HomeMy WebLinkAbout766 16TH ST - Building Permits••••••�••flMl•�lu ILIII.L liV.rtnn� ••• •
JOB ADDRESS est t ree BUILDING PERMIT NO.
ru�cnu rnu�ro�rrno •. , nce�o�or�nu_t�unov i___is__ n�sa.. r,..,.....
A" No` q�4_•� �•1,_nSV••LOT Por ,71 �
ECTIONS
SOIL
GAS
W�TEN
ROUGN PLUM6ING
PROP. $WR. LINE n HOUSE CON.
SPRINKLING SYSTEM
MISCELL4NEOU5
ROUGN ME4TING ANO AIR CONOITIONING
TEMPOAAqY SEHVICE OP �OLE
UNDERGROUND � POWER �
ROUGM WIRING
TRENCHES FORMS STEEL REINF.
FLOOR SVSTEM
BON� BEnM � STEEI REINFOPCE ❑
SHERTHING
FqqME RNU FL�SHING
LRTHING - IN n OUT �J
PL�STER,BROWN COAT
'CTURPL. FINAL
1 .NG, VENT., REFRIG. AND A.C., FIN�L
PLIIMBING, FINAL RND G�5 TEST [,
ELECTRIC, FINAL
Bl11LDING. FIN4L
SPECIRL REOUIREMEHTS
SUBCONTRACTOR
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Aoo��cant to fill in all spaces eaeept tnose within neavY bortler lines antl sl9n a11 aoPropriate aeelarations.
' CITV OF COSTA MESA � � �� � PERMIT NO. TRACT NO. - LOT NO. . BL � �
� C6Y�ISTRUCTION PERMIT ' ` ; " ' (n � Q%A � � �
FrOjectA'ddfess 7�1�i l��- �FiY}1 SY. • � � - ' ' 'jVpEOfCONSTRUCTON. NEW �ADD 'ALTERATION 'REPAIR ' '
ApplicanYSMailingAdd�€36 �- CratP r(1� � � P.gP. _ nT'AII�T .� CONVERSION � DEMOLISH ❑ OTHER" . - q;p,#
OWnet'SNam¢ mm�lt}�nnr�Yn 'PhddP��-���n' , DESCRIPTIONOFWORK � - .
_ . S Main Building:
Address �1�.(�11L lhth �t Cneta Maca �('a - E '
-� TVPEOFPERMIT GRADING.'❑ FOUNDATIO[-N7 STRVCTURAL _ T Ffont �
AfCh/Eng. ' � LiCense No. ❑ TENANT ❑ ELECTRICAL ❑ PWMBING y� MECHANICAL - B � -
Address; � � ` � � �� ,oTHEq � ' ' - ' . ' A ReaC .
� C Right
Contractor's NameA3�r1 S� A1T � COrid �' � Phon� Z d- 1 fiQ S� � PHOJECT DESCRIPTIONi 5c3: F7.• �, OCCUaArvcv K
Addre55�mailing� �.17-i1 N S'�'d�P rolTege; QTSR�e � CONSTRUCTIONTVPE ' ; ; 'VALUATION$ �� �g LCft
Clty LicenSe NO�[.g.��Ay� n 7 Q Sh c ' � � ' ZONE ? GRADING CU. VDS. ACRES Ping. F12f. # '
LICENSED CONTRACTOR DECLARATION ' ' Remarks: " . - ' . ' � ' ! . ' Parking Re4./Provided �
I hereby:aftirm that I am licensetl untler provislons of Char �9 mmenci
with sec[ion 7000) ot Division 3 ot the Business antl fes5 s Cotle n
my liiense is in tull foice antl�etTect. . �
License Class Licen e N
Date� Si9nature
�0.KER5'COMPENSATION �EC R IONj �� � '
reby�attirm that I have a certiticate of consent to self-insure or a ceriificate
Workers' Compensatlon Insurance; or a certifietl'copy thereoT'(Sectfon'
' 3800, Ldb. Q � •
aoncv nklT A�/9(17300, comva�v TnS.� C'o. 1Vest.
Q Certified <opy is hereby (umishetl. �
,�J Certitie IS til¢tl with the city BuiltlinQ�Dpivi�siqTnp. '� �L 7 , �
6ate�— Applicant �fa.Vb+.t, ,
'�� - EXEMGTIO FROM WORKERS' COMPENSATION'DECLARATION ' '
(This section neetl not be completetl if the permit Is for one huntlretl ($100) or
less): � ; � � -
I certity that in the per,formance of the work tor;whlch this perm�t is issuetl I'
shall not employ any person In any manner so�as to become subject to�ttie '
Workers' Compensatlon Laws o( Califomia. � �
Date -�' Signature �
NOTICE: If,'zfter making this tleclaration, you shoultl become subject to the .
Workers' Compensation provisions of'the Labor Cotle, you must torthwitti
comply with' such.provlsions'�or� this.permit shall De!tleemetl revoketl.
CONSTRUCTION CENDING AGENCV, -
1 hereby affirm tnat there is a construction lentling agency for the pertormance
of [he,wark tor which this permit is'issuetl (Se<tion 3097 Civ. CJ �
Lentler's Name � � �
Lender's Atltlress - � ' '
OWNER BUILDER�DECLARATION ` ' � ' ' - -
I her¢by affirm that I am'ezempt irom the Contractor'S LICanS¢ L.aw tor the
following reason (Section 7031.5 Business antl Professional Cotle: Any city or
a
'`e Contractor'S LicenSe Law (Chapter 9(commencing wlth Sectlon �000) of
rision 3 of the BUsin¢55 antl Professions Coee) or tha[ he/she i5 exempt �
�refrom antl the basis for the allegetl ezemption: Any violatlon ot Section '
..,o31.5 Cy any applicant for a� permiY subjects tbe applicant to a civil
�enalty of not more than (ive huntlretl tlollars ($500). '
I, a5 owner ot the. pmperty or' my employee5 wtth wages a5 th¢ir sole i
compensatlon, will tlo tne work, antl the'structure is not intentletl or otferetl .
for sale (Section 7044, Bu5ine55 antl 7rotessional Cotle: Th¢ ConVactOr'S
License law tloes not apply to an�owner ot a property who�builtls or improves '
thereon, antl who tloes sucn work'himself/nerselt or through hls or her own �
employees, providetl that such improvements are notdntentletl or offeretlYor
sale. If, however, the bulltling or improvement Is soltl within one year of com- �
pletion, the owner. will'have the burtlen ot proving he/she tlIC not builtl or im- !
�rove foi the purpose of sale). '
1, d5 owner of [h¢ property, am exclusively contracting with licensed con-
tractors to cons[ruct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License taw does�no[ apply to an owner of property who�
Ouiltls or Improves t�ereon, antl who contracts for such projecls with a con-
tra<tor(z) license pursuant to the Contractor's Li<ense Law)l �
❑•1 am exempt untler Section , B. & P. C. for this reason
i
I Bar Sink
� Backflow Preventer
' Backflow Irrigation
Service
Kitchen Sink
Lavatories
loof Dreins ;
Reinspection Fee
� ' PLUMBING ' ' ' ' FEES
- $h'oWerS •
Service Sink � �
Sewer Cap
- Sewer Connection �
! � � Solar Collectors
.. . Snlar Pinina, •� , � ` '
� ; Solar Tank � �
� � � ' Swimming Pool w/Spa � . �
Urinal •
Outlets I Water Cloret� � �
.Water Heater ' -
� Water Service -
� , .
� _ � ' ,
Boiler ' -
Duct - Under Ground �
Duct � Structural
Duct-Ventilating '
Exhaust System � MWtiple ❑
Firepl/Fact.-81t. ICBO #
Heating System & Ducting
_]. WD700,OOOBTUO100,OOOBT
I,.'.,`.� _ _"'� .. � J I I ReinsPection Fee I ��5� I
9rivers' "c � e � ° I
h �CMF'0865=46rev.'7/83-' White-Builtling;Canary-Applicant;"PInk=Accountirig;GOltlenrotl=Assessor ' "� ' "
`\
� Istue Fee � '
iANICAL �
Hood or� Type 1 . ❑ ,
Canopy - Type I I ❑
Refrigeration System . �
�10..100,000 BTU ❑100,000 Bl
System Fiepair/Alteration ._
$ �3
FEES
�s
� Issue Fee ' ' $ 3
r._� _. � . . .�._. _�. ...
Use of Building: � �
Planning Notes: •
Automatic Washer
Dishwasher �
Dryers ❑Gas� DE
F2n , _ , _
F.A.U. '•
Fixtures � '
Device Boxes
Outlets
Switches
Garba9e Disposal
Generator �0.5 KY
i. �
8044 8/05/85
Park.Fees
N ,
N
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� �
U
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R
� E
E
� ELECTRICAL � • � FEES
' �Tran'sformer 0 15-50 KW � � '
. � O50+KW �
� Meiei ��up to 100 amps �� ���
Meter ❑over100amps t �
� .Sub Panel � � �
_ 'MotorsOO-1HPO1'f.-B__;_ �
� InaSolar 09-15 HP �i6-15* '
� Microwave � . � . ,
5-15 K W
--� Reinspection Fea
PUBLIC SERVICES FEQUIR
Zoning Approved By
Appliwtion APProved BY _
Application laued By
Pole Light
Fange .
Sign '
Standing Sections � �
Trash Compactor . � ' •
� '
Issue Fae . $�3
Date
� ' ' SUMMARY OF FEES ' '
BUILDING PERMIT $ SMIP � $
PLAN CHECK � $ PERMIT �
PLUMBING $ �SSUANCE $ . .
, PLANCHECK $ • ENEFGV.P.C. $
ELECTRICAL � $ ' � GRADING : $
• PLAN CHECK �$ � � MICROFILM �$
' MECHANICAL � $ � 5�� � TOTALFEE $b�S vo
' PLAN CHECK � • $ ' +
. . _. . � _ .. . ... �-�-.. . . . .. ..._... .' " _ , " ""�
CONSTRUCTION ANDPLANNING� � � P�� SPA . �
�APPROVALS � Permit# � � Date Inspector AppROVALS Permit# Date Inspector
1. Temporary ElectricBl Service or Pole �� ' 52. Pool & Equipment Location �. �
� �2. Soil'Pipe-Undrgrnd. ' " . . 53. Steel Reinforcement •
-3. Electrical Conduit Utility-Undrgmd.� - 54. Forms �. . ,
'4.�Electrical Conduit-Undrgrnd. . ' - 55. Electrical Bonding '
5.' Steel Reinforcement ., - � 56. Rough Plumbing & Pressure Test
'6.; Electrical UFER Grnd. ' . � � 57. APPROVALTO COVER-GUNITE .- , , �
7. Footings • �. 58. Electrical Conduit-Undrgrnd. "
. 8.; Foundation � - - 59. Gas Pipe, O Undrgmd., Test . �
9. Water Pipe-Undrgrnd. i 60. Backwash Lines, P-Trap, O Undrgrnd. r
�
10. Structural FloorSystem '� � 61. APPROVALTO'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 Electrira6Conduit --- - • 66. Solar System-Final �
� 16. Rough Electric Wiring � - � , . � �- � 67." Fencing & Access Approval
77. 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. Undergraund Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
� 23. Gas Pipe-Rough & Test 72. Underground Flush
' 24. Roof Framing � 73. Undergrnd.StorageTank �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: �3 �D ��,ry�i'r' �y((>�Q�p (k$ �L_
34. Final Heating & Air Conditioning 3�3 (�, V�� L��
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. Handirap Regulations ' . '
47. FINALSTRUCTURE&BUILDING ' . ' � �
48. Special Requirements Completed - , � �, � • .
49. Electric Release to Edison . , - - . .
50. Gas Release to Southem California Gas Co ' � � . ��
51. CERTIFICATE OF OCCUPANCY � .
No. - ` Date - � � �-
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THESE PLANS MUST BE ON JOB A7 Al.l� T1ME5
MAKE NO CHANGFS W�THOUT PRION APQROKAL
��S H A 0 r" v��,
�ani9�t�� . PR04AL
OF PLAyS ANf/ISPt CATIONS SHALC NOT BE C{,O,�NSTRUED
OF ANY OfETHETPROVI50NS OF PHI3,CC�I�,.NO�P RMIT P b
SUMING TO G�VE A(17HORITY 70 VIO[A�E OR CANf�� �F
PROVISIONS OF THIS CODE SHAIL BE AL'D3'EXCEP7TN SO
FAR 0.S THE WORK OR USE WHICH IT�ORI2ES IS IAWFUL.
THE ISSUANCE OF A PERMIi BASEU UPQN PlANS AND
SPECIFICATIONS SHAIL NOT PREVENT TNE BUIIDING OFfICIAL
FROM THEREAFfER REQUIRIfV6 THE CORRECTION OF [RROflS
IN SAID PLANS AND SPECIFICATIONS� OR FROM PREYENTING
BUILDING OPERATIONS BEING CARRIEO ON iHEREUNDER WA�N
IN YIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE
OF THE CITl, ; -;) ! , ,
�x g'
�
SEPARATE PERl�17S ARE REQUIRED
� ��FQR ELECTRICA�, PLUMBING,
RR j � ��A71NG, VENTlLATING AND
'�,G REFRIGERATION wnRk
`"�,_ ,
7�6 G�.
P d
THIS NUMBER MU�S qCCpNV � Ny
ALL INSPECiION REQlJESTS
• FOR BUILDINGS WHERE PERSONS q ER p
BE EMPLOYED, WE SUGGESi TNAT THE
SiAiE OF CAIIFORNIA DIVISION : OF
INDUSTRIAL gpFEiy gE CONSULTED FOR
ADDITIONAL REQUIREMENTS ,
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� MESA
C�(y OF COnA
pLANNING ��T�
�y� 7o eioc. oFrr. aco.
���3� DAT
D `8�
. . BY o�RECi04 �' �NtNo
C_iY OF COSTA MESt.
CALJFORNIA 92828 P.O. BOX 1200
FROM TME OFFICE OF TME DIRECTOR OF BUILDIN6 SAFETV
Project Aaaress � '� (o � c�J ( (o � h
Project Name �4 Ra w. . n� �r �v� c -�l rvc
r 1 '
O.mers Name 6. C-� _ � h� ��� o S
Owners Address ���� � �q-h��-Q �„ ,�
Oaners Telephone 5� g q 6� Z
�r,,,�t # S/ 3 S�
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City Ose Chly
ann � co -
Z t,'� �.� as Owner, fentraebor, �gewt (strike out all
except one) do here attest that e�loynent of any person, or persons, is not
anticipated at the time of seeking the abovrreferenced pecmit. In the event that
any person, or persans, are er�loyed under the prwisions of this permit, I shall
imnediately cause a valid Certificate of Worlarens Co�ensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own oost, arrl to indenmify and hold harmless, the City,
its officers, agents and/or e�loyees, fran and against, arry arr3 all liability,
damage, costs, l�ses, claims and expenses, howscever caused, resulting directly
or indirectly fran, or oonnected with the irtqxovement under this pexmit.
Z further state that I have read and fully imderstand the implications and re-
sponsibilities of the above statements, and will crn�ply with all provisions of the
Contractors State License Law found under the Business arrl Professions Code,
Division 3, Chapter 9, of the State of California.
U`'�A2K P1�.11,PS
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Print Name �
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Signature
CMF 0777-46
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COSTAMESABUILDING-SAFETYDEPARTMENT APPLICATIONFOR4Sl�KU�f�PERMIT 20
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �
REC BY PERMIT ' -
For Applicant to Fill in Completely — Use Ink Only N° 513 5
BUILDING 1 A.P.NO. ���— Z
ADDRESS � � � u� T �
BUILDING /
OWNER OR (� �' l N _ T G ADDRE55 ���p C.L.� +� �'
TENANT � L
UNIT OR
MAILING SPACE NO.
ADDRE55 % 60 �� ' TR�NO LOT r t � BLK.
/� TEL. p
CITV L,p �� q NO.S 2Z N� qDD AL R REPAIR MOVING DEMOLISH
CONSiRUCT70N
LENOER
BRANCN • _ / �- / �
OWNER 9�i l/�
ADDRE55 / VALVE /
ARCHITECT TEL. USE Q� 5 �O�
OR ENGINEER `� /��
ADDRESS ZONE `v` TVPE � GROUP •�'��/
APPROVED
CONTRACTOR �i(/�"L(�Q�`� BV DATE Z �O �I
ADDRESS
TEL.
CITV NO.
STATE CITY APPROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OF BLDGS. (FtiOM C TREET)
OF LOT NOW ON LOT ONT FT.
VSE OF /' r
EXISTING BLDG. �O�C�
� Separate permits are required for L. SIDE � FT.
electric, plumbing and heating work:
REAR � FT.
USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
I p,qTE
O" APPROVED
��- APPRO D �r� � /1/
��CJ tll
I hereby acknowlatlpe that I havo read thia applleeNon nntl stata
that the ebova information is corract and epree to comply with
all laws reguleting builtlinp conrtrucNon, entl I shell not employ
eny perwn in violation of ihe workmen's compansetion lewa of
the State of Californie. /7
L S�. FT.
I �areby certify that I am properly Ilcensetl as a contractor untler
the State oi California Business entl Protessions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapier 9, entl that such licanses ere in tull force antl et}ect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from the provisionsof theSteteof California Businacs VALVATION
end ProfessionsCotle, �ivision 3, Chapter 9. PERMIT FEE E O, OD
Signaturaot � (/� PLANCHECK E
Permittee $ /,qD TAX S O• s�
or A �V
AuthorizeE Agent Date 2 �� �+ TOTAL PAID S 2� . S�
50