HomeMy WebLinkAbout434 EMERSON ST - Building PermitsApplicant to fill in a11 spaces exeept those witnin heavy Doreer lines antl sign all a0vropriate tleclarations.
CiTY OF COSTa MESa CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. P#
: ProjectAddress 434 Firer'son• Costa N�sa, Ca 92627
Applicant's Mailing Address
Owner's Name � �ros � Phone 714-583-19C
Address P 0 Eox 8064 Laauna Hills Ca 92654
Arch/Eng. License No.
Address
Convactor'snlame Vance & Assoc Roofino IIIC phone ��4—��3��
Address (mailing) P.O. Box 1045F, Costa P�sa,�a 92627 '
Ciry License No. �g�3 �
LICENSED CONTRACTOR DECLARATION
I hereby affirm tha[ I am Iicensetl untle� provision5 of Charte� 9(mmmencinq
with section 7000) of Division 3 of [he Business antl ProtesSions Cotle, antl
my license is in full force antl eifect.
License Class — nse No.
Date 5p'I `p�yp��� e
WORKERS' COMPENSATION DECLARHTION .
i hereby atfirm fhat I have a certificate of consen[ to selt-insure or a cerUticate
�Workers' Compensation Insurance, or a certifietl copy Ihereof (Se<tion
�0, Lab. C.)
roiicy No. ��%.�(��rj��any lihprh�i Mrf'iial Tncn�r
eCertifietl copy is hereby turnishetl.
Certifietl copy is filetl with the nty Builtlin9 Division.
Oate��—�%G�licant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATIO
(Thissection neea not be completetl if the permit is for one hundred ($100) or
IE55).
I certi(y that in [he performance ot the work for which thi5 perm�t i5 i55uetl, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensalion Laws o( Califomia.
Date Si9nature
NOTICE: It, after making this tlecla�ation, you Shoultl beGome Subject to the
WorkerY Compen5ation provisions o( the Labor Cotle, you must fortnwith
comply witM1 such p�ovisions or [hi5 permit shall b¢ tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 h¢reby aifirm Ihat there is a construction lentlinq agency for the performance
of the work tor which this permit is i55uetl (Section 3097 Civ. CJ
L.entler's Name �
Lentler's Atltlre55
OWNER BUILDER DECLARATION
I hereby affirm Lhat I am exempt from the COnVactor'S License Law.for tne
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
� county which �equires a permlt to construct, alte�, Improve, tlemolish o� �epair
�� any structure, prior to its issuance, also r¢quires the appliGant fot such permit
to file a si9netl statement thaf ne/she is licensetl pur5uant to the p�ovisions ot
,the Convactor's License Law (Chapter 9(commencinq witb Section 7000) o(
��vision 3 ai the Business and Professions Cotle) or that he/she is exernpt
�efrom antl the basis tor the alle9etl exemption. Any violation ot Sectlon
1.5 by any aOPlicant fo� a pe�mit Subjects the applicant to a'civil
.alty of not more tnan tive huntlretl tlollars ($500).
LI I, as owner ot the property or my employees witn wages as their sole
compensation, will Co the work, and the structuve is not intentl¢tl or ofteretl
far sale (Section �044, Business antl Professional Cotle: The Contractor's
LicenSe Law does not appty to an owne� ot a property wlto builtls o� improves
Ihereon, antl who tloes svch work himself/herself or through his o� her own
¢mployees, provitletl that such improvements are nOt intentletl o� offEretl fo�
sale. If, however, thE builtling o� imp�ovement is soltl within one y¢ar of mm-'
pletion; the owner will have the burden of'proving he/she tlitl not builtl or im-
prove for the purpose of sale).
❑ as owner Of the property, am ezUusively tont�acting wi[M1 licensetl con-
tN, ors to construct the oroject (Section ]044, Business antl Professions Code:
Tn. �ConVacfor's License Law tloes not apply to an owner of property who
builtls or improves th¢reon. antl who contract5 for such oroiects with a�con-
tractor(s) hcense pursuant to [ne Cantractors License Law�. I am aware that
proof of their Worker's Compensation insurance shoultl be orovitletl to me.
❑~ am exempt untler Section B. & P. C, for this reason
Date Owner
I hereby certify tnat I have reatl�this application antl state that the above
iniorma[ion is correct.'I agree to comply with all city antl county ortlinances
antl state laws relating to builtling con5truction, antl hereby authorize re0re-
Senta[ives o! this city to en[e upon tn above-mentionetl pvo0e�ty �o�
InSpection pwposes 7_1'Z_�
,Signature � Date
Drivers' License or 55 � —
3 z� �
TYPE OF CONSTRUCTION NEW AD� ALTERATION REPAI R
❑ CONVERSION ❑ �EMOLISH ❑ OTHER ' ' '
DESCRIPTION OF WORK/USE OF BLDG.
TYPE OF PERMIT �J GRADING LJ FOUN�ATION LJ STRUCTVRAI
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5Q. FT. ocCUaANCv_R
_R
CONSTRUCTION TYPE � VALUATION ^y ����
ZONE� GRADINGCU.VDS. ACRES_
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs _
rinking Fountains
loor Orains
loor Sinks �
as Service
Kitchen Sink .
Lavatories
P—Trap
Roof Drains
Reinspection Fee
Boiler
Duct-�UnderGround
$15
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. BIt �CBO # �
Heating System & Ducting
❑P700,000 BTU 0100,000
Reinspection Fee � $75
0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goltlenroa - Assessor
Showers
Service Sink
Sewer (;ap
Sewer Connection
$OIdI C0112CtOf5
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
+Nater Service
AutO-W25h
Laundry Trays
Isue Fee
Hood or Type I ❑
Canopy Type I I ❑
RefrigeraUon'Sys[em
❑0-100,000 BTU ❑ 100,000 E
System.Repair/Alteration •
Fire Dampers
Registers
laue Fee
A. .
S Main Building:
E
T Front
ARear
C Right
SLeft
Ping. Ref. #
Planning Notes:
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher �
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switch¢5
Garbage Dispoul
Generator �0.5 KW C
Zone
Accessory Building:
Parking
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps .
Meter ❑over100amps
Sub Panel
Motors �0�1. HP 01'/, - 8
IncSoiar �9-75'HP �16-15+
Microwave
Pole Light
Range
Standing Sections
15 KW Trash Compactor
Reinspection Fee $15 Issue Fea
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
FEES Building Approved By
Appliration Issued By
$ 3
i3;
FEES
$ 3
O
N
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N
G
R
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Q
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T
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SUMMA V OF FEES '. .. T
BUILDING PERMIT $ �c SMIP $ ��
PLAN CHECK $ PERMIT
PLUMBING $ :,I$SUANCE $ �
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $� ��_�_
PLAN CHECK 25% $
�IZ�`�� 0? �G037715-0003771E TiJT
�ASE: a7/13/$i TII'E: l0:ib
63. ��D
,. � \ � •
CONSTRUCTION AND pLANNING POOL �A
APPROVALS Permit� Oate Inspector AppROVALS Permit# � �te 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. - j"!
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding �;1
5. Steel Reintorcement - 56. Rough Plumbing & Pressure Test .,�
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �� A
7. Footings �� _ 58. Electrical Conduit-Undrgrnd. �) �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test `� f,.
9. Water Pipe-Undrgrnd. -�� 60. Backwash Lines, P-Trap, O Undrgrnd. �`�j
�
10. Strucwral Floor System C 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. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16� Rough Electric Wiring 67. Fencing & Access Approval
19t Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Cpnditioning FIRE DEPT. REQUIREMENT
Z0. Rough Factory Fireplace � �APPROVALS Permit # �
�t . �. ,
21. Ducts, in Structure -7,0. Underground Hydro
22. Ducts, Ventilating 71 ;Product Piping 0 Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Undergrouncl Flush
24. Roof Framing 73. Undergrnd. Storage Tank � GaS ❑ Oil
25. Roof Sheathin9 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 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Nleter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
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 � r
45. Sound Attenuation ' �-
46. Handicap Regulations E X P I R E D
47. FINAL STRUCTURE $ BUILDING tncomplet (1S �
48. Special Requirements Completed e ,D � � _�.
49. Electric Release to Edison % - �� ��
50. Gas Release to Southern California Gas Co '� t� +�
51. CERTIFICATE OF OCCUPANCY � ,. ;'
Ci •.
No. Date -
�ioe�
COSTA MESA BUILDING.S,4FETY DEPARTMENT
P.O. BOX H17 C09Tq ME9A� CALIFORNIA
For Applicant ro Fill In Completaly
TYPE OR PRINT
a���o,Ne .v3y ��,�f�,� s,—�r�-
ADDRESS
COSTA MESA, CALIFORNIA
OWNER Ca e Series Inc. - �
MAIL 504- No. New �ort Blvd.
ADDRE98
�,,,. Newport Beach, Calif. No'-646-9341
ARGHITECT .. � . .. ... . TEL.__.�..,�.,,�
CONTRACTOR �a['e `�er�e`S InC.
ADDRESS 504 No.� N�wport Blvd.
��TM Newport Beach, Calif. � �
uc".TNo. 221233. No • 646-9341
s�=E 18. 83 x 52: 08 I NO.OP BLC
OF LOT rvOw on Lc
USEOF n�ne
EXISTIN6 BLDG. '
6ETBACK LIN! FROM+�(� h ^R ^ �G
� ' RIGHT
OF WORK
�{ �� acrFwannr.i � �� enn�r�nu � ��
1235sq.ft.p���a 4 r,,,e,�e 2
BEPERFORMED,
1
I HEREBY AGKNOWLEO6i TXAT I MAVfi PEAD TXI9 /�PPLICATION
ANO 9TATE THAT TH8 ABOV6 16 CORflECT ANO A6REH,TO COM-
PLY WITH ALL CITY ORDINANC68 /�ryD BTATi UWB RHOULAT�NG
BWLOIN�CONBTNIICTION. � . �
SIGNATUREOF� r+ ���X.� �G -
PERMITTE p
(//�/��. ,�. 1 /n/
AUTHORIZ6DA6ENT�i'Y!/J�%i _J' - O . _
FEE RECEIVED
� NOV 2 7 1963
FINANCE DEPT,
CITY OF COSTA MESA
APPIICATION fOR PERMIT
BUILDING
For Office Use Only
I R[C[IRNO. I �F�I
R[C61V80
ZONING.
NO.OP� I Ue80PN8W,'
�I.ANe BUILOIN�
n
Lot 30 Tract 5212
OVERHANO SHALL BE LE55 THAN
YAROSAPPROVED
MAIN BUILDING
tOM GL 6TREETI
BET
VAR. �j
YARDSAPPROVED
ACCESSORYBUILDIN6
BET. MAIN @
ACCE58. BLI
DATE
TX6 �MOUNT BHOWN UNDEP VALUATION IB FOR TXe F
PURPOSH OP 88iABLIHHINO A PERMIT PE6 ONLY. p
�VALUATION � p^/ ^� N
11, 423�. 75 pERM1T FEE $ J/. 2/ j
m
S PLAN CHECK $ oo �
' r..r.� e�v a 37. 2/ 4
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