HomeMy WebLinkAbout2014 BALTRA PL - Building Permits . PROJECT ADDRESS: 2014 BALTRA PL iyp UNIT: CITY OF COSTA MESA BUILDING PERMIT PERM NO: B 044724 •
OWNER'BNAME:-HARRY & ANN KLITZNER
ADORESS: 2014 BALTRA PL PERMIT NO: B 044724 PLAN CHECK NO: 01217-89 S GOVT: N SUPP : N
COSTA MESA .
CA 92626 • • • CONSTRUCTION TYPE: V--N PERMIT TYPE: STR - • PURPOSE: NEW
ICH/ENGINEER: • REG.ND.: JOB DESCRIPTION : 75 LIN FT OF 6FT H MASONRY WALL SQ FT: '75 •
ADDRESS: UNIT: •
CLAIM VALUE: CALC--VALUE: 1, 500. 00 GROUP OCC: R-3 /
PERMITTEE:HARRY KLITZNER ( 714 ) 546-5976
ADDRESS: 2014 BALTRA PL 0 • COMMENTS:
COSTA MESA CA 92626 ********************>FO6*a6a6****x- -OkN-***D6*x-*at-->E***OE06*+e*a6******ad*a<-*K*a6*a6#***x*.dEar-x-dt***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY LIC.: STATE UC.: CLASS: •
Date: signature: MAIN BUILDING ACCESSORY BUILDING -
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 25 FT IN REAR: FT 1 IN FRNT: FT IN REAR: FT LN
Compensation Insurance,or a certified copy thereof(Section 3800, Lab.C). LEFT: - FT 1 IN RGHT : 11 FT IN LEFT: FT IN RGHT: FT ' IN -
'OUCY NO.: • EXP.DATE:
COMPANY: • PARKING REQUIRED : PARKING PROVIDED : PARCEL : 13945213 ZONE: R1
❑ Certified copy is hereby furnished. 0 Certified copy isfiled with the city Building Division. PLANNING NOTES> 6 FT HIGH BLOCK WALL ADJ TO- RES AND ON LEFT SIDE PL. •
. > PARTY WALL AGREEMENT •HAS BEEN SIGNED
Date: Applicant: t ******36*********************************************)E*************** j6*****!E***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:,(This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N ,T' S •
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become 1 /J
subject to the Workers'Compensation Laws of California -; ZONING APPROVED BY C P iefe1/% . . , DATE: (eik"t-7 kr
Date: Signature' BUILDING APPROVED BY / / 8"'9
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor : • „lie j DATE: ��30/ /
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. /,� A
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ►C �� A .,(�� DATE: la/30
which this permit is issued(Section 3097,Civ.C). ******#***************” a '* " ' •**********'iF;� �{�-�- **
LENDER: - • *******************************************IBI*************************' ********* •
ADDRESS: - - LEGALIZATION:N - - F E 'E ' S U M• M A R Y • - - STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 35 . 00 • . 50
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed '
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 22 . 75 - SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by '
any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($500). ISSUE FEE ••
'I, as owner of the property or my employees with wages as their sole bompensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN- CHECK TOTAL PAID DUE •
❑ tructure is not intended or offered for sale(section 7044,Business and Professional Code: The Contractors'State License Law TOTALS-----> , 35 . 50 0 . 00 22 . 75 58 . 25 58 . 25 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended orxgl(ered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 58 . 25 OVER/SHORT: , 00 '
improvement is sold within one year of completion,the owner will haye.theborden of proving he/she did not build or improve
for the purpose of sale). _ BLDG PMT PLUMBING ELECTRIC MECHANIC -FIRE SMIP/TOT GRADING PLAN-CHECK
•I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 3 5 ' 0 0 5 0 22 . 75
)] and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. . I N D I V I D U A L ' • F E E B R E A K D O W N •
❑ I am exempt under Section: B.8 P.C. y •
for this reason: 'TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: ••
SFR 75 RES CONCRETE BLOCK WALL 20 . 00 1 , 500 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.'25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes andthe requirements for a -
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. '
Date: Applicant:
I hereby certify that I have read this application and state that the move information is correct.I agree to comply with all city and county -
ordinances and state laws relating to building construction and her• authorize esentatives of this ity to enter upon the above-mentioned
property for inspection purposes.
'o/$y _ .
Date: Signature: ��- �.:! • /A1. _- _
Driver's License or Social Security x: I ; _ -,• .
1641-46 White—Building;Green—Code Enforcement;Canary—App scant;Pink—Revenue;Goldenrod—Assessor — - '
CON yON AND PLANNING POuL & SPA -
C.
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
,5
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 - f
5, Steel Reinforcement, 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. �) 57. APPROVAL TO COVER-GUNITE -
7. Footings i�y3'�1 G\" 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test o
9. Water Pi a-Undr rnd. 60. Backwash Lines, P-Trap, 0 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 "-1
14. Rough Plumbing 65. Electrical-Final 1
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 - I 71. Product Piping O Gas 0 Oil
23. Gas Pipe:Rough & Test - - , 72. Underground Flush •
24. Roof Framing - 73: Undergrnd.Storage-Tank 0 Gas 0 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 ,:1 �•-' ' 78. FIRE PREV. FINAL '
30. Drywall-Nailing -- -- - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' -79. FINAL INSPECTION
32. Electrical Power Meter-Final i• - 80. FOOD CERTIFICATE ISSUED
- 33. Final Electric L- r•i t1- Notes: /
. 34. Final Heating & Air Conditioning - _ . /Z.---1 9
35. Final Gas Pipe-Test " ' -
• 2
36. Hood or Canopy , -
5' 9-20- C - ,!4� ,d 4-0 re cell
37. Final Factory Fireplace - - ht .. e t C _ 6 Wa
•38. Final Plumbing _ t k.
39.-Water Service-Final ' • •
,40. Gas Service-Final - •
441, Solar Domestic-Final -• •
42. Backflow Preventer .
43. Backflow Irrigation .
-
:44. Landscape Irrigation System ' - - ._
45. Sound Attenuation -
46. Handicap Regulations' • -
47. FINAL STRUCTURE & BUILDING Gttc(. .441-
48. FINAL PLANNING -
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY -
No. Date
I
� ' MOVED �F
1 41
•d' OF COSTA MESA ,�jfi2
Pennit # 72� PLANNING DEPT.
APPROVED P�
THIS NUMBER MUST ACCOMPANY ECT To BLDG. DEPT. REG
1
-
City of Costa
Mesa Building Dept. ALL INSPECTION REQUESTS 1 Int DATF 10•3p •R
BY - i1/ L32 DATEI9 DII OF PLANNING
Wd�y�1
THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE .
• NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. "��•
y
TH ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF SIA} '
PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO DE A t :,,y I I
THE PROVISIONS OF THIS CODE OPERMIT' PERMR FOR, OR AN APPROVAL OF, ANY rf RESUMING TO GOF ANY IVE
ADDITIONS DELETIONS, OR CORPECTIONS SHALLF
AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Of THIS Bt APPROVED BY THE PLAN?IIiVG DEPARTMENT
CODE SHALL BE VAUD, EXCEPT IN SO FAR AS THE WORK OR USE A
WHICH IT AUTHORIZES IS LAWFUL, `7/
i I
THE ISSUANCE OF APE%.:11T BASED UPON PLANS AND PI
SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL
FROM THEREAFTER REQUIRING THE CORRECTION CF ERRORS IN
SAID PLANS AND SPECIFICATIONS CR FROM PREVUITING
BUILDING OFERATIONS BEING CARRIED ON THEREUNDER WHEN 1
IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF
THE CITY. _
•
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*ESSENCE *ts1NE*Ct -,k9C R [enove *ESSEucs
• 010/S 0 VI 070/54
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- _ - STREET S - -
S .
TYPICAL 6" CONCRETE BLOCK FENCE
a
Cement Coping Optional �—
Channel Block With 1.3/8* II' 1 I I GENERAL— NOTES
Horizontal Top of all iN I I I
Fences MORTAR; One Part Plastic Cement, and
• C Three Ports Sand
For Fences 5'or Leo GROUT: One Part Cement Thee and
Vert.Bars 3/8"�at 0'.0"O.C. %d� o I I I One Hal} Parts hand
e = - im COPING: One Port Cement, Three
�q� a • Parts Sand
For Fences Higher Than W NY , a CONCRETE: Well Mixed 1'2-1/2: 3-1/2
Vert.Ban 3/8"c6 at 32"O.C. W
a z Mat. of 7-1/2 Gallons of
. Fill Cells Solid With Grout �i > Z . I" Water Per Sack of Cement
Where Steel Occurs > - -
Reinforcing Steel Shall • %N 2 'o GROUT MAY BE POURED FROM THE TOP
Conform to Sec.A•15.38 I W O + . OCCUgSFENCE IN CELLS WHERE STEEL
A.S.T.M. IN 2 ~ I I CELLS AND AREAS OF HORIZONTAL REIN
All Steel t0 be Lapped W n _ FORCEMENT SHALL BE CLEAR,CLEAN&
� a FREE OF ALL MORTAR DEBRIS,ETC.
2e"or to Code
I
. NATURAL GRADE i
•
� '1 ,,
s;tel!// •YN Y Ni , I'.iYir
a - _
TWO 3/8"0 BARS 'ai[SSI t. r . • •.. .
CONTINUOUS TOP
&BOTTOM WIDTH TO 161 0 C. MAX.
SEE CHART ' . b
.HOSLST EEL MUST BE TIED IN BELOW , OE PTH OF EARTHTCOTH .
PLACE AT TIME OF TRENCH r 1 I D THE HE IGTH OF FENCE •
INSPECTION. (. OW BOTTOM OF FOOTING. •
3' 7y7�
1_114_1 lo" 2' _- -1 --. SCALE: 1/2" a e .
r
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6 5 , 4 • 31
• WIDTH 14" 14" 1 ..I2".•..: . .: . 12" ._
THICKNESS 10" 10" 8" 8 "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . .20" 16" . . 12"
SPACING OF EARTHTOOTH. 12 14' 16' . 16'
_ _ OWNERS NAME:
City of Costa Mesa, California PJOB ERMIT NUMDRESS:
' • Building Department SIGNATURE. — _ _ -- _- _ -
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STREET A
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STREET 4 •
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PLANNING DEPT.
SUBJECT TO BLDG. DEPT. REG.
LW, .. DATE
DREcrol or PLANNING
•
TYPICAL 611 CONCRETE BLOCK FENCE
Cement Coping Optional '& • • • • GENERAL- NOTES
Channel Block With 1.3/80 II Nil t
Fancret Dotal Top of all N I I MORTAR: One Port Plastic Cement, and'
• Three Ports Sand,
1Q GROUT: One Port Cement Three and
FmFentea5'orLaa ! ! One Half Ports Stand
Ven.Ban 3/8-Oat 4'-0"O.C. ?d o I COPING: One Port Cement, Three
�a atb. Parts Sand
For yen.Ban
3/8"0 atgher han32" ' iln u CONCRETE: Well Mixed 1:2-I/2:3-I/2
Vert.Ban 3/8"Qat 32"O.C. > m
of 7-I/2 Gallons of
. Fill Cells Solid With Grout I` ^c x
> z -" Max .Water.Per Sack of Cement
Where Steel Occurs >
Reinforcing Steel Shall 1 'o• I it.
GROUT MAY BE POURED FROM THE TOP
1 OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A•l5.39 W O s OCCURS.
AS.T,M. �IIZ ~ ( ICELLS AND AREAS OF HORIZONTAL REIN.
All Steal to be Lapped la W FORCEMENT SHALL BE CLEAR,CLEAN&
21"or to Coda �� I FREE OF ALL MORTAR DEBRIS,ETC.
NATURAL GRADE =1! I.i . �r
tel►//`\ iii I iG �'� �i
%` O'.(. ' f Ir.:Id.
zo
, DAM
TWO 3/11"m BARS 'tZ� s , • • g� .i
CONTINUOUS TOP II
&BOTTOM - y.1 I-...---WIDTHTO I61 0 C. MAX.
SEE CHART : ., e,,_
.NOWZSTEEL MUST BE TIED IN BELOW i. I DE PTH OF EARTHTCOTH
PLACE ATI TIME OF TRENCH .,: Ct I L,-. ... 3 0W EBOT TOM OF HEIGTH i FOOTING i
INSPECTION.
I . 10" 1 � SCALE: 1/2" • 1'
FOOTING REQUIREMENTS CHART _
WALL HEIGHT 6 5 1 4 • L
WIDTH 14" 14" 1 •_12°..,_, , . 12" '
THICKNESS 10" 10" 8" 8 "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . .20" 16" . , . X12" •
.• SPACING OF EARTHTOOTH. . 12' 14' 16'. . . . . 16'
OWNERS NAME: _.
City of Costa Mesa, California JOB PERMIT DRESSER'
Building Department SIGNATURE. _
...t.a .......
PARTYWALL ACIPME T
Y
THIS AGREE/M/S, made and enteredin this QG 47 day of •
/ n
i , gm, by and between A22y k(-1 72,\/(L
hereinafter referred to as •I.AAID WNER•, and a Let KG
hereinafter referred to as •ADJACENT PR PEA.1 WNER'.
It is hereby agreed that a party wall will be constructed on the
property line between 2O/1 34 2o/V' )9L7744 nL
(Address of Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map
recorded in Bode " , Page_ of Miscellaneous Maps, in the office of the
County Recorder of said County. The party wall shall be permitted to encroach
IN WITNESS W ERZOF, the parties have entered into this Agre€nent :he
day and year first above written.
LAND • mr AD7 CENT PROPERTY WNER
4/1
•
(Signa �"e (Sign tire)
/7A '9 %v. AI[., fz,✓E' /2 Lute
Name ( •-• or Priv =•) �.�- � Name (Typed or �Pr�inted)
020/1/ ea/irk C%f'' dost( New L4 _ 02a /PP FQ/7ra 6/ desk? *so
(Address) %c�6�6 / (Address) {7
. • I 9 I is fir, RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 4J MAR 2 2 1963P.O.BOX 317 COSTA MESA,CALIFORNIA �a\.FINANCE DEPT.
For Applicant to Fill In Completely APPLICATION tFOR PERMIT MESA
TYPE OR PRINT ID r G/, BUILDING
For Office Use Only
BUILDING -/� T�
ADDRESS .YD/.�/ OaI *r3 /-
i.
RECEIPT NO. P7 MrI/T NO.
COSTA MESA. CALIFORNIA / �y D
RECEIVE?BY DATE RECEIVED DATE ISSUED
OWNER -.Pace s errer West' Clint 4h11.41
/�!/ —73-63 fliAH z 196,?
MAIL BUILDING
ADDRESS /G S 3 C .` ADDRESS
hor ZONE TYPE GROU y
V /
/a ./,
TEL Z
CITY 1_05(¢ M es a_ NO. 4,I 90395
APPROVED
ARCHITECT TEL
OR ENGINEER fid/fen be. el, NO. 7'7.7,-3361 BY DATE
ZONING \may \ VS—
ADDRESS 97�J,2 )1<a fe_7�E—, ZONK / I NO.OF v UBEOP 41/
// n /�. PLANS US O INVN)(/(�(((�w�w,�;���111�����VVV _
CONTRACTOR �.��eh,O S h d b C� l-0 • ^! ' ��( ��
LEGAL UX(`fi_
DESCRIPTIO
ADDRESS /6S3 AiihO re. "
/ A.P.NO. '
CITY ( eLtd- Me s Z
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATETEL. ✓✓ 30'TO SIDE 8 REAR P.L.
LIC.NO. it7/ 4L N0t7i 9'039r
SIZE r � EAVES
NO.OP BLOCS._ ALLOWED (U. B.C.REQUIREMENT)
OF LOT ' 73 x /00NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. —'
(FROM C/L STREET)
SETBACK LINE FROM / ) / // FRONT '5j SeFT. FT.
CENTER OF STREET 5,2 REAR YARD -U. L
SIDE YARD I LEFT /3/ RIGHT /.2 R.SIDE ( / FT. FT.
DESCRIPTION OF WORK L.SIDE /7c;.FFT.
C
NEW Il ALTERATION ADDITION REAR 3O FT. N FT.
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
VAR.* DATE
BUILDING 0 NO.OF
SIZE o2.2 4o ROOMS A STORIES -2 C.U.P.# A APPROVED
EXTERIOR WALL , ROOF A a/T t APPROVED �/�/ 3j
COVERING Sy(,F coCOI COVERING Sb in /e BY0DATE - _ v ✓y
USE OF BUILDING AND esWORK TO
BE PERFORMED
2 iSence / o/oc rgtc hon
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOW NDER VALUATION IS FOR THE i
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COW PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. 2J N
SIGNATURE 0 PERMIT FEE $ /2 O
PERMITTEF ,� 9
• EeecaJ/ $ 01: 5-9,2 A HE 1 3 6— O
AUTHORIZED AGENT �J' r
a \ TOTAL FEE 5 /�G
OWNER PACESEAER WEST JOINT VENTURE DATE 3-22-63
JOB ADDRESS 2014 Baltra Place BUILDING PERMIT N0. 19170
GENERAL CONTRACTOR Andros Land Company VALUE $ 22,592.00
AP No. LOT 86 TRACT 4348 FIRE ZONE DESCRIPTION OF WORK res att gar
INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE Bl
Soil 7 /4' 3 PERMITS ISSUED
Gas ` SUBCONTRACTOR DATE NUMBER
Water f -- 4--
Rough oin. tieing. 0 Air Cond.
Rough Heating ,A407 q-n--G7 cnu t /W-G, /die -
Risce Plumbing Q //-/7�G ' . - 9� �' -1.i r�/r'c�
0 jile'
Miscellaneous —/
Prop. Swr. Line V House Con. O St. Swr. 1E *. /j 6i.-O,/3 (�GO7S �w f/, .4/z/F,3 ....63Z
Sprinkling System ""`�' 4 a
Construction Pole
Underground 0 Power p ,
Rough Wiring J'/ 7.)t `— .
;•CS c-.2 ,_o 4/2,�„
, �•_ JUL 1 ' •` .%f r(if.
Trenches tr Forms [r Steel Reinf. • — 5--2-4)
! --
Floor System s— c,3
Bond Beam 0 Steel Reinforce 0
Sheathing t.K-_b,vN a A4 7-9-e-3
Frame and Flashing', 1 "2-24-44
Lathing— In:l I Out Vy�4Z.6:5—,S
Plaster, brown coat !/-0 4'---7Y-bi
Refrig. ❑ Air Con, 0 Final
Heating, Final 07. AP-Ab--4T
Plumbing Fixtures, Final airOtai /4 s.2,Y-t t
Final Gas Test/,J'/1 �, 7' -?d-.j
Electric Fixtures, Final _
/� r
Building, Final -brlEr-3
OCCUPANCY
Form BU4-5M-3-63—S-B P •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
- CITYOF COSTA MESA CONST RUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
x. 014- 64AL-'T PL $ 2 87 4-3 5175 C/ / ' A
Project Address r
Applicant's Mailing Address TYPE OF CONSTRUCTION U NEWpyH ADD U ALTERATION ❑ REPAIR
N AP-12Y KuTZA/ER S'I rSI7b ❑ CONVERSION ❑ DEMOLISH OTHER A.P.# Zone
Owner's Name Phone/� /� r�� DESCRIPTI�NTr�F WOg1c/US OE DG.
Address c7•°/� gALTR4 PL Co-PM t\ESA 9.24.26 IAN
F (� rjrdo—Srrr— S Main Building: Accessory Building:
E Z
f
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION [at STRUCTURAL T Front O
Address - /I n^^ �'�1�•��A ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name/`I�MI/Oftyr �A41(r�PeCMgone Cr:- OW ❑ OTHER A I
Address(mailing)1Sdt9_ E �heP4 )E 540.4 4v4 92705 PROJECT DESCRIPTION SQ. FT. len f7 OCCUPAN�C7y,rt/s� C Right G
337 3 CONSTRUCTION TYPE VALUATION$ LJ W.+.00 $ Left R
City License No. �./1 ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION !!�� • fs� �/ ,/ y n� Ping. Ref. # Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: emtw/ cot) imas REgwF wan
)Z-ow
PKWO((/�I Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and /CGrWPF lJr-Y W)/r/•r�-+)
rT
M my license is in full forc�an• efa ct. y'S 12 •3o Faa'� A+-�a A+-umiNunt s�As Zeta 3��7 •
S
4J Licens' Cla• 1i L• ase /
,� Date . - r- Signature Ora_ _ ... _ J. •- 'PLUMBING • FEES 4
WORKERS'COMPENSATION DECLARATION
in Bar Sink Showers —.■ ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate
'? of Workers' Compensation Insuran7ce, or a certified copy thereof Section Backflow Preventer Service Sink ��
4+ Automatic Washer Transformer 0 15-50 KW
3800, Lab. C.u� QQ�j ;tn� ,�y�.•I•� c111
Policy No. ��7 /ter+ Company 5777 � /' Backflow Irrigation Sewer Cap0 50+ KW Construction Pole Sub.
Certified copy is hereby furnished. •
Cert" ied py i e4with the city/,'per♦'I�In Di�v -d. Bathtubs Sewer Connection Cooking Unit Meter ❑up t0 100 amps
Oate (p 'a n / ApplicantL/sr&t. 1%A'L' �h[7
EXEMPTION FROM WORKERS'COMPENSATION DECLAR TION Clarifiers Solar Collectors Dishwasher M¢t¢r ❑Over 100 amps
(This section need not be completed if the permit Is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is Issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan Motors ❑0-1 -- ❑i%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swim ' g Pool w/Spa F.A.U.
NOTICE:If,after making this declaration,you should become subject to the _ � Inc.Sol- •9-15 HP ❑1645+
Workers' Compensation provisions of the Labor Code, you must forthwith .Floor Sinks ■E i _■ Fixtures
comply with such 'provisions or this permit shall be deemed revoked. Mi. owave
CONSTRUCTION LENDING AGENCY Gas Service Outlets ,Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name Interceptors • Water Heater Outlets
Range
Lender's Address Kitchen.Sink
A Water Service Switches
BUILDER BUILDER DECLARATION Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry TraYs Generator ❑0- W ❑5-15 KW
any structure, prior-to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drain
the Contractor's License Law(Chapter 9(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500).
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3
^ompensation, will do the work, and the structure is not intended or offered Reinspection Fee —1 $15 Issue Fee $ 3
or sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
icense Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 Zoning Approved By Date
sale. If, however,the building or improvement Is sold within one year of com- Canopy Type II 0
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
prove for the purpose of sale). / /l Building Approved By '//--����{/;� Date Aisve7
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who .Duct-Ventilating 00-100,000 BTU ■ 10,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that ■Exhaust System 0 Multiple 0 A� PLAN CHECK $ PERMITlteration BUILDING PERMIT $ /8 , Oa SMTP $ 0.50
proof of their Worker's Compensation insurance should be provided to me.
-
0 I am exempt under Section B.& P.C.for this reason 5 Firepl/Fact.Blt. ICBG# �V'" •' PLUMBING $ ISSUANCE $
Date Owner - Heating System& Ducting
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 01001:1 :T GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre-
PLAN CHECK 50% $ MICROFILM $
sentatives of this city to a rduppn yne7 ahoy¢-mentioned p ape ty
inspection p y /ZL ,C�_ /.. /�� I MECHANICAL $ p
Signature /�/ �X�U'T�•� ate!!�� 000 TOTAL FEE $ IO • 50
• :Inspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' Llcens or SS#
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor _
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
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, 0 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
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 0 Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 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 PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION 0o/87 ,"t-<
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 •
39. Water Service-Final -
40. Gas Service-Final -
41. Solar Domestic-Final 1
42. Backflow Preventer
43..Backflow Irrigation
44. Landscape Irrigation System v•� .
45. Sound Attenuation
f
46. Handicap Regulations /
47. FINAL STRUCTURE & BUILDING 7i4,
48. Special Requirements Completed /// C, •
49. Electric Release to Edison }
50. Gas Release to Southern California Gas Co ti
51. CERTIFICATE OF OCCUPANCY •
No. Date -: