HomeMy WebLinkAbout873 GOVERNOR ST - Building PermitsPflOJECT AUORE55: 3'] 3 GOVERNOR S T
OWNEP'S NaME: MASSEY PAUL E
noneess: g�3 GOt�ERNOR ST
CO.STA MESA,CA 9262'7
646-4621
PPCHIENGINEEN: NEG.NO.:
FOOPESS:
UNIT:
UNIT:
PEflMITTEE: AKS ELEC'YRIC (7i4)641.-3550
ADDNE55: �3},J EAS'i' ST. ANDREWS PLACE C
SAN'TA ANA CA 92705
LICENSEo WNTBpCtOP UECLAPATION: I hereby aihrm Iha� I am licensetl un0er provisions ot Chapter 9(commencing with Section
7000) of �rvision 3 of Ihe Business antl Pmfessions Code. anA my li�ynse is in full force an0 ellect.
aTruc.:04 390 STpiEUC.:�8O224 cuss,;�i�
���/� SignaWre'.. ��� � 1
WOflNEP ' CO PENSATION OECLANRTION: I hereby a��irm Ihai I hdve a t¢tli�icaie o� Consen� �o Sel4insure or a ce " o� rkers'
CamPensaiion �5�ag��q�ca4c�i�ea��vv me�em ise�rExPeopTEao. i��U / O 1/ 9 2
POIICY NO.:
comeaNr: r lREMANS F,UYND
� CeNfiea capy is erehy �urnishetl. LT Cehi�ie0 copY is fA w h t�¢ ciry Building Oivision.
�� Applicanl:
EXEMPTION FBOM WUPREFS' COMPENSRTION OECNPATION: ( his sectipn nee0 nol Ce tampleted i� �he permit is lor a ndred (8100 or less�,
I certify �ha� in Ihe pedormance of �he wark for w�ich this permi� is i55ued, I shall no� employ any person in an anner so a become
sublect ta t�e WorkerY Compensation Laws of Cali�omia.
Oale SignaWre:
NOTICE: II. after makinq �his declaralion. you shoultl become spble�� �o �he Workers' Compensation pmvisions oi �he la�ar
'� Coae. you must lotlhwith compty wi�� such provisions o� Ihis permi� shall be deeme0 revoked.
CONSTNUCTION LENUING AGENCY: I hereby affirm I�a� Ihere is a Conslmtti0n lentling agenCy for ��e pedormanCe oi Ihe work tor
which Ihis permn is issued (Section 309Z Civ. C�.
lENOEB:
aooxess:
OWNEfl BWLUEH �ECtAflPTION: I hereby a�firm ��ai I am exemp� �mm I�e Coniractors' State License Law br ihe follawing reasan
(Section 7031.5 Business antl Prolessional Cotle: Any city of coun�y whic� requires a Dermit b tons�mci, al�er, improve, tlemolish, or
repair any s�mc�ure. prior �o ils issuance, also requires Ihe applican� �or such permi� �o tile a signed statement thai he/she is licensetl
pursuanl to �he pmvi5ion5 0� �he Contractors' $tate License Law (ChaN�er 9(cammencing with Section 7000) o� Division 3 0� the Business
anU Prolessions Code) or �hal hehhe is exemp� t�erelrom and ��e �asis br the alleged ezemD�ion. Fny violation ol Seciion 7031.5 by
any apPlican� �ar a permit suble��s Ihe aDPlicant to a civil penally oi no� more Ihan five hunUretl tlollars ($500).
i, as owner oi Ihe pmpetly or my employees wit� wages as their sole compensation, will do the work, and [he
❑ simcture is not imentletl or offered lor sale (Section 7044, Bu;iness and Pmfessional Cotle: T�e Contracrors' State License Law
tlaes not apply to an owner oi a propeny who �uilds orimD�oues ihereon, and who does such work himselflAerseli orlhrough
his or her own employees, pmvideU Iha� suc� impmvemenis are nol intendetl or ollered 1or sale. I�, however the building or
impmvemenl is soltl witM1in one year ol comple�ion. t�¢ owner will have the burden o� O�oving he/she tlid noi build a� imp�ove
lor Ihe purpose ol sale�.
I. as owner ol Ihe pmper�y, am exclusively canVacting wiih lir,¢nsetl contractors �o constmc� �he pmjec� (Sec�ion 7044, Business
❑ and Pmie55ion5 Cotle: The Coniraclors' S[aie License Law d0es not apply �o an ownerol pmperty who builtls or improves lhereon
antl who coniracis far suc� pmlecls with a conVactoqs�lic@nse Oursuan�lo the ConVac�ors' Sia�e License Law).1 am aware
Nat pmo� of Iheir WOBer's Compensalion insurance shoultl be pmvitled Io me.
� I am exemp� untler Sedion�. B. 8 P. C.
' for I�Is reason:
�aie'. Ownec
I Qo hereby cerlily thal i am aware of an0 untlersland ihe requiremen�s of Califomia Healih ana Sa�ery Cotle Sec�ions 25505, 25533, anA
2553a antl Ihal I or any lumre �uilding occupant willlwill nm (circle one� neetl m comply wi�h saiU s�a�e codes and ��e repuiremen�s �or a
pormit for conslmmion or motlllication from t�e Air4ualay Management Oislnct FesiOential conslmction applications ere exempt fmm
Ihese p�ovisions.
Oale'. ApPlicant:
I hereby cetlifythai I �ave read I�ig applicalion antl slale Iha� Ne ahOveinlormalion is correcl. lagree to camply wi�b allciry and counly
ortlinances ana sia�elavrs relaunqto builtling cons�mctian and her ap�hor¢erepreseniatives oi�his ciry ro enier uponl�e above-men�ianed
pmpetlY lor msypt�ion purposes.
�� �/ y,//� / o
�lldlC._�(;FW ; �IGn��i�rc�/ /< �
�nver's License or Social Securiiy >: � —
16ab06 W�ile—Bmldmg: Green—CoOe EnlorcemenL Canary--qpplican�; Pmk—Revenue; Goltlenrod—Assessor
' • CITY OF COSTA MESA - BUILDiNG PERMIT PERM NO: E 05497,2
PERMIT NO; E 059922 PLAN CHECK NO: N GOVT: Y SUPP: N
CONSTRUCTION TYPE: V-N `- r��iRMIT TYPE; ELE PU�POSE: UT'H
JOB DESCRIPTION ; SERVICE CHANGE & CQNNECTTON SQ FT:
CLAIM VALUE: CALC-VALCTE: GROUP OCC: R-3 /
COMMENTS: k�'* CSTY PROJECT NO. 91-07 �*�
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN BUILDING ---------- ACCESSORY BUILDING
FRNT: FT IN REAtZ• FT IN FRNT: :T IN REAR: rT IN
LEFT: FT IN RGHT; FT IN LEFT: cT IN RGHT; FT 1N
PARKING REQ� PROV; PARCtL: 42243306 ZNE; RnF NO:
PLANtdSNG I�tSTES>
i
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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
2013ING APPROVED BY DATfi;
BUILDING APPROVEI) HY : DATE:
APPLICATION ZSSUED BY• Cr • � DATE• rIZ'�"I.
ifiE�E#if���flE3Edf�IF3i�iFiEic;sli�3('IF�lE�3Ei!�7i�lF'i�F�i�Fi .. . �� ��r�r�'� i��.� � �N-ii�ih3Fff�%�1fiFiE3E. t...r r iEif
if iF �)f 3F * 3E if� j4lE aE if X� 3i� iF 3E iF 3f iFjf if 3E iF �E j! 1E 3E �F if 3F iE it {(� if iE 3E 1h iNEiY� N' J� �F 3E ff �f� i'r iE iE �lE 1F if if if �lE i(� 3F iE# � if iE-1f iF il--li� iE iE if } if R 3E � iE if i4 iF iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAI, SEGN,ENT:N
BLDG FMT PLUMbING ELECTRIC .MECHANIC FiRE SMIP/RES GRADING
PERMIT 18,50
50� SMIP/NOiV-RES
PLAN
ZSSUE FEE 15,00
BiIILDING-DIV-> PcRNTT ISSJE PLAN-CHECK
ro•raLs----> o.00 o.00 o.00
REVENUE DIVTSION TOTALS--> COI.LECTED:
BLDG FMT PLUMBING ELECTRIC MECHANIC
TOTAL PAID DiIE
0,00 ,00 ,UO
,OU OVER/�HORT: .OU
FIRE SMIP/TOT GRAI�ING PLAN-CHECK
-li iE !E �7'r iE if�it� aE #(� if �lE iE iC� iE * 1f iE iF 3E iF 3E �1F 3f iE iE �IF iE 3F aE ih �.Y� #�I[� iF iE 3E ib 3F �1'r �1F 3f 3F ib �1F �1E �F 3E 1E % lf if %iF iF �lE 3E if?e ��' iE�k� i'r df 3f 3c �1i K 3E # iE !F !F iE if iE �Y it� if
I N D I V I ll tJ A L F E E B R E A K D O W N
TYPE QTY D E 5 C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V& HELOW 201 AMP �: ;zdt8; 50_;.: ;-.;; ,u -' -- 18. SU
END OF FEES G.;� :2.:;�-'. -_., . .' ..= `
�^ II/I�!
I F., � �• y
� P001 'PA
CONSTRUCTION ANp PLANNING - .
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electriwl Serv�ce or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. .. 53. Steel Reinforcement
3. Electrical Conduit Utility-UndrgYnd. 54. Forms
4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesi
6. � Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �
7. Footings 58. Electrical Conduit-Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., 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 Connection 62. Backwash & Receptor�Final
12. Sewer Cap ' , 63. Heater & Vent-Final
73. Roof Dreins � �� 64. P�um6ing System � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrica6Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rougfi Heatin9 & Air Conditioning FIRE DEPT, flEQU1REMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Structuie � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
� 23. Gas Pipe-Rou9h & Test . 72. Underground Flush
�
24. Roof Framing � 73. Undergrnd. Storage Tank � Gas ❑ 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 � HEALTN DEPT. REQUIREMENT
31. Plaster Brown Coat I 79, FINAL INSPECTION �
` � --
32. Electrical Power MeterFinal . `� ,� '80. FOOD CERTIFICATE ISSUED Y�
33. Fir�al Electric � � � . � � Notes:
34. Final Heating & F,ir Conditioning �.� ,
-- i
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 � i
43. Backflow Irrigation -
44. Landscape Irripation SYstem :
45. Sound Attenuation
�46. Handica� Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING ' '
49. Electric Release to Ed�son ,
50. Gas Release to Southern California Gas Co , � �,
51. CERTIFICATEOFOCCUPANCY `�
!'
No. Date � `
ORANGE COUNTY BUILDING DEPARTMENJ _ APPLICATION FOR PERMIT �
636 North Broadway � �� � � � � � � �q
. ��' SANTA ANA, CALIFORNIA �J�
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
L RECEIPT NO. 2FRMIT NAO.
A00 E'S5 873 Governor St• �3p y �'���+
SCHOOL DIST. t
OR TOWN COS l�H. Mesa RECEIVEO BY DATE REG'D. DATE ISS4E�
NEAREST ��\(J//�) �tAAY 5 7g54 MAY 6 igq4
cRoss sT. National Ave.
CITY Beverly Hills NO. �/R
ARCHITECT R LIC.
ENGINEER ,,;n_N?cKerrachev�o.
AOORESS 011/� F Liolrv�t_FnauA
NTRACTORBAZbOA. VZ$ta Ci;o`143231
ADDRE55 9 63 4lilshire_ „
DESCRIPTION NO. L�7 BLOCK ITRACTZ�+IZ
IATTACH METES B BOUNDS)
SIZE OF LOT 67 X ZO7 I NOW ON IOTs O
USE OF NO. OF NO.OF
E%ISTING BLDG. Fqmi�ies I ROOMS
CEN�TERKOF STREETM�L I 1 ti _ SEDE VARDr� (j 1�R
DESCRIPTION OF WORK
NEW I I ALTERATION I I AODITION I
REPAIR I I MOVING I I DEMOLISH I
5 ZIEOING, ����QMS � STORIES Z
E%TERIOR WALL CO�VERING pm�j Olp
COVERW6 Stnnr.nl �h fi
OF NEW
OING RPCIl�AY1l�.A�A�'.t: �:OTTliI'�'f:
I HEREBY ACKNOWLEOGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTV OROINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
51GNATURE OF
PERMITTE B�V�-st$��. .
l�
AUTHORIZEO AG�T. /Y� r • /�
� L'.S3O�OO P6RMIT FEE S /L/
VALUATION /1
PLAN CHECN $ .S
TOTAL
FEE E/
BUILDING
CORRECTIONS
BRAQNG. BOLTS
LATH.INT. �r
LATH, EXT. /
PLASTER,INT.
PLASTER, EXT. `_
MASONRY REINFORCED
BOND BEAM
FINAL
ALS
J
r
PLOT PLAN
Show location and �stances from
property line and between buildings.
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