HomeMy WebLinkAbout2868 BALLOW LN - Building PermitsApO��cant to fill in all spaces exceo� those witnin heavy bortler lines ana sign all appropriate Oeclarations.
ICi�Y OF COSTA MESA CQNSTRUCTJON PERMIT PERtvjYJ NO. TRACT NO. LOT NO. UNIT N0.
-,-Project Address GI45¢�Q �/���-aU�J
Applicant's Maili aan IoBI Z LA �Is� �—�vnn—z��q7"7���
Owner's Name D�"� � '� Phone ��_V
Address Zg6g �i � ��w ��� ��
ArchlEng. �icense No.
Address
Contractor's Name�J�� F�H P o)ne��/� /��
Address�mailing�ll.C()I�� Cin SPTIST{l,j � /,('}.�,�%(,�
City.LicenseNo. �i�9��
LICENSED CONTRACTOR DECIARATION
I hereby atfirm that I am licensetl untle� p�ovisions ot Charter 9(commencing
with section ]000) of Divisian 3 Of the Bu5ine55 antl Prof¢ssions Cotle, antl
my license is in full force antl efiecL ' �'�
LJcense Class ' ns o.
Date (–��•RT7 Siqnature
WORKERS'COMPENSATION DECLARATION
I hereby atfirm that 1 nave a certificate of consent to self-insure or a certificate
of Workets' Compensation Inmrance, or a certifietl cOpy thereof (Section
3800, Lab. CJ ,
Polity No. - Company
BCertilietl copy is hereby lurnishetl.
Certifietl copy is fileC with the city Builtling Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thiszection neetl no[ be comple[etl it the permit isfor One huntlr¢tl ($100) or
less).
I certily that in Ihe Performance o( th¢ work tor which this p¢rm�t i5 i55uetl, I
snall not employ any oerson in any m�r�s�q.peco e s� ubject to the
Workers' Compensation Laws�of Califor /
Date � �'7-Z._$'7 Signature 6 �'
NOTICE: If, after making ihis tleclaratio you shoultl become subject to the
WorkerY Compensation provi5ion5 ot thE Labor Cotle, you must torthwith
comply with such p�ovisions or tnis pe�mit shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV
1 hereby affi�m that there is a const�uction lentling agency fo� the pe�to�mance
of the work tor which Ihis permit iz issuetl (Section 309] Civ. CJ
Lentlet'S Name
Lentler's Atltlress
OWNERBUILDEN OECLARATION '
I hereby atfirm that I am exempt trom the Contracto�'S License Law for the
lollowin9 reason (Section ]031.5 Business and Profeszional Cotle: Any city or
counry which �equire5 a pe�mit to const�uct, alter, improvE, tlemolish o� repair
any st�ucture, prior [O its issuance, also requires the applicant for Such pe�mit
lo tile a Signetl statemen� that he/she is licensetl pursuant t0 the provisions ot
`he Cont�acio�'S LicenSe Law (GhaOte� 9(commen[ing with $eclion ]000) of
JlviSion 3 ot t�e'Business antl Protes5ion5 Catle) or that he/she is exempt
[herefrom antl the basis for the allegetl exemption. Any violation of Section
�031.5 by any applicant for a permit subjects the appliwnt to a civil
eenalty of not more than (ive huntlretl tlollars ($500).
L� I, as owner of the propErty o� my employees with wages as their sole
compensation, will tlo the wo�k, antl th¢ structure is not intentletl o� o(feretl
for sale (Section 7044, Business antl Professional Cotle: The Contraccor's
License Law tloes not apply [o an owner Of a prope�tY who builds o� im0�oves
tnereon, antl who tloes such work himselt/herself or through his or her own
employee5, provitletl [hat such improvements are not intentletl or offeretl for
sale. If, howeve�, ttte bulltling or improvement is soltl within one year of mm-
O�etioq the owner will' have the burtlen of proving he/she tlitl not builtl or im-
prove for the purpose ot sale).
❑ I, as owner af the property, am exclusively conVacting with licensetl con-
traCtorS to construct the project (Section ]044, Business antl Protessions Cotle:
The Contractor's License Law tloes not apply to an owner of property who
builtls or improves thereon, antl who wntracts for such projects with a con-
tractor(sl license pu�suant [o the Cont�actor'S License Law). I am aware that
P�oof of their Worker'S Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. for this reason
Date Owner
I nereby certify tnat I have reatl
information is wrrect: I agree to �
antl state laws relating to builtlina
sentatives of this cit � o enter�
inspection purpos '
Signature
DateJ�['Q_G
TVPE OFCONS7RUCTION LJ NEW LJ A�o LIALTERATION IJ
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
. DESCRIPTION OF WORK/USE OF BLDG.l�• N.A iL�CrLG��
nG�� \ (�� 'S C�
TVPEOFPERMIT GRADING ❑ FOUNDATION STRUCTURAI
❑ TENANT ❑ EIECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sa.FT. occuPaNCV—
CON STRUCTION TVPE VALUATION $ _��
ZONE ' GRADING CU. VDS. ACRES—
Bar Sink
Backflowi Preventer "
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking'Fountains
Floor Drains �
Floor Sinks
Gas Service Outlets
Kitchen Sink .
Lavatories
?–Trap
Roof Drains
Reinspection Fea $15
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0-100,000 BTU � 100,000 BTi
� Drivers' License o• «� � I I Reinspection Pee I $15
CMF 0865-46, rev. 10/B4 Wnite - Builtlinq; Canary - Applican[; Pink - Acmuntln9: Goltlenrotl� AsSezsor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Soiar Tank �
Swimming Pool w/Spa
Urinal
N1dLC! C1052[
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Isue Fee
REPAIR
$ 3
$ 3
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
5
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
D ishwasher
Oryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
O utlets
Switche5
Garbage Disposal
Generetor �0-5 KW �5-15
0852 I/26/87
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 700amps
Meter ❑overi00amps
Sub Panel
Motors D O-1 HP � 1'/: - 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
Sign
$tanding Sections
Trash Compactor
� Reinspection Fee !$15 � � Issue Fee
DEVELOPMENT SERVICES RE�UIREMENTS:
Zaning Approved By
Building Approved By
ApplicatiOn Issued By
16050 .TL
FEES
$ 3
SUM RVQ,FFEES '\
BUILDING PERMIT $ <<�� SMIP g � Su
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PIAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $ c�
MECHANICAL $ TOTAL FEE $ / '�–+�-�
PLAN CHECK 25% $
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CONSTRUCTION ANDPLANNING POOL&SPA . ,
APPROVALS Permit # Date Inspector qppROVALS 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. Elecirical 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 ConduibUndrgrnd.
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
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electriral-Cqnduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1S. 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 & 7est 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Struc,tural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe .
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 7S. 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
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final '
42. Backflow Preventer � �
43. Backflow Irrigation
44. Landscape Irrigation System .
i'
45. Sound Attenuation . ' '
•46. Handicap Regulations . �`
47. FINALSTRUCTURE&BUILDING I�I ' i
lS i
48. Special Requirements Completed , '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY �,�
No. Date •� t
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING
ADDRESS
COSTA MESA. CALIFORNIA
IJEE RECEIVED
Lots�� t 4204 Plan 1-D
FINANdE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO.
OWNER O
MAIL
RECEIVED BY
D'R�CGI11/P- I DATE ISSUED
ADDRESS 800 R' Coast Highway
/ !V RFF fi 1W
Corona del klar Calif• 34220
BUILDING
CITY NO.OR
ADDRESS
ARCHITECT TEL.
OR ENGINEER aCCO Corporation NO. 220
COSTA MESA. CALIFORNIA
FIRE yL.
ADDRESSy
ZONE TYPE GROUP
_
CONTRACTOR Macco Corporation
APPROVED
BY DATE
ADDRESS 3800 E Coast Highway
ZONING
ZON
`
NO. OF •
UBE OF
CITY
I
PLAN6 7
BU ILDINO
STATE D
LIC.NO. 98808-SBNO. OR 220
DESCRIPTIONSIZE
OF LOT 7102 S F
NO. OR BLDGS
NOW ON LOT none
A. P. NO.
USE OF none
YARDS EVES
EXISTING BLDG.
APPROVED ALLOWED
SETBACK LINE FROM
11611
33 11011
(CENTER LINE BT.)
sQ�
CENTER OF STREET REAR YAAR�D
FRONT FT. IN.
81
I
I 9
SIDE YARD LEFT
RIGHT • ^Q
R. SIDE/FT. 1N.
DESCRIPTION OF WORK
Q
L. SIDE v FT. IN.
NEW Ixx
IIALTERATION I IIADDITION
I
REAR 33 FT. 1N..
REPAIR
MOVING I DEMOLISH
I
APPROVED /
ByCti/t /a DATE 1+
BuILD[N x' NO. OF 6 1
fl d
SIZE vooms STORIES
EXTERIOR WALL S UccoROOF
COVERING wOOd COVERING comLivinkp.
area1281 S F
USE OF BUILDING AND WORK TO BE PERFORMED
q4-18 family reqijerrp
Garr e area 448 S F
w/attached garage
Covered Porc area
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIGTION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
-
e
PLY ALL CITY ORDINANCES AND STATE LAWS ROULATINO
VALUATION'/
BUILDING CONSTRUCTION.
SIGNATURE OF M Del Mar Development Co.
PERMIT FEE $ "
�j
PLAN CHECK $
PERM FF
$ 14,111 .00
B.V
`
AUTHORIZED AG L
70TAL FEE