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Home My WebLink About1150 CHARLESTON ST - Building PermitsN CITY Of COSTA MESA CONSTRUCTI N PERMIT Project Address —1/5-1) / 2 e Applicant's Mailing dress Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMVA NO. I TRACT NO. I LOT NO. I I w1T wn Owner's Name �t Address —Phone /&J -7q Arch/Eng. License No. Address Boiler Clarifiers Solar Collectors TYPE OF PERMIT 71 GRADINGFOUNDATION STRUCTURAL Contractor's Nam "Phone 11 TENANT El ELECTRICAL PLVMBING Address (mailing) 1_ Duct - Ventilating TT Exhaust System ❑ Multiple ❑ City License No e V OCCUPANCY LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f d effect. Lil% s o. —` Dale -_6 cense�cySignature L e::J WORKE S' MPE NSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -Insure or a certificate ,f Workers' Compensation Insurance, or a certified copy thereof (Sects n 100, Lab. C��1//}►��n2�7//�� f olicy No. 5/"]/NcJ`/� I�i`f �" ( Company ceert ifietl copy is filedbwithrthehc city B(� 1$f�Als / Date Applicant--��fl�iv / EXEM PMP IO�RKERS' COINPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 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 Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, Improve, demolish or 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 TYPE OF CONSTRUCTION L I NEW LJ ADD LJ ALTERATION = REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER SUMMARY OF FEES DESCRIPTION OF WORK/USE OF BLDG. Boiler Clarifiers Solar Collectors TYPE OF PERMIT 71 GRADINGFOUNDATION STRUCTURAL Dishwasher Solar Piping 11 TENANT El ELECTRICAL PLVMBING ❑ MECHANICAL Duct - Ventilating ❑ OTHER Exhaust System ❑ Multiple ❑ PROJECT DESCRIPTION SO. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES Remarks: Kitchen Sink Water Service PLUMBING Si Backflow Preventer I Service Sink Backflow Irrigation Sewer Cap SUMMARY OF FEES Bathtubs Sewer Connection Boiler Clarifiers Solar Collectors Duct - Under Ground Dishwasher Solar Piping Duct - Structural Drinking Fountains Solar Tank Duct - Ventilating Floor Drains Swimming Pool w/Spa Exhaust System ❑ Multiple ❑ Floor Sinks Urinal Firepl/Fact. Bit. ICBO db Gas Service Outlets Water Closet Date Owner I hereby certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- Interceptors Water Heater Heating System & Ducting 00.100,000 BTU ❑100,000 BT' Kitchen Sink Water Service 25% Lavatories Auto -Wash ENERGY P.C. P—Trap Laundry Trays Inspection puri s s. /_ C Roof Drains Division 3 of the Business antl Professions Code) or that he/she is exempt •herefrom and the basis for the alleged exemption. Any violation of Section 131.5 by any applicant for a permit Subjects the applicant to a ci vll t nelty of not more than five hundred dollars ($500). J I, as owner of the property or my employees with wages as their sole co mpensalibn, will do the work, and the structure is not intendetl or offered for sale (Section 7044, Business and Professional Code: The Contractor's License 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 employees, provided that such Improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con. 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 builds or Improves thereon. and who contracts for Such proiect5 with a ..n- tractor(s) license pursuant to ine Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. Reinspection Fee $15 SUMMARY OF FEES Boiler Duct - Under Ground SMIP Duct - Structural PLAN CHECK Duct - Ventilating $ Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO db ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- Z% ISSUANCE Heating System & Ducting 00.100,000 BTU ❑100,000 BT' PLAN CHECK 25% sentatives of this city to enter Pon the above-mentioned pro erty for ENERGY P.C. $ Inspection puri s s. /_ C $ GRADING Reinspection Fee $15 Signature Date Drivers' Lic o SS;P 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System ❑0-100,000BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 FEES $ 3 .r. m S Main Buildi E T Front B Rear A C Right K S Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW C Zone Accessory Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter Dover 100 amps Sub Panel Motors 110-1 HP ❑1'/h-8 Inc. Solar 09.15 HP 1:116-15+ Microwave Pole Light Range Standing Sections 15 KW I I Trash Compactor Reinspection Fee $15 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By — FEES $ 3 d N G R E O M T S. bATE1 Ni '1J. Ci '11t_= 'it .Ki SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ Z% ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $__ PLAN CHECK 25% $ bATE1 Ni '1J. Ci '11t_= 'it .Ki CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL A APPROVALS Permit 4# Date Inspector 1. Temporary Electrical Service or Pole -. 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-UndrgCnd. 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. B. Foundation - i 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 Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval !17. Rough Wiring Sign 68. APPROVED FOR PLASTERING X18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL -19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping []Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73.E Undergrnd. Storage Tank DGas []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 ='3 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation �• 1 44. Landscape Irrigation System •' 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Snecial Requirements Completed 49. Electric Release to Edison _50. Gas Release to Southern California Gas Cc -- -' 51. CERTIFICATE OF OCCUPANCY No. Date 21383 .COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA, CALIFORNIA nt to Fill In Completely PE OR PRINT [A17DDR 0 Charleston ,MESA. CALIFORNIA OWNER North ate Homes MAIL ADDRESS 1 Las Flores CITY Fountain Valle TEL 316 92 ARCHITECT TEL OR ENGINEER NO. e«e Anaheim L�IC.TNO. 21 04 NEL 16 2 ZE OF LOT 6Qx1 19 NOW ON LOTS O ' USE at- _ OO PROM 1 DESCRIPTION OF WORK BUILDING SIZE EXTERIOR COVERING USE OF BU II HEREBY ACKNO AND STATE T TI PLY WITH A CITY BUILDING C NSTRW THAT I HAVE READ THIS APPLICATION JV ECT AND AGREE TO COM - AND TATS LAWS REGULATING FEE RECEIVED JAN 1 7 1964 6 � FINANCE DEPT. ��TY OF COSTA MESA APPL ATION FOR PERMIT BUILDING For Office Use Only REC[I VRD BY ZONING No. or De r I PLANS )/ EU I1N[ . i I n YARDS APPROVED MAIN BUILDING VAR. as SHALL BE LESS THAN (U. B. C. REQUIREMENT YARDS APPROVED ACCESSORY BUILDING DATE 9 163 SQ. FT. 1 L4 THE AMOUNT SHOWN UNDER VA PURPOSE OF ESTABLISHING A s//l, 785 00 AUTHORIZED AGENT I V 4� n 0 In le FOR TI IT PEE ONLY. O OD n s �B ; Q �R YV — On s