HomeMy WebLinkAbout129 CLEARBROOK LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
CITl COSTA MESA CONSTRUCTION PERMIT
PERMIT NO. TRACT NO. LOT NO. UNIT NO. -
�Project Address Iz% G c 2 �/(.O �( • �" �S - 1 799 I I/07/84 5.00 TL'
Applicant's Mailing Address . -•
- TYPE OF CONSTRUCTION ❑ NEW LI ADD U ALTERATION L REPAIR . -
(• dd A ' l.�" ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# - , - Zone 1
Owner's Name - `+ �+ Phone7S /36 / DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building: '
Arch/Eng._ License No. TYPE OF PERMIT ❑ GRADING ❑.FOUNDATION ❑ STRUCTURAL T Front ., - _ p
Address Rear
• El TENANT ❑ ELECTRICAL ElPLUMBING El MECHANICAL B .I N
A
Contractor's Name H A P//7 Phohef/5 /L2�c/ ❑ 'OTHER • - ` C R g ht
-�- N
PROJECT DESCRIPTION SD. FT. OCCUPANCY
Address(mailing) 7 C97 Zr 8/Z /.Cir'/ A/t p. P CONSTRUCTION TYPE i VALUATION $ $ Left G
City License No. ZONE ' GRADING CU.YDS. AC RES - R '
LICENSED CONTRA CTOR DECLARATION Ping. R¢f.# • Parking •Req./Provided E
u — --I hereby affirm that I am licensed under provisions of Charter'9 (commencing Remarks: . Planning Notes: _ - M
with section 7000) of Division 3 of the Business and Professions Code, and _ - - - .
mY license is in Lull force ntl effect. l •
License lass - Licens ' •
$^
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Date - Signature J,L.r• l�'kJ� , PLUMBING , FEES
WORKERS'COM NSATION DECLARATION • Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate • , ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section - _ - -
3800, Lab. C.) Backflow Preventer -Service Sink Automatic Washer - -- ' Transformer 0 15-50 KW • -
Policy No. Company Backflow Irrigation I 0 50+KW.
Certified copy is hereby furnished. •
g Sewer Cap Construction Pole Sub.
- Certified copy is filed with the city Building Division. Bathtubs Sewer Connectiori Cooking Unit .
Meter Dup to 100 amps ' ' '
Date Applicant I I - , -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers I Solar Collectors Dishwasher Meter Dover 100 amps •
(This section need not be completed if the permit is for one hundred ($100) or - -- -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I -
shall not employ any person in any man er o as tq ome subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8
Worker}} Compens7ppp��'.Laws of Calif a. y q -
Date !, -/-VY Signature 1t d• f".•''K_K Floor Drains Swimming Pool vii/Spa F.A.U. .
NOTICE:If,after m ing this declaration,you should become subject to the • Inc.Solar 09-15 HP 015-15+
Workers', Compensation provisions of the-Labor Code, you must forthwith - Floor Sinks Urinal - Fixtures - J- - - - --
comply with such provisions or this permit shall be'deemed revoked. 'Microwave
.CONSTRUCTION LENDING. AGENCY - / Gas Service LI Outlets Water Closet .. �r Device BOx¢a
I hereby affirm that there is a construction lending agency Mr the performance / Z-X� Pole Light
of- the work for�uhjth-rysr. perml is ued ( - tion 3097 Civ. C.) • •
_L/ �'�l oC •
a - Interceptors Water.Heater - - Outlets Range
Lender's Name 9
Lender's Address V •1"•:2 5'-- • - r. 70. ic . Kitchen Sink. - . Water Service - - Switches •
,
OWNER BUILDER DECLARATION ' 7 - - Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - •
-
f Lfollowing reason (Section 7031.5 Business and Professional Code: Any city or ; - Garbage Disposal 'Standing Sections
County which requires a permit to construct,-alter,improve,demolish or repair , P-Trap • Generator ❑0-5 KW ❑5-15 KW -
•
^/(Yeny structure, prior to its issuance, also requires the applicant for such permit - Trash DOmpaClOr
-t-to file a signed statement that he/she is licensed pursuant to the provisions of Roof.Draina - ‘--the Contractor's License Law (Chapter 9 (commencing with Section 7000) of. - - '
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom-and the basis for the alleged exemption. Any violation of Section I - - `
•
7031.5 by any applicant for a permit subjects the applicant to a civil - - -
pnalty of not more than five hundred dollars($500). 1 I - r ' -
LJ I,.as owner of the property'or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered 111 - Reinspection Fee ' $15 Issue Fee $ 3 '
for sale (Section 7044, Business and Professional Code: The Contractor's - . MECHANICAL FEES - -
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: '
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 '
sale. If, however, the building or improvement is sold within one year of com- - - Canopy Type I I ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct'-Under Ground Building Approved By Date
glove for the purpose of sale). - r
LJ I,as owner of.the property, am exclusively contracting with licensed con- ' Duct-Structural ' Refrigeration System Application Issued By Dat
tractors to construct the project (Section 7044,Business and Professions Code: '
The Contractor's License Law does not apply to an:owner of property who Duct'Ventilating 00-100,000 BTU 0100,000 BTU S MARY OF FEES
builds or improves thereon, and•who contracts for such projects with a con- - -
tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. '
PLAN CHECK $ • PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# PLUMBING $ -en ISSUANCE $
Date ' owner - - Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BTL - - - - • ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city o enter u•on the above-mentioned property for
inspection pur.o / / MECHANICAL $ 'TOTAL FEE $ S.OC
Signaturespectio - -
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
. N
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - -
•
"' . OOL&SPA -
, CONSTRUCTION AND PLANNING •
.
iDate - Inspector .Date Inspector
APPROVALS Permit#- APPROVALS Permit#
•
1. Temporary Electrical Service or-Pole 52. Pool & Equipment Location - 4 - '
2. Soil Pipe-Undrgrnd. i 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 COVE R-GUNITE -
7. Footings - - 58. Electrical Conduit-Undrgrnd. , _ '
' 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
' 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.;
10. Structural Floor System 61. APPROVAL TO DECK '
11. Property Sewer Line & House 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. Solar System-Final . -. -
16. Rough Electric Wiring ' - 67. Fencing &Access Approval -
_
17. Rough Wiring Sign - . 68. APPROVED FOR PLASTERING
4 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 ' 1 71., Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush - •
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 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. Drywall Nailing ,HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION -
32. Electrical Power Meter-Final . . 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:,
34. Final Heating & Air Conditioning - i _
35. Final Gas Pipe-Test u/J/eh1 coo
36. Hood or Canopy . . - ' . -
37. Final Factory Fireplace - - -
38. Final Plumbing ' . '
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final .r -
42. Backflow Preventer
43. Backflow.Irrigation . . - .,
44. .La.'ndscape Irrigation System , • . -
• 45.. Sound Attenuation ' - '
46. Handicap Regulations ' I -
47. FINAL STRUCTURE & BUILDING .
48. Special Requirements Completed ,
49. Electric Releaseto Edison •
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50. Gas Release to Southern California Gas Co • ' •.
51. CERTIFICATE OFOCCUPANCY _ ,
No., Date - -
2.2825 •
FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT AUG Z 1964
P.O.BOX 917 COSTA MESA,CALIFORNIA •
FINANCE DEPT.-
CITY OF COSTA MESA
For Applicant 9 Fill In Completely APPLICATION:FOR PERMIT ' •
pR PRINT p BUILDING
cj TI COo9JT 1 z-o-e-YL �LOA1 1 For Office Use Only
BUILDING
ADDRESS �' �/R/MI��IT��/_^
RECEIPT NO. i 128(LJ
COSTA MESA, 'CALIFORNIA tel/
By DA DATE ISSUED
OWNERG EAij R oo /.AA/P 0 Rpo Q ¢T/
. O A/ � .A , - - ,- /
GRk e;
, MAIL -}- BUILDING
ADDRESS Io 9r I /ft .i ElG ReG ADDRESS
i FIRE II T
'TEL. ZONE TYPE GROUP F1-�3
CITY�/ew On l.T Aia QCh No.473-Ia ye TTT
ARCHITECT/ ' . TEL.• APPROVED
ORENGINEERA4UA WAG S ' NO.6,73-7010 BY • DATE E
tu
3`�3G2 ZONING
' ADDRESS / h • I! • .. -- & !. II:_Le ' CI x7;1_, No.OF USE OP New / ✓ fa
a
/ PLANS I BUILDING " GI,
CONTRACTORI �1_ISo -jC�oMLST Co ` . )
ADDRESS /0 VC .71 /4-Ai b oR-e LEGAL 5� ���/�/�� ^/T
DESCRIPTION /.'yam/I rz/11/ Z �I (/� '- •/ / (L.,
A.P.NO. Y. -✓ / ✓ — 3 .„1
CITY NEwporrr Bell Ch a
J NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
• LIG:NO. is/f i i (J NO. ({1�3—I2 liO 90"TO SIDE a REAR P.L. w
EAVES
SOF LOTio. ' j( s,•j I NOW ON LOTS�O ALLOWED (U.B.C.REQUIREMENT) a
h
USE OF YARDS APPROVED ' YARDS APPROVED a
' EXISTING BLDG. ,MAIN BUILDING ACCESSORY BUILDING
0
- - - (FROM C/L STREET) , fi.
SETBACK LINE FROM Zm �1/ J FRONT -- Fr. 1— FT.
CENTER OF STREET pJ V REAR YARD n S - .•
SIDE YARD I LEFT /Q / - ' I RIGHT/0 I R.SIDE F !n FT. - FT. •g•.'
DESCRIPTION OF WORK L.SIDE I 0 FT. FT.
—
L— P'' /
EAR \ FT. Ft
L. NEW _ ALTERATION ADDITION
DISTANCE BET. BET.MAIN Q
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
DATE
p NO.OF
SIZE 131.7<79/^ 7t s//ROOMS -1 STORIES / APPROVED •
• EXTERIOR WA Lt�� I ROOK - / UAPPROVED/ � —6"
COVERING 7ULUD COVERING OG - DATE
USE OF BUILDING AND W RK TO BE PERFORMED, 1 - ' ,,i �/1
'J X D Gr_)e1---i- ( Y-/
11 2
&ORA1..e- ,4the d S2 SQ.FT. 777 1U/l , •
I HEREBY ACK WLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Z
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. • PURPOSE OF ESTABLISH I NO A PERMIT FEE ONLY. G
' PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION �� .� 0
' BUILDING CONSTRUCTION. - N
SIGNATURE OF ' ' • PERMIT FEE $
PERMITTE 4 iib m
AUTHORIZED AGENT A , A, / / 411,•
•. .-.. ..\' TOTAL FEE $ / f