HomeMy WebLinkAbout240 AMHERST RD - Building PermitsPNOJ�1CTpU0BE58 �)qO AM3ERST RD
OWNEfl'SNAME: O:IMER, KARL A
aooness: `0701 $EACH 3I�VD SP 115
AiJNTIVGTO� BEAC:-I,CA 92648
ANCHIENGINEEN: 7" 4 S: O— 3 H 6 S pEG.NO.:
pU0XE55:
uxiT:
UNIT:
PENMITTEE: SAIK GrlAY KRAT7. (71a)331-�072
aooness: 129? TIFFP.NY PL
TUSTIht CA 92680
LICENSEO CONTBACTON OECLAFpTION: I here�y afiirm Ihal I am IicenSeA under provisions o� Chap�er 9(commencing wiih Sec�ion
7W0� of Division 3 ot Ihe Business antl Prolesvons Cotle. antl my license is in lull larce antl eifect.
c�,ruc.: gg�a sTn.euc.:351498 cus� �
Oate: ��— Signalure: — �_ —
WOBKE S' COM NSpTION OELLARATION: I her¢by ' Iha� I have a cerli�ita�e o� Wnsenl �o Sel4insure Or a iCale o� WOrkers'
Compen5aiion Insurance, or a cer�ified copy lhereo� 1 ion 3800. Lab. C�.
POLICY NO.: E%P. OATE:
� COMPPNY:
❑ Ceriified copy is herebY �umis�ed. ❑ Cerli�ietl copy is filed wi�� Ihe ciry Builtling Oivision.
Oate'. FpplicanL
E%EMPTIONFHOMWOBNENS'COMPENSRTIONOECNflpTIUN: (ihissectionneeenot6ecomplele0iithepermitislorone�unOrea�31W)orless�.
I certily �hat in Ihe pedormance ol Ihe wark for which ��is permi� i�ssued. I shall no� employ any perso in any manner sa as Io become
subject Io �h Worke�s' Compen5ation �aws o� Cali�omia �
Dale: �L' Signatu - �/� ' �,
a
NOTICE: . afler making �his declara�ion. you sho ecome sublect �o the Workers' ComDensation provisions o� Ihe La�or
Code. you mus� Iorl�wiN complV wit� such pm ions or ihis permil shall 6e 4eeme0 remketl.
CONSTBUCTION LENOING AGENCY: I here�y allirm thai Ihere is a construclion lentling agency �ar the De�ormance af lhe work lor
which Ihis permil is issuetl (Section 3097. Civ. C�.
LENOEfl:
ADDflESS:
OWNEB BUILOEP oECLABRTION: I hereby aflirm that I am exemv� ��om Ihe Coniractors' State License Law for ihe following reason
(Section 703L5 Bu5ine55 an0 Pro�essional Code'. Any ci�y ol caun�y whic� require5 a permi� to cons�mct, aller, impmve, demolish, or
repair any simcNre, priar to iis issuance, also requires Ihe apDlicani lor such permil to lile a signed s�alemeni lhal he/s�e is licensetl
pursuam lo �he pmvisions of �he Comracmrs' Slaie License Law (Chap�er 9(commencing with Sec�ion 7�00) ol �ivision 3 of ��e Business
antl Pmfessions Cotle) or Ihai he/she is exempt there�mm and the basis lor �he alleged exempiion. Any violalion ol Seciion 7031.5 by
any apPlicam �ar a Dermii subjects �he applicanl �o a civil penally of no� more ihan �ive hundred tlollars (5500�.
I, as owner oi �he pwpetly or my employees with wages as �heir sole compensaiion, wi0 Uo Ihe wo�k, and Ihe
❑ stmcwre is nat imentled or olleretl for sale (Section 70a4. Business an0 Vmiessional Code: The Coniractors State License Law
tloes not appty to an owner of a pmpeny who builtls or impmves ihereon, and who does such work hlmself/herselt or tAmugh
his or her own emDloyees. pmvi0ed �hal such impmvemems are nol inlentle0 or olleretl br sale. If, however �he 6uil0ing or
' improvement is sold within one year ol completion, the owner will have �he bur0en of proving �e/she tlid no� Uuiltl or imDmve
�� lor ihe purpose of 5a1e1.
I, as owner ol Ihe pwpeny, am exclusively contracling wi�h licensed coniractors �o cons(mc� Ihe pmle�� (Section 1044, Business
❑ antl Pmfessions CoOe: The ConVaciors' Sta�e License Law tloes no� apDly Io an owner oi pwperty who builtls or impmves Ihereon
antl who comracis lor such pmiects with a contractor(s) Ilcense pursuantlo ihe Caniractors' State license Law�. I am aware
�hat pmoi oi Iheir Worker's Compensa�ion insurance s�oultl be O�ovided �o me.
� I am exempi under Sec�ion: B. 8 P. C.
lor Ihis reasOn:
Date: Ownec
I ao �ereby cenily �ha� I am aware af ana un0erstanU Ihe requirements ol Caldomia Heallh an� Sa�ety Code Sections 25505, 25533, antl
2553a and ih# I or any fuNre 6uilding occupanl will/witl not (circle one) neetl to compty wR� saitl sta�e cotles and ihe requiremenis for a
permil �ar consimclion or modilicalion irom Ihe Fu Ouality Management DislricL ReSitleniial constmclion applica�ions are exempt Imm
ihese provisions.
Date: ApplicanC
I here6y certilyt�a� I have reatl Ihis application antl 5tale�ha�ihe a�ove inlormaiion is correcL I agree b comply wiih all ciiy and coun�y
orainancesantlstalelaw5relalinglobuilUinqconSlmclionandhereb author¢erepre5enta�ive5of�hiscilyloenierupontheabove-men�ionetl
pmperiy far mspection purposes.
Oale'. � � � Signalure: _
onver's License o� �aai Security a�
164646 WM1i�e—Bmlamq; Green—Gotle Enlorcement; Canary—Applicanl; Pink—Revenue', Goltlenmd—Assessor
CITY O? CUSTA ,�iESA - BJII.DING PERNIT nERM NO; B 051'03
PERMIT NO: H U51634 PLAN CHECK NO: N GOVT; N^DPP: N
CUhSTRDCT?ON T.YPL; V-N PERMIT TYPE: STR PIii2PUSr.; Aii
JOB DESCRIPTION . T/OrF RER30F WITi1 CUMP. SHING�c.S SQ FT: 3,800
CLASM VALJE: 3,80U,00 (:ALC-VALUE: 3,800,00 C-ROJP OCC; R-3 /
CON.NENT5: SN,OKE UETEC'PUk ( S) RE�iIZRED IN TH£ �O,`�E
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7 O N I N G R E Q U I R E M E N i S
S c, T H A C K S
------------ MAIN'BUILllING ---------- --------- ACCESSORY BUILDING ---- ---
cRNT; r? IN REAR; F1' IN =RNT• FT rN REAR: FT ZN
LEcT; r'P II. xGHT; FZ' TN L�FT: FT ZN RGHT; F'i IN
PAitKiNG :tE{}� F+ROV: PARCEL; 14146115 ZNE: R�F h0;
PLA1VId3NG NtSTES>
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D E V E:t, " U P M E N T S E R �� Z C E S R E Q IJ I R c 1. E N�'i 5
20NING APPROVED HY DATc•
BUIiDING APP�tOVED BY ; DATE; n
APALICATION ZSSJSD BY; �"�-�_� DATc; `t� �0��'%
-N iF # 3E # iF i'r if 7'r if 3f if i�:� ti� #�: �lf� iE IF iE iF if X-3F�R 7Fiti!i:'3FiFit�TririF3�'it�iF�FiF i�r �"i�i�r �Y �'rif�3FiFi��& if ) ie 3f 3't ii iF �k� �If #�'3��'�'£�3FiZ� .k'��i�F£ ii iF
N�>Makif3F�ler.}`ie�3Eti'r3tM'�iEiF?fiE3F}:�ik3i#`�3hiE�le�3FY��%�M�}.i!-'i�)E1iiEiEiFidiF?f ±E}}ii�iFleiFiE+r.?'ri+iFX�klf?E?(�iii(-itY,!"iE?t#?i��F3l�±E��lra:y#3fY:�ii�-#�
LEGAL?ZATION,N F E E S U M M A� Y STRJCTURAT. SEGME�UT:Y
BiDG PM? PL'JN,BSNG ELECTRZC MECHANIC FIRE SNeTF/RES GRADiNG
PERMIT 63,00 ,50
SP,SP/i�ON-RES
PI.AN
ISSUE FEE -
BUILDiNG-DIV-> FERMYT ISSUE PLA�-CHECK TOiAL PAID DiJE
TUTALS----> 63,50' 0,00 O,QO 63,50 63.5U ,00
REVENliE T�SVSSION TOTALS--> COLi.ECTED: 63.50 OVLR/SHURT: ,00
BLDG A'flT PLUMBING EL:CTRIC MECHANIC `r'IR? SMIP/T01 GrZADTiVG PLAN-C3ECK
63,00 ,50
:K• I't fE 3E ai� �!e iE M fz 3E 1E iF if IP i�- 3i� if ,}' iF aF 7't K�li 3F iF if 1f aF *-0i 3f 1F 1f if u 1E'R'E 1f iE i(� i't?k 1i� le 3e 3F iF #:� iFlF iE=T?f jf if 1f ib �16 iE iE i� iE iF i4 i'v?E if iF 3i� ie;f iE �IF #ii i{ �t a.�
Z N D I V I D U A L r a n B R E A K D O W N
TYPE QTY D E S C R I P T.L Q N UNIT COST TOTAL COST
SFH 3f300 Rr.ROOF BY VAi,UE Rc.SZDENIAL �OZ0,3E
END OF FEES
i.00 3,800.00
t7L OODE4614-CRQ84d2` g�cs� .j,�l
DpTE: 04110'9t 'IiE: iZ:39
�
CONSTRUCTION AND PLANNING Pv�� & SPA
' APPROVALS Permit #' Date Inspector p�ppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrg�nd. 53. Steel Reinforcement
3. Electrical Conduit Utllity-Undrgrnd. 54. Forms
4. Electrical Conduit�Undr9rnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVEFi�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
S. Foundation ' 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgmd. , 60. Backwash �ines, P�Trap, O Undrgmd.
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 �
13. Roof Drains 64. Plumbing System � Final
14. Rough Plumbing . 65. Electrical-Final
15. Rough Electriral-Conduit 66. Solar SYstem-Final
16. Rough Electric W�ring ' 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Undergrou�d HYdro
22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing U l 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
37. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heatinq & Air Conditioning
35. Final Gas Pipe-7est
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 Irriga4ion
44. Landscape Irrigation System
45. Sound Attenuation JC'�?�( �
�
46. Handicap Regulations w�
47. FINAL STRUCTURE & BUILDING $'�? q'/ �w�i
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to 5outhern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�
/_ � . .. � . . . '
.y " , �
���J , '. � o �..:�1 �_ . . _ ,
COSTA MESA BUILDING DEPARTMENT r`��y�'� �l �
P. o. aoX 3,� FIN�,f�'CE DEPT.
COSTA MESA, CALIFORNIA , r� �n�T� ��f�i�
r.t . ,
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
Bl11LDING �0 Amherst Road - BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONL.Y
RECEIPT NO. pEFMIT NO.
owr,eR Amherst Develo ent Co. ' �
n t RECEIVEO BY C�ATE RECEIVE� OtTE ISSUEO
MAIL [`].9 F'i• l/tifl .Sti. /
A�DRE55 � 6 � —�l� �,��� i :t 1958
WSt.B Mesa �E�.Li 81159 BUILDING
CITY NO. qDDRE55
nRCH�recTCarlson & MiddlebPookic.
oR ENGINEER No. COSTA MESA. CALIFORNIA
Garden Grove FIRE
ADD_R1E'55q (� ZONE
Dl6e 6 U��Qi��vB� �nCi• CITY ���. �333 ZONE � pLpNs TYPE GROUP
CONTRACTOR NQ �/
AT_�SF'. �'7t'h St'•��'i0S'f.$ Mesa N�,Li 81159 BYPRa�E� DATE
�E�A� �or C CORRECTIONS
oesceiPnorv NO. ��J BLOCK TRACT ��SS
A.P. NO.
SIZE /_!� X �oo MO.OF eLOGS.
OF LOT W �IOW ON LOT none
USEOF none
E%ISTING BLDG.
SET6/CK LINE FROM
cENrEA or s1aEE1 SO� REAR VARD2O�
SIDEYARD RIGHTO' LEFT S,
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION
REPAIR MOVING DEMOlISH
BUILDING 1222 s ft Ro°oM`s
SIZE q 2 STORIES 1
E%TERIOR WALL SUCCO ROOF
GOVERING COVEftING Comp
BUELDFNGEW Single £amily residence
garage attached
Plan 720AR
I HEREBY B<KNOW�EOGE THnT 1 HwVE liEnO TNIS APPLICATION hNO
STATE THPT TME ABOVE I$ CORRECT 4NO AGREE TO COMPLV WITH 4LL
C�TY ORDINANCES PND ST L/�W$ REGULATING BUILOING CONSTRUC�
nON. VA W ATION
SIGNATURE OF � PERMIT FEE S 26�00
PERMITTEE ZO 7OZ�OO
1 PLAN CHECK S OO
_1' $
AUTHORIZEO AGENT Dine & Colegrove, TI1C• TOTAL FEE $ 39�00 `AM�
6-1
OB ADDRESS ',
GENERAL CONTRACTOR I}ike & COleglrove VALUE $ 10,702.00
�' No. . LOT 115 TRACT 2955 FIRE ZONE DFSCR[PTION OF WORK RES. & At. Garage
I & J - TwF V
PERMITS I$SUED
INSPECTION$ DATE gUBCONTRACTOR
DATE NUMBER
btown
Pinal Gas Test