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Home My WebLink About813 CORTEZ ST - Building PermitsADo�icant to fill in all spaees excev� �nase witnin heavy Ooraer lines antl sign all apo�opriate tleclarations. ;iT;�.oF COSTA MESn CONSTRUCTION PERMIT �,P` Address �/ 3 Co RT£'2_ S r nt's Mailing Address s'�3 CoRYFZ S/� Owner'sName �Y�+ E, F716n.�u:r_ Phone_rYY-v4�� i�_ — Address Arch/Eng. License No. � Address - Contractor's Name_ � "Phone Address (mailing) City License No ' LICENSED CONTRACTOR DECLARATION ' I hereby aftirm [hat I am licensetl untle� p�ovi5ion5 of Cha�ter 9(commencing with section �000) ot Division 3 of the Business antl Professions Code, antl , my Iicense is in full Porce antl eftect. LJcense Class License No. Date Si9nature WORKERS' COMVENSATION DECLARATION 1 hereby aHirm that I have a certiticate of consent to self-insure or a certiticate of Workers' Compensation.lnsurance, or a certifietl copy. thereof (Section 3800, Lab. CJ � Policy No. Company 8 Cer[itietl copy is M1ereby fumishetl. Certifietl mpy is filetl with the city Builtlinq Division. , Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completed it the pe�mit i51or one huntlretl ($100) or less). I certity that in the per(o�mance of the wor for which this perm�t is issuetl, 1 yhall not employ any pe�son in any ma er so az to bemme subject to the Workers' Compens i n Laws ot Calif r a� � Date �� '� y �� Signature 7 E. Q NOTICE: If, after makinq this tleclaration, you shoultl become subject to the Worke�s' Compensation p�ovisions of the Labor Cotle, you must forthwith comply with such .provisions or tM1is permit shall be tleemetl �evoketl. CONSTRUCTION�LENDING AGENCV. I hereby aftlrm ihat there is a coosiruction lending a9ency for the pertormance of the work for wM1ich inis permit is issuetl (Section 309] Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUIL�EH �ECLARATION - I hereby atfirm that I am exempt fram the Contractor's License Law for tne followin9 reason (Section 4031.5 Business and Professional Cotle: Any city or county which �equires a pe�mit to const�uct, alter, improve, tlemolish or repai� as ire, prio� to its issuance, also requires tne applicant for sucM1 pe�mit 7netl statemen[ �that he/she I5 licensetl pursuant to the p�ovisions of ctor's License Law (CM1apter 9(commencin9 witn Section �Ooo) ot ot the BuSinesS antl Professions Cotle) or that he/she i5 exempt antl fhe basis to� the allegetl exemptiOn. Any violation of Section any applicant tor a permit subjects the�applicant to a civil not more than five huntlretl tlollars ($500). an owner o* a properry wno owms rork�himself/herseli or throu9h his imorovements are mt intentletl or sale. If, however, thE builtlinq o� Imp�ovement I5 sola wimm One yea� oi com- pletion, the owner will have the burtlen of proving he/she tlitl not builtl or im- p�ova for the pu�pose of sale). � . • ❑ I, as owner of the property, am exclusivery <ontracfing wifh licensetl com tractorst6 construct the project (Section ]044, Business antl Professions Cotle: The Contractor's License l.aw tloes mt apply to an owner ot property who builtls or improves lhe�eon, antl who'contracts for such projects with a con- tractor(SI license pursuant to the Con[racto�'s License Law). I am aware that ptoot o4 theii Wo�ke�'s Coinpensation insurance Shoultl be provitletl to me. ❑ I am exempt untler Section 8. & P. C. for this reason TYPE OF CONSTRUCTION NEW ADD LTERATION REPAIR ❑ CONVERSION ❑ OEMOLISH ❑ OTHER � DESCRIPTION OF WORK/USE OF BLDG. TYPEOFPERMIT GRA�ING�{ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL l�\PLVMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq. FT. OCCUaarvcv CON STRUCTION TVPE VA�UATION $ _ ZONE GRADINGCU.VDS. ACRES_ Remarks: � _ Bar Sink Backflow Preventer Backflow Irrigation rinking Fauntains loor Drains loor Sinks as Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee � $15 Boiler Duct- UnderGround Duct-Structural ' - Duct - Ventilating . Exhaust System ❑ Multiple ❑ Firepl/FacL BIt. ICBO # Heating System & Ducting I hereby-certify tnat i ha e reatl this'application antl state that the above � �0-100,000 BTU �100,OOOBTt intormation is correcL I agree to comply with all dty antl munty ortlinances antl stale laws relating to builtling <onstruction, antl hereby authorize repre- sentatives of this ty. to enter pon the above-mentionetl �pro0erty �tor inspettion purp . � Signa[ure � �d oate ��"�Y—�� - Drivers' License or 55 � � f Reinspaction Fee $�S � CMF 0865-4fi, rev. 30/84 White - Builtlinq; Canary - APP��cant; Pink - Accountinq; Goltlenrotl - Assessor u!O �tc� l i.l �p✓4/�:/i1�0('.✓ Tc�UT�4 PLUMBING FEES Service Sink ' '� 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 Fae Hood or Typel ❑ Canopy . Type I I ❑ .�� s■ Refrigeration Sys[em • - ❑0-t00,0006TU ❑100,OOOBTU System Repair/Alteration � Fire Dampers � Registers . � � luue Fee � $ 3 A.P. # S Main Building: E T Fron[ A Pear C Right • g Left Ping. Fef. # Planning,Notes: GI01 II/14/B6 :,_=:n Zone Accessory Building: � Z ' " O N I . , ' N G � , R - Parking Req./Provided � E Q M T $ Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan � F.A.U. , ' Boxes Garbage Disposal Gerierator DU5 KW 05-15 ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100�amps Meter ❑over 100 amps Suh Panel Motors �0.1 HP O1 %- 8 Inc.Solar �9-15 HP �i6- " Microwave Pole Light � Range Siqn ', Standing Sections ! Trash Compactor ' '�pection Fee '$15 I . I luue Fee �PMENT SERVICES REQUIREMENTS: pproued By Approved By on luued ev - 0 FEES $ 3 ,i • , SUMMARV OF FEES �/•� BUILDINGPERMIT $ SMIP � $ y PLAN CHECK $ PERfN17 ..!' PLUMBING $ � �SSUANCE , $ �� PLAN CHECK 25%� $` ' S� � ENERGY P.C. $ ELECTRICAL $ � GRADING $ �'PLAN CHECK 50% $ � MICROFILM � $ �:MECHANICAL $ � TOTAL FEE $ '�_5� , P�AN CHECK 25% $ � . � , � � , �STRUCTION AND PLANNING POOL & SPA � � PROVALS Permit # Date Inspector AppROVALS Permit # Date � Inspector 1. Temporery Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinfo�cement � _ : r 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, � Undrgrnd., Test � 9; Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 � 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 ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � - � 24. RoofFraming 73. Undergrnd.StorageTankOGas ❑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: �( Z��s �[.��'r C'.q=Q(.�, L,rLQ , 34. Final Heating & Air Conditioning ��7 35. Final Gas Pipe-Test . � � � 36. Hood or Canopy � � 37. Final Factory Fireplace 38. Final Plumbing ' ' 39. Water Service-Final . . - 40. Gas Service-F,inal � . � 41. Solar pomestic-Final � , 42. Backflow Preventer , � � 43. Backflow Irrigation . � - . 44. ,Landscape Irrigation System � ' 45. Sound Attenuation � . , � ' -. � �, 46. Handicap Regulations � . � - � 47. FINALSTRUCTURE&BUILDING ' 48> Special Requirements Completed ' . � 49. Electric Release to Edison � - .-- 50. Gas Release to Southern California Gas Co .' . . � . 51. CERTIFICATE OF OCCUPANCY _ ' No Date . ApD��eant to fill in all spaces except those wii�in heavY bortler lines ana sign ali approDriate tleciarations. I CiTv oF COS7A MnESA CONSTRUCTION PERMIT . ""'"" """ � ...""" '." -- "'." "" � Project F.ddress_-� a �-3 � oqTE L s % � � � . . . �ApplicanYs Mailing Address ' 8�-3 'YcRTEZ- ST .. TYPE OF CONSTRUCTION � � ,NEW /�DD ALTERATION REPAI R — ( � F �Jfle.�e-c PhoneS-%Y�/%f37 �- �CONVERSION ❑�DEMOLISH ❑OT _ —s .A.P.# � Owner's Name. K� . D CRIPTION OF ORKN En F BLDG. ^ � Address F"t � ' E`t cT ,Cnlj� /i%EY/��CA� �� (- ��p % ' ,5� - E' MainBuilding: �ArchlEng. '' - License No: ' TVPE OF'PERMIT ..�� GRADWG FOUNDATION • STRUCTURAL .T • Front Q� Address � � '� ' ' ' ❑ TENANT. ❑ ELEGTRICAL ❑ PLUMBING ❑ MECHANICAL � B � Rear Contractor'S Nam �- �� ' ' ❑ �OTHER ' � ' � ' ' A " "• ��'� Phone - C Right � ' ' PROJECT DESCRIPTION' SQ. FT.• - oCCUcA�rv �v7�� K. Addreu�mailing) � CONSTRUCTIONTYPE � VALUATION$��__ -$ Left � City LiCense NO.' " � ' , - ' ZONE GRADING CU. VDS.' ACRES � LICENSED CONTRACTOR DECLARATION . � � _ � Plny. R¢f. #' �� ,I, hereby atfi�m that 1 am licensetl untle� Orovisions of Cha�ter 9(commencing' Rema�ks: -� � �� "� ' CJy.,�p�' Planning Notes: HI witn section 7000)'of oivislon 3 ot the Business antl Protessions Cotle, antl� - _ . , . �my license is in full force antl effect. � � i� • � '� � ' � �G 66 --- S � � t � �. License Class license No. —, � � � � •Date ' Signature � � - � � � ' PLUMBING • � .- ' ' f FEES ' WORKERS^COMPENSATION DECLARATION � ' Bd� Sink � . � ShOwC�s � ;�� I M1ereby affirm [hat I have a certiticate o/ mnsent to self-insure o� a Certificate � 3372 I0/31�/B5. � ,, ' ' � _ . � Zone - ' � Accessory Building: � ' � ��, ' - . . ' . . � �' ' Parking Feq./Provic SPECIAI. REOUIRF.MF.N'�S ' - , . , of workers Compensation Insurance, or a cerfiLetl copy thereoi (Secbon Backflow�Preventer - - •ServiceSink- - --' - - --- 380o,��ab. C.) . , . �! ' Automatic Washer. ' Policy No. � Company ,' Backflowlrrigation , '�SewerCap�t �- yw� i ' j � ConstructionPole6ub. eCertitietl�copy is hereby furnishetl. . ' ; - . � - � - - . Certifietl copy is tiletl with.the city Builtling�Divisioo. 8athtub5 Sewer ConnectiOn.�� Cooking Unit oate Applicant � " '� ' . � . - .��.0 _ � , . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifief5 ' �Solar C011ecto�s' - Dishwasher ' �Thissection neetl not be completetl if [he permii is for one huntlretl ($100) or � less). r . � Dishwasher �'Solar'Piping i• . � Dryers ❑Gas ❑Electric I certify that in the performance of the�work'tor which this pe�m�t is issuetl I• w . snall not employ any person in anytmanner so as to become�subject to tFe. Drinking Fountains � ;%SolarTank� / y�.'=��; 4' �' � Fan � � workers' Compensation Laws oi'ealifornia. _ � " ' Date Signature � Floor Drains � ' � � Swimming Pool w/Spa � � F.A.U. ' 'NOTICE: I(, after makin9 tnis tleclaration, you shoWtl become subject to the . Workers' Compensation_provisions o( Ihe Labor Cotle,youu must forthwith , FIoo�Sinks ' _ .U�inal - --- Fixtures ' - � compty with such p�ovision5 or thi5 permit shall be tleemetl revoketl.• ' � � � CONSTRUCTION iL'ENDING AGENCV ' �� - � �' � �. Gas'SeNiCe . Outlets . � ' Water Closet • � ' n � DeviCe Boxes � � I hereGy zffirm that there is a construction lentling agency tor tbe pertormance ' ' �� ✓ oi the work for .which ,this pe�mit is issued (Sectian 3097 Civ. CJ Interceptors �� Water Heater � • ' Outlets � Lentler's Name -- ' !'� ��" Lenaer's Atltlress � Kitchen Sink�� - ' � - Wa[er Service' - ' ' Switches-,�� ,� � � OWNER BUILDEH bECLARATION� ' ' - , � �� I heleby affirm that I am exempt trom the Contlactor'S Lioense Law for the - LdvdtO�ies ' AutO-WdSh `' ' G3�bBgE Di following.reason'(Section 7031.5.Business antl Profe55ional Cotle: Any city or ' , , �' - county wM1iCh �epuires a permit to const�uct, alter, improve, tlemolish o� �epair P-hep ' - . �dund� T�d 5 ' • ^ any svucture, prior to ics issuance, aiso requires tne appiicant tor.such permit � Y _ Generaior to file a si9netl statement that he/she is licensetl pursuanf to [he provisions of ROOf Drains' ' � ' ' - -� � the Contractor's License Law (Chap[er 9:(commencin9 �+ith Section7000) of - - _ , OiviSion 3 ot the Business antl Profess�ons Cotle) o� that he/she is exempt -- � th¢�ebom antl tM1e basis.Por [he allegetl exemption. Any.violation ot Section . , ` , ]031.5 by iany applicant for �.arpermit subjects tM1e apPlicant to' a' civil ' . � pen of not more than five huntl�etl tlollars ($500). , . ' ' ' � I, as owner of iM1e property�or my�employees with waqes as their Sole RBinSpeC[iOn FBe $15 �compensation, will tlo the work, antl the structure is not intentletl or oftere0 lor sale (Section ]044, Business antl Professional Cotle: The Contractor'S' � .- � Li<ense Law tloes not apply [o an owner ot a properry who builtls or improves thereon, antl who tloes such work himselt/herself or through his or her own ' employees, �,P�ovitletl that such imp�ovements a�e,not intentletl o� of(eretl tor � BOiI¢f ' f �, � sale. If, however, the builtling or improvement is soltl within one year of,com- , � pletlon, the owner will have the bu�tlen of proving he/she tlitl not buiitl or im- Duct � Under Ground . �rove tor tlte purpose of sale). ' I, as owner of the property„am exclusively contracting witn licensetl mn= Duct - Structural ' ' - tractors to construct the project (Sectlon 7044, Business antl Professions Cotlei The Contracror's License Law does not apply to an owner of property who Duct - Ventilating . builtls o� improves thereon, antl who coM�acts tor Such project5 with a con- � � � tractor(s1 license pursuant�ro the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ proof of tneir Worker'S Compensation insurance shoultl be provitletl to me. _ ❑.I am exempt untler Section B. & P. C. fo� this reason FirepVFact BIt. ICBO # Date � ' Owner Heating System & Ducting . I hereby certify�that I have reatl this application antl state mat the above' ❑0.100,OOOBTU �100,OOOBT Intormation is mrrect. I agree to comoly with all city antl county ordinances ' antl state laws relating to builtling construction, antl nereby authorize repre- . sentatives of this city to enter upon [he above-mentionetl Oroperty to j inspection purpo5 e . � Si9nature ��L� �� Date/O'3/-�) Drivers' Li / � Reinspee[ion Fee CMF OB65-46, rev. 30/84 White - Builtling; Canary - qpp��cant; Pink - Accounting; Goltlenrotl - Assessor \ $15 + � � � $ 3� Issue Fee . . �Hood or Type I ❑ - �CanoPY TYPeII ❑ �� Refrigeration System . � , ❑0-100,0008TU ❑100,000•BT System Repair/Alteration . Fire Dampers ' Registers 1 � laua Fee m ft I7pO T� 2 O N 1 N G i `` �e � ., l T � , ' . ' � S' r:. ELECTRICAL , 'FEE; ' Transformer j� 15-50:KW ' � , ❑ 50+:KW � � • ; Meter �up to 100�amps � Meter ❑over 100 amps � . Sub Panel f `� i�;� ' MotorsDO-1�HP0L'h�-8 . . Inc.Solar 09-15 HP'�16-15+ Microwave � -'• . - Pole Light ' ' ' Range � � ' Sign ; Standing Sections 5-15,KW TrashCompactor � -'DEVELOPMENT SERVICES Zoning Approved By ``Building'Approved B�� .��. � n....o.....:�...i....ew.o:. ��f � , $ 3 i . $15 � Issue Fee � $ 3 IEQUIREMEN75: p 'u ' ��'� �� w u oate� � `�•� � Date�..� . ' � � na.e f � ' .•. '_; . SUMMARV OF �� ..'y : j. { � '��BUILDING�P.EFMIT� $ �� 'd �� ' PLAN CHECK �� $ �sSG r� PLUMBING � $ � •^' PL4N CHECK� 25% $' ELECTRICAL $ PLrdN CHECK' 50°h $ � ,�� MECHANICAL $ PLAN CHECK 25% $, � � SMIP $� .�V PERMIT. � � � ISSUANCE i $ . ENERGV P.C. $ � GRADING � $` MICROFILM� $ �TOTALFEE� $� (7'rx� a _ . _ a .- _ . . CONSTRUCTION AND PLANNING POOL & SPA - ' �qppROVALS Permit# � Date Inspector AppROVALS Permit# � Date Inspector , t. iTemporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. . 53. Steel Reinfarcement - 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 � ,�r �jj1� .� 58. Electrical Conduit-Undrgrnd.' 8. Founda[ion . �� S 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. ��IG . . b_ � 60. Backwash Lines, P-Trap. O Undrgrnd. 10. StructurakFloor..System -� 61. APPROVAL TO DECK � � � `i��l.� 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 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 ❑ Oil 23. �Gas Pipe-Rough & Test � � • 72. Underground Flush �- - � - 2.,Roof Framing ' • , � 73. Undergrnd. Storage Tank O Gas ❑ Oil :� Roof Sheathing � �� 74. Overhead Hydro � 26. T-Bar Ceiling (Structura�) & Monocoat 75. Dry Chemical 2. Frame and Flashing �' 6"' 76. DFy Standpipe 28. Lathing &�ridlfig g 77. FIXED SYSTEM FINAL � 29. Insulation . � ' 78. FIRE PREV. FINAL ' � � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat' ' � ' G 79. FINAL INSPECTION � 32.�Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric � ' � Notes: � b� 34. Final'Heating & Air Conditioning HOLD FOfl SPECIAi. QUfA��a , E 35. Final Gas Pipe-Test + � �3� � y� n/aT� ' y��r-� � 36. Hood or Canopy L3 �' Qn_ _ ./lA_ t�c�e� Vcf(1 37. Final Faciory Fireplace.' �, � �� Z� �� L.-� ,�� " : '� z %�b. 38. Final Plumbing' ' ' ' E ,� �rt -,G' i� � 2 �� 39. Water Servlce-Final ' �tL` �'p N � �� 40. Gas Service-Final � ` � � 41. �Solar�Domestic-Final , 42. Backflow Preventer � - . . 43. Backflow Irrigation �: � � , .� . b . , . 44. .Landscape Irrigation System: , . � 45. Sound Attenuation � -- 46. Handicap Regulations ' •� ; - . 47. FINAL STRIICTURE & BUILDING- 48. Special Requirements Completed `�y,� � L�� ,'.� � 49. Electric Release�to Edison � , . � ' 50. Gas Release to Southern California Gas Co � � �� 51. CERTIFICATE OF OCCUPANCY No. Date � � � � AOP�icant to fill in all spaces except those wilhin heavy �ortler lines anE si9n all appropriate tleclarations. CITY:�qCOSTA MESA CONSTRUCTION PERMIT PERMCIT NO TRACT NO. LOT NO., UNIT NU. � � � . �/ 3 C O�-rr-z- S x" � 33 7'7 _ �jeci Address , Applicant'sMailingAddress g�3 C�Q'r$'� ST TYPEOFCONSTRUCTION NEW .qD� ALTERATION REPAIR Owner'S Name fB O AJL� L �� Phone S�y9'99�� CONVERSION ❑ DEMOLISH ❑ OTHER q,p. # ZOne -� �� `'' � DESCRIPTION OF WORK/USE OF BLOG. Address �� e 7 �_� � S Main Building: Accessory Building: Arch/En . License No. TYPE OF PERMIT GRADirvG FOUnlDA7iorv E . . Z 9 ❑ $TRUCTURAL T F�Ont � � Addre55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear ' N ❑ OTHER Contracmr'sNam Phone ' C Right - - � � � N Address (mailingl PROJECT DESCRIPTION 54. FT. OCCUPANCv . CONSTRUCTIONTVPE ' VAWATION$ S Left R City�LiC2nseNo ZpryE GRADINGCU.VDS.� ACRES LICENSED CONTRACTOR DECLA0.ATION Ping. R¢F. # Parking Req./Provided E Q I h¢reby affirm that 1 am licensetl untle� provision5 of Charter 9(commencing Remarks: Q �� . Planning Notes: ry� WIIh SCCII00 %�0�) O} pIVI510O 3 oi the Business dlltl Protessions Cotle, antl T my license is in tull force antl effect. ' - . , , . License Class LicenSe No. . . � , S Date Signature PLUMBING : � FEES � ' ' WORKERS' COMPENSATION DECLARATION BafSink ShOwerS � ELECTRICAL ' - FEES I hereby affirm that I have a ce�tificate ot mnsent to selt-insure o� a certificate oi Workers' Compensation Insurance, or a certlfietl copy thereot (5ection gackflow Preventer Service Sink ' 3800, �ab. c.) � Automatic Washer Transformer ❑ 75-50 KW Policy No, � Company BackflOw Irrigation Sewer Cap Coristruction PoleSub. ' � 50+ KW BCertifietl copy is hereby furnishetl. Certifietl ropy is flletl with the city Builtlin9 Division. Bathtuhs Sewer Connection Cooking Unit Meter ❑up to 100 amps , Dale APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cld�ifi¢�5 SOId� COII¢Cto�s Di5hwd5h¢I M¢t¢� ❑OVCf 100 drtlp5 (ThiS zEction neetl not be completetl if the permit i5 Tor one huntlretl ($100) or � less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the perfo�mance of the work for which this perm�t is is5uetl, I � shall not employ any person in dny manner so as to become subject to the Drinking Fountains Solar Tank Fan � � Workers' Compensatipn Laws of Californ' Moto�s DO-1 HP �1:% - 8 Date � S�3(—dY Signature � �� -' Floor Drains ' Swimming Pool w/Spa F.A.U. NOTICE: If, afte� makinq this tlecla�ation, you Shoultl become subj¢ct to the _ Inc SOIa� 09-15 HP 016-15+ Warkero' Compensation p�ovisions of the Labor Cotle, you muSt forthwi[h FIOO�SinkS U�inal Fixtu�¢5 MiCrowav2 � compry v+ith such provisions or this permit shall be tleemetl revoketl. ' CONSTRUCTION LENDING HCaENCV Gd5S2Nic¢ OuU¢ti WBL¢fC1052t D¢viG¢BOx25 � I hereby affirm that there is a construction lentling agency for tM1e performance Pole Light of the work for which this permit is issuetl (Section 309] Civ. C.) , Interceptors Wat¢� Heat¢� OutIBtS Rang¢ Lentler's Name Lentler's Atltlress - Kitchen Sink Water Service � Switches � Sign - "- ' Q OWNER BUILDER �ECLARATION I hereby affirm that I am exemoi irom the Cantracror's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections . following reason ($ection ]031.5 BuSinesS antl Professional Code: Any ciry or county which requires a permit to wnstruct, alter, improve, tlemolish or repair P—Trap � Laundry Trays Generator DO-5 KW �5-75 KW Trash Compactor any Structure, prio�.[o it5 is5uance, also �equire5 [he applican[ tor Such pe�mit to file a signetl slatement that ne/she is licensetl pursuant to the provisions oi ' Roof.Orains ' • ' M the Contractor's License Law (Chapter 9(commencing with Section �000) ot O 3— W Division 3 ot the Business antl Prote55ions Cotle) or that he/she is exempt , , ' the�efrom antl the basi5 for the allegetl exemption. Any violation of Section � - �]031.5 by any applicant fo� a permit subjects the applicant to a civil penalty of not more Ihan five huntlretl tlollars (E500). � , I as owner o� me properly or em ' ' Reinspection Fee $15 laue Fee $ 3 ' �o �ne work, antl ructure is noi intentled orofteretl Reinspectian Fee $15 Issue Fee �'� $� dfor sal��ion 7'044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES � License Law doe5 not apply to an owner ot a properry who builtls or imp�oves thereon, antl who tloes such work himself/herself or through his or her own . •DEVELOPMENT SERVICES REQUIREMENTS: .. . . employees, provitletl that suth improvements are not intentletl or ottered tor BOiler HOOd Or Type I ❑ sdle. I(, however, the buiitling or improvemenf is soltl within one year of com- . Cdnopy Type I I ❑ Zoning Approved By Date pletion, the owne� will have the burtlen of p�oving he/she tlid no[ builtl o� im- DUct - Und2f G/Ound , ' Building App�oved By Ddt� p�om for the purpo5e of sale). ❑ 1, as owne� of the property, aT ezclusively cont�acting with licensetl com Duct -$t�uctuf3l R¢f�ige�ation System Appliwtion Issuad HY - Def t�a<torsto construct N¢ project (Section ]044, Business antl Protessions Cotle: The Contrac[or'S Li<ense Law does not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES . - builtls or imp�oves Ihereon, antl who contracts for such project5 w�th a con- _ • tractor(sl ucense pursuant m tne Contractor's �icense Law). I am aware thaf Exhaust System ❑ MWtiple ❑ System Repair/Alteretion BUILDING PERMIT $ SMIP 5 proo( of their Worker's Compensa[ion insurance shoultl be provitletl to me. _ PLAN CHECK $ PERMIT ❑ I am exempt untler Section e. & P. C. for this reason Firepl/Fact. Blt. ICBO # Fire Dampers PLUMBING $ ISSUANCE $ . Date � "' Owner �.G�my%o ��v Heating System & Ducting Registers PLAN CHECK 25� $ ENERG�' P.C. $- I nereby certify that I have reatl this application and state that the above ❑0�100,OOOBTU �100,OOOBT , ' 0 � GRADING $ information is mrrect. I agree to comply witn all'city antl munty ortlinances ELECTRICAL $ antl state laws relating to builtlin9 construction, antl hereby autnorize repre- PLAN CHECK 50� $ s MICROFILM $ sentatives of tnis cily to ente upon the above-mentionetl.property tor inspection purp s. ��a,�� MECHANICAL $ TOTAL FEE � a8 •so Signature Date Reinspaction Fee $75 Issue Fee $ 3 PLAN CHECK 25q $ _�� __ __ , __ , , __ __ �Dtive�s' License o� 55 �' CMF 0865-46, rev. 10/84 Wnite - Builtling; Canary - Applicant; Pink - Accountinq; Goltlenrod - Assessor CONSTRUCTION AND�PLANNING '% !'� �� POOL & SPA APPROVALS Permif� _ �Date . Inspector Date Inspector � # , ��i .�;, APPROVALS Permit# i 1: ;Temporary Electrical�Service or Pole 52. Pool & Equipment Location �� .- � 2' Soil Pipe-Undrgrnd. t' . 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ^ 4. Electrical Conduit-Undrgrnd. �t � • 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. Wate�'Pipe-Undrgrntl<� , � � 60. Backwash Lines, P-Trap, O 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 76. Rough Electric Wiring 67. Fencing & Access Approval � / �7i 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush .. 24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑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 �� s 31. Plaster Brown Coat 79. FINAL INSPECTION �� •�� 32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED � Y i v' i 33. Final Electric � es: 34. Final Heating & Air Conditioning �i1 35. Final Gas Pipe-Test 36' Hood or Canopy ,� 37. Final.Factory Fireplace � � . 38. Final Plumbing . . •t 39�a Water Service-Final , �. -, ' � � r 40. Gas Service-Final ' � �. � � � ` �. . 41. Solar pomestic-Final • i r-42. Backflow Preventer � ' • � � i,43. Backflow Irrigation ' .� � J' �, '-� ry ' �'44. Landscape Irrigation System j ��" � �.45. Sound Attenuation , f/-� • � ti '46. Handicap Regulations �� : �7. FINALSTRUCTURE & BUILDING � `' � . � � h ,r • 48; Special Requirements Completed '� d, i: 49. Electric'Release to Edison �� , �� 50. Gas Release to Southem Califorrua Gas Co � ^` , e 51. CERTIFICATE OF OCCUPANCY„ - i ,a,;. � No. Date .. � �2299 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA M�A. CAL�RORNIA For Applicani fo Fill In Complefely TYPE OR PRINT COSTA MESA. CALIFORNIA . ADDRESS�Sll1C0 1� 3HOO E• CO88C �,ry Corona del Mar NE OR ENGEI EER �Ymond Levan&s NE ADDRESS 3432 Vi8 oito� Newpo CONTRACTOR �CCO CorpoFation FEE REC�1��.D � �FINANCE DEQT. APPLICATION FOIF�P�R�ir��s�A M ESA Lot 4k 64 BUILDIIdG Plan R 2B For Office Use Only RECE�PT NO. � PERMR NO. 8tW8� RECENED !V i I OA jE RECEIVED I �TE 186UE[ ll i _ / b �� .J � 34220 ApORE65 813 Cortez Street 37010 COSTA MESA. CALIFORNIA Beach �:.`:� T.,o� i� �o,.,�e �! IL I OF LOT 65 x 93 � � xow ox ora�0 uN6PNOM 40 qEAR YARD 31 p giREBT RD I LEFT S I RIGHT 5 DESCRIPTION OF WORK OF VR AL LL{.�l�V RVVf WOOY i ?RING $ RK COVERING OF BUILDING AND WORK TO BE �'ERRORMED with attached garage 1 HEREBY ACKNOWLEDGB THAT I XAVE READ TMIB MFLIWTION AND BT�TH THAT THE ABOVE IS CORfl6� ANU AOREB TO COM- PLY- WITN ALL CITY ORDINAN B ANO��TTT ATE LAWB REOy GTINO BUILDINO CONBTRIICTION. // . �. � // 81GNATURE OF / �/ / / SAUTHORIZEDAGENT � Project Manager ZONING 20NE ��/ I NO.OF I USE OF NEW PL}�ANB BUILDING LEGAL /LuL�� YARD6 EVES APPROVED ALLO (CENTBp LINE BT.) f1 FRONT ' - V FT. R. SIDE � FT. L. SIDE � FT. REAR FT. APPROVED BY [ �/7i/, �' `6 � — � `�Y �TO/ .I � TH2 AMOUNT BHOWN UNDER VALUATION IB FOP THE PURP08E OF EBTABLIBHING A PEqMIT FEE ONLY. VALUATION 3'L�OO PERMIT FEE $ s 13 , 515 . 00 P�pN CHEGK $ 16 � OO