HomeMy WebLinkAbout767 GRAYLING BAY - Building Permits�
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PPOJECTpDOflE55: 7f�'� GRAY.,i`v .�piY
OWNEH'S NAME: yHI�'�,.. ZA, GARY
POUHESS: SAN�
955-6&72
PPCHIENGINEEfl:
aooxess:
flEG.NO.:
UNIT:
uxiT:
PEFMITTEE:IRVINE WEST HEA'�'ING 6 t1/C (7;4)921-OSQO
NDOPESS: (� 3 R SOUidi�RN
ORAUGE CA 92665
LICENSEU CONTflACTOF OECLAflFTION: I hereUy al�irm ��at I am licenrea untler provisions ol Chap�er 9(commencing wi�� Semion
7000� o� �iv�sion 3 al ihe Busmess antl Pmlessions CoOe, aqd my license is in full force antl ellecl.
ciTvuc.:��5729 srnreuc.:345284-�}�� cuss:C-20 n
�a�e:_.������ Signalure:__f i ���n�"-�
WOflREBS' COMPENSATION �ECIABATION: I here0y allirm �pai l have a cen�h at ot consent to seli-insure or a certilicate oi Workers'
Compensalion InSurance. or a cetlilie0 coOY �hereof (Seciion 3gpp, Lab- C�. -
Poucrxo.:pC9460b9 EI(p.DATE:O%IO:II3
COMPANY:REPUBLIC INDE,�1
❑ Ceriilied copy is hereby lumis�etl. Q Ceriified copy is filetl wi�h �he ciry Building �ivision.
Oate�, S / T � 7—� Applicanc � �
El(EMPTIONFAOMWOXREHS'COMPENSATIONUECIAHATION: Qhissectionnee0nolbe oiplete4i�theDermitis�oronehuntlred(5100�oNe55�.
I certify Ihal in Ihe per�ormance ot Ihe work lor w�ich Ihis permii is issuetl, I shall no� ploy any person in any manner so as to became
subleci lo Ihe Workers' Compensatmn Laws of Galllomia.
Oa1e: Signa�ure:
� NOTICE: If. alter making this aeclaration, you snoula 6er,ome su�iect to ihe workers' ComDensation provisions of ihe Labor
Cotle. you mu5i fo�hwit� comply with suc� O�ovisions p� ��is permi� shall be tleemeC revake0.
LONSTPUCTION LENOING AGENCY: I hereby affirm Ihat ��¢�e is a consimction lenaing agency br �A¢ pedormance o� t�e work br
wnicA Ihis permit is isSueA (Sec�ion 3097. Civ. C).
LENDEB:
nooeess:
OWNEfl BUILOEF �ECIAHATION: I hereDy a��irm Iha� I am ¢x¢mpt Irom �he Contracmrs' S�a�e License Law for Ihe followmg reason
(Seclion 7091.5 Business anU Pmlessional COAe'. Nny city o� coun�y which requires a permit �o conSlNc�, alter, impmve, demolish. or
repair any S�mcNre, priar Io i�s issuance. also reQuires ��e applican� for such permi� �a file a signetl statement ��at helshe is licensed
pursuan� lo ��e pmvisions of Ihe Contramors' State License Law (Chapter 9(commencing with Sec�ion 7000) oi �ivision 3 af �he Business
antl Pm�essions Coae) or �hai he/she is exemp� thereirom antl �he hasis tor the alleged ecemD�ion. Any violation o� Sec�ion 7031.5 by
any appliCanifor a permit suble��s Ihe appliCan�lo a tivil ppnaliy of nol more lhan tive Aundfed tlollar5 ($500).
❑ I. as owner ol the Ompeny or my employees with wages as �heir sole compensation, wi0 tlo the work. anU the
s�mcWre is no� intenaed or olleretl br sale (Section 7p44, Business an0 Pw�essional CoOe: The Cantracmrs' Sia�e License Law
tloes nol apDty Io an owner of a OmDe�Y wha �ui105 or impmves thereon, an0 w�o tloes such work himsel�/hersel� or �hmugh
his or her own employees, pmvide0 ihat suc� impmvements are nat inlen0e0 or ollereU �or sale. I�, however t�e huilding or
impmvement is sold wi�hin one year ol completion. Ihe owner will have Ihe burden o� pmving he/she Oitl no� buila or impmve
lar ihe purpose ot sale�.
I. as owner af �he pmperty. am exclusively con�mcting with Iicen5e0 conVac�ors lo consimct ihe pmleci (Sedion 7044, Business
❑ antl Prolessions Code: The Con�mcbrs' Sla�e License Law Uoes no� appy �o an owner ol pmpehy who builds or improves lhereon
antl w�o coniracts �or such pmlecis with a conVac�pqs�license pursuan� �a ihe ConVactors' S�a�e License Law),I am aware
ihal prooi of iheu Worker's Compensation insurance should be pmvi0ed to me.
� I am exemp� under Settion: B. 8 P. C.
lor Ihis reason�.
Date: Owner
I tlo �ere�y rerlity tha� l am aware of antl un0er5tantl ihe reQUirements o� Califomia Heallh antl Saleiy Cotle Sections 25505, 25533, antl
25534 ane IAat lorany lulure builtling occupaniwill/willnol (Circle one�need ta comply wi�h saitl state wdes and the requiremen�sior a
p¢�mil lor conslmction or modifica�ion �mm ��e Air Ouahry Managemenl �iStncL Besitlenlial ton5imc�ion applicaiion5 are exempl �mm
�IICS¢ pf�Vi5i0�5.
�ale: QODlitani:
I hereby cetlify Uat I have rea4 ihis ap0�iwlion and slale Ihal �he above in�ormalion is correcL I agree lo comply wil� all city an0 counly
ortlinances antl 51aie laws relaiing Io builtling conslmdion antl hereby au�horize representaiives of ihis city lo enier upon Ihe above-mentione0
praperty foi inspec�ion purpases / � n
�ate: ��,� � 7� SignaWre: �[�� O�— L.F�i�M
ndvn�t i Ironcc nr Fnriai Securim a: ) -)
t6aba6 W�ile—Boiltling', Green—Cotle Enlorcement; Canary—Appllcanl: Pink—Revenue: GolOenrotl—Assessor
� CIiY OF COS;A �ESA - BU_i,DING P£RXIT Pt�,v NO; EX 062070
PER:�:Ii NU: EM 062070 PLA\ CHECK ti0: N GOVT: :� StiPP: :v
CO:�STRUCTION TYP�: Vti PERNiT TYPE: h'�� :�!EC PUBPOSc; O"'H
JGB ilESCRIP=ION : REPLACE A/C UNIT SQ FT:
CLAIv VALUE: CALC-VAi,U�: GROUP OCC: R-3 /
CUMM:NTS; EI,ECT WORR INCEDENTAL TO MECH INSTALi,t?TION
!F i! IF if � iE �1E!E #!E �E �1! �# 3c !E 1f 1E iF # if if iE # k�1E #,r,. # iE 3P?f iE iE if # iE �lE?E i£ 3f ihiE iE ib �(- 3f # 3f iE 3F i4 ic jE ## K�?Fu #:c K� K K� # 1c if-# ?F # K Y.• #;i ��.v.:? �1F?4
Z O N I N G R E Q J i R E M. E N� S
S E T 3 A C K S
- N.AIN Bli�LDIIvG ----
FRNT: FT IN REAR; FT
LEFT: : T I,� RGHT: FT
- ACC�SSURY BJILDIt�G - -
IN FRNT: FT IN R�AR; FT It�
IN LcFT; FT IN RGHT: F': IN
Pt?RKZNG REQ: PROV; PARCEL: 93768076 ZNE: REF NO;
PLANNING NtSTES>
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D E V E L O P M E N T S t. ;Ft %t,* I C E S R E Q li I R E iy E N T S
ZONING AP?RUVED BY : •'�� DA"'E:
BUILDING APPRUVEU BY : ' PATE:
APPLICATION iSSUED BY: -' � � DATE; ^ %�
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iEGALIZATZON:;3 F E E S U;�; M A R Y STRUCTURAL SEG�GNT;N
BLDG PN�T PLUMBING ELECIRIC MECHAi\IC FIRE SMIP/RES GRADING
pERMZT 15.00 9.00
t 50� 258 SMIP/NON-RES
PLAN ' '
ISSti� PE� :S.OU 15.00
BUILUt,VG-D1V-> PERMIT ZSSUE PLAN-CHECK TO:Ai, PAID PU5
TOTALS----> 24.00 30.00 0.00 54.00 59.00 .00
REVENJE DIVISION TOTAi:,--> CO:,LECTED: 59,00 �VER/SAORT: .00
BLDG P:✓.T PLU.'✓iBING EicCTRIC A",ECHANIC F_RE SYiIP/TOT GRADING PLAt�-CHEC'Ii
30.00 24,00
if i� �7E ?f 3f iE ��l't iE �!f iE i4 # if #�!f # iE ff iE 1E iE �7E �lF iE iE � iE 3f 1(-jE rt?E iE Mirt �3E iF # iF;t iE 3E iE iE 3F X� jE lF' # iF-lE fEi4 3f # if #�H #?E 1E lE �f iE # ic # i(��IE iE ### ff iF i( ?E �lE
I N U Z V Z D U A L; F E E B R E A K D O W N
TYPE QYY D E 5 C R I P T I Q N iiNIT COST TOTAI, COST
ELE 2 :^.OTOR/POWR APPARATpS 1?- 10.0 HP 7,50 15.00
MEC 1 REFRIGERATIOv SY5T«M <= 100 R BTU/H 9.00 9.00
END OF :EES
O1 00138734-0013E73S T�] T 54.00
QATE: 0�/p7/93 TItIE: 12:46
� C�NSTRUCTION ANO PLANNING
APPROVALS Permit#.___�.__,�
i
1. -emporary Efectrical Service or Pole
2, io�l Pipe�Undrgrnd.
L --
i 3. Elect��ctl Conduit UT;fity-Undrgrnd.
j �i. E:lectrca� Condu�t-Undrgmd.
5 Steel Rainforcement
, S. EIetG�cE' i;FER Grnd.
7 Foot�no�
�Fou�aaPon
, 9. 5dater Pipe-Undrgrnd,
�--
� 10. Str❑ct�rai fiaa. System
i
7 7. P�oper�y Seiaer Linn & Nouse Cbnnection
r 12 Se�ver CAP
i i3. Roof p�ains
�
� ;�;. Rc�phPlumbino
i -
15 liough ��acttical�Condu�t
iu. Aou3h �leciric!Nirinq
� 17. Rough'::':ring S;gn
�lII F�..�'� E�ectricabT Bar Ceii�np
79. Rougn Heating & A�r Condit�.oning _-
�20 Roi.�n Kactory Fireplace
27 U�crs, ��n SVucturo
I-- -
i 21 D..�tv.'r'enti�aLny
� 23. :�er, ?�pr�o�.g� & Test-
JC i;oo.` f-r5mi^,c� �
75. Roo' Sheaihinn
'---- - �
�� -26. ',-�car C:i'���ng ISV�ctu�ail & i:'o�oroat
I� 21. �'_ " a"•, ; !8=h,
i 79. .otii r.g & S�tl� -,g
�--
' 7... InSu�at.Jn
30. Uryv,�ali ��a:hng ---- -
31 _ P.a,tc B o:•:n CciT__._�_ _
� 32 :'�c�ur� Pc•� er l�.ecc� r-��.,..
� 3=_ `i�__I EI.^ctoc _-_ ^ -
�J4. -=���.�1 Heaun_ L�: Air Cord�t�o�����
3. '���a'� Gas Pipe�Test ---
f--'-- --- -
i 33. icr..i ci C:anoPl'
�-___ __--_
'-' :'�:�&I Fcciory �inr'dCt
� 3E. P�ncl p���mbing
i ---- -_�
39. 1'later S5r�'�ce�Final _
� -00. Gas Serro�ce�Final
r41. Sol.r �o'^estic�F;na:
�2. ��c�c!i�:: Prerant;:�
43. 3ad:fio�v Irr'paLon
44. I andscane irnqation System
45. �oucd Attenuation
4u. F!andicap Regulatio�5
F--- - -
47. =11�ALSTRUCTURE & BUILDING
�- -
48 'Ii\'AL PIANNING
A9. cler.cric Reiease to Editon
50. �as Release to Southem California Gas Co
51. CERTIF�CATE OF OCCUPANCY
o. Date
Date � Inspector
POOL ,PA
ApPROVALS Pennit'-r�
52. Pop! & Equipment Locatl�n
53. Steel fteinforcement
54. Forms
55. Electrical Boncbng
56. Ro�c}h Plumbing & Pressure Test
5�. APPROVAL 70 COVFR�GUMT[
56_Electrica� Cordu�t�Undrgrna.
59. Ga> P�pe, �i Undrgmd., Test
60. Bac!twash Lines, P�Trap, � Undrgrnd.
61. APPROVALTOD[CK
62. Backwash & Recepror•F�na!
63. Heate: & b'enbFinsi
E4. Plumbing S�'stem - F�nr�f
65, Fleczrical-final
66. Solar 5ystem Pinai
67. Pencing R Acc�ass Anproval
68. APPROVED FOR PLASTERI�dG
G3. P06L!SPASYSTEi�.1SFiNAL
FIi7E DEPT IiEQUIREiViENI
APPROVALS Permit;h __
70. Undergr�und HY�ro
71. Produci P �.ry `. G:�s �.Oii
72. Und¢rgrOunti f��v` -.
73. Ur.dergmd.Srorag::_ank ^Gas -:O�I
74. Overhead Nydro
75. Qry Chcrrical
� � -� 76 Dr� S[z•�t.oL.e I '.
-- - -------- -----}--�- - �----�
I 77. FIXED SYtiTE`' i-IP:AL � I
�7II. FIRF PREV. "rINAL � � �i,
----- - '- -- - - �
� �HeALTH DEPT. REQUIREA_IENT _ _
79. FINAL IP'�:�CCT10.'V I !
_'__ . _ ________- � .�
_ I _�
1 i5J t�]�U f�C!i � G IC�H �� I$SU�IJ __ ' ___-.
-- y__-' - __�/ _ �--L . ""' "
7 iot,:s /�4p1' '!� GqQ.f�7�c -(.�D GE/)
----�--� - --- - ---- - - --- - --a
Date � InspeCtor
--------- -----------�----{
- - - -- ---- ----- - --- - - - - - �
_-- _--_- __ _ __i
-------.._ - - -I
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�,�'�oy�/�N� 89V 74;4��/�j�Y7�9�/�S�,6d S��GiL3j�6�?ilrYr71
2 2$ 3�
- . L�►.+�p7a B.9 3ozQ z�' N�6� �
�� COS�TB�MEZAOe UIOLDIANM SA�CALI ORN�IA9 szs�. �P�CATTONF��`�'I'RI�C''�ttAi.PERMI7683.5D TL
For Applicant to Fill in Completely - Use Ink Only !
BUILDING
ADDRESS TI'8Ct 10626 ��
OWNER OR �
TENANT M.D. Janes CO. 1
ADDRE 5 2950 Airwa Ave. D-
TEL.
ciTv Costa Mesa No. q7q_aq•.
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BRANCH
ADDRESS
ARCHITECT Danielian & Assoc. No 'S46-36!
OR ENGINEEfi
ADDRESS 3848 Campus Dr., N.B. �
I
CONTRACTOR owner
ADDflESS e
TEL. '
CITY e NO. e
STATE � CITV
LIC. NO. B LIC. NO. e
OF LOT 55� � x 334' NOW ON LO S e
USE OF
EXISiING BLDG. N�A
Separate permits are required for
electric, plumbing and heating work: �
USE OF BUILDING AND WORK TO BE PERFORMED
I hareby acknowletlpe ihet 1 have reed Shia apPlicetion antl stete
Mai t�e above Information is eorrect enG epree io comply wIM
ell laws reBuletinB DuiltlinB �onrtruction, enG I shell not employ
any perwn in violation of Me workman's compensation laws of
Me Stnta of Calitomia. }
1 hareby certify that I em DroOe�iy licensed as a eonttactor unEer
Me State of California Business entl Profasslons Cotle, Divlsion 3,
Chaptar 9, entl that a�eh licanses era in f�ll force and effect, or I
am exempt from Me rovisions of the State of Celifornia Busirwcs
antl Professions Cotl Divi Ot�3, Chapter 9.
Slpnature of �
Parmittee
o,
Authorizetl Ape te
C
)
��
BUILDING����S � /�rQ
ADORE55 y {,
UNIT OR � �
SPACE NO.
TR�IXO/�/' LOT
�C1(o GE�
NEW ADD LTER REGAIR
OWNER
USE
_„�. 3
20NE
APPROVED
APPROVEDSETBACKS
(FROM GL STREET)
PLANNING ACTION
THEAMOUNTSH
THE PVFiPO6E OF I
VALUATION
$5�y,���
VALUE
S
DATE
DATE � l / �
APPHOVED LFJ
C ,[�
v
i �0
m �l
N �!J
VN UNDEii VAIUATION IS FOR m N
"ABLISHING A PERMIT FEE ONLV: �
PERMIT FEE E � ''
N
n+
PLAN CHECK f ^'
(o c�! , 5 0 �y,
TAX S LL�� �
f nt� �y! 9�
TOTALPAID Syn�j_�