HomeMy WebLinkAbout3178 BARBADOS PL - Building Permits� -P.VP��cant to fill In all spaces-extapt thosa within neavy Oortler Iinas antl sign all appro0riata tleclarotions.
� CITY OF COSTA MESA PERMIT NO: • TRACT NO. �,QT NO. � BLD .
� CON$TRUCTION PERMIT �/�3r,3 ' '
PrOj¢Ct A[Jd�e55 .� �% . TYPE OF CONSTRUCTION NEW � ADD ALTERATION , REPAIR —
AppliCanYS M2iling A�f@}5 ; " ' j .❑ CONVERSION ❑ DEMOLISH ,❑ OTHE,R ' p� p#
OWnEr'S NemB � ppo�e.4�t3-RGfFI, DESCRIPTION OF WORK 1 - - .
�i 5 Main Bu
Addrew ,�I%7S - h�J% -��� �%% ' _ . - ' : - E. .
' TVPE�OF.VERMIT , GRADING � FOVNDATION STRUCTURAL , T Front -
ArCh/Eng. LiCen52 NO. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' - B Rear .
Add�E55 � ❑ �OTHER ' ' ' ' %� '
- / - •- � C Ri9ht
Contractor'sNam �Phone'1�7'�� PROJECTDESCRIPTION 5�.F7. �- OCCVaANCv ' K
Address (mailing) Q� s� -�u aiD7 � CONSTRUCTION TVPE VALUATION $ ' g Left
�p S(�� ZONE GRADINGCU.VpS. ' ACRES PIOg.R¢f.#
City Licen<n Nn 4�
�ICENSED CONTRACTOR DECLARATION Remarkr. � . ' � P2�king Req.
1 hereby aftirm that I am Iicensetl untler provislons of Charter 9(commencing
wllh Sectlon J000) Of Divlslon 3 of the BuSiness antl Profe551on5 Cotle, antl
my Iicense Is In full forGe e f ec4 � , ��Cj�/'1/S
ClcenSe CI 5� � L Sa N�
Date ,��a% �Si9 at e
�.y:,ORKER ' COM ENSATION DECLAFATION .
-��nereby aftlrm that I hdve a bertiflcate of consent to selt-Insure or a tertifitate
E-;t Workers' Compensation Insurante, or a certifletl copy thareot (SetHon '
� '3800, Lab. C.) ' �
Pollcy No. Company
eCertifietl copy Is hereby furnishetl.
Certltiea copy is fileA with the city Builtling DIvlSion.
Oate Applicant
EXEMPTION FROM WORKE0.5' COMPENSATION DECLARATION
(Thls section neetl not be completetl if the permlt is for one huntlretl ($100) or (
Iess). •
1 certify fhaf in tne Performance of the work for�whlch thls perm�t I5 issuetl I
shall not employ any person in any manner so as to b come subj ct to [{�e
Worker C pe I n, Laws of Califomia. �
�ate Si9nature - �
NOTICE: 1 iafte making this tleclaration, you 5houltl become subjec to che
Workers' Compensation provislons.ot the Labor Cotle, you mus[ f tbwltn
comply with such provisions or this permit shall be deemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby a�tlrm that there is a construction lentling a9ency for the performance
of the wark tor whlch this permit is issued (Sectlon 3097 Civ. C.)
Lentler'S Name
L.entler'S Atltlress �
OWNER BUILOER DECLARATION
I hereby attirm that I am exampt from the Contractor'S License Law for the '
fo�lowlno reason f5ection 7031.5 Business antl Professional Code: Anv citv or
^,^'3retrom antl the Oasls for the allegetl exemption. Any violailon of Saction
'<'il31 5 by any appllcant lor a permit subjects tha apP���ant to a civil
'�`�enalty of mt more than flve huntlretl tlollars (y500).
� I, as ownar of tlte property or my employees with wages as their sole
compensatlon wlll tlo the work, antl che structure it not intentletl or offeretl
for sale (Secflon 7044, Business antl Prote55ional Cotle: Tha Contractor'S
License Law tloes not aDVly to an owner oi a property who bulltls or improves
thereon, antl who tloes such work himself/hersolf or throu9h hls or her own
employees, provltletl tnat such Improvements ara not intantletl or offeretl for
ule. If, howaver, tha bulltlln9 or improvement is soltl withln one year of com-
pletlon, Ihe owner wlll have the burtlen of proving he/sha tlltl not bulltl or Im-
�tove for the purposa of sale).
I, as owner of the property, am ex<1u51vely contracting wlth Ilcensatl con-
tractor5td construct tha project (Section 7044, Businets antl Professlonz Cotle:
The Contractor'S Llcense Law doe5 nOt apply t0 an ownar of property wh0
builtls or Improves the�eon, antl wM10 contracts for such projects wit� a con-
tractol(5)Ilcenie pursuantto the Contractor'S Llcense lawl.
❑ I am exempt untler Sectlon B. & P. C. for this reason
Date Ownar
I herabv cartl7v that I have reaE this aoolicatlon antl state that tne above
Sink
Preventer
Irrigation
Dishwasher� ; �/ (
Drinking Founteins
Floor Drains
Floor Sinks� �
Gas Service :Outlets
Interceptors
Kitchen Sink � '
P—Trap -
Roof Drains -
Reinspection Fea $25
Boiler �
Duct - Under Ground
Duct � Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fect. Bit. ICBO #
Heating System & Ducting
❑ 0100,000 BTU -� 100,000 BT
sentatives of tnls clty to enter, upon tna above-mentlone0 p opert tor
Inspectlon purpo5e . 2/ Date � , ��
Slgnature -
Orlvers' License or 55 � ReinspeCtion F9e
CMF 0865-46 rav. 12/83 Whlte - Builtlin9: Canary - Applicant Pink - Accounting; Goltlenrotl - Assessor
$25
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimmin9 Pool w/Spa
Urinal —
Water Closet
Water Heater •
Water Service
Isue Fea
FEES
Hood or Typel ❑ � '
Canopy , Type 11 ❑ , �
Refrigeration System ,
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteration
Issua Fee $ 3
Use of Building�.
Planning Notes:
ing:
. . �Z�d �11����821
,� .
, Zone
� � Accessory Buildin9:
�
AUtOTBtIC W85�IEf:`
Construction Pole Sub.
Cookin9 Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fari' "
F.A. U.
Fixcures
Device Bozes �
Outlets
Switches
Garbage Dispoul
Generator �0.5 KW �5-�
. .. �
, 5n�. . Tl�
_ � , '
Park.Fees $ � - -
ELECTRICAL '
� Transformer ❑ 15-50 KW
� ❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps .
Sub Panel
MotorsO41 HPO1Y�-8
Inc.Solar �9-15 HP 076-15+
'� Microwave .
Pole Light '
Range
Standing Sections
Kti' Trash Compactor
� Reinspection Fee �$25 � �uue Fee
PUBLIC SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved ey �
$ 3
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SUMMARV OF FEES '
BUILDING PERMIT $ SMIP $ -
PLAN CHECK $ PEFMIT '
PLUMBING $ � ��UANCE $
PLAN CHECK 25% $ ENERGV P.C. $
GRADING $ � �
ELECTRICAL ' $
PLAN CHECK 50% $ MICROFILM $ _�
MECHANICAL $ TOTALFEE $ �
PLANCHECK 25% •$ _ ., _ , ,
CONSTRUCTION AND PLANNING - . POO. ,PA . -
APPROVALS Permit# Z�. �1i Date Inspector p�ppROVALS � Permit# � • Date'� Inspector, _
� 1. Temporary Electrical Service or Pole - 52, Pool & Equipment Location . _
2. Soil Pipe-Undrgrnd. • � , . 53. Steel Reinforcement �
� 3. Electrical Conduit Utility-Undrgmd. - , 54. Forms � .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' -
5. Steel Rei,nforcement �• ' � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings � � . . 58. Electrical Conduit-Undrgrnd.
8. Foundation ' '_ � 59. Gas Pipe, 0 Undrgrrid., Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Co"nnection 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 66.1 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
19. �Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace � APPROVALS Permit # �
27. Ducts, in Structure ' ;� 70. Underground Hydro �
22. �Ducts, Ventilating . ' � 71. Product Piping 0 Gas, ❑ Oil
� 23. Gas Pipe-Rough & Test : � � 72. Underground Flush .
24. Roof Framing� � 73.� Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � � 74. Overhead Hydro '
2�. 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 i
31. Plaster Brown Coat 79. FINAL INSPECT�ON
32. Electrical Power Meter-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 , ' t� /��dy G�p ' �
39. Water Service-Final �
40. Gas Service-Final � , "
41. Solar pomestic-Final � '
42. Backflow Predenter ' . . � �
43. Backflow Irrigation �
44. �Landscape Irrigation System � ' �
45. Sound Attenuation�, � , ' . .
46. Handicap Regulations . � . � �
47. FINALSTRUCTURE & BUILDING ,
48. Special Requirements Completed . �
49. Electria Release to Edison � � � - � � - �
i
50. Gas Release to Southem California Gas Co i '• �
51. CERTIFICATEOF OCCUPANCY ; -
No. ' Date ' . � .. _. . . , � .
•; .
0
C08TA MESA BUILDING DEPARTMENT
P. 0. BOX 317
COSTA MESA CAIIFORNIA �[[
LL
C.L. OF STREET �
" _��PROP L�NE
I------- T--
I 10 FT. FOR 60 FT. STREET
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�_ C.L. OF STREET� � _�
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES
�
.I
I 83s� I
FOR APPLICANT TO F�.L IN
BUILDING
/i �
Mail A d�resI�� � � � � 'J �""''u '�'�'L`��
City ��`�/ �'�� _ _ Ph. No.�Q �
Contractdr "Y"�`-�"� r Ph. No,�� l
Address { �
City Lic. No. Sta Lic. No.
Size of Lot Cd !,�f �s �-^ AP No. - '�
Setbacks: C/L Street . 7 � � Reqf
// a
Side Yard - Right—�� D �- Lef �� 0
Type of Fence � (, � �"'"u'�'
7�1
,�t�`C-t+-Tr. -�ek' l F� p f;� � �8 � �
I hereby ackno lw edge�hat I ha�ve read liis application and state
that the above is correct and agree to comply with all City Ord-
I FOR OFFICE USE ONLY I
IReceived by Date Received
I� �-�-7"✓ / . S~-,5`
I VALUATION t��
e mit Fee
� � �d / ' c� Plan Check
I • I TOTAL FEE
USE REVERSE SIDE FOR DETAILS
0
�
owxEx AAIDERSON
Barbados Place
DATE
AP. No. �" L�T TRACT FIRE ZONE DESCRIPTION OF WORK Concrete Block £ence
GROIIP TYPE ZONE PLAN NO. f�'iF�9
INSPECTIONS DATE SUBCONTRACTOR � PERMITSISSUED
I DATE I NUMBEF
coat
Pinal
�.
�., ,- �-
COSTA
.�o��
MESA BUILDING DEPARTMENT
P. O. BO% 31]
COSTA MESA, CALIFORNIA
FEE REC�''/ED s�
�c�.�� , i �� r 1-� �.
FINANCE'�DEPT.
cirv oF cosra mEsa
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 3,7& ;�aruados �venize BUILDWG
ADDRE55 1
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
FECEIPT NO. PEf��
OWNER Ci�,-•�man an r9 ('.n Z1-
RECEIVED BY DFTE RECEIVEO DRTE ISSVED
ADDRE55 ,S, _ �' MAY �
TEL. BUILDING
QTY T.n. iina C r �� NO. ADDRESS
ARCHITECT LIC.
oR er�GiNeeR ���J1�.1131ttS rvo. COSTA MESA. CALIFORNIA
FIRE
A�DRE55 ZONE
11T�1 Y� T CITV LIC. �ONE 1,//� pL1N5 TYPE / GROUF �
CONTRA�TORmE' 1`c�nd Landr � NO. / � f 1'-'i /'� v
ri
TEL. APPROV O
ADDRESSi. u1'urol Po (`Ctl i P NO. BV DATE
�E�A� �or " q i CORRECTIONS
oeSCr+iPnOn NO. �n BLOCK TRACT �,
A.P. NO.
SIZE � �OW ON LOTS YZOYlO
OF LOT �11',(i(�
USE OF
E%ISTING BLDG.
SETBACK LINE FPOM L 1
cervrEn oF Sin[[r ti() t REAR YARD2
'1 I
SIDE YAFD RIGHT y � LEFT yZ �
DESCRIPTION OF WORK
NEw ALTERATION qDOITION
REPAiR MOVING DEMOLISH
SZEDING 1��� ROOMS � STORIES �
EXTERIOR WALL ROOF
COVERING (�.( COVERING Rock
USE OF NEW
BUILDING ' (*�P, �a]ii]_ZTJ D�relli
in n
I HEflEBY nCNNOWLE�GE THAT I HPVE FERO THIS PPLICnTION FNO ,
STATE THRT iXE RBOVE IS ORRECT nN0 AGFEE TO OMPLY WITH l��L
CITY OROINANCES 5 E W REGULF ING DING CONSTRUC�
TION. VA W ATION
SIGNATURE O ,� // / PERMIT FEE S �U� OO
PERMITTEE SG�� l
$/D �O �% J PLAN CHECK $ y��OO
AUTHORIZEO AGENT / / TOTAL FEE $ 39 � �� v
OWNER SUA4°IE1iLAND LAND CO. DATE 5—'3—�'j
JOB ADDRFSS 317� Barbados Avenue BUILDING PERMIT NO. #�t9(H �
GENERAL CONTRACTOR (lumar Rlrlr_ VALUE S 10_909_00 �
AP. No. LOT 3$ TRACT
GROUP I �c J TYPE
INSPECTION$
Trcnches , Forms Stecl 1
Floor System �
S[ecl Reinforce Chimney Re-Rod
Bond Beam
Framc aad Plashing /
Lathing, In Out �
Plas[cr, brown wat
Test
FII2E ZONE
DATE
DESCRIPTION OF WORK
PLAN NO.
SUBCONTRAGTOR I DATE
PERMITSISSUED
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