HomeMy WebLinkAbout3274 CALIFORNIA ST - Building PermitsAoolicant to fill in ali soaces exceot ehose witnin heavv boraer Iines antl sicn a11 aoorooriate aeclarations.
CITY OF-COSTA MESA CONSTRUCT,I N PERMIT � PERM NO. TRACT NO. ' � LOT NO. UNIT NO. . 5252 2/ j 7/83 ' . 5000 TL
P.roiect Address � � � � � � _ _— � , ' �
� Applicdnt�5 Mdilipy df¢55 # � TVPE OF CONSTRUCTION NEW AD� ALTERATION PAIR
/��../7�-�g -❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# . 2one �
Owner's Name Phone._/_..7J1ra¢� DESCRIPTION OP WORKNSE OF BLDG. - -
� Address � S Main Building: Accessor,y Building:
Arch/Eng. � � License No. TVPE OF PERMIT GRaoirvG� /FpurvDATION ❑ STaUCrV RaL T Fmnt . ' p
Addf¢55 ❑ TENANT ❑ ELECTRICAL I.Y?LVMBING ❑ MECHANICAL A qear N
Contractor'S Nam � [� ❑ OTHER
]/jL///�r �1,�.�P# � rn PROJECT DESCRIPTION 5q. FT. � ocCuvarvCv K Right � G
Addfe55�mafng��� �/_L(,IL� '� CONSTRUCTIONTVPE VALUATION$ - S Left
City Lic¢nse No ZONE GRADING CU. YDS. ACRES � R
LICENSED CONTRACTOR DECLARATION - PIOg. Ref. # - � Parking RCq./PrOvidEd E
1 nereby affirm roat I am licensetl untler provisions of Charter 9(commencing Remarks: ' � Planning Notes: M
with section ]000) of Division 3 0( the Business antl Professions Cotle, antl _
my license is in fu �t c ana eHecL �- � - T
License C a s '� ens No � , S
Date Signature _ - "ti PLUMBING � FEES
�WORKERS' CO PENSATION DECLARATION gar Sink ' � Showers
I here�y aifirm that 1 have a certificate of consent to zeli-insure or a certificale � � ELECTRICA� FEES
oi Workers' Compensation Insurance, or a certitied copy thereoi (Section � gackflowPreventer ServiceSink
i 3800, Lab. C) /�, // � �/ Automatic Washer Transformer � 15-50 KW
� voiicy No. 79lg3y d�'l Comoany l�l�./ XP .��.%7U Backflow Irri9ation � � Sewer Ca . _ ❑ 50+ KW
P Construction Pole Sub.
9, erYifietl wpy is hereby fumishetl. .
��erti ie py is tiletl with the city e m iqr�. ' /J � � Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
,;{-[e " APPlicant�,���CIZ/ '
;:��?iXEMPTION FqOM WORKERS' COMPENSATION OECLARATION Clarifiefs ' Solar Collecrors DiShwasher Meter ❑Over 100amp5
(Thissection neetl nof be campletetl if the permlt Is for one huntlretl ($300) or � .
less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel
1 certify that in the performance of the work tOr which this perm�t is issuetl, 1
shall not employ any person in any manner so as to become subject to the Orinking Fountains Solar Tank � Fan Motors �0-1 HP �1'f. - 8 '
Workers' Compensation Laws ot Calito�nia.
oate Signature Floor Drains Swimming Pool w/Spa � F.A.U. Ina Solar 09-15 HP �16-15+
NOTICE: If, atte� making this tleclaration, you Shoultl become subject to the —
Wo�kers' Compen5a[ion provi5ion5 of the Labor Cotle, you muzt farthwith FI00/SiOkS U�iOdl Fixtu�ES
compry wi[h such ptovisions o� this Dermit shall be tleemetl �evoketl. Mic�ow2ve ,
CONSTRUCTION LEN�ING AGENCV �� GasService Outlets WaterCloSet' DeviceBoxes . PoleLi ht '
1 he�eby affirm that the�e is a const�uction lentling agency fo� the pe�to�mance . 9 -
. of tM1e work Por which thi5 pe�mit is issuetl (Section 309]' Civ. C.)
Interceptors Water Heater Outlets Range
Lentler's Name
�ender•s atldress '� � Kimhen Sink � Water Service Switches .
OWNER BUIL�ER �ECLARATION / _ Sign �
I hereby af(irm that I am exempt t�om the Contractor'S �.IcenSe�Law for the Lavatories AUtO-WBsh . Gd�b2 2 Di5 OSdI � � .
foilowing reason (Section 7031.5 Business and Professional Cotle: Any city or 9 P Standing Sections
county which'requires a permit co construct, alter, improve, tlemolish or repair p—Trap Laundry Trays Generator �0-5 KW �5=15 KW
any structu�e, prior to its i55uance, also requires the appliCant for'such permit T/d5h COrtlpacto� � .
to tiie a signetl statement that he/she is IirenSetl pursuant to the'provisions of qOOi D�ainS.
the Contractor'S License Law (Chapter 9(commencing with Section 7000) of
Divislon 3 of the Business antl Professions Cotle) o� that he/she is ezempl � .
' therefrom an0 tM1e basis for the alle9etl exemption. Any violation of Section . ' ' -
]031.5 by any appiicant for a permit subjects the applicant to a civil
�enalty of not more tM1an five huntlretl tlollars (E500).
1, as owner of the O�operty o� my employees with wa9e5 as thei� sole RlinSpeetiOn F¢e $15 . Issue Fee $ 3
.comoensation, will tlo the work, antl the svucture is not intentletl or otteretl Reinspection Fee $15 155ue Fee $ 3
- sale (Section �044, Business antl Professional Cotle: The Contractor's � MECHANICAL FEES'
r�:�',--_ense Law does not apDly to an owner of a property who bui1G5 or improve5
�.`w'"reon, antl who tloes such work himself/herselt or tnrough nis or her own . � - DEVELOPMENT SERVICES REQUIREMENTS: . , -�
R' %i, 10�oyees, provitletl ihat such improvements are not intentletl o� o(feretl for BOil2� HOOd O� Typ¢ I ❑ -
, 5ale. If, however, the builtlin9 or improvement Is soltl within one year of com- Canopy Type I I ❑ Zoning Approved By Date
� pletion, tM1e owner will have the bu�tlen of proving he/she tlid no[ builtl o� im- DUct - Unde� GrouOd . - . Building Approved By D2tp ^�
�ova for lhe purpose af sale).
I, as owner ot the proDerty, am exclusively contractin9 witn licensetl con- � Duct -Structural Refrigeration System Appliration Isued By k� Dat 0�
Iractors to construct the project (Section �044, Business antl Professions Cotle: - .� .
The Contractar's License Law tloes not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU . . SUMMARV OF FEES
' builtls or improves the�eon, antl who contract5 to� such project5 with a con-
tracmr(s� bcense pursuant to the Contractor's License �aw). I am aware tnat Exhaus[ System ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT 3 SMIP $
prool o meir Worker's Compensation insurance shoultl be provitletl ro me. _ - PLAN CHECK $ ��—��, '- PERMI7
❑ I am exempt untler Section � B. & P. C, for this reason Firepl/Fact Blt. IC80 # Fire Dampers � �pLUMBING $ �' u V �SSUANCE $
Date Owner Heating System & Ducting Registers PLAN CHECK 25% $ - ENERGV P.C. $
i nereby certiN that I have read Ihis appiication antl state that the above ' ❑4100;OOOBTU 0100,OOOBT ELECTRICAL GRADING $
information is correct. I agree to comply with all city antl coanty ortlinances $ �
antl state laws relating to builtlin9 construction, antl nereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of tbi5 city to enter n the above-mentionetl property to� /��
inspection p es �' �1p MECHANICAL $ TOTAL FEE $ v
Signature Oate / "! painspection Pee $15 litue Fee $ 3 PLAN CHECK 25% $
Driv¢rs' LI nse or SS � '
CMF OB65-46, rev. 10/84 White - Builtling; Canavy - Applicant; Pink - Accounting: Goltlenrotl - Asse55or .. . '
;
CONSTRUCTION AND PLANNING - _ . POOL & SPA - - "� - •
APPROVALS Permif# ' Date �. Inspector; AppROVALS P.ermit# � • 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-Undrgmd. , � 55. Electrical Bonding �� , , .
5. Steel Reinforcement 56. Rough Plumbing & Pressure'Test ,
6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
7. Footings � �.� , 58. Electrical Conduit-Undrgrnd.
8. Foundation; (�; -� ' '- 59. Gas Pipe; � Undrgmd., Test � � �
9. Water Pipe-Undrgrnd. � -- -- 60. Backwash Lines; P-Trap, Q;Undrgrnd.
:.0
10. Structural Floor Systein 61. APPROVAL TO DECK ^�.�;.
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final� � �
12. Sewer Cap . - 63. Heater & VenUFinal,
13. Roof Drains . 64. Plumbing System - Final � � -
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit � 66. $olar System-Final ,
16...Rough Electric Wiring .; : . . . _, ..,_ , - . 67:: Fencin.g & Access Approval� � � � �
17. Rough Wiring Sign � . -66. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling . ,✓ 69. POOUSPA 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) & 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 �� � i�1
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � ��
�r, n
33. Final Electric Notes:Z.(�j_�}j (�,�" C�p� p �
L.E. r>
34. Final Heating & Air Conditioning . ' .
35. Final Gas Pipe-Test � g, , �+ �
36. Hood or Canopy '
37. Final Factory Fireplace ' - • � �
38: Final Plumbing - .- ' 8� G� ' • � - ' • r'
39. Wafer Service-Final ' ' � ,���- . " � .
40. Gas Service-Final - . `'
. 41. Solar pomestic-Final � � _ � J,'.
" /
. 42. Backflow Preventer � ' �� � � ,
43. Backflow Irrigation� � ,
' 44. .Landscape Irrigation System � � � ' � . �
45. Sound Attenuation , ' ' : �r'
46. Handicap Regulations � .,- �� i �
47. FINALSTRUCTURE & BUILDING , .. 4` ; � ,. i��
.' ,�i
48. Special Requirements Completed , . � �
49. Electric Release to Edison � ' - ' ' � �
. - •�
50. Gas Release to Southern.Califomia Gas Co '� , .
51. CERTIFICATEOFOCCUP'-'^.Y � , _ -
No. Date
r. \
� `� _ -
�� . ., �. ' �'.: . .. .. ,. . .. . �. _ . , - . �.. _
;OwNER Rr�unRn�soN� ru
�U'JOB ADDRE55 3274 Calif�
GENERAL CONTRACTOR Dam
�AP No.139-052-21 LOT
INSPECTIONS
SOIL
GAS
W ATER
ROUGH P�UMBING
PROP. $Wft. LINE Q HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANE0I15
ROUGH HEATING AN� AIR CONOITIONING
TEMPORARY SERVICE OR POLE
I1N�ERGROUNO' � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL RE
FLOOR SYSTEM
BONO BEAM � STEEL REINFORCE [
SHEATHING
FRAME ANO FLASHING
LATHING - IN ❑ OUT �
PLASTER,BROWN COAT
STRIICTURAL, FINAL
HEATING, VENT., REFRIG. AN� A.C.
PLUMBING, FINAL ANO GAS TEST [
ELECTRIC, FINAL
BUILDING, FINAL
ZONE
DATE 2/7
BUILDING PE
K Fire f
VALUE $ ]
SUBCONTRACTOR
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COSTA MESA BUILOING-SAFETY DEPARTMENT
P o_ Ro% 7200 COSTA MESA. CALIFORNIA 92626
�r� � 5-����, °OC sF � ; . s�� . �;�1 C.50
. APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECEI e ev DAT RE�E ED
''j DATE ISSU
ADDRESS .,J Z 7 L/ "� '�- � � � — S /
OWNEfl � �/
A.P. NO. � '— '�/ PERMI h'��
BUILDING � L/� /� „ / � • � /
ADDFESS �� (sJ—i AODRESS 'Z 7 7 �i�i < c�rrGt1 V
cirv
CO$/�f yeSry NOL � TRACT� Qi LOT BLOCK
CONSiRUCTION A A
IENDER G N � �
BRANCH /� d SO N
OWNER (^J U (C AI�
ADDRESS VALUE / �{
ARCHITECT TEL. $ v�D
OR ENGINEER N
FIRE
AODRESS ZONE YP GROUP
/ � APPROVED �
CONTRACTOR /�//J/J LO�ST BY DATE
ADDfiESS ��./'k�• '�iLf/f/L l C�LI�� IY'(✓ �
/ � / ZONEy /7 NO.OF USE OF NEW � �
CITV 44%/�f �«iGh NOL�ZJ'j��6 ^ PLANS� BUILDING �J
LIC. No. z i3�y y LICVNO. �GS Q YMAIN BUI DOING ACCESSOPV BU�ILDING
SI2E NO.OF BLOGS. (FROM C/L STREET)
OF LOT NOW ON LOT ftONT T FT.
USE OF
EXIS7ING BLDG. SI � . FT..
SIZE OF No. oF
NEW BLDG. ROOMS STORIES L. SIDE fT F.
EXTERIOR WALL ROOF
COVERING COVERING REAR FT. � FT.
USE OF BUII.DILVSj,A[J� WORK TO BE PERFOFM I DISTANCE BET. BET. MAIN &
� MAIN BLOGS. ACCESS. BLIX'aS.
• , VAR.# ' DATE
C.U.P.# APPROVED
APPR //,/� / ' 2 /, '
" �_ � �
I heraby acknowletlge ffiat I have reatl this aoP�iwcion antl state . '
that the above information is correct and agree m comply with
ell laws ragulating builtling construction, antl I shall not employ �
any person in violation of the workman'S compansatiOn laws of
W
t e tate o a i ornia. �
I hereby cartify that I am prope�ly licansetl as a contractor untler SQ. FT, o
the Stete ot California eusiness antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that such licenses are In full force antl affect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: m
am exempt from the provisions of th�ie ot California Business �
VALUATION (� W
antl Professions Code, Divi��� '
PERMIT FEE $ �
Signetura of �
m
Permktee $ %/S�� �Q PLAN CHECK $ E
�� `o
Authorizetl Ageni ' �� LL
TOTAL FEE $
�u�'�3
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 977 C09TA MEBA. CALIRORNIA
For Applicant fo Fill In Comple+ely
_ TYPE OR PRINT
BUILDING ......� .. . . n__-1 _ na�__i
COSTA MESA. CALIFORNIA .
OWNER Amherst Development Co,
MAIL 1533 Baker St♦
AOORFSS
■ STATE
Bal�r St.
TEL.
NO. OF
�
LEGAL
F�E RECEiVED
C Fl`I��1�E�'D`�T.
APPLICAT� iQ�R�1011ME�
BUILDING
For Offiee Use Only
BY
OATE
COSTA MESA. CALIFORNIA
ZONING
NO. OF � I use on
PLANB BUILOIN
GeNTERKOPN6TREETM �� ��' REAR YARD �,2% F O�RUNEBT.)
SIDE YARD I LEF7 . S� I RIGHT �, R. SIDE
DESCRIPTIOId OF WORK
L. SIDE
NEW I 6IIALTFRn710NI IIADDITION I e�..,
■ U6E
TO BE PERFORMED
residence rrith
I APPROVEO
BY /
S �.
tll. �.
attached ar e. Plan R "
1 HEFtEBY ACKNOWLE06E TXAT � HAVE RPAD THIB APPLIGT�ON THE AMOUNT BXOWN UND¢R VALUATION 19 FOR TH¢
ANO BTATE THAT TH¢ A90VE �B EOPPEGT ANO AOREE TO COM-
PLY WITH ALL CITY ORDINANCEB AND 9TATE LAW6 REOULATING PURPOBE OR E9TpBLIBHING A PERMIT FEE ONLY.
BUILnINa CONBifiuciloN. VALUATION
SIGNATUHE OF � PERMIT FEE $ 36�
PERMITfE - ' o
$ 16)O��AO pLAN CHECK $ lV•
AUTHORIZED AGENi Dike & Co egrove InC. 5��
70TAL FEE
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