HomeMy WebLinkAbout491 16TH PL - Building PermitsowrveR MATI�Y, R. A, , 'T � DATE 7-i5-55 ��-
JOBADDRE8S lt91 lbth Place BUILDINGPERMITNO. 1S2B
GENERAI�CONTRACTOK a•mer-Builder VqWE $ �-��07(��
� L w BLOCK TRACT 17� HORt�
�I � GROUP I TVPE � ZONE � FIRE DISTRICT 1"�715
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR
I / / DATE I NUMBER
Foundatio� Forms and Gra
Rough Framing
Plumbing, pough to Slab
Plumbing, Rough Complete
Temoorarv Pole
Seotic Tank or
L ng, InX
Fixtures
Occupancy LGli��� yl' —
v.._....��n�� cr tcnni GC
d G`..�. _ I ll —i S-
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AVClicant to fi11 in all zoaces except those witnin neavy �ortler Ilnas anC sign all avVroOriate tleclaratlons.
CITY OF COS'_4 MESA CONST UCTION PERMIT PERMIT NO.�I � TRACT N. L T O. UNIT N0. �
��� y,41 ' �� � � /�P�d I �
Prolect Address (/
ApplicanYs Mailing A dre55 7 �µ R[t Su- TVPE OF CONSTRUCTION NEW />DD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p #
Owner'sName - � � ° � � - Phone J 8�3 DES RIPTIONOFWORK/USEOFBLDG. ��m��- �
Address
(6n ��a�t . � ,,a� - � � S Main Buildi
A¢h/Eng. � Lic¢nse No. TVPE OF PERMIT^/ GRADING�— y' FOUNDATION STRUCTURAL' T Front
AddrC55 ❑ OTHERT L� ELECTRICAL 'LJ PLUMBING ❑ MECHANICAL A qear -
Convacror's Name— � Phone � - � -
PROJECT DESCRIPTION SQ. FT. ;3�• S� OCCUPAracV D C Right
Addreu (mailing) p K
CONSTRUCTIONTVPE VA�UATIONS= 8i0 O S Left
City LicenSe No. ' � ZONE ' � � GRADING CU. V�S. ACRES
LICENSED CONTRACTOR DECLARATION . Ping. Ref. #.
1 hereby atfirm tnat I am licensetl untler provisions ot Cnarter 9(commencing Remarks: • I� I_�{ � , Planning Notes:
with Sec[ion 7000) of Divislon 3 of [he Business anC Professionz Cotlo, antl
my Iicense is in full (orce antl e/fect. '
License Class �' �n58 No. �
Oate Si9naWre ' �
WORKERS' COMPENSATION DECLARATION � � Bar Sink '
1 here�y affirm that I have a tertiticate o/ consent to self-Insure or a certiilcate
•f Worke�s' Compensation Insurante, or d certlfietl� cOpy Ihereof (Sec[Ion gackflow Preventer
900, Ldb: C.) . ' - •
Mlicy No. � Company ' � 82ckflow Irri9ation
8 Certitietl <opy is hereby furnishetl. �
Cerlifietl copy is fll¢tl wltn the city Bulltling Division. '�' B3LhtUbS
Date Appllcant /
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION " Clarifiefi %"
(Thissection neee not be complatetl it the permit is tor one huntlretl ($100) or- - -
less). • - . Dishwasher ' ,
I certify that initne pertormance oi'the worJ�l for, whlcn th�'s.perm�t is' suetl, I i
shall not employ any persOn in any man�{pt� so as n ecory�e subj [o the� � Drinking Fountains
Workers'� �pens�i�Laws of Cali rn� J� O Dl7v/'
. Date � �S Signatura ���.0 ��� ���«� � Floor Drains ,
�NOTICE: If, after making thi5 tleclara on, you shoultl become subject to the ' _
Workers' Compenwlion provislons oi lhe Labor Cotle, you must forthwith FIOOf$ink5. �
comob'�+'�th such provlsions or thiz permit shall be'tleemetl revokea.
CONSTRUCTION LENDING AGENCV ' ' �� 1 GasServiC,2 �OULIetS l
I h¢reby afBrm ihat there IS a con5truttion I¢ntlinq agency for the performance '
of the work tor whiGh this permit is issuetl (Sectlon 3097 Civ. CJ Int¢lcept0f5"
Lentler's Name'
Lenaer's'Atlaress Kitchen Sink . � ' '
OWNER BUILOER OECLARATION -
I hereby affirm that 1 am exampt irom the Contractor's Ucensa Law for the �'�,_ tavatories' ..
following aeason (Section 7031.5 Businass antl Professlonal Cotle: Any city or _ '
county whlcn requires a Oermit to Cons[rucl, alter, improve, tlemolish or r¢pair . p-7�ap '
any struc[ure, prlor to its i5suance, also requlres the applicant for such permit
to tile a signe0 SWt¢ment tbat Ile/sh¢ IS licensatl pufsuant to tha pfovision5 ot ROOf Dldins �
the Contractor's Licanse Law (Chapter 9(commencln9 witb Section ]000) ot "
Division<.3 ot the Business antl Protesslons Cotle) or that he/she is exempt � ,
�herefrom antl tbe basis for lhe alleged exemption. Any violation of SecHon -' -�- � ��
'131.5 by any appliCant fo� a permit SubjeGts the,appliGan[ to a civil ' -
nalty ot not more than five huntlretl tlollars (y500). - . �-"
-:� I,'as owner ot the property or my employee5 with wages' as thei� sole � AeinSpectiop •FC¢:.
� compensation, will Co the work, antl the structure is not intentletl or offeretl
tor sale (Section ]044, Business antl Protessional Cotle:� The Contrattor's"' . - ti � � _
License Law tloes not apply to an owner of a property who builtls or improves
thereon, antl who tloes such work�himself/he�selt or (hrough his o� harown " �
em0�oyee5, prOvitletl tM1at such Impwvement5 are not Intentletl or offerctl fo� BOiI¢� �
sale. If, howeveq the builtling or Improvement is soltl wlthin onn year of com- -�
� pletion, the owne� will nave the burCen of provin9 hC/She tlItl not builtl or Im- DuCt - Und¢i G�Ound �
�rove,torthe purpose o(sale). ' �
I, as owne� of the prop¢rty, am exClusively cont�ac[ing with licensed con- Duct -.StrucWral •
Vactorstd construct the project (SeClion 7044, Busin¢55 antl PrOfessions Cotle:
PLUMBING .
Showers '
Service Sink
Sewer.CaP i
Sewer Connectio`m �
Solar Collectors
Solar Pipin9 . �
Solar Tank � �
Swimming Pool w/Spa
Urinal
' Water Closet
.Water Heater
Water Service
Auto-Wash -
$15 � ' laue Fee
MECHANICAL
Tne Contractor's License Law tloes not apply to an owner of proper[y who } Duct - Ventilating
builtls or improves ihereon, antl who contracts br such projects w�th a con- �
tractor(s) license pursuant lo ih¢ ConVa<tor's Li<ense Law). I am aware tnat Exhaust System ❑ Multiple
O�oo� of theit Worke�'z Compensation insu�ance Shoultl be prOvitleO to me. -
❑ I am exempt untler Section , B. 6 P. C. for thls reason Firepl/Fatt. BIL ICBO �I`
� narn "' 2 � nwna. . /1/ H ting System & Ducting
'. I hereby certiry that I� have reatl tbis application an� state that the above � �4100,000 BTU �100,000
informatian is correct. I'agree lo comply with all city antl countY ortllnances
antl state laws relatin9 to bulltlin9 constructlon, ana hereby authorize repre-
sentatives of th�SZtity, to e�,ter-�upon tn�g above-mantioneG property jor
� � Rainspectian Fee $15
Drivers' Lic s � � C� -
�\CMF 0865-46, rev. 10/84 W�I[e - Builtlin9; Canary - A pllwnt; Pink - Accounting; Goltlenrotl - Assessor
FEES
/ ' L
u
,Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteretion
Fire Dampers '
Registers
laue Fee
�
Auromatic Washer
Construction Pole Sub.
Dryers LJGas� LJElectric
• 1 ' Fan
� ' F:A.U. -' +
�� Fixtures ' � � � -�
. �-�- . � DeJice Boxes ,an'
��� �Outlets '
Swi'Iches �'' � � �
1 Garbage Disposal�. ' �
: Generator �¢5 KW �5-15 K
_ t �/.
' _ : - . f�." ' _
�
FEES
$ 3
aoa6 2i�_ir,�
. Zoue
Accessory Building:
Req./Provided
ELECTRICAL � '
- Transformer 0 �15-50 KW
❑ 50 + KW
�Meter ❑up to 100�amps
Meter ❑over100amps'
;Sub Panel ' �
Momrs � 61 HP � 7 X- 8
Inc.Solar 09-15 HP �16-75+
-- Microwave - - � � -
Pole�Li9ht �
Sign
; Standing Sections
Trash Compactor
.'.ReinspeMion Fee "' {$15 �'� � Issue Fee
DEVELOPMENTSERVICESREQUIHEME T. : U
Zoning APProved BY �
Building Approved By:.
Appliration Issuad BY
� p; /� �SUMM RY�I�FE
. � BUILDING PERMIT � $ 3 `�
'PLAN CHECK �, � $' �
• PLUMBING �. $ �
� PLAN CHECK •'25% $'�� ��
_'' ELECTRICA4 $ ' �•0�
• PLAN CFiECK 50°6 $�� Z• SD
' MECHANICAL '- $ � �• �� �
'�P�AN CHECK 25% $ - ��Z
t
1
.u:�i_ Y!�'.
2
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G
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$
FEES
$
ES ,1�. _� �,�
SMIP , $ �_
PERMIT
ISSUANCE $
ENERGY P.C. $
GRADING, $ �
MICROFILM $
TOTALFEE $ �
� ��
�CONSTRUCTION ANDPLANNING � � POOL .PA .
APPROVALS � Permit # Date Inspector AppROVALS Permit # Date InspPctor
•(;�. Temporery Electrical Service or Pole 52. Pool & Equipment Location
!. �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. �7 � 57. APPROVAL TO COVER-GUNITE .
7. Footings �'� �j �. ` �$ 58. Electrical Conduif�Undrgrnd. �
� 8' Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe=Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor Sysfem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains . � � 64. Plumbing SYstem - Final
14. Rough Plumbing j �f t�` 65. Electrical-Final '
15. Rough Electrical�Conduit 66. SolarSyst�m�Final . �
16. Rough Electric Wiring 9' J 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning F��/ � £ FIRE DEPT. REQUIREMENT .
20. Aough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure �• 70. Underground Hydro
22. Ducts, Ventilating ; 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test - r ' }�, Underground Flush
24:-Roof Framing _i,. 73. Undergrnd.StorageTank OGas ❑Oil
25. � Roof Sheathing � �Zcj � 74. Overhead Hydro . �
26. T-Ba�yCeiling (Structural) &?�Monocoat 75. Dry Chemical �
27_FrameandFlashin r �
9 , � � 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation O g � 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 , y� PL Notes: 3L�
34. Final Heating & Air Conditioning �zyJy� � j �l �,.�, v o S[
35. Final Gas Pipe-Test -� ��
S < S � 3 ��L? -.
36. Hood-or Canopy �, � s��� $ ! OI�
/
37. Final�Factory Fireplace , ' '�/� L
38. Final�Plumbing ' 9 L- 9 •
39. Water Service-Final , � '
40. Gas"Service-Final 3 2 � � � �
41. Solar pomestic-Final � � �, ,
42. Backflow P.reventer , • ` �
43�Backflow�irrig9tion, �� ' .
44. Landscape Iiijpation.System -
45. Sound Attenuation �_"� ,
,
46. Handicap Fiegulat�orts� •
47. FINAL-STRUCTURE�& BUILDING � �
48. Special' Requi�ements COmpleted
49. Eleciric Release to Edison -'
50. Gas��Refease to Southem California Gas Co � " � '
r :
51. CERTIFICATE OF OCCUPANCY . •
��. Date
� �_ .. -•.•• .
.� Costa Mesa Building Department APPLICATION FOR PERMIT
'�� � 711 EAST 20th &TREET �5�..5 B U I L D�t N G �
• T; COSTA MESA, CALIFORNIA
FOR APPLICANT TO d+'ILL IN �OIL OFP'ICE USE ONLY
, _._. _ .Receipt.No._ Permit No.
Building 9/.� / �
ewa.we � �� - / S .�- �
Costa. Mesa, California
' 6 �'
� � ,
Tel. ,
No. ,( i $�-
or Lic.
No.
�R City Lic.
r � y��c,�...r/ti No.
_�
on I No. ��� I Block�'i��/I Tract�
4ttach Metes and Bounda)
A �Y i
ize of Lot /.i� � Ci�
se of
xisting Bldg. `
ethack Line irom �q �
Yard
Demolish
I by- Date Rec'd. Da'
%- //- _
/- i6
Costa Mesa, California
. �.
FYterior I n U� I Rooi
eri�g �,,�_� �__.,.rCovering �� AppROVALS
: of New 1/ _ _
Building �l-c�,�,_,�. Foundation Loeation Inspecto
� . Forms, Materials,
Under-Pinn��g
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is correct and agree to rnmply
with all Clty Ordinances and State Laws regulating Lath. Ext
building constructio �
Signature of Plaster, Int
Permittce
Masonry Reinforced
Valuatfon Permit Fee $ � o
`Q O-7� Plan Check $ Sl O d Bond Beam
$ f / Feea' $ 3/, d d FINAL
CONM 20A G-H 2M b-59
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JUL11-55POyEsa�415u .*'**31.00
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PLOT PLAN ' : :" � .._ ".
3how Iocatlon and distanxa irom "� - - '� �
, prop�rty Iine and 6etween bullding& �.. ,�� �
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