HomeMy WebLinkAbout411 GLOUCESTER DR - Building PermitsI
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AVG�icant to fill in a11 spaces ezcev< those within heavy Gortler Ilnes anC sign a11 apo�ao��ate aeclarations.
� 1I 1T PERMIT NO. TRACT NO. LOT NO. UNIT NO.
ICiTv oF CosTn CO STR,��tJJ+CTI AN PER 1�},� Q . a.r. � .
I� Project Address ����lOLICe$�r� l.l�S�d I•I�Sd� Ca�LOL7 ✓� ' 1 S Main Buildi
Applicant's Mailing And,d,re,sns. ' TYPE OF CONSTRUCTION NEW ADO ALTERATION REPAIR E
Owner'sName t��nu,tlxJ$ � Phone�llk.�Jg,�—'�Q9 � CONVERSION ❑ DEMOLISH ❑ OTHER ' 6 Front.
DESCRIPTION OF.WOFK/USE OF BLDG. A Rear
Address P � �JJC � �.d�llfl] �'iil-I5, C�q2�� � .
Arch/Eng. �icense No. ' TVPE OF PERMIT GRAOING FOUNDATION S7RUC7URAL � I K Right
Addre55 � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' g�, Left
Contractor'S Name PhOne ��� O'OTHER � '_ , Ping. Ref. #
Address (mailingl P � �(1X ���J �ClSta r'�25d� Cd--�l2� PROJECT DESCRIPTION � 5c,. F7. OCCUaAy��v .� planning Notes:
Ciry �icense No. �Y1riQ�i � CONSTRUCTION TVPE VALUATION $ 3
ZONE GRADINGCU.VDS. AGRES
1.ICENSED CONTRHCTOR DECLARATION
I M1ereby affirm that I am licensetl untlet provision5 of Chdrte� 9(commencing Remarks: TE�p �ff Sh(�I(PS a�d lace with class B Hardi Shakes
with section 7000) of DivlSion 3 of the Business antl Profe55ions Cotle, antl
my license is in full force antl eHect. _ . �
License Class LjG�nse No. g PLUMBING FEES
Date — �
WORKERS' COMPENSATION DECLARATION Bar Sink Show0f5
� hereby afiirm Ihat I have a certiflcate of consent to sel/-insure or a certiticate
Workers' Compensation Insurance, or a certifietl copy thereof (Section BackflOwPreventel SefviteSink
0, Lab. C.) y�161030253Q��, Liberty M.rtual Insur -
olicy No. pany Backflow Irrigation Sewer Cap �
8 CerEfietl copy is hereby fu�nishetl.
ce�tuiea mov u r�eq�i�the <ity Bui���nnC����i�Rlssoc Roofing Inc aathtubs Sewer Connection
�ate �lpplicant
E%EMVTION FROM WORKERS' COMPENSATION DECLARATION Cl2�ifi¢�5 ' S012f COII¢Ct0�5
(Thisseclion neetl not be completed ii the permit is for one huntlretl ($300) or Di5hwa5h¢!
Iess). Solar Piping
I certify that in the perfo�mance of tlte work fo� which thi5 perm�t i5 i55uetl, I
shall not employ any pe�son in any manne� so a5 to be[ome 5ubjeCt to the Orinking Fountains $OIdI Td�l(
Warkers' ComDensation Laws ot Calitornia.
Date Si9nature FloOr Drains Swimming Pool w/Spa
NOTICE: If, after making this tlecla�ation, you Shoultl become Subject t0 th¢
Workers' Compensation provisions o� the Labor Cotle, you must forthwith . Floor Sinks Urinal �
comply with such p�ovisions Or tltis p¢rmit shall be tle¢metl �revoketl.
CONSTRUCTION LENDING AGENCV ' GasSeNiCe �OutICLS WaterCloS¢L
I hereby aHirm tha[ Ihere is a conitruction lentling a9ency tor the pertormanc¢
�. oi the work for which ihis permit is issuetl (Section 309� Civ. CJ Interceptor5 Wate� Heat¢�
� LentleYs Name
� Lentler's Atltlress Kitchen Sink Water Service
OWNER BUILDER DECLARATION ,
I hereCy affirm ihat I am exempt from the Contractor's License Law tor [he Lavatories Auto-Wash
following reason (Section ]031.5 Business antl Professional Gotle: Any ci[y or
counly which requires a permit to conStruCt, alter, imp�ove, Oemolish or �epair P—T�ap . L2undry T�a'y5
any structure, pnor to its issuance, also requires the applicant for sucn�permit
to file a signetl statement that he/she I5 licensetl pursuant to [he O�ovisions of ROOf D�ainS - �
the Contractor'S License Law (Ghapter 9(commencing with Section �000) o(
Auromatic Washer
Construction Pole Sub.
Cooking Unit
D ishwasher
Dryers ❑Gas ❑Electric
2one
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Fan
F,A.U.
Fixtures
Device Boxes .
Outlets
Swi[ch¢S
Garbage Disposal
Generator �65 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over100amps
Su6 Panel ' '
MotOrs DO-1 HP O1 %- 8
Inc.Soiar �9-15 HP �16
Microwave -
Pole Light
Range .. �
Sign
Standing $ections ��
Trash Compactor ,
D^�'�ion 3 of tne Business antl Professions Cotle) or tnat ne/she is ezempt Reinspection Fee ,$15 luue Fee
'�om antl the basis for the allegetl exemption. Any violation of Sectlon .
i by any applicant to� a permit subjects the aOP��cant to a civil '
,y of not more tM1an five huntlretl tlollars (g500). 3 DEVEIOPMENT SERVICES REQUIREMENTS:
V i, as owner o� the property.on my employees with wages as their sole Reinspection Fee $15 Istue Fee $ Zoning Approved By
com0ensation, will tlo the work, antl the structure is not intentletl or�offeretl
for sale (Section 7044, Business antl Professional Cotle: The Contractor•s MECHANICAL � FEES Building Approved By
License Law tloes not apply to an owner of a property who builtls or improves
thereon, antl who tloes sucM1 work himsell/herself o� through h15 or he� own Appllteti00ISSUBd BV
� emp;oyees, prOvitletl that such improvements afe not intendetl or atfeletl for BOiICI HOOd OI Type I ❑ _
sale., If, howeveq the builtling or imp�ovement i5 Soltl within one yea� ot com- CdOOpy Typ¢ II ❑ -
Oletion, the owner will have the burtlen o( proving he/she ditl not builtl or im- Duct - Under Ground
prove forthe purpose of sale).
❑ I,�as owner of the property, am ezclu5ively conVacting with IicenS¢tl con- DUCt-$t�uciU�dl Refrigeration System
tractG rs to construct Ihe project (Section ]044, Business antl Protessions COEe:
The Contractor's License Law tlaes not apply to an ownEr ot prope�ty who Duct- Ventilating ❑0-100,Q0�BTU ❑���,O�O BTU
builtls o� imOroves thereon. antl who contracts for Suth oroi¢<ts with a r,on-
tractor(s1 hcense pursuanc to me Contractor•s l.icense Law), i am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration
proof o1 Ibeir Worker'S Compensation insurance Shoultl be p�ovitletl to m¢.
❑ I am exempt untler Section B. & P. C, for tnis reason Firepl/Fact. Blt. ICBO dk Fire Dampers
Oate
I hereby certiy that I
iniormation is correct. I
dOd SSdI2 IdWS I¢IdIl09 �
5¢fltdtiv¢5 Of i1115 Clfy
InSpection pu�pose5.
$igpature
Orideri' License or SS �
Owner
ng cons
r upOn
Heating System & Ducting
❑ o-i oo,000 sru � i oo,000 sT
Reinspection Fee I $15
0865-46, rev. 5/88 Wnite - Builtling; Canary - Applicant; Pink - Accoun[ing; Goltlenrotl - Assessor
Registers
Issue Fee � $ 3
SUMMAR'V O�F FEES
BUILDING PERMIT $ �-� SMIP �
PLAN CHECK $ PERMIT •
PLUMBING $ �SSUANCE
PLAN CHECK 25% $ ENERGV P.C.
ELECTRICAL $ GFADING
PLANCHECK 50% $ MICROFILM
MECHANICAL $ TOTALFEE
PLAN CHECK 25% $ �
$
FEES
$ 3
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ACCitUNT �: E11741"13t1f;;!
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CONSTRUCTION AND PLANNING POOI '� SPA �
APPROVALS Permit# _ Date Inspector pppROVALS P� _,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 :�%1
5. Steel Reinfarcement 56. Rough Plumbing & Pressure Test �_.`�
� 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE .�
c.
7. Footings � �% 58. Electrical Conduit-Undrgrnd. ��
8. Foundation ' '� � 59. Gas Pipe, O Undrgrnd., Test ��
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9. Water Pipe-Undrgmd. �� 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System �� 61. APPROVAL TO DECK
11. Property Sewer Line.& House CAnnection 62. Backwash & Receptor-Final
12. Sewer Cap t�i 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
�i6. Rough Electric Wiring . 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
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18. Rough Electriral-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) & Monocoai 75. Dry Chemical
27. Freme 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 Coat ' 79. FINAL INSPECTION
c.�
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
41. Solar pomestic-Final
42. Backflow Preventer �}
43. Backflow Irrigation '!)
44. .Landscape Irrigation System `i `
s.,
45. Sound Atcenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILdING �ypJ 5��� ��o
48. Special Requirements Completed
� 49. Electric Release to Edison _ -'
:,
50. Gas Release to Southern California Gas Co � � �� �
N r _� �J
51. CERTIFICATEOPOCCUPANCY � �:
1" (7
No. Date �.
�sos�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.B0X91] COBTA MlSA.CALIFORNIA�
for Applicant to Fill In Completely
TYPE OR PRINT�
eui�oirvc /��� G'LOlKSTE� )7��vt=
A�DRES6
COSTA MESA, CALIFORNIA
OWNER Ca e Series Inc.
'""" 504 Nai Newnort Blvd_
A�ORE9S
Brent
Series
ADDRES9 504 No. . New ort Blvd. �
�,T� Newport Beach, Galif.
�;�TNo. 221233 No � 646-9341
OF LOT ��• �� X"�' O" I NOW ON LATn O
USEOF none � �
EXISTING BLD6. � �
SETBACK LINE FROM ' ' �
CENTER OF BTRElT �� � R6AR YARD
SI�E YARD I LEFT �- �1' • V I RIOHT �� r4:
DESCRIPTION'OF WORK
0 EXTERIOR
1235 sp. �"�oMe 4 . �oR�fis 2
TO
1 HEREBV ACKNOWLEGOE THAT 1 XAV6 ReAO TXIB APPLICATION
ANO 9TATE THAT THH ABOV6 18 COPRELT AN� AOREH TO COM-
PLY WITH ALL C�TY OpOINANC88 AND 6TAT[ LAW9 RHOULATINO
BUILO�NO CON9TPOCTIOII. . . .
SIGNATUREOP �'�O� ��^�(� ��J['�
PERMITTEE n
AUTHORIZ6D AGHNT /J�«/�/ s J. � y�r n �—
rtt Kt�tivtu
6?Q�V 2 7 1963 ' �,
- fINANCE DEPT. / �
CITY OF COSTA MESA �
. APPLICATION POR PERMIT 4
a
. BUILDING a
For" Office Use Only ��
. I R[C81PT NO. IPN�myq.I
� ul�
J
RiC81VgD DY
Ki
BY �� DATE
ZONINCi
ZO NO.OF, USEOFNH� ti-ti�
��--- I P1./�N9 � I BUIL�L�V}��/`. —
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'-°°"'- Lot 7 Tract 5212
oeecnin�oN
A. P. NO. . ✓ ' �
NOTE: NO EAVE OVERHAIJG SHALL BE LE58 THAN
YARD9APPROVED
MAIN BUILDIN6
lOM C/15TREET)
BET
VAR. �j
YARpSAPPROYED
ACCESSORY BUIL�ING
BET. MAIN d
ACCE55. BL[
DATE
�� ��-�-
I
1235 s,. �.
THE AMOUNT BHOWN UNOEF VALUATON IS FOfl THE
PYFP086 OF 68TABLI6HIN0 A PERMIT FEE ONLY.
VALUATION � ^��
11� G�'�3.'75 PERMITFEE $�37.2/
f , PLAN CHEGK S OO '
37.27
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