HomeMy WebLinkAbout2214 PACIFIC AVE - Building Permits_. . . .... . . . . . AOPl�eane �e flll In all seaeea eveeel thme
CITY OF COSTA MESA _ .
CONSTRUCTION PERMIT
vroie�t narwl.!- " - � �- � �'
Applican['s Mailing Addreu .�S3y �x''�'�� y� d� g�����'N
Owner'sName P�'�FIL W��S L�. ahone7/'FG'/5-'�f913
Addreu /.�� /�o.vCn �i� HvE .diF'r .tY� �,�� �i/
Arch/Eng��"=/F/G ��"�G �p��!'Ej'TS�icense No. ��'� �
Address .�-i�i' � ��i�i\ S,rik��s [�QS'R� Ml—SA
Contractor'sNam ��1UPoizT'Il4A.Paoc �1-0�5 vhone 13
Addreu (mailingl p � p L#\ VOR7��'-lf
City License Na. �� 5
IICENSED CONTRACTOR DECLARATION
I hereby affirm that I am Iicenzetl unUer Orovislons of Charter 9(commen<in9
with uctlon 7000) of Division 3 of the Business antl Profeisions Cotle, anC
my Ilcense Is in (ull orce antl etfeci. �� ���
Licensar lC.l�a'ss,L.c ' ense No
^ate.e��(�Gri� 579nahre
�RKERS' COMPENSATION DEC ATION
.ereby a/flrm tnat I have a certificate of consent to self-Insure or a tertifiwte
ot Workers' Compensation Insurance, or a cer[IfIeC capy t�ereof (Settion
3800, Lab: C.)
PoIICY No. � YR�N .lSi�3.i5�.2� ComPanYj��no,� r z'�ltl�inN i� s�
}n.� Cartifietlfcopy is hereby furnlzhetl.
�9 Ce� iy etl 2 p�j; is filed wlth tha Uty Iltl g i le� �
Datay-�G;- +� APPlicant
EXEMPTION FROM WORKERS' COMP ATION DECLARATION
(This section neetl not be complatetl if th rmlt is for one huntlretl (5300) or
less). + -� �
I certify that in tne performante ot the work tor which this perm�t is issuetl 1
shall not employ any person in any manner so as to be<ome subject to t�e
workers' Compensatlon Laws o! California.
Date Si9nature
NOTICE: If,iafter making thiStleclaratlon, you shoultl betome SUDject to the
Workers' Compensatlan provisions of tha Labor Cotle, you must forthwkh �
comply with such .provislons or thiz permit shall be tlaemetl revokee.
CONSTRUCTION LENDING AGENCV '
I hareby afflrm that thare Is a construction lentling agency for t�e performance
of the work for hich this vermit .is issuea (SectloR 309� Clv. C.)
txnder'S Name ��a^�«' �C2�T -sAi�/.YbS
Lenaer•s Atltlress. � n[: Ai7A�< .Q'/ !'LY.TTt //1 -'s'
OWNER BUILDER OECLARATION � `
1 hereby aftirm that I am exempt trom tha Contractor•s License Law for the
following reason (Settlon 7031.5 BuSinesS antl Profezslonal-Cotla: Any city or '
county whlch requirez a permit to construct, alter, improve, Cemolish.or repalr
any structure, prior to Its Issuanca, also requires the"applicant tor such parmit
� file a signetl ttatement�that he/she is Ilcensatl pursuantYo the provizlons of
a Contra<tor's Licanse Law (Chaplar 9(commencing with'Saction 7000) ot
�031,5 by any appucant tor a. perm¢ SUD�¢Ct5 me appncam m a crvu
� Gnelty of not more than flva huntlretl t1011ars (5500). ('
� I; as owner of the�property or my amployees wi[h wages as their sole •
tom0ensation will tlo tha work, antl the structure Is not intantletl or offeretl •
for sale (Sec4lon 7044, Business anC Profe55ional Cotle: The Contractor'S
License Law tloes not apply to an owner of a property wM10 bullCs or Improves
thereon, anC who tloes such work nimself/harselt or throu9h his or her own
employ eas, provltlatl that tuch Improvements are not Intentletl or otiaratl for �
sale. It, however, the builtling or Improvament is soltl wlthin one year ot com-
pletlon, tne ownar will have the burtlen ot proving he/sha tlitl not builtl or im-
��ove tor Ihe purpose of salej. '
I, as owner ot tha property, am excluslvely contracting wlth Ilcansetl con-
tractorstb construct (he project (Section 7044, Busines5 antl Aofesslons Cotle:.
Tha Contractor•s License Law does not apply to an owner of property who
builtls ar improves thareon, and w�o mntracts tor such Oro�e<ts wlch a con-
trdtt0/(s) IlcanSe puRuant to t�e Cont�actOr's License Law). �
❑ I'am ax¢mpt untler SeCHon , , B. & P. C. for this reason
Date
Signature �
Drivers' Lltense Q
CMF 0865-46 rev.
th15
GorEer Iines antl sign all apGropriate tleclarations.
TVPE Of CONSTRUCTION Ll NEW LJ ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A P �6
OESCRIPTION OF WORK
. S Main Build
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front �
❑.TENANT � ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Reef
��OTHER ��arn� r,Fc�isn�G �(3i)I[..�IrJ(JS� A
PROJECT DESCRIPTION 54. F7. oCCUaA Cv�{,�/� • C Right
CONSTRVCTIONTYPE VALUATIONS.�GILS� 5 Left
ZONE GRA�ING CV.YDS. ACRES ping. Ref. #
Remarks: Parking Req./Pr
Use of Building
PLUMBING FEES Planning Notes:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains
Floar Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Levatories
Roof Drains ' �
Reinspection'Fee' $25
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
�- �0.10D,OOOBTU �100,OOOBT
� - _ — ., I I Hainspeetion Fee
W hlte - Builtling; Canary • Appliwnt; Pink - Accounting; Goltlenrotl - Asussor
$25
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa '
Urinat
Water Closet �
Weter Heater
Water Service
laue Fee � .. $ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers OGas �Electri�
Fan '
F,A.U.
Fixtuies�- -
Device Boxes
Outlets �� ' .
. ➢,' .•
7527 3/29/84
IZone
Accessory Building:
ELECTRICAC
Transformer ❑ 15-50 KW
❑ 50+KW
Meter Dup to 100 amps
Meter pover 100 amps
Sub Panel
Motors �0.1 HP 0.1 h- 8�
' Inc. Solar 09-15 HP �16-15+
� Microwave '
Pole Light
Range
" Standing Sections
�5=15 KW Trash Compaccor
� Reinspection Fee $25 Issue Fee �
IANICAL FEES
. PUBLIC'SERVICES RE4UIREMENTS:
Hood or Type I ❑' Za�i�a qPP�o�ed By ' � �
Canopy Typell, ❑ , .
' ' Buildine APP�oved By�;
Refrigeretion Syrtem
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Issue Fea � $ 3
4h.37 rt1
Z
0
N
I
N
G
R
E
Q
U
R
E
E
N
T
$ 3
�'� �� ' � �." SU RV F FEES � + -
BUIL��ING PERMIT'� $ � �� SMIP $ ' � �a
.• PLAN.CHECK� .�,$ ___� PERMIT . � ' ,
� PLUMBING ,;.$ C�� ISSUANCE $
..� PLANCHECK 25%��$ ' ENERGVP.C. .$ '
ECECTRICAL �'�§ �O . IS '� GRADING �$
PLANCHECK 50%- $ MICROFILM $ '��
, MECHANICAL $ TOTAL FEE �$ _ �`�
� PLAN CHECK 25% $ � - .
� CONSTRUCTION AND PLANNING . ' . . POl , SP.A _ � � r � �, � - ,�
Date. Inspector � ° � ' � � Date �lospecior `
'APPROVALS Permit# ' APPROVALS -�Permit#�- � �
.' 2.
� 1. Temporary Electric8l Service or Pole � ar� LJ 52.�.Pool & Equipment Location . - -.a, --
2. il Pipe-Undrgmd. . : 53:, Steel Reinforcement . ' ,- �
� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms- - � ��" f
?4"Electrical Conduit-Undrgmd. 55. Electrical Bonding _ - - '
5.� Steel Reinforcement 56. Rough�Plumbing & Pressure Test '' • •'
6. Electrical UFER.Grnd. � 57. APPROVAL TO COVER-GUNITE .- ;��. '
„
7. Footings ,_ 58: Electr�cal Conduit-Undrgrnd., � ''
' . , . ','�' a
f3. Foundation � ' . 59. Gas Pipe, O Undrgrnd., Test � � .. .
19. Water Pipe-Undrgrnd. _ , �60. Backwash Lines;�P;Trap, O Undrgrnd. - . f
ib. Structural Floor System. �� � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � . � �
12. Sewer Cap j'l� � 63. Heater& VenbFinal . �.
13. Roof Drains ' • 64. Plumbing System - Final .
74. 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. Duc[s, in Structure 70. Underground Hydro '
22. Ducts, Ventilating • 71. Product Piping O Gas ❑ Oil � � i ��
��3. Gas Pipe-Rough & Test � ' 92. Underground Flush � � �
`24. Roof Freming � 73. Undergrnd. Storage Tank O.Gas ❑ Oil �
,�
25. Fioof Sheathing ' 74. Overhead Hydro �
' 26. T-Bar Ceiling �Structurel) & 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. Elecirical Power MeterFinal ' 80. FOOD CERTIFICATE ISSUED -
� 33. Final Electric �" Notes� �� 0 Q�QOU�60- (,EFT GO_ -
34. Final Heating & Air Conditioning N
. S��Ge. c�►a rar �sF�. ��o y 8
35. Final Gas Pipe-Test � . � � � ' ' � .
36. Hood or Canopy � � � � -
37. Final FactorY Fireplace � �
38: Final Plumbing ' r � � �
39. Water Service•Final � � , � �
/
40. Gas Service-Final � � , • , • .
41. Solar pomestioFinal ' � - , - � - -
42. Backflow Preventer _ _ , � � , i �
, '�
43. Backflow Irrigation . . " �
44. .Landscape Irripation System . � � � - i � , �
45. Sound Attenuation � - � :,i � � `
46. Handicap.Regulations � � � � , � � ' ! `
47. FINAL STRUCTURE & BUILDING - � • � ' ,�; � J r
i '
48. Special Requirements Completed ' � � , � ' � " ' ' ' � � -
i
49. Electric Release to Edison , � ' -� � � � � . ' ' '
, �
50. Gas Release to Southern California Gas Co , ' ' � � ' ��� ��
51. CERTIFICATEOFOCCUPANCY , , � ' � �� � � - - � , ' ,
No. � . .:Date ' - _� • .. .._ _ � . ' - � c . _. . .- . . '