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HomeMy WebLinkAbout3061 CLUB HOUSE CIR - Building PermitsAvv�icant to fill in all spaces except lhose within heavY Oortler Iines antl sign all appropriate tleclaratians. CIT.Y OF COSTA MESA CONSTLR/ UCTION PERMIT aFR^niT �in Tancr Nn �or Nn �����T ..�., Project Address -3O� I C Il/b l7OUSe '�/�✓1i�-�e- Applicam'sMailingAddress �`�3�% ml�U��-lU�JcL�''�1��Q���}S; Owner'sName ��M' �LG��-���%1� Phone��� Aiidress 3d�� LlUbhnUsc Ci'rc/t •� Arch/Eng. LicenuNo. S��S�� Address Contractor's Name V��C�%bev'2`� P�(,/Mb /nG Phone y Address (mailing) ����� ��/ �5/ �e7�L%�n • City License No. 4% �� LICENSED CONTRACTOR DECLARATION . I hereby affirm that I am IicenSetl untler provislonz ot Charte� 9(commencing with Section ]000) of Dlvision 3 ot the Bu5ine55 dntl Prot¢S5ion5 Cotl¢, antl my license is in f,u1ll force an effect. � ^ LJCCO52 CId55 [�� ICEl152 NO. � lry � Date 3-2y-8�._ Signature � ��_ '�qG'pl� 'RKERS' COMPENSATION DECLARATION eby affirm tnat I have a certificate of consent to self-insure or a certlticate .Vorkers' Compensation Insurance, or a ceriifietl copy thereof (Section �e00, lab. C.) ' , Policy No. Company Certifietl Copy is he�eby tumishetl. ' Certifietl copy is tiled with the city Builtling Division. . �ate Applicant � EXEMPTION FROM WORKERS' COMPENSATION DEGLARATION (This seclion neetl not be comple[etl if th¢ permit is for One huntlr¢tl ($100)br - less). I certify'thal'in the perto�mance ot the work for which tM1iS pe�m�t is i55uetl, I snall'not employ any oerso8 in any manner so as to become subject to the . Workers' Compens tion l.aws oi Calitor ia. � oate 3— Z�-J ��ti Signature ��� Uri-«dan.�irn r.� NOTICE: It, after making this tleclaration, you shoultl bewme sub ect to the . Workers' Compensation provisions of the Labor Cotle, you must forthwith comply wi[h� suth proviSiOns o� this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV ' 1 hereby afiirm that chere iz a mnstruction lentlin9 a9ency for the performance 01 the work fo� which this pe�mit is i55uetl ($ection 3097 Civ. CJ Lentler's Name L¢IItlE(�5 AddfC55 OWNER BUILDER DECLARATION - I he�eby attiim Lhat I am exempt trom Ihe Gont�actor'S Lit¢nse Law tor the � following reason (Section 7031.5 Business and Professional Cotle: Any city or munty which requires a permit to construct, alter, improve, tlemollsh or repair' any structure, prlor to its issuance, also requires the aoP��cant for such permit to (ile a siqnetl statement [hat he/she is licensetl pur5udnt to the p�ovi5ion5 oi �e Contractor's License Law (Chapter 9(commencing with Section ]000) of 'ision 3 ot the Business antl Professions Cotle) or that he/she is exempt efrom antl the ba5is for. the alleqetl exemption. Any violation of Section 031.5 by any. applicant tor a permit subjects the applicant to a civil ��enalty of not more than five huntlretl tlollars ($500). I, as owner of the property o� my emplOye¢5 with wage5 d5 thelv sole 'wmpensation, will tlo the work, antl the structure is not intentletl or.ofteretl , for sale (Sec[ion 7044, Business and Professional Cotle: The Contractor's License Lzw tloes not apply to an owner o� a property who builtls or-improves thereon, and who tloes such wO�k himself/herseli o� th�ough his o� her own employees, providetl [bal zuch �mprovements are nof intentletl or o(tere0 for sale. If, however, the builtlin9 or improvement is soltl within one year ot com- ple[ion, [he owner will have ihe burtlen of proving he/she tlitl not builtl o� Im-' prove forthe purpose of sale). ❑ I,as owner of the property, am exclusivety mntracting with licensetl con- t�actors to construct ihe project (Section ]064, Busine55 dntl Profes5ion5 Cotle: The Contractor's License Law does not apply fo dn,owner of property who builtls or improves thereon: antl who contracts to�'such oroiects with a con- ' tractor(sl Lcense Oursuant [o rne ConVactoYs License L.aw). I am aware that proof o� their Worker'S Compen5ation insurance Shaultl be O�ovitletl to me. ❑ i am exempt untler Section B. & P. 0.(or this reason Date ' Owner I'hereby certify that 1 have reatl this'application antl stata that the above intormation is correcL I agree to�compiy with all clty antl county ortlinances antl.state laws relating to builtling construccion, and hereby authorize re0re- � Sentatives� of thi5 city to enter upOn the above-mentionetl � P�operty� for �.. InSpectlon purp�e�_ � i//,��/„✓,/ , G . . � �-w�y I�`�Signature O� L�U I/ � �' � �' 0865-46, rev. S/88 WM1ite - Builtling; Canary - Applicant Pink - Acwunting; Goldenrotl - Assessor $15 $hoWers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping � Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Watei Service Auto-Wash ��aundrvSra4s _ Issue Fee Hood or Typel � Canopy Typell ❑ s�.r. � S Main Building: T Front B Rear A C Right K . Left S Ping. Ref. # � Plannin9 Notes: FEES Automatic Washer Canstruction Pole Sub. Cookin9 Unit Dishwasher ' " Dryers ❑Gas :�Electric Fan F.A.U. Fixtures Device eoxes � Outlets Swi[ches Garbage Disposal Generetor �0.5 KW �5-� � PEES Refrigeretion Sys[em ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampe�s • Registers , laue Fee Zone AccesSory Buildin9: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW � 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors �Oi' HP �1'f. - S Ina So1ar 09-75 HP 016-15+ Microwave � Pole Light Range Standing Sections KW Trash Compactor � Reinspection Fee �$15 I � luue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By Building Approved By � Application Issued BY SUMMARV OF F BUILDING PERMI7 $ .� P�AN CHECK $ PLUMBING $ .� �� PIAN CHECK 25% $ e ELECTRICAL $ .. PLAN CHECK 50% $ � MECHANICAL $ � PLAN CHECK 25% $ - N I N G R E Q M T $. FEES I $3 I Date Date / t�''!J�' Dat�� L— SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ �� ��� TOTAL FEE �$. y�_'.� 0?�UOi7?9i77-D4029i77 �"�T 4.p(?� DATE:,`13l24/�9 TI�'I'c� 15:4b � � .. , i o- .. .. . , . ...�r....���• _ „ ..,- ,. . . . .- -.. � . , , . ' . _.,.e:. .. . _ .,. : ,. ' . � CONSTRUCTION�ANDPLANNING r P� �SPA � Date .Inspector Date Inspector . APPROVALS Permit# ' APPROVALS Permit# �� 7. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. , :.' ' 53. Steel Reinforcement ' t.� 3.,Elect�ical Conduit Utility-Undrgrnd. � �• 54. Forms ' 4:-Electrical Conduit-Undrgmd. � - 55. Electrical Bonding . �. _. �� 5. 'Steel Reinforcement L� . � 56. Rough Plumbing & Pressure Test � � �. - 6.-'Electrical UFER Grnd- ti � 57. APPROVAL TO COVER-GUNITE , 7.; Footings • �(,�� ; � ' 58. Electrical Conduit-Undrgrnd. " i 8:' Foundation . 59. Gas Pipe, � Undrgrnd., Test � 9. Water Ripe-Undrg}nd. � . 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System . . 61. APPROVAL TO DECK - ' 11: Property Sewer Line & House Corinection 62. Backwash & Recegtor-Final 12. Sewer Cap - " � - 63. Heater & Vent-Final 13. Roof'Dreins - '� 64. Plumbing System�- Final � � 14. Rough Plumbing ' ' 65. Electrical-Final � .. 15. Rough Electrical-Conduit 66. Solar System-Final �d6. Rough Elearic Wiring � , 67. Fencing & Access Approval �17.� Rough Wlring Sign .68. APPROVED FOR FLASTERING � 18. Rough'EJectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �_ r19� RougFi �Heating & Air Conditioning FIRE DEPT. REQUIREMENT �20: Rough Factory Fireplace APPROVALS Permit # i , 21. DuCts,�in�Structure 70. Underground Hydro ' 22. Ducts, Ventilating �;� 71. Product Piping OGas ❑Oil 23. Gas Pipe�Ro�gh & Test ' 72. Underground Flush •' 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil .� 25. Roof S�eathing 74. Overhead Hydro 26. T-Bar Ceilirig (Structural) & Monocoat � 75. Dry Chemical� • 27.�Prame and Flashing . - 76. Dry Standpipe� � 28. Lathing�& Siding 77. FIXED SYST'EM FINAL � 29. Insulation 78. FIRE PREV. FINAL -i-.- • 30. Drywall Nailing ' HEA'LTH DEPT. REQUIREMENT 31. Plaster Brown Coat � - 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80. FOOD CERTIEICATE ISSUED 33. Final Electric Notes: ZCT �C� G��r CQfC(J, L,�i� 34. Final Heating & Air Conditioning - � v � 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 pomestic-Final � . �� 42. Backflow Preventer ��f � � � 43. Backflow Irrigation ' f � i ,�: �I :i � � � ; 44. �Landscape Irrigation System - � �� 45. Sound Attenuation � +rlj -3. 46. Handirap Regulations '. � ' 47. FINAL STRUCTURE & BUILDING � � 48. Special Requirements Completed . ' , , 49. Electric Release to Edison '`•: i: I 50. Gas Release to Southem Califomia Gas Co � � �' 4.. 51. CERTIFICATE OF OCCUPANCY ! " ;�1 No. Date �� ' � - � c�,n _�... � � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. 60X 817 COBTA M6qp, C,pLIPORNIA For Applicant to Fill Ih Completely � TYPE OR PRINT BUILDING 3061 Club House Circle ADORESS COSTA MESA, CAUFORNIA OWNER Mesa Verde �V.CQ. AD RE88 2850 Mesa�Verde Dr. � �iTy Costa Mesa � No •549�395 ORENGINEER E. Kaltenbach � No•5478046 ADDRE53 _,,.._...__,...Same as Owner 181322 No 26 x 70 � BETBACK LINb FftOM DESCRIPTION OF WORK x �� � �� N6 U9H OF BUILDINC AND WORK TO BF, Res.w%att.Gar, 5 sroRi�s ,a Builtup ` FEE RECElVED FEB 25 1965 FIN�ANCE DEPI: APPttC/tTIGN �FC7k"PERNI�i" BUILDING For Oifice Use Only P R8C6�IT NO. I P. A RiC6�[O!Y I DAT 11[C[IV{p OATEIBBOFD —a�-�S E^,A° 4 1965 BUILDIN6 . ' ADDR683 FIRE ZON6 TYPE ' GROUP J APPROV6O BY �ATE ZONINCi ZON NO. OP UHe OP N6W R_1} ruNe'� eu��o�rvo ggr�g Deecrs�mox LO't 6 Tr. 46� A. P. NO. 110IIf NOTE: NOEAVEOVERHAN08HALLBELESSTHAN 4fl^ T(1 fJ11lF R RFAR 0. L YARDS APPROVED MAIN BUILDINO (FROMC/N �LBTREE�I FRO T Y FT• R. SIDB � FT. L. HID6 O FT. � REAR D F�. DIHTANCE BBT. MAIN BLDaB. VAR. iR �l� r n o S! YARD9 APPROVEO ACGESSORY BUILDING OATE /1� APPRpVED 1'1-�'6�0'+ owTe �'�-�1 � L S N $Q. �. �. 1 HEREBY ACKNOWLECOH THAT I XAVB p�O TXIB �PPLICATION THE AMOUNT 9XOWN UNDEP VALIlFT10N 18 FOR THE F' •NO 9TATE THA H¢ �BOV6 IH CORHECT �NO AOREH TO COM. PURP06fi OP 88TABLISMINa A PERMIT FEE ONLT, � vLY WITH ALL I ORDINANCHB ANO B}AT[ LAW9 ReOUTATiNO ypLUATION m BUIL�INOCON RU ION. . " PERMIT FEE $ � � SIGNATURE O � $ /� O�%_ � m PERMI7TE ;rj� ¢ 7 V AUTHORIZ6D AGEfiT � ' /�� . , � oWNF.ft MESA VERDE DEV9C0. OB ADDRESS - GENERAL or DESCRLPTION 0 SUBCONTRACTOR