HomeMy WebLinkAbout2850 CHIOS RD - Building PermitsAOO���ant to fill in all soaces excev� those within heavy noraer lines ana sign all aoP�opriate Ceclaratians.
CIT '�1F COST�A ��,$JpS� CON LsUCTfON(�p�f{�'�'IT
tAddressts�Vv� �"/ �ds /l`'S
Hpplicant'sMaily ddre � /� SAC�g.ec..ab a/E'j`
Owner'sN me dP �Y���,.�r,��'s—,—y/'�^---` Phone n
Addres � 3�C��^� r�@S�l
Arch/Eng. License No.
Address —
Contracto 's Na i T 0��9 Phon O � �
Address (m 'I' ��%O � e"'� �A''"`�
Ciry License Noi3 ia i
IICENSED CONTRACTOR DECI,ARATION
I he�eby a(firm that I am licensetl untler provi5iOn5 0/ Char[Er 9(commencl�g
with section ]000) of Division 3 of the Business antl Professions Cotle, antl
my license is i 11 ntl effect. /% �
license C1Sjs � Tce�sq N�
�at ��� 7 � 8 5'g { �
/ORKERS' COMPENSATION DECLARAT
I hereby aitirm inat I have a certificate of co sent to self-insure or a ter[iticate
ot Workers' Compenzation Insurance, or a certifietl copY thereof (Sectlon
3800, lab. C.)
Policy No. - Company
eCertifietl copy is hereby furnishetl.
Certifietl copy is filetl with the t�ty Builtling Division.
Date Appli[a�t
EXEMPTION FROM WORKERS' LOMPENSATION OECLARATION
(This section neetl not be completed it the permit is tor one huntlretl ($300) or
less).
I c2rtity that in the p¢r/ormance ot the wOrk for h is e� t is issuetl I
shall no[ employ any person in a m o c subject to t�te
Workejs� Coqipe�ti� Laws of �
Oate// 1 0 Si9nafut
NOTICE: If, after making this tletlaratiOn, y0u shOultl become Subject to tbe
Workers' Compen5ation provision4 of the L2bor Cotle, you must forthwith
comply with such O�ovisions oV this pe�mit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that tnere is a construction lentling agency for the Derformance
ot the work for which this permil i5 issuetl (Section 309] Civ. GJ
LRnaer's Name
Lentler's Atltlress
OWNER BUILOER DECLARATION
I hereby aifirm Lhat I am ezempt from the Contractor's License Law for the
following reason (Section 7031.5 Business antl Pwtessional Cotle: Any city or
�unly which requires a permit to construct, alter, improve, tlemolish or repair
y structure, prior to its is5uanc8, also requires the applicant tor such permit
, file a signetl statement that he/she is IicenSetl pu�suant to the provisions oi
�he Contractor's License Law (ChaO<er 9(commencing with Section 7000) ot
Division 3 o( the Business antl Professions Cotle) or Ihat he/she is exempt
therefrom antl the basis tor the a�legetl ezemption. Any violation ot Section
7031.5 by any applicant tor a Permlt subjects [he applicant to a civil
penalty of not more than five hundretl tlollars ($500).
LJ I, as owner of the property or my employees with wages as their sole
compenSatiOn, will tlo the work, dntl the 5[�ucture is not intentletl o� otieVetl
for sale (Seclion 7044, Business antl Protessional Cotle: The Contractor•s
License Law tlo¢s not appty to an owner Of a pro0erty who builds o� improve5
tnereon, antl wlto tloes such wotN him5elf/ne�selt or IhrOu9h his o� her own
employ¢es, provltletl that sucb imP�ov¢men[5 a�e not Intentletl or otfe�ed !or
sdle. 11, howevet, the builtling or improvement i5 Soltl within one year of Com-
pl¢[ion, �ne owner will have the burtlen of proving he/she tlitl not bui10 0� Im-
�rove for the pur0ose ot sale).
I, as own¢r of the property, arn exUuSively ContraCting with licensetl COn-
tractor5 to mnstruct the project (Sec[ion 7044, Business antl Prote55ions Code:
The Contractor's License Law does not apply to an owner of property who
builtls or imoroves thereon, and who conVacts tor such oroiects with a con-
tractor�sl Lcense pursuan[ m me ConVa<tor•s Licanse Law). I am aware that
proof o� their Worker'S Compen4ation insu�ance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. �or this reason
Date Owner
certify
in is c�
Signat ure �C(l �"
Drivers' License or 55 '�
0865-46, rev. 5/88
have reatl tnis application antl state that the above
agree to tomply ' h all city antl county ortlinances
o� by il ' con ruc ion, antl hereby authorize repre-
iyihn r upo t above-mentioneiir=perty�fy
� / � � (%
��_� Date
TVPE OFCONSTHUCTION LJ NEw LIADD LJ TERA
❑ CONVERSION ❑ DEMOLISH ❑ OTHER �_
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRA�ING LJ FOVNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SQ. FT.-� y DD OCCUPA C
CONSTRUCTION TVPE VALUATION $�
ZONE GRADINGCU.VOS. ACRES—
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Showers
Service Sink
Sewer Cap
Sew`er Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Po�l w(Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
FEES
A.P. #
S Main Building:
E
T Fron[
ARear
C Fil9ht
K Left
$
Ping. Ref. #
Planning Notes:
Accessory Building:
Parkin9 Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A. U.
Fixtures
Device Boxes
OUtI¢t5
Switche5
Garbage Dispoul
Generator �0.5 KW �5-15 KW
Zona
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors OO-1 HP O1 h- 8
Inc.Soiar �9�75 HP �16-15+
Microwave '
Pole Light
Range
Standing Sections
Trash Compacmr
Fee �$75 � � Issue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
ReinSpection Fee $15 Isue Fee Zoning Approvad By
MECHANICAL FEES ,- I Building Appraved By --��_
Boiler �
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact BIt iCBO #
Heating System & Ducting
❑ 0.100,000 BTU � 100,000 BT
Reinspection Fee � S15
Wnite - B�iltling; Canary - Appllcanq Pink - Accountinq; Goltlenrotl - AsseSsor
Hood or Typel ❑
Canopy Type II ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
Sys[em Repair/Alteration
Fire Dampers
Registers
Issue Fee
N
I
N
G
R
E
�
M
T
$.
FEES
$ 3
- SUMM V F FEES E��
BUILDING PERMIT $ � SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
� PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROPILM $ G' �—'\
MECHANICAL $ TOTALFEE $ �
PLAN CHECK 25% $
Qt (100?E53b-Cp018�37 �'�-�-
s a Da7E: il/u3/,4° TI(!E: [le:i3
?i.��
N$TRUCTION AND PLANNINi. �L & SPA
Date Inspector Date Inspector
�ROVALS Permit # , r APPROVALS Permit #
1. Tempora�y Electrical Service or Pole 52. Pool & Equipment Location � 7
2. Soil P,ipe'-Undrgrnd., � i 53. Steel Reinforcement !%
� �.
,
3. Electiical Conduit U'tility-Undrgrnd� � 54. Forms :;� .
�4. Electrical Conduit-Undrgrnd. '% 55. Electrical Bonding ;�.�•1�
5: Steel'Reinforcement� ' 56. Rough Plumbing & Pressure Test �-�
, . . �
6��EJeciiical UFER�Gmd. �, � .� 57. APPROVAL TO COVER-GUNITE � ,�
7. •Footings �� ! •� .�_.� 58. Electrical Conduit-Undrgmd. � ��.I -
8.� Foundation . ,t .' f' 59. Gas Pipe, O Undrgmd., Test � ���
F ��
9. Water�Pipe-Undrgmd. 60. Backwash Lines, P-Trap, � Undrgrnd. 1'
� I "-'.l
10':''St�uctural Floor System ��.. 61. APPROVALTO DECK
1•1'. Property Sewer Line�& House Confiection ' 62. Backwash & Receptor-Final
:
12. SAwer Cap �;� '� n� ? , 63. Heater & Vent-Final �
13. Roof D�ains ` -. � = �
. 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
d8i Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19i Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
2,1-.�'DuCts, in Structure 70. Underground Hydra
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Tiest 72. Underground Flush
24. Roof Framing 3. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing '� �)� 5 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frar(ie and Flashing 76. Dry Standpipe
28. Lattiing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. D"rywall Nailing l �' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ��� 79. FINAL INSPECTION
32. Electriral Power Meter-Final S0. 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 pomesiic-Final
42. Backflow Preventer '
,]
43. Backflow Irrigation • . ��
�'�
44. .Landscape Irrigation System • :�
45. Sound Attenuation
46. Handicap Regulations � �
47. FINALSTRUCTURE&BUILDING , �v
48. Special Requirements Completed
49. Electric Release to Edison � -+ ,
50. Gas Release to Southern Califomia Gas Co •; � �
51. CERTIFICATE OF OCCUPANCY i � '
No. � Date ,
OWNER PACESEPP
JOB ADDRESS 285o Chi
GENERAL CONTRACTOft
AP No. LOT
INSPECTIONS
coat
TRACT 4
� Signature
� PIRE ZON�
DATE I GROUP
DATE
VALUE $ �4�41j.00
D�SCRIPTION OF WORK reS
TYPE � 7.ONE
SUBCONTRACTOR
'GL g3T
fEL
BGR
�
1\ ,,,��
�Lr �b^
._��.,
COSTA MESA BUILDINGSAFETY DEPARTMENT
G.O. BO%91] COSTq MH9A, CALIFORNIA
For Applicant fo Fill In Completely
�� TYPE OR pRINT
ADD E68 a ����Q' (.C.
GOSTA MESA, CqLIFORNIA
I �:4\N
7n�
� ARCHITEGT ... i 4..J-- A D TEL. �I
✓
9
exis� inu ewn.
BETBACK LINB FPOM
CENTEN OP BTiI¢6T � RHAR
SIDEYARDI LERf � I RIGHT
DESCRIPTION OF WORK
PERFORMED
I HERHBY �CKNOWl8D3! THAT 1 XAVH RGO TXIB APPLIGTION
ANO 9TAT8 THAT THH ABDYR �8 COpqlCT AND AOR88 TO COM-
PLY WITH �LL CITY OpDINAtICEB AND BTATB LAWG H80YLATINO
auamna corvernuci OH. /-.
SIGNATUREOF G
PERMITTE
AUTHORIZED A68NT
FEE RECEIVED
MAR 2 2 1963
FINANCE DEPT.
APPLICATIOIVTPORFP�A MESA
BUILDING
For Of(ice Use Only
N8C6�L=
BUILDINO
ADDRHGB
PIRH
�t��������
BHALL BE LE55 THAN
YARD9APPROVED YAROSAPPROVED
MAIN BUILDING ACGESSORV BUILDIN6
:OM GL bTREET)
/ i�
REAR � FT. O F
DISTANGE BET. BET. MAIN Q
MAIN BLDGS. AGGE59. BLI
VAR. # DATE
C�3�6 fio.�. ozo�' �
TNB �MOUNT BHOWN UNDBP V�LUATION 19 FOR THE 1
PUHP098 OP E9TABL18HINO ♦ PHqMIT P¢8 ONLY. p
VALUATION p
PERMITPEH $ j
$ ��/, yis 9— a
0
��'✓N� TlF T AMGRFy R .T. DATP: 'j-tj-66
JOB ADDRESS 2$50 CL1ia5 ROQd. BUILDING PER�fIT NO. 25891
GENERAL CONTRACTOR Owner-Builder DESCIiTPTION OF WORK pat30 COVCT
AP No, li9-!F%+2-21 LOT TItACT FIRE ZONE VALUE $ 300.00
�INSPECTIONS I Sieaature 1 Da[e � GROUP .T TYPE V ZONE R_�
SUBCONTRACTOR
Service or
, .� ` ' 2589 I
COSTA MESA BUILDINGSAFETY DEPARTMENT
V.O. BOX 7200 COSTA MESA, CAUiORNIA 92626
For Appl7canf ro Fill In Completdy
TYPE OR PRINT, ^
BUILOIN6 i/ � j� �1 /
ADDRE86 (� (l ���
COSTA ME3A, CAG.IFORNIA
airv C'o
ARCHITECT
e rf,
TE4
DESCRIPTIOtd OF WORK
�eu��oiNa No.
SIZE RO[
BXTHRIOR WALL R
pmv
�1 XERBGY ACRHOWL[D06 TXAT I HAV[ 11QAD TXI/ MPIiGTOM
ANO BTATH THAT TN8 A80V6 It CORR[R ANO AOPBI TO COM.
PLY WITX ALL CITY OqO1MANC�/ AND YTAT[ LAWY R[OUTATINO
BUILOINOCONETRYGTION, n
� AUTHORIZCD AO[fiT
M-S-66 OD 369n3*°�**3.00
APPLICATION POR PERMR
BUILDIN(i
f0! ��C9 {/!0 �II�
11[C[IF1' NO. �I
E�
ZONING
Ho.or ucaor
�ue. nw�mi
��� J , `-� �'7'Q• �3 � �
D[1CRITON %—D"
A. P. NO. I � � ^ Y' �� � �' /
NOTR: N0 6AVR OV[RHANO SMALL D6 Ll88 THAH
80' TO 81DQ a RBAR P. L
ewvea
ALLOWHD (U. B. G. REQUIPHMHNTI
VARDBMPROVHD YARDSAPPROVED
MAIN BUILDINO ACCEDSONY BUILDINO
�i
��.� �/-- /G --
c. u. r. # n
APP,lOY[� ,� / i
wr Y 1 r r� i
BR. MAIN Q v
ACCE99. BLD68.
o�re � _�� �
�wrnoveo /
D�TE / � ���✓ C%I
— — " (7/j7 a
m
�
�
eo. vr. �
n�i wrounr sxowx uHoen vw�u•rion 19 POq rws i
�YPPOOt OP �BTABLI8XIN0 • PBHMIT I88 ONLV. qy
VALUATION � 6,v^ �
� PERMIT F8H ^ p
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