HomeMy WebLinkAbout765 GRAYLING BAY - Building PermitsCITY OF COSTA MESA
CONSTRUCTION PERMIT
Applicant to fiil in all soaces axceo1 ��oze within neavY �orCer lines antl si9n all appropriata Oeclarations.
PERMIT NO. TRACT NO. LOT NO. BLD . .
m � 3�.3 s
ProjectAddress- ���5 VKLLTIL�Y�G CY�.Y � TYPEOFCONSTRUCTION NEW ADD ALTEFATION REPAIR_
Applicant'sMailin9Address ��� N Q��IC1X�� �RC7 � ❑CONVERSION ❑DEMApLISH ❑ 9THER � p,p,#
OWnef'sName � ��L PhoneZ��'��� DESCRIPTIONOFWORK ^�Q--�n'-`��^�IN6 �% S MainBulldi
Address� �'�" . TYPEOFPERMIT GRADIrvG FOUNDHTIO{�N STRVCTVRAL T Front
Arth/Eng. LiCense No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING y� MECHANICAL � B Rear
Address ❑ o7HER A
Contractor's Nam FA�1 n' d ET�IYIF!'p.�phone 6�� PRQIECT DESCRIPTION SQ. FT, oCCUPaNCv C Right
CONSTRUCTIONTVPE � VALUATION$ - g l¢ft
Address (mailing) �� � � ��•
� � ZONE - GRAOING CU.YpS. �ACRES ping. Ref. #
City Licanse No.
LICENSED CONTRACTOR OECLARATION Remarks: � Pa�king Req./Pr�
I hereby atflrm that 1 am Iicensed untler provislons o1 Charter 9(commentln9
wltn section 7000) ot Dlvision 3 ot the B slness antl Protesslons Code, antl � , , , Use of Building:
my Iicense is in full forcj �� ef/ect. (� � , � „({.� \n - PLUMBING FEES Planning Notes:
Oa[¢ V���ay 519nature �/�'\
WORKERS'COMPENSATION DECLARATION
hereby atfirm tnat 1 have a<erN/ica[e of consen[ to se -ins re or a certiflcate
Workers' Compensatfon Insuran<e, or a certiBetl thereof (Section
d00, Lab. C.) vn(�.� \1^1
POIicY No. 2�}....S�S;f�Lb9 Com Y`� ""��.
Certltietl cooY is hereby furnisbetl.
Certitiytl ciyy.js f{�py�wAPPI qanl �n9 D n.
Oate l.o " ` —�C V
EXEMGTION FROM WORKERS' COMPENSATION DECL Tt N
(This se<tion neeG not be completetl if the permit is for one u retl (E300) or
Icss).
I c¢r[ity Ihat in tlte Oertorm0nt¢ Of Iha wo�k for which thi e� �t is isSueQ I
Shdll OOI 2Tp�0y d�1y pClSOfI �O dfly manner TO�dS f0 b8C0 bjCCL IO S�IC
Workers' Compensation LawS of CalifOmla. � '
Date $f9naturC
NOTICE: If, atte� making this tlo��a�ation, you shOultl become subject to the
Workers' Compensation provlsions of the Labor Gotle, you must torthwith
comply with such provisions or this.parmit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a consVuctlon Ientling agoncy for tha performance
of tho work far which' this pormil i5 ISSuatl (SecHon 309] Civ. C.)
Lentler's Name -
L.entleYs Atltlress �
OWNER BUILDER DECLARATION ' ' '
I her¢by d(firm that I am exemp� from Ihe Cont�aclor'S LlcenSe Law fo� tM1e
f011Owing reason (Section 7031.$ Business antl Pro(¢SSlonal Cotle: Any city or
county which requires a permit to constru<t, alter, improve, demolish or repair
any 5tructure, prior to Its issuan�e, also requires the apP�icant for such permit
to (ile a si9netl statement that he/she Iz Ilcensetl pursuant to the provisions of
the Con[ractor's License l.aw (GOapter 9(<ommencing wi[b Section ]000) of
'�ivision 3 0( fhe Business antl Professions Cotle) or tha[ ne/she is exemp[
erefrom antl the basis for the allegetl ¢x¢mption. Any violation ot Section
�31.5 by any applicant for a. permit subjects Ne applicant to a civil
kendlty ot not more than fivC hurytlretl tlollar5 ($500). ,
LJ I, as owne� of the propC[ty o� my ¢rtiPloyaes with wages as thei� sole
<ompensatlon, will tlo the work, antl the structure is not intentletl or offeretl
� i0( Shc2 ($CCII00 %044� BOSIOCSS dOd PIOf25510OdI Cotle: The COlIIfdC[O('S
License Law tloes not apply to ary ownar ot a Oroper[y who builtls or imOrovez
thereOn, antl who tl0es such work himself/hersell o� Ih�ough hls o� her Own
employees, provitletl tnat such Improvements are not intentletl or offeretl tor
sale. It, however, the bullUing or improvemen[ Is zold within one year of com-
pletlon, the own¢r wlll hava the bu�tlan Of O�oving he/sh¢ tl10 not builtl ot im-
�rove tor the purpose ot sale).
I, as owner of the property, am excluzively contractln9 w��h licensetl con-
t�aGtors lo construct the project �SecliOn 7044, Busine55 antl ProfeSsions Cotle:
The Contractor's License Law Opos not apply to an owner of property who
�uiltls or improves thereon, antl �vho contracts for such orojects witn a con-
Vactor(s) license pursuant to tho Conlractor's License ldw).
❑ I am exempt untler Section , B. & P. C. for thi5 redson
Oate
ana state laws relatlng
sencatives oi this
Inspection purposes.
S�gnature
Drivers' Llcense or 55 �
Owner
�n antl stata that the apove
city ana <ounty ortlinances
antl hereby authorize repre-
Ye•menHonetl plroperty�1tor
_ Date b�� �U�
3ar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs I
Clarifiers '
Dishwasher - .
Drinking Fountains
Floor O�ains
Floor Sinks
Gas Service Outlets
Interceptors �•
KitchenSink � �- �
Lavatories
P—Trap '-
Roof Drains `
Reinspection Fee : $25
Duct - Under Ground
Duct - Structurel
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
�I0.100,000 BTU � 100,000 BT
Reinspection Fee � $25
CMF 0865-46 rev. 7/83 White - Builtlingtibnary - Applitant; Pink - Actountin9; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Sular Piping "' '
Solar Tank
Swimming Pool w/Spa
Urinal
Wet¢f CIOSQL
Water Heater
Water Service
Issue Fee
Hoodar Typel ❑
Canopy Type I I ❑
Refrigeration System
�0.100,OOOBTU ❑100,000
System Repair/Alteration
Issue Fee
c
Automatic Washer
Construction PoleSub.
Cooking Unit '
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes � '
2932 � 6/26/84
Zone
Accessory Building:
Park.Fees $-
ELECTRICAL .
�Transformer � 75�SOKW �
, ❑SO+KW i
Meter ❑up to 100 amps �
Meter ❑over100amps
Sub Panel
Motors�0-1 HP �1X-8
Inc.Solar.�9-15 HP 016-15+
Pole Light
Range
Switches Sign
Garbage Disposal Scanding Sections
Generami 00.5 KW �5-15 KW Trash Compaccor
$ 3
Reinspection Fee $25 �uue Fee
FEES
PUBLIC SERVICES REQUIREMENTS:
Zaning Approved By
APPliwtion APProvetl By
APolintion Issued Bv �
$ 3
BUILDING PERMIT
PLAN CHECK
PLUMBING
PLAN CHECK
ELECTRICAL
PLAN CHECK
MECHANICAL
PLAN CHECK
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FEES
$ 3
SUINMARV OP FEES
$ SMIP • $
$ PERMIT
$ ISSUANCE $
$ ENERGY P.C. $
� GRADING $
$ MICROFILM $
$ � TOTALFEE $ �y�
$
. CONSTRUCTION AND PLANNING •� P��� 'PA
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.lElectricafConduit'Ufility-Undrgrnd,� � 54. Forms � �
4.Electrical'Conduit;Undrgrnd. •`-: - � 55.ElectricalBonding � � � ;
5. Steel Reinforcement, " 56. Rough Plumbing & Pressure Test .
6.:Electrical UFER Gmd. � 57. APPROVALTO COVER-GUNITE - '
�. •
7. Footings , = � � • _ �,_� . � � 58. Electrical Conduit-Undrgrnd. -+--
8. `Foundation -� � �� ' � 59. Gas Pipe, 0'Und�grnd., Test
9: Water Pipe-Undrgrnd; . � �,� �60. Backwash Lines, P-Trap, O Undrgrnd. � �
10. Structural Floor�System' . �.,�� � �61. APPROVAL TO DECK
11. Property Sewer Line & House Corinection' 1 :'� " . . 62. Backwash & Receptor-Final
12. Sewer Cap . � y �� 63. Heater & Vent-Final �
13. Roof Drains � r" � � �
64. Plumbing System - Final
14. Rough Plumbing = � 65. Electrical-Final
15. Rough Electrica6Conduit , ' � 66. Solar System-Final
16. �Rough Electric Wiring � '� 67. Fencing & Access Approval
17. Rough Wiiing Sign , ' � 68. APPROVED FOR PLASTERING
18. Rough Electiical-T Bar Ceiling . 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � �. FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • ' . APPROVALS ' Permit #
21. DuCts, in Structure 70. Underground Hydro �
22. Ducfs, Ventilating . � 71. Product Piping � 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. Frartie 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 � � S0. FOOD CERTIFICAT.E ISSUED
33. Final Electric ' � ' Notes: �
34. Final Heating & Air Conditioning 7/���L� (�� �
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. 6ackflow Preventer , .
43. Backflow Irrigation � � . . � ' ' � ,
44. Landscape Irripation System . '
45. Sound Attenuation . ,
46. Handicap Regulations . . -
47. FINAL STRUCTURE & BUILDING . �
48. Special Requirements Completed �
49. Electric Release to Edison --
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY „ -
No. Date � � •
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For Applicant to Fill in Completely - Use Ink Only
BUILDING •
ADDRESS Tract 10626 , �/(� Ci/_
TE AN �R M.D. Janes Co.. Inc.
ADDREss 2950 Airwav Ave., D-9
TEL.
CITV Costa Mesa No� 979-33Z
CONSiRUCf10N __ _
BRANCH N/A
ADDRESS NIA
ARCHITECT Danielian & Assoc. No �546-36!
OR ENGINEER
ADDRESS 3848 Campua Dr., N.B.
i
CONTRACTOR owner �
ADDRESS e
TEL.
CITV e NO. e
STATE CITY
LIC. NO. A LIC. NO. e
SIZE NO.OF BLOGS.
oF �or 550' x 334 � NOW ON LOT 9
USE OF
EXISTING BLDG. N/A
Separate permits are required for
electric, plumbing and heating work. �
USE OF BUILDING AND WORK TO BE PEFFORMED
I �araby ecknowletlpe that I have reatl this eppllcaiion enA ctata
Met Ma ebova Informetion B corree< entl aprae <o compty wIM
ell lews rap�latinp �uildlnp construction, entl 1 shali not employ
any person in vloletion of the workman'a compensation lawc of
tt�e Stnta of Celitornie. ,
I heraby certlfy Mat I am properly Iicen�etl as e contractor un0er
Ma Stnta of Californie Busineu entl Profeclons Code, Division 3,
ChapMr 9, entl Met weh lieenees ere In tull forca enA affect, or I
am axempt from Me rovisions of the Smte of Callfornia Busirreu
antl Professions Cotl Divi 'm� 3, Chapwr 9.
sipna[u,e of
Permittce
o.
Authorizetl Ape te �
4
A.P.�O. �'� 1� �O� I I Tf1 ` I
BUILDING �
ADDRESSL�IA�S � C�•p iJ��_
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UNIT OR
SPACE NO.
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NEW ADD ITER REPAIR MOVINC. D
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OWNER
USE
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APGROVED
APPROVEDSETBACKS
PLqNNING ACTION
THE AMO
THE 7URR
VALUATION
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"ABLISHING A PERMIT FEE ONLV:
PERMIT FEE E ,
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