HomeMy WebLinkAbout665 PLUMER ST - Building PermitsAVo���ant to fill in al1 sDaces ezceDt those witnin heavy Doreer lines ana sign all appropriate tlectarations.
GTY OF COSTA MESAt� CONSTRUCTION PERMIT ' °F MIT NO TRACT NO LOT NO ����r.��
Project Address �� J PL+u.�lMm E,t st �].
Applicant'sMail�ing�A/d�d,�r�ess� ���/'���L/�'iI%i�/��:1�'� ��I/�
Owner's N�am�e—,('.�'/.I[1/ifQy�� Phone �g[��
Address rp�: -�P1� � - , n , ,r� s�- qai �
Arch/Eng. License No.
Address �'}�
Contracto 's N e� �.I1%i2�J��� Pho e(z.Sf��
Address (mailingl 7 .l � ! � �� 9�
City License No. �
LICENSED CONTRACTOR DECLARATION
1 nereby affirm tnat I am licensetl antler provisions of Cnarter 9(commencing
with section 7000� of Division 3 of t�e Business antl Professlons Cotle, antl
my Iicense is in lull tgrce antl effect,^ l, � .� ��.i „�
'ORKERS' COMPENSATION DECLARATfON ��
iereby aftirm that I have a certificate of consent to self-i ur or a certiticate
..f Wo�ke�s' Compensation InSuranGe, or a certified C py here f(SeCtion
3800, Lab. C n r�.c� �,�.v 1
Policy No. ��_1��` CompanY N1 � `
�Certifietl copy is hereby furnisnetl.
Certifietl Copy i5 (il¢tl with [he cil ' in9 n` 'J��
Date APPIi 'V
EXEMPTION FROM WORKERS' COMPENSATION DECLARA N
(This sectian n¢etl not be com0letetl i( t�e permit is tor one huntl e(5100) or
less).
I certity that in [he perfo�mance of the wo�k for wbich tIt15 pe�m s issuetl, I
shall not employ any pe�son in any mann¢r so as to become sub�eCt [o the
Workers' Compensation Laws ot Cali(omia.
Oalo' Signa[ure
NOTICE: If, af[er makinq this tleclaration, you sM1oultl become subject [o the
Workerz' Compen5ation provisions of lhe L2Got Cotle, you must forthwith
comply with suc� provisions or this permit snall be tleemetl revoketl.
CONSTRUCTION IENDING AGENCV •
I h¢reDy aftirm that the�e is a con5t�uction lentling agency for tha pertormance
ol Ihe work for w�ich thi5 permit is i55uetl (SeCtion 309] Civ. C.)
L.ender's Nam¢
Lentler's Atltlress
OWNER BUILDE0. DECIARATION� �
I hereby affirm that I am exempt trom the ConVactor's License Law for the
followin9 reason (Sectlon ]031.5 Business antl Professional Cotle: Any city or
county which require5 d permit to construct, aller, improve, tlemolish or reDai�
any Structure, priOr t0 its issuance, alm reQuireS the applican[ tor such permil
to fil¢ a signetl statement tnat he/s�e i5 IiG¢nsetl pu�suant to the provi5ion5 of
ihe Contractor's Llcense Law (Chap[er 9(commencing with Section 7000) ot
'��)ivision 3 ot the Business antl Professions Cotle) or that he/she is exempt
�S�fh¢refrom antl Ihe basi5 for the allegetl exemplion. Any violdtion of $ection
7031.5 by any applicant (o� a pe�mit Subjects the applicanl to a civil
eenalty of nof more than five huntlretl Aollars ($500).
�J I, as owner of the oroperty or my employees witn wa9es as Iheir sole
compensation, will tlo the work, antl the structure is not intendetl or offeretl
for sale (Section 7044, Business antl Protessional Cotle: The Contractor'S
�icense Law tloes nol apply to an owner ot a property who builtls or impmves
Nereon, antl who tloes sucb work himself/herselt or throu9h his or her own
emoloyees, provitletl that such improvements are not intenaetl or offerea for
Sale. It, however, th¢ Duiltling cr imp�ovement is soltl within One yea� ot com-
pletion, tne owner wlll have the burtlen ot provin9 he/sne tlitl not builtl or im-
�ova for the purpose of sale).
I, a5 owner o/ tM1e D/o0erty, am excluslvely con[racting wi[h Ilcensetl con-
lra<tors [o tons[ruct the projec[ (Settion 7044, eusiness antl Protessions Cotle:
Tne Contractor's License Law does not appry to an owner of property who
builtls or improves lhereon, antl who cont�acls for Such projecls wlth a con-
t�actor(s) IicenSe pursuant�[dthe�Conlractor'S Li[ens¢ Law). I am aware that
proot of [helr Worker'S CompenzatiOn insurance shoultl b¢ O�ovitletl to me.
❑ I am exem0� untler $ection B. 3 P. C. for Ihis rea5on
Date Owner
I hereby certHy that I have reatl IN5 appliGation antl state that the above
InlOrmation is torr¢cL I agree to comply with all city antl [Ounty Ortlinances
antl state laws relaling to builtlir]p construc[ion, and h¢r¢by du[�o�ize repre-
Senta[ives oflhi! citv [o,erflC4/uoon. Ihe aboaE-mentimetl orooertv fo�
Drivers'
t
23 `
PE OF CONSTRUCTION NEW P.DD ACTERATION
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LI GRADING FOUNDATION LJ STRUCTVRAL
' ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL
❑ �OTHER �� '
PROJECT DESCRIPTION Sa.FT. oCCUaANCv_
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCU.YDS. ACRES_
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinkin9 Fountains
Floor Drains
Floor Sinks
Gas Service
Inierceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee
Service Sink
SeWer Cap
Sewer Connection
Solar Collectors
Solar Tank
Swimming Pool w/Spa
Urinal
s Water Closet
Water Heater
Water Service
$15
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/FacL Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 eru O i oo,000
Reinspection Fee � $15
CMF 0865-46, rev. 4/84 White - Builtling; Canary - Applicanh Pink - Atcouniing; Goltlenrotl - Assesm�
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑o-ioa,000aru ❑ioo,000
System Repair/Alteration
Issue Fae
A.P. #
S Main Buildin9:
E
T Front -
ARear
C Right .
g Lef[
Ping. Ref. #
Planning Notes:
Auromatic Washer
Constructior Poie Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elecvic
Fan
F.A.U.
Fixtures
Device Baxes �
OuNets
Switches
Garbage Dispoul
Generator �0.5 KW �5-'
$ 3
Fee
FEES
1017 4/Ii/85
Zone
Accessory Building:
Parking Req./Provided '
ELECTRICAL �
' Transforme� ❑ 15-50'KW
❑ 50+ KW
Meter Dup ro 100 amps
Meter �over 100 amps
5KW
$15
Sub Panel
Morors DO-1 HP � 1 f. - 8
� InaSolar �9-15 HP �16-15+
Microwave
' Pole Li9ht
Range
Sign
Standing Sec[ions
Tresh Compactor
Issue Fae
o.00 T�
2
O
N
I
N
G
R
E
Q'
M
T
S.
FEES
$ 3
DEVELOPMENT SERVICES REQUIREMENTS:
� Zonine Approved ey Date
Building Approved By Date
Appliwtion Issued By � Dat^ `I
SUMMARV OF FEES �
BUILDING PERMIT $ SMIP §
PLAN CHECK $ PERMIT
PLUMBING § �CO ISSUANCE S
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �� ��
$ 3 PLAN CHECK 25% $
CONSTRUCTION AND PLANNING PO� _& SPA
APPROVALS Permit #-_� Date Inspector qppROVALS Permit # Date Inspector
�7. Tempora�y Electrical Service or pole 52. Pool & Equipment Location
2. Soil.Pipe-Undrgrnd. 53. Steel Reinforcement
3.•Elect�ical Conduit Uti�ity-Undrgrnd. 54. Forms �
� 4. Electr,ical Conduit-Undrgrnd. ' 55. Electrical Bonding � .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
� �
6. EIecV�fcal UFER Gr�d. 57. APPROVAL TO COVER-GUNITE
7.;Footings.. 58. Electrical Conduit-Undrgmd.
8. Foundation "� 59. Gas Pipe, � Undrgrnd., Test
9..Water•Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10.,Str'uctural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer�Cap � • 63. Heater & Vent-Finel --
13. Roof'Drains , � 64. Plumbing System - Final
14. Rough'Plumbing'•, :. 65. Electrical-Final � '
15. Rough Elec[rical-Conduit . 66. Solar System-Final
76. Rough Electric Wiriog . - 67� Fencing & Access Approval
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. Rough Factory Fireplace - . . _ _ _ ., - , APPROVALS Permit # �
21. Ducts, in Structure � - 70. Underground HYdro
22. Ducts, Ventilating - 71. Product Pi in ❑ Gas ❑ Oil
'_t�..:.., e.a..Yic�:=- P 9
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing �� - � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Mbnocoat 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: . r�'/
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. Solar pomestic-Final
42. Backflow Preventer .
43. Backflow Irrigation .. . .
44. ,Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILpING
48. Special Requirements Completed
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY .
No. Date -
„
. ,,_, 81`��
� COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31�
COSTA MESA. CA�IFORNIA
FOR APPLICANT TO FILL IN
BUILDING 665� plu�ner J1��p n�U�V
ADORE55
COSTA MESA. CqLIFORNIA
OWNEft K, id. Ko12 Investment Co., Inc.
MAIL 1555 Placentia
A�DRE55
CITY 1YeWjJOi"L Deiil:ll� VnJ-• 'NO.
ARC ;T Raymond Levantts ���.
OR E JEER NO.
ADORE55 v n n
A. �i . il�ll UOIl$t• VD CITY LIC.
CONTRACTOR NO.
ADDRE55 SBID�
�E�AL LOT
oescAialiorv NO.
A.P. NO.
SIZE
OF L
EXISTING BLOG.
SETBhCI( LINE FROM I� �
CENTER OF STREET 4.
BLOCK
I �122! qD[
FIR
zor
534 �°"
S8ID8 BYF
NO.OF BLOGS.
/ I
REAR YARD / y.
�
SIDE VAR� RIGHT ���3�� LEFT S
DESCRIPTION OF WORK
NEY, g ALTERATION IADOITION
REPAIR MOV�NG DEMOLISH
BIZIEDING 31z4 $Q £� ROOMS �� STORIES �
EXTERIOR WALL ftOOF
COVERING '4tuC'C� COVERING WOOd Sh1Rg1BS.
BUELDINGEW t$• ��pl� and attached
� �,
.'t��, 6m���tl��ily
C 8 1958 �
fiNANCE DEPT.
CITY OF CQSTA P�9ESA
APPLICATION FOR PERMIT
' BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. P6RNjT fJ(
Tri'tl �/
� . �J�jnb
IVEO 6Y DPT� R EIVE � OeTE �j'rV/
COSTA MESA. CALIFORNIA
�
' NO.OF TYPE �
PLPNS � �
{�
/ Z-
DATE
COR -TIONS
CI'!"Y �;=C{-I.-%�Ta �gESA
r
N
1 car garage and.2 car carport. '� � L�i,� /h�”
• i�:; ,-
; r:<���^� E�,,)v�_D%_/,�'
I MEREBY RCKNOWLEDGE TH<T I MAVE FE4O THIS APPLICATION FNO ����-�' �-
$TPTE TNFT THE ABOVE IS CORRECT FN� qGREE TO COMPLY WITH FLL
CITY OROINFNCE$ FND STRTE LPW$ REGUtp}ING Bl11LO1NG CONSTRUC�
riorv. VALUATION
SIGNATURE OF PERMiT FEE $ �
PERMITTEE � f J
� � � �y, ^l � 7 PLAN CHECK $ Z �
j t
AUTHORIZED AGENT ' TOTAL FEE $��/ ��� �M�
r