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Home My WebLink About160 19TH ST - Building Permits APPLICANT: DO NOT FILL IN SHADED AREAS: ` CITY OF COSTA MESA CONSTRUCTION PERMIT _ PE-,. T NO. /, UNIT MODEL A.R d .Zone 1--4 �av S Accessory Building Pmleet Address: 1)O E . 101 sl-. •• UnitE z Front Owners Name: n L.....00• O PURPOSE: ❑ NEW ❑ ADDITION 3 ALTERATION ❑ REPAIR - T O Address: 1 6O E E . 1 nk 'ST• • . r - A Left N •I C...414LAc19._.4, Z ( ❑ CONVERSION 0 DEMOLITION 0 OTHER C Right G Ar1dJEnglo•tt: . Rep.Na: L — / r S Rear Address: Unit DESCRIPTION OF WORK/USE OF BLDG. • - a -V-1/ " // Ping.Ref.N Parking Req./Provided E PermhtM': F`-oy Awl CZ-00 F1 ea 4.•a /�pt'S S AX L_�O wt p . - 0 Address: 1 C- W 4.r.--w1TA FF lit) _77� 1 Planning Notes: M Fvty>�2-TL9N CSF. • 0I?_b.37- J TYPE OF PERMIT: 0 GRADING 0 FIRE STRUCTURAL 0 SIGN - T • S. UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL 0 REINSPECTION with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lus force and effect. • p' - - ELECTRICAL FEES CITY UG:+-66(7 8 SPATE uc.:43 Z3 Cl- CLASS: G 3q • JOB DESCRIPTION: 0 SQ. FT. • OCCUPANCY GROUP F-' 3 Automatic Washer Motor 0,0-1 HP 0 1-10 HP Date: Sipnatum: \ yq/ 0° Christmas Tree Lot ❑ 10-50 HP ❑ 50-100 HP ' YORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure CONSTRUCTION TYPE V'N VALUATION E• 7-.00 0 'GRADING CU. YDS. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). �/ Construction Pole ' 0 over 100 P000Y NO.:1 051 G') 561_01 Q ENP.DATE: )Z.O I ..ca) 1 CATEGORY: N MINOR CONSTRUCTION 0 MAJOR CONSTRUCTION(Under 200,000 sq.ft.) COMPANY. s rH.T. •� Sub Pole . outlet . Certified copy is hereby furnished. LAYCedifled cop/.is.tiled with the_dry Building Division. 0 MAJOR/HIGH RISE(Over 2WAOD sq.ft.) , - Cooking Unit Pole Light • Dishwasher Outlet ' Applicant: ' Remarks: La - ••-.,• An !•■ • . Dryer 0 Gas 0 Electric Square Footage Fe: ' I I • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less).I certify that in the performance of the work for which this permit is issued, PLUMBING FEESStanding , I shall not employ any person in any manner so as to become subject to the Yorkers'Compensation laws of California. Backflow Prevention Re I e Date: Signature' Backflow Irri9ati n Prro- C1 R rain , -�,• NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation Prow ;8,. A • j�,.4. L� Service Sink sloe of the labor Code,you must forthwith comply with such pmAsva a this pemet dol be deemed revoked. ` tYi A-. mance of the LENDING AGENCY: 1 hereby affirm that there is a construction lending agency Mr the eerier- =atRtuD r A RE�; -.- Generator: Size Temporary Work With mance of the work for which this permit Is issued(Section 3091 Civ.C). 1„Tg ' LENDER: • Clarifier Meter 0 up t• ere amps Transformer . ADDRESS: Dishwasher Meter 0 . or 200 amps Size ' MINER WALDEN DECLARATION:- I hereby affirm that I am exempt from the Contractors'State Liunse law • Drinking Fountain . I - Microwave Trash Compactor for the following reason(Section 70315 Business and Professional Code: :Any city of county which requires a P permit to construct,alter,Improve,demolish,or repair ary structure,prior to its issuance,also requires the appli- Floor Drain - _ • cant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of the Contras- • ' tors State License Law(Chapter 9[commencing with Section 7000)of Division 3 of the Business and Professions Floor Sink ' - - Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 70315 - Relnapectlon Fee .530 Issue Fee r ' • by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). • Gas Service - Swimming Pool w/Spa ' I $15 ❑ I.as anter of the property or my employees with wages as their sole wmpensatiun,will do the work,and " Gas System a utlet DEVELOPMENT SERVICES REQUIREMENTS: the structure is not Intended or offered for sale(Section 7044,Business and Professional Code: The Con- tractors'State License law does not apply to an owner of a property who builds or improves thereon,and Interceptor who does such work hienselmerset or through his or her own employees,provided that such improvements Zoning Approved By '-Date . are not intended or offered for sale.If,however the building or improvement is sold within one year of Com- Kitchen Sink - _ -{{ petion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). Laundry Tray Building Approved By •"•i, Date I,as'owner of the property,am exclusively wntractio with licensed contractors to construct the project i (Section 7044,Business and Professions Code: The Commctons'State License IS does not apDN to an P Trap . Water Heater Application Issued By -i�— o owner of propertyto the builds or Improves thereon and l who awareelt for oof theirs withk s Comps sa) , ' , ® PP - o Date O PO.5�/ .1=1license pursuant the b provided m'State License Law).I am that proof of meet a'c Compensa- • tion insurance should be provided to me. I am exempt under Section: B.&P.a . SUM . OF FEES for this reason: x • MECHANICAL • BUILDING PERMIT $ J MECHANICAL ."E • Date: - Owner: Boiler, Heating System &Ducting - PLAN CHECK I $ PLAN CHECK 25%'$ I do hereby certify that I am aweie of and understand the requirements of Califomu Health and Safety Code Sec- Duct-Underground . 0 0100000 BTU + 0 100,000881 + PLUMBING . Sem tions 25505.25533,and 25534 and that I or any future building occupant eathKELOM(circle one)need to comply Duct-Structural ' - -- Hood or Type 1 i :- - E SMIP $ with said state codes and the requirements la a permit for construction or modification from the Ail Quality Manage- - - mem District. Residential construction applications are exempt from these provisions. Duct-Ventilating • Canop '•pe 11 ❑ PLAN CHECK 25% $ GRADING $ s. Exhaust System 0 Multiple ❑' ' -efrigeration System • IT :-ELECTRICAL $ Dale: Applicant: 6-0 .I hereby certify that I have read this application and state thatthe above information is correct.I agree to complyFan • 0 0108,000 tTTU + 0 100,000 BTU + /r . _ DP 0 PLAN y45 $ TOTAL FEE $ `Y with all city and county ordinances and state laws relating to building construction and hereby authorize represen- Fire Damper' '- • - System Repair/Alteration el t �I� CHECK, • atives of this dry to enter upon the above-mentioned property for inspection purposes. Fireplace/F: ' e :It. ICBG N Date: Signature: • �1�\� r Driver's License or Seal Security N: • Reins action Fee $30 Issue Fee ' Le 1 00C6-r`c'�L-Lcuc`d8r'S 'if-gid-"- y;:,;° • P '.. \ I QRIE: 'GE/C i�- TIP', . ';f4c" 0965-45 rev.10189 While-Building:Green-Code Enforcement; CanaryApplicant: Pink-Revenue; Goldenrod-Assessor \- - . 1 . 1 i • •j CONSTRUCTION AND PLANNING POOL 'A . APPROVALS Permit# date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole-_ . 52. Pool & Equipment Location 27-Soll Pipe:Undrgr.nd:- - 53. Steel Reinforcement 3: Electrical Conduii UtilitytUndrgrnd1/2 54. Forms 4. Electrical Conduit;l7ndrgrnd. 55. Electrical Bonding 5. Steel Reinforcement I 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ` t /? 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, 0 Undrgrnd. y 10. Structural Floor System !,1 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & ileceptor-Final - 12. Sewer Cap ,t -• 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing" 65. Electrical-Final 15. Rough Electrical'-Conduit 9 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 7 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Ga.! Pipe-Rough & Test , �- 72. Underground Flush 24. Roof Framing:-• - 73.- Undergrnd.Storage Tank 0 Gas •❑Oil 25. Roof Sheathing 1 q - 7'4. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat •r1 75. Dry Chemical 27. Frame and:Flashing _ 76. Dry Standpipe 28. Lathing &.Siding ;t, 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 35. Final Gas Pipe-Test 36. Hood or Canopy - �. ' 37. Final Factory Fireplace • 38. Final Plumbing ' 39. Water Service-Final - 40. Gas Service-Final / • ij' 41. Solar Domestic-Final ei.g_ ' 42. Backflow Preventer I / `' 43. Backflow Irrigation 1 - 44. Landscape Irrigation System Ti 5 45. Sound Attenuation - 46. Handicap Regulations t ' �� " - ` • tc 47. FINAL STRUCTURE & BUILDING 1/2#2._ /�'�/��,-�}/-- rr,,,----;. • 48. FINAL PLANNING Li -•v'S�l�', - • 49. Electric Release to Edison ba, • - 50. Gas Release to Southern California Gas Co �^'� d; 51.'CERTIFICATE OF OCCUPANCY 'v , No. Date - �� . CITY OF COSTA MESA CONSTRUCTION PERMIT r f7 TR Protect Add":�b E . I - 1 sT. UnU: OvmrY Nam: ns A tz O Aditn: 1% O M I CN F'kw 'ST. c,rn LA. X9_621 AmAngfeesr: Reg. Nn: Addnn: Unit: ParmitM.AL GI r� c. F Addrsaa: 1 F V ai8 ¢_TCOrJ Go.. �I Lb . Z LICENSED CONTRACTOR DECLARATION: I hereby affirm Nal l an ecersed under provisions of Chapter 9 (commenting with Sedan MOD) of Division 3 0l the Business and PMessions Code, and my license is in hub force and effect. CITY sec: q-6 6 6 8 SrArE uc:43 Z3 S"Z tugs: G -3°I - Date: Sionatum: WORKERS' rOMPENSATION DECLARATION: I hereby affirm that I have a cenfficate of consent to self -insure or a certificate at Workers' Compensation Insurance, or a certified cop/ thereof (Section 3800 Lab. C). POLICY NR: 10101 Cl 561— O ENP- DATE: 1'L • O I : 0) COMPANY: s rH•t-�- � � Cenlfied copy a ornery furnished. LAYCedilled copy. is - filed with -the -city Building Division. Applicant: ' EAEMPr10N FIMM WORKERS' COMPENLOMN DEUARA71ON: (This section need not be completed r the permit is for one hundred ($101) or less). I certify that in the pertinence of the work for which this permit is issued, I shelf not employ arty person in any mariner all as to become subject to the Workers' Compensstan Lays of California. Date: -Signature: NDTICE: II, after making thisOeclanNon, you should become subject to the Widens' Compensation prmy Sam be the Labor Code, you must lorduilh comply with such pmvksaks a Das permit stall be deemed revoked. CONSTRUCTION LENDING ARENCY: f hereby affirm that them is a construction lending agency for rho perfor- mance of the work for which this permit Is issued (Section 3097. Civ. C). LENDER: - - ADDRESS: . OWNER BUILDER DECLAMTION:- I hereby affirm that I am win pt Imre the Contractors' State License Law for the following reason (Section 70315 Business and Professional Us iAej city of county which inquires a prima to construct. after, Improve, demolish, or repair any drudum. prior to its issuance, also requires the appl4 cant for such permit to file a signed statement that he/she is licensed yursuant to the provisions d the Canner - tars' State License Law (Chapter 9 )commencing with Section 70DOI of Division 3 d the Business and Professions Code) or that he/she is exempt therctrom and the basis for the alleged exampbon. Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty, of not more than five hundred dollars ($501). ❑ I, as owner of the impery or my employees whin wages as their sole compensation, will do the work, and the structure is not Intended or offend for sage (Section 7074, Business and Professional Code: The Con- tractors' State License Law does not appy to an owner of a propend who builds or improves thereon, and who does such work Mmself/hemeff Or through his or her own emploRas. provided that such Improvements are nor intended or offered for Sale. 11, however the building or improvement is sold within one year of com- pefion, the comer will have the burden of plowing hejshe did rid bold or improve for the purpose of sate). I, as •comer of the DropeM, am exclusivelIyy contacla9 with licensed contractors to construct the project (Section 7144. Business and Protessioro Co Oe: The CUntacton5' State License Law does not appy to an hearse pursuant to the Contactors' State License Law). I am aware tion insurance should be Provided to me. ❑ 1 am exempt under Sedan: G. 8 P. C for this reason: Date: - Owner I do hereby canny that I am aware of and understand the requirements of California Heahh,and Safety Code Sec- tions 25505, 25533 and 25534 and that I or and future building occupant wilim 11 not (circle one) need to comply YAM said sate woes and the reffehemems for a permit for construction or modification tram the AD Quality Manage- ment District. Residential construction applications are exempt from these provisions. Date: Applicant: .I hereby certify that I have read this application and state that the above information is coned. I agree to comply with all dry and county ordinances and state laws relating to building canstmction and hereby authorme represen- ashyes of this dry to enter upon the above-mentioned propeny for inspection purposes. Date: Signature: APPLICANT: DO NOT FILL IN SHADED AREAS: UNIT I MODEL PURPOSE: ❑ NEW ❑ ADDITION Q4ALTERATION ❑ REPAIR - ❑ CONVERSION ❑ DEMOLITION ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. T1 OG F TYPE OF PERMIT: ❑ GRADING ❑ FIRE STRUCTURAL ❑ SIGN ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ REINSPECTION JOB DESCRIPTION:❑ SO.' FT. OCCUPANCY GROUP �' 3 CONSTRUCTION TYPE y_I_ VALUATION z- �D GRADING CU. YDS. CATEGORY: L7 MINOR CONSTRUCTION ❑ MAJOR CONSTRL COON (Under 200,000 sq.N.) ❑ MAJOR/HIGH RISE (Over 200.ODD sq. it Remarks:GRACiA Qc—.6LYL11T. ��S�OOG� Bacdow, Prevention Backflow Irriaation . Clarifier 'rIL—ti Dishwasher Drinking Fountain Floor Drain Floor Sink - Gas Service Gas System Kitchen Sink Laundry Tray P Trap Reinspection Fee Boiler Duct—Underground Duct—Structural Duct—Ventilating Exhaust System ❑ Multipli Fan Fire Damper Firoplaco/Fewllt. ICBG N PLUMBING Sink Sewer Solar Piping Solar Tank Swimming Pool w/Spa Toilet r ,Urinal Wash Basin 'Washing Machine Water Heater Water Service $30 Issue Fee FEES $3 FEES Heating System & Ducting Cl 0-100,010 STU + ❑ 190,000 STU + Hood or Type 1 - - Canop pe 11 ❑ }_ h F refrigeration System IT COT(JIC:e, ❑ at0D.000 BTU + ❑ IDaOW BTU + O fiber's License or Social Security s: Relnspectlon Fee I $301 I Issue Fee 0865-46 rev. tried) write - Building; e Enforcement; Canary - Applicant; Pink - Revenue; Gddenmd - Assessor $15 Rear W.T. N Parking ing Notes: Z O N I N G R E O M T S. Reinspection Fee I 530 I Issue Fee f $15 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By -:,.Date - Building Approved By �' Date Application Issued By I Data �_C7.5� ELECTRICAL L Automatic Washer Christmas Tree Lot Construction Pole Motor ❑ 0-1 HP ❑ 1-10 HP ❑ 10-50 HP ❑ 50.100 HP ❑ over, 100 - Sub Pole Outlet . Cooking Unit Pole Light Dishwasher Sign Outlet Dryer ❑ Gas ❑ Electric Square Footage Fe F.A.U. Blending on ;.1 Fireworks Stand S anal -• Fixture Swimming Pool/Spa _ Garbage Disposal Switch Generator: Size Temporary Work With Meter ❑ up t 0 amps Meter 0,alrer 200 amps Transformer Size Microwave Trash Compactor Z O N I N G R E O M T S. Reinspection Fee I 530 I Issue Fee f $15 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By -:,.Date - Building Approved By �' Date Application Issued By I Data �_C7.5� PLAN CHECKSig y45 $ SUM ` OF FEES pU MECHANICAL PLAN CHECK 2545'$ SMIP $ • Sm GRADING $ /1 6-0 TOTAL FEE $ 4 01 00097V2-L'.L14 853 QRiE:'GE/C::yc'; TY(i;. BUILDING PERMIT $// PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ _ -iinn5 -ELECTRICAL $ PLAN CHECKSig y45 $ SUM ` OF FEES pU MECHANICAL PLAN CHECK 2545'$ SMIP $ • Sm GRADING $ /1 6-0 TOTAL FEE $ 4 01 00097V2-L'.L14 853 QRiE:'GE/C::yc'; TY(i;. _ .., �:y... ... V'_+-4:7 •j CONSTRUCTION AND PLANNING APPROVALS Permit# date Inspector POOL 'A . APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale-_ . 52. Pool & Equipment Location 2`So1l Pipe:Undrgr.nd:, 53. Steel Reinforcement 3, Electrical Conduit Utility!Undrgrnd.-, 54. Forms 4. Electrical Conduit,Ondrgrnd. r ' 55. Electrical Bonding 5. Steel Reinforcement 1 56. Rough Plumbing & Pressure Test 6. ElectricalLIFER .Grnd. `t �? 57. APPROVAL TO COVER-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 9 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Ieceptor-Final 12. Sewer Cap ,t ' ' -• 63. Heater & Vent -Final 13. Roof Drains64. 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. POO USPA 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 0Gas 0Oil 23. Gas Pipe -Rough & Test �� 72. Underground Flush 24. Roof Framing- - 73; Undergrnd. Storage Tank 0Gas 0Oil , 25. Roof Sheathing r- - A. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and'Flashing _ 76. Dry Standpipe 28. Lathing &,Siding ,t, 77. FIXED SYSTEM FINAL 29. Insulation - r 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 35. Final Gas Pipe -Test 36. Hood or Canopy - •�.' 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final X, 41. Solar Domestic -Final 41. 42. Backflow Preventer 43. Backflow Irrigation 1 44. Landscape Irrigation Systemoi '4 n 45. Sound Attenuation 46. Handicap Regulations t ' 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING v tl-®�- y�vVV 49. Electric Release to Edison g, , 50. Gas Release to Southern California Gas Co d; 51.'CERTIFICATE OF OCCUPANCY No. Date 'v , ��