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Home My WebLink About3010 CLUB HOUSE CIR - Building PermitsApplicant to fill in all soaces exeept those within heavy bortler linas an0 sign all appropriate aeclarations. "- CITY OF COSTA MESA CON TR UCTION PERNUT PERNj1q fx0. _ � TRACT NO. LOT NO. UNIT NO. P rass .S ' r- - AppCcanYs Mailing Address ��y�� t Owner's Name Phonec.ts]Les-L1J Address � Arch/Eng. License No. Address i Contractor's Name Phon Address Imailing) � City License No. � �� - LICENSED CONTRACTOR DECLARATION I'hereby affirm ihat I am licensetl untle� prOvisiOns at Cha�te� 9(commencing with section ]000) ot Division 3 ot the Business antl Professions Cotle, antl my license is in full antl ef(ect. �License Class �icens No. Date Signature � WORKERS' COMPENSATION DECLARATION - - ' `ere�y affirm that I �ave a certificate of consent to self-insure or a certi/i<ate Workers' Compensation Insurance, or a certi(ietl copy thereof (Section \ �0. lab. C.) �p� - ��[ yf,p � ' � � Policy No.�f�� 9.�� ComPanY-1LYG1+b� � ❑.Cer[ifie c py is hereby fumish¢tl. Cj�Certi tl co� filetl with the city gG]Itlj� i�io . � Date �/%%^� Applicant db(�� E%EMPTION FROM WORKERS' COMPEN ATION �ECLARATION . (This section neetl not be completetl if the permit is tor one huntlretl ($300) or � iess). I tertify that in the performance of the work tOr whith this pe�m�t i5 i55uetl, I. shall not employ any pe�son in any manner so as ta become subjeCt to the Workers' Compensation Laws ot California. Date Si9nature � NOTICE: If, after making this tleclaration, you should become subject to [he Workers' Compensation provisions ot the Labor Code, you must forthwith comply with such provisions or this permit shall be tleemetl revoketl. CONSTRUCTION IENDING AGENCV ' I nereby affirm that tnere is a construction lentling agency for ihe performance o( the work (or which this permit is issuetl (Section 309� Civ. CJ LPntler'S 'Name lentler's AtltlreSs OWNER BUILDER DECLARATION . � I hereby affirm that 1 am exempt from the ConVacror's License Law for the followin9 reason (Sec[ion 7031.5 Business antl Professional Cotle: Any city or munty which requires a permit [o construct, alteq improve, tlemolish or repair .any sVucture, prior to its issuance, also requires the applicant for su<h.permit to tile a signe0 statement that�he/sne is licensetl pursuant to the provisions o( ,-the COMractor'S License Law (Chapter 9(commencing with Settion 7000) ot �sion 3 ot the Business antl Protessions COGe) or that he/she is exempt rfrom and the basis for the allegetl exemption. Any violation of Section ..5 by any applicant tor a permit subjects Ihe appliwnt to a civil ..alty of mt more thzn tive huntlretl tlollars ($500�. "� I, as owner of tM1e p�operty Or my employee5 with wages as their sole mmpensation, will tlo the work, antl the structure is not �intentletl or.offeretl tor Sal¢ (Section 7044, Business and Protessional Cotle: �The Contractor'S � License Law tloes not apply to an owner o( a property who bulltls or improves thereon, antl who tloes such work himself/herself o� th�ough his or her own employees, provitletl that such improvements are not Intentletl or ofteretl for sdle. If, howeve�, the builtling or imprOvement is soltl within one year ot com- pletion, tne owner will nave the burtlen ot proving he/she tlitl not builtl or im- prove tor the purpose of sale). ❑ I, as owner of the property, am exclu5ively cont�acting with licensetl con- tracto�s to wnstruct the oroject (Section ]044, Business antl Protessions Cotle: The Contractor's License Law tloes not apply to an owner of property who builtls or imp�oves thereon. antl who cont�acts for such oroiects with a c:on- lractor(51 license pursuani to me ConVactor'S Llcense Law). I am dware thai proof oi their Worker's Compensafion insu�ance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date Owner I hereby certify that 1 have reatl this application antl-state that the above information is mrrect. I agree to comply with all city antl county ortlinances antl state laws relatin9 to builAing wnstruction, anE hereby auMorize re0re-� Sentdtives of thi5 ci[y to enter u On th¢ above-mentioneG p�operty fo� InspeCtion purp e s. C/a, p� Signature Date-J G' Drivers' LicenSe or $ TVPE OF CONSTRUCTION LI NEW LJ AOD LJ ALTERATION L�REPAIR ❑ CONVERSIOM ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USEOF BLDG. � � TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5(�. FT. OGCUPANCv CONSTRUCTION TVPE VA�UATION $ ZONE GRADING CU. VDS. ACRES Remarks: Sink Preventer. Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Ouilets Interceptors . Kitchen Sink ' Lavamries � P—Trap Foof Drains Reinspaction Fee � $15 Boiler Duc[- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact BIL ICBO # Heating System & Ducting ❑0-700,000 BTU �100,000 Reinspection Fee � $15 OB65-46, rev. 5/BB White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor Shawers Service Sink. Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash Laundry Trays Issue Fee Hood or Typel ❑ Canopy � Type II ❑ Refrigeration System ❑0-100,OOOBTU ❑700,000 System Repair/Alteration Fire Dampers Registers laue Fee A. . # S Main Building: E T Front ARear C Right K S Left Ping. Ref. # � Planning Notes: FEES Auromatic Washer Construction Pole Sub. Cooking Unit �ishwasher � Dryers ❑Gas ❑Elec Fan F.A.U. t FixWreS ' Device Boxes OutletS . Zone Accessory Building: 2 � O N 1 N G R Parking Req./Provided � E � M I •i � T ELECTRICAL , Transformer ❑ 15-50 KW ❑ SO+KW Meter ❑up to 700 amps Meter ❑over 100 amps Sub Panel MotorsO0�1 HP O1X-8 - InaSolar 09-15 HP �i6-15+ ' Microwave ' Pole Light �awrtcnes Sign .Garbage Disposal Standing Sections Generator �0-5 KW �5-15 KW Trash Compactor �J :_ " i) 'Reinspection Fae ,: i $ 3 �.y `DEVELOPMENTSER - �Zoning APProvad BY_ FEES„ ��BuildingAPP�a�edBy $ 3 $15 � � Iwue Fee REQUIREMENTS: FEES $ 3 �i. SUMMARV OF FEES BUILDING PEFMIT $ SMIP $ �`+ PLAN CHECK $ � PERMIT , PLUMBING $ �� ISSUANCE $�� PLAN CHECK 25% $ ENERGV P.C. $� � ELECTRICAL $ GRADING $ { PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ �6v , PLAN CHECK 25% $ � � O1 40033??,�-�Ga3323S 'f'��"P , GAiE: �35117/8� iIiiE: tS.?. . . . _ . . .� . .;. i��'.. ;_` 1NSTRUCTION AND PLANNING ... POO' -� SPA �P_ROVALS Permit# Date Inspector p�ppROVALS Pt�init# Date Inspector 7 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 Grnii. . 57. APPROVAL TO COVER-GUNITE 7. �Footings ; � ' , % 58. Electrical Conduit-Undrgrnd. 8.,Foundation � � 59. Gas Pipe, � Undrgrnd., Test : 9.'Water Pipe-Undrgrnd. ��' 60. Backwash Lines, P-Trap, O Undrgrnd. 10'�Structural Floor System , ;, 61. APPROVAL TO DECK 11. P,roperty Sewer Line & House Corinection ' 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 117. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' � �18'. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL . �7�_ Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT � 2Q. Rough Factory Fireplace � APPROVALS Permit # VJ 2d. 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. Undergrnd.StorageTank OGas ❑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. Orywall Nailing � . HEALTH DEPT. REQUIREMENT 31. -P.laster Brown Coat - � 79. FINAL INSPECTION - 32. Electrical Power MeterFinal � 80. FOOD CERTIFICATE ISSUED � 33. Final Electric Notes: /s . L�tT(��. G�� 34. Final Heating & Air Conditioning Q_(Cr-��( �%/��r-�,L�J12� F}S PrtiZ� Z(i� 35. Final Gas Pipe-Test (),(.J� -�(„�� 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing � _ � 39. Wa[er Service-Final �i'; _ � 40. Gas Service-Final � �`�,r� � � . � 41. Solarpomestic-Final f7 . 42. Backflow Preventer 4-� �� 43. Backflow Irrigation �-C ' �� 5u t;;p �i 44. Landscape Irrigation System � 45. Sound Attenuation �"' � ' 46. Handicap Regulations�i . � 47. FINALSTRUCTURE&BUILDING - 4R. Sner,ial Requirements Completed � 49. Electric Release to Edison r�� /�j� i �i . 50. Gas Release to Southern California Gas Co T� � 57. CERTIFICATE OF OCCUPANCY . ��j No. Date � P'✓' e (714) 754-5273 • Fax (774) 754-4856 CITY OF COSTA MESA BUILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 3010 CLUB HOUSE CI Suite No Vicinity:. Parcel Nunmber: 13951553 Applicant: NOCK, RON Address: 11672 KNOTT ST GARDEN GROVE,CA -,.i := � .� . . i, �,, i.� , i Owne�i!/ ULTZ,'ALBERT C JR Address 3010 CLUBHOUSE�CIR ; l'/ � /,� ".�!j � , COSTA MESA, CA ��. , �'Contrector: .NOCK PLUMBING Address: � 11612 KNOTT ST � - ' GARDEN GROVE , CA � l. i A�ch / Eng y . - �/Address:. / WATER HEATER CHANGEOUT. "`-� � � � �; AMT QTY ISSUE FEE � $22.00 � Backflow irrigation _ $0.00 0 BackFlow Preyenter . $0.00 �� 0 Bathtub �� $0.00 � � 0 ClariferSystem,�.. $0.00 0 Connect pce,Soda,etc) -' $0.00 0 Dental Units '�� - . �-$0.00 0 Dishwasher - , $0.00 0 Drain, Floor � � `.$0.00 0 Drein, Rainwater � �$0.00 0 Drain, Roof ` $0.00 0 Drinking Fountain $0.00 0 Ezpansion Tank $0.00 0 , Gas Earthquake Valve $0.00 0 Gas (1-4 outlets) $0.00 0 Gas (Over 4 outlets) $0.00 0 Gas Repipe $0.00 0 Gas Service $0.00 0 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 PLUMBING PERMIT Phone: 714 895-1246 Zip: 92841 Phone: Zip: 92626 Phone: 714 895-1246 Zip: 92841 License: 707775 Phone: Zip: License: � r SCOPE OF PERMIT. ; PERMIT NUMBER � P99-00376 77 FAIR ORIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/O6/1999 Issued: 07/06/1999 ISSUED BY: FEE SUMMARY AMT QTY Laundry Tub / Washer $0.00 0 Landscape Irri9ation $0.00 0 P-Trep $0.00 � 0 .PressureRegulator $0.00 0 Process Piping (per 10 ft) $0.00 0 Receptors $0.00 0 SepticTank � � $0.00 0 � Sewer Cap for Demo $0.00 �� 0 Sewer Connect � - $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial - $0.00 0 Sink, Floor $0.00 0 Sink, kitchen $0.00 0 Sink, servicelmop $0.00 0 Spa (private) $0.00 � 0 Spa (public) $0.00 0 COMMENTS I SPECIAL CONDITIONS SumpPump � � Swimming Pool Trap Primer . Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+),' Wash Basin� � ' Wash Basin Set , Waste�and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Wafer Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT, $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $11.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALCALCULATEDFEES: $33.00 QTY 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 U] NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commencad within 180 days, or if work is suspended or abandoned for e period of 180 days. INSPECTIONS: In order tor the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. fOR INSPEC710NS CqLL: (714) 754-5626 I WORKERS' COMPENSA710N DECLAHA710N: I herehy ettirm untler penelry Of perjury one of Ihe following tleciarations: ' � ❑ I have end will maintain e certificete of consent to self-Insure far workers' compensation, es provitled for by section 3700 of the Labor Code, for ihe peAormance of the — /wark for which this permit is issuetl. . � I have and will maintain workers' compensation insurance, as requiratl by section 3700 oi the Labor Cotle, for the pertortnance of the work for which Ihis permil is issuea. My workers' compensation Insurance c.�arryier �and� policy �nu ber are: � 9 /r '.r7 ��+ Carrier: �!'iL�%GJ\� F �TTr9� r`- POIIcyNumber/(/LCJ�-�'/� ` � � �T.�7c_ (Thts section need nof be camp/eted 11 fhe permit is va/uea af one huntlred Dollers ($f 00) or less.) ❑ I cenify Ihat in the pertormance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, end ag�ee that ii I should become subject to ihe workers' compensation provisions of Section 3700 of the Lahor Cotle, I shall forthwith COmply with ihese provi5ion5. Applican� SigneNre: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CAVERAOE IS UNL4WFUL AND SHALL SU&IECT AN EMPLOVER TO CFIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSFND OplARE ($100,000), IN ADDRION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O60F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn ihat I am torce end aflecL Lic. # _ Comractors Signature: 9(commencing wlth Section 7000) of Division 3 of Ihe Business antl Professions Code} and my licanse is in full Class # L� 3 Sm � Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm ihat Ihere is a conslruction lending agency for the pedortnance of iha work tor which this permit Is issued. (Sec. 3097, Civil Code). Lentler's Name: LentleYs Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm that untler Oenalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sac. 7031.5, Business antl Professions Cotle: Any ciry or county which requires a pertnit to consimct, alter, improve, tlemolish, or repair eny structure, prior to its issuance, also requires the applicant for such permit to file a signed stetemant ihet he or she Is licensed pursuant to the provislons of the Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business end Professions Code) oi ihet he or she is azempl t�ereirom and Ihe basis for the elleged eaemption. Any violation of Section 7031.5 by any apD�icant for e permit sub�ects the applicant to a civil penalry ot not mora than five hundretl dollars ($500).): ❑ I, as owner of ihe propeny, or my employees wlth wages es their sola compensation, WILL DO 7HE WORK, entl the structure is not Intended or oHeretl for sale (Sec. 7044, Business antl Professlons Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, providetl that such improvemenis ere not intendetl or ofFered for sale. If, howaver, Ihe 6uilding or Improvement is soltl within one yeer ot completion, the owner�builtler will heve Ihe burden of proving Ihet he ar she did not huiltl or impiove tor purpose at sale.). � ❑ I, es owner ot the property, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions Cotle: 7tie contrectors License Law tloes not apply to an owner of property who builds or improves thereon, antl who coniracis for such pmject with a contractor(s) license pureuant to Ihe Contractors License Laws.). ❑ I am exempt untler sea Business end Professions Cotle for Ihis reason: Signature: Date: Owner ID verifietl by drivers license. ❑ Ves ❑ No Driver's License No. Expires: Verification of Ownership by (type ot daument, i.e. - propeny tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity that no ezcavation five (5) or more feet in depth into which a person is required to descend, will be matle in connection with work euthonzetl by ihis permit, antl that no bulltling siructure, scaflolding, talsework, or tlemolition or dismantling Ihereof, will he more Ihen thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Galifornie Adminisiretive Code). - ❑ As ownei-builder, I will not emptoy anyone to tlo work which would requira a permit from Ihe Division of Indusirial Sefery, as noted ebove, unless such person has e permit to do such work from Ihe tlivision. Signature: Date: Division of Intlustrial Satery Permit Number: CERTFICATE OF COMPUANCE AND AUiHORIZATON OF EMAV: I certify under penalry ot perjury that I have read this application antl state ihat ihe information given Is wrrect I agrea b comply with all stete laws and ciry ordinances relating to building constmction, and authorize represen�atives of iha Ciry of Costa Mesa to entar upon ihe above-descnDetl property lor inspection puryoses. I agree not to occupy or ellow wcupancy of any builtling authorized by this permit until tinal inspection. f �gnature Ot Legel Owner/(s) J ,� J Date� c �-- / / � � l �And/Or Aut�iized Applicant �— Date COUE I. INSPECiIONTVGE 1676 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Roof 201 Final BIxWRetaining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demoli�ion LA_E Irmn�LS COOEN INSPECTIONflGE 206 Final Mechanical 200 Final Plumbing 210 Finel Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Builtling/Occuoan� Pe�I€ � -iNrmnis . � r OWNEft GENERAL Final or Gas nn•rE DESCRIPTiON OF WORK ' .RE ZONE VALUE: SUBCONTRACTOB ZONE , , ��G �OSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 2f 7 C08TA M69A. CALIFORNIA For Appllcan► to Fill In Comple►ely . TYPE OR PRINT � ADDRE59 O10 Club House Circle COSTA MESA, CALIFORNIA �,,,,tiF, Mesa Verde Dev.Co. ■ STATE Costa Mesa E. Kaltenbach 23 E. 17th St. TEL. 78046 25 p bG . I NO.OPBLDYY. NOW ON LAT OO. ��_�_ FNOM �leT � R6AR YARD LfiFT ' ( R16HT DESCRIPTION OF WORK I JC II .. ___._._..I II ___._.__. S Z'E �1N6 1495 ROOMS COVERINGWALLStiUCCO ROOF COVER USE OF BUILDIIYO AND WORK TO BE Res.w/att.Gar• R6C[{Y8D vA �EE RECEIVED FEB 25 1965 FINANCE DEPT. AF��A�E�IRQ�� I�� BUILDING For Office Use Only ReC61Pi NO. � DE �45 ��ii�i�S ZONIN(i. rvo. or uoe or xew�� PLANB 2 BUILDINO gaT.�F Lot 53 Tract 4660 ' none /E OVERHANG SHALL BE LE35 THAN YARD3 APPROVEO MAIN BUILDING FROM C/L rSTREET) RONT �iJ Ff. . SID6 � tT. 91DE O FT. � EAR Ff. ISTANCE BET. 6 2 , VAR. Qi :�Gm �1 HEREBY ACKNOWLEDO! TH�T 1 XAVfi RFJ�D TXIB �PPL�CAT�ON •NO STATE TXAT TH8 ABOVB 18 COpRECT ANU AORE6 TO COM- PL�" WIT CITY OR�INANC88 AND BiATH LAWY HeYULATING BUILOIN CO ylUGTION. `� � AUTHORIZED A6iNT YARDSAPPROVED ACCESSORY BUILOING BET. MAIN ACCESS. B DATE ��-�U HOLD FOR SPECI7� REQUIREM�N7's See permit on Lot 1 for conditions 1525 64. �. J 44o Bai. 66 � THE AMOUNT BHOWN UNDEP VALUATION 18 FOR THE t', PURPOSE OF iBTABLI6HINO ♦ PEFMIT FEE ONLY. �' VALUATIOfi � m PERMIT FEE S C�� n i m S d �3a� � � � .3�— � � 4 " TOTALFEE $ � �