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Home My WebLink About1121 DANA DR - Building PermitsApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. _ TRACT NO: LOT NO. UNIT NO. Project Address 1121 DANA DRIVE Applicant's Mailing Address bUl N. POPLAR ORANGE Owner's Name I U MI Phone Address SAME' AS. ABOVE Arch/Eng. License No. Address Contractor's Nam ENVIRONM � hone Address (mailing) a t City License_ No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am'IlcenSed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fu$forlCe aryp e&t. License No. 318149 'rens, f-L'ns II33�� ilii LL ate 1 J Signature ' �yyyy��I t OR KERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate , of Workers' Compensation Insurance, or a certified copy thereof (Section Polis Lab. 83225853 , company FREMONT Policy No. Certified copy is hereby furnished. _ Certl��yn �y py is filed with the city it i Division: Date 'r IC AppliCant EXEMPTION FROM WORKERS' COM NSAT I ON ECLA RATION (This section need -not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work tor.which this permit is issued, I shall not employ any person in any manner so as to become Subject to the Workers' Compensation Laws of California. DataSignature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labar Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address — OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any City or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for Such permit ,to file a signed statement that he/she is licensed pursuant to the provisions of 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 7031.5 by any applicant for a permit subjects the applicant to a civil eenalty of not more than five hundred dollars ($500).' - , Lj I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for Sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, .however, the building Or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- tEve for the purpose of sale). IJ I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and stale laws reldtln to building construction, and hereby authorize repre- SentatNes o1 this i to enter upon the above-mentioned or pe y (or Inspection pur Signature Date TYPE OF CONSTRUCTION YS' NEW LI ADD LJ ALTERATION LJ REPAIR Bar Sink I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. 4s DESCRIPTION OF WORK/USE OF BLDG. Backflow Irrigation Sewer Cap Bathtubs S Main Building: Solar Collectors E Solar Piping TYPE OF PERMIT GRADING FOUNDATION 11 STRUCTURAL - T Front ❑ TENANT El ELECTRICAL El PLUMBING MECHANICAL_ B Urinal ❑ OTHER A Rear Water Heater C Right PROJECT DESCRIPTION SQ. FT. 'OCCUPANCY KLeft P—Trap CONSTRUCTION TYPE VALUATION S ZONE GRADING CU. YDS. ACRES Ping. Ref.+ Remarks: Planning Notes: PLUMBING Bar Sink I Showers Backflow Preventer 1 Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers -- Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains Swimming Pool w/Spa Floor Sinks Urinal Gas Service Outlets Water Closet. Interceptors Water Heater Kitchen Sink ;: Water Service Lavatories -' $ P—Trap Roof Drains - Reinspection Fee - ` $15 Boiler Duct - Under Ground Issue Fee Hood or Type 1 ❑ ; Canopy Type If ❑ $ 3 FEES Duct - StructuralRe igeration System Duct - Ventilating o-100,000 BTU D100,000BTU 4 XD Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ O 100,000 BTU ❑ 100,000 BTL Drivers' Liter SS _ I I Reinspection Fee CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Issue Fee $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Pao F.A.U. Fixtures Device Boxes Outlets 4952 7/25/B4 4 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KN ❑ 50+ KW Meter ❑up to 100 amps' Meter Dover 100 amps Sub Panel Motors ❑ 0.1 HP 011/-8 Inc. Solar 09-15 HP 016 Microwave _ Pole Light Range Garbage Disposal I I Standing Sections Generator 00-5 KW 05.15 KW I Trash Compactor Reinspection Fee $15 I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By 15+ 7.00 7L FEES $ 3 Z O N 1 N G R E Q M T S. SMIP $ SUMMARY OF FE BUILDING PERMIT ISSUANCE $ PLAN CHECK $ $ PLUMBING MICROFILM $ PLAN CHECK 25% $ ELECTRICAL S PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ 15+ 7.00 7L FEES $ 3 Z O N 1 N G R E Q M T S. SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ %tCJC) CONSTRUCTION AND PLANNh, APPROVALS Permit # Date Inspector AOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 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. Water Pipe-Undrgrnd., 60. Backwash Lines, P-Trap, ❑ 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 APPROVALS Permit # 20. Rough Factory Fireplace 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. Storage Tank,❑ Gas ❑ 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 7 G� 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 Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ,® , COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING �% ADDRESS g— roper ies Yves eve oilmen OWNER C '!i!V 10-77FCAIBCMSAOO 54# i.',r'k 2 103.36 APPLICATION FOR STRUCTURAL PERMIT MAILBUIL NG ADDRESS508 29th Street 51,, '•r� ADDRESS CITY Newport Baach. Car Nro4.75-4910 TRACT 986 LOT BRANCH roper les es eve o OWNER Co ADDRESS Res . Atd . Garr. VALUE100 5;5,100 ARCHITECT yy�� TELA OR ENGINEER rank SDanaler 6 —0 ADDRESS 2240 Newport Blvd. FIRE ZONE YPE GROUP CONTRACTOR Owner APPROVEDjfit�L BY DATE ADDRESS TEL CITY NO. —L NO.OF PLANS USE OF BUILDING t YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING STATE CITY LIC. NO. LIC. NO. w S1ZE NO. OFBLDG- (FROM C/ EET) Or OF LOT NOW ON LOTFRONT FT. Q �N. USE OF EXISTING BLDG. y HSeparate permits are required for electric, plumbing and heating work. L. SIDE FT, FT. REAR FT. FT. lO AMAIN USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET.BET. SLOGS. MAIN & ACCESS. SLAGS a Construct single family 3 bed— VA CURP.�— DATE APPROVED roo house, Pla #2 APP 0 w p 1% 1 hereby acknowledge that I ha read this a Iicatlon and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shell not employ N C m HOLD FOR S�?EC {� St'i �,e1n, AL R=QU Z any person in violation of the workman's compensation laws of the State of California. ,F.n Y C V V •70 _ „TTW 3 I hereby certify that I em properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I .m SO.� FT 2,057 m_ THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Code, ivision 3, Chapter 9. Signa Perms tes of _ p,�� .� Permittee ,�f .sLl�13.86 e d J, m 0 � VALUATION s55,100 PERMIT FEE S PLAN CHECK 3 99.50 TAX $ Authorized Agent u TOTAL PAID S EC —9-77�,Pd {Sxt9O0 489 v ,*** 19 9-00 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BV DATE RECEIVED D4ITN BUILDING / ADDRESS P OWNER A.P. NO. MAIL BUILDING / ADDRESS ADDRESS TEL. TRACT LOT CITY NO. CONSTRUCTION W A A PLENDER BRANCHOWNEADDRESS LUARCHITECTTEL.ORENGINE RFIRE ADDRESS ZONE TYP GR APPROVED CONTRACTOR �02r r BY DATE ADDRESS TE TEL. ZONE NO .OF USE OF NEW CITU PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIG. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM CILSTREET) OF LOT NOW ON LOTFRONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT. FT Separate permits are required for L SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& MAIN BLOCS. ACCESS. BLDGS. VAR. 46 DATE • C.U.P.46 APPROVED APPROVED AV QATP I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Cad D' islpn 3, Chapter 9. VALUATION PERMIT FEE E Ile PLAN CHECK E Signature of�/� TAX E Permittee �H��'/ Ls E _ TOTAL PAID E Authorized Agent --