HomeMy WebLinkAbout3044 CLEVELAND AVE - Building Permits. ' AOP�leant to fill in ali spaees excepl those within neavy boraer Iines an0 sign all approoriate aeclarations.
CITY OF COSTA�MESA� ' ' - �� ' ' � ' PER IT NO. / TFACT NO. � • LOT NO. � � BL�Dt='�� ' " ' �- � � j5I 3 3/�I B/ �5 ,. . .2!1.9� _._�' �
'�COLSTRUCTION P,•BRMIT; , , �'� C�2t`7 ' " , , 1� _ . . � • , � ;
. �
Projeet Address- f - TVPE OF CONSTRUCTION � NEW ADD "ALTERATION .REPAIR '
. ❑ CONVERSION ❑ DEMOLISH ❑ OF{�IER _ � �
APPlicant's Mailing Ad r ss ' - , J �'L�� ' A.P. # : ' ' . _ ' ' ' �Zone _ ,
'DESCRIPTION.OF VJORK � �.i
Owner's Name ' �' Phon ' I� , , . ' •� . �- - . _ _ S Main Building: � . - "Accessory Building: " - ` Z
Address .. , . � . . � �
/ _ TYPE OF PERMIT� �• GRAOIrvG O�FouivoqTloN S7aUCTURAL � T Front N:
. Arch/En .,� ' � - � License No. - � � - : � ' ' �
g , . . ❑ TENANT � ELECT.R,/I�CAy GLUMBING_ ❑ MECHANICAL . . 6 Rear � - - �
�Add�255. � ' ��OTHER . Q�{iiOr� �-L� . • . . : ' . A' . , " . . N i
I Contiac4or;sName� ��`-« Phon � a' (�� PR JECTDESCRIPTION Sq.PT.- �0�� �oCCUPArvcv C Right G
r� K � q
:�'7 ''�}� CONSTRUCTIONTVPE - � ��VALUATION$ I'��'T� g Left - i ' ' E
Address.lmailing) �� � � � � _ .
I ! ZONE ' ' GRADING CU. VOS: ' ACRES � � ' � � • - Q
City LicPnse No. �� ���3� Ping. Ref. # � . � Paik[Fees $ , u t
LICENSED CONTRACTOR DECLARATION - ' ` � Remarks: � _ _' - � � . ' Parking Req./Provided - � . ' �-
1 hereby affirm that 1 am Iicensetl untler provislons ot Charter 9(commencing ' - . . , , R
wi[h section ]000) of Dlvision 3 ot the Businezs antl Protessions Cotle, and ; � � � , � ' � Use of Building: , • E �
my license is' f II f ce nd0 E . • �p/_Y ..01 ' - . . . . � , . - ,
Licens I 5� � Lic ns �«�«91 � PLUMBING FEES Planning,Notes: M e
Date ' Signature . � ' � ' - E
WOR ERS' COMBENSATION CLA FTION ' � Bar Sink ' ' Showers = _ �� ' ' '
I hEreby atti�m thdt I hdve a ce� iticate� consent If-insu��e or a certiticate Backflow Preventer ' Service Sink � � -� �� •
ot'Workers' Compen5at(on In5 ,"or d certi(ietl tOpy thereof (Section " - •' f ' - � i
3800, tab. C,J� o� `.A�. L ' �T,�T,� �.��� � Backflow Irrigation � � Sewer Cap� � � � � ELECTRICAL � "�� , ' FEES
Pollcy No.2L eT �J4� Company . . . . ' ` ' � ' - '
Certifietl copy is hereby furnishetl. � ' � Bathtubs . Sewer Connection ; � Automatic Washer . Transformer ❑ 15-50 _KW .
�Cer tileG with Ihe city ivi5ion. • . . . � _ , , .
� 50,+,`KW �
ClarifieFs �� . Solar Cullectors ConstructiOn Pole Sub.
Date������ �— APPlicant ` . � _ ' _
EXEMPTION FROM WORKERS"CO EN ATION�DEC ATi rv� -- DishJ✓asher . ' � Solar Piping. � ' CoOking�Unit , MEteI ❑up to 100amp5 - ��
(This sectiomneetl not be completetl " the p rmit is Tor o e h ntlr ($300) or
.iess): � � � Drinkin Fountains '
I certify�,that in the performance of e k for which perm�t is�issuetl I 9 Solar Tank Dishwasher � Meter ❑over 100 amps.
shall not employ any pe�son in any manner so as to become Subject to t�e � � . - ' _ _ �
workers} Compensationi Laws oi californiaJ Floor Drains, . Swimming Pool w/Spa Dryers ❑Gas ❑Electric �Sub Panel .} .
Date Siqnature �
NOTICE: 1f,'after making tliis tleclaration, you shoulA become subject.to the � Floo� Sinks Urinal ' Fan� • MotOrs �a1 HP 01'/z- B ��
Workers' ComOensation'provisions ot the Labor Cotle, yoh must forthwitti ' - - ' ' -
comply with such provlsions or this� pe�mlt • Shall b¢' deemetl revoketl.� , G35 S2fvit¢ Outlets Water Closet. ' F.A.U. ' . �Inc Solar �9-15 HP 016-15+ � '
CONSTRUGTION'LENDING'AGENCV�• ' � ' ' ���• ' ' ' -
I hereby ifflrm that there is a construction lentling agency for the performance Intereeptors . Water Heater � � Fixtures ; ' � Microwave � '
ot th¢ ;work tor which thi5 permit -is issuetl ,(Section �,3097 Civ. iC.); � � '
Lenaer's Name� ` ' 1 Kitchen Sink . . lNater Service '� � � ' Device Boxes • . Pole Light � � � '
Lentler's Atldress ` "' " � ' ' � �� ' - r �
OWNER BUILDER DECLARATION - ' � . 1 , � � , 1 Lavatones � � - �' � � - � � � i -. _ Outlets � � Range ' ' � �
I hereby attirm that I am.exempt from the Contractor's License Law for the � p_Tra
following'reason (Section 7031'.S7Buziness antl ProTessional.Cotle: Any city or ' P` ' ' - _ - Switches � , Sign �
.county whicti �equire5 a permit to construct, alter, Imp�ove, tlemolish orrepai� � I� �, '
any structure, prior to Itrissuance, also requi�es the applicant tor such permil Roof.Drains. n .. - . ��' . Garbage Disposal Stariding Sections ' .
to file a si9netl Statem¢ntthat he/she is licensetl pu�suant to'the provisions of-. '
the Gontractor's License Law (Chapter 9(mmmencin9 with Section 7000) ot . ' Genera[or �P5 KW 05-15 KW Tresh Com actor . �
Division 3 oi the Businets antl� Professions Cotle)ror that he/she-is exemp[ . � . .� '' ' . ..�� P '
therefrom.antl the basis for t�e alle9etl exemption. Any,violation of Section ' M . ' ' . . � ,
7W3.5 by. any'applitant for a permit subjectz the applicant :to a civil � � • � ' � � � • .
; enalty ot not more than tive huntlretl tlollars (g500). , � � Reinspection Fee-�� �$25� �' ' Issue Fee :' ,' 1-�� a'3
•� I; as' owner of the' property o[ my employees with wages as their sole ' � Re105peCtiOn FBB ' $25 ISSUB F¢8 - � '$' $
compensation, will tlo the work, antl the structure is not intentletl or offeretl � "; - ' MECHANICAL ' . FEES
for sale� (Section �7044, Business antl' Vrofessionai Cotle:', The` Convactor's ; � PUBLIGSERVICES RE�UIREMENTS: ' ' � '
License Law tloes not apply to.an,owner of a property,who;builtls or improves .; � � �, � � � i . . , � � , � .
thereon,-and;who tloes such work himself herself or throu h his or her own � BOile� � HOod of Type I ❑. � . ,
� i 9 �Zoning Approved By D'ate
employees, provitletl that such improvements are not�intentletl or offeretl,for � • Canopy' Type II� ❑: . , i , . �. �
sale. It, howeveq the bulltlin or im rovement is soltl wlthin one Duct: Under Ground , .
q c year ot com- ' , � Application Approved By Date
pletion, the owner wlll havevthe buraen of provin9 he/she ditl not builtl orlim- � . . ' , '
�rovefoitne�purposeofsale). � � � , � { Duct-Structural , , .RefrigerationSystem , .'� ' �ApplicationlssuediBY ' Datw . 3 R
I, as owner oi tha property, am exclusively mntracNnq with licerisetl con- � � L
❑0-100,OOOBTU ❑100,OOOBTU
tractors to construct the project (Section ]044, Business anC Professions Coae: Duct - Ventilating- 1 ' ' SUMMARV F FEES - � " �
'The Contracto�'s'License Caw-d oes'not apply to-an owner of property who - � . .
builtls or improves thereon,�antl who mntracts for such projects with a con- � Exhaust System ❑ Multiple �� System Repair/Alteration , BUI LDING�PERMIT $ 2� SMIP • �$ ' J�
Vacmr(s) license pursuant toR�e Contractor's License Law). ' PLAN CHECK $� PERMIT � '
❑ 1 am exempt untler SecHon B. & P. C. for mis reason � FirepUFact.,Blt. ICBO �k � ' � 1 ^ PLUMBING �$ � �SSUANCE �$
Date � Owner, � HeatingSystem&Ducting : � ' 'pLqNCHECK � $ ENERGY'P.C.' $ �
I hereby,certity that I have read this application antl state that the atiove i ❑6100,000 BTU �100,OOOBT � ELECTRICAL � GRADING $�
information is correct. I agree to.compty with all city antl county ortlinances � -� ' ' ' "- ' � � " " '� ' ' $ .
'antl,state laws rei ngkto builtli. g construction antl hereby authoriie reore- . . ' - PLAN CHECK � ' ' ' MICROFILM ,$' �
sentatives thi Ity ,to ente upon the'above-mentionetl � rop rty for � ' � ' ' � , �$ (/
inspectia pu es i • • � � � MECHANICAL , , $ � TOTALFEE ' $ _Zry"SQ_
Siqnatur � t.L- ' _ Dat�,���� : Reins ec[ion Pee � . . . . • ..
Drivers'� cense or 55 � P .$25 , , Issue Fee $ 3 PLAN CHECK ' ,$ }
CMF 0665 � v.7/83 Wh - Builtling; Canary -'Applicanq Pink> Accounting;'Golaenrotl -'Asseszor - � " �- - '- � � � ' ' -' ' . ' --- - ' --+� • • --.- - . . -_ , .. ' . ' '_
� CONSTRUCTION AND PLANNING ;'_ ' ; '�._ ' � '� ��- � . : POOL & SPA _ . ; .
^ �• •. Date�' � I nspector : � � - � - �Date� Inspedtor
' APPROVALS- .Pe�mit# , . '�APPROVALS �Permit# � � .
; � ,. .
1�. Temporary Electrical Service or Pole � - . - " 52. �Pool & Equipment Location -: � . • �
: 2.. Soil�Pipe•Undrgmd�. _ � � .. . � 53�. Steel Reinforcement . � � . " �
,3��Electrical Conduit Utility-Undrgmd. - . . � 54.�-Forms � . - • - � . •- � . . �
,*"4�'Electrical Conduit-Undrgrnd._ � _ • � 55. Elect�ica_I Bonding' - . .
5.;Steel Reinforcemenf , ' . - .. " . 56. �Rough'.Plumbing.& Pressure Test,'� • � -
� 6. Electrica! UFER Grnd. , - . �� . - 57. APPROVAL TO COVER-GUNITE . � ' , �
� 7.� Footings . . � � � � • � �' � - 58. � Electrical Condui't-Undrgrnd. `, ' ' � �
8.�Poundatipn � � , � ' � � � 59. Gas Pipe, � Undrgrnd:, Test. - � � �
9. Waier Pipe-Undrgrnd. , '60.'Backwash Lines�, P-Trap, O Undrgrnd: � '
10.��Structural�Floor�System , � � �. .61.�APPROVALTODECK� � ,
11.� PropertY Sewer Line & House Connection , ' 62..Backwash,& Receptor-Final -� '
r
12. Sewer Cap ' , . ' � �63. Heater & Vent-Fin21 � ' � �
, . �,
13. Roof Drains � � . , 64.. Plumbing_System�: Final �:. ' �
14. Rough�Plumbing � - ' •`� 65. Electrical-Final � . . � - � . .
15., Rough Electrical-Conduii - � �, ., � ' "' ; 66. Shcar System-Final - ' " � ' ' , � � '
_ 16, Rough Electric Wiring � ' � -, ' . . - � j ' 67.=-Fencing & Access Approval � ' _ ��, � . '
17. Rougli Wiring�Sign� = : � ' " � - 68. APPROVED FOR PLASTERING ' � • �
�18.•-Rough Electrical-T Bar Ceiling - " � � � ' 69. POOUSPA SYSTEMS FINAL ' � '
19. Rough Heating &�Ait�Conditioning ' FIRE DEPT. REQUIREMENT � �- '
20. Rough Factory Fireplace � � � �APPROVALS Permii # , �
21: Ducts; in Structure , � . , 70. Underground Hydro
22.�Ducts, Ventilating � ' � 77, Product'Piping �Gas ❑Oil � �
.23. Gas Pipe=Rough�& Testr ; � , : ' � � � 72, Underground Flush •
i
� 24. RoofFraming . . , � '73. Undergrnd.StorageTankOGas ❑�OiL �
25. Roof Sheathing � '' 74. 'Overhead Hydro , �
26. T-Bar_Ceiling (Structural) & Monocoat , � - � ' 75. Dry Chemiral . - - �
27. Frameand Flashing , � � � � 76. Dry Standpipe� � '. � '
28. Lathing & S:ding ' • � � � 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 GERTIFICATE ISSUED �
33. Final Electric ' . � � ' Notes: ' ' � .
34. Final Hedting�& Air Conditioning- ' � � ' ' ' �
35. Final Gas�Fipe-Test - • � � . � . � . . '
36. Hood or �nopY 1 ' . : �- , , , ' '. . • ' ' -. - . .
37. Final Factory Fireplace ' � � ' ' • � - � �
38. Final.Plumb'ing � ' � � ' � . ' � -- � � ' �
39. Water Service-Final' ' � ' ' �
�
40. Gas Seryice-Final � � ' �
41. Solar pomestioFinal . � .. � ',� . � , ._ ' , �
42. BackflowPreventer . ; . i � v�
�
43. Backflow Irrigation � , , - _ � ' � ' � .� � '
� 44. ,Landsca'pe Irrigation System � � ; � � , , . , � t r , • , � -
45. Sound Attenuation � , ' ' ' ' � , � �, ` ' . '
46. .Handirap Regulations� � � � ' � - � . .. �
47, FINALSTRUCTURE & BUILDING � ? 'v ' � . ' �
�
48. Special Requirements�Completed ' � � , ' , . �
49. Electric�Release to Edison � � - �� - � - � - � � � . '
50. Gas Release to Southern California Gas Co -: i � • � �. • � � .
�
, � .
51. CERTIFICATE OF OCCUPANCY �f� �J� " ___ �, { , ,, . ; � ,
No. " Date � � � - ' ' , '
AOP��cant to fill in all spaces exeept those within �eavy oortler lines antl.si9n all apvrooriate aeclarations. �
CI�Y OF COSTA M A CONSTR CTION ERMIT ,- •PER T NO ' TRACT NO. , LOT NO' . UNIT N6. ' � . . ' , ' ' � � ' � � � � �
� � "�1 � S�s�9 - . � _ -
. PrOject Address � ' /��, AO ' , . ., �
ApplicanYS Mailing-Addre55 ���5 ^S� �%�/�G GLIi/ TYPE OF CONSTRUCTION , ' NEW DD ALT.ERATION REPAI R ' � _ , y.
p��— ❑ CONVERSION ❑ DEMOLISH OTHER � A p, �t • � �� . Zone
Owner'sName. � �Ption._P-���_a� �DESCRIPTIONOFWORK/USEOFBI.DG.� - -� -
Address � �' '�'� � �-�'�-Q�O � ' � � S Main Building: ' Accessory Building:
Z
,Arch/Eng. _ ' Liiense N� TYPE OF PERMIT GRADING FOUNDAT(Ory ❑ STRUCTUR,CL T Front _ . � ' '� p
Addres5 - ❑ TENANT ❑ ELECTRICAL. ❑ PLUMBING�c.�i�MECHANICAI_ . A .Rear . ' . N
ContraCtor'sName ���' E . - ❑�OTHER . � -
� Phon // C Right N
Address Im�'i'�nl ,�OO � S� -4�mziCLcq���/7-. PROJECT DESCRIPTION SQ. FT. _ OCCUPaNCv K. G
, � �/ � � CONSTRUCTION TVPE VALUATION $ S � Left ,
City..Licen�e Nn, � , ZONE GRA�ING CU. VDS. ACRES� - �� � E
LICENSED CONTRACTOft DECLARATION � PIn9. Ref. # P2/ki0g R¢q./PfOvid2d
.I hereby affirm that I am licensetl untler provisions of Charter 9(commencing Remarks: ' 'Planning Notes: ' . � ry�
with section 7000) of Division 3 of the Business antl Grotesslons Cotle, antl
my license is in full force�tl ei ect. ?/ . • - T
LIC205f.�(:Id55 �� _ icense N . � _ , � � S
Datey — Si t ts < --^�-� . PWMBING ' FEES
WORKERS' COMPENSATION DECLARATION Bd� Sink ShaW¢�5 ELECTRICAL � FEES
� I hereby affirm that I nave a certificate of wns¢nt to self-insure or a certiticate
�„ of Workers` Compensation Insurance, or a certifietl copy thereof (Section _ gackflow Preventer SeNice $ink � `- ^' �
�.�, Automatic Washer , Transformer ❑ 15-50 KW
" ❑ 50+KW
�. olicy � Com Backflowlrrigation Sewer.Cap- ConstructionPoleSub.
rtitietl copy is he�eby tumishetl. � .
r"' tl cppy is " w' tling Di ' ion. athtubs Sewer Connection Cooking Unit � Meter ❑up to t00amps ,
Da[e ��a� Applica � .
ON FROM W MPENSATIO LA TION Clarifiers $Ola� COIIect0�5 Dishwa5hef MEt¢� ❑Ov2� 1002mp5
is section neetl not be completetl if the permit is fo� one hunOretl ($100) o� . �
less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric '� Sub Panel
1 cer[ity that in the performance of the wo�k tor whiCh ihis perm�t i5 issuetl, I � ,; ,
snall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank f Fan Motors �0-1 HP �1 %- 8 '
Workers' Compensation Laws ot Califomia. � . ' .
Date Signature Floor Drains Swimming Pool w/Spa � F.A.U. IncSolar �9-15 HP �16�15+
'NOTICE: It, aftei making thi5 tle[laration, you shoultl become Subject to the .
Workers' Compensation provisions of tbe Labor Cotle, you must forthwith_ FIOorSinks- • Urindl Fixture5 • -�
comply with such p�ovisions or this permi[ shall be tleemetl �evoked. Mic/Owdv¢'
CONSTftUCTION LENDING AGENCV � �� ° CjaSSCrvic¢ Qutl2ts W2t¢fC1052t DCVICCBOxCS POIELight
I M1ereGy affirrti that there 15 a construction Ientling agency tor tne periormance
' of the work for which this Oermit is issuetl (Section 309] Civ. CJ In[erceptors Water Heater - Outlets pange
Lentler'S Name ' '
Lentler's Atlaress — - Kitchen Sink " Water Service � Switches � Sign ��
OWNER BUILOEH bECLARATION -
I hereby a/firm that I am ezemp[ from tM1e Contractor's License Law�the_ Lavatories , . - ' Auto-Wash , " ' '
following reason (Section 703L5 Husiness antl Professional Cotle: An� or Garbage Disposal , ', Standing Sections
county wnich requires a permit to construcq alter, improve, Cemolish, pair P-Trep Caundry Trays Generetor �0�5 KW �5�15 KW Trosh Compacmr
any 5t�ucture, p�Io� to its i55uance, also requires tne applicant for suc rmit
to file a si9netl statement [hat M1e/she is licensetl pur5uant to the proJ.�ons at ROOi Dfei05
�the Contractor's License law (Chapter 9(commencing with Section ]000) of
Division 3 of the Business antl Professions Cotle) or �that he/she is exempC �
therefrom antl the basis for the allegetl exemption. Any violation ot Section ., ' � '
703L5 by any applicant-fo� a permit subjects the applicant to a civil -
� enalty ot not more than five nuntlretl tlollars ($500). '
� I, as owner ot Ihe pro0erty or my employees with wages as their sole ReinSpettiOn' Fee Issue Fee $ 3 .
compensation, will tlo ine work, antl the structure is not intentletl or offeretl - qeinspection Fee $15 Issue Fee $ 3
tor sale (Section 7044, eusiness antl Professional Cotle: The Contractor's - - . • MECHANICAL . FEES
License Law tloe5 not apO�Y to an owne� of a property who builtls o� improve5 •
thereon, antl who tloes such work himself/herself or throu9h his or her own goiler ' Hoo T e I ❑ DEVEIOPMENT SERVICES REQUIREMENTS:
employee5, provi0etl that sucn impwvements are not mlenaetl or otfered tor -- YP �. _ Zoning Approved By Date
sale. If, however, the builtlin9 or improvement I5 soltl within one year of com-, nopy Type II ❑ �
pletion, the owner will nave the burtlen of proving he/she tlitl not builtl or im- Duct - Under Ground � Building Approved By Date
prove for the purpose of sale). � , , �����]�
❑ 1, as owner of tne'Droperty, am exclusively mntracting with licensetl con- Duct - Structurel � Refrigeration System Appliption Issued By � Datp�/ e���/�r/
� tractors to const�uct the project (Section 7044, Business antl Professions Cotle: . �
The Contractor's License Law aoes not apply to an owner ot properry, who Duct - Ventilating : ❑0-100,000'BTU ❑100,000 BTU ; SUMMARV OF FEES '
-builtls or Improves Ihereon, antl who conVatts for such projects with a con- �' - - - �'- ' � �
tractor(sS licenie pursuant to the Cantractor's License Law). 1 am aware that Ezhaust System ❑ Multiple ❑ System Repair/Alteration � � BUILDING PERMIT $ SMIP $
proot ;of their Worker'S Compensation insurance shoultl be provitletl to me. _ , PLAN CHECK $� � PERMIT � �
❑�I am exempt untler'Section B. 6 P. C, for this reasan Firepl/FacL Blt. ICBO # Fire Dampers � � . PLUMBING $ ISSUANCE $, �
�ate Owner ' ating System & Ducting, Registers � � PLqN CHECK 25% $ ENERGV P.C. $�
-I nereby certify"that=l have reatl this aoPlication antl state that the above 4100,OOOBTU �100,OOOBT - �. -, - • � GRADING $�
information is carrect. I a9ree to comply with all city antl county ortlinances /�' � ' ' ELECTRICAL $
ana state laws relatin9 to builtling co ruction, antl hereby authorize repre- S OO�/(� 3� �: f � � UU PLAN CHECK � 50% MICROFI LM i $
sentatives O( s city to'enter u the above-mentionetl pro0er[y.to� ��, i �/ ^�
, MECHANICAL TOTAL FEE � $ �
D9vers'rLicense or 55�� ' Heinspection Fee � $15 ,' ' laue Fee � � $ 3 PLAN CHECK 25% $ � � � �
CMF 0865-46, rev. 10/84 White - - Accounting; Goltlenrotl - Assessor - � '
.��
� . CONSTRUCTION AND PLANNING - � • � � � POOL & SPA - ' � � -' ' �
�� APPROVALS Permit # Date Inspector qppROVALS Permit # Date � Inspector
r -
� 1. Temporary Electrical Service or Pole ��` ' 52. Pool & Equipment Location
a�, ' .
2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement -, .
' �3. Elecfrical Conduif Utility�Undrgrnd. . 54. Forms � " � "
�� 4 -Electrical Conduit-Undrgrnd. � � " - 55. Electrical Bonding ' . � �
5�. Steel Reinforcement �� - 56. Rough Plumbing & Pressure Test ' . �
�,
6• ElectricalUFER�Gmd.• . . 57. APPROVALTOCOVER-GUNITE . ,��` �
' 7� Footings� ". � �' - ?�` 58. Electrical Conduit�Undrgmd.. � � ' ,• ���
y
, . , 59. Gas Pipe, � Undrgrnd., Test '� ��
� 8f'Found�ation ;'
�-9.`Water Pipe-Und�grnd. .\ F 60. Backwash Lines, P-Trap, O Undrgrnd.
tO:�Str'uctural Floor System . f ��,A 61. APPROVAL TO DECK . �
11. Property S�wer Line & House Connection �`� , 62. Backwash & Receptor-Final '
12:.,Sewer Cap; � � � - . 63. �Heater & Vent-Final � �
•� 13: Roof�Drai�s . - . ". �'�; 64. Plumbi System�-Final . .
� 74. Rough Plumbing � � �. . c.� 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 �
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 �Gas; DOiI � � . � „'r
�
�23.'Gas Pipe-Rough & Test � - � � 72. Underground Flush f � � � - , -� '�'
.�
24..Roof Framing . 73. Undergmd. Storage Tank O Gas ❑ Oil � � -, � y�
' 25. Roof Sheathing • � 74. Overhead Hydro .�� / , i
� 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 � �75. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
� 31. Plaster Brown Coat ' . 79. FINAL INSPECTION -,
32.-ElectricafPower Meter-Final 80. FOOD CERTIFICATE ISSUED � � ��
33. Final Electric Notes: - � c-- ' "
34. Final Heating & Air Conditioning f� Z�(� (,,�j� , ' "� ' "
35. Final Gas Pipe-Test . - . - .
36. Hood or Canopy � � � � �
37. Final Factory Fireplace , � � , -
38. Final Plumbing , • ' , .
39. Water Service-Final ,r;., � , _
40. Gas Service-Final - ` � � - � �
41 . Solar pomestic-Final � - • •
42. Backflow,Preventer �'- '�.i ' • � °
; . i
43. Backflow Irrigation, ' �' � , ' '
f.
44. Landscape Irrigation Syste"m ' � � • � ��
45. Sound Attenuation � - •. ' . , •
46. Handicap Regulations �- " � � . � .
i7-
47. F,INAL STRUCTURE & BCIILDIM1IG `
48. Special Requirements Completed � ,
49. Electric Release�to Edison ' �
50. Gas Release to Southern California Gas Co � ° � . .. "���
51. CERTIFICATE OF OCCUPANCY , - � �
No. -� Date � •- �%
;I�Y OF C STA MESA 3�`�
CALIFORNIA 92826 P.O. BOX 1200 �-
FROM THE OFFICE OF THE DIRECTOR OF BUIlDINO SAFETV
Project Address �Q �� I Pernut #
Project Name
Qaners Nane
OVmers Address �Q/�i City Use Only
Raners Telephone . �� .3 %Oa ' - - - —
//
/I�_���� 7/� l/!/i�r� as Owner, Contractor, Agent (strike out all
except one) do hereby attest that employment of any person, or persons, is not
-anticipated at the time of see]cing the above-referenced permit. In the event that
any person, or persons, are employed under the prwisions of this permit, I shall
irtmiediately cause a valid Certificate of Worlanens Cong�ensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own �st, and to indemnify and hold harmless, the City,
its officers, agents and/or e�loyees, fran and against, any and all liability,
damage, costs, losses, claims and expenses, haascever caused,-resulting directly
or indirectly from, or connected with the improvetrent under this pezmit.
I further state that I have read and fully imdezstand t
sponsibilities of the above statements, and will c�nply
Contractors State License Law found under the Business
Division 3, Chapter 9, of the State of California.
�� l�<�!�s1�.
Print Name
/i / /�'G �f/�
S gnature
he implications and re-
with all provisions of the
and Professions Code,
_�—L7-.%�
Date
OWNER D. M. WEST �
JOB ADDRESS 3044.Cleveland
GENERAL CONTRACTOR wner
AP No. 141-141-46 LOT 1
INSPECTIONS �
SOIL
GAS
W �TEH
ROUGM VLUMBING
PHOP. $WR. LINE n NUUSE COM. �
SPNINKLING SYSTEM
MISCELL�MEOUS � -
ROUGN NE�TING AND AIR CONDITIONING
TEMPORARV SENVICE OR POLE
UNDENGROUNO � POWER �
ROUGH WIHING
TRENCNES FORMS STEEI NEINF.
FLOOR SVS EM
BOND BEAM [-] $TEEL REINFORCE ❑
$HE�THING
FRRME ANO FL�SNING
LATHING - IN n OUT n
P�ASTER, BROWN CO�T '
STRUCTURAI,fINAL
ME�TING. VENT., NEFRIG. AND A.C., FINA�
PLUMBING, FINAL ANU GAS TEST ❑
ELECTRIC, FINAL
BUILOING. FINAL
E
DATE 10-01-79
SUBCONTRACTOR
� 4020 10/01/79 6.50 TL
6 ... . . . . _ . . _..
`" COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVEDBV PERMIT N� 48853
For Applicant to Fill in Completely — Use Ink Only
BUILDING 2 �{ /% A.P. NO.
ADDRESS ��V ��t
OWNER OR Ni /� ��s A�DRES �
TENANT � /�� � (�✓
UNIT OR
MAI LI NG SPACE NO.
ADDRE55
CITV e %%1 • NO�fJ /��O TR �IQe�[q� OT � BLK.
J� �T✓
NEW ADD ALTER REPAIR MOVING DEMOLISH
CqNSTRUCTION -��
LENOER
��
BRANCH
OWNER
ADDRESS � - /'/ f WE
ARCHITECT -� TEL. USE �O 4(/ $
OR ENGINEER
ADDRESS
��� ZONE TVPE GROUP
�j AP �
CONTRACTOR BV DATE
ADORESS
TEL.n� �O'
CITV NO. /
STATE �7 /j CITV S, APPROVEDSETBACKS
LIC. NO. =3 �/ 7 Z 3 �IC. NO.
SIZE NO.OF BLD(3S. (FROM C/L STREE )
OF LOT OO NOW ON LOT � FRONT F
USE OF
EXISTING BLDG. F
Separate permits are required for �. s
electric, plumbing and heating work:
REAF FT.
USE OF BUILDING AND WORK TO BE PERFOFMED PLANNING ACTION
�/�� DATE
/� APPROVED
APPRO � � �
I hereby acknowledge that I have reatl this application end state �
that the ebova information is correct and agree to comply with
all laws regulating building construction, antl I shall not amploy �
any person in violation of the workman's compensation lews of d
the State of California.
m
I he�eby ce�tify that I am p�ope�ly licensetl as a contractor untler SQ. FT. �`+
the State of California Business entl Protessions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOF m
Chapter 9, and that sueh licenzes ere in full force entl effect, or I THE PURPOSE OF ESTABLISHING A PEIiM1T FEE ONLV: �
am axempt from tha Drovisions ot iheStata ot Calitornia Business VALUATION PERMIT FEE S
antl Protessions Cotle, Division 3, Chaptar 9. �` �
a (y m
Signaiura of /�//1� PLAN CHECK $ �. o
Permittee � $ ��(f4 LL
or TAX $
Authorized Ag¢nt Date '� �/`+ TOTAL PAID U
S
OWNER �ST. Mr. DATE �_�_��
jJOB ADDRESS 3044 Cleveland Avenue BUILDING PERMIT N0. 4341 i
AP No.
WATER
ROUGH
ILL
[�[.I'.11
R CONOITION
ROUGH wIRING
TRENCHES FORM$ STEEL REINF.
FLOOR SVSTEM
REI
FRqME AND FLRS
L>TMINf. - IN r
SUBCONTRACTOR
.�.
h
r7".
F
G7
F
�
�
a
>
r
'- � 434I 3
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely — Use Ink Only
BUILDING ,.-� _ „ _. �. �.. � ... .c, /i�
OWNER (',��s J
ADDRESS ��/��C �� �G
TEL
CITV C/L« /Y. L�T/.7 NO.
BRANCH
ADORESS "
ARCHITECT TEL.
ADDRESS
CONTRACTOR ,��OZZI �%)/NON/
ADDRESS �/u?�� �S%AN�Q��''L
//� �! TEL./
CITY G/T/lllt:/L� G�Q /G NO. (�J'Q�
STATE Q CITV
LIC. NO. `�1Z�O / LI0. NO�Q �
512E I NO. OF BLDGS.
OF LOT NOW ON LOT
VSE OF
EXISfING BLDG. /��-S /�E�G�
Separate permits are required for
electric, plumbing and heating work.
USE OF BUIIDING AND WORK TO BE PEFFORMED
//
"FR -7_-7;raa7o00 0$3.�, ��:r�t:7.5Q
c F.,
A PL AT N FOR STRUCTURAL PERMIT
R 1 E ( DATE RECEIVED DATE ISSUED ,
� � � ��
/! PEFMIT NO.
A.P. NO.
BUILDING
AODRES,�' Q�
TRACT LOT / BLOCK
NEW A D A R PAI M
OWNER . (�/�
/� VALVE
y�1� b $ s�'
FIRE �
ZONE TVPE '.GROUP
BVPp � DATL/`I � �" �
ZO NO.OF� USE OF NE �
PLAN$ BUILDING �
VARDSAPPROVED VARDSAPPROVED
MAIN BUILOING CCESSORV BUILOING
(PROM G STREE _.,,� . q/ / %/
BET. MAIN &
I haraby acknowled8e thet I have reatl this application end state
that the above information is correct end agree to comply with
all lews repuletlnB building conscrucUon, entl I shall not employ , .
any person in violetion ot the workman's compensatlon laws of
the Steta of California.
I he�eby certlfy ihet 1 am properly licensetl as a contvactor under SQ. FT.
the State of Calltornia Business and P�ofessions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALU
Chapter 9, and that such Iicenses are In full forca antl affect, or I THE PURPpSE OF ESTABLISHING A PERI
am axempt f�om the Orovisions of the State of Celifornia Businass VALUATION � PERMIT FEE
and P�ofa55ions Cotle, Divislon 3, Chepter 9. ��" $
/ /�T1 p� PLAN CHECK $
Peemltteeo� ���7�_ $ � S V / TAX $
Authorizetl ABent � � TOTAL PAID $
N
n
m
�
d
w
N
TION IS FOR m
T FEE ONLV: "
e
� a
m
m
0
f
U
5�
�or � TRn�r 4 95
• '�.�
�� r� �_ I 6?..84
C057A MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIFOFWIA
For Applicanf fo FiII In Complefely
TYPE OR PRINT
BUILDING
ADDRESS A A E
COSTA MESA. CALIFORNIA
oWNER K& K DEVELOPMENT CO. INC.
MAIL
ADDRESS A ENT A A ENUE
CITY NEWPORT BEACHE NE�I 6 2Z
ARCHITECT . TEL.
F E RECEIUEp
JA�u 3 1 iss2
FINANCE DEPT.
CITY OF COSTA MESA
�PPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
RECEIPT NO. I PHRMIT NO.
,r � � TE��=E��-��T� 't�9�o2
•�crn urcn rn� �rr�ov�n
ZONE NO, OF USE OF NEWS�H� -J)�
ci7Y� MNEWPOHT BEACH /�-( I PLANS � I BOILDINGw��-
��:.TNO. �`I0. I O- �� L6GAL . L � / %�' S'3q.r
OE6CPIPTION G
SIZE �' I NO. OP 6LDG8.
OF LOT � � Now oN LOT O A. P. NO. �
USE OF YARDS EVES
PXISi1NG BL�G. NONE APPROVED ALLOWEO
B¢TBACK UN6 FROM 11 / (CENTSR Llele BT.]
CeNTeR op BTrse6r � REAR YAR� Z4 � O�� FRONT `J O FT. �--' IN.
SIOE YARD I LEFT � I RIGHT � R. SIDE � FT. �- IN.
DESCRIPTION OF WORK L. SIDE i� FT. r— IN.
NEW ' I IIA4TERATIONI IIADDITION I REAR ZS— FT. � IN.
REPAIR I MOV�NG I IIOEMOLISH I BYPROVED '.�/ll �/ja/�Z
" � �K DATE
BUILDING AR 5 F NO. OF
SIZE ROOMS STORIES
EXTERIOR WALL ROOF /
COVERING STUCCO COVERING ROCK r �- Q
USE OF BUILDING AND WORK TO BE PERFORMED
NGLE FAM LY RESIDENCE WITH ATTACHE �� �
GARAGE �
� H¢qHBY AGKNOWLEDOE THAT 1 HAVE PEAD TH19 APPLIGTION THE AMOUNT BHOWN IINOER VALIIAT�ON 18 FOP THE
AN� BTATE THAT THE A60VE I8 CORPECT AND AGPEE TO COM-
PURP09E OF E6TpBLIBHINa A PERMIT FEE ONLY.
PLY WITX ALL CITY OPDINANCEe AND 9TATE IAWe RE�UIaTING
emLGING CON9TRUrnoN. VALUATION
31GNATURE OF - PERMIT FEE $ �YS��
PERMITTE � %/ (J � u
. Y /�� ( O�� �Y PLAN CHECK $ � � �G
F
AUTHORIZED ACaENT TOTAL FEE ����5� LL
I