HomeMy WebLinkAbout2478 FAIRWAY DR - Building Permitseooxessoremtowo: L4%8 tAlHWAY Lt( uMr:
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11CFN5ED CONfF�CTOqS OECLAPATION: I hreby ellim uMs pme�y d pmyvy Nel I em Gcanetl imder pro�"v'wie d Cheqs 9
(mmnarbn0 wLh Sxlian ]000) d Oweion 3 d Ns Bue'uru eM Vmla��om COEe. W my 4m�ua e m hA Mu md Nlea.
c/muc.No.: Vby�l.71 uc.cuss: l—LV uc.No.: b&4�JJ tXY: UJ%7�
/ma: •� � comreao.:�j�� -
OW BUILOER OECLARATION: I hentr/ e1Nm uMa penNy d per'µy tAm I em a'emq hom tM CaM�etlm licaua lew la ths
oc re..� �seu� �w,s e�:�, �a a�ae.�+ coe.: rNr w a�+rv �e, �e.. o«m. m�+wa..e«. �woA.
emd'eA. n repv my �wcnae. prior b da iauerca. ebo nV�s tM epplimN la adi penm io fib e�qneA qatemaN tlut M a�he
ucmuw o�^� m �ne w�u a m. comrman Lim�as tar jc�eq« 9(mmm«cnc .'vn seelm rom) d oM'vion � d u,e
uei�ss eM Rohaiom COMI a �hm M a Mie u ssamq �MrMmn eM ilr Eetie la Ne eAeOb mmmqun. Mrv vultlun d Ssdion
M�t.S tr/ ury MWifaN la e permn aRjW� tM eppfraM to e dvi pmxlry d nol mas �Mn fx� Ixmd�sd da0en �5500�.
❑ i.�.o.,�aineww�r«mr�dm�..�nw��ine:.de�o�+�.w�naomswon�..�dm..m�ne�a�m�a.e
ar Mared M eeb (Seclion 1060. BuunmeeM Pmloseiau Lods: TheCaniredas lirenee LewEom nd ePMYto en owrw d popeny
wM10 buiM a inpo.e+iAxeon. end xho doee euM v.wk HmWI a hmeM a Wap� he a M1a wm amWMw. D�a'� �hel wrh
impma�eNa vs m� i�uaidad n dled lu uls. tl. howe.er.IM GriMmO a inV��ai w wtl wuhm arYm d mmOMion. iM
ownerbWix �wll Mro Ihe bvdm d pwinp M a qro dq ro� buid a impova ta �he piryiwa W rlel.
❑ I, m eww d tro nown. em e.dim�dr ow�euro won 4mmee convepan ro m�mud m. c�9a (s«am �ou. aoF.. rd
PMmtim� Coda: The Caorman Ucwua law Aoea nal xpply m an oxw d papany who deld� a imrywr IMnm and Wn
mntrecb tor uM V�d�s wdn e mxree«Ie) Icmd W�+uem to the Cam�etlas Lim�se LM.
� I em mamq uedx Sepion: B. d P.G..Ia Nu iaeson:
oda: �
i eo n«eM «nM mm i.m.�..r. a.na uw�.�,d u,. n��amen, a c.im�de Heeen w sme�v coa. swo�. uws. usa�. «w
Y55].1. enE tl� 1 a my Mwe dulEuq ompem_ will / wil nq (�6 aw) ��o m�Wly wYh aid uNs mEee eM IM nawanaW br
e G�ro IumrewNion a mod5wianlmm Na M�m�mwu DiYntl. RadEe�[il m�a�uqion eGV�'vuers exemN hamYw
wo�doro.
WONNEP'S COMVENSATION DKL�NATION: I MraEy etfiem wder perehy d perjury ona d tla Idbvriip tletlutlbrro:
� I heve eM vAI meinlen � ta�2icet� d mn�enl Io �epimins br wakae' oompsmYion. m provMed la Ey Setlbn 91W d iM lebv
coe.. �a in� wn�e a ub .m� i« w� m� c� s m.wd.
fl 11wa ud wil m�imen wM1as' mmw�ion imurum. a �Wind bY Swian 3100 d Me lebv Cade. br tM G�m� d iM
1� wak frc wh� Nu 0� o uaueA. MY warken' odnW�ian'vnumnca wrir mM O�Y numEer ero:
Cev'xr: lF1LIY I.VMY t)lYl!(EJ
Pdiry Number: { i J/ 1 4 V �/ // 2// y�
(This sedion rieeE rwt 6s canpbfed / tM prmt is br aro hundrsi dW4n /SIOD) w Iw.J
� I een/y thm in �he perlomiviee d tM work M wM1c� Ihis p�mX u iseued, I ehell m� employ eny penon in eny menew o n lo
bxome wqeq to tM xoMre' mmpenemion lew* d Celilomu. enE epree Ntl il I ehouk become eubjtl lo �M wwkore'
ensmion pwiviom d SaUbn �]00 d IM lebar Cads, l ehell M�wnh mmpfy Ih �Iwss powioro.
a,: /0 3 —5'7 .�w�: ��
eml : FaNun ro��eun woikwi mmpwu+tlon rov�rap� 1� un4N/ul, �ntl Msl/ sWJ�el �n wnplay�r ro eilMnl pxvltlq �M
ro�'q ro on� h�ntlml thouunE tlolYr� /J�04 WOA M W11tlon ro M� ewt ol romp�rwebrt a�W �� pA�bb ror In
on J]O6 0l fhs L�6or Cod, Infeiesf, �M attomq'� /w.
CONSTRUCTION LENDINO AOENC�: I hereby elfirm uMer penely W perjury �htl thero ie e caMrud'wn bMi�p apency br �M
oon«m�, d ma .o� i« wn�a, in: ro�*i �. oa�.e (saaao aos�. cw. c�.
LENDEN'S NAME:
LENDEN'S AUUPESS:
1 cenM �� I heve reaE ihia epplicelian eM mme Ihel �M ebwa iMamubn h cmw. I epree lo wmpty wi�h dl ary ud mumy adinen�m
eM eiete lews reletip io W ildip cwuvuabn ard heraEy aulhorixa mpaeemetivea W th'v dy io enbr upon IM ebwe�mentioned poperry
lorimpeaion purpoaea.
t11LL SAMMONS
(515tde.WP) WhitsBuild'vp 8 SNory:OreerrFle; Genery-�ppfrani; Pink-Ravenue; OdEenmd-A+weor
�17 Ooo S7
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18-31-1997/18:48 Al9/t35.25
RCPT�:�1-01i148�1
❑ERI'i I T : 085543
._`,
CONSTRUCTION AND PLANNWG � � �C.�PA
APPROVALS Permit # Date Inspector AppROVAIS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. � , 53. Steei Reinforcement
3. Electrical Conduit Ucility-Undrqrnd. 54. Forms
4.: Electricai Cond�it-Undrgmd. 55. Electricai Bonding
5: Steel Reinforcerpent 56. Rough Plumbing & Pressure Test
'6. Electrical UFER G�nd. � 57. APPROVAL TO COVER�GUNITE
7. Footings :- � 58. Electrical Conduit�Undrgrnd.
6. Foundation _ . 59. Gas Pipe, �7 Undrgrnd., Test
� 9. Water Pipe�Undrgrnd. " 60. Backwash Lines, P-Trap, � Undrqrnd.
i0. Str�cturai F1oor System 61. APPROVAL TO DECK
� 17. Property Sewer Line & House�Connection 62. Backwash & Receptor-Final
12. Sewer CaP ' 63. Heater & Vent�Final
13. fioof Dr3ins . 64. Plumbing System - Final
14. Reugh Plumbing � 65. E�ectrical-Final
75. Rough Electrical-Conduit . ' 66. Solar SYstem�Fipal
16. Reugh Electric Wiri�g ' 67. Fencing & Access ApAroval
77. RoughWiringSign - _ 68. APPROVEDFOR�PLASTERING
78. Rough Electrical-T Bar Ceiling '� 69. POOL/SPA SYSTEMS FINAL
79. Reugh�Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rougb Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Structure •� 70. �Underground Hydro '
22. Duc{s, Ventilating. t �s. , 71. Product Piping C7G�s OOiI
23. Gas Pipe�fto�gh & Test • � . 72. Undergraund Flush
24. Roof-Framing ` ' . 73. Undergrnd.Stora9eTank OGas ❑Oil
25. Roof Sheaxhing � , ' • . � 7q, Overhead Hydro '
26. T-Bar Ce�ling IStructuraq & Monocoat .� - � 75. Dry Chemical �
27. Frame and Fiashing : - ., 76. Dry Standpipe '
28. Latfiin9 & Sidin9 �" r �� 77. FIXED SYSTEM FINAL �
29. Insulaiion • � 78, FIRE PflEV. FiNAL '
30. Dry�va�l Nailing _ , . ,-HEALTH DEP7. REQUIREMENT �
31. Plaster B�own�-Coa: � -. , • 79. FINAL INSPECTION �
' ' I /1
��5_l1`I_I� A��bUL,
32 Eiectrical Power Nlecer-Final - 8Q: FOOD CERTIFICATE ISSUED �
33. Finai�EleCtric . � + �� Notes: �
34. Fir,af.Heeting & Air Conditioning � a p �� S
- `�/O! fP _ ! CGcT�
35. Final Gas PipG•Test � - �
�[o�c� �c- -4i}a�
. 36. Hood�or Canopy � �- ' '
. 37. Fina( FaGtory Firepiace - ' � ' , •
38. Final Plumbing � � ' _ ' ,
39. Water Service�Finai ; � ' ' ' � �
� 40. Gas Service�Pinal � � • ' � �
41. Solar pomesticFinaF � , - �
42. Backflow Preventer t , � .
43. Backflow Irrigation r � � _ , � ' �.
44. Landscape Irrigation-System : �� ' � ,' • '
45. Sound Attenuation _ _ , ' � ,� , ; �
-`,•' 46. Handicap.Regutaiions � � . � �
, 47. FINAL 5TRUCTURE & BUILDING ' �
48. FINAL PLANNING � .
� 49. Electric Release to Edison � �, .
50. Gas Reiease to Southem California Gas Co -
57. CERTIFICATE Of OCCUPANCY
I No._ Date
Applicant to till in all spaees exceD� tnose within heavY boraer lines ane sign all avPropriate aeelarations.
�Y OF COSTA MESA tf CONSTRUCTIQN PERMIT PERMIT NO� � � TRACT NO. LOT NO. UNIT NO.
Ject Address � �%7 �i a-i Ct.taC�a.. ��.1 .
Applicant's Mailin Address � u- } l
�-II'S `
Owner's Name � � Phone
Address A�L
Arch/Eng. License No.
Address
C �
Contractor'sName— Phone `��9-/��S
Addresslmailing) � ' ���=��+� � 9�7��
City License No. ��Ci '�3�
LICENSED CONTRACTOR DECLARATION
I M1ereby attirm that I am licensetl untler p�ovi51on5 of Charter 9(mmmencing
with section 7000) ot Division 3 of the Buslness antl Professions Cotle, antl
my Ilcense is in fu I(orce antl eftect. (�
Licen CDIasVS �' Lite e No. •G ���
Date �- Zg S Signature
WORKERS' COMPENSATION DECLARAT ON
I hereDy aftirm that I have a certificate oi mnzent to self-insure or a certificate
o/ Workers' Compensation Insurance, or a certlfietl copY hereof (Section
3800, Lab. C.)
P licy No. ���' �� 0 � Company
�Certifietl copy is he�eby tumishetl. �
Cer{ifiea co y is filetl with the city B�n DivisiyJy �
Date I -��_�S AP�licant � �`� �+
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissection neetl not be comple[¢tl It the permit I5 for one huntlre0 ($300) or
less).
I terlity lhat in [he performance o( the work to� which this permk is issuetl, 1
s�all no( employ any person in any manner so as to become subject to the
WorkerS�— mp n5�tlon Laws ot CaliforryN�' �
Date Si9nature -c�c�.—� �
�NOTI E: , after making this tleclara i0[ n, you sbOultl become subject to Ihe
Wo�ke�s' COmpensation provisions ot Ihe Labo� Cotle, you musl forthwith
comply with such ptovisions o� this Oermit Shall be tleemetl revoketl.
CONSTFUCTION LENDING AGENCV
I hereby afffrm that there is a construttion lentling agenty for the p¢rformance
o( [he work tor which this erml[ is Issuetl (Section 3097 Civ. CJ
Lender's Ndme
Lentler's Atltlress
OWNER BUILDER DECLA ATION
I hereby affirm that I am exempt from N¢ Contractor'S License L.aw for the
lollowin9 reason (Section ]031.5 Business anU Vrofesslonal Cotle: Any city or
County which requires a pe�mit to construct, al[e�, improve, tlemolish o� repair
any sVucture, prlor to its issuance, also reqWrez the applicant for such permit
to fiie a signetl statement that he/she is Iicensetl pursuant to the provisions ot
the Contractor'S License Law (Chapter 9(commencin9 with Section 7000) of
Division 3 0( [he Business antl Prote551ons Cotle) or that he/she is exempl
[he�efrom antl the basis for the alleqetl exemption. Any violation o/ Sec[ion
7031.5 by any applicant for a pe�mit Subjects the applicant to a civil
�enalty of not more [han five huntlred tlollars ($500).
I, as owner of [he proDe�ty'or my employees witlt wages as their sole
compensa[ion, will tlo ihe work, antl tho struc[ure is not intentletl or offeretl
� tor sale (Section ]044, Business antl Professional Cotle:. The Contractor's
�'� License law tloes not apply to an owner ot a pro0erty who builtls or im0�oves
thereon, antl who aoes such work himsalf/nerselr o. throu9h his or her own
employ¢es, provitletl [hat such improv¢ments are mt intentletl or ofleretl tor
sale. If, however, i�e builtling or Imp�ovemeni is soltl within one year ot cOm-
pletlon, the owner will have tbe burtlen ot proving he/sM1e tlitl not bui10 or im-
prova tor tne purpose ot sale).
❑ I, as owner of the pro0e�ty, am ezUusively cont�acting with licensetl con-
tractors to constract tne project (Section 7044, Business antl Professions Cotle:
The eoniractor's License Law tloes not apply to an owner oi praperty who
builtls or improves lhereon, antl who conVactS for such projects wi[h a com �
tractor(5} license pursuant to the ContraG[orY License Lawj. I am aware that
prooi of tneir Wotker's Compen5atlon Insurance shoultl be proviaed to me.
❑ I am exempt untler Seciion � B. a P. C. for this reason
Date Owner
1 hereby c¢rtity ihat I have reatl th' appl aUon antl state that the above
information is mrrect. I a9ree ro co ly wit i all clry antl coun[y ortlinances
antl state laws relating to builtling construction, an0 hereby authorize repre-
zentativ¢s ot this ciry t enter upo the ab -menlionetl roperiy for
�inspectlon purposes.
Si9nature �� � Date �
Drivers' License or 55 �
TVPE OF CONSTRUCTION lJ NEW LJ ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT GRADING�( FOUNDATION STRVCTURAL
❑ TENANT ❑ ELECTRICAI ip PI.VMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION $Q. FT. OCCUPANCV
CONSTRUCTION TVPE VALUATION $
ZONE GRAOINGCU.VDS. ACRES
Rema�ks:
Sink
Preventer
Irri9ation
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service OuUets
Interceptors
Kitchen Sink
Lavarories
P—Trap
Roof Dreins �
Reinspection Fee
Under Ground
$15
Duct - Ventilating
Exhaust System � Multiple
Firepl/FacL BIL ICBO #
Heating System & Ducting
❑0100,000 BTU 0100,000
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 White - Bulltling; Canary - APPlicanp Pink - Accounting; Goltlenrotl - AsSezsor
Showers
Service $ink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood ar Type I ❑
Canopy Type I I ❑
Refrigeration System
❑0.100,0008TU ❑100,000
System Repair/Alt¢ration
Fire Dampers
Registers
laue Fee
$ 3
$ 3
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Constructian Pole
Cooking Unit
Dishwasher
Dryers ❑Gas ❑
Fan
F,A,U.
Fixtures
Device Boxes'
Outlets ' •
Switches
Garhage Disposal
Generator �0.5 K
DEVELOPMENTSERVICES
Zoning Approveil By
.Buildin9 Approved By —
5094 I/07/B5
Zone
Accessary Bui
ELECTRICAL
Transformer �'15-50 KW
❑ 50+ KW
Meter ❑up to 100 amps
Meter ❑overi00amps
Sub Panel
Morors OO-1 HP O i%- 8
�Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
; Sianding $ections
75 KW Trash Compactor
$15 Issue Fee �
0000 TL
FEES
$ 3
� SUMMARV OF FEES
BUILDINGPERMIT $ � SMIP $
PLAN CHECK $ PERMIT
PLUMBING g •� ��UANCE ' $
PIAN CHECK 25% 3 ENEFiGV P.C. $�
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM 5
MECHANICAL $ TOTAL FEE $ SOb
PLAN�.CHECK 25% $ .
Z
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'CONSTRUCTION AND PLANNING
' APPROVALS Permit#
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd.
3. Elecirical Conduit U[ility-Undrgrnd.
� 4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
• 6. Electrical UFER Grncl.
. 7. Footings
8. Foundation
9. Water Pipe-Undrgrnd.
10. Structural Floor System
11. PropertY Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains �
'14. Rough Plumbing
75.,Rough Electriral-Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
18. Rough Electrical-T Ba� Ceiling
79. Rough Heating & Air Conditioning
20. Rough Factory Firepl3ce
21. DuCts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat •
32. Electrical Power Meter-Final
33. Final Electric
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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem
45. Sound Attenuation �
46. Handicap Regulations
A7. FINAL STRUCTURE & BUILDING
4S. Special Requirements Completed
49. Electric Release to Edison . �
•� 50. Gas Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
��n, pate
Date
P00 � & SPA
Inspector AppROVALS Permit#
� 52. Pool & Equipment Location
53. Steel� Reinforcement -
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. .Gas Pipe, 0 Undrgrnd., Test
60. Backwash Lines, P-Trap, � Undrgrnd.
�61. APPROVAL TO DECK
� 62. Backwash & ReceptorFinal �
63. Heater & Vent�Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem-Final �
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL(SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT .
APPROVALS Permit #
70. Underground Hydro
71. Product Piping OGas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Siandpipe
77.. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
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Date � InspPctnr
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MEBA. Ca-�RORNIA
For Applieant to Fill Iq Complefely
TYPE OR PRINT
BUILDING t (j , �
ADDRE68 d f��
COSTA MESA CALIFOR IA
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ARCHITEGT
OR ENGINEER NONE
� STATE
FEE RECEIVED
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FINANCE OEPT.
CITY OP COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
I �-�O4 BUILDING
ADDRE68
COSTA MESA. CALIFORNIA
ZONING
ZO I NO. OF I U86 OF NEW
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DESCRIPTIOtd OF WORK 7
I L.SIDE
NEW A IIALTERATIONI IAD�ITION I @EAR z U
REPAIR . I IIMOVING I IDEMOLI6H I ePPROVED gV,��-
BUILDING /� (� NO. OF
SIZH !/ ROOM6 STO IE
IXTERIOR WALL ROOF
COVERING STUCC COVERING !'%'
U6E OP BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RESIDENCE AND
F�TACHED GARAGE y3� �P
PLAN N0. � b . �
I HQMT' ACKNOWlED06 THAT 1 HAVB R6AD TWB APPLIWTION
AND BTATH THAT THE ABOVE 18 CORRECT AND AGREE TO COM-
PLY WITN ALL CITY ORDINANCEB AND BTAYB u� �6ULATINa
OUILDINp CON8T11UGTION�
61GNATURE OF
PERMITIE
AUTHOR2ED AGENT /I V"
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WED OY�. 3%/
C/L 1 N.
^— IN.
3 �N.
6 �N.
�erc 7��//C/
THE AMOUNT eHOWN UN�ER VALIIATION 19 FOR TXE
PURP08E OF EBTABLI9HINO A PERMIT FEE ONLY.
.UATION I � / �
CHECK