HomeMy WebLinkAbout431 GLOUCESTER DR - Building PermitsADo���ant to filt in all spatts eacevt those witnin heavY borGer linez ana sign a11 apvrooriate tleelarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT °"'""'T "" TRorr n�n �nr Nn � ����T ���
Project Address 1��� ���yEes��^� �6j5� (v�'Sd� F� q2(�] -
G6
Applicant's Mailin Addrep�s
Owner's Name �e ""'roS �0 hoy, —��
Address P• •�X agi:na 1 S� d�L�—
Arch/Eng. License No.
Address
Contractor's Name ance X S� ld Sd a�YL�g2� 1
Address (mailing) '
City License No. �
LICENSED CONTRACTOR DECLARATION
I hereby atlirm that I am licensetl untler provisions of cnarter 9(commencing
with section J000) of DiviSion 3 of the Bu5ine55 antl Pwfe55ion5 Cotl¢, antl
my license iz in full�o({�g antl effect. �G��
License Class dy�'p� nse No. ����
Date 7—��pture
WORKERS' COMPENSATION DECLARATION
i hereby a/tirm tM1at I have a certificate of consent to self-insure or a certificate
`Norkers' Campensation InSurante, or a certitietl wpy thereo� (Section
J, Lab. C.) �1610302530'�$ Libertv Mrtual Insurar
iicy No. ' mpany
eCertified copy is hereby fumishetl.
Certifiea copy i�/fil h the city Hui ing Di si n.
�a[e /—� — pplicant (Pance � Rssoc Roofina Inc
EXEMPTION FROM WORKERS' COMPENSATION �ECLARATION
(This section neetl not be completetl if the permit is for one huntlretl ($100) or
less).
I certify that ln the performance ot the wo�k (or which this perm�t is i55uetl, I
SM1all� not employ any person in any manner so as to become subject to the
Workers' Campensalion Lnws of Galifomia.
Da[e Siqnature
NOTICE: If, after makinq this declaration, you shoultl become subjeci to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply with sucn orovisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby atflrm that there is a mnstruction lentling agency for the performance
o( the work ror which, this permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNERBUILDER DECLARATION
I hereby aifirm lhat 1 am exempt trom the Contractor's License Law for the
(ollowing reason (Section 7031.5 Business antl Profe55ional Cotle: Any City or
<ounty which requires a Oermit to construct, alter, improve, tlemolish or repair
any stru<ture, prior to its issuance, also requires the applicant for such permit
to file a signetl statement that he/she is li[en5¢tl pu�suant to [he provi5ions of
Ihe Contractor's License Law (Chapter 9(commencing with $eCtion 7000) of
DiviSion 3 of the Business antl Professions Cotle) or tM1at ne/she is exempt
`rom antl the basis for the allegetl exemption. Any violatlon ot Section
�� ➢ by any applicant for a permit subjects [he applicant to a civil
�I ,y ot not more than five huntlretl tlollars (5500).
IL i, as owner ot tne property or my employees with wa9es as their sole
mmpensalion, will tlo the work, antl the structure is not intentletl or-offeretl
� for sale (Section 7044, Business antl Professional Cotle: Th¢ Cantractor'S
I license Law tloez not apply to an owner of a property who builtls or improves
Ithereon, antl who tloes such work himself/h¢rself or tM1rough his o� he� own
employees, provitletl that such improvements are nOt intentletl o� offeretl tor
sale� If, however, the builtlinq or improvement is soltl within one year of com-
pletlon, the owner will have the burtlen oi proving he/she ditl not builtl o� im-
prove for lhe pur0oze of Sale).
❑ I, as owne� of Ihe proper[y, am ezciusivery cont�acting with lic¢nsetl con-
tractorsto construct the project ($ection ]044, Busine55 antl ProfessiOns Cotle:
ThN contractor's License Law tloes not apoly to an owner of property who
builtls or Impwves [hereon. antl who mnlraCtS for such oroi¢cts witn a mn-
tractor(s) bcense pursuan[ ro[ne ConVactor's License L.aw). I am aware that
proof of their Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. for this reason
Date pwner _
1 hereby certify that I have reaC this
informa[ion is correct. I agree to comp
antl ztate laws relatinq to builtling con
senta[ives of this city to ent upor
inspection purpases.�+n �
s' Litense or 55 � _�
ication antl state that the above
Ih all city antl county ortlinance5
:ion,antl hereby authorize repre-
� above-men[ionetl property for
�oate 7-12-89
�3� 30l I I I -
�E OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCfiIPTION OF WORK/USE OF BLDG.
TYPEOFPEHMIT LJ GRADING LJ FOUNDHTION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION �SQ.Fr. OCCUaANCv D_�
CONSTRUCTIONTYPE VALUATION$ ��_
ZONE GRADINGCU.VDS. ACRES
Rema�k�: Tear off shakes and replace with Class B Hardi Shakes
P
Backflow Preventer
Backflow Irrigation
Bathtubs
iking Fountains .
>r Orains
�r Sinks
Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater �
Water Service-
Auto-Wash
A.P. #
S Main Building:
E
T Front '
ARear
C Right
S Left
Ping. Ref. #
-Planning Notesr
FEES .4utomatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Reinspection Fea � $15 � � Issue Fae � $ 3
Boiler
Duct-UnderGround
Duct - $trUctufal
Duct�.Ventilating .
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. iCBO #
Heating System & Ducting
❑ o-i oo,000 sTu 0 i oa,000 eT�
Reinspection Fee I $75
OB65-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Hood or Type I ❑
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
� 2one
Accessory Building: � �
Req./Provided
N
I
N
G
R
E
Q
M
T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Garbage Disposal
Generator O0.5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel ,
MotorsO0.7 HP O1'/:-8
Inc.Solar 09-15 HP �16-75+
Microwave '
Pole Light �
Range
Slgn
Standing Sections -
Trash Compactor
I Reinspection Fee !$15 I I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By
Appliption Issued By �
SUMMARV OF FEES
BUILDING PEFMIT $ ��� N SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $
ELECTRICAL . $ GRADING
PLAN CHECK 50% $ MICROFILM
MECHANICAL $ - TOTALFEE
PLAN CHECK 25% $
FEES
$ 3
$ ��
O1 �3�?3?,773i-CUO's773E "4'�T ;�,5,r,
DATE: 0?/S3/E9 'tIME= 4fJ:22
. �l� ��
CONSTRUCTION AND PLANNING POOL' SPA
APPROVALS Permit# Daie Inspector AppROVACS Pt, .c# `" � Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel ReinforcemenY
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms � ��
4. Electrical Conduit-Undrgrnd. ' ' 55. Electrical Bonding '1
��`)
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �.�
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE `
G
7. Footings r� 58. Electrical Conduit-Undrgrnd. p
8. Foundation 59. Gas Pipe, � Undrgrnd., Test �n
Gv
9. Water Pipe�Undrgrnd. '� 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. �Structural Floor System [� 61. APPROVAL TO DECK
11 . Property Sewer Line & House Conne �ion 62. Backwash & Receptor-Final
12. Sewer Cap �� 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electriral-Final
75. Rough Electrical-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
r
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 Freming 73. Undergrnd.5torageTank 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 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 .
41. Sola� Domestic-Final
42. Backflow Preventer
�.
43. Backflow Irrigation �
�J
44. .Landscape Irriqation System ,� ; '
,�
45. Sound Attenuation ,r
46. Handicap Regulations
47. FINAL STRUCTURE & BUILOING 7�P
48. Special Requirements Completed �
49. Electric Release to Edison '
_ ^
50. Gas Release to Southern California Gas Co �-'
, �
51. CERTIFICATE OF OCCUPANCY �!
No. Date �
�
. a�o-ri . I-t �ovKtC9 3VtU `
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. � �
' P.O.BOXD17', C08TA M83A.CALIFORNIA .
CITY OF COSTA MESA fr�q
For Appllcanf /o Fill In Completely APPLICATION FOR PERMIT �7
TYPE �OR PRINT - _ BUILDING t1�'
eui�oiNc /' y � For Office Use Oniy � '�`
ADDRESS ��I V'LQUGFfT�n 7%�/I�,�
. PECEIPI' NO. P
. COSTA MESA. CALIFORNIA � � - �
PECEIV O BY DA RECE VE O�TE 166IIEO
oWNER Ca e Series Inc. �a� 3/�`„2-�3
' BUILDIN6 � �
A�DRE54 1Vd ' A�DRE49
TEL ZONB TYPE '� GROUP
��r New ort Beach Calif. No.646-9341
' � rT n APPROVE� '
ORENGINEERBTeIiC S. TObC NO.11Y4�7HS BY DATE
AooRE591320 Garmelita La una Beach ZONING. _.
ZON , NO. OP UBE OF NEW
. . I PLANB - BUILUI �LLL
CONTRACTOR S ❑C
ADDRE98 504 No. Newport Blvd: `°°"` Lot 17 - Tracr 5212 �
DEBCPIIl10N
� �
CITY Ne ort �Beach,- Calif�. � - "� P• NO• . z
L ` 1 NOTE: NOEAVEOVERHAN68HALLBELE53THAN W.�
LIC.TNO. 221233 NEL�v4v-���1 �30"TO,SIDE@REARP:L. u�
41.83x44.33 I Q EAVES ,c;
�512E No.oFBLoa pLLOWEO (U.B.C.REQUIREMENT) a
OF LOT rvow orv T �
YARDSAPPROVED YAROSAPPROVED d
USEOF 11One MAINBUILDIN6 ACGESSORYBUILDING 1•
EXISTINO BLDO. ' �•
n f FROM C/L STREET(�j� //��
9ETBACK LINC FFOl�_�� � �r � S�S FRONT �j FT. 1� / I'� � D�� �. ,
cENTER oF BTRE�S'c`�A. REAR YARD� `
SIDE YARD I LEFT � ��O I RIGNT " � Z R. SIDE FT. � F7'. �U
C-.
DESCRIPTION OF WORK �. sioe O�. Fr. '�
�r c4
NEW � ALTERATION � DEMOL SH REAR ��� �. �
DIBTANCE BET. BET. MAIN Q' n
REPAIR MOVIN6 MAIN BLDG9. ACGESS.BLDG3. �
BUILDIN6 p NO.OF l VAR'# ' DATE�
SIZE 1OUO - ROOMS 4� 8T RIE9 1 C. U. P. APPROVED '�
COV RINGW/��,� I ROOF Cedar shake BYPRO ,I.L'�� DATE �(`� � J�
b'LUCCO COVERIN6
USE OF BUILDING AI�O WORK TO BE PERFORMED .
famil residence .
1080 sc.'Fr. �
1 HEREBT ACKNOWLEDOB THAT 1 MAVe READ THIB APPLICATION TM8 AMOUNT BXOWN UNDER VRLUATION IB FOP TH8 $
AND BTATfi TMAT TH8 ABOVE 19 CORqECT AND AOpEE TO COM� PIIRPOSE OR EBTABL�HHIN6 A PERMIT FEE ONLY. p
PLY WITH ALL CITY OHOINANCfie AND BTATB LAW6 R66ULATINO ypLUAT10N f1^�
BUILOINOCONBTRUCTION. $9990.00 PERMITFEE $ �2_y/ �
P RM^ITTE E OP ��_ S�.a,G � .�N� � �
m
f A C E oo O
AUTHORI2ED A6ENT '32 � (�'7 1''
TOTALFEE $