HomeMy WebLinkAbout622 CENTER ST - Building PermitsUWNER SIQdAN �4YNE
JOB ADDF2ESS Center St.
GENERnL CONTRACTOR Owner-Builder
SUBCONTRACTOR
�Water
Rough Com.
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j' ►•� 23164
, �COSY,4,�MESA BUILDING-SAFETY ,DEPARTMENT
P.O. BOX 91] CO3TA MEBA, CALIFORNIA
For Applican► to Fill In Completely
TYPE OR PRINT
BUILDINO /
ADDRES$ (p S l
COSTA MESA. CALIFORNIA
I ARCHITECT `— TEL. ^
�
I STATE
USE OF '
E%ISTIN6 BLDO.
6CTlACK LIX6 FROM
FEE RECEIVED
OCi 2 9 1964
fINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDINCi
Fo� Office Use Only
BY
Lea�L
NOTfi: NO 6AVE OVfiRHANO 8 BE 1�E55�BWAN'
Tfil. . 80' TO BIDfi 8 R6AR P. L. W
No. �� 4G 4 i'��
� � EAVEB
no.oFaLDa/. ALLOWED (U.B.C.REQUIREMENT'
I NOW 011 LAT �
� YAR�SAPPROVHD YARD9APPROVED
!IT/AI MAINBUILDIN6.. ACCESSORYBUILOINa
DESCRIPTION OP WORK
VAR. iF
BIIILOIN6 NO.OP .
61ZE ROOMS bTORIfiB ' C. u. P.
EXTERIOR WALI.i B/�C CO�VERIN6, U' L
COVERING J L
SE OF BUILDING AND WLO-RKTO Bfi fiRF R �>/�
�
/J OvN .✓— 5 iv
1 HEREBY ACKNOWLEOOE TXAT 1 XAVB qEAD THI6 APPLIGTION
ANO BTM1TB TNAT THH ABOVB 19 COqq6CT ANO AOpEH TO COM.
PLY WITN ALL CITY OROINANCED AND YTAT[ 9 R[OYLATINO
BUILOINO CONBTRYCTI . �
SIGNATUREOP �
PERMITTE
AU HORIZHD A6HNT
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Fr. R=
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BHT. MAIN Q , Q '
ACCE85. BLDGH. C
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DATB O
APPR VED �'
� r a
DATE � � --i8 c
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'�e�� e�°,✓� "� � � �
THC AMOUNT HHOWN UNDlH VALU�TION Ie FOR TM8 F C
PUNPO88 OP 88TABLIBHINO ♦ PEflMIT FEE ONLY. �
VALUATION ��d m �
PERMIT FEE $ � 1�
i
SO m
s�SO(�� � � o
�J �_� � \ _
TOTAL FEE $pj �
Applicant to fill in all spaees exeeD< <hosa within neavY eortler lines ane siqn all aov�a�riate tleclarations.
CITY OF COSTA METSA� CON TRUCTION PERMIT
Project Address ��1 - ��1/�1-'�'-
ApplicanYs Mailing Address ��� � `'� ' � g�� �
Owner's Name _ ��� � lo��( Phone
r
Addreu —[yjs�c��
Arch/Eng. _ _ � License No.
Address � ����� ���
Contractor's Nam ` � Phone /.L�2��7_L--Y-C.�)
Addreu�mailing) Zb�� � �^ � � W� �l` '
City License No. ��� /3 S xS
LICENSED CONTRACTOR DECLARNTION
1 her¢by affirm �hel I am lic¢nsetl untla� Orovisions of Charter 9(comm¢ncing
with ze<[ion 7000) of Division 3 of the Business and Professions Cotle, antl
my Iicense.is in tull fo�e a eftect. � ���
License Class � �1 �
� Date g �o�6ti1 Siqnature �
WORKERS'COMPENSATION DEC ATIO '
I h¢reby affirm [hat I �ave a certi/ita[e of consenf to selt-insure or a<ertificate
of Workers' Compensation Insuranca, or a certifiea copy thereoi (Section
3800, Lab. C.) .
Policy No. Company
�Cer[ifietl Copy I5 M1ereby furnishetl. �
Certifietl copy is fileC with the city Builtling Division.
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tnis section neetl no[ be completetl if (he p¢rmit is for on huntlred ($100) or
less).
I certlfy 4hat in the performance of the work for�which this ssuetl, I
snall' not employ Any person in any manner so as to ect to the
Workers!!Cm7pe�n53tlq�LawS of Callromia. ,
Date d S 4t Si9nature -
NOTICE: 1(, after making Ihis tleclaratl ou shoultl becom subject to the
Workers' Compensation provisions o e Labor Code, you-must �orthwitn
comply with Such p�ovislons o� th15 pe�mit � zhall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV � '
I nereby af(irm that [nere Is a constructlon Ientlin9 agency tor tbe pertormance
of lhe work for which this permit is issuetl (Sectlon 309� Civ. C.)�
LenCer's Name
Lentler's AGdreSs ' _
OWNER BUIlDE0. DECLARATION--
I hereby aHirm that I am exempl irom the Contractor's License Law for the
following reason (Section 7031.5 Buziness antl Professlonal Cotle: Any city oi
county which requires a permit to constru<t, alter, improve, tlemolish or repair
any StruGture, prlor lo ils issuance, a150 requi/es,the appliCant for such permit
to fiie a sioneE slatement that he/she is licensetl pursuant to the provisions ot
tnerelrom antl the basis br the allegetl exempllon. Any vwiatmn o� necuon
7031.5 by any applicant tor a permit subjecls the -applicant to a civil
�enalty ot not more than tive huntlretl tlollars (5500).
I, as owner of Ih¢ P/o0erty or my emplOyees wi[h wage5 a5 [heir sole �
�.:Yompensation, will tlo the work, antl the z[ructure is not intentletl or offeretl
']tor wle (SeGlion 7044, Busine55 dntl Profe55iondl COtle: The Contractor'S
License.Law tloes not apply to an owner of a property who buiitls or improves
thereon, antl who does such work himsalf/harsolf or through M1is or� her own
employee5, prOvitletl that such improv<men[s are not intentletl o� offeretl tOr
sale. It, howeveq the bullding cr improvement is soltl wi[hin one y¢ar of com-
o�e��on, the owner will nave the burtlen of provin9 he/she tlitl not Euiltl or im-
��OVG �o� the purpose of Sale).
I, as owner ot the property, am e%clusivety tontracting with licensed wn-
tractors to construct the project ISectlon �044, Buziness antl Protessions Cotle: �
The Contractor's License l2w doez mt apply to an owner of Oroperty_who
Cuiltls or improves [hereon, antl wno conVacts tor such projects wl[h a con-
tra<tor(sl license Oursuanl�to [he Contractor'i License Law�. 1 am aware that
proof of their Worker's Compensatlon insurance shoul0 Oe provitle� to me:.'
❑ I am exempl un0er $eclion B. 3 P. C. to� this �eason
Date Owner
I hereby certlty that I have rea
IfIfOlTdL10O IS COIlCCL. � d[fYf�` l0
Signature ��/
Drivers' License��55 �
CMF OB65-46, rev. 4/84
above
inances
_p j SO �-I 1 � _
TVPE OF C�NSTRUCTION NE
❑ CONVERSION ❑ DEMOLISH
DESCRIPTION OF WORK/USE,Q�
J ADD L1 ALTERATION LJ REPAIR
OTHER
0
TVPE OF PERMIT L� GRADING LJ KOUN�HTION U STRVCTVRAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION 5�. FT. oCCVaANGv_
CONSTRUCTION TVPE VALUATION $
20NE Gf3A�ING CU. VDS. ACRES—
Remarki:
Sink
Preventer
Brinking Fountains �
Floor Drains
FloorSinks -
Gas Service Outlets
Interceptors
Kitchen Sink '
Lavatories
P-Trap
Roof Drains - ,
Reinspection Fee
$15
Duct - Under Ground .
Duct - Strucmral .
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0.7 00,000 BTU 0100,000 BT
Reinspection Fee � $75
Wh i[e - Builtling; Canary - APplicant; Pink - Accounting; Galtlenrotl - Assessor
Service Sink -
Sewer Cap
Sewer Connection
Solar Collecmrs �
Solar Piping, '
Solar Tank � � �
Swimming Po01 w/Spa''
Urinal -
Water Closet
Water Heater � �
Water Service '
Issue Fee
Hoodor Typel ❑
Canopy Typell ❑ -
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
laue Fea
A.P. aW
S Main Building:
E
T Front
A Rear
C Right
gLefc
Ping. Ref. #
Planning Notes:
7479 8/30/B4
Parking
Bu
5,�u' TL
zo��
� EI.ECTRICAL � . ' ,
- Automatic Washer " •Transformer ❑ 75-50 KW - -
Construc[ion Pole Sub. � 50 + KW
Cooking Unit �. ' Meter ❑up to 100 amps ,
Dishwasher Meter �over 100amps
' Dryers OGas ❑Elecvic Sub Panel '
� Fan� . ;-; 'MotorsOO-iHP�t`h�8 .
' F.A.U. " InaSolar �9�15 HP �16-75+
- - - Fixtures . Microwave
Device Boxes � Pole Light
� ' Outlets - Range
' Switches Sign '
' Garbage Dispoul � Standing Sections
' - Generamr �0.5 KW �5-15 KW Trash Compacror
�
$31
�— Reinspection Fee $15 luue Fee $ 3
FEES
DEVELOPMENTSERVICES REQUIREMENTS: •
Zoning Approved By Date
Building Approved By Date
Appliption laued By Data �'3� •
$ 3
Z
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G
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S.
. SUMMARV OF FEES � � �
BUILDING PERMIT $ SMIP $
PLAN CHECK $ ' PERMIT
PLUMBING $ �i� ISSUANCE , $
P�AN CHECK 25% $ ENEfiGV P.C. $
ELECTRICAL $ GRADING $ '
PLAN CHECK 50% $ MICROFILM $ � ��/'�
MECHANICAL $ TOTAL FEE � $ �_
PLAN CHECK Z5% $
CONSTRUCTION �AND PLANNING ' � POOL & SPA _
APPROVALS Permit# Date - Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole. 52. Pool & Eguipment Location � � .
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -
3. -Electrical Conduit Utility-Undrgrnd. 54. Forms �
4; Electrical Conduit-Uniirgrnd. . 55. Electrical Bonding
5. Steel Reinforcement �. • _ 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, � Undrgrnd., Test
9. Water Pipe-Undrgmd._ �, ' , , 60. Backwash Lines, P-Trap, O.Undrgrnd. �
10. Structural Floor System ' � 61. APPROVAL TO DECK �
11. Property Sewer Line &'House Cqnnection �, 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final ��
13. Roof Drains , �- 64. Plumbing System - Final
14. Rough Plumbing �� 65. Electrical-Final � �
75. Rough Electrical-Conduit � � 66. Solar System-Final
76. Rough Electric Wiring � , 67. Pencing & Access Approva!
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 OGas ❑Oil
23. Gas Pipe-Rough & Test � , 72. Underground Flush �
24. Roof Framing� .� 73. Undergrnd. Storage Tank O 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 1-leating & Air Conditioning
35. Finai Gas Pipe-Test '
36. Hood or Canopy ' . ' � ' � � . �_
37. Final Factory Fireplace ' -
38. Final Plumbing ' 10'/���i L
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