlau�htere� P1ml4Go�
CICENSED CONTRACTOR�DECLARHTION�
I hereby afflrm th:.t I am IlcensoE untler pravlilons o1 Cbarter 9(<om-
mencin9 with seCtion 7000) of DlWslon 3 of the Business antl
Ro(essions Cotle�l 'anaa1 my Iltenso Is in full torc'e �n,tl' GeltE1ct.
Licens CIas�J`� � �c nse' o.�
Dale Signatura � �
WORKERS• COMPENSATION DECLARATION
1 hereby affirm that I have a cartHitdtO Ot cOnsent [o self-insum Or, a
certitiwte of- WOrk¢r5' CampensatlOn' InSurance, or a Cert11iG0 <opy
thereof (Section 3800, Lab. C.).
G-•'cy No. Company
artifietl�copy�is hereby furnish¢tl. - • �
.ertifietl copy IS filetl with thB City Builtlin9 Divlilon.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section-neetl no[ be completeU it tna pe�mit IS for One huntlr¢tl
(E300) or leu�.
1 certify that. n t�e performance of the work for whic�,this Oermit is
I55ue0, 1 shall nOl ¢mPloy any pe�5on in any mdnn¢r 50 a5 lo becomc
SubjGGt t Ihe Wo� �Comp¢nzdti La � aSFallt nia, ��.
�ate ignature � �� �
NOTICE: 11 after making [his tletl ation, you shoultl become subjec[
to the Workers' Campensation provisions of [he Labor Cotle, you muzt
(orthwith Comply witn such p�oNSiOns Or [his pe�mit snall be deemetl
�evoketl. - -� � -
CONSTRUGTION LENDING AGENGV
I hereby altirm tnat t�ero is a<onstructlon lentling agency tor tha per�
tormance o( the work ior whicn th15 permi[ is issu¢tl (SuttlOn 3097
Civ. C.1.� � ' ' " ` ' �" -'
Lentl¢r's Name
Lentler•5 Atltlress
OWNER BUILDER DECLARATION ' ' — '
I nniebv ai/irm [ha[ 1 am exemn[ tmm th¢ Contractor'z Llcenso Law lor
Hny CI[y O! COUO[y wnlCll ICqWl05 a pCfml[ [o conslrucl, auer�
improve, tlemolish or repair ahy struc[ure, prior to its issuanco, aiso ro-
qWreS lhe ap:litanl lor Such permit to flle a slgnetl statement thal hC
I5 �Ilcensetl pursuant to lhe proJisions ot tho'Contractor'S Licenso Law
tChapter 9(Commencing with Sectlon 7000) ol DlviSiOn 3 oi tnG
Business antl Pro!¢55iOns Code) or thdt h¢ IS axOmpt thorelrom antl ttla
b•sls far the alle9cU exempUon. Any vlolatlon ol 5e<tion ]031.5 by
appliwnl lor a pGrmit SUD�¢ct5 the appllCant [O a' Clvll penalty
ol more lhan livu huntlretl tlollars (E500�.
� i; d5 ownCr o� llla propBrly, or my OTp�oyee5 wilh wa9as as thCir
Sole compunsatlon, wlll do.lh0 wOrk, antl lhe Slrutture Is not Inlendetl
ConVactoYs Licens¢ Law Ooes not appry to an owner m a proPerry
wh0 builtl5 or imP�ovez Iheroon, antl wM10 does such work him5elf or
titrou9h his own employceS,�Orovitletl that such imprOVCmenls a�a nol
intenaetl or ol/eretl lor sale. If, howeveq the bulltlin9 or improvoment
is soltl.wilhin one year ol complolian, [hC owneLwill hdv0 thp Durtlan
ot provinq he Ultl no[ builtl or Impwvo ior thc purpose ol saln).
�� I, a5 owner ot Ihe property,-am ¢zclusively•conlracting�wi�h
Ilcensetl COntrattors to conSVUGt thC Project (Sectlon �044, Buziness
antl'Professions Cotle: -The Coniractor's Liconso Law tloes not apPIY to
an owner ot property wno builtls or ImDroves thcreon, antl who con-
[�at(5 IraT 'zu[h prolects wi[h a' contractor(s) IICeSneA Oursuan[ to
tne Contractor's �icense Law).
❑ I am exempt untler Sectlon B. 6 P.0. Por lhis
ieason'
Date Owner -
LherEby tertiiy thdt I hav0 rCatl tbii aOP���tlon antl StatG that th¢ above
Intormation is correcL I a9ree to comply witb all city antl coun[y
ortlinance5 antl state laws relaUng IO ConSVUGlion, antl hereby duthoriie
�eoresentatives of this cicv to enter upon tha above _ mentionetl
boracr Iines ana sign all approorlate eeelaratlor
TRACT NO. LOT NO. BLDG. NO.
TVPE OF CONS7RUCTIQN
❑ NEW ❑ ADD ���ALTERATION
❑REPAIR ❑CONVERSION ❑DEMOLISH
❑ OTHER
DESCRIPTION OF WORK
TVPE OF PERMIT � �
❑GRADING ❑ FOVNDATION -OSTRVCTVRAL
❑ TENANT ❑ ELECTRICAL �LVMBING ❑MECHAI
❑ OTHER
PROJECT DESCRIPTION
5�. FT. � . ' "
OCCUPANCV_CONSTRVCTIONTVPE '
VALUATION � ZONE �
GRADING CV. VDS. ACRES
PLUMBING
BATHTVB$
TOILETS
LAVATORIES
KIT. SIfJKS -
SERVICE SINKS
FLOOR SINKS
.PLAN CHECK
SHOWERS �
VRINALS -�
DOUBIE LAVS "'
' DISHWASHERS -
SUMP$ ' '
FLOOR DRAINS
DRINICING FOUNTAINS� � � -
INTERCEPTORS ' CLARIFIERS �
SWIMMINGPOOL PTRAP
WATERSERVICE � A�TERATION
GASSERVICE OVTLETS
WATER HEATERS BTU OUTPVT
SEWER CONNECTIONS '
SOLARTANK COLLECTORS,
SOLAR PIPING SVS.
ISSUE FEE
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-300,000 BTU_
ANDDUCTING 300,000'+BTV_
REFRIGERATION 0-100,000 BTU_
'SYSTEM 100,000� BTU _
BOILERS BTU
SYSTEM REPAIR,ALTE(3ATION
EXHAUSTSVSTEM MULTIPLE
�'..�.'-. ' _ � ISSUEFEE - t _
rivers' License or 55 �
CMF 0865-J6 White-Builtling; Gnary-Appliwnh Pink-Ac<ounting: Goltlenrotl-Assessor .
A.P. �
ZONE
5241 4/29/82 5.00 TL.
� d4N�
.(
ZONING REGULATIONS �
*.—
PLNTGp.gRUEF�.p3t p
PROPE�RTVNLINE .�
. - . . �
REAR VARD (TO P/l)
PKG. SPACE�REQ.
STREET WIDTH
ZONI NG APPRO V ED B V
SPECIAI CONDITIONS:
� -�- ELECTRICAI� -
PROVIDED � p�
PARK FEE E.- (�'
DATE -'�
_ ^.
-FI
. .? �
.. �. .��
'GENERATOR' 0-1 KW_ 1-30 KW'_
TRANSFORMER -� �
APPLIANCE '30-50 KW_50't KW _
MOTORS - 03 HP_1d0 HP _
(INC.�SOLAR) 30-SOHP=50+HP_
FIXTURES OUTLETS -SWITCHES
�HSTVBE'SIGNS " - -
,POLELIGHTS � . -
�PANELS ' - MAIN" SUB
SERVICE ' � ' AMP
ISSUE FEE" - " �
�APPLICATION APPROV EO BV ' - ' DHTE
SUMMARV OF FEES .� - a pF
�BUILDING � '-' -- ' -
PERMIT E . SMIP , �b, ." .'+n
PLAN CHECK E PERMIT f. .C�E
PLVMBING S �.nn "ISSUHNCE $'� -
CE
iPLANCHECK S � -" -�- GRliDING E B£
ELECTRICAL S � � E
,PLANCHECK $ MICROFILME .eE
MECHANICHL.S � TOTAL FEE E �Oj'
- ' 7 LESS AD� .�A
'PLAN"CHECK' E ' VANCE'PC S_
� � ��
� . . FINAI FEE SS.�CL
\
. 1'�'
CONSTRUCTION AND P�ANI
APPROVALS Permit #
1. Temoorarv Electrical Service or F
9. Water P.ipe-Undrgrn
10. Structural Floor System
11. Property Sewer Line & House Connection
12. . Street Sewer Connection �
13. Rough Plumbing
14. Rough Electric-Conduit
15. Rough Electric-Wiring
16. Rough Heating & Air Conditioning -
17. Ducts, in Structure
18. Ducts. Ventilatina -
23. Insulation - -
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final�Heating & Air Conditic
30. Final Gas Pipe-Test
Final
�4. soiar uomesucrinai
� 35. Landscape Sprinkling Svstem
� 36. Sound Attenuacion
r 37. Handicap Regulations - --
38. FINAL STRUCTURE & BUILDIN
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California
42. CERTIFICATE OF OCCUPANCY
No. Date
�. -� POOL & SPA - . .
Date Inspector qppROVALS Permit # Date Inspector
43: Pool & Equipment Locatiori � • ` •
4 � Steel Reinforcement �� • - � �
45. Forms
46. Electrical Bondin
47. Rough Plumbin & Pressure Test �'
- 48. APPROVALTO COVER-GUNITE � -
- 49. Electrical Conduit-Undr r� � � -
50. Gas Pipe ❑ Undr rn Test ' �
51. Backwash Lines P•Tre •� ndr rn -� -
59 APPR(]VAI Tn ffFCK - - - - - -- . -
56. Electrical-Final -
57. Solar System-Final � �
• encing & Access Approval
• APPROVED FOR PLASTERING
60. POOL/SPA SYSTEMS FINAL V �
NOTES: �
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