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HomeMy WebLinkAbout2983 CEYLON DR - Building Permits�, � AVPlicant to fill in all spaces ezcept those within heavr �ortler lines anA sign all approoriate tleclarations. CITY OF COSTA� MESA � CONSTRUCTLON PERMIT �; � PE IT NO. ' TRACT NO. � LOT NQ. UNIT NO. � - �. � � / 0 28 3. G / � � � Project Address � � C %� " Applicant'SMailingAddf2si � �' � � TVPEOFCONSTRUCTION�' NEW' /��D ALTERATION REPAIR ' 9875 5704/84 --- 13.5� :Tl, , - : - , � , ,�:.,- _ . - - I_ /'�y ❑ CONVERSION ❑ DEMOLISH '❑ OTHER � p,p,# �- Owner's Namy� ' Phone DESCFIPTIO OF WO$�C /USE OF�BJ�QG: ' � Address � Z �.� � C„Q ��'_� dh_� r.'MC �� S /�[��C S �`%��a � ' _ ' E Main Building ' Arch/Eng. � � � License No ' � TVPE OF.PERMIT � GRADWG LJfoUNonnoN _ �57RUCrURaL � - T ��.Front _• - , r �� � � , � ❑�TENANT ❑ ELECTRICAL' L�J"PLUMBING O MECHANICAL � B ' ABdress � � � � � . , . , � ' � A Rear ; _ � i i ... •.. - ' �:��,OTHER � � -- � � • . � � Contrector's Name� �� �+ ' - 7hone ' � � . •. , � C ,Right Address (mailingl � � ! -� � � � � PROJECT DESCRIPTION� �Sq� FT. 'OCCUPANC K L2ft� ' ' ' i � - � y � - CONSTRUCTIONTVPE - + � VALUATION$ $ . . City LicenSe No. ' � � � � ZONE ' � ' GRADING CU. VDS_ �ACRES - �ICENSEO CONTRACTOR DECLARATION ' ' Ping. Ref. #. I_hereby affirm that I�am licensetl untler provisions ot Charter 9(commencing qemarkr. �- � ' � � Planning Notes: with section 7000) of Division 3 0( the Business antl Profeiaions Gotle, antl �� ' my license is in full force antl effect. ' . � ' - � , [. � ' License Class � � � � License No. — Date � � � r� Signature ' I = ' � ' ' PLUMBING - ' � ` FEES WORKERS' COMPENSATION DECLARATION � ' � j � 1 � ' � I hereby affi�m that I have a certiticate ot consentlto self-insure or a Certificat¢ Bdf Sink � ShOw¢�5 - � ot Workers' Compensation InsurSnce,'or a certifietl copy thereoi (Section BackflowPreventer ___... . ServiceSink 3BOQ..Lab. C:)__ '''_ �" � I' '_ " � . j . ' . "' y_ _ ' "_ _ Policy No. ' � Company � Backflow Irrigation � Sewer Cap � eCertifietl copy is hereby fumishetl. ! ; ' . � � . , , , Certitietl copy is filetl with the city Builtlinq Division. � • Bathtubs Sewer Connection ! Date � ' Applicant '-= ' i � EXEMPTION�FROM WORKERS' COMPENSATION �ECLARATION ; Clarifief5 ' Solar CollecLo�S ' (ThiSsection neetl not be compleletl if the permitis for:one huntlretl ($100) or . . less): � '. Dishwasher - � Solar Piping • ' I certi(y [hat in the pe�fo�mance of the work for whi[h this p¢rmk is �issuetl, I : � . - shall mt emoloy any person in any nnep�so�[ A beco�ne subject to the � Drinking Fountains , Solar Tank Worke[S� Cq7�p 5 ion'LawSofCallf ia./� /,�/�' /..� Date.) � N".���Signature � /\ _ \)\'�'�A � ' Floor Drains � � Swimming POoI w/Spa � . NOTICE: If, aiter makin9 this declaration, you shoultl become subject to the ' ' �' , Workers' Compensation>provisions oi dhe Labor Cotle, you muzt forthwith Floo� Sinks �_ i �.. _ Urinal comply with such provision5 or IM1iS permit�5hall be tle¢metl��evoketl. , �- ' - GONSTRUCTION L'ENDING AGENCV�, • �� . � • � � �' GdSSC�vic¢ � ,Outl¢t5 Wdt2�CI052L � I hereby affi�m that there is a construction.lentling a9ency tor the perto�mance � ' of tne work tor which.t� is perm' is issuetl (Secfion 3097 Civ. C.) Interce tors� '� � -WaterHeater �� Lender's� Name ' •1\Ir1 �I �ri� - _ P . ' Lentler's,Atltlress. ' � - � ' � KitchenSink - ' WaterService - � OWNER BUILDER DECLARATION � - L � �' ' . � • • � ' i . I her2by aHlrm-[hat I am exempt trOm the Contractor'S" License Law for.the � L2v3tO�i¢5 ,. I � - , following reason. (Section 7031.5 Business antl.Professional Cotle: Any city or , , . counry which repuires a permit f0 const�uct, alter, imp�ove, tlemolish or.�epair �, P-Tfdp � ��. • - ' ' any structu�e, prior to its'issuance, also �equires the applicant fOr such pe�mit 'to file a,signetl statemenbthat he/she is licensedpu�suant to [he p�ovi5ions of � ROOf�D�3ins, rJ ' � � � � the Contractor's�License Law (Chapter 9(commencing with Section ]000) of. ]ivision 3 ot the Business antl Professions Cotle) or that ne/she is ezempt � - •- �, � . 'herefrom antl the basis for the allegetl'exemption: Any violation oi Section � � .. 7031�.5 by any applicant for a� permit subjects the�appliGant to a civil ' �nalty ot not more Ihan five huntlred tlollars ($500).. �.� '. -, ' ' LJ I, as owner o( the properry or�my employces with wa9a5 as [heir sole � �Reinspection Fee i$15 'compensa[ion, will Co the work, antl the structure is:not intenAetl ot oiferetl for sale ($ection ]044, Businesz antl Professionab Cotle: The Contractor's . -, ,, License Law tloes not appty to an owner o( a property who builtls or improves thereon,' antl whatloes sach work himselt/herseli or throu9h his or'her own � employees, provitletl that such-improvements are not intentle0 or offeretl� for sale. I(, however, the buildin9 cr improvement is so10 within on¢ year o( com- � pletion,SM1e owner will have'tne bu�tlen of ptoving he/shetlitl not builtl or,im- r ve �orthe purpose oT sale). � � 'as�owner of the property, am exclusively contracting wltFi Iicensetl con- i ac ors [o construct the project (Section ]044, Business antl Professions Cotle: ' he Contractor's License Law tloes not apply to an owner of property who "builtls or Improves thereon,'antl who contracts�fo� suth projects with a con- tractor(sl license pursuant�to the Contrac[or's License Law). I am aware tnat proof o1 their Worker'S Coinpensation insurance shoultl be provi0etl to me. ❑ 1 am exempt uritler $ection B. & P. C. for [his reason Date pwnen - I nereby certify Ihat-I� have reatl this-appiication antl state thaLthe above Information is correct. I agree to comply with all city ana county ortlinances antl 5[ate laws relatina tn builtlino cnnsM1uction: antl herebv autholi2e reore- . Boiler � � � - Duct- Under Ground Duct - Structural Duct-Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO # Heating System & Ducting 04100,000 BTU 0100,000 BT mspecuon purpo 9! � . j Signafure � i � Dafe � aeinspettion Fee Drivers' Licens r 55 CMF0865-46,rev.4/84 White-Builtling:Canary-ApplicanLP�nk-Accounting;Goltlenrotl-Assessor $15; laue Fae Hood or Typel ❑ - CanoPY � Type 11 ❑ . ' ' Refrigeration System � ❑o-ioo,000sru ❑�oo,000s� System Repair/Alteration '•$3 FEES i � Issue Fee � $ .3 Automatic Washer ' - Construction Pole Sub. 1 Cooking Uni[ � DisFiwasher Dryers ❑Gas ❑Electric Fan� F.A:U. � �. . Accessory Building: i . � `' � Parking Req./Provide� Zone i , . � ELECTRICAL � 1 ! � . +Sransformer ❑.15'-50 KV i ❑ 50+KW Device Boxes � � Outlets ' Switches . ' Garbage Dispoul � ' Generator �0-5 KW �5-15 KW I Reinspection Fee ,I $15' DEVELOPMENT SERVICES REQUIR Zoning Approved By Building Approved By Aoolication Issued BV Meter ❑up to 100 amps Meter ❑over100amos' Sub Panel Motors �0-1 HP Ina Solar 0&,t 5 Microwave.- Pole Light � � � � Si9n '• Standing�Sections ' Trash Compacmr ' Issue Fee Z - O ,i � N I � N j ' R � . : E _ n ; . ' T� I � S. � t ' ,. 1 � � SUM ARV OF FEES ', ' /�-� BUILDING PERMIT .$� .� SMIP , $ D. J � PLAN CHECK � $ � PERMIT' � ' PLUMBING �. • $ , ISSUANCE $ PLAN CHECK 25% $ � ENERGY P.C.' $ ELECTRICAL � $ ' GRADING � $ - P�LAN CHECK �50°�', $ � MICROFILM� $ , MECHANICAL $ TOTALFEE $ _l3.sa � PI.AN CHECK 25%i $ � � • . _ CONSTRUCTION-AND PLANNWG �� � � � ' . - - PG_ .x SPA , ., � > - " Date Inspector - �- � ' _ � Date Inspector � APPROVALS -_ Permit # • _ _ - � � APPROVALS � Permit # - . � •,1..Temporary Electrical Service or.Pale �� . � � 52. Pool & Equipment Location '� • . - . -� 2. Soil Pipe,-Undrgrnd: " - ` , 53. Steel Reinforcement � � ' � - - � 3. Electrical Conduit Utility;Undrgrrid. „ �. - - 54. �Forms � . � ' � " -- . 4. Electrical� Conduit-Undrgrnd. ' . �- , � , � 55. Elect}ical Bonding � � - . � � , ' � 5. $teel� einforcement. � � . � � 56. Rough,Plumbing &"Pressure Test - � � ' ,: � � ;. 6. Elecfrical UFER Grnd. � . , � � „ . - � - ' 57. �APPROVAL TO COVER-GUNITE � •' '-7. Footings'� � � � ' .. � - -'58. ;Electrical'Conduit-Undrgrnd.�� - . -'B. Foundation � , " _ ,' -� �" � , . 59.'Gas�'Pipe,.� Undrgind`.,�Test� - .' ' . , � '9.WaterPipe-Undrgmd. - � �� • ' 60.1Backwash�Lines;P-Trap,OUndrgrnd_- '�i� 10. Structural Floor System � � - •61'. �'APPROVAL,TO DECK' � ' �� 11. Property Sewer, Line & House Connection� 2 (�� ,. 62- Backwash &,Receptor-Final ' � ' �`: 12: Sewer�Cap � �� 63. Heater& Vent-Final � ` 13. Roof Drains � . �� ; _ ; � 64. Plumbing�Sy`stem - 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, , � . - ; � : �r. . 68. APPROVED FOR PLASTERING � , . ' 18: Rough Electrical-T Bar Ceiling � �, � � �� 69: POOL/SPA SYSTEMS FINAL' ' .� ' 19.-Rough Heating & Air Conditionirig ; .- , � FIRE DEPT: REQUIREMENT 20. Rough�Facto"ry Fireplace � � ' - APPROVALS Permit# , � � 21.iDLcts„in�Structuie� ' � ' ", � , , ' 70. Underground Hydro � �. 22:.Ducts, Ventilatingr ' � ' ' � � . .71. Product Piping � Gas- � Oil - ;�23.�Gas Pipe,-Rough & Test � � ��� ' ' � , � , �72. Underground F.lush y ' � 24. Roof Framing ' ' �� �� ,, � 73. Undergrnd. Storage Tank � Gas ❑ Oi'I 25.' Roof Sheathing . � , � . ' 74. Overhead Hydro � , 26: T-Bar Ceiling 1St�ucturill'& Monocoat � - 75�. Dry Chemical � � , 27,. Frame and Flashing j � ,'� 76; Dry Standpipe' , � 28., Lathing &'Siding % ' � � �. - , 77. FIXEDSYSTEM FINAL � � ; � 29.� Insulation ' �° � ' '� � � ' 78. FIRE PREV. FINAL ' � �30. Drywall Nailing - . , � , ! . ' ' HEALTH DEPT. REQUIREMENT 31: Plaster Brown Coat ' ' � 79. FINAL INSPECTION � • -� �T � 32. Electrical Power Meter-Final I �80. FOOD CERTIFICATE ISSUED � ;� 33. Final Electric � ! ��. ` � Notes: � ' , � � � 34. Final Heating�& Air,Conditioning �� ' � , � , � � ' ' � , � 35. Final,Ga's Pipe-Test , � - � + - � ' � , � � . �� � 36. Hoo'd�or CanoPY � . � . . � '. � � � . � 37. Final'�Factor�y Fireplace � . ' � , � � - . • ' � „ 38. Finaf Plumbing ' , � �� � , � � � � ' - � � . - ' - � , . � , 39. Water� Service-Final ; , � , „ ,�-� � ' , , • 40. G9s'Service-Final ' � . • � , � � � . . . ^ , 41. Solar pomestic-Final , , � _' " �_ , • ' ' � ' - 42. Backflow Preventei • � � • � �. � , . � .'i 43. Backflow Ir�igation � Y' , � . � � ,-� � , - � • �- :i 44. ,Landscape Irrigation System; � ' � � � � - � . � . 3i i 45. Sound , Attenuation , ' ' � . � ' `' ' " ' ' . � � . � i ; , 46. Handicap Regulations ' 1 ; ' ' ' , � � " , . � ' . ' 47. FINAL STRUCTU,RE &�BUILDING , � � . � � � ' „ . ' 48. Special Require�ments Complete8 � � , . _ � � ' � � � - . � � 'I 49. E�ectric Release ta Edison ` . � �- -- - •� � •- ' • �- � i - - , - - �- , ° . � � � • �- 50. Gas Release;to Southem California Gas Co � ' � � � � � ' • � •� 51. CERTIFICATEOF,OCCUPANCY �� � _ ' ' ! � ' - � - � .}' , ' - - � - . ' • ; ';� �. . No. ' 'Date � � ' , . . � , ' . - � _ ___ _ Applicant to fill in all spaces except those wilhin heavy Oortl¢r lines anC si9n all app�opriate Oeclarations. CITV OF COSTA� ,MES�A% CON�TRUC)TION PE M�I�T� /� • P I ' TRA L1OT NO. UNIT NO. Project Address �.i4 �+ � Q � ! b !�_(�/'(' l' �. � ` ��D� ��� � � ..! �� � • . —� TYPE OF CONSTRUCTION- NEW'. ADD ALTERATION ' REPAIR Applicant's Mailing Address ' � � '- ' [� � . Ownef"5 Name ' ' ' hone�;Si� / �� CONVERSION ❑ DEMOLISH 0 OTHER ' add�es: 1�" ��� r, I7�Y�_� �/� " DE��/CFL wf��ES"j G� t�[�'T Arch/Eng. ` �'� "License No.; TVPE OF PERMIT GRAoJrvc ❑ FourvDAT oN �RUCTURA� Addf¢55 � � - - ' -❑ TENANT ❑ ELECTRICAL ❑ �LUMBING ❑iMECHANICAL D�%lill�f% N ' " ❑�OTHER _ .. . .1 . - Convactor's Name' �' � � -Phone ' � . � ' � , ' � 5 PROJECT DESCRIPTION 54. FT. � � �ocCUaANCv' Addfe55�mailing� ' CONSTRVCT.IONTVPE � :VALUATION$� CityLicens2No. ' � � � ,_ � , ZONE � - GRADINGCU.YDS. � �ACRES L'ICENSED CONTRACTOR DECLARATION ' 1 hereby,affi�m [M1at I ain licensetl untle� provisions of Charte�-9 (commentlng � qemarks: � / . with section 7000) ot Division 3 oi the Business antl Professions Cotle, antl �=��� •j ���' � my license�is in iWftorce antl efiecL � i _ � i ' ' � ' � _ ' , . � , Licenze Clazs license No.� � � Date � � -� Si9nature � ' • PLUMBING � ' WORKERS' COMPENSATION DECLARATION , • ' ' � gar Sink � . Showers ' � I heretiy aitirm tnat I have a certiticate ot mnsent to self-insure or a certificate r � ot. workers' compensation InsurSnce, or a certi�ietl copy theieoi (Sectlon � gackflow Preventer- ' - -�ServiceSink+-- ssoo, �c. c.� , �,-. ` - { ; , . � �. .� . . r- '-- Policy No. ' �� - - � Company � Backflow Irrigation � Sewer Cap . ; eCertifietl copy is hereby fumishetl. '. , � . � . . Certifi¢tl copy is flleU witli the city Builtling Division. 62Lhtu65 S2w¢� Connection Date �AOPlicant ' - � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers � Solar Collectors - � (Thi55ection neetl not be completetl'if the permit is tor one huntlretl ($100) or iess)- � � ., � � � i Dishwasher � , Solar Piping� I certify that in thC Pe�formance of tM1e wo�k to��which this pe�mR is issuetl, I � shall� not empioy any person in any ma Rn�er so�$s to ome subject to the Drinking Fountains � Solar Tank Wo�kets' m en i n LawS of Califor�.: �[/ � - Date ��Signature A � �+� ' Floor Drains ' Swimming Pool w/Spa NOTICE: If, a ter ma �inq this tleclarati , you s i�oultl become subject to tne ' Wo�ke�s' Compensation p�ovisions of the Ldbot Cotle, you mus[ fo�thwitn FIOOf$ink5 _ U�in21 '. ' comoly with; sucn provisions or this permit shall , be � aeemetl revoketl_ CONSTRUCTION LENDING AGENCVr , � � , • GasService'. =0utlecs, ". .WAterCloset 1 hereby aftirm that there is a construction IenOing agency for�the pei'formance� of the work Por whith thi5 pg rmit _ is •1'ssuetl .(Section _309] Civ. CJ, ' ltnaer'z Name -i\I!h 1N F Interceptors� _�-� � WatenHeater - Lentler's Aatlress - � 'a ' Kitchen Sink ' Water Service " � - OWNER BUILDER DECLARATION� � ' - � - . I bereby atfirm�.that I am exemp[ from the Con[�acto�'S� License,Law for tne . Lavatories - � � , - • following reason (Section 7031.5 BuSiness antl Professional Cotle: Any city or ' ' county which requi�ei a permit to consVuct, alter, improve, tlemollsh o� repai� P-Tldp ' � � ' any structure, prlor to its'issuance, also requires Ihe applicant tor such permif t0 file a signetl staiement that he/she is IicenSetl'pu�suant to the provisions of ' ROOf D�dinS �� the Contractor'S License L'aw (Chapter 9.(commencing with Section ]000)�of _ I- Divlsion 3 ot the Business antl Prote55ions Cotle) o� that he/She is exempt -� - , therefrom and the Casis for the allegetl exemption. Any violation o� Section _ ' _ ' _ +7031.5 by any.apPlicant for a' permit subjects the applicant �[o a civil � " '� enalty of not more than five huntlretl tlollars (g500). � � I, as' owner ot the' property'or my empluyees with wages as their sole Reinspettion Fee�" $75 ' . Issue Fee • mmpensation, will tlo the work, antl the structure i5 not intentletl o� offeretl for sale (Section 7044, Business antl Protessional Cotle: The Contractor's - '. �MECHANICAL � ' Litense Law tloes not appty to &n owner of a property who builtls o� improve5 � thereon, antl who tloes such work himselt/herself o� throu9h his or her own �gOii¢� ' � HOOd O�. T 2 I� ❑� � employees, provi�etl that such improvements are not intentletl or of(eretl�for YP zale. If, howeveq the building cr improvement is soltl within one year of com- Canopy Type II ❑� � pletlon, the Owner will have [he burtlen Of proving he/she tlitl not builtl or im- � DUct � Und¢f GroU�d ' �ove to� the Ou�Oose of sale). � , ' I, as owner of the p�oDerty, am exclusively wntracting wim licensetl con- � Duct -Structural �� Refrigeretion System t o�s to wnstruct ih¢ project ($ection ]044, Business antl Prote55ions Cotle: he Contractor's License Law tloes not apply Yo an owner of property who Duct - Ven[ilating �0-100,000 BTU ❑100,000 E builtls or'improves thereon, antl who contracts for such'projects with a con- - - - - -- � tractor(s1 license pursuant to the ConVactorY License Law). 1 am aware that Exhaust System ❑ MWtiple ❑ System Repair/Alteration proof of thel� Worker's Compensation Insurance Shoultl be provitletl to� me. ❑ I am exempt untler Section _ B& P. C. for tbis reason � PirepUFact. BIt. ICBO�# ' ' ' Da[e ' Owner. �� v�� Y��Y�+� Signature O ' Drivers"Licerise or-55 CMF 0865-46, rev. 4/84 Whi[ - Accounting; Goltlenrotl - Assesso� � Issue Fee $�3 FEES 0 $ 3 A.P. # S .Main E T Front ARear C Righ[ K e Left 3R - - o' . Building: _ ' � # Automatic Washer= Constructior Pole Si Cooking Unit ' , Dishwasher Dryers ❑Gas ❑EI Fan' � F.A.U. Fixtures . - -. oevice eoxes � Outlets � Switches , ' 9873 :5/04%84 � _ Accessory Building: ' f :/7 Y' . ,,.. king�Req./Provided � ELECTRICA,L � � -- Transformer � 15,50,KW -, , ❑50+KW , •Meter ❑up to 100amps � Meter ❑over 100 amps � Suh Panel 1 .� Motors OO-1 HP O1 % -�B ' ' Inc.Solar �9-15 HP �16-15+ Microwave - � Pole Light � • . i . Range � ' Sign ' � 4 ' Standing Sections � Generator �0-5 KW 05-15 KW Trash Compactor � N 22.40 7I. Z � ' p N F : � " N G R E Q ,. M ; S. , - � I —FEESy— i ;- ' I - I ReinsPection Fee I$15 I I Issue Fee . . I $ 3 I DEVELOPMENT SERVICES REQUIR, Ery1�NTS: Zonin9 APProved BY—�-�� �_ ���C..' Date��'�_�_ 1' —_ _'�_ Building Approved By �Data��_��� Appliotion luued By � • Dat� � ' ' SUMMARV OF FEES BUILDING PERMIT $ ���.o�c7,� SMIP � $ � Q •SO PLAN CHECK $ (2. � v PERMIT � � � � PLUMBING $ � � ISSUANCE $ P,LANCHECK 25% $ -��� ENERGV•P.C.� $ , ELECTRICAL $ 'T,IDV GRADING �. $ � ' �� � MICROFILM ' $ , PLAN CHECK 50%' $ _= Sjv ' MECHANICAL $ � TOTALFEE . $ ,� PLAN CHECK 25% $ � % Q, �fj�j � CONSTRUCTION ANDPLqNNING �� ' -� - � � : -•,; PG.._& SPA , : . � APPROVALS Permit #- � - � Date � Inspector ' AppROVALS-. � •Permit # � ' Date Inspecior, '_ �1.;Temporary Electrical.SerJice or.Pole .' • - , � �- . 52. Pool & Equipment �Location � . ._ I� I � ' � �-2.� Soil Pipe-Undrgrnd.-� ' , . � . , . -- .53..Steel Reinforcement, � u�- _ • `- -3. Electrical•ConduitUtility`-Undrgrnd. `' � ;��- 54. Forms�. �-• ' � ' �' . 4. Electrical�Conduit-Undrgrnd-, � . a���� L� ' 55. Elect�ical Bonding � � . . ��- � , � ; i 5. Steel Reinforcement �� � _ Q Q '� 56. Rough Plumbing & Pressure Test • 6.`Electrical.UFERGrnd.' ' 57. APPROVALTOCOVER-GUNITE � _ ' � �.7. Footings: . ' ' ��)9 � G �_ 58. Electrical Conduit-Undrg�nd. - -. • . � ' S. Foundation � - � - 59�. �Gas Pipe, O Undrgrnd., Test . ' � � . � � . i "9. Water��Pipe-Undrgrnd. - � 60. Backwash Cines; P-Trap, � Undrgrnd. � � � , - �� 10. Structurel Floor System ` � - ', ` t�� r61-. APPROVAL TO DECK� '• - � � � �� ,. 11. Propecty Sewer Line & House Connectiom . � � . �62. Backwash & ReceptorFinal ,. ' I ' �" � i !12.SewerCap ' - • � ' � � - --.63:-Heater&Vent-Final - �" � . �� � 13.-Roof Drains - - . - �64. Plumbing Sysfem - Final � � ' . . � � 14.%Rougli Plumbing � .. � � - 65. Electrical-Final _ , � - 15. "Rough Electrical-Conduit � • � � -� � - � 66. Solar System-Final ' � ' - - �` � ..:1,6. �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,Cohditioning �� ' �FIRE DEPT. REQUIREMENT � � � . 20'. Rough Factory Fireplace � � '' - . � APPROVALS . Permit# , � 21 /Ducts, in Structure ' � � ' � ' ' ' � � . � 70. Underground Hydrq , � 22. Ducts,�Ventilating � • '71, product Piping O Gas : OOiI � . ' ',.23. Gas Pipe-Rough & Test - � •-� • �- � � . , i ' 7Z! Underground Flush � , � � � �24. Roof Framing a . . ' , • 73. Undergrnd.StorageTank O.Gas ❑Oil � � , ' 25. Roof Sheathing � � , - � �74. 0'verhead Hydro ' '. � � � t26. T-Bar Ceiling (Structural) & Monocoat � y ,. � -� �i �75. Dr Chemical : _ � 27� frame and Flashing . ' � � . � 76. DrY Standpipe , , : ��- �. . 28. Lathing•& Siding "� � . ' 77: FIXED SYSTEM FINAL , ' _ . � 29. Insulation � � ' i � 78. fIRE PREV. FINAL � ; 30 Drywall IVailing � . f ' ; HEACTH 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��.,z � , . . � , . 35. Final Gas Pipe-Test �� - � �� - �� • � � � .. , . . 36. Hodd or, Canopy - , , ' • � , - 37. Final Factory Fireplace ' � '- � ' ; ' - - - ° _ � 38. Final Plumbing i . i i ,� , � . � ' . � . ' . - - ' � 39. Water'Service-Final, � " . , � � 40. GasService-Final ' � �...� `, ' � ' ' ' - �� . ' 41. Solar pomestio-Final ' , , � � � � � � � � � - � -- - . . . _. 42. Backflow Preventer ' � � '� , • ' � ' . - � - .��.• ' . � ' � 43.Backflowlrr,igation �, r;,, ��_ , ' � ' �. " �.' ' � r 44. ,Landscape'Ircigation SYstem �. . : , ' � ' . ' , � 45. Sound Aftenuation, ' ��• ' . - - � ' � � � � -'� - ' � . � . .i, i . . z�'�, � 46. Handicap Reguletions � 1 � �, . ' � �, { ' ' ' - ' 47. FINAL STRUCTURE & BUILDING9 � � ��� � . � � � , , 48. Special Requirements'Completed' � ' .' , , � � 49. Elect;ic Release to,Edison • ! • - ' , . - ' ' • � � � 50. Gas Release to Southem California Gas Co - � � i - �. � ' �:-. � 57. CERTIFICATE'OFOCCUPANCY_ __. .i._; �'_.:..! � : + '_ ! ' , � � � . � � • ,. , : � . �i--,_ . ,, , - . No. ' ` - � ' Date . , . � � _ i \ r ADVlicant to till in all spaces except those within neavY Dortl�r� lines antl sign all a� CIT�oF �. ESA CONS�RUCTIONPERMIT /�/� P cITNO. • TRAC��c, �030. i Project Address, '�9� 3' C' eJ_J�Q r � C�' / �� • �L �" O� � - TVPEOFCONSTRUCTION. NEW ADD ALTERATION ApplicanYs Mailin Address - � - � ' - � �n 'O CONVERSION '❑ DEMOLISH '0 OTHER Owner's Name - 1 �Phone�E%�/ _DES�R1pT10N F WORK SE OF e DG. � G7 PAIR� a:r.,#' i.� Address � � {; �� �� ti� �n � a✓� ��' - ' A ,) �_��Ui� ' �rtl✓�PJ EX/S�T' � �s�� _ Arch/Eng. ^ ' License No. -- TYPE OF PERMIT ' � GRAoI G'� ❑ FOUNDATION ❑;STRUCT.URAI . ' ' �, � � ' + ' �� -� � = � ❑ TENANT � ELECTRICAL .❑ PLUMBING ❑-MECHANICAI ,�- y Address ' ' � � ❑ .OTHER ' � ' - `� Contractor's Name� �� �W�E2 phone � � � • � � Address (mailing) � ' � . � PROJECT DESCRIPTION' SQ. Fr.� � w .oCCUPANCv' �� � � �CON $TRUCTION TVPE VALUATION $ � City License No. ' ' • • ' ZONE � GRADING CU. YDS. ACRES � LICENSED CONTRACTOR DECLARATION ' � 1 he�eby aftirin that I am licensetl untle� provi5ion5 of Charter;9 (commencing Rema�ks: ��i� �/ 3� � ' - � with section 7000) of Division 3 ot Ihe Business antl Pro(essions Cotle, antl ' � � � my license.is in fuil force antl effecL , ' � ' ' � . �G' i _ �J � D � , ' License Class ' - � license No. � ' � �' � � Q )ate � � Signature ' � � ' ' � PLUMBING FEES ,VORKERS' COMPENSATION DECLARATION � ' � ' Ba� Sink � � � Showe�5 � ' � Z I hereby affirm that I have a certificate o( consent to selt-insure or a certificate 1 � � i of-Wo�kers'- Compensztion� Insurance, or a-certifietl�copy thereot (Section - ' ' . _ . .i ' _ _� _ . 3800, Lao, c.) f� � �,. .- Backflow Preventer Service Sink • � � �; Policy No. ��' Company � r gackflow Irrigation Sewer_Cap eCerti(ied copy;is hereby fumishetl. , � ' . � � i . ' Certifietl cbpy is filetl with the city Builtling Division. '� �� ,• BatM1tubs Date "� APPlicant � , ' . . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION. _ � Clarifiers I � ' (This section neetlinot be completetl if the permit is for one huntlretl (5100) or. Dishwasher , ' less). :. . � , � - . . � � _, 1 certify tM1at in the performance ot the work for which this perm�t is i55uetl; I shall: not employ any person in any m ne� o as to become'subject [o th`e . � DfinkiOg FOUntain5 ' Workars' mp sa ion Laws ot Calito n)a. ' � / � - Date�`7—Si9nature '�? � _ � NOTICE: f, afie� n5aking this tleclara a6, you sho�1� Wo�ke�s' Compensation provision5 of the Labor Cc comply �with such proNsions or . this ,permit �shx CONSTRUCT,ION LENOING AGENCY•._ '� I hereby affirm that there is a�wnstruction�lendinq a9t of che �work .tor wnlch . this permit, is - issuetl y Lentler's Name- ' " LentleYs�Atltlress � "� � ' OWNER BUILDER DECLARATION - � ' I hereby attirmShat I am:exempt irom the Contrac tollowing r¢ason. (Seclion ]031.5 Business antl.Profe rnuntv whlch renuves a oermit to construct. alter. ir me 5ubject to the u mu5t forthwith tle¢metl revoketl. r the performance' n;�3097 Civ. C.) �,ense law for the otle: Any city or � tlemolish or repair it (or such oermit o file a'signetl sia[ement tbat ne/sne is Ilcensea pursuani [o [ne provisons o* he Contractor'S LicenSe Law (Chapter 9(commencing with Section ]0�0)!of Jivision 3 ot the Business antl Profes5ion5 Cotle) P� that he/she-is ez¢mpt theretrom antl tne basis Tor the allegetl exemption. Any violation of Sec[ion 703L5 .by any applicant for a permit subjects the appllcanY-to.a civil eenalty of nol more llian five huntl�etl tlollars ($500). �� - I `LI I,' as owner of the property'or rriy emoloyees with wages as thelr sole compensa[ion, will tlo tlte work, antl the. structure is nof in[en0etl or otferetl for sale (Section'7044, Business antl Protessional Cotle: The Cantractor's License Law tloes not apply to nn'owner of a property who builtls or improves thereon; antl'whd tloes such work nimselt/herselt:or tnrou9h his or'her own ' emplaye¢S, provitled that 5uch improvements are n0t'intentletl or oiferetl�fo� � sale. If, however, the builtling Gr imp�ovement is soltl�within one yea� ot com- pletioqttne owner will, have the burtlen of p�oving he/sne tlitl not builtl or im- ' �Ovlforlhe purpose of sale). ' " I as own¢r o! the pio0erty, am exclu5ivety mntracting with licensetl con- rac �o�s to construct the project (Section ]044, Business antl Professions Cotle: he�Confractor:s License Law does not appty to an�owner of prope�ty who , bulltls or Improves thereon, antl who contracts for such orojects-with a con-' tractor(sl Ilcense pursuant fo the Contractor's License Law). I am aware that proof of fhei� Wo�ker'S Compensation in5urance shoultl be provitled to me.' i ❑ 1 am exempt untler Section � B. & P. C. for tnis reason i Date Ownerl 1 hereby certify'tbat I�bave reatl tlii5 application antl state thaf the above information is correct. I agree to comply wlth all dty antl county or0inances • antl State laws relating�to builtling co st�uction; antl hereby authorize repre- sentatives ot this city to enter, up t bove- entionetl =roperty to inspectlon pu�poses. � Signature Date � � Floor Drains� FloorSinks '- � - Gas Service r0� !el Roof�Drains. � � � , ` r .- � � _ � i �Reinspection=Fee � $15 Boiler � . � � Duct� Under Ground Duct - Structural Duct � Ventilating � � . Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO�# Heating System & Ducting ❑ 0.100,000 BTU O 100,000 BTi L - - Reinspection Fee �� D'fivers' �License or 55 � CMF 0865-46, rev. 4/84 White - Builtling; Canary -Appli ant; Pink - Accounting; Goltlenrotl -Assessor $15 Solar Collectors Solar Pipin9 Solar Tank - Swimming Pool Urinal Water Closet Water � � � Isue Fee � � s, main ci - E. T ,Front B� Rear A - C Right - K Left S - PI'nq. Ref. # �9874 5/04/84 •�� _�O � �Accessory Building: r � . J . ' . . Park;ng Req./Provide � Automatic Washer-" Construct ion �P �a`te. Si Cooking UniC'�'r Dishwasher ;.���i, Dryers� OGas DE Fan � : � , F.A.U. ' ��� �� � ���� �-•-•� ����� ����� ��e�� ����� Hood or' Typel ❑ Canopy Type I I ❑ � ' Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Issue Fee � .i Disposal �r �05KW �� $s r Reinspection Fee FEES DEVELOPMENTSER .. Zaning APProved By- / Building Approved 6y $ 3 6�.54 T4 ,17�/.�L:��.:�,a� :i li�i.G1��7Lir� . v � . ' ELECTRICAL I i • FEES ' ' -"' ' Transtormer �-1&50'KW""' ' " � ❑ 50+�KW _ . �. 7 . �Meter ❑upto100amps , ' Meter, Dover 100 amps � . �ctric , Suh Panel � � 1 Motors OO-1 HP O1 Yh'-'8 ' InaSolar09�15HP076-15+ ' +Microwave- ' , ' 2- Pole Li9ht �� � � Range , � � � ' � ' Standing Sections � 5 KW ' Trash Compactor ! , ' - $15 luue Fee � $ 3 iEQU1RE�ENTS: . , S� � 1 ✓ SU%� RV OF FEES � � /� {��[ a BUILDING PERMIT $ �`� •DO �SMIP � $ �� ', PLAN,CHECK $ ' � �C� PERMIT � J.� PLUMBING � $ '� ISSUANCE � $ ' � PLAN CHECK 25% $ • D �ENERGV P.C. $ � ELECTRICAL � $ 00 GRADING $ • PLAN CHECK �5D% $ ' .00 MICROFILM ' $ �f 4 MECHANICAL $! �TOTAL FEE ,$� r� 6 � PLAN CHECK �25% $ '� � � ' . � : i - CONSTRUCTION qND PLANNING - � ' - - ' F' - g` SPA ' ' " � I � Date � Inspector � � - ' . . , . Date ;Inspector � APPROVALS � �Permit # ' � _ ' APPROVALS � Permit # � � . , Temporary Electrical Service or Pole - � �•�- 52. Pool & Equipment Location --. _-. � . Soil Pipe-UndrgmU. . ' . i��� (�� + - � ��53: Steel Reinforcement � _ -. _ � � � f - . Electri�al Conduit Utility-Undrgrnd. " � 54. Forms` � �. . - � . � , � '4. �lectrical ConduitUndrgrncJ-.. � . C � � � , , 55. ElecYrical Bondirig � � - 5? Steel�Reinforcement _� ' � 56. � Rougli Plumbing & Pressure Test . � i �. �6. Electrical'UFER Grnd. • ' � � 57. Af�PROVAL TO COVER-GUNITE � ' ;•; J. �Footings �^� � � .. - 58. Electrical Conduit-Undrgind �; � � . � � , _ �6. Foundation � � ' � � � .'�59: Gas Pipe,;� Undrgrnd., Test - - , � �. ��� � • �9. Water Pipe-Undrgrnd. . � Z/��k Lf�f 60.� Backwash Lines, P-Trip, O Undrgmd.� � ' 10. Structural Floor System ' . � ` ' 61. APPROVAL TO DECK � � � � � , 11. Property Sewer Line & House Connection Z� 8,.� EG� :62. Backwash & Receptor-Final� : �, 12. Sewer Cap ' � � %63.�T�Heater & Veni-Final ' . � , �13. Roof Drains' � ' 64_ Plumbing System�- Final� %. , �' , � 14: Rough'Plumbing � � � l�Z�% LF',/] � '65. Electrical-Final - • ' � . - ' � 15. Rough-Electrical-Conduit--"- - , . "' 66. SolarSystem�Final ' ' ' - ' � - 16.` Rough Electric Wiring., � ' � 01 g ' 67. Fencing & Access Approval -, � , .' , � 17,.�-�Rough Wiring Sign � . , ��' ' � � g$. APPROVFD FOR PLASTERING. , � _ �'. ' 18. Rough Electriral-T Bar Ceiling � ' , � 69. POOL/SPA SYSTEMS FINAL : ' � _ � , • 19. Rough Heating & Air Conditioning � , ' FIRE DEPT. �REQUIREMENT � � , � - • 20. Rough Factory Fireplace ' ' . � � � APPROVALS Peimit�# ' " _ .� 2L�Ducts,'in�Structure � , . ; , 70. Underground Hydro � - 22. Ducts, Ventila{ing � � � , � � � �71. Product Piping 0 Gas �� Oil ' � . 23. Gas Pipe-Rough &,Tesf�-. � ��` � i !., •�, ' � 72r Underground Flush ' � � 24'. Roof Framing �'' ' ' , .. ' � 73.� Undergmd. Storage Tank � Gas" ❑ Oil � - � • 25. Roof Sheathing �% , �_ :� .T 8 v�_ 7q.�� Overhead Hydro � - 26. T-Bar Ceiling (Structural) & Monocoat � � -. , 75. Dry'Chemical � ' � � 27��Frame and Flashing _7 /$/�/' , ' 76. Dry Standpipe � . , ' � ' 28. Lathing & Siding � ' �� � - � 77.. FIXED SYSTEM FINAL � � � - 29. Insulation •. � - �' � `-L, 78. fIRE PREV. FINAL � � 30. Drywall_Nailing � ; � , �HEALTH DEPT. REQUIREMENT � . � 31. Plaster Brown Coat: ;�t�� � ' . ^ ; -� � 79.; FINAL INSPECTION � � } � -,� 32. Electri�Sal Power Meter-Final '; , 80, FOOD CERTIFICATE ISSUED ' 33. Finab Electric - - Notes: � � ,�. , � - � � ,, j . ; ' 9r „3 � o• �-� ,a � r.- 34. Final Heating & Air1Conditionin� '.� ; /.�7' ' 8��� - D �� . 35. Final Gas Pipe-Test. � ' � . � OP � - i J ' . C . 36. Hood or Canopv . ' ' '�j' ��L,� ..•,'� / - ' ' i r ✓!� 37. Final Factory Fireplace ' ' - � ' - � . � i i .�.." '. . . . . 38. FinalPlumbing�:" � .� `i r , '� � . � � 39. Water,�Service-Fi,na1- ' ' �' � � ' � � • - �- , . � . �� � � �i . � . . . 40. Ga's Service-F,inal .: � I � ' ' � ' . , . 41. SolanDomestio-Final ' ,!' .., � � . � � � . . .� .. . . . . .. 42. Backflow.Preventer � ' '� �- , � � � � ,.,.' ;�• „ • i y 43. Backflow Irrigatiori� � �� �;;y' � � � � " . , . ', � , ' ' ",� - . .� 44. ,tandscape Irrigation System �� � '' � . . i . • � � , � n 45. Sound ;Attenuation , , . � � . � , , , . , . ' I ' ' 46. Handicap Regulations � � j � ' ` � - ' • 47. FINALSTRUCTURE&BUILD�NG , , , ' . ' 48. Special Requirements Completed� � ' ' � ' � • ' , .. 49. Electric Releaseto Edisonr �� �' ; - � �-�-� •• - - -- • � �� . ' � .t { . 50. Gas Release to Southern Celifornia GasCo � , ' � � - : � • .�� � � 51. CERTIF.ICATE OF OCCUPAN�Y.., _ _ _' ._ _ . . � � � ' � I ` � , � No. " _ . . Date -% �� ' . � , . 1 , . '� � ... ; � ' . - ' �Li_� �y�� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31� COSTA MESA. GALIFORNIA fOR APPL/CANT TO f/Ll /N COMPLfTELY TYPE OR PRINT - ADDRE55 2 8 Ce� lon Drive . COSTA MESA. CALIFORNIA . ' owNERKen rof Develo ment Co. Inc """" 1555 Placentia AIIIIRFSC �=EE RE��i�l�l� Cc c� ,2 _ .3.- 6 0 FINAIICE DEPT. APPLIC'AT10N�F0TI�t r�MIT BUILDING ADDRE55 FIRE ZONE CONTRACTOR K. W� K011 . LIC. NO. 61195 ByPROVED fOR OfF/CE USE ONLY Y I DATFtiR=CF�IVEj)QI [��E�SSUE� p[ / !I J COSTA MESA, CALIFORNIA � TVPE V GROUP F1 � LEGAL ILOT 1Q6 I I J�L% Z�NE NO.OF OESCRIPTION NO. � 6LOCK TRAGT PLANS A.P. NO. °.PPROVED BY % OF LOT ! JXZQO, irre I How oN �oT6 0 REQUSRED USE OF None I�ENTER LINE BT.�. EXISTING BLDG. FRONT � serewcK ��Ne cnon� CO ( REAR YARD 1� CENTER OF STREET J R. SIDE SI�E YARD ILEFTJ, IRIGHT J t � L.SIDE DESCRIPTION OF WORK - REAR NEW I�` II ALTERATION I II ADDITION I SZ�EDING 1SOO Sf ROOMS O STORIES EXTERIOR WA I ROOF Wood Shakes COVERING C COVERING '� USE OF BUILDING ANO WORK TO BE PERFORMED Sin le-Famil Aesidenc and Attached Garage aa� 1 HENEBY ACHNOWLEDGE THAT 1 HAVE REAO THIS APPLICATION TND STATE TH HE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH AL CIT OROINAN S AND STAT LAWS REGULATINO BUILOING C ST TION. • 1 ■ AUTHORIZED AGENT ZONING FT. THE NMOUNT SHOWN UNDER VqLL1pTION IS FON TNE PUNPO6E OF ESTABLISHING q PERMIT FEE ONIY. VALUATION �j PERMIT FEE $ �J � � $ /��3s (� / PLAN CHECK $ ' � 7 � � TOTAL FEE $ � 7—