HomeMy WebLinkAbout803 GOVERNOR ST - Building PermitsPHOJECTp0�flE55: 8O3 GOVERNOR ST
OWNEfl'SNAME: 'LEMTSEV, NIi(OLAI
noonEss: 3854 VALLEY BRINK �D
LOS ANGELES,CA 90039
213 485-3063
ANCH/ENGINEEH: flEG.NO.:
FUOpE55:
uxir:
UNIT:
PEflMITTEE: ARS ELECTRIC ( 714 ) 641-3550
AOOpESS S31S EAST ST. ANDREWS PLACP C
SANTA ANA CA 97.705
LICENSED CONTflpLTOR OECtAflATION: I �¢reDy aflum Ihal l am li[¢n5e0 un0er DmNsions o� Chapter 9 �CommenCing wii� Settion
7000� ol Div�sion 3 oi Ihe Business and Prolessions CoOe, an cense is in tull lorce antl e��ec�.
cirv uc.: ,Q •i 6 3 g Q STATE LIC.: �! S O 2 2. CUISS' 1�] � --
nam� ���/ f/{a' ✓�
�_=E_�_p�� SignaWr¢ _
WOBREPS'COMPENSRTIONOECLABATION: IhereGyallirmt�atl�aveacetlilicaieol[Onsenitoselbinsur acenilicai IWorkers'
POLICY N0. n i��a�e4� 4�����`�PY Ihereal (SecliE%P. OATEab. ���0 / O 1/ 9 2
comvaNr: FIr�EMANS FUND
� Cerlilie0 [opY is Aereby fumished. � Certified coOY is I' wilh [he ciry Builtling Division.
. e^'e (�/��,9� APPlicant: � .
E%EMPTIONFflOMWORRERS'COMPENSRTIONOECIAMiION: 5¢qqnneetlnolbecom0 �e7ilNepermtisf (5100�arip55�.
I cenily Inat in ine De��ormance ol the work tor which Inis Dermit is issuea, I shall not emplay any Derson i manner so as to Oecome
sub�ecl lo ine Workers' Comoensation Laws ol Califomia.
Oale: SignalUre:
NUTILE: II, ailer making I�is tleclara�ion, you s�oultl Gecome suGject �o IOe Worker5 Compenution provisions ol Ihe Labor
Coae. yau mus� btlhvnlh tompty vnt� Sut� provi5ion5 or IMS Dermi� shaA Oe OeemM rEVOk¢E.
CONSTPUC7ION LEN�ING AGENCY: I nereby affirm inat Inere is a consiNction leneing aAency for Ihe Dedormance ot ihe work for
wAich �his permit is issuetl (Seciion 3097. Civ. C1.
LENDEfl:
aooness:
OWNEP BUILOEB oECIABATION: I hereby affirm Inat I am exempl Imm tne Contractor5' Stale License Law for ihe followinp reazon
(Sec�ion 7037.5 Busine5s and Professional Coae: Any cily ol wunty which repuires a p¢rmil Io [anstmci, alter, impmve. GemoliS4 ar
repair any SlmcWre, prior lo ils issuance. also requires I�e apP�icani lor such permil Io lile a SigneE sla[emen� Iha� helshe is licensed
Dursuam m tne Dmvisions ol tne Canlractors Staie License Law IChaD�er 9(commencinp wIh Section 7000) oi Division 3 of the Business
ane Pmlessions Coee) or Ihal ne/sne i5 exempt inerelmm ana ine Cavs tor ihe allepe0 ehemplion. any violation ol S¢C�ion 7031.5 Dy
any ap0licanl lor a permil sublecls Ihe aODlicantlo a civii penaliy af not more �han live hundrea dollars (5500).
I. as owner ol I�e pwperty ar my employees vn�� waAes as t�eir sole com0ensation. wiil do the work, antl Ihe
❑ stmcture is not intenaee or ollere0 lor sale (Section 7044, Business ana Professional Cotla The Coniramors' S�ate License Law
tloes nol avPly to an owner of a pmperty wno builds or impmves iherean, antl who tloes such work himself/herself or Ihrough
�i5 or �er awn ¢m0loyee5. pmvideE I�ai sUch improv¢menis are not in�entl¢tl or OHered �or 5aie. I�, �owever Ihe builtling or
improvement is solU wilhin one year ol compleiion, ihe owner will have Ine �ur0en al pmvinp ne/she Oitl no� builtl ar imD�ove
br Ihe Durpose ol sa�el.
� I, as owner of ine pmpeny. am eKClusiveN comraninq vnth licensed comractors to conslmcl ihe prol�� (���ion 70aa, Business
❑ an� Pmtessions CoOe: T�e ConVaclar5' $tate License Law Jaes noi appty lo an owner of propehy w�o UuilaS or improves ihereon
antl who tonlrati5 lar SUth D�ojetis wiih a cOnlratloi�5�liten5e pursuan� �0 Ihe COnVat�aR' Slaie Li[¢n5e law�.l am awdf¢
Iha� prool of Ineir Worker's Compensaiion insurance s�oulA �e pmd4e0 to me.
� I am exempt untler Seclion: B. 8 P. C.
for Ihis �easOn:
Oaie. Ownec
I Oo ner¢by cenily Inai I am aware of anU untlers�anA ��e requiremenls oi Califomia Heali� anC Sa�ety CoOe Sections 25505, 25533, an0
2553a anelhallar anyfuture Ouilaing acupanivnlVwillnot�circle onelneetlta wmoly with 5ai0 slate caAes ana ihe reQuiremenisior a
permii Ior tonslmc�i0n or moaili[a�ion Irom Ihe Air Oualiry Management DislriCl. fle5i0en�ul tOnSim[�ion appliCation5 are exempi tmm
Ihese OmNsians.
Da�e: Np0litant:
I hereCy certily i�a� I have reatl Ihis aDPlicaiion and stale ��at ihe ahove in�ormalion is cortep, I agree to comply with all ciry antl
ortlinances ana sialelawsrelalinglo Guittling con5lmciion antl hereby auihor¢erepre5entaiiveso�t�is ci�ylo enter1u0a �ove�me
pmperry �or m50eclion purposes. /1 ^ �.
Driv¢r'S L¢ense oi SOCial Se[urily +: ,
i6nb46 Wbne—Builtlmg; Green—Cotle Enlorcemem; Canary—AOPIi<anl; Pink—Revenue; GolOenrotl—Assessor
i
'• � CITY OF COSTA MESA — BiiILDI2.G PER.KZT PERM NO: E 05990C
PERMIT NO: E 059900. � PLAN CHECK NO; N GOVT: Y SUPY: N
CONSTRUCTZON TYPE: V—N PERMIT TYPE: ELE PURPOSE: 03H
JOA DESCRIPTION : SERVICE CHANGE S CONNECTION SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP UCC: R-3 /
COHMENTS: *k� CITY PROJECT NO. 9i-07 �**
�lE % dE �� ii K iE1E if IE fE iE �N� ii ��7FK � i'r �1F �Y, iE �k iE if iF dE If- lf ii� �f IE �lE iE iF K� �f �lE if if �IE� �%�� iE R if jE iF 3F #�)k i(� iE aE iE �1E if �lf iE �� iE 1E 7f �k�iE iE �M �K� ��# �lF if �� 1E dE �M #�� #
Z O N I N G R E Q GT I R E M E N T S
5 E T H A C K 5
----------- D1AIN HUILDINC ---------- --------- ACCESSORY BUILDING ---------
F'RNT; FT IN REAR: FT IN FRNT; FT IN REAR; rT IN
Lr.FT: FT IN RGHT: FT IN LEFT; rY IN RGHT: rT '1N
PARKING REQ: PROV: PARCEL: 9Z243319 ZNE: REF NO;
PLANNING NOTES>
i
7E # iF IF M� if ic if fE IF �)f iE 3! if� 3f iE ik if� iE 3f iF H� iE if ?f �lf if if k## if• #i(� %-�lh iF iF iF iF 3E iF iF 1'r iF if it iE if� if 3F iE IE �7F i(� if ff iE �1F ih if �E #f if i!� ii� iF �1E M: iE iF ie le R if 3e 3F if� iF
D E V E L O P M E N T —S, E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY pATE:
BUILDTNG APPROVED BY : DATE;
APPLICATION ISSUED BY; DATE; ��J��
ifjE1E3E)E#61F1fffiE+h�7fN�if�3'riElE#3fifiFi('iFiF � iF'�' iFi � ifliFiF%'iriFi�TciFiF;citg'�x"iFiF7FifkiEiElEiFiFi(-iElf.. re ViE
ifiFiEiElEiFif3EiEiF�E�EjF*if?fiE3EiEiEif#�iElEiFiFiEifiEdfiEiF%�iFit :".itiPifiEiE�Fii�if�3'rififiFlEiFi�ifififlEiFiE�EiFiEjFjfF3fifi�if%�EiEi�iF3Eir}lEif
LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMEI3T:N
HLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADT_NG
PERMIT 18.50
503 SMTP/NON—RES
PT,AN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSiTB PLAN—CHECK TOTAL PAID DUE
TOTALS----> 0.00 0,00 0.00 0.00 ,UO .00
REVENUE DIVISION TOTALS--> COiLECTED; ,OU OVER/S30RT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE S�yTF/TOT GRADING PLAN—CHtCR
if # iE 1f 1(' IF iF�If 3e iE 3f' 3(' K' iE N' 1E 3i' if 1E iE if iF if 1E ii �(' if if ��f �')f i(' 3E iF iE iE )E if If� iF if iE ii' if iF iE ik Y,� ii' ih �E if� N ii iF iE iF 1E 1F %' iF iF ii iE iE lE �lf 1f if i(� ii if Y.' 3� } iF iE if
I N D I V i D U A L F E E B R E A K D O W N
TYPE QTY D E S C R l P T I O N UNIT CUST TOTAL COST
ELE 1 SERVICES BELOW 600 V G BELOW 201 AMP 18,50 18.50
END OF FEES
����w,g.,�..., �-
... _ � 1. �,I + : � .
�
""_-�_ i
CONSTRUCTION ANDPLAN�ING POOL ��PA '
APPROVALS Permit# Date Inspector pppROVALS Permit# 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 Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. footings 58. Elec[rical Conduit-Undrgrnd. '
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final
14. Rouqh Plumbing . 65. Electrical-Final
15. Rough Electrical-Conduit 66. So�ar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. 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. fiough factory Fireplace APPROVALS Permit #
27. Ducts, in Struclure 70. Underground Hydro
22. Ducts, Ventilating 71, Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
�25. Roof Sheathing 74. Overhead Hydro
- e26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. 1.3thing &$iding 77. FIXED SYSTEM FINAL
29. Ihsulation '. 78, FIRE PREV. FINqL
30. Crywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Mete�-Final n/ �� 80. F000 CERTIFICATE ISSUED
33. Final Eiectric /`J 4/ � Notes:
34. Final Heating & P.ir Conditioning
35. Final Gas Pipe•Test
36. Hood or Canopy
37. Final Fattory Fireplace
38. Final Plumbing �
39. Water Service-Final
' 40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handica� Regulations
47. FINALSTRUCTURE&BUILDING '
46. FINALPLANNING -
49. Electric Release to Edison .J. /
50. Gas Release to Southern California Gas Co �, •'
51. CERTIFICATE OF OCCUPANCY `
No. Date
1 '
OWNER rl�wunrv� �M1'1LL1H1"1 DATE'� ��rov
Jpg D��x�,ss overnor , BUILDING PERMIT NO.
GENERAL CONTRACTOR eY'- VALUE $ �
AP. N 1- - LOT T12ACT FIRE ZONE DESCRIPTION OF WORK �• •�
IP'"�ECTIONS DA7E I GROUP TYPE ZON
i _rground Soil U.G. Water I peRMirs issueo
: , ,,, ----I SUBCONTRACTOR
�Y -
. � 12�39
COSTA MESA BUILDING-SAfETY DEPARTMENT
' P, p. BOX 917 COBTA MEBA. GLIFORNIA
� For Applicanf fo Fill In Comple+ely
TYPE OR PRINT
BUILDING Di .�r�l/v.� ./A� � '
AD�RE88 c7 fJ'v �
� COSTA MESA CALIFORNIA
■ MAIL
f/ NE�' //
STATE TEL.
LIC. NO. NO.
OF LOT G,� I� l G� '.J � I NO. OP BLDG6.
NOW ON LOT
USE OF � S `
ISTING LDG
BtiBAGK LINQ FROM ���
CENTeR OP S�R REAR YARD
/� � /
SI�E YAR[7 I LEFT !i' /� RIGHT
DESCRIPTION OF WORK
'8 ZHDING /h IX•��' ROOMS �
r-
-----�-- ...... . . � i ..___
�,� p�e 2�s wsn
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
R8C81PT NO. P MIT NO.
�11�`ta
necaiyeo ar I.P�otS/liJf7 I�DA .2 3ugC O
�,ci �9�
BUILDING GO S� X_H1`�L�L�-C�r�"�./'/
ADDRE88 A ��
� �'i06TA MESA. CALIFORNIA
FIRE � � � n
1.II -� � I PLANB✓ I BUILDINp
P
�a,.� t � � S"� 7`'k
YH¢ 4T.1
APPROVED
BY
/
0
I HHHBBY AGKNOWLHOOB THAT 1 HAVE ReAD THIB APPLIGTION TNH AMOUNT BHOWN UNDHR VALUATION 19 POR TH8
AND 8T�T8 THAT TNH /�BOVe IB GORpER AND AGFIL6 TO CON-
YUIiPOB6 OP 68TAGL19HING A PQRMIT F8E ONLY.
"PLY WRH ALL CIiY OqO1NANC¢9 AND BT Tl WB flBGOLATING
BUILOINO CONlTIiUGT10N. VALUATION '
SIGNATUR6 OF� ��� PERMIT FEE $ ,
PERMITTE � i/ %'V �`O n
� i` J �,� � -
S PLAN GHECK $ /
AUTHORIZ6D AGENT � � ! p
T07AL FEE y
� ,ORA��iGE COUNTY BUILDING DEPARTMENT
� - " 636 Noreh Broadwar • .
��. �' SANTA ANA, �ALIFORNIA �
FOR APPLICANT TO FILL IN
BUILDING 8b3 Governor St.
AOORE55
SCHOOL DIST.
OR TOWN �nryt8 MEeQ
NEAREST
�RosS �. Placentia Ave.
OWNER Chevenne Bomes InC•
ADDRE55 9363 Wilshire Blvd.
��TM Beverly Hills No CR 54361
ENG IiN EERTC $ l II�MCK C I'Y'ACheTNO.
ADDRE55 2110 E.Walnut-Paeadena
VTRACTOR �alU�a '/ ista No �i�3231
ADDRE55 6 Wilahlre—Beverly Hill
LEGAL LOT KQ e.n.-v Ire.r,�H/Z
nwcra�or�nu nin
SIZE OF �OT �7 X ZO� � NOW ON LOTS O
USE OF NO. OF NO. C
E%ISTING BLDG. Fpmiues I R O
SETBACK LINE FROM: P+ REAR VARO
CENTER OF STREEf �7 L V• SIDE VAR�� O�
DESCRIPTION OF WORK
P1:
REPA�I{RN,� I I MOVIN6 I [
5 Z'E J_�J J� 8G . Pt . ROpMS J
E%TERIOR WALL ROOF
COVERING StUCCO COVEI
1' OF NEW
I JING Reaidence—utt.
APPLICATION FOR PERMIT
= �Bui��iN�
� FOR OPFICE USE ONLY
' RECEIPT NO. �}�
j3� y y
�.ECEIVEO BV DATE REG'D. DATE
i�T/�J MAY 5 �p44 MAY 6 19Sq
BUILDING O'? /p��r�/
ADDRESS ✓ �yy
SCHOOL DIST. ii'll'�✓[/ . •
OR TOWN -
___'__— /1 -�-_'. ..
APPROVED
CORRECTIONS
APPROVALS
FOUNDATION: LOCATION INSPEGTOR
I HEREBY ACKNOWLEDG@ THAT I HAVE READ THIS FORMS, MATERIALS,
APPLICATION AND STATE THpT THE ABOVE IS CORRECT UNOER-PINNING ♦ V
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. � q
BRACING, BOLTS �^
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. �
AUTHORIZE� AGT: //
� 4�•
VALUATION S�`�JO�OO PBRMiT Fea S
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PLOT PLAN . ,
Show location and distances from � - ,
property line 6nd between buildings. ' �: „
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