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