HomeMy WebLinkAbout1567 DOUGLAS DR - Building Permits • 3126 5/16/65 41 .25 TL
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
II R/IT-fyO�?D TRACT NO. LOT NO. UNI14/5. -
=CITY OF COSTA MESA (�ON�/STRUCjT�N PERMIT Ol/ --�-- �'""'aIRY
.arolec Address �-s 7 •
J o f6 rGs r 1
Applicant's Mailin ddress / J/ "///!� TYPE OF CONSTRUCTION I� NEW LI ADD U ALTERATION U REPAI R
G�,,� ❑ CONVERSION_❑ DEMOLISH ❑ OTHER A.P.# • _ Zone
Owner's Name/ ���
----
?hope�/��/�L/1>-� DESCRIPTION OF WORK/USE OF BLDG.
Address'/67/ 4& /4 57:, z, iv S Main Building: _ Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front - _ • p
i ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
V 1 Address •
❑ OTHER _ -. _
/ 731,_-• 90
Contractor's Nam•-----;/ '� - 'hone PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right N
•
W c�T 40.47,09- - CONSTRUCTION TYPE - VALUATIONS S R
Address(mailing) T/ -0:1,2,91,�i�--n Left
City License No. �� ZONE GRADING CV.YDS. ACRES E
I Ping. Ref.# Parking Req./Provided
LICENSED CONTRACTOR DECLARATION
1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: / �'J !/a Planning Notes: - Q
e_ with section 7000) of Division 3 of the Business and Professions Code,and ,s 7 M
11�- my license is in full force e tett. /!�// ,/ T
License It—0 • Li nse C. /x-
Date inn• Signature - � - �^ PLUMBING FEES /
WORKERS'C•MPENSATIONder provisio •
Sink Showers - • ELECTRICAL FEES
'hereby affirm that I have-a certificate of consent to self-Insure or a certificate
,f Workers' Compensation Insurance,-or a certified copy'there (Section Backflow Preven[er Service Sink- - -
3800, Lab. C��/�����y . '� - Automatic Washer Transformer 0 15-50 KW •
Policy No. 1 company � ��G Backflow Irrigation Sewer 0 50+KW
Cap Construction Pole Sub.
Certified copy Is hereby turn ishetl. - '
der��, •
�'Jr�r/,{co I led with the city r`g 0jvi n. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps
Date.rf/li,5 Applicant. /�/a•�( - ��y�
-
EXEMDDTIO((JJ FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors Dishwasher - Meter yover 100 amps -7 50
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher -
Solar Piping Dryers ❑Gas ❑Electric Sub Panel •
I certify that in the performance of the work for which this permit is issued, I -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank 'f's Fan Motors 00.1 HP ❑1'/x-8
Workers' Compensation Laws of California.
Date Signature Floor DrainsSwimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑16-15+
NOTICE: If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwithFloor Sinks Urinal . Fixtures r---
comply with such provisions or this permit shall be-deemed revoked. ^_ Microwave - 1 (0C
CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet' -
9 Device Boxes Pole Light ' ^
I hereby affirm that there is a construction lending agency for the performance i00
of the work for which this permit is issued- (Section 9097 Civ. C.) Interceptors: - Water Heater - - - �2 Outlets Range
Lender's Name - —a - - -T c
Lender's Address - - • Kitchen Sink Water Service • - . / Switches Sign 2<.)
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License-Law for the Lavatories
following reason (Section 7031.5 Business and Professional Code: Any city or - - Garbage Disposal Standing Sections
county which requires a permit-to construct,•alter,improve,demolish or repair P-Trap -
-
any structure, prior to Its issuance, also requires the applicant for such permit - Generator 00.5 KW 05-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of ,Roof Drains - -/_/�jG / e s
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of _ , a / ///!G ��.le5 2- '
Division 3 of the Business and Professions Code) or that he/she is exempt •
',herefrom 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 — -
penalty of not more than five hundred dollars($500). -
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL ' FEES - - -
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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for - Boiler • Hood or Type I 0 •
sale. If, however, the building or Improvement is sold'within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletiDrove for the purpose of sale).
LJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
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 Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ - SMTP $
•
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ _ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ •
Date Owner • Heating System& Ducting • PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL ELECTRICAL $ ZQ�•5� GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building nstruction, and hereby authorize repre-
sentatives of this city to enter on he above-mentioned property for r'
inspection pun /
Signature ;� • Da[e �o5
MECHANICAL $ TOTAL FEE $ • 41 • Z'S-
Drivers'
f�
Drivers' License or 55# )
Accounting;Goldenrod -Assessor • O/
,+
C6NSTRUCTION AND PLANNING POOL _-SPA
APPROVALS Permit fir` Date Inspector 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? 4 54. Forms
4. Electrical,Conduit-,Undrgrnd. 55. Electrical Bonding
s.csteel Reinforcement 56. Rough Plumbing & Pressure Test
6.;�E�ectrical OF ER drnCli,* 57. APPROVAL TO COVER-GUNITE
3f11(fr� CC
7. Footings 58. Electrical Conduit-Undrgrnd.
8.,Foundation 59. Gas Pipe, U Undrgrnd.,Test
9. Water-Pipe-Undrgrnd.1 , 60. Backwash Lines, P-Trap, 0 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 1441- 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 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 !// ` �/J1" ' 80. FOOD CERTIFICATE ISSUED
•
33. Final Electric [(! � /� Notes: Sta// Pario. e.e
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
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 _ -
1"4117.L_ 'G,2� �" Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - 21 70 5/02/B5 - 18.00 IL
•
CITY OF COSTA MEA CONSTRUCTION PERMIT - PERMT NO. TRACT-NO. LOT NO. UNI6.,, '
1>'� 7 rjoy/C.ts �JiPvrR t tc�� �uJ •
Project Address r1' G // _ - - `
Applicant's Mailing(Address '1 NL DATA,tVIIA- DIxPw#6-• a I/-Vb TYPE OF CONSTRUCTION Li U ADD U ALTERATION H REPAIR - '
Owner's Name I"/+I,zvio /`l`/`Nost Aftsa phone g74'r Jf'bJr El CONVERSION ❑ DEMOLISH ❑ OTHER "
A.P.qPZone,
251b N sN9�I E� R GDA �4tESY1 DESCRIPTION OF WORK/USE OF BLDG.` -
Address G( - 'r S Main Building: • Accessory Building:
f
Arch/Eng. License No. TYPE OF PERMIT • Eli GRADING ❑ FOUNDATION .❑ STRUCTURAL T Front • - - - - • 0
Address - ' /,� _ /`` • ❑ TENANT ❑-ELECTRICAL ❑ PLUMBING ❑ MECHANICAL' • B Rear , N
Contractor's Name 40(106 'WEST PLBG lac Phone+T••17-1,9t .0 OTHER - - - A • 4•
- I
llhh�' PROJECT DESCRIPTION SQ. FT. • • -OCCUPANCY' g
k. ,AddresslmailingI 12a7 .N Dd7AVIQ 6QANGI: G q2(p I . _ " _- K_ Right
p / -.� CONSTRUCTION TVPE VALUATION $ ' $ Left l
City License No. OII'9OV ZONE GRADING CU.YDS. •ACRESR
( .LICENSED CONTRACTOR DECLARATION ClIv Ping. Ref.# Parking Req,/Provided' - E
1 I hereby,affirm that-I am licensed under provisions o{charter 9 (commencing Remarks: �+ I J t_4 Z Planning Notes: • - 0 -
with section.7000) of Division 3 of the Business and Professions Code, and l 1 J
�- my license is in full force ane�fect. I - • T.
1 License Class c License 0.31702 - - - S
--• 'bate Signature ' / PLUMBING. _ - - •FEES - .
—• 'WORKERS'COMPENSATION DEC ATION/' , ':1 hereby affirm that.' have a certifica a of consent to self-in ure or a certificate Bar Sink Showers' ELECTRICAL - FEES
at_Workers' Compensation-Insurance, or.a certified. copy,thereof (Section - - - - - - _ - -
3800, Lab. C. Backflow Preventer Service Sink' Automatic Washer Transformer ❑ 15-50 KW
W0605903• e 1 21Av6P- INS. c o
PyoflCe No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. • ❑ 50+ KW •
Certified copy is hereby furnis etl. '
LLLJJJ Certified copy,I5 filetl with the city Bui nQ �i�'�I s�ion. `- n I- Bathtubs l Sewer Connection 'Cooking Unit 'Meter Cup to 100 amps •
Date S - Applicant Y.Cc-Y\L�P�iT r 1 to P/ '-
EXEMPTION FROM WORKERS'COMP6�lI ATION DECLARATION • YY Clarifiers _ Solar Collectors _ Dishwa5het _ 'Meter ❑overt100 amps. ._
(This section`need'not be completed if the permit is for one hundred ($100)or •
less). • Dishwasher Solar Piping I Dryers ❑Gas DElectric 'Sub Panel ' '
I certify that'in the.Derf ormance of the work for which this permit is issued, 7 - •
shall not employ any person in any manner so•as to become subject to the., Drinking Fountains Solar Tank Fan - ,Motors Do-1 HP ❑1'-,8
Workers' Compensation'Laws of California. �_ •
. Date' - Signature . / Floor Drains • , • Swimming Pool w/Spa 420 F.A.U.
'NOTICE:If,after making this declaration, you should become subject to the Inc.Solar'LA-15 HP 016-15+
•
Workers'. Compensation provisions of the.Labor.Code, you-must forthwith '-. Floor Sinks Urinal' - . .. - - 'e -
comply with such provisions or this permit shall 'be deemed revoked. • Fixtures Microwave. t
CONSTRUCTION LENDING AGENCY " ' - - Gas Service' Outlets - -Water Closet - Device Boxes • '
I hereby affirmithat there is alconstruction lending agency for,the'performance 'Pole Light - .
of the work for which this permit is issued--(Section 3097 Civ. C.) - - - - _- - `. _
Interceptors.- ( "Water Heater - --P--09 Outlets - - Range
Lender's Name - - - - - r -
Lender's Address ' Kitchen Sink .. / Water Service '
- [ a- OJ Switches Sign
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories . • 3 Auto-Wash ' - . : 6 OD Garbage Disposal 'Standing Sections •' '
following,reason ( ices a permit.5 Business and Professional Code: Any city or • - - - - '
county which requires a to construct,alter,improve,demolish or repair - TP- - - Laundry Trays: - - Generator ❑0-5 KW ❑5-15 KW Trash Com actor i
any structure, prior to its issuance, also requires the applicant for such permit - p
to fit¢a sa La at,h ashe is•licensed,pursuant to the provisions of Roof Drains -
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of• ' - '
Division. 3_of the b Business'and_Professions Cotle) or that he/She is exempt • • . . _ '
therefrom and the basis for the alleged exemption. Any violation of Section . . _ - I 1 '
7031.5 by any applicant for a permit subjects the applicant 4o.a. civil -'• - - '' ! a
Li I,, of not more than five hundred dollars-t$500).- -
LJ I, as owner of the;property or my employees with wages as their sole -Reinspection.Fee I $15 •
Issue Fee $ 3
•
-compensation, will do the work,and the.Strutt ure is not intended or offered - Reinspection Fee $15 Issue Fee •
( $ 3 ,
who
for sale (Section 7044, Business and Professional Code: uhe Contractor's I • ., -, MECHANICAL FEES l
License Law does not apply to an owner of a property who builds or improves - - ,
thereon, and who does such work himself/herself.or lintendh his or:her own ' I - - DEVELOPMENT SERVICES REQUIREMENTS:- • '
employees,however,
ed that such improvements are not.intended or offered for ! Boiler Hood or? Type 0
sale. If, hever, the building or improvement is sold within one year of com- - • - Canopy Type I I 0 , Zoning Approved By Date •
pletion,the owner,will have the burden of-proving he/she did not build or im- . Duct"- Under Ground • - Building Approved By I Date l
drove for the purpose of sale). - f+n e d ` /�
LJ I, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System Application Issued By • Y��ul, Date J(
tractors td construct the project (Section 7044,Business and Professions Code: .
The Contractor's License Law does.not apply to an•owner of property who . Duct-.Ventilating 1 - 00-100,000 BTU ❑100,000 BTU „ SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with.a con- - • - - • .
tractor(sj license pursuant to the.Co ntractor's License Law). am aware that • Exhaust System ❑ Multiple ❑, System Repair/Alteration - • BUILDING PERMIT $ SMIP , $
proof of their Worker's Compensation insurance should be provided to me.
PLAN CHECK $ • PERMIT " l
0 I am exempt under Section •
B.B. P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING: $ I S•� ISSUANCE $ '
Date Owner - . . ' Heating System& Ducting Registers
PLAN CHECK 25% $ ' •De ENERGY P.C. • $ •
I hereby certify-that I have read- this application and state that the above t • - 00-100,000 BTU 0100,000BTL —- .. - - ELECTRICAL GRADING $ •
•
information is correct. I agree to comply with all city and county ordinances ' ' $
and-state-laws relating to building-construction, and hereby authorize repre- MICROFILM $
sentatives o this city to enter upo9 the above-mentioned property for PLAN CHECK 50% $
/ inspection p'L•oses. - p,.� - •
MECHANICAL t $ Cr) ��
Signature a(
• Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •
\0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor
CONSTRUCTION AND PLANNING POOL SPA
Date Inspector
APPROVALS Permit# * APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole / 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ,021/0" Wen 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms •
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Styel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE
7..Footings 58. •Electrical Conduit-Undrgrnd. -
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
• 9. Water Pipe-Undrgrnd. Shyio' Geo .60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System - 61. APPROVAL TO DECK n
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 . q/silar Ggo 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring J 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 0 Gas 0 Oil •
• 23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 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
35. Final Gas Pipe-Test fl/7ld�S c-go
36. Hood or Canopy •
37. Final Factory Fireplace •
38. Final Plumbing i1f151/43- cxf)
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 Cn '
51. CERTIFICATE OF OCCUPANCY. •
r,
No. Date '
Applicant 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. IT NO. - 3794 5/30/85 - ' -.5050 . TL
Project Address 1567 Do • .s-. (L- dr • #2 I//J`` ,
• Applicant's Mailing Address OS a Mesa a. • • . - .TYPE OF CONSTRUCTION •• [XI NEW ❑ ADD 'LJ ALTERATION 'U REPAIR 1 ,j
Company •714�863-1JOO ❑CONVERSION ❑ DEMOLISH .❑ OTHER . A p # Zone -
Owner's Name Fairview Management Phone DESCRIPTION OF WORK/USE OF BLDG. • .
S Address 1176 Main St. , Irvine, Ca. 92714 '3a - • - 5 Main Building: Accessory Building: _ I
• Arch/Eng. •-r ' A' - & A S•C. _L' se Np. C008008 TYPE OF PERMIT ❑'GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front • 0
s e • i'
`ate• 0Vv 111 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL -g' - - - N
I kAddress •- Rear . .
Contractor's Name.DMH Buildet$ 3nC. Phone 714/979-5057 ❑ 'OTHER ' A I
A PROJECT DESCRIPTION SQ. FT. 238 OCCUPANCY C Right N
Co -Address(trailing/ 2512 N.Shelley Circle,Costa Mesa,Ca. K G
34704 92626. CONSTRUCTION TYPE VALUATION $ 2,380 S Left R
City License NO: ZONE GRADING CU.YDS. ACRES -
(�� LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided - E
t(\ hereby affirm that am licensed under provisions of Charter 9 (commencing .Remarks: .p �/�S"'�� •
Planning Notes: • . - -' • M
V with section 7000) of Division 3 of the Busi ess and Professions Code, and ere it r
Amy license is in full force and effect. - i I r F T
1. `License Class 1 icense No.• 4653R5 . ' - - ' - r
$
Date ) =)5 Signature PLUMBING FEESA • ' , � I I I
WORKERS'COMPENSATION DELLA l NBar Sink Showers •
' ELECTRICAL • '
I hereby affirm that I have a certificate of consent to self-insure-or a certificate • FEES
of Workers' Compensation Insurance,_or a certified _copy thereof (Section_ •Backflow Preventer •
- .- - Servide Sink - - ' , - - -
3600, Lab.'C.) - Automatic Washer Transformer-❑ 15-50 KW
' Policy`No.WS 85-332'344-01company • Fremont I Backflow Irrigation Sewer.Cap • .• ❑ 50+ KW '
• Construction Pale Sub.
Certified copy is filed with thehed1 `,'• 1 • • -
•Certified copy is filed with city Bu,tLc�lng Dtvl5 pn. -/•• I Bathtubs . ' ' • Sewer Connection 2 00 Cooking Unit Meter ❑up to 100 amps
Date ' Applicant Dmn BulJQerS', Inc. - -
• EXEMPTION FROM WORKERS'COMPENSATION-DECLARATION Clarifiers I Solar Collectors 1 Dishwasher • Meter Dover 100 amps I
' -(This section needsnot'ibe completed if the'permit is for one hundred1($100)-or - -- - - - - - "-" - --- ' -
less). l Dishvvasher I I Solar Piping ' Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I' - • I
shall not employ any person in anyl manner so as to become subject to the , Drinking Fountains ` i • Solar Tank, , - Fan •
Motors❑0.1 HP ❑i A-8
Workers' Compensation Laws of California. 1 - - -
Date Signature Floor.Drains Swimmin Pool w/S a
I , , 9 P _ F.A.U. , Inc.Solar 09-15 HP 016-15+
• 'NOTICE: I{after making this declaration;you should become subject to the - u
Workers•-Cth ation provisions of the Labor Code, you must forthwith - loor Sinks-- -t ' 1 Urinal - - - - - Fixtures'"- _ " ' - -, Microwave"� - ' - _
, comply with such provisions .or this permit shall be deemed, revoked.: , ;
CONSTRUCTION LENDING AGENCY Gas Service Outlets- - Water Closet• - Device Boxes •
' •
I hereby affirm that there is a construction (ending agency for the performance, Pole Light
of-the work for .w hicch thi ' permit .is issued (Section 3097' Civ. C.M - - - .- . . - - - -
' Lender's Name •Dani or. amer1Ca . -. . Interceptors -- r Water'Heater r - - ` Outlets - •- -- _ { Range' - - . `,
I •
Lender's Address Rol' N. Main :At ' .Santa Ana,rn' g97o2 - Kitchen.Sink- I Water Service , - , ' _ Switches Sign
OWNER-BUILDER DECLARATION - •
• : - - - --- '
I hereby,affirm that I am exempt from the--Contractor's-LicensefLaw for the , . Lavatories .4 Auto-Wash ' - f- Garbage Disposal i •
• following'reason'(Section 7031.5 Business and.Professional Code: Any city or • - - 9 P , Standing Sections - .
county which requires a-permit to construct,alter,improve,demolish or,repair ' P—Trap r, r I Laundry Trays , ' - • Generator ❑0-5 KW ❑5-15 KW •
any'structure,,prior to its issuance, also'requires the applicant for such permit - Trash Compactor
• to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - - '
' ' the Contractor's License Law(Chapter 9 (commencing with Section,7000)of ' - - I I
Division-3 of the Business and Professions Code) or that he/she is exempt , _ _ I - • '
therefrom and the basis for the alleged exemption:Any violation of Section - ' '
7031.5 by any applicant for fa permit subjects the applicant to a civil - ' - - '
eenalty of not more than five hundred dollars ($500). - • - -. I ' - - I '
LJ I, as owner of the property'or,my employees with wages as.their sole Reinspection'Fee• I I ' $15 Issue Fee $'3
' compensation, will do the-work,and the structure is not intended-or offered
•
for sale (Section 7044, Business and'Professional. Code: The Contractor's . . MECHANICAL -
Reinspection Fee $15 Issue Fee $13
License Law does not'apply to an owner of a property who builds or improves - FEES
• thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: • '
' employees,'provided that such improvements are not intended or offered for Boiler Hood or Type I 0 . . -
sale. If, however, the building or Improvement is sold within one year of.com- Canopy Type I ❑ Zoning Approved By Date
pletion,the owner will have the burden of proving he/she did not build or im- Duct-Under Ground I I - Building Approved By
, Date'
a7
prove for the purpose of sale).
0 I, as owner of the property, am exclusively contracting with licensed con= Duct-Structural , Refrigeration System I ' • Application Issued By v' • i Date1
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 Duct-.Ventilating _ ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a'con- - •
s. tractor(s) license pursuant Ito the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration - BUILDING PERMIT $ SMIP $. _
proof of their worker's Compensation insurance should be provided to me. - _ PLAN CHECK I $' ' PERMIT ' I
• 0 I am exempt under Section 'B.& P.C.for this reason —1 Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ 5.00 ISSUANCE $'
Date owner - Heating System& Ducting t RegistersPLAN CHECK 25% $ .50 • ENERGY P.C: $ '
l- I-hereby certify,that I have read this application and state that the above- ❑0-100,000 BTU ❑1100,000BTU - - - - GRADING $ �
information is correct. I agre to comply with all city and county ordinances I � ELECTRICAL $, I
and state laws rela g 0 •ilding construction, and hereby authorize repre- MICROFILM( $:
sentatives of this y J-nter upon the above-mentioned property for ' PLAN CHECK ' 50% $
inspection purpo Hifi p Q_$> I
- • ,rj,SQ
' � - `/ Y - - MECHANICAL • $ ' TOTAL FEE $;
Signature ' .or 55 -I •Date
Ori vers' License or SS = - Reinspection Fee • $15 Issue Fee $ 3 PLAN CHECK 25% $ '
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING . - POO i. SPA
APPROVALS Permit# Date Inspector APPROVALS Permit it 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. Electrical
55. Bonding -
-
5. Steel Reinforcement, . 56. Rough Plumbing & Pressure Test
6. 'ElectricalUFERGrnd. '57• . APPROVAL TO COVER-GUNITE
7.rFootings I 58. Electrical Conduit-Undrgrnd.
8'. Foundation. . _ 59. Gas'Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
' 40. Structural Floor System .t 61. APPROVAL TO DECK
11. Property Sewer Line'& House Connection 0,452-2 L EQ 62. Backwash & Receptor-Final
12. Sewer Cap . : ' 63. Heater & Vent-Final ' '
i
13. Roof Drains . • • 64. Plumbing System - Final
14. Rough Plumbing65. 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 FireplaceI ' APPROVALS Permit# _
21. Ducts, in Structure70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush •
24. Roof Framing 73. Undergrnd.Storage Tank 0Gas 0 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 - -
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 . •- -
' 5 v LJ$S 8
` • J Applicant to fill in all spaces except those within heavy border linea ane sign all appropriate declarations. 1 658 4/t�3/aj 4eu j• '�„
•' CITY OF COSTA MESA CONSTRUCTIONl. PERMIT PERMIT„� NO. 'TT�RRyA,p_CT NO. Rs,
NO. • UNIT NO. '
Plkt Address 055 - Laundry Bldg. #2 J P l c�5�kZ IBJ rs• /of /� '�-, fiz
+ ' Applicant's Mailing Address 7633 Woodsboro Ave. ,Anaheim,Ca. TYPE OF CONSTRUCTION {Xl NEW ADD U ALTERATION U REPAIR 1 �/ _
Fairview Management Company 714/863-1500' ❑ CONVERSION- ❑ DEMOLISH ❑ OTHER A.P.# /` o- D/2 -/G • Zone /1c�,
Owner's Name 4 Phone DESCRIPTION OF WORK/USE OF BLDG. -
Address 1176 Main St. , Irvine, Ca. 92714 �;1 S Main Building: Accessory Building: -'
Gilbert Aja & ASSOC. C008038 •
TYPE OF PERMIT HGRADING 161 FOUNDATION ll-�T� E z
Arch/Eng. Licence No. LH STRUCTURAL T Front - Q
23117 Pia . Pointe Dr. Ste. 100 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g
f1' Address _ha v ..-. - r _ • - A Rear • •/'ol/ .fp Yl Gi�1-y�f /j/� 1 I
V14/777-4666 C7'OTHER 7;
Contractor's Name IIMH Rol lderS, IncTnC Phone C Right ' / N
CO!, PROJECT DESCRIPTION SQ. Fr. 238 OCCUPANCY - 31 ro ac-424-10-2f C-40-47)—•-•fr C,
/I Address(mailing) 7633 Woodsboro Ave. ,Anahe lm,Ca. 92807 CONSTRUCTION TYPE • VALUATION$ 2.380 S Left / /«--ant hi€.174 . •. R
N it City License No. _34704 ZONE GRADING CU.YDS. ACRES Ping. Ref.# �c g.t1 Parking Req./Provided —- , E
LICENSED CONTRACTOR DECLARATION �T'"�Q��I•go !/ Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' : Planning Notes: M
N with section 7000) of Division 3 of the Business and Professions Code,and • HOLD FOR SPECIAL REQUIREMENTS
` my license is in fulforce and effect. • • /11.1! •`••` JL{:l.j"" - T
. License Class -.._—__13 p {License No. 46R3R5 SI,
</.� s,._ .e#/lq PLUMBING FEES •
Date ! 'L--$ rsignatu." / -
WORKERS'COMPENSATION DEC LA TION - •
'
I hereby affirm that I have a,certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL : FEES
I of Workers'Comp@Psago Insurance, or a certifie co y thereo (Section Backflow Preventer - Service Sink
3800,-Lab. C.)W NDS<-31 2bl0• . •
�OI'l . - - Automatic Washer - Transformer 0 15-50 KW- - - . - _
00011940-
Policy No. Company 1 • Backflow Irrigation Sewer Ca• p l ; `. Construction Pole Sub. - 0 50+ KW
Certified copy is hereby furnished. - -
j •
B;Certified copy is filed with the city Build i{}1tg Divii`ion.Q I,(11�,<� Bathtubs . •
Sewer Connection”; -,;� Cooking Unit Meter ❑up to 100 amps •
Date Applicant WVIA l ` 010.c Yil�+l `1
EXEMPTIONFROMWORKERS'COMPENSATION DECLARATION Clarifiers SolarCollectors r- Dishwasher Meter Dover 100 amps '
(This section need not be completed if the permit is for-one hundred ($100)or Dishwasher '
less). _ Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I - • '
shall not employ any person in any manner-so as to become subject to the Drinking Fountains Solar Tank - -r V - Fan Motors 00-1-HP 01%-B •
Workers' Compensation Laws of California.
. Date Signature Floor Drains ' Swimming Pool w/Spa F.A.U.
NOTICE: If,after making this declaration,you should become subject to the _ Inc.Solar ❑9-15 HP ❑16-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • _ Fixtures Microwave •:, - -
comply 'with such provisions or this permit shall be deemed revoked.- - - t
' CONSTRUCTION LENDING AGENCYGas Service 'Outlets Water Closet '•� Device Boxes•_ - --" - '
I hereby'affirm that there is a construction lending agency for the performance - - - - - v Pole Light
of the work for mM1 this-permit is sued (Section 3997 Civ. CJ - Interceptors _. Water Heater _
Lender's .Name: . 'ank. rer1Ca ---. - -. • - - - - - P Outlets Ran• ge
Lender's Address 801 N. Main St. ,Santa Ana.Ca.-92702. . Kitchen Sink 1 - Water Service . { Switches Sign
OWNER BUILDER DECLARATION '
, I hereby affirm that I am exempt from the Contractor's License Law-for the . Lavatories t •, .Auto-Wash - ' Garbage Disposal Standing Sections n. '
following reason (Section 7031.5 Business and Professional Code: Any city or -
county which requires a permit to construct,alter,improve,demolish or repair. P-Trap - Laundry Trays . , Generator ❑0-5 KW❑5-15 KW
any-structure, prior to its issuance, also requires the applicant for such permitTrash Compactor
.to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
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 theapplicant to a civil '
•,
venalty'of not more than five hundred dollars($500). - I $ 3 , - '
❑ I as owner of the property or my employees with wages as their sole Reinspection Fee- V $15 Issue Fee
ycom pensation, will do the work,.and the structure is not intended or offered - Reinspection Fee ! $15 Issue Fee - $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
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 / DEVELOPMENT SERVIC S REQUIREMENTS: -
employees, provided that such improvements are not intended'or offered for Boiler : • Hood or Type I 0 - y � /
sale, If,.however, the building or improvement is sold within one year of com- Canopy Type I I ❑ Zoning Approved By Yom•• Date -
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - t
prove for the purpose of sale). _ Building Approved By Date
0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System Application Issued By Date 21- _r
tractors In construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who' Duct-Ventilating 00100,000 BTU 0100,000 BTU SUMMARY OF FEES •1
builds.or improves thereon,and.who contracts for such projects with a con- . -.e7 tractor(s) license pursuant.to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration .t BUILDING PERMIT $ -� • SMTP $
proof of their Worker's Compensation insurance should be provided to me. 2.5.03 -
_ PLAN CHECK $ PERMIT -
❑•I am-exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ -
Date . - Owner Heating System& Ducting , Registers ,:.• PLAN CHECK 25% $ ENERGY.P.C. $ '
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000 BTL • • ELECTRICAL $ GRADING $ .-
information is corre I ag .- to comply with all city and county ordinances i . -`. •
and state laws relaf • •/�, ilding construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM) $
sentatives of this/ •j enter upon the above-mentioned property forte r
inspection Purp. / I �?`a� ! / 0
>•/ 's -- MECHANICAL $ TOTAL FEE $ l4
Signature as( Dat �-
Drivers' License or 55# . ��� ' Reinspection Fee $15 • Issue Fee $ 3 PLAN CHECK 25% $ •
SIMIS i
CMF 0865-46,rev.-10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
Fa.
• CONSTRUCTION AND PLANNING POOL , .rA
4 PPROVAILS Permit# Date. Inspector- APPROVALS Permit# Date Inspector
- 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
Il 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. I 57. APPROVAL TO COVE R-G UNITE
_7. Footings - • 56(I�S Ds _ 58. Electrical Conduit-Undrgrnd. •
I ',8. Foundation e.‘24‘ .
. s��y���J- . 59. Gas Pipe, 0 Undrgrnd.,Test
:9. Water Pipe-Undrgrnd. . a r 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System - I, 61. APPROVAL TO DECK .
. 11. Property Sewer Line & House Connection r - 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. -SolarSystem-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 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush `
24: Roof Framing , - . 73. Undergrnd:Storage Tank 0 Gas 0 Oil ,
25. Roof Sheathing licti • 74. Overhead Hydro ,
26..T-Bar Ceiling (Structural) & Monocoat l! 75. dry Chemical -, - _
27. Frame and Flashing ci� '9! 76. Dry Standpipe •
J
28. Lathing & Siding . J 5� 1 77. FIXED SYSTEM FINAL
29. Insulation ,,S ' D,,, 78. FIRE PREY. FINAL •
30. Drywall Nailing • HEALTH DEPT. REQUIREMENT
31: Plaster Brown Coat t / � 79. FINAL INSPECTION �-
32. .Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33, Final Electric , Notes:* rN �. ,tea. Nu' Cir ` C
34. Final Heating 8/Air. Conditioning t �'/!• t .bs ,/-c / �1
35. Final Gas Pipe-Test • - . '
36. Hood or-Canopy .
\ 37. Final Factory Fireplace " - - a
38. FinalPlumbing _ •
39. Water-Service-Final -
40. Gas Service-Final - .
41. Solar Domestic-Final • ' r� - -
: 4
42. Backflow Preventer I •
T. ,
•
43. Backflow Irrigation - -
44. .Lndscape Irrigation System,: - ' ' -
45. Sound Attenuati ' •
on .
46. Handicap Regulations ' EC • ' ' ' -
I
47. FINALSTRUCTURE& BUILDING - 3 f3 .l / -a .-A_ - +P - . ..
48. Special Requirements Completed ' .244i
49. Electric Release to Edison. • F- - _ --� -
' 50. Gas•Release to Southerri California Gas Co 1 , 1 '
51. CERTIFICATE OF-OCCUPANCY , ' I 1' •
No. - • - Date. -% . I
. . . J r- - - .