HomeMy WebLinkAbout3348 ALABAMA CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us . // hAIM UMIVC, GVJ I H MCJH, l.H tlGo<O
PLUMBING PERMIT
Job Address: 3348 ALABAMA CI
Suite No
Vicinity:
Parcel Nunmber: 139581�2
Applicant: SAETUNG, KONGKA (CORPORATE EXPRESS)
Address: FOR:NETCLERK
Owner:
SO SAN FRANCISCO, CA
720 DUBUQUE AV
GROOTHUIS, ELLEN
Address 3348 ALABAMA CIR
COSTA MESA,GA
Contractor: ALAP ASSOCIATES GP
Address: 7229 VARNA AVE
Arch / Eng :
Address:
NORTH HOLLYVJOOD, CA
Phone: 888-330-1777
2ip: 94080
Phone:
Zip: 92626
Phone: 800-444-8865
Zip: 91605
License: 771905
Phone:
Zip:
Llcense:
SCOPE OF PERMIT
1 WATER HEATER REPLACEMENT.
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect pce,Soda,etc)
Dental Units
Dishwasher
Draiq Floor
Drain, Rainwater
Drain, Roof
Drinking Fountafn
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY .
Laundry Tub / Washer
Landscape Irrigation
P-Trap
Pressure Regulator
Process Pipi�g (per 10 ft)
Receptors
Septic Tank
SewerCapforDemo
Sewer Connect
Sewer Private Line
Shower
Sink, bar
Sink, commercial
Sink, Floor
Sink, kitchen
Sink, service/mop
Spa (private)
Spa (public)
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied�. t0126(2�00
I ssued: 10126/2000
ISSUED BY:
SumpPump
Swimming Pool
Trep Primer
Urinal
Vacuum Brkr Bkflow(7-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater/ vent
Water Piping Qnst or Rep.)
Water Re-pipe
Water Service
Water Sokener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 535.80
QTY
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatiCally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days. -
INSPECTIONS: In order for the work aUthorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required tnspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
24464fi (fi�00)
WORKERS' COMPENSA710N DECLARATION: �•
I hereby aHirm under penalry of perjury one oi ihe following declarations:
❑ I have and will maintain a certifiwte of consent to self-Insure lor workers' compensation, as provided for by section 3700 ot ihe Lebor Cotle, for ihe pertormance ot the
�''ork for which this Oermit is issue0.
„B" I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pedortnance of ihe work for which this pertnit is issued.
My workere' compensation Insurenca carrfar antl policy numbar are:
Carner: Policy Number:
(This sectian neetl not be completed il the permit is valuetl ef one hundred dallars ($100) or less.)
❑ I certify that in the pertormance of Ihe work for which this permit is issued„I shall not employ any person in any manner so as to bewme subject to the workere'
compensation laws ot Califomia, end e� e that it I shyuId Uecome subjact to t�e workers' compensation provisions ot Section 3700 ot Ihe Lebor Code, I shall forthwith
camply with ihese p o' ions. �/ /U' �,� (o -,�, O U �
� //
ApplicantSignaWre: �� Date:
WARNING FNLURE TO SECURE WORKERS' COMPENSATION COVERA6E IS UNLAWPUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND OOLL4RE ($100,000), IN AODITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�O60F LHE LABOR CADE, INTEFEST, AND ATTOPNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, antl my license is in full
forca end eHect. Lic. A Class k
cono-aaors signaw�e: ��'— oate: /D - �� 6–�,1 On0
CONSTRUCTION LENDING AGENCY:
❑ I hereby aNirm ihat there is a consiruction lentling agency for the pertormance of Ihe work for w�ich this permit is issuetl. (Sec. 3097, Civil Cotle).
Lentler's Name: Lentlefs Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aflirm Ihat untler penelry ot perjury thet I am E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business an0 Protessions
Code: Any ciry or counry which requires e permit to construct, elter, improve, tlemolish, or repair any simcture, pnor to its issuance, also requires the applicant for such pertnit
to file a signed stateman[ ihat he or she is licensed pursuant to the provisions oi the Coniractors License Lew (Chapter 9(commencing with Seclion 7000) oi Divislon 3 of ihe
Business antl Professions Code) or ihat he or she is exempt therefrom and iha basis for the alleged e:emption. Any violation of Section 7031.5 by any applicent for e permit
subjecis the applicant to a civil penalty oi not more than fiva hundred doilars ($500).):
❑ I, as owner ot ihe properry, or my empioyaes with wages as their sole compensa�ion, WILL DO THE WORK, and the stmcture is not intentletl or oHered for sale (Sec.
7044, Business end Professions Code: The Contractors License Law does not apply to an owner ot property who builds or improves thereon, and who does such work
himselt or herselt or ihrough his or her own employees, provided ihat such improvements are not intended or ottered for sale. If, however, Ihe building or improvement is
sold within one year of completioq Ihe owner-builder will heve the burden of proving that he or she did not build or improve tor purpose of sale.).
❑ 1, as owner of ihe properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions
Code: Tha contractors License Law tloes not appry to an owner of property who builds or improves thereon, and who comracts for such project with a cornrector(s)
license pursuant to ihe Comractors License Laws.).
❑ I em exempt untler sec.
SignaWra:
Owner ID venfied by tlnvers license. ❑ Ves ❑ No
Business and Professions Code tor this reason:
Venfication ot Ownarship by (type ot dwumem, i.e. - properry tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Dnvers License No.
Data:
Expires:
❑ I hereby cenih/ that no excavation five (5) or more faet in depih into which e person is required to descend, will be mede in connec�ion wiih work euthorized by �his
permit, and ihat no building sWCWre, scaflolding, falsework, or demolition or dismantling thereoi, will be more ihen thirty-six (3s) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Ttle 8, Calitomia Atlministrative Cotle).
❑ As owner-builtler, I will not employ enyone to do work which would require e permit from Ihe Division ot IndusMel Sefery, as notetl e6ove, unless such person has e
permit to do such work fmm the division.
Signature: Date:
Division of Industrial Safery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTAY: I cenity under penalry of perjury that I have read ihis apD���tion antl state that the infortnation given is
correct I agree to comply with flll state laws and ciry ordinances relating to building consWction, and emhonze representatives of the Ciry of Cwta Mesa to enter upon ihe
ebove-described property tor inspection puryoses. I agree not to acupy or ellow occupancy ot any building authorized by ihis permit until tinal inspection.
/J Signature Of Legal Owner(s) /0— a 6—aOle
6 OD
nNOr Authorized Applicant Date
COUE �, INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Fectory Fire Place
203 Final Sign
206 Final Demoli�ion
PeIE INTRIpLS
COUE� INSPECTIONTYPE
20fi Final Mechanical
20B Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuildingiOccupancy
PAT� UIIIDELfl
I � �
AOPlicant to till in all spaces except those within heavy boraer lines ana sign all appropriate tleclarations.
CITY OF,COSTA MESA
COfySTRi1�TION PERMIT
ProjectAd e�s a ama
Applicant's MailingAddress 863 N. Ba tav i a � f
owner'sName Varady Pno�e545�3444
Address ��mP
Arch/Eng. License No.
Address
Contracror'sNam�nme Comfort Eng. Phone63�-5340
Addresslmailingl R63 N Batavia Orange
City Licanse No.
LICENSED CONTHACTOR DECLARATION
I hereby aftirm that I am Iicensetl untle� p�ovision5 of Cha�te� 9(commencing
with section 7000) of Division 3 of the Business antl Professlons Cotle, antl
my license is in full forc�$a��+e�t. � 41 1 8 2 4
tJcense Class, Z�_ tt� lo.
ate �ure
,ORKERS' COMPENSATION DE LA ATION
I hereby atfirm that I have a certlFlcate of consent to Se} -insure or a certiticate
of Workers' comoensation Insurance, or a certitletl copy thereof (Sectlon
3aoo, �b. �.�p� 973060 � Repub 1 ic I ndem.
Policy No. Com ny
�ertifietlf�%� 1e/ O�PPnca�n�tY�
Date
EXEMPTION FROM WORKERS' COMPENSATION DE ARATION
(Thissettion neetl not be completetl if the permit is far o huntlretl ($100) or
Iess).
I certify that in the pertormance of the work tor whfch this permK is issuetl, I
snall nOt employ any person in any manne� so d5 to become subject to the
Workers' Compen5ation Laws o( Calitornia.
Da[e Si9nature
NOTICE: If, after makin9 this tleclaration, you shoultl become subj¢ct to the
Workers' Compensation provisions of the Labor Cotle, you must torthwith
comply with such p�ovisions �or this pe�mit Shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lentling agency for the performance
' of the work for which this permit is issuetl (SecHon 309� Civ. C.)
, l.entler's Name
' Lentler's Atltlress
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Gontractor's License law Por the
tollowinq reason (Section ]031.5 Business antl ProfeSsional Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair
--,ny structure, prlor to its issuance, also requires the applicant for such permit
�=N'i tile a si9netl statement that he/she is licensetl pursuant to the provisians of
��*^le Contractor'S License Law (Chapter 9(commendng with Saction 7000) ot
:'�Jivision 3 ot the Business antl Professions Cotle) or that he/she is exempt
there(rom antl the basis for the alle9etl exemption. Any violation ot Section
]031.5 by any applicant fOr a pe�mlt subjects the applicant to a civil
�enalty of not more than five nuntlretl tlollars ($500).
I, as owner ot the property or my employees with wages as their sole
compensation, will tlo the work, antl the� structure Is not intentletl or otferetl
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
LicenSe Law tloes not apply to an owner ot a property who builtls or imprOves
thereon, antl who'tloes such work himzelt/he�self or Ihrouqh his o� he� own
employees, provi0etl tnat such improvements are not intentletl or otferetl for
sale. If, however, the builtling or improvement i5 Soltl witnin one year ot com-
pletion, the owne� will have the bu�tlen ot proving he/she tlitl not builtl or iT-
�rove to� the purpo5e of sale).
I, as owner of ihe property, am exclusively cantracting with licensetl con-
tractors to mnstruct the project (Section 7044, Businezs and Professions Cotle:
The Contracto�'S License Law tloes not appty to an owne� of Oroperty who
builtls o� improvez the�eon, antl who cont�acts fo� such p�ojeGts wifh d con-
tractor(5) license pursuant to the Cont�actoYS LicenSe Law).
❑ I am exempt under Section B. & P. C. for this reason
Date Owner
I hereby certity that I ave reatl thls a
information is correct. a ree to comply
antl state laws relatin to b iltl' c nst
sentatives of this cit
inspettlon purpoze � � �
SigOd[ur¢
Drivers' License or 55 � �
state that the above
�tl county ortlinances
'eby autho ize repre
���. e�/��3+�$�
TYPE OF CONSTRUCTION IJ NEW U ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTH�
DESCRIPTION OF WORK
TVPE OF PERMIT LJ canolNG
❑ TENANT ❑ ELECTRICAL
❑ OTHER
PROJECT DESCRIPTION 5c1.FT.—
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCV.VDS. A(
I FOUNDATION LJ STRUCTURAL
PLVMBING ❑ MECHANICAL
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
rinking Fountains
loor Drains
loor Sinks
as Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspaction Fee
$25
Boiler
Duct - Under Ground
Duct - Structural
Duct - Vencilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ai oo,000 aTu � i oo,000 eT
Rainspection Fee � $25
CMFOB65-46rev.�/83 White-Builtling;Canary-Applicant;Pink-Accounting;Goltlenrotl-ASsessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteretion
luue Fee
FEES
A.P. �k
S Main Building:
E
T Front
ARear
C Right
SLeft
Ping. Ref. #
Parking Req./Provided
Use of Building:
Planning Notes:
Automatic Washer
(o Construction PoleSub.
' 2 Cooking Unit
D ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW �5-'
$ 3
$ 3
5798 I/16/85 2ua��
Zone
Accessory Building: Z
O
N
I
N
G
R
E
Park.Fees $ n
U
I
H
E
M
E
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors� 41 HP �i'/:-8
Inc.Solar �9�15 HP �16-
Microwave
Pole Light
Range
Standing Sections
5 KW Trash Compactor
� Hainspection Fee �$25 � �uue Fee
PUBLIC SERVICES REQUIREMENTS:
Zo�in9 APProved By
Application Approved By
Appliwtian Issued Bv
BUILDING PERMIT
PLAN CHECK
PLUMBING
PLAN CHECK
ELECTRICAL
PLAN CHECK
MECHANICAL
PLAN CHECK
FEES
$ 3
SUM ARY OF FEES � SO
$ ��VO SMIP $
$ PERMIT
$ � � . CiO ISSUANCE $
$ ENERGV P.C. $
$ �. j O GRADING $
$ MICROFILM $ �y.f
$ TOTAL FEE $ ` � "�
$
� CONSTRUCTION AND PLANNING . � - & SPA
. Date Inspector Date Inspector
�� APPROVALS Permit # APPROVALS Permit #
."7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
-5. Steel Reinforcement ' � 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, � Undrgrnd., Test
9: Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
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 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
19. Rough Heating & Air Conditioning 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. Storage Tank O Gas ❑ Oil
� 25. Roof Sheathing 74. Overhead Hydro . .
' 26. T-Bar Ceiling (Structural) & Monocbat 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 8rown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED
33. Final Electric (f(](,?5' C�/J 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 j�7�j L�
42. Backflow Preventer
43. Backflow Irrigation �
44. Landscape Irrigation System '
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �117��5 ���(/
48. Special Requirements Completed •
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�
Applicant to till in all soaces except those within neavy Oortler lines antl sign al1 aDCropriate eeelarations.
CITV OF (:OSTA MESA CONST UCTION PE MIT �
Project Address
Applicant's Mailing Address C
Owner's Name �J� /�An Phone� v�ss�
Address �L�(/�A,�'/
Arch/Eng. License No.
Address o
Convactor's Nam /^ �hone�,
Address (m� I'nnl ��I'! � t.t/%� '
City license No. _1� ��—_
LICENSEO CONTRACTOR DECLARATION
I hereby affirm that I am licensetl untler provisions of Cbarter 9(commencing
with seGtion ]000) of Diviiion 3 of the Busine55 antl Profes5ion5 Cotle, antl
my liGense is in f I r e antl eifect.
License /GI�, � L,�c e �
�ate p� 5'9 t �l
JORKE 5' C MPENSATION OECLARATION
1 hereby affirm that 1 have a certititate of consent to self-inzure or a certiticate
of Workers' Compensation �I`n�s7urance, or a cer4�fietl coOryY t�herqe,ot� (Section
3800, Lab. G.)2���.�0 /� Company—T-4LL`l//�//��_
Pnoli,c.y_ No. /�/✓
Cl Cer[i�etl m0Y is i�letl�with�th¢�c ty Id D� i5�p /p��/,,� ,/
EX EM PTI O-_-12�R K E RS aCO��CC� `'arib �l�
(This section need nat be com0letetl it the permit is for one huntlre0 ($300) or
less).
I r.ertify that in the performance ot the work (or which this permit is issuetl, 1
shall not employ any pCrson in any manner So as to b¢Come subject to the
Workers' Compensation Laws of Caliromia.
Date Signature
'NOTICE: If, after making this tleclaratlon, you spoultl become subject to the
Workers' Compensation provislons of fM1e Labor Cotle, you must forthwith
comply with such provi5ion5 or [hi5 permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 M1ereby affirm tha[ there is a tonstruGtion IentlinQ aqency tOr [h¢ performance
of the work for which this pe�mi[ is issu6tl ($ection 3097 Civ. CJ
Lentle�'s Name
Lentler'S Atltlress
OWNER BUIIOER OECLARHTiON
I hereDy affirm that I am exempt from tne Con�ractor'S License Law for the
following reason (Section �031.5 Business antl Professional Cotle: Any city or
county which requires a pe�mit to con5truct, alt¢�, improve, tlemolish or repai�
:Cny structure, prior to its issuance, also requires the applicant for sucn permit
��-�`.'.n fi�e a Signetl statement that he/she is licensetl Pursuant to the provisions ot
'�i`;""�e Contractor's License Law (Chap[er 9(commanctng with Section �000) of
�'iilivision 3 ot tne Business antl Professons Code) or that he/she is exempt
the�efrom antl the basis for the all¢getl exemption. Any violation of Section
7031.5 by any applicant (Or a pe�mit subjeGts'tM1e applicant to a civil
��nalty o! not more than (ive huntlretl tlollars ($900). �
LJ I, as owner of the property or my employee5 with wa9es as their sole
compensation, will tlo tne work, antl the structtlre is not intentletl or oiTerea
tor sale (Section 7044, Business and Professional Cotle: The Contractor's
License Law tloes not apo�Y to an owner of a proPerty who builtls or improves
thereon, antl who tloes such work himseif/hersClt or through his or her own
employees, proviaetl that such improvementz are not intentletl or otfered for
sdle. It, howeveq Ihe builtlingb� imOrovement i85oltl wlthin one yea� of com-
plelion, the owner will M1ave the burtlen of proving he/she tlitl not builtl or im-
prOve for the pur0ose of Sale). '
❑ 1, as owner of Ihe property, am exclusively Contracting with licensetl con-
tractorsto construct the Oroject (Sec[ion 7044, 8usine55 antl Professions Cotle:
The Contractor'S License Law <loes no[ apply to an owner of property wM10
builtls or improves thereon, antl who contratt5 for such projects with a mn-
tractor(s) license pursuant�to the Con[ractor's License Law). I am aware tbat
proo( ot their Worker's Compensation insurance shoultl be provitletl to me.
❑ I am exempt under Section — B. & P. C. tor this reason
Date
Lignature J,��_��
Drivers' License or 55
CMF 0865-46, rev. 10/84
Owner
nave reatl tliis application antl state that the above
a9ree m comply wirn a�� ciry anC county ortlinances
n nuiininn rnnct.uctinn. antl herebv authorize reo�e-
upon
TYPE OFCONSTRUCTION LJ NEW U A�D LI ALTERATION L�REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q p,#
DESCRIPTION OF WORK/USE OF BLDG.
S Main Building:
E
TVPE OF PERMIT GRA�ING OUNDATION STRUCTURAL T Front
❑ TENANT ❑ El_ECTRICAL PLVMBING ❑ MECHANICAL B Rear
❑ OTHER %�
C Right
PROJECT DESCRIPTION 5q. FT. oCCVaarvcv K
CONSTRUCTIONTVPE ' VALUATIONS S Left
20NE GRADING CU.YDS. ACRES Ping. Ref. #
pemarks: Planning Notes:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks .
Gas Service Outlets
Interceptors '
Kitchen Sink -
Lavamries
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. 61t. ICBO #
Heating System & Ducting '
❑ ai oo,000 sTu O i oo,000 eT
Heinspection Fee � $15
White - Builtling; Canary - APPlicant; Pink - Acwunting; Goltlenrotl - Assessor
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
$olar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteretion
Fire Dampers
Registers
luue Fee
FEES
$ 3
FEES
$ 3
Automatic Washen
Canstruction Pole Sub.
Cookin9 Unit
D ishwasher
Dryers ❑Gas ❑Elec
Fan '�
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garhage Disposal
Generator DO-5 KW [
Fee
5 KI
$15
9764 2/2I/86
2one
Accessory Building:
Parkiny Req./Provided
ELECTRICAL
� Trensformer ❑ 15-50 KW
❑ 50+KW
Merer LJup to 100 amps
Merer ❑over 100 amps
Sub Panel
Momrs DO-1 HP 01'/:-8
Inc.Solar �9-15 HP 016-75+
Microwave
Pole Light
Range
Sign
Standing Sections
Tresh Compactor
Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By . ��
:o;,. 1'�
FEES
$ 3
Z
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SUMMARY OF FEES
BUILDING PERMIT $ SMIP $ °
PIAN CHECK $ ' PERMIT
PLUMBING $ � �SSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRAOING $
PLAN CHECK 50% $ MICROFILM $ �
MECHANICAL 3 TOTAL FEE $
PLAN CHECK 25% $
' CONSTRUCTION AND PLANNING � _ & SPA
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
t 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-Undrgrnd. 55. Electrical Bonding -. �
5. Steel Reinforcement 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, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
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
73. Roof Drains 64. Plumbing System - Final
74. Rough'Plumbing 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
19. Rough Heating & Air Conditioning 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 & Tesi 72. Underground Flush
24. RoofFraming � 73. Undergrnd.StorageTank�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
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 }[y_y� «n
39. Water Service-Final
40. Gas Service-Final t��
41. Solar pomestic-Final rf�
42. Backflow Preventer �,�
43. Backflow Irrigation �
.,
44. Landscape Irrigation System
45. Sound Attenuation '�
46. Handicap Regulations � �
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison . �
� 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
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P!�OUPi'f i�GUT:Fasten �c roof •:;itn 3�c tolt
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CITY OF COST� D1ESA REQUESTeFOR OCCUPANCY
TRACT N0, , _� _ DATE�'�O
LQT NO, g% _
ADDRESS_ � ��C-�i-a���4�CG�/�-�f ��
G �-
The developer of- the above entitled tract desires to sell the
above set forth lot prior to the time that the tract has been
completed and its streets accepted by the City oi Costa Mesa .
Tlie undersigned, by e�ecuting this agreement, acknowledges
that (h�m-they) (w�e� were) advised
that this tract has not been given final inspection ttor has
it been accepted by the City oi Costa Mesa as having complied
with the conditions of approval which were imposed by the city
at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by
surety bond,
The undersigned agrees to indemnify and hold the city harmless
from any ciaim resulting in damage or personal injury to the
undersigned by reason of the aforementioned uncompleted condition.
� /i . .� �� _. o
er ap�fl/o��authorized
representa7�ive
� Lender
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vnrv��c HERMES DEVEIApMENT v"�� i-1—Oy
JOB ADDRE$$ �q(�p p�phama (]irrlA BUILDING PERMIT N0. 40122
LOT 42 TRACT
SUBCONTRACTOR
SWft. LINE
H
UNOERGROUN� � POWER �
ROUGH WIftING
TRENCHES FORMS STEEL REINF.
FLOOR SVSTEM
BONO BEAM � STEEL REINFORCE n
SHEATHING
FRAME ANO FLASHING
LATHING - IN
��
PLASTER, BROWN COA'
STRUCTl1RAL FINAL
HEATING, VENT., ftEFRIG. AND A.C., F AL ��q � / ,(J
PLUMBING, FINAL AND GAS TEST (i"/�/-'L
ELECTRIC, FINAL /.�y `
FINAL
REMENTS
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
n i �rnioOO1317� *** 152.25
PR 2 t 6y�Msf
APPLICATION FOR BUILDING PERMIT
For Applicant to Fi!l in Completely
ADDRESS �� " ♦ REC ��V DA`E REOEIVED ppTE ISJUED
BUILDING P� fn r /�
�l rG
PE �(� � O
OWNER Hermes Dev. Co. A•P• NO. '^�
MAIL BUILDING
ADDRESS 1104 E. 1 th Street /aDDRE55^�� -
CITV Santa Ana nTio.`' 547-7044 TRACT(9�L � LOT BLOCK
CANSTRUCTION W ADD A P
IENDER
BRANCH 1 0 Broadwa Ave.
OWNEF
ADDRESS D lforn'
� �A� $ a98o3
ARCHITECT K. Dorius No`� 6-ii64 SE
FIRE '�
ADDRESS 2 12 E. Coast Hw . Corona D. M. ZONE � TVPE GROUP X'
APPROVED
CONTRACTOR BV DATE
ADDRESS
TEL. ZON NO.OF USE OF NE �
PLANS �� BUILDING
CITV NO.
STATE CITV �'ARDSAPPROVED VARDSAPPROVEO
LIC. NO, '2 '� 6o LIC. NO. MAIN BUIIOING ACCESSORY BUILDING
SI2E NO.OF BLDGS. (FROM C/L STREET)'
OF LOT 1 OO X O NOW ON LOT O :�ONT FT. � G� FT.
USE OF
EXISTING BLDG. SI E V T. FT.
SI2E OF NO. OF
NEWBLDG. 2 S S�t'iROOMS STORIES2 L.SI�E FT. � FT.
EXTEFIOR WALL ROOF �mP�gog�
COVERING COVERING REAF FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISiANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
c u P# V-�S-(v APPFlOVED� —].()�b Q
APPROVED J _ y
i
I nereby acknowledge that I nave reatl this application antl state HOL� p,(CA1 •-
that the above information is correct and agree io comply with _
all laws regulating buildin8 consttuction, antl I shall not employ ��
any person in violation of the workman's compensation laws of
the State ot California, m
/� �
I hereby certify ffiat I am properly licensetl as a contrector untler / SQ. FT. � (J o
the State ot Calitornia Business and Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that such licenses are in tull force antl atfect, ar I THE PURP�E OF ESTABLISHING A PERMR FEE ONLV: m
am exempt trom the provisions of the State of California Business Q
VALUATION
antl Professions Cotl 7visioR 3 ter 9. N
PERMIT FEE $ �D� �Q
r �
Sienamre of �9 �,03 �, ^� m
Permittee PLAN CHECK $ , / � E
`o
Authorizatl ABant �y LL
TOTAL FEE $ ♦ O� �