HomeMy WebLinkAbout3005 FILLMORE WAY - Building Permits3005 1=l LC.�70k'.L
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C! i� �F COSTA MIiSA
Pf.A NING DN{SION
SURIECT TO BLDG. DEPT. REG.
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� �[c.'TlUNS SIiALL l3E
�. �e. � IiY THE PLANNING DIV.
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PFOJECTAOOHESS: 3UOS FILL,YORE wY
OWNEH'S NpME: GLORG� P:'IELFS
R��HESS:
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RflCH/ENGINEEB: � 3�— II� E) 5 pEG.NO.:
nooRess: WSt,LIA,u CORREA S2uxli:z
16912 BdLSA CHICA RD 201
PENMITTEE: H•�• CA 92649
aooness: ➢RTDGBPORT BGILDERS (714)241-3077
174 E. GEARY
LICENSEO CONTflACT�B DECLAPA�TIONA I hA by a��irm iha� I am licensed under p wisio�ns o Ch�ap er 9(commencing wi�h Section
7000� ol Div;sion 3 of Ihe Business an0 Pmlessions CoOe. ane my license is in tull lorce and elfect.
CITY LIC.: STATE LIC.: � S5:
017159 �Ic063 B� (
oam: _p_'/�' ..G.� �_/ signam�e: — _ _ —
WOXREHS'COMPENSATIONOELIAHFTION: Iherebyailirm�hatlhaveacetli�itateo�wnsen�to5e msureoraceN�icateo�Workers'
Compensation Insurance, or a certilietl copy thereof (Section 3800. LaO. C�.
vo��cvNo.: pWC-112161 E%P.OpTE: O3�I�LI�J2
COMPpNY: (:J ODEN BAC' B IN
1 Cem�ietl coDY �s AereGy �umished. 4 enitietl copy is file0 wi�h ciry Bwlding D)i�visio�n.
Oate: � � �' G � pPDlicant: �� �I ' �� — x� ,
E%EMPTION iBaM WOPKEflS' COMPENSpT10N OECLAflATION: Qhis section neetl na� be comple�e0 il Ihe pem is lar ane hundreU �$100� or less�.
I certify thai in I�e petlormance oi Ihe work tar which this permit is issued. I shall not employ any person in any manner so as �o become
sublec� �a Ihe Nlorkers' Compensation Caws ol California.
'�aie: ' Signature:
NOTICE: II, atter making Ihis tleclaratioq you shoule �ecome subiect to Ihe workers' ComDensation provisions of ihe Labor
Cotle. you mus� lorlhwith comply wilh such pmvi5ions or this De�mi� shall be tleemed revoked.
�' CONSTflUCTION LENDING PGENCY: I hereby a�firm (�al ihere i5 a Conslmciion lending agency lor �he pedormance of �he work �or
which Ihis permit is issueA �Sectian 3W7. Ci¢ C) ..
LENOEN:
aooAEss:
OWNEB BUILUEH OECIABpTION: I hereby a��irm �ha� I am exemp� irom ��e Contracio�s' S�ate License Law �or the IollowinA reason
(Seciion 7031.5 9usiness antl Pm�essional CoOe: Any city o� counry which requires a permit m conslmci, alter, impmve, tlemoiis�, or
re0air any simcWre, prior lo ils Issuance. also requires ttle apD�icam for such permit Io file a signe0 statemem �ha� he/she is licensetl
pursuam io I�e pmvisions o� �he Contractors Sta1e License Law (Chap�er 9(commencing wi�h Sec�ion 7000) of Division 3 oi the Business
antl Pmie55ion5 CoOe) or Ihat he/s�e is ezempt Iherelmm and �he basis �or the allege0 exemption. Any violation ol Seclion 7031.5 by
any applicanl �or a permi� subjecis the applicanl to a civil penalry oi not more ��an five hunaretl tlallars ($500�. _
1, as owner ot ine DroDeny or my empioyees with waAes as Iheir sole compensation, will Oo the work, antl the
❑ simcWre is not imended or ollerea lor sale (Sec�ion 70a4, Business and Pmtessianal Cotle: The Coniracbrs State License Law
does not aD01y to an owner ol a pmpeny who Ouiltls or impmves ihereon, antl who tloes such work himself/hersetl or through
his or her own emplayees, pmviUetl ihal such impmvemenis are nol intenAetl or offeretl for sale. tl, however the �uil0ing or
impmvemen� is soltl within one year o� comple�ion. Ihe owner will have Ihe burtlen oi proving helshe tlitl no� build or impmve
, for �he purpose ol sale).
. I, as owner af �he propetly, am exclusively conVacting wilh Iicen5e0 conVac�ors �o constmcl the pmlec� (Sec�ion 7044, Business
❑ ana Professions COUe: The ConVac�ors' S�a�e License Law Ooes wl aDPly to an owner of pmp¢M who builds o� improves �hereon
antl who cantracis br such prole��s wi�� a canirac�m�s) license purSuanl �o ��e CoNractors' S�ale License Law),I am aware
thal pmo� o� �heir Worker's Compensa�ion insurance s�auld be pmvitled �o me.
� I am exempt untler Seciion: B. 8 V. C.
for Ihis reason: '
Da1e'. Owner.
I Do nereby cenify Iha� I am aware oi antl underslantl ��e requirements o� Cali�omia Heali� an0 Salely Cotle Sections 25505, 25533, and
25534 antl Ihat I or any fuiure bmlding occupanl willlwill noi (circle one) need lo compty wi�� said s�a�e codes and �he requiremenls tor a
peimil br cons�mclion or mo0ilicalion �rom ��e Air Oualiry Management DiSUic�. Fesidential con5�mciion apDlica�ions are exemp� �mm
these pmvisions.
�a�e: Applicant:
I he�eby cetldy Ihai I �ave reatl Ihis apP�icalion antl 5tateihat (he abovein�orma�ion is wrrecL I agree to comply wiih all city antl county
ortlinances antl stalelaw5relaiinglo Auitaing c s�mction antl �erebyaulhorizerepresenlalive50�Ihi5tiiyto enleruponihe a6ove�mwlioneA
pmpeny �ar inspeqcim�n purpases. _--���!��� �
Date: � r O'O (,9 � SignaNre', � �
oiiver's License oi so��a� se�����Y .�
i6ELe6 W�i�e—Boiltling�, Green—Cotle Enlorcemenl: Canary—AOPlicant: Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING P�RNIT PERM NO: B 053568
PERMIT NO: B 053568 PLAN CHECK NO; 032�3-91 S GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYFE; STR PURPOS�: ADD
St�B DESCRIPTION .: OOTING DA,�iAGB REPAZR SQ FT: 2, 000
CLAiM VAL'JE: 2,UOO.UO CALC—VAI,TJE; 2,OOO,UO GROJP OCC: �-3 /
COMXENTS: NO OTHER 5TRUCTliRAL WORK PERMZTTED
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7. O N I N G R E� J I R E N E N T S
sETaAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY 3JILDING ---------
FRNT: FT' ZN i�EAR: FT IN F�NT: Fi IN RnAR; FT IN
LEFT; FT IN RGHT; ;T IN LEFT: FT IN RGHT: rT IK
,PARKING Rn0• PRQV; PARCEL: 13944405 7.NE; REF NO:
FI�A1�NIiVG NGTES>
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D E V E L O P M E N T 5 E R V S C E S R E� G I R E?: E N T S
20NING APPROVED $Y .
BUILDING APFROVED BY :
DATE.
DATE:
APPLICATIOt� ISSUED 3Y: J,��� DATE: �(�£���
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LEGALIZATION;N F E E S U M M A k Y STRi]CTURAL S�GNEN'i:Y
BLDG PMT PLt7MBING ELECTRSC ,uECHANIC FIRE SM,iP1RES G�ADING
FERMIT 95.00 .50
SMiP /NOt�I'R :S
PI,AN 29.25
ISSUE FEE
HiTILUI,tiG—DIV—> PERMIT ISSliE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 45.50 0.00 29..�.5 74,75 74,75 .00
RfiVENi7E DIVISION TOTALS--> COL�ECTED; 74,'/S OVER/SHOkT: ,00
BLDG PMT Pi,UM3ZNG ELECiRIC MECHANIC FIRE S,uIP/TOT GRADING PLAN—CHECK
95.�� ,S� ��,�J
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T N D Z V I D J A L F E E B R E A FC D 0 W N
TYPE Q'fY D E S G R I P T I O N UNIT COST TOTAL COS2
S�R 2000 AiTER BY VALQE RESIDENTIAL NOZONn 1,00 2,Q00,00
END QF FEES
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CONSTRUCTION AND PLANNING � POO ,PA ' _
APPROVALS Permit# Date Inspector qppROVALS Permit# Date inspector
as'
1. Temporary Electrical Service oF pole j� 52. Pool & Equipment Location �--
2. Soil Pipe-Undrgrnd. •• ' 53. Steel Reinforcement v
3. Electrical Conduit Utility-Undrgrnd. '� 54. Forms
+ •s_
4. Electrical Conduit•Undrgrnd." r 55. Electrical Bonding �-
5. Steel Reinforcement �Q-ar �t/ 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. . 57. APPROVAL TO COVER�GUNITE
7. Footings �0-q� �' 58. Electrical Conduit-Undrgmd.
8. Foundation �r •L 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. �r' -� 60. Backwash �ines, P-Trap, O Undrgrnd. ,r�
10. Structural Floor System � ti !F �' 61. APPROVAL TO DECK ',�r
11. Proper[y Sewer Line & Hous� Connection �'� 62. Backwash & Receptor-Final �r'
12. Sewer Cap :,; ,�f 63. Heater & Vent-Final �)
13. Roof Drains "' �
�. �/ 64. Plumbing SYstem - Final "+��
14. Rough Plumbing �' l �•'% 65. Electrical-Final ��
15. Rough Electrical-Conduit � � 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough 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 Framing 73. Undergrnd.StorageTank OGas ❑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 MeterFinal � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � r Notes:
34. Final Heating & F,ir 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 pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ��Gf/ ���
48. FINAL PLANNING
49. Electric Release to Edison ,
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
LOT 22 TRACT YZH�
� �CS � �%�
>STA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 COBTA M6BA, CALIRORNIA
or Applicani to Fill In Complefely
COSTA MESA. CALIFORNIA
}C�NN.ETH W. KOLL ,,,,
FEE REC����ED
�/ JAN 1
1' FlNANCE D�PT.
CIiY QF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
6Y
NONE � Np,- ----- COSTA MESA. CALIFORNIA
"'__�_�'_"""__'__�__'_ FIRE
ZONE TYPE / GROUP
K. W. KOLLC.ONSSRl1CTInN C.O. APPROVED ___
OPLO7 2� X �20� I
6E OF
EXI ING BLDG.
98TBAC1( LINL IROM �
C!ry}gR O� 8T1I1C6T
_'__"'__ 1'�� 71
?DR�i4CJt9 SFRoc
WALL ,;___"_IRC
TIA AVENUE ZONING
ZONE I NO. OF I UB8 OF NEW j r� G
�� 3 PUNB � B�1ILDINO w J-
4M
O i•1 I• �- �L ESCPIPTION `� Z Z (� T Z�(
NO. OP BLDGB. ^�-�
EG . NOW ON LOT O q, p, NO.
VARD6 EVE6
APPROVED ALIOWED
� (C8M[R LINe BT.)
REAR YARD � S FRONT �S FT. IN
pI p
RIGfli V R. SIDE C7 FT. �1 IN
�F W�RK _ . n �
2 6TORIE6 i
RocK
FORMED
INGS WITH
PLAN #
� HHflBBV AGKNOWL6DOC TXAT 1 XAV6 RB�D THI9 A�PLIWTION
/�ND �Ai! TXAT TH8 ABW6 18 COItABCT AND AOAEE TO COM•
PLY WRH ALL CITY DIiOINAN�9 AND BTATE LAWp RCOULATINO
UILpING CONOi1iUGT10N.
8 NATURE OP yJ��} /v,���
PERM�7TEa fL�f
AUTHORIZEC AGENT
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g7
THe AMOUNT BHOWN UNOEP VALUATION �8 FOR TXE
PURP098 OR EBTABLIBXINO • vERMIT FEE ONLY.
VALLIATION /.�-
�7 PERMIT FEE $ �J n "
$ �% �/ � �� ^ PLAN GHECK $ .� 'S �
TOTAL FEE S /'S '�