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Home My WebLink About3160 COUNTRY CLUB DR - Building Permits�` � AOV�icant to till in all spaces ezeeD� tM1ose within heavY �ortler lines antl sign all apOropriate tleclarations. iClTlfjO•F COSTAy MESA CONSTRUCTION P/ER/MIT( PER NO� ,� _ �� TRACT NO. LOT N0. UNIT NO. �folect Address `� �� Q CL y'� t� 4 �/ N r/ • J/C� . Applicant's Maili Arc� dr¢ss "�SO rP U 4 Ht R id (�+ P ! c'�C � Owner's Name �'+� M e��-J l T hone Address �� r/� L/ �.� �P y �- U b ��. Arch/Eng. License No. � Address Contractor's Name cp C u� pho eJ S3C='} %�lO Address (mailing) "?'3'j� NQ� ^� /'P �L' � City License No. � /7 Q9_ � LICENSED CONTRACTOR DECLARATION I hereby aftirm that 1 am licensetl untler provisions ot Charter 9(mmmencing witM1 sec[ion ]000) of Division 3 of the Business antl Grofessions Cotle, antl my license is in f W Ijprce antl eftecL ��` �z� License Class �- r // ^L•icgns�;f�lo. Oate ' ' Siqnature %F;��G>"G�'-�— WORKERS' COMPENSATION DECLARATjON I hereby affirm that I have a certificate of consent to self-insure or a certificate ` Workers' CompensatiOn CInsuran[e, or a certifietl copy thereof (Section ic�Y No.��33� � ' o�� ComPanY��P �y � � �Certified mpy is hereby furnishetl. Certifietl co�py is tif?tl with the city Buil Rq ivhl ` �� - Date ��2 j � �n APplicant ��%-�� -�"�"� EXEMPT�ON FROM WORKERS' COIVIPENSAT.1 N OEGLARATION (Thissecllon neetl not be completetl if the permit is for one huntlretl ($300) or less). I certify that in the performance of tM1e work for which this permii is issuetl, I shall no[ em0�oy any person in any manner so as to become subjeCt to the Workers' Compenzation Laws of California. Oate Signature NOTICE: If, after making this tleclaration, you shoultl become subject to the Worke�s' Compensation p�ovisions ot the Labor Cotle, you must forthwith com0ly with such provisions or thi5 permit Shall be tleemetl rewketl. CONSTRUCTION LENDING AGENCV I hereby affirm that there is a construction lentling agency for the performance of the work for twh�ch Mis permit is issuetl (Section 309] Civ. CJ '� Lentler's Name ' I Lentler's Atltlress � OWNER BUILDER �ECLARATION I hereby aftirm that;l"am exempt from the ConVactor's License Law for the following reason (Sec[ion•7031.5 Busine55 antl Professional Cotle: Any city or county which requires a pe�mit to construct, alter, improve, tl¢molish o� �epair any structu�e, p�ior [o,it5 issuance, also �equires the applicant to� such permi[ to file a signed Statement that he/sM1e is litensetl pu�suant to the provisions ot the Contractor's License Law (Chapter 9(commencing with Seotion 7000) of Division 3 at the Business antl Professions Cotle) o� that he/She is exempt �herefrom antl the basis tor the alleqetl exemption. Any violation of Section '31.5 by any applican[ Po� a pe�mit subjects the applicant to a civil �.dlty of not more than five hund�etl tlollars ($500). I, as owner of tM1e property or my employees with wa9es as their sole compensation, will tlo the work, antl the struc[ure is mt intentletl or offeretl fo� sale (Section ]046, Business antl Prolessional Cotle: The Cont�acto�'s License taw does not apply to an owner ot a property who builds or improves thereon, antl who tloes such work himself/herself or tnrougn his or her own employees, provitletl that such improvements are not intendetl o� ofteretl for sale. It, howeveq the building or improvement is soltl within one year of com- oletion, the owner will have tne burtlen of provin9 ne/she ditl not builtl or im- prove for the purpose of sale). ❑ I, as owner of the' property, am exclusively contracting wi[h Iicensetl con- tractorstd tonstruct the project (Section ]044, Business antl ProteSsions Cotle: The ConVactor's License I�w tloes not apply to an owner of property who builtls or improves tnereon, antl who rontracts for such orqects with a con- tractor(s) license pursuant to the Cont�actor'S License Law). I am awa�e that proof of their Worke�'s Compensation insurance Shaultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date - owner Signature or 55 � Is application antl state that the abave ply with all city antl county ordinances nstruction, antl.hereby authorize �epre- �n the abOve-mentiOnetl �P/ro�pe�rty �to��y 7 O% i� O D �� r oate_f, �_ TYPE OPCONSTRUCTION �LJ NEW U ADD LJ ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑�OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRIGAL ❑ ,P/LUMBING ❑ MECHANICAL �QOTHER RP �CG'� �J�uS e PROJECT DESCRIPTION 5c1. Fr. .Z SD� 4 ocCU CON STRUCTION TYPE VALUATION' ZONE GRADINGCU.YDS. F Remarks: Sfnk Preventer Irrigation Clarifiers Dishwasher . Drinking Fountains Floor Drains Floor Sinks Gas Service Kitchen Sink Lavatories P-Trap Roof Drains Reinspection Fae Showers Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outlets Water Closet Water Heater Water Service Auto-Wash Laundry Trays $15 Boiler Duct - Under Ground Duct - Sbuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating $ystem & Ducting � ❑0.100,000 BTU 0100,000BT Reinspec[ion Fee � $15 65-46, rev. 30/84 White - BuilCing; Canary - Applicanh Pink - Accounting; Goltlenrotl - As5es5or Issue Fee' Hood or Typel ❑ Canopy Type I I ❑ Ref�igeration System ❑0-700,000 BTU ❑100,000 BTU System Repair/Alteration � Fire Dampers ' . Registers luue Fee ?+7 FEES $ 3 $ 3 A.P. # S Main Buildi E T Front B Rear A C Right K Left $ Ping. Ref. # Planning Notes: 9447 4/�7/8B , Zone Accessory Buildin9: i Parking Req./Provided ELECTRICAI Automatic Washer Transformer ❑ 15-50 KW ConstructionPoleSub. ❑50+KW , Cooking Unit ' Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Elect�ic Sub Panel Fan � Motors DO-1 HP Oi %- 8 F,A,U. ' � Inc.Solar �9-15 HP �i6-15+ Fixtures Microwave Device eoxes Pole Light O ut lets Ra nge Switches Sign - Garbage Disposal Standing Sections Generamr �0-5 KW 05-15 KW Trash Compactor Fee �' $15 � � Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: 2onin9 APProved By Building Approved By � � - S A V7 �OF FEES BUILDING PERMIT $ �1 - SMIP PLAN CHECK $ PERMIT � PLUMBING . $. � ISSUANCE PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ GRADING PLANCHECK 50% $ MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25%� $ � ' ' 63.50 TL Z O N 1 N G R E Q M T S FEES $ 3 ,CONSTRUCTION AND�.PLANNING � POOL & SPA - , APPROVALS iPermit�# Date Inspector' qppROVALS Permit# � Date Inspector ' \ 1��Temporary Elecirical,�Service or Pole 52. Pool & Equipment Location .-.'.. 2��Soil Pipe-Undrgmd.�� ` 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE � • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test � � 9. Waier Pipe-Und grnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor Sy tem ' 61. APPROVAL TO DECK 11 . Property Sewer Line`& Fiouse Connection 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. SolarSystem-Final i6. 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 Conditioning , FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # ^. 21. Ducts, in Structure 70. Underground Hydro �� - 22. Ducts, Ventilating � 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe-Rough & Test ' 72. Underground Flush 24. Roof Framing- 73. Undergrnd. Storage Tank 0 Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structureq & Monocoat 75: Dry Chemiral , 27. Frame and Flashing 76. Dry Standpipe � }� ' 28. Lathing & Siding , 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL �„�� 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT �� 31. Plaster Brown Coat 79. FINAL INSPECTION '`� n., 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED � �•t,� 33. Final Electric � Notes: r ,.�. 34. Final Heating & Air Conditioning - '�f � r'0 35. Final Gas Pipe-Test . � - - 36.• Hood or Canopy 37�. Final Factory Fireplace � a� 38;' Final Plumbing ' - 39� Water Service-Final - ' . � � . ;� 1.40. Gas Service-Final ' � - ' ' '�41. Solarpomestic-Final ' -• � � � � :� 42. Backflow Preventer � ' � � t 43. Backflow Irrigation - : � . i � • 44. Landscape Irrigation System � �� ' ' � ; 45. Sound Attenuation � . -� � ; - 46. Flandicap Regulations • . n' ' . _Y v . 47. �FINAL STRUCTURE & BUILDING QS - , � ...+ • . � : 48=Special Requirements Completed ' �' - ' �" 49' Electric Release to Edison , : - 50. Gas Release to Southem California Gas Co �,� '- � � � 51. CERTIFICATE OF OCCUPANCY � No. � Date •` ��r,� � � - - - -- - � - - - �" .-�� \�= .. , � � . _ . . . ._, _ _ u _ . . .:.. . .. . . OWNER HENDERSON, C. B. nnT� 5-10-62 JOB ADDRESS C011ri ry u p. BUILDING PERMIT NO. �IZ— GEN�RAL CONTRACTOR ^rier— VALU� $ 9Q� AP No. 113—S�A3� LOT TRACT FIRE ZONE D�SCRIPTION OF WORK PHtlo COVeY' IN�^ECTIONS � Signature DATF. GROUP J TYP� ZONE — i��a SUBCONTRACTOR �, mER� IITS ISSU�D fZe` He. OCCUPANCY � F �, i�oi2 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX Sf7 C08TA MEBA. CALIFORNIA For Appiieanf fo Fill In Complefely TYPE OR PRINT ADDRESS �} ( (�' V (_ � / /t v C , I✓ h � COSTA MESA. CA ORNIA a MAIL TEL. TEL. 1 , SIZE I NO. OF BLDGB. OF LOT NOW ON LOT � 88lBACK LINE FROM ■ eui�oiNc DESCRIPTION OF WORK 0 TO BE I HEREBY ACKNOWLEOOE THAT � MAVE READ TH18 APPLIWTION ANO BTATE THAT THE ABOVE 16 CORRECT ANO AGREE TO COM- PLV WITH ALL CITY ORDINANLEe AN� BTATE LAWB REGULATINO euILDIN6 CON9TR"'��T `" �'� _ �' $IGNATURE OF PERMITTEF AUTHORIZED AGENT FEE RECEIUEU Mn�r 10 �962 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only COSTA MESA, CALIFORNIA FIRE ZONE APPROVED 195UED ZON5 (i' I I PLA 8F �� I BUILDINd EW C j�fj�/ l LEGAL �.OT /O^'( rK 3 36 DESCRIPTION � ,J � A. P. NO. .0 �r J !�'� N YARDS EVES APPROVED ALLOWED ICENTEq LINE 8TJ . / / � TH6 AMOUNT BMOWN UNpER VALUATION 18 FOR THE PURP08E OF E6TqBL18HING A PEFMIT FEE ONLY. VALUA ON ' ��J I—V �..��. PERMIT FEE $ N $ �� PLAN CHECK $ /.r a x TOTAL FEE � �� 4 �� COSTA MESA BUILDING DEPARTMENT � P.O. BOX 31] COSTA MESA, CALIFORNIA ,�, �.v..,. „.�., AUG > t959 --,�� -�- . -- _'_'.. FOR APPLtCANT TO FILL IN APPLICATION FOR PERMIT Aooa°E'S5 3160 Country Club Drive BUILDING ' COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY ' RECEIPT rv0. PERMIT NO. OWNER N ort Homes InC• ' � MAIL 1555 Placentia RECEIVE� BY DATE RECENE� Da E�+ ED ADDRE55 7-3rsy AUG CITY N2wpOT't BeHch TNO. 1'� �J2<7- qDDRe�ss ARCHITECT ��c. COSTA MESA. CALIFORNIA OR ENGINEER NO. F�RE AOLp (� ZONE 11• ��. Koll Constr. UOQ�T�' L�C. 20NE �� pLq05 TY� GROUP CONTRACTOR � NO. ADORE55 Nei,rport Beach TNU, y�u �3227, B�PROVEO DATE �E�a� �or 103 CORRECTIONS DESCaiviiON NO. BLOGK TRACT A.P. NO. SIZE !)J ;X�t/1Q[� NO.OF BLOGS. OF LOT ��'L� �"/ I NOW ON LOT lISE OF E%ISTING BLDG. SETBACH LINE FROM ,/ �'� cerv.cw or srAcc. 'SS• REAR VARD '+ SIDE'YARD RIGHT LEFT / �p � DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPi MOVING DEMOLISH BUIL�ING NO.OF (- � SIZE � y .t ROOMS STORIES 1 E%TERIOR WALL SI.UCCO ROOF WOOCI $I7. � COVERING COVERING BUELDFNGEW dwelling '� ��T. G�`�U, � d- � �1 I HEFEBV ACNNOWLEDGE THAT/I HAVE REAO TMIS APPLICPTION FNO STATE TXqT TNE pBOVE IS CORRECT AND iGREE TO COMPLT WITH wLL . C�TY OROINFNCE$ f�NO SiRTE LAWS REGIILI�TING BUILOING CONSTPIIC� TION. ' ' VAIUATION $IGNATUR ' �� PERMITFEE � Jy�' PERMITTE /J/ G � � / (� � • PLAN CHECK $ �I ( "� $ AUTHORIZEO n r�r � TOTAL FEE g ,�j �..� eir