HomeMy WebLinkAbout403 GLOUCESTER DR - Building PermitsAoolicant to fill in all soaces exceot those within heavv bortler Iines antl siqn all aDGrovriate tleclarations.
p p^n ERMIT NO. - TRACT NO. LOT NO. UNIT NO.
CITY oF COSTA A CONS RUCT ION,l_E/,�1�7� T 2 p , .4.P. # zooe
Project Address �����C25�P� �Std I•CSl� l.tl 7GOL� � � 7 � (7 � " � � �
S Main Building: Accessory Building:
ApplicanYs Maili�9 Ad r ss TVPE OF CONSTRUCTION NEW ADD ALTERATION EPAIR E Z
I�le �roS ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front Q
Owner's Name PFy B ' � . N
Address
' X Laguna 1 S� a y� DESCRIPTION OF WORK/USE OF BLDG. _ I A Rear � - �.
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL ' �� C Right . . N
Arch/Eng. - License No. ' K -� . �
Address. ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL � g� Left ' R
��� �"� 321 �'OTHeR ' ' Ping. Ref. # ' Parking Req./Provided ' E
Conttactor's Name ��Ep ��r� +.w. T� Phone—���__ pROJECT DESCRIPTION 5q. FT. ocCUPaNCV Plannin Notes: n
Addresslmailingl__p-,g, �j� �QQ�_�� ���o_�Q_��� CONSTRVCTIONTVPE � VALUATIONS 3703.00 9 M
T
City Lic¢OS¢ NO. _�� . ZONE GRADIN6 GU. VDS. ' ACRES S.
LICENSED CONTRACTOR DECIARATION •
I hereby affi�m Ihac I am licensetl untler provisions of Charter 9(commencin9 Rema.k�: Tear off shakes and lace with Class B Hardi Shakes
with section ]000) of Division 3 of the Business antl Professions Cotle, antl
my license is in full(�o�j antl effect. ELECTRICAL ' FEES �
License Class y-J� nse No ��� ,
�ate %���ature ' � PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
WORKERS' COMPENSATION DECLARATION . COnSL�UCtIOn P012 Sub. ❑ SO + KW
'eby altirm that I M1ave a certificate Of consent to self-insur¢ Or a certificate Bar Sink ShOw2f5 �
orkers' Compensation Insurance, or a certifietl copy thereoi (Section BackfiowPreventer ServiceSink . _. . �, CookingUnit Me[er ❑uprot00amps
., Lab. C.) ��6103025301$ Libert Mltual Insuran e P P
' Policy No. ompany y Backflow Irrigation Sewer Ca ' Dishwasher Meter ❑over 100 am s
eCertifietl copy is hereby furnisnetl. � - Dryers ❑Gas ❑Electric Sub Panel '
Certifietl copy �s iq1c�fp�w�ith the city Builtling Division. BdthLubS Sewer Connection
Dale �'�L_VJApplicant ' Fdn �
EXEMPTION FROM WORKERS' COMPENSATION DECIARATION Clarifie�t Solac Collectors Motors �0-1 HP O1'/z-8 '
iessissection neetl not be completetl if the permit is �or one huntlred (E300) or Dishwasher Solar Piping F�A�U� Inc.Solar �9-75 HP 016-15+
I ce�rtify Ihat in lhe Pe�fo�mance ot the work for which Ihis perm�t is Issuetl, I . FixtU�25 .
shap not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank' Microwave
Workers' Compensation Laws oi California. Device Bozes'
Date Signature Floor Orains Swimming Pool w/Spa Pale Light .
NOTICE: If, after making ihis tleclaration, you 5hou10 become subject to the OUtI¢t5 Rd0 E �
Workers' Compen5ation provisions of the Labor Cotle, you must torthwilh FI00! Si0k5 . lJ�indl 9
compty with such provision5 or this pe�mit sitall be tleemetl revoked.
CONSTRUCTION LENDING AGENCV GaSServiCE ' OUtlets Water Closet - $witches Siqn '�
1 hereby affirm [hat there�is a construction lentling agency for the performance Garba e Dis OSdI Standin
of [he work tor which thi5 permit is issuetl (Section 3097 Civ. CJ Interceptors � Water Heate� 9 P g Sections
Lentler's Name
�enders Aaaress Kitchen Sink Water Service . Generator �0-5 KW 05-75 KW Trash Compactor
� OWNER BUILDER DECLARATION � •
' I he�eby a(firm l�at I am-exempt irom the Cont�actor'S License Law (or the LBv2tOfi¢5 AUtO-W35h -
Pollowin9 reason (Settion ]031.5 Busine5s antl Profe55ional Cotle: Any city or �
�� county wnicn requires a permit to construct, alter, improve, tlemoiish or repalr P-Trap ' Laundry Trays
any siruciure, priOr to its issuanGe, alm require5 the applicant tor such pe�mit _ , �
' to nle a signetl statement lhat he/she is licensetl pursuant to the provisions ot Root Drains � � •
� �he Contractor's License Law (Chapter 9(commencmg with Section 7000) of
'on 3 of the Business antl Profesvons Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
rom and th¢ basis for the allegetl exemption. Any violation of Section
i by any applicant tor a pe�mit Sublects the applicant to a civil
ty of not more than five hundred aollars (y5o0). ' DEVELOPMENT SEPVICES REQUIREMENTS: .
� � I, as owner of tne property or my employees with wa9es as their sole Reinspection"Fee $15 Issue Fee _ $ 3 Zoning Approved By
mmpensation, will tlo the wo�k, antl the 5t�ucture i5 not in[entletl o� offeretl �0te
for sale (Section �044, Business antl vrofessional Cotle: The Contractor's MECHANICAL FEES Building Approved By Dat�
License Law tlnes not aOPly to an owner of a property who builtls O/ improves
[hereon, antl who tloes such work himselt/he�sel! ur lhrough his or her own' goiler HOOd o� Typ¢ I ❑ APplication ISsuBd By Det
employees, provitletl that such improvements are not intentletl or offered for - ,
sale. If, however, the builtlin9 or improvement is soltl within one year of com- C2nopy Type II ❑ ' ' SUMMARV OF FEES
pletion, ihe owner will have the burtlen ot proving he/she tliC not builtl or im- Duct - Under Ground (� � �J
�rove for tne purpose of saie). BUILDING PEFMIT $ �2� SMIP $_ d—
�� I, as owner of the property, am exclusively mntracting with licensetl con- Duct -Strucmrel Refrigeratfon System PLAN CHECK $ PERMIT
"tractorsto construct Ihe project (Section ]044, Busin¢55 antl Profe55ions Cotle: •
T.he contractor's License law does not apply to an owner of property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
bi�iltls or improves the�eon. antl who Cont�act5 Tor Such oroiects with a r.on-
trqctor(s1 license oursuanc to me ConVactors License Law�. I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration PLAN CHECK 25% $ ENERGV P.C. $
proof o( tneir Worker's Compensation insurance shoum be provitletl to me. ELECTRICAL $ GRADING $
, ❑ I am exempt untler Section B. & P. C. for [his reason Firepl/Fact. BIt. ICBO �k Pire Damper5
� PLAN CHECK 50% $ MICROFILM $ �/
Date Owner Heating System & Ducting � Registers MECHANICAL .$ TOTAL FEE $ y,�
, I hereby certity mat 1 have read this application antl state Mat the above ❑P700,000 BTU �700,OOOBT ' pLAN CHECK 25%
information is correct. 1 agree to comply with all city antl county ortlinances $
antl state laws relating to builtling mnstruction, antl hereby authorize repre-
Sentatives of [his city to ent upon the above-mentioned p�ope�ty to� ' •
Inspettion pu�poses.
Signature oate 7-1i—RQ (:t l�'L.=;' i'�Q(1��7i�r -�,.'.�}'
� _ peinsPectionFee $15 IssueFee $3 (jC±'G, �7;i:ff:`J j�'j� itj;+`3 .�.�.
Drivers' License or 55 'r
0865-66, rev. 5/BB Wnite - Builtling; Canary - qpplicant; Pink - Accounting: Goltlenrotl - Assessor
._ `, �1
CONSTRUCTION AND PLANNING POO' "� SPA �'� ..
APPROVALS Permit# Date Inspector AppROVALS � .it# �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 � . � �i 58. Electrical Conduit-Undrgmd. . ��,
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �'�
r,
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. ���
10. Structural Floor System � f 61. APPROVAL TO DECK
11. Property Sewer Line & House Conne�tion 62. Backwash & Receptor-Final
12. Sewer Cap �'
'� 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing � 65. Electrical�Final '
75. Rough Electrical-Conduit 66. Solar System-Final
�76. Rough Elec[ric Wiring 67. Fencing & Access Approval
i7. 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. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frameand Flashing 76. DryStandpipe
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. 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 Plumbing
39. Water Service-Final
40. Gas Service-Final - �
47. Solar pomestic-Final
42. Backflow Preventer - ' �: .
43. Backflow Irrigation '
,�
44. Landscape Irrigation System � � �
i
45. Sound Attenuation �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING p��7Y� SMoµ,.E DEI� oK-
48. Special Requirements Completed
49. Electric Release to Edison .-'
� .�
50. Gas Release to Southem California Gas Co �J �`? �.� �
51. CERTIFICATE OF OCCUPANCY ' " • � i
No. Date _.-- '
.. . �a i o�-�
COSTA MESA BUILDING-SAFEfY DEPARTMENT
P. O. BOX 917 COSTA M68A� CALIPORNIA
For Applicant to Fill In Completely
� TYPE OR PRINT
BUILDIN6 yQl7 �,'/OUGES��" ��YVG
ADDRE55
COSTA MESA, CALIFORNIA
ADDRE88 JO`= N�. l�e �rt U�
�,:�. Newport Beach, Cal
^R�"!'E9?�.:Brent S. Tobev �
46985
ADDRES3 504 No. New ort Blvd.
�,T,r . Ne� ort Beach Galif.
�;� No. 221233 No 646-9341
OF LO�O. 83x44. 33x56. 83 I NOW ON LOT00 �
USEOF none �
EXISTING BLD6. '
BETBACK LINE PHOM a�{� q� /l
CENTER OP BTREBT 'f .:1 �� REAR YA�fRD Y�' v
SIO6YAROI LEFT S•S RIGFR' F ^-""
DESCRIPTION OF WORK
BUILDINGlz6f1S . fC, RO M9 � STORIHS 1
SIZE 7
EXTERIOR WAL,L ROOP
COVERING S'[�jCCO ' COVERINqCed'clY .Sh`cik
US6 OF BUILDING AND WORK TO BE PERFORMHD
I HEREBY ACKNOWLEO08 TNATJ HGVH READ THI6 APPLICATION
AND BTATE THAT THC ABOV[ IH COqpB<T ANO AOREB TO COM.
PLY WITH AL� CITY OpO1NANCHH AND BTAT[ LAWB flEOULATINO
BUILOING CONBTRUCTION. . .
PERMITTE� F G���/-� S�'r�-� �IN��
AUTHORIZED A6ENT // / /��L24 p.t P '
�
rtt rttl;tlVtD
NOV 2 7 1963
FINANCE DEPT,
CITY OF COSTA MESA
APPIICATION FOR PERMIT
BUILDINCi
For ONIce Use Only �
. � nece�rr no. I.� P4
w
DAT6
3 ia �
ZONIN(i -
NO.O�/� UB80RN6 _ �
� I PLANO I CYILUINO !1
o� ( c7v� IS'. 1n
R,,.,o„ Lot 3 Tract 5212
NO.
-C�
i: NO EAVE OVERHAN6 6HALL BE LE88 THAN
� YAROBMPROVED
� MAIN BUICDING
(FROM C/LBTRHET)
FRONT��� FT.
R. SIDB I ��FT.
L.81D8 � FT.
REAR � FT.
DISTANCE BHT.
MAIN BLDGB.
VAR. iZ .
YARD9 APPROV ED
AGCESSORV BUILDIN6
DATE
1269 5,..�.
TX8 AMOUNT 9HOWN UNOER V/
pORPOSE OP fiBTABLI8HIN0'A
VALUATION
�11, 738. 25 PERMIT
$ PLAN CI
T. �
T.
�
�.
T. [_
.%:
J09. +�
�'�
�
��i• � j ����.
W
C.
l�
Cf.
O
u.
o .o
�8 FOq TH8 F O„
FE8 ONLY. �
w�.
yY
38. 21 ;
0o p
38. 21 �