HomeMy WebLinkAbout3330 ALABAMA CIR - Building PermitsApplicant to fill in all spaces except those within neavy bortler Iines antl sign all aOP�aP��ate tleclarations.
CITY OF•COSTA �M7ESA/� CO�/��$ TR C^TI,/O�^N/r�PERM�yI� RERMIT NO� . TRACT NO. �. LOT NO. UN1T NU.
�Qroject Address �„'���6�L)'� �� , IC.I� 1 ��� '
Applicant's Mailin9!�j �dqess /y
Own¢r's Name fGl �� V1� PFnna 73
Address
Arch/Eng. License No.
Address Q�]�]��
Contrecror'sNam Phonef,�+-ry.=.�-� �
Addresslmalling) 2 - __
City License No - \ )C�7�
LICENSED CONTRACTOR DECLARATION
I hereby attirm that 1 am licensetl untler provisions o/ Charter 9(commencinq �
with section 7000) of Division 3 of the Business antl Professions Cotle, antl
my license is in f W tprc antl effect. '
License Clas " e se o.
Date � Signature
WOHKER ' COMPENSATION DECLARATION
I M1ereby affi�m tM1al I have a certificate of consent [o self-insure o� a certifica[e
of Workers' Compensation Insurance, or a certifetl copy hereof (Secilon
`800, Lab. �Cj /%p�(
ilicy No. f" �✓/(,�f"�� Company �
�ertitjetl coPY is (iletlbwithrthehc tyMy�y,�Npm',{9� i}J' $io D/ ' /�
Date '���� APPlicant / / W�1� �^^�`�, 1�
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tnis section neetl not be completetl it the permit is tor one huntlretl ($300) or
less).
1 certify [hat in the performance oi the wo�k for which thi5 perm�t is issuetl, I
shall not employ any Oe�son in any manner so as to become subject to the
Workers' Compeniation Laws ot Califomia. ,
Da[e Si9nature
'NOTICE: If, after making thi5 tleclaratlon, you shoultl become Subj¢[t f0 the
Worker5' Compen5ation provisions of tne Labor Cotle, you must forthwith
comply'wilh such O�ovisions o� thi5 permit Shall be tleemetl revoked.
CONSTRUCTION LENDING AGENCV
� 1 herety affirm that tnere is a construc[ion lentling agency for the performante
\of the work �fov which this permit is issuetl (Section 3097 Civ. CJ
Lentler's Name
Lentler's Atltlress �
� OWNER BUIIDER bECLARATION ' "
I hereby affirm thal I am exempt from the Contractor's License Law for the
tollowinq reason (Settion �03L5 Business antl Professional Cotle: Any city or
County which requires a pe�mit to construct, alter, improve, tlemolish or repalr
any sVucture, prior to its issuance, also requires the applicant for such permit
to tile a signetl stafement that he/5M1e is licensetl pu�suant to the provi5ion5 of
the Contraclor's License Law (Chapter9 (commencin9 w�th Section ]000) ot
DiviSion 3 ot the Business antl Professions Cotle) or that ne/sne i5 exempt
.[herefrom and the basis tor the alleqetl exemption. Any violation of Section
]031.5 by any applicant for a permit zubjects tM1e apPlicant to a civil
enalty o� not more rnan five M1undretl tlollars ($500).
� I, as owner of the property or my employees with wa9es as their sole'
<ompensation, will tlo the work, antl the structure is not Intentletl or otteretl
for sale (Section 7044, Business and Professional Cotle: The Contrac[or's
License L�w Coes not apply to an owner oi a property who builtls or improves
the�eon, antl who tloes sucM1 ork himselt/herself or fhrough his or her own
em0�oyees, provltletl that such improvements are not intentl¢tl or offeretl f0�
sale. If, howeveq the builtlin9 or improvemenf is soltl within one year of com-
pletion,'tbe owner will have the burtlen of provinq he/she tlitl not builtl or im-
�rOve for the purpose ot sale). �
LI I, as owner of the property, am exclusivety contracting with licensetl con-
[�actors to wnstruct the project (Settion ]044, Busine55 antl Protession5 Cotle:
The Contractor's License Law does not apply to an owner of property wbo
builtls ar improves tltereon, antl who contracts fo� such projec[s with a con-
tratto�(5) license pursuant�to Ihe Con[ratto�4 License law). I am aware IM1at
proof of [heir Wo�ke�'S Gompensation insurance Shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C, tor thi5 reazon
oate
I hereby certity that I
IpfOlTdi1011 IS COfI2CL 1
antl sta[e laws relatin9 t
sentatives of this city
inzpection a
Signa[ure
Drivers' License or 55 �
Owner
have reatl this application antl state tnaf the above
a9�ee to comply with all city antl county o�tlinanGes
o buiitling mnsVuction, antl hereby autnorize revre-
to ef!ter upon the above-mentionetl prop,e�/ty�lt///qqq�
� �' Date_=�=9�
TYPE OF CONSTflUCTION LJ NEW LJ ADD LJ ALTERATION AJ REPAIR �
❑ CONVERSION ❑ DEMOLISH ❑ OTHER p�p.#
DESCRIPTION OF WORK/USE Of BLDG.
- S Main Building:
TVPE OF PERMIT GaaowG�-❑y FourvoanoN ❑ SraUC7URnL T Front
❑ TENANT ❑ ELECTRICAL�J PLUMBING ❑ MECHANICAL A Rear
❑ OTHER
PHOJECT DESCRIPTION 5�. FT. oCCUvarvCv C Right
K Left
CONSTRUCTIONTVPE VALUATION$ $
ZONE GRADING CU. VDS. ACRES p�ng. Ref. #
�—
Remarks: ' Planning Notes: �
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
GasService Outlets
Kitchen Sink
Lavatories
?-Trap
Roof Drains
Reinspection'Fee � $15
Boiler
Duct - Under Ground -
�uct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
00-100,000 BTU � 100,000 BT
Reinspanion Fee � $15
GMF 0865-46, rev. 10/84 White - Builtling: Canary - Appliwnt; Pink - Accountlng; Goltlenrotl - Assessor
ShOwers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinal
Water Closet �
Water Heater '
Water Service
Auro-Wash
laundry Trays
Issue� fee
Hood or Typel ❑
Canopy Type I I ❑ _
Refrigeration System
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteration
FireDampers -
Registers
laue Fee
Auromatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher �
Dryers ❑Gas ❑Elec
Fan
f.A.U.
Fixtures
Device Boxes '
Outlets
Switches
Garbage Disposal
Generator �0-5 KW C
$ 3
Fee
F
�f�,1,$ ' 6%27/86 �
b�l�K^.. '. . � . __
Zona
Accessory Building:
Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
5-15 KW
$15
Meter LJup to 100amps
Meter ❑over100amps
Sub'Panel '
Motors �0-1 HP 01 %- 8
IncSolar �9-15 HP �16-75+
Microwave
Pale Light
Range
Sign
Standing Sections
Trash Compactor
Issue Fee
3
5.00 TL'�
FEES
$ 3
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DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By Date
� Building Approved By - - � Date
�, Appliwtion Issued By �.^ nata _��
SUMMARV OF FEES .
BUILDING PERMIT $ SMIP $
PLAN CHECK $ � �PERMIT ,
PLUMBING § ISSUANCE $
PLAN CHECK 25% $ ' ENERGV P.C. 5
ELECTRICAL ' $ GRADING S
PLAN CHECK 50°,G $ MICRORLM � 5; ���n
MECHANICAL $ TOTAL FEE � $ "�
$ 3 PLAN CHECK 25% $ .
CflNSTRUCTION AND PLANNING POOL &
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
}. Temporary Electric8l 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. � y; 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, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. 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
76. Rough Elearic 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 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
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 rvoces: 7-�`I-86 C�F.F'r �4�N� LC,O lO:Y.$
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory Fireplace
LJ`
38. Final Plumbing rr; 7-/g-yG G�c�i
39. Wa[er Service-Final � '�
��
40. Gas Service-Final r:'
41. Solar pomestic-Final `-��
42. Backflow Preventer
-�3. Backflow Irrigation a,..,
�4. Landscape Irrigation System�"
;45. Sound Attenuation t''. .
�46. Handicap Regulations 7,•
•,
�7. FINAL STRUCTURE & BUILDING r#�: '.
�,y
�48. Special Requirements Completed .
49. Electric Release to Edison '=" �
�50. Gas Release to Southern California Gas Co
i51. CERTIFICATE OF OCCUPANCY �
No. Date ' •.•
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0, b /�
LOT �?O. �_
ADDRESS ��2� ��q,�is.q �/{-c��
DATE-1�%�
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 of Costa Mesa .
The undersiqned, by executing this agreement, acknowledges
that (�-they) (�r were) advised
that this tract has not been given final inspection nor has
it been accepted by the City of Costa Mesa as having complied
with the conditions of approval which were imposed by the city
at tne time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions
necessary for appYoval other than those conditions protected by-
surety bondo
The undersigned agrees to indemnify and hold the city harmless
from any claim zesulting in damage or personal injury to the
undersigned by reason of the aforementioned uncompleted condition.
ri� /i , n „
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Developer any!/
representat�ve
BY
Lender
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D-'- �'��101
i PA��O01295� *�� 152.25
APR 2 i-69�„sL
COSTA IVIESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fi!l in Completely
RECEI D �E RECEIV D OATE ISSUED
ADIDRE55 � � �"�'K '• � -��� ��/f
r�_ PERMIT NO.
OWNER H2rmes DeV. CO. A.P.NO. ^.nI
MAIL ADIDRIE 53��j v
ADDRESS 1104 E. 17th Street
cirv S�nta Ana nTio�47-7044 TRACTip6 �or s�ocK
CON5fRUCT�rvnited States Ndtionl Bank Ew noo a r
LENDER
BRANCH 190�Broadwa Avenue
OWNEfl
ADDRE55
j � � �y }' Q�ALU$
ARCHITECT TE USE 1L W�.GLU
�war,e�ssx K. Dorius rv `675-1164
FIRE �
ADDRE552%7.Z E. COdSt Hw . Corona D Z�NE TVPE GROUP
APPROVED
CONTRACTOR �Wr]eY BV DATE
ADDRESS
TEL. Z�N / NO.OF USE OF NEW
FLANS� BUILDING
CITV NO.
STATE CITV YARDSAPPROVED VARDSAPPROVED
uc. n,o. 252560 LI0. NO. MAIN BUI��ING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L S ET)
OF LOT ],OO X SO NOW ON LOT Q FRONT FT. FT.
USE OF r�
EXISTING BLDG. I E FT.
SIZE OF NO. OF
NEW BLDG. 2�-OO ROOMS J STORIES 2 L. SIDE D FT. FT.
EXTERIOR WAL ROOF COICl�iO Oi '\
COVERING UC O COVERING V✓OOC� REAR V FT. FT.
USE OF BUILDING AND WOFK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLOGS. ACCESS. BLDGS.
VAR.#` �/'� S�� D DATE
Resid nce w attached ara e c.u.P.� v cr APPROVED S-�v--(o
�Ro�Eo _ _6
I hereby acknoWletlge �r,a� I have reatl ffiis epplicetion a�a ��a�a OLD FOR SP.iCIAL REQUIREMENT
that the above information is correct antl agree to comply with
all laws regulating builtling construction, and I shall not employ
any person in violation of the workman's compansation laws ot
the State of California. —�- ,/
I hereby certity that I am properly licensed az e contractor untler ��OO SQ, FT,�OY
the State of California Business and Protessions Code, Divisicn 3, THE AMOUNTSHOWN UNDER VA�UATION IS FOFi
Chapter 9, antl that such Vicenses are in ful{ force entl eftect, or I THE PURPO6E OF ESTABLISHING A PEAMIT FEE ONLY:
am exempt from the provisions ot the State of Celitornia Business VALUATION
ana Professions Cotl ivisi n iapter 9. , pERM1T FEE $ �'��
Signat�re of �l�_ 1'/� ^ ^ S � �D ��
Permittae SU� y Q � PLAN CHECK $
Authorizetl ABePt TOTAL FEE $ �-/�J '�j�