HomeMy WebLinkAbout1709 GISLER AVE - Building Permits CITY OF COSTA MESA •
BUILDING DIVISION
F `• �,„� �1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT 7MO 00614
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 1709 GISLER AV Status: ISSUED
Suite No Applied: 11/15/2004
Issued: 11/15/2004
Vicinity:
Parcel Number 13913117 ISSUED BY:
Applicant: LAURA YENULONIS .,, .
Address: 422 JENKS CI . " 1 _ '
, Phone: 714-998-4300 ,
CORONA,CA , N Zip: 92880 , , // - -
Owner/ HUBER, MURRAY AND COLLETTA
Address: , ,1709 GISLER AV' , - ' '
i.
Phone: 714-444-1288 .
• COSTA MESA,CA Zip: 92626 - '
Contractor ' ALLIED PLUMBING - HEATING -AIR CONDITIONING
Address: 422 JENKS CI ,
• Phone: 714-998-4300
CORONA,CA --Zip:.- 92880
-License:610780 - ,
SCOPE OF PERMIT - , ,
CHANGE OUT 70K BTU FURNACE , , ,
/ -FEE SUMMARY '
Quantity - - - - - - - - - '' .=-Quantity;'
ISSUEFEE • $23.50 Repair/Alt Absorbtion Unit ;, $0.00 ;. 0 '
Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit . 47•$0.000
Inst FAU>100 k BTU ' $0.00_ 0 - , - m Ventillation Syste .' '$0.00 _ 0
Repair/Alt Cooling/Heat $0.00 . Evaporative Cooler $0.00 6:
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator /. $0:00-_ 0 ,
Rettig Sys<100 k BTU $0.00 0 • Domestic Incinerator . $0:00-. 0
Refrig.Sys>100 k.BTU $0.00 0 Compressors/Absorption Systems .
Gas Piping - $0.00 0 Up to 3 hp/100 k BTU ' 0'4
Factory Fireplace,- '. $0.00 0 __ 3 To 15 hp/500 k BTU ,>,;-% _-$0.00/ 0 ,:,
Hood w/Mach Exhaust $0.00 0 ` - 15 To 30 hp/1,000 k BTU , <ijr,' -$0.00 -0, /
VAV Boxes , $0.00 0 _ 30 To 50 hp_/1,750 k BTU752;,1,7 $0.00 1 A
Vent Fan/Single Duct.- ' _$0.00 0 .:4•:.:r,` - Over 50 hp/Over 1,750 BTU -ter',' $0.00' ', 0'
Appliance $0.00_-"0 - 'Boilers
Fire Dampers , • 2 $0.00 •.0 - Up to 3 hp . $0.00 ; 0
Smoke Dampers`" , ' ' ' $0.00 0 - - 3 To 15 hp ' $0.00' 0
Inst or Relocate Appl Vent- '% $0.00 0 _ _ _ ' ' 15 to 30 hp % .z /$0.00 0
Air Handlers< 10000cfm ' •' 40.00 0: ,.` _ -30 to 50 hp,- - ->, .Y $0.00 0
Air Handlers> 10000cfm •. .. $0.00 0 . - ' -Over 50 hp- - $0.00 0
Floor Furnace $0.00 -0 ' - Other Mechanical Fee ' '
Floor or Suspend Heater $0.00 . 0 - Investigation Fee 7 - $0.00
Plan Check Fee $0.00
Reinspection Fee ' $0.00
TOTAL CALCULATED FEES $38.30
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2146.46(6/00) .
WORKERS'COMPENSATION DECLARATION; -
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
G `My.workers'compensation^IIn��su�rance� carrier and policy number are: �] / t 1
Cartier�� �A YxC� Y""n`(elct CO-r Policy Number: �-)�—2-13TbC0C-f 3-01
(This section need not be completed it the permit is valued at one hundred dollars($100)or less.) C----""
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation la "- of California,and agree that If I should become subject t• he workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with th:.e 114,•visions.
�AA ` `—\Th C
�
_O r
plicant'Signature:.S&. �_ _ _ Jl 6 • AA . ' _SIV_ A C S( e\ \Date:
� �
WARNING:FAILURE TO SECURE WORKERS'COMP ` A ON COVERAGE IS UNLAWF ANI�:ALL SUBJECT AN EMPLOYER TO,C,CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,0:0),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm.thatl.am.licensed,under provisions of Chapter 9(commencing with Section 7000)of Division 3 oLthe.Busin s and Professions Code,and my license is in full
((�tomeandeffect.ucL#`:QQ'Vb , Lcla'ds p. TkL.20 j C'j(p
r ,bitrectarsSign`eture.,- ��
1111 tete: 1\-� —nil
CONSTRUCTION LENDING AGENCY: ��
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that ha or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i,e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a gpermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
i CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature O gal Owner(s) Date
An Lknom, �,)r ,Ao/Qtr? 1 -n_04
_-. rr utfioriie plicant^ r�,•Date---^�`
;ODE I INSPECTION TYPE PAll INTITIALS CODE I INSPECTION TYPE PATE JNTIi1AL$
-
1616 Fixed System Final Fire Prevention _ _ 206 Final Mechanical II 'Q3'-69
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final BlocldRetaining Wall . . 212 Final Fire Prevention
202 Final Factory Fire Place - • . 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition - • • . • ' 250 • Final Building/Occupancy .
E_SS8 _ ..
Applicant to fill in all spaces except those within Heavy border lines and sign all appropriate declarations.
•
CITY OF COSTUMES' CO TROCT!ON PERMIT�� " , Pr*7 TRACT NO. LOT NO. UNIT NO.- ,
• 7i •
• Project Address ��//ci a� - �/9 - •
Applicant's Mailing:Addres; 3 0 1^^-Y,.,��y '(1ya TYPE OF CONSTRUCTION ❑ NEW U ADD ❑ ALTE RATIOf�'CJ REPAIR
DO" t+ 2— �, ' 9
El CONVERSION ❑ DEMOLISH ❑ OTH
Owner's Name D C' Yas�k kex�'S2 Phon C.] l • rESCRIPTI■N OF WO'K/ E O :AN.
1 • ____ T� — P-# •
Zone
Address . -eet tt .cL ' �-I' la • • Main Building: Accessory Building:
�. d �i �
Arch/Eng. License No. TYPE OF PER IT GRADING MI FOUNDATION .1a`STRUCTU RAL • ■
Address ! ❑ TENANT ELECTRICAL, ❑ PLUMBING S,ECHANICAL
•_ � . • 7�• ❑ OTHER " -
Contractor•s Na - ��t p
Address(mailing) t54`'0�'Lp- aq`.. �•2 c ✓eA (-- 3L-_. -PROJECT DESCRIPTION SQ. FT. OCCUPANC�w/�'3
- ' l — /•_ /' 07 l "CONSTRUCTION TYPE - VALUATION $ �eoz—� ,s Left
City License No. ac CA ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTORtha •
DECLARATION in /Provided E
g f• m ,.5 �� �e� • e a
I hereby affirm that I am licensedon3 of provisions of Charter 9 (commencing' • Remarks: i/ \ l//_/JJ - ft Planning Notes:
with section 7000)'of Divi ion 3 of the Business and Professions Code-, and [///;1(�7AAA...•p L7 < �I/T
my license is in full force a effect. /�Q / �� •' Sec-
_ /�i
License —.. •Liens- o. 2.1 3g O. " ! Fors �C C —/ /�`ec- �L'fl
Date Z o •nature - • ..1 - PLUM ING FEES
WORKERS'COMPENSATION DECLARATION
ti'-;lereby affirm th. .�ryavpy�4$Y,Lpfiepeonsene I or or a cer "ficate Bar Sink Showers
Workers' Come s66tiodd ps a e o a - ' •• -r-of -p coon
".00, Lab. C, eta Ac Trani-former ■ a
f.S.. Y� _a roc ®Ba ■w Back-flow Preventer Service Sink II • a '
Policy No. • •.
Cert if tl copy her y furnished.cit .0
.0y
l o y i with the city I . • ■ 11 amps .
Date - Applicant
EXEMPT ON FRO WORKERS'COMPENSATION DEC ATION 1 ■ Clover as amps
(This section need not be completed if the permit is for one undred ($100) Or Dishwasher Dryers .Gas .
Electric Sub Panel ,
0less).
I certify that in the performance of the work for which this permit is issued;I
(`t� shall not employ any. person in any manner so as to become subject to the ■ Motors 00-1
V Workers' Compensation Laws of California. '1 •
V Date Signature -- . Drains
1 NOTICE: If,after making this declaration,you should'become subject to the . ill ■
Floor
Workers' Compensation provisions of the Labor Code, you must forthwithFloor Sinks • Urinal
�� l Fixtures Microwave
comply with such/provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY ■ Deviceateroset
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Outlets
Lender's Name -
• Kitchen Sink ' Water Service - Switches , Sign
OWNER BUILDER-DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or
county which prio.to a permit c ,construct,alter,improve, t for uc or repairmi ® , Generator 00-5 KW 05-15 KW Trash Compactor
any structure;requires its issuance, also requires the applicant for such permit P
to file a signed statement that he/she Is licensed pursuant to the provisions of (MainsRoof
the Contractor's License Law(Chapter"9 (commencing with Section 7000) of . Lci—.�Qa /
wiei ro 3 of the Business and Professions Code) or that he/she is exempt '
•refrom and the basis for the alleged exemption. Any violation of Section ea• . , /
31.5 by any applicant for a permit subjects the applicant to a civil �`^-���,�� /
natty of not more than five hundred dollars($500). '
I: I, as owner of the property or my employees with wages as their sole Reinspection Fee . $15 Issue Fee
compensation, will do the work, and the structure is not intended or offeredIIIIIIIIIMIMIIIMIIIINIIIIIIIS—MECHANICAL
Reinspection Fee I $15 Issue Fee
for sale (Section 7044, Business and Professional Code: The Contractor's
License Law does not apply to an owner of a property who builds or improves DEVELOPMENT SERVICES REQUIREMENTS:
thereon, and who does-such work himself/herself or through his or her own
employees, provided that such Improvements are not intended or offered for "
sale. If, however, the building or improvement is sold within one year of com- •y Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- j' itm ' Building Approved By ateprove for the purpose of sale).❑ as owner of the property, am exclusively contracting with licensed con- • • Application Issued By Datetractors to construct the project (Section 7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of property who 00-100,000 0100,000 SUMMARY OF FEE • .
builds or improves thereon, and who contracts for such projects with a con- /J
tractor(s) license pursuant to the Contractor's License Law). ham aware thatIIIIstem IIIystem BUILDING PERMIT $ 7--07 • on SMTP $ /• J Q
proof of their Worker's Compensation insurance should be provided to me. •
PLAN CHECK $ - PERMIT
O lam exempt under-Section B.& P.C.for this reason . :• lil •: PLUMBING $ ISSUANCE ' $
Date Owner, ' DuctingPLAN CHECK 25% $ ENERGY P.C. $
i hereby certify tect. I have rayst his application and state that the above 0-100.000 : 100,000 BT 'y. rs0I GRADING $
jri.j= ELECTRICAL $ 7
information is correct. I agreebui •• plyst with-all city and y county ordinances res PLAN CHECK 50% $ MICROFILM $
and state laws rola tin•.to be- construction, and hereby authorize repro-,
of this ci to a upo th- ..eve-mentioned rorty f
inspection purposes. •
Signature Date �� MECHANICAL $ TOTAL FEE $ �JS.90
- Drivers' License or$5#
��-
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ��+r uuu,i+".+++. a ..• a
DATE: 06/01/89 TIME: 13:1C
J
`.CONSTRUCTION AMY PLANNING - ,� _ POOL&SPA
' • Y i Date Inspector Date Inspector
APPROVALS „?P.ermit# APPROVALS Permit# _
Ai
1 i Temporary Electrical'Service orPole ' 52. Pool & Equipment Location
ti:.
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 UFE_R Gr.,/
57. APPROVAL TO COVER-GUNITE .
7. Footings `. •r ./ t- l 58. Electrical Conduit-Undrgrnd.
8. Foundation 1 ��; - 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd ., - 60. Backwash.Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor Systr€,, 61. APPROVAL TO DECK
11. Property Sewer Liner& 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 - &-1.5in Q 67. Fencing &Access Approval '
•
(17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING - -
18. Rough Electrical-T Bar Ceiling . POOL/SPA SYSTEMS FINAL; �.y . '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace _ . APPROVALS Permit# , iy
21. Ducts, in Structure -. ' 70. Underground Hydro j j -
22. Ducts, Ventilating . . . , 71. Product Piping 0 Gas moil !
23. Gas Pipe-Roughi& Test 72. Underground FlushG
Roof Framingt -"
24.
73. Undergrnd.Storage Tank/O6as 0 Oil
25. Roof Sheathing • , • . . _ 1 •74, Overhead Hydro r., ,
26. T-Bar Ceiling (Structural) & Monocoat z 751 Dry •Chemical 'iS �;. - •
27. Frame and Flashing tKZ7 • 76. Dry Standpipe ,. '' r. '
28. Lathing & Siding 77. FIXED SYSTEM FINAL = x
" , ; -
29. Insulation • 78. FIRE PREV. FINAL U.,••'" i
30. Drywall Nailing L1-7111 S?REQUIREMENT f(
•
31. Plaster Brown Coat 79. FINAL INSPECTION j ; .1
32. Electrical Power Meter-Final Wiley 80. FOOD CERTIFICATE ISSUED
33. Final ElectricNotes:OUB tiU A rtcCL�1
i' 34. Final Heating & Air Conditioning �7CA,rda: ,v 516*/ .i...1,4,--n _ (",.t
35. Final Gas Pipe-Te'st' , T ��Z/� r
e � G: 7 Y
36. Hood or Canopy . 077�Y1 Nice Acc.r.SS " ‘w - 1+
37, Final Factory Fireplace �_ . - .t i
38. Final Plumbing '
Ji
39. Water Service-Final • 1- .t x
40. Gas Service-Final . •- "1
_ 41. Solar Domestic-Final . • • IJ
t 42:•Backflow Preventer , : - ; '4
1 ;
,`43. Backflow Irrigation _ _ +
, 44!Landscape Irrigation System _ o0r° � .r
-45. Sound Attenuation - - • ' .
• 46. Handicap Regulations • - - .. .. } '
47.'FINALSTRUCTURE & BUILDING - ' - - I i
•
t5 a :rte o IPA i- _ 2a ' .8-- • 'G
48. Special Requirements Completed / `
49. Electric Release to Edison , " -- •,
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY ,
- No. Date _ - -
- . . r, t, . . ' ' - -
• Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -
ICITY OF COSTA MESA ' P MITNO: ^" TRACT NO. - -j LOT NO. -BLDG.'NO:- " - ` -' - ' - - • ' •
CONSTRUCTION PERMIT 3�p�J j } '' f f.""'6300: 5/24/82`' `1*-'. 15.50 TL+
,7t. , Project Address It/v ci G 1—c B _4- TYPE OF CONSTRUCTION - ...1.'/-%-: ` •*+`
;:Owner-Do+ns?ARK tour= - Phone979,434 "Oa N .-EW` 0 ADD 0 ALTERATION ` - ' - • '...I - -- --- -' - •- : - •_ ' - -'-' -1.
tAddress -�"1f99 'C.ISI�r-Ac12 - O.REPAIR ❑ CONVERSION.❑DEMOLISH- ZONING REGULATIONS
' Arch/Eng:'^--•- - - - - - -- - --License-No.13 aiciig ft S OTHER-c Aa.CM)S •+.G`I - -
IAddress" '---•' ' '-- ---- {- - DESSCRIPTI_ON O_F'WORK L1 K{- W "roan_ I !A.P. -- - -r
,OCISkesk-s`er& 3.\tAr Scrc;Cat.-•. 1 - ._. -!ZONE _ _. _ _ _.PLNG'.''Contractor 0-au-r,-.-A - —Phone9-74.63q 3 •TVPE�OF,PERMITy , -' '- - TTpp BMt1C
VGp Y1R�t;L1/•t(nrs'♦SL`(lM { SETBACK C/LST. - PROPERY LINE' - '
Addressa2�IA/.'T1.l.l iii 444-k(L(• •Oreti;7-Ce-o4 Q2(eG,C 0-GRADING '_0 FOUNDATION - 0-STRUCTURAL- ' 'SIDE YARD-- - ---' -- - 7- ^•
s.'.' :LEFT
' LICENSED-CONTRACTOR.DECLARATION—. .. .:: --: "'Ex-TENANT- - - z _ .7.,---.4,
� •' ;cf.:
_
t it AL.
LRPLUMBING-O MECHANICAL 75145-YARD"PVARD- --
'1 encln of ith' s ct I am licensed uncles provisions- of of Charter 9(-and l: - •t - -- - ( i RIGHT 'r.^'Th.-°•
renting^-with settlor 7000) cofe Division -3 the Business-and •❑-OTHER - - -
• Professions Code, and my license Is in full force and effect. '- *REAR YARD(TO P/L) .. ,- -
License Class� ,,- - L55ense No.41�?9qZ' A.SRQOFECT DESCRIPTION . 1 -- - , _ -PKG.SPACE REQ. PROVIDED _, , .
Date at' '" Signature &n_nJe=F4•q•; •f - ,F _. ... _ _ - .
r• •STREET WIDTH PARK•FAT
.WORKERS'COMPENSATION DECLARATION-- --- _ , -. ' g.00CUPANCV '• i/' CONSTRUCTION TYPE- ' "u' $ ' J.
I herebyaffirm that have a certificate of consent to self-insure or a - c- ,ZONING APPROVED:BV - DATE •
certificate•of-Workers'.Compensation--Insurance, or-a certified-copy ".VALUATION'-^ _ ZONE -- - _+_ _ •� i I t•�.I
thereof(Se$$,,ti n 3800, Lab.C.). I �i'g p / ��� L ,•or r GRADINGrCU YDS. • ACRES _I 1 SPECIAL CONDITIONS
ry•No'14D"al 7:30 'Company�a.*S &*jetna-3+°dL 4. —_- _. _.. _ _ __ _ _ _ _
:Wiled-copy-is hereby furnished.^ ):.•C -REMARKS:_. . i^ .�.__ •
_ _ 'm '' ' 'P~'r'' - !
_ertifietl copy is filed with the city Building Division. - ... , ' - ', t .,. - ., -
EXEM PTION'F ROM WORKERS"COMPENSATION DEC EA RATION' - _' - _ _ - ' -�-'I""' -"' _ .._ ._______. _._ __
( ction need not.be.completetl.if_t he,per mit-is-for one hundred __mow__ i
($$100)100) or less). 1 , -.'- ••• r '- .-- I, -+_ -
I_certify that inthe-performance of the work for which this permit is - _ _ -_ _ —I
issued, I shall not employ any person in any manner so as to become -P.LUMBING, ,i .:PLAN CHECK �'� - -,ELECTRICAL -' PLAN CHECK .-, I
subject to the•Workers'.Compensation-Laws.of California. • - _ _ ---. _ -
Date -- I Signature _ BATHTUBS SHOWERS •SO FT GlivtLLING SO FTGE
•
NOTICE: If after makingthis declaration, •
`- - " '- ' -'-' - --
you should be come subject TOILETS,. '� nr• (]RURINAL`5 GENERATOR' "0-1 KW_1-10-KW
- to the Workers' Compensation provisions of the tabor Code;you must )TRANSFORMER �. �•T :-o i -
forthwith comply with such provisions or this permit shall be deemed LAVATORIES . DOUBLE'L-AVS" '•` 'APPLIANCE-- '10-50'KW_50'a-KW-- :- - o ' .,,; -
CONSd..
CONSTRUCTION
LENDING AGENCY
„__v_ ”
KIT.SINKS -"' DISHWASHERS-S'-'- -` MOTORS"- -CONSTRUCTION AGENCY I '0-1 HP--/-4-4111•0141P- '- "
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS c.4"•+b SUMPS- - -.--. 4._ -'- -- ;(INC.-SOLAR)----10-54)-HP. - 50-4-I
-IP -- ♦�
formance of.the work for which this permit is issued (Section 3097 - I - . .. ... - �'•r
Civ. C:): -_` •_. _ ____ __.._- _._ .. - _---. __ _ __ _ _ _ __ _ _ I
-FLOOR SINKS' '-` FLOOR-DRP.INS'-' -` 'FIXTURES"'" ""OUTLETS `SWITCHES"" ' `-
Lender's Name - ! t
-
Lender's Address DRINKING FOONTAINS "'-"- - - :GAS TUBE SIGNS ""- "i - �
_ .__ __�._ E _ i .- __. ____.___. .{ _.
1 hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE'L'IGHTS'-
the following-reason-(Section-7031-.5-Business and Professions-Code:- -SWIMMINGPOOL`- - "'P TRAP-- --• '- - "-•
- LUNSl-NU -muN_ _ •
Any city or county which requires a permit to construct, alter, POLES METERED +SUB ... - - ^<
Improve,demolish-or repair-any structure,-prior to its issuance,also re- WATER SERVICE ` 'ALTERATION- I- - ''PANELS 44- " - • MAINI7 _!. _ -5UB' —
quires the apt licant for such permit to file a signed statement that he - , i
Is-licensed pursuant-to-the-provisions-of-the Contractor's-License Law• GAS SERVICEOUTLETS' - v - 7 ,SERVICE'- --'--"'"- ^' -' MP
A ' -' . 4- . `I
Business-and-Professions Codeyor that-he is exempt-therefrom and the- 'WATER-HEATERS—- BTU OUTPUT" - --' - -._-_ ' -" ' - - --- - - 7,-,,,--,,,,:r,-47,' - -- - -'- - -for the alleged exemption. Any violation of Section 7031.5 by - - - -
;applicant fora permit subjects-t he-a pplicant to-a civil penalty SEWER CONNECTIONS - 'r"'
"t more than five hundred dollars ($500). _1
es owner of'th -p`roperty,-or my employees with wages as their SOLAR TANK •/--' -COLLECTORS- / - +`'6 -- I- r"' - -' - - s-
sole,compensation, will do the work,_and the structure is not intended, _ ___ _ _ __ _ __ - _" !
or offered for sale. (Section 7044, Business and-Professions Code: The SOLAR PIPING SVS /.. _ T-` -•SSU E'FEE"-' --'-- - - ,., 3 '"
Contractor's.License-Law_does_not-apply to an owner, of a Property _ __--II,
_" ___ __ _ _ _ _
who builds or improves thereon, and who does such work Himself or '- ISSUE FEE - I; _� - 1" ':APPLICATION APPROVED B - '" DATE Z'••
I
through_his own employees, provided.that such improvements are,not - I
Intended ()Coffered for sale. If, however, the building or improvement MECHANICAL •PLAN CHECK ' : 3 `
Is sold within ane year,ofcompletion, the owner will have the burden - A SUMMARY OF,FEE$
of proving he did not build or improve for the purpose of-sale). ,, .BUILDING- -•--^ """ "'- - • - - -
CI-1,- as owner-of-the• property,-am •exclusively. contracting-with HEATING SYSTEM 0-100,000 BTU PERMIT $ _ SMIPy $ •
licensed contractors to construct the project (rojec[ Section.7044, Business AND-DUCTING' h : -•ry -- -- +
100,000+BTU (PLAN CHECK $ • 4PERMIT t 'lt .'r` J
•and- of property-
pert:-Thebuild orContractor's License-Law does a not apply to ISSUANCE- $anowner of uch - rty-whp builds improves thereon, and who con- REFRIGERATION 0-100,000 BTU I PLUMBING $
tracts-hefrom-such sh crnjecL-wither contractor(s)-licesned- pursuant-to -SYSTEM'- - ------ - �^ -- - - - -- -- - - -- -- ---GRADING--$
the Contractor's License Law). ]00,000(+BTU PLAN CHECK $ • � ': T •-y',y; I l *-; .,
0 I am`exempt under Section -- -- --'-T -"B'&-P'C.for this- -" --- -r-- �,-5'b -- - -- - � $`
BOILERS BTU IELECTf21CAL $ A,?
reason -- -- - . - — - - -- - . -- 'PLAN CHECK" $"" MICROEILM St,-
Date, Owner SYSTEM REPAIR,ALTERATION -• '"���TOTA�FEE$`� -f •
"'
y y application and state that the above _ EXHAUST SYSTEM. MULTIPLE • MECHANICAL $ ,
I hereby certif that I have read this , "f LESS AD-- • f _ '
information'-is correct.`• agree to-co-en-plc/with all tete and county - „ ,PLAN CHECK $ ' --. -VANCE PC -- - '
renewno• _n• statetaws relating to construction,and hereby authorize , $ t
repies- ativ+ s� this to enter""uncut-the above mentionedc� •" -' h'"' - ' I
sin at �� � �.� ._ a 'Y 1�r __ , -FI NAL FEE $ 1- . 99 f
Drive- ' icenseor SS • ..� ' •' — -- - - -.- _ . _ _ . _ _. _ . .
- -
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
•_ ',�, I CONSTRUCTIONAND PLANNING
APPROVALS Permit # -
ate Inspector
POOL & SPA,
APPROVALS Permit # - , Date , Inspector
_ i.
Temporary Electrical Service or Pole
43.
Pool & Equipment Location - - •-1
2._SoilPipe-Undrgrn
'
,
44.
Steel Reinforcement -- •- -- '
_3.
Electrical Conduit Utility-Undrgrn
45..
Forms
4.
Electrical Conduit-Undrgrn
_ 46.
.Electrical Bonding '
5._Steel
Reinforce -�,�.,_ :,f-
�+
47.
Rough Plumbin' & Pressure Test - -
_6.
Electrical UFER Grn _ '_ ' t
- -
- 48,
APPROVAL TO COVER-GUNITE - - - - - •y •� -
7.
Footings
"-
49.
Electrical Conduit-Undr rn + '+++ - .r •+ r
8.
Foundation
50.
. Gas Pipe, ❑ Undr rn, Test
9..
Water Pipe-Undrgrn _ _
51.
Backwash Lines P-Trap.❑ Undr rn'
10.
Structural Floor System) e
52.
, APPROVAL TO DECK
1. 11.
Property Sewer Line &_House Connection_'" .'
_ _ _
.53.
_Backwash,& Receptor-Finale
_12.
_ Street.Sewer Connection54.-
..._
'Heater'& Vent-Fina6
13.
Rough Plumbing
, .: ,,-, .
- ... %i
14.
Rough Electric-Conduit -
- - - - -
- -
56.
Electrical-Final - •'' c
'- 15.
Rough Electric-Wiring - -` " ' "' -
- - -
- 57.
Solar System-Final-
16:
Rough Heating & Air Conditioning- -- _
_ -
-
encing & Access Approval
".17.
Ducts, in Structure
59.
APPROVED FOR PLASTERING
. 18`.L-
-Ducts, Ventilating
.60.-..POOL/SPASYSTEMSFINAL
-
19' GasPipe-Rough&Test-
20. Roof Framing'.
21.
Roof Sheathing-
heathin
-
^ NOTES:
.221
22i ' Frame and:Flashin
1--23.
Insulation-
i 24:
LathinQ &Siding
-- -- - - ---
25..
Drywall Nailing
'+ -
26.
Plaster Brown Coat
27:
Electrical Power Meter-Final
28.
- Final Electric
•- - "•'' '
29i.
Final Heating & Air Conditioning
- - -
30.
Final Gas Pipe-Test
i 31.1
Final Plumbing
• .32.
. Water Service-Final
33.
-Gas Service-Final
34.
Solar Domestic-Final
' 35.
Landscape Sprinkling System
1 36.
Sound Attenuation
37.
Handicap,Regulations
38.
FINAL STRUCTURE & BUILDING
39.
Special. Requirements Completed -' -
' "' "- �' - �- •'
40.
Electric Release to Edison-
dison41.
41.
Gas Release to Southern California Gas Co.
- +
42.*
CERTIFICATE OF OCCUPANCY
No Date
-
,
2 5 rA>J-DFlR� Pl.� 0
SOLA R
C IL PCl OR5
I
�I
I
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COI. LL CTOR
14 NSOR
F AE61c
l i0q C-#-;sc&Z
AIR VENT
APPROVED
CITU3r. ggk-T;j MESA
Mechanical Divisicn
Building Department
Approved �--------. Date.
N- .-r�J5LLLATED* S/y cOPPER3 TYPq Y�1
I 3/y" coPPG2, TY P6 rv1
I
�I V2
.'�uYo
.r'oAjTKoLLfR
II -
� 1 cREuc
(I
VALVE 1`
I
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(I
II
I1
I { 1 ma
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-rAI ----- r
ENH
SNSoR
V I - Vb 6ATE YALVCS
VI
\V3
Ml)(W6 VALVE
�TAEP,fAOm£TEQ
\P.T VALVE
SOLAR T-AjK
Permit #_P C, - .
THIS NUMBER MUST A('CO;tiipANY
_ALL INSPECTION REQUESTS
co Lb
WATT
—<
v5 Nor
T WAr
OACuu-P
TAt1K
i 1
ALL PIPG I45KLAT104 To BE V,w WALL THERrq ACEI, FOR wT6AI0 R, 3lky" WALL TIERMAC(L
PDX Er7calok , OR EGtWYALIAT
.
I
� '
�•
11�f
gaievst
-il
1(111--ed--JJSho.ke
1I
-
!
-;h
I 'Panel W r�IvF:r{
!
-
a
I 1
-
Ix
'
i I- { -
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Rhem
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Costci.
nets '
92E46
OWNER JACKSON, D. E.' DATE 4-11-62 1
JOB ADDRESS 1709 Gisler St. BUILDING PERMIT NO. 16843
GENERAL CONTRACTOR Owner -Builder VALUE $ 17,505.00
AP No. 113-376-4 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res.w/att.Gar.
INSPECTIONS
Signature
DATE
GROUP I & JTYPE p ZONE R-1
Soil
-5-
=H-cz
SUBCONTRACTOR
PER
ITS ISSUED
f-
DATE
NUMBER
r
A.LU
Rough Com. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous ^Q�iiy-�e�.' /..W
Prop. Swr. Lin 1} -House Con. 8 -St. Swr.
Sprinkling System
9--
7 9
—
S i m K -`f wr2 a
Tz�
_-
�p
p
Construction Pole
Underground ❑ Power
Rough Wiring
n2
j3
So
renc es E Forms �' Steel Reinf.
W/%/-
Floor System
/Q/ji4
,+-/-/- (91-
tBond
BondBeam ❑ Steel Reinforce ❑
Sheathing
/('H
S -/<J -6y
Frame and Flashing���
1- 3 ^ C
Lathing — In O- Out p-
x7
Plaster, brown coatRe
frig. ❑ Air Cond. ❑ Final
N--'ing, Final
S
YY
ing Fixtures, Final
O -y--* >-
est
r_ _. Gas Test/5—
Electric
Electric Fixtures, Final
Building, Final
�.
OCCUPANCY
WHM UU4 - W - /-til IUULt-�'
C 16843
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
FEE RECEIVED
A"MAR 301961
FINANCE DEPT.
For Applicant to Fill In Completely
APPLICATION FATYP���STA MES(
TYPE OR PRINT_
BUILDING
BUILDING 1 70q 67 1h
ADDRESS
For Office Use Only
COSTA MESA. CALIFORNIA
/
IV
RECEIPT NO. PFf�
OWNER�fJ
MAIL ./
Gi% L
RECEIV BY TJ C IVE Dy�Tp�I66UED
ADDRESS e�- (/F%L -e �7 1 e W
TEL. �^
CITY SCI. D NO S%s
BUILDING
ADDRESS
All!
EER i
COSTA MESA. CALIFORNIA
g / M(�R'GNe.7.TNoi
FADAS
FIRE
ZONE TYPE GROUP
OW/V -13 1
'
APPROVED -4
CONTRACTOR lip
BY rTA DATE
�� 13Fl k e t6 13.
16NING
ADDRESS ISE -Y 4.I
ZONE
OF�
USE OF NEW
clrY
PLANS
FLA
BUILDING
STATE TEL.
LIC. NO. NP.
LEGAL ^�
DESCRIPTIO 7 L1V q
L
'ZEOF / C
I NO. OF BLDGB.
♦♦♦
LOT V J
NOW ON LOT
1
A. P. NO. ( b
USE OF
YARDS EVES
EXISTING BLDG.
APPROVED AL WED
SETBACK LINE FROM
(CENTER LINE ST.)
CENTER OF STREET REAR YARD
FRONT V FT. IN.
)
ILEFT
(RIGHT S
SIDE YARD �S
R. SIDE FT. IN.
DESCRIPTION OF WORK
L. SIDE FT. IN.
NE` I
I ALTERATION I II
ADDITION
REAR SFT. IN.
REPAIR
II MOVING I II
DEMOLISH
ABPPROV b PATE ����
BUILDING NO. OF
SIZE ROOMS STORIES
AJ�
aJ
EXTERIOR WALL ROOF
COVERING C -LO COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
�Q��Gf�L-v.iL✓ L
Ile 3
c � � �✓
D
yob
I VEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
HE AMOUNT SHOWN UNDER VALUATION 16 FOR THE
PLY WITH ALL CITY ORDINANCES ND=STATE LAWS REGULATING
PURPOSE OF EETABLIBXING A PERMIT FEE ONLY.
VALUATION
BUILDING CONSTRUCTION.
SIGNATURE OF-
PERMIT FEE $ 3;7�-
PERMITTE
1-/7
//l
$
PLAN CHECK $
AUTHORIZED AGENT
TOTAL FEE S i�l