HomeMy WebLinkAbout595 FAYETTE CIR - Building PermitsApPlicant to fill in all spaces exce0t ��ose wit�in heavy GorEer lines antl si9n all app�o0��ale tleclarations.
cirY oF coS7A MESn CONSTRU TION PERMIT
Proiect Address � � � �
Applicant'sMailingA dress � � �
Owner's Name . � Phon� �
Address �
�
Arch/Eng. License No.
Address �r�
Contractor's Name �� Plione �c/
Address ( mai I i ng) �'�
City License No. -� '3 ��
LICENSED CONTRqCTOH DECLARATIO '
I he�eby atfi�m tM1at I am licensetl untler p�ovisions ot Charter 9(commencing
with section 7000) of Division 3 of the Business antl Professions Cotle, and
my license is in f 1 for � a tl effect. ' � /+i
License Class Li ei'ee o. �
Oate � Signature - �
W00.K RS' OMPENSATION DECLA ATION
1 hereby affirm that I have a certificate of con5ent to sel(-insure or a<ertificate
of Workers' Compensation Insurance, o� a certified c py tnereof (Sec[ion _
�800,-Lab. C�:/)�- '� l
olicy No. ,�sr�.� � `J� � Compan - � C/
Certifietl coOY is hereby fumishetl. �
. Cer "f'etl < py i filetl with the city ui in ivis'p� . - )
Da[e - Applicant - � �
E%EM 101 FROM WORKERS' COMPENS ION OECLARATION
(TM1isSection neetl not be completetl if the permit iz for One huntlretl ($300) or
Iessl'.
I certify that in thC performance ot tM1e wo�k for which this permR is issuetl, I
shall not employ any pe�son in any manner so as ta become subject to the
Workers' ComDensation Laws of CaliPomia. '
Date Si9na[ure
'NOTICEi If, after making this tleclaration, you shoultl become subject to the
Workers' Compensation provisions of tM1e Labor Cotle, you mus[ forthwitn
comply with.sucb p�ovisions or thib permit shall' be tleemed revoked.
CONSTRUCTION LENDING AGENCV � �
I hereGy affirm that there is a construction Iending agency tor the pertormance
of the work tor which this permit is issuetl (Sec[ion 3097 Civ. C.)
Lentler'z Name
Lentler's Atltlress -
OWNER BUILDER OECLARATION '
1 hereby affi�m=thal 1 am exempt trom the Cont�acto�'s License Law fo� the
following reason (Section 7031.5 Business antl Professional Cotle: Any city or
county whicH requires a permit to tonst�uct, alter, imOrove, tlemolish or repai�
any structure, prior to its issuance, also requires tne applicant for zuch permit
to file a signed statement tM1at he/she is licensetl pu�suant to the provisions of
♦en rnn�.w��n.•a i icenae i aw lChaoter 9 Irommencina with Section ]000) of
M� 32CD'�'d: , �����-
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOUSH �� OTHER � A p #
DESCRIPTION OF WORK/USE OF BLOG.
' � � ' S Main Building: '
TVPE�OFPERMIT GRADING �.FOUN�ATIOF�N O.STRUCTURAL T Front
❑ TENANT �ELECTRICAL ❑ PLUMBING ol MECHANICAL B qear
❑ �OTHER ' %�
PROJECT DESCRIPTION 5a. FT. ' oCCUaArvcv C Right
K Left
CONSTRUCTION TVPE VALUATION $ $'
ZONE GRADING CU. V�S. ACRES p�ng. Ref. #
qemarks: � . Planninq Notes: '
'03L5 by any applicant for a permit subjects the.applicant to a civil
�alty of not more than five huntlretl tlollars ($500).
I, as owner of the property or my employees with wages as thei� sole ;
....mpensa[ion, will tlo tM1e work, antl the sVucture is not in[entletl or offeretl
for sale (Section ]044, Business and Professional Cotle: The Contractor's
License Law tloes not apply fo an owner of a pwperty who builds or improves
thereon,'antl who tloes such work himseli/herself or through his or her own
employms, provitletl that such improvements are not Intentletl o� otteretl for
sdle. H, however, the builtling or improvement is Soltl witbin one year of rom-
pletion, the owner wi11 have tne burden of provin9 he/she tlitl not builtl or im-
prove for the purpose of sale). � —
❑ I, as owner of the O�operty, am exclusively contracting�with licensetl con-
tractorsto construct tne project (Section 70a4, Business antl Profezsions Cotle:
The Coniractbr'S License Law tloes not apply to an owner of property who
builtls orimpwves thereon, antl who contracts for such projects witlt a'con-
tractor(s) license pu�suant to ihe Conttacto�'s License Law). I am aware that
p�oof o( theit Worker'S Compen5a[ion insuranw should be provitletl to me.
,� I'am ezempt untle� Section B. & P. C. fOr Ihis rea5on
Date � � Owner � '
1.�ereby certity that I�have reatl �M1is ap0���ation antl state that the above
information is correct. I'agree to compry witn all city antl county ortlinances
antl'state laws rela[in9 �o builtling con5truction, antl hereby authorize repre-
sentatives of tnis city to nt r pon the above-mentionetl property for
-inspection p
Signature . ' � Date
Driver5' Licens r 55 � "'�
Sink
<flow Preventer
<flow Irrigation
Dishovdsher
Drinking Fountains
Floor Drains. �
Floor Sinks � - �
Gas Service �UtIE
Interceptors � '
Kitchen Sink �
Lavatories
P—Trap
Roof Drains
ReinspeMion.Fee ' , $15
Duct-UnderGround
Duct-Structural � �
Duct-Ventilating .
Ezhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
�eating System & Ducting
4100,000 BTU 0100,OOOBTI
peinspec[ion Fee � $15
CMF 0865�46, rev. 10/84 White - Builtlin9; Canary - APplicant; Pink - Accounfinq; Goltlenrotl - Assessor
Showers
Service Sink ' -
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipinq
Solar Tank
Swimming Pool w/Spa .
Urinal
Water Closet '
Water Heater �
Water Service
Auro-Wash
Issue Fee
Hoodor Typel � ❑
Canopy ' TYPe I I ❑
9e rigeration System
-100,OOOBTU ❑700,000
System Repair/Alteration
Fire Damp'ersq
Registers y�(� ���'�J
luue Fae
FEES
$ 3 � ".
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas � DElectric
Fan
F.A.U.
Fixtures
Device Boxes
/ V✓�/ v/ � �r rv .
�
2one
Accessory,Building: �
2
' O
N
I
• N
G
R
Parking Req./Provided ' � E
Q
M
, , T
S
ELECTRICAL
Transformer ❑ 15-50 KW
' ❑ SO+KW
Meter ❑up to 100 amps
_Meter pover100amps _ ,
Sub Panel
Motors O0.1 HP O1'/: - 8
'IncSolar �9-15 HP �16�15+
Microwave
Pole Light
Range
0
Garbage Disposal I I;Standing Sections
Generator �0-5 KW �5-15 KW Trash Compactor
= Reinspection Fea �$15 Issue Fee
i DEVELOPMENTSERVICESREQUIREMENTS:
' Zoning Approved By
Building Approved By
Appliwtion laued By
FEES
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $ �
PLAN CHECK �$ PERMIT
PLUMBING $ ISSUANCE $ �
PLAN CHECK 25% $ ENERGY P.C. .$
ELECTRICAL $ IZN GRADING 5
PLAN CHECK 50% $ � MICROPILM $ �—��7
MECHANICAL $ � TjOTAL FEE $ T= - ✓
PLANCHECK 25% $ ' � l�.5�
.. ,_ . _
� ' -
CONSTRUCTION AND PLANNING POOL E 1 - �'
APPROVALS Permit# Date Inspector AppROV,ALS Permit# � Date Inspector i
�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-Undrgmd. . 55. Electrical Bonding '
5. Steel'Reinforcement � 56. Rough Plumbing & Pressure Test
6, Electrical UFER Gr.nd. - � 57. APPROVAL TO COVER-GUNITE
7..Footings � .+, 58. Electrical Conduit-Undrgrnd.
8. �Foundation_ '. .. � � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrg"rnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. �Structural Floor System ' � 61. APPROVAL TO DECK , '
11..'Property Sewer Llne & House Connectlon � . 62. Backwash & Receptor-Final �
12. Sewe� Cap ��' . 63. Heater & Vent-Final
13. Roof Drains ,�� � 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrica6Conduit 66. Solar System-Final _
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough EleGtrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19' Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20: Rougfi Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71 . Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test �72. Underground Flush �''
24. Roof Fram�ng 73. Undergrnd. Storage Tank O 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 HEALTH DEPT. REQUIREMENT .
31. Plaster Brown Coat 79. FINAL INSPECTION �'.;�
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ,�� �%'y �'
•��%'�
33 Final Elect�ic Notes: �� ��-�,p,.LO `(y,tA � ,�r :
3..Final Heating & Air Conditioning 7•�•,� ��.yY►� �KP�C�J� QS 0 F
35.,Fina 30�. i (J+vy) G (•,.�•,(,�
36.'�Hood or Canopy � •
37. Final FactOry Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final
1 !,
42. Backflow Preventer � �� �"
43. Backflow Irrigation , , ' �
44. .Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING -
48. Special Requirements Completed
49. Electric Release to Edison . - ' � ,; ,.j
i.
50. Gas Release to Southern California Gas Co � � � s ^" �
J� '' ,
51. CERTIFICATE OF OCCUPANCY . • �lp� , ` ' .
�n. � Date � ��� � ' -
27940
COSTA MESA BUIIDING-SAFEfY DEPARTMENT
P.O. BO% 1200 GOSTA MESA. GAIIFORNIA Y�62!
For Applicant to Flll In Campletaly
TYPE OR PRINT
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APPLICATION FOR PERMR
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For OHlce Use Only
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ALLOW6D SU.B.C.PEQUIREMHNTI
YARDSAPPROV6D YARDSMPROVED
MAIN BUILDINO ACCEYSORYBUILDINO
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DATE
a PROV[D WLD DAT! 11�Z7-67
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tfOLD FOR SPI'CtAt, � ��_• •-•-_ �
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TN8 �MOUNT GXOWN UNDBR VALIIATION 19 POR TH8 j
rYPPOB6 OP UTABLIBXINO A PEPMIT F88 ONLY, i3
VALUATION 1 �
PERMIT FEH $ � JY� p
a/� �79— �2 . °
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