HomeMy WebLinkAbout2815 FRANCIS LN - Building Permits0
V
CITY Of COSTA
• t Project Address —
� Applicant's Mailin5
!01 Owner's Nam �
�Addreu �B �
Arch/Eng.
Applicant to fill in all ipaces except Ihose within heavy Cortle� lines ar�d n all aoorao��ate eeclarations.
UGTION PERMIT PE�MI; `N10.� �� TRACT NO. LOT NO` � UNIT N0.
No.
Address Imailing) �' �'jU � K(��� n'J"� J.H. LC _
City license No. � �� ��
GCENSED CONTRqCTOR DECLARATION
I hereby af/irm tnat 1 am licenzetl untler provisions ot Charte� 9(commencing
wiM section ]000) of Division 3 of the siness an0 Proteszions Cotle, an❑
� my Ilcense is in (ull,{orce ana ffect. �� O�' �
Lice�ie Class �- 3 _ � 6.�
Da�g� � G" Si9nature �
WORKERS' COMPENSATION DECLARATION
�•ereby aHirm that I have a certiticate bi consent to self-insure or a certificate
Workers' Compan5ation Insurance, o� a certifietl cOpy thereof (Sectlon
_aoa. �b. T�t�.�]1�, y J"�4�e Fu�
Policy No.l �/ ��V �Company
�Certifietl copy is hereby fumishetl.
Cer fi¢ cop,Y letl witM1 the titY Itling,Dy�' �/ ,./
Date �� �'— +'�� APPlicant v/�'A � �L`+ ��/C"�
EXEMPTION FROM WORKERS' COMPENSATION DECLA0.A�TION
(This section neetl not be completetl if the permit is for one huntlred ($300) or
less).
I certity that in the pe�formance of tne wo�k tor which this pe�m�t is issuetl, 1
shall not em0�oy any person in any manner so as to become subject to the
Workers' Compensation Laws of Califomia. ,
Date Si9nature
NOTICE: If, after making this tleclaration, you shoultl become subject to the
WorkerY Compensalion provisions of tM1e LabOr Cotle, you must forthwifh
comply with such provisions o� thi5 permlt 5M1a11 be Ceemetl revoked.
CONSTRUCTION IENDING AGENCV
I M1ereby af9rm that the�e is a construc[ion lentling agency tor the performance
of the work for which rois permit is issued (Section 3097 Civ. 'C.)
Lentler's Name
Lentler's Aatlress
OWNER BUILDER DECLARATION
I hereby affirm that I am eaempt from the ContractOr's License Law for the
followinq reason (Section 7031.5 Business antl Professional COGe: Any ciry or
cOunty whicn requires a permit to cons[ruct, al[eq improve, tlemolish o� re0air
any siructure, prior to its issuance, also requires the aoP�icant tor such permit
to tile a signetl statement tnat he/she Is licensetl pu�suant to the provi5ions of
�the Contractor's License Law (Chapter 9(commencinq with Section ]000) ot
'livision 3 of the Business antl Professions Cotle) or that ne/she iz ezempt
ieretrom antl the basis tor [be allegetl exemption. Any violation of SecHon
031,5 by any applicant to� a permii subject5 tne appliGant to a civil
��enalty of not more than five huntlretl tlollars ($500).
I, as owne� of the p�operty o� my employees wilh waqes as their Sole
compensation, will tlo the work, antl the s[ructure is not intentletl or otfe�etl
tor sale (Section ]044, Business antl Pwfe55ional Cotle: The Gontractor's
LiCenS¢ Ld W tl0¢5 nOt dpply t0 an owner Ot a prop¢rty wM10 builtls or improve5
thereon, antl who tloes such work himselt/herselt or.throu9h his or her own
employees, provitletl that such improvements are not intentletl or otferetl fo�
� Sale. Ii, howeveq Ihe builtling cr imorovement Is soltl within one year of com-
. pletion,'the Owner wili have the burtlen of prOving he/she tlitl no[ builtl or im-
� �ove for the�pu�pose of sale).
1, asowner of the property, am exclusivery wntracting with licensetl con-
tractorsto const�uct the project (Section 7044, Business antl Professions Cotle:
The Contrac[oYs License 12w does not appty [o an owner ot pro�erty who
builtls or imo/o�es thereon, ana who wniracts (or such projects with a con-
tractor(5 license punuant to the Con[tactor'S License Law). I am aware [hat
pvoof o� their Worker's Compensation insurance shoultl be provitletl So me.
❑ I am exempt untler Section B. & P. C. (or tnis reason
Date
I hereby certlty Ih I
iniormafion is mrr c. I
antl State laws r Y g t
SEOIdIIV¢5 Of [ 5 IIy
inspection pur se j,�
Signature
Drivers' Licenze or SS �
CMF 0865-46, rev. 4/84
Owner —
have reatl thls
the above
ortlinances
TYPE OF CONSTRUCTION LJ NEW LJ ADD ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT ECt7✓E.P �00 F Ap #
DESCRIPTION OF WORK/USE OF BLDG. �S/I7�n.IS�
S Main Buildin9:
TYPE OF PERMI7 GRADING FOUNDATION STRUCTURAL T Front
❑ TENANT ❑ EL TRICbAL ❑ PLUMBING ❑ MECHANICAL B R¢dr '
❑ �OTHER _�C/�_�_O� A
PROJECT DESCRIPTION Sq 7 e oCCUaArv v C Right
COfJSTRVCTIONTYPE � /�OG — VALUATION$ �� g LEft
ZONE GRADING GU. VDS. ACRES Ping. Ref. #
Remarks: ' � Planning Notes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher �
Drinking Fountains
Floor Drains. '
Floor Sinks
Gas Service —Outlets
<itchen Sink "
Lavatories.
?—Trap
Roof Drains
ReinspaMion Fee $15
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Pact. Blt. ICBO #
Heating System & Ducting
❑o-ioo,00a sTu Oioo,000ar
ionea O`�otp�e�rzy pror �
Datel'_a6L;1_.�
Reinspec[ion Fee $15
White - Builtling; Canary -Applicanh Pink -Accounting; Goltlenrotl -ASsesso�
Showers
Service Sink
Sewer Cap
Sewer Connection '
Sotar Collectors
Solar Piping�
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Issue Fee
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0�100,OOOBTU ❑100,000
System Repair/Alteration
Issue Fee
FEES
Automatic Washer .
Consvuction Pole Sub.
Cooking Unit
Dishwasher '
Dryers ❑Gas ❑Electric
Fan '
F.A.U.
Fixtures
Device Boxes
O utlets
Switches
Garbage Dispoul
Generator �0.5KW �5-
Zone
Accessory Building:
Z
O
N
I
N
G
R
� Parking Req./Provided _ E
Q
� M
T
5.
ELECTRICAL FEES
Transformer ❑ 15-50 KW
' ❑50+KW
Meter ❑up to 100 amps �
Meter ❑over 100amps
Sub Panel ' '
Motors �61 HP O1 h- 8
' Inc. Solar �9-15 HP �16-15+
Microwave .
Pole l.ight
Range
' Standing Sections
15 KW Trash Compacror
$ 3 I
�— Rainspection Fee $15 luue Fee $ 3
FEES
DEVELOPMEN7 SERVICES REQUIREMENTS:
. Zoning Approvad By Date
Building Approved By Date
Application Issued By Date % �
S MAR OF FEES O
BUILDING PERMIT $ �� ' SMIP $ ' �
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PIAN CHECK 25% $ ENERG� P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50°h $ MICROR�M $
MECHANICAL $ TOTALFEE $ �'S�
$ 3 PIAN CHECK z5% $ �
� • L ' .�
CONSTRUCTIQN;,4ND PLANNING `' . � POO SPA
APPROVALS Permit # Date Inspector p�ppROVALS 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 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. . ' '
S. Foundation . .. � 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. .� . 60. Backwash Lines, P-Trap, � 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. Root_Drains - i 64. Plumbing System - Final . , -
14. fiough Plumbing 65. Electrical-Final �' � �
15. Rough Elecirical-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. Rougb Factory Fireplace � APPROVALS Permit #
21. Ducts,in Siructure ' . 70. Underground HYdro
22. Ducis, Ventilating � � 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. floof 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
� 28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown ('qat . � 79. FINAL INSPECTION �
32. Electriral Power Metei-Final • 80. FOOD 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 Plumbiny, •
39. Water Service-Final �
40. Gas Service-Final ' �
41. Solar pomestic-Final
42. Backflow Preventer " �
43. 8ackflow Irrigation . . , _
44. Landscape Irriqation System �
45. Sound Attenuation ; -
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING �/� � '
48. Special Requirements Completed �
49. Electrie Release to Edison •
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY .
No. Date
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31476
COSTA MESA BUILDING-SAFETV DEPARTMENT
P_b_BOX 1200 COSTA MESA.CALIFOHNIA 92626
PA70 # ,k�*.a
HAR -5-7C�a57O0 145 52.50
Fo�Applicant to fillin Campletely APPLICATION FOR BUILDING PERMIT
RECE V D B DATE RECEIVED DATE IS UED
BUILOING .� � - '3- � �._� ^�rJ
ADOFESS l'�.N (, I S L E�M`�
OWNER L0.iNY�/1CZ C/O/II A.P.NO. �'J - �J/`/%�
` BUILDING �
ADDRE55 a 8 J -�'An C� Li.�.N � ADDRESS � �,S �
CITV LC J '
/� r i Ct. NOL �f�(+ r,� � TRACT 3PS3 �or e�ocK
CONSTRUCTION
LENDEF Nd �t �
BRANCH •
OWNER �GL✓u�K�— �C/
ADDRESS VALUE
ARCMITECT TEL. S� S
OR ENGINEER %�� �� '�
FIFE
ADDRE55 20NE TVPE GROUP
APPROVED
CONTRACTOR l7VJ� L� i' BV DATE
ADDRESS
TEL. ZO NO.OF USE OF NEW
CITY NO. — � P�� � BUILDING
STATE CITV �'ARDSAPPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE �� x� NO.OF BLOGS. (FROM C/L STR T)
OF LOT NOW ON LOT qOfYT T. FT.
USE OF
EXI5TING BIDG. T �� FT
NIEWBLDG.�Z� x�� ROOMS /-� STORIES � L.SIDE FT. FT.
EXTERIOR WALL FlOOF ,,l
COVERING ST� `� �OVERING K'�`�� S�j iH � REAR FT. FT.
USE OF BUILOING AN� `�10RK TO BE PERFORMED DISTANCE BET. BET. MAIN &
'�� �-�� O MAIN BLDGS. ACCE�. BLDGS.
`+ E OD%r%i � � VAR.ME DATE
C.U.P.�b pPPROVED
.4F'PROVEO �
I heraby eeknowletlpa tna[ I hava reatl [hia apPlice[ion and stete
thot the above intormadon Is cornct antl aprae to comply wlth
oll lews regulatinB builEi�B conrtr�ctlan, entl 1 shall not employ
any persOn In viOletlOn Of ihe workman'f eomponsetlon laws ot
t�a Stata of Californio. ''/� m
I hereby certify thnt I eT properly Iicanxtl na e eontractor untler �� SQ. FT. + o
i; , Me Stare of Cellfarnie Bufinass ontl Profassionf Cotla, Dlviaicn 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR �
y. �Chepter 9, and that 9uth ���enses ero In full force entl eftect, or 1 THE PURP06E OF ESTABIISHING A PERMIT FEE ONLV: m
' 'nm aiiempt from tha pro��sianz af ihe Stnto of Catifornia Businau �
VALVATION r
'and Grofessions Cotle, Div}��on 3, Chapter 9. PERMIT FEE 5 J � j
SlOnnture of /O� ��(� �J �� m
Permittea ��'�"�� � `�'T' S// S� z PLAN CHEGK S� / SD E
W � `a
Au[horizetl AOent �/ r LL
TOTAL FEE $ L+ J O
- - � � ����� .
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX Sf'7 COBTA MESA. CALIRORNIA
For Appliednt fo Fill In Complefely
TYPE OR PRINT �
BUILDING
A�DRE55
COSTA MESA. GALIFORNIA
OWNER Mesa Del Mar Development Co,
MAIL ____ _ _ _ _" " . . . �
ARCt11TECT
OR ENGINE
�_ � ����� � ' .
tiF�
�}--DEC 9 1986
La � 9G, !'L�n� �f��ft;� D��T.
riry n� r�SU1 IVicSF1
APP�ICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. PCNMIT NO.
� ��.��
RECEIVE{i pi I pATE NECEIVED I DATE�ISSl1E�,
/rs- l�l --�_/_A.R£P�...7.
COSTA ,MESA.
FIRE
ZONE � �TYPE
APPROVED
ADDRE65 38�0 F+. Coast Highvay ZONING
ZONE NO.OF LIBE OP NEW
CITY Corona del Mar � � I PLAN9 BUILDINO
STATE TEf.. LEGwL
LIC. NO. - NO. oESCPlri�oH
SIZE .7 . � . � ... � I NO. OP'BLDOB. _ . I
� 88TBACK LIN6 PROM (/ ( ' . .. . "J,� I
ILEFT 3 I RIGHi �l /
DESCRIPTION OF WORK
■ BUILDING NO. OF
0
�
LIN¢ 6Td
�
Y
/l HEREBY/ACNNOWL6DG6 THAT 1 XAVE READ THIB APPLIGTION TXE AMOUNT BHOWN UNOER VALIIATION I6 FOF TNE
VAND 8TA4+L THAT TH ABOVE IB CONRECT ANO REG TO COM• pURPOBE, OP EBTABLI6HING A PERMIT FEE ONLY.
PLY WITH ALL CITY RDI NC68 ANU 9TAT8 6 RlOULATINO�
BUILo1No CONeTRu 1oN VALUATION
SIGNATURE OF PERMIT FEE $ �� /n
PERMITTE
� $' �'� �'3 O. ro PLAN CHECK $ ,� CYO
AUTHORIZED AGENi\ � '
TOTAL FEE