HomeMy WebLinkAbout2121 BRISTOL ST - Building Permits� C
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�� ADPlicant to f�ll in all
CiTY OF COSTA MESA CONS�7JRU�fjTIO�N pjE�RMIT
Project nddress �! � � s• C 6R1 Si��
Applicant'sMailingAddress ��� ��+�.�� 1� �G'�"
Owner'sName � - Phone�a_��
Addreu � �.� � - �'%[_ � L_ �-
Arch/Eng. -LicenseNo.� �
Add�ess " �-�[�•p��-�
Contractor'sName �� Phone.�.[tL-7LT�
Addresslmailingl�j�� � �� �
City License No: - 3 3�
LICENSED CONTRACTOR DECLARATION '
I hereny affirm ihat I am licensetl untler provisions of Cbarter 9(commencing
with Section 7000) Of Division 3 of the BuSiness antl Profe351on5 Cotle, antl
my Iitense is in full forc antl etiecL � /
LICBf152 5 � T Lice�s �� 1'`/��/ �����
Date�j�'. Signature.��..��� ��= „f�_
WORKER$' COMPENSATION DECLARATION �
I nerebY aHirm that I �ave a certlficate of consent to selNnsure or a certlfitate
of Wo*kers' Compensation Insurance, or a certitietl coPY thereot (Sectlon
3800Y �ab. CJ �$Z—Ofd � - / ��
blic No.WCZ'L''�� dv� ompan L(��s2 /i�Vlw19
4f
Certifietl caOY �5 he�¢by turnishetl. �
Certi�t}'�� OY is flletl with the city Buil n Dlv{Sbp'�.
Date_��J_=�__.._ Applicant ��A/—i7�A 1C/�
EXEMPTIdN FROM WORKERS' COMVENSATIpN DECLARA ON
(T�is s¢ction neetl not be wmpletetl if the permit I5 for one huntlreG (E300).or
Iessj.
I certily that in the periormance of the work for which this oerm�t is IssueG, I
shall not emo�oy any person In any manner so as to berome subject to the
Workels' Compensation LawS of Calitornia.
Date Signature � '
'NOTICE: It, atter making this tleclaration, you shoWa become subiect fo tne
Worliers'. Compensatlon provisions of tne Labor Cotle, you must forthwith
comply with Such prOvi5ion5 0� this Permit shall b¢ tleemetl revok¢tl.
CONSTRUCTION LENDING AGENCV .
I nereby atfirm tha[ there is a constructton lentling agency tor the performance�
of the work tor which this permit is i55ueE (Section 3097 Civ. C.)
l.entler'S Ndme - -
Lentler's Atltlress
OWNER BUILUER �ECLARATION
1 hareby af5lrm.thal I am'exempf from tbe'Conttactor's License Law tor the
�nun..�ino rnacm �Gninn lOit 5 Fii¢iness antl Professional Cotle: Anv tltv o�
a
the�efrom antl the basis to� [he allegetl exempUon. Any vloiatlon oi 5ection
�031.5 by any appliGant Por e permiC suDjects the applican[ to a civil
nalty oi�not more than five huntlretl tlo�lars (E500). ' o �
� I,'.as owner ot the. property or my employees with wages as [heir sole
ompensation, will tlo the work, antl the structure is not intentletl or offeretl
for 5ale' (Sectio� 7044, Business anU Professional Cotle: The Contractor's
License law tloes not apPly to an owner of a property who builtls or improves
tnereon, antl wno aoes such work nimselt/herself or through his or hor own
employees, provitletl that such {mProvementz are not inten�etl or offeretl for
sale. If, however, Ihe builtling.or improvement 15 Soltl witM1in one year of <om-
pletion, th¢ owner will have Ihe burtlen Ot provin9 he/s�e tlitl not builtl ot im-
prova fo� the purpose of zaleJ. .
❑ I, as own¢r Of the p�operty, 9m exclUsively cont�acHng with IiCensetl cOn-
tractors to consbuct the �roject (Section 7044, Business antl Profe551ons Code:
The Contractor's License Law tloes not apply to an owner of property who
builds or improves thereon, antl who co�tracts for such prqects wrtn a con-
[rac[or(s) license puisvant�to the Contractor's License Law). I am aware tbat
proof ot thelr Worker'S Compe05atlon insutan<e shoultl be provltletl to me.
❑ I art��exempt untler 5¢[tion � 8. & P. C. for thi5 reaSOn
Date Owner _
1 hereby <ertNy thai I have reatl ihis z
Intormation is correct. I agree to comply
antl state laws relating to builtling const
sentatives ot this city enter• pon
InSOection purp s
Signature •
except lhOSe within �eavy Sortler Ilnas anG sign all a00�opriate tleclarationz.
TVPE OF CONSTRUCTION LI NEW LI ADD LJ'AI.TERATION LI REPAIR
❑ CONVEFSION Q DEMOLISH ❑ OTHER A.P. #
DESCRIPTION OF WORK/USE Of BLDG.
S Main Buildi
TVPEOFPERMIT GRAD�NG FOVNDATION S7RUCTURAL T FfOn[
❑ TENANT %�'`�,. LECTRICAC ❑ PWMBING ❑ MECHANICAL B qeaf
❑ �OTHER / C Right
PROJECT DESCRIPTION Sa.F7. ' oCCVaaNCV
CONSTRUCTIONTYPE VALUATION$ S Left
ZONE GRADING CU. VDS. ACRES Ping. flef. #
Remarkf: /� dA qU� hp,y ry�� Planning Notes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks '
Gas Service Outlets
Incerceptors "
Kirchen Sink . � -
�nes � ..
ip
Diains
Rei�spection Fee { $75
Boiler �
Duct - Under Ground �
Duct-Structural '
Duct - Ventilating .
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating,System & Ducting
❑0_t00,0008TU O}00.000
LDrivers' License or 55 � I I Reinspection Fee
CMF 0865-46, rev. ]0/86 White - Bufltling; Canary - Appllcant; Plnk - Accounting; Goldenrotl - Assessor
PLUMBING
Showers
Service Sink
Sewer Cap
Server Connection'
Solar Collecrors
Solar Piping
Solar Tank •
Swimming Pool w/Spa
Urinal
Water Closet '
Water Heater
Water Service
Auto-Wash �
.Laundry Trays
. � lisue Fee
Houd or Typel ❑
Canopy Typell ❑
Retrigeration System
❑o-ioo,000eTu ❑�oo,000
System Repair/Alteretion
F ire Oampers
Re9isters
$75 �I I luue Fee
Autometic Washer
Construction Pole Sub.
Cooking Unit .
Dishwasher
Dryers UGas LlElectric
Fan-
F.A.U.
Fixtures '
Device Boxes
- Outlets
,; $WIMh25
y, .;: Gar6age Disposal '
" Generetor �P5 KW O5�'
�
2689 ..�/,p9/85 ..
..
--- 3.20= TL
j '. n ,:� C I
�, I c i
Y
Zone i
Accessory Bu�lding: ' '
_ . .. - il . � Z �
p I
� N I
�
, . ' G
I Parking Req./Provided �
I
�
ELECTRICAL
- - -.Transformer � 15�50 KW—
O SO+KW
Meter ❑up to 100 amps,
Meter ❑over 100amps �
Sub�Panel �
Motors O41 HP O 1 K- 8
,Inc.Solar��9-75 HP �16-15+
Microwave . . ' '
Pole Light -
Range �
Sign �
; Standing Sections ` ' '
5 KW Trash Compactor
t
... - $ 3 . . � i
ReinSpection Fee $15 'Issue Fee �
FEES
DEVELOPMENTSERVICESRE�U�REMENTS:
�� Zoning APProved BY ' � � .
� Building Approved By _ �
$ 3
$
SUMMARY OF FEES ' � � �
BUILDING PERMIT $ .SMIP. $
PLAN CHECK � $ PERMIT � '
PLUMBING , $ ISSUANCE '$
PLAN CHECK 25% $� ENERG� P.C. $
ELECTRICAL ' $ �J. ZQ � GRAOING $ � � � �
PLAN CHECK 50% $ MICROFILM �$ � �
MECHANICAL $ TOTALFEE t$ � I
PLAN CHECK 25% $ ' � � ' � I
CONSTRUCTION AND PLANNING . �� POOL A
Date Inspector Date Inspector
'APPROVALS - Fermit# APPROVALS Permit#
�
1. Temporary Electrical Service or Pole � . 52. Pool & Equipment Location
2. �Soil Pipe-Undrgrnd. � 53. Steel Reinforcement �
3t Electrlcal Conduit Utillty-Undrgcnd.' - 54. Forms
4.� Electrical Conduit=Undrgrnd. _ 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
8. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE � •
7. �ootings , . 58. Electrical Conduif-Undrgrnd. �
8f Foundation "' -- 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, 0 Undrgrnd. -
� 10: Structural Floor System 61. APPflOVAL TO DECK
11: Property Sewer Line & House Cohnection . 62. Backwash & Receptor-Final
12. Sewer Cap .� �� � 63. Heater & Vent-Final �
13. Roof Drains � 64. Plumbing System - Final - �
14. Rough Plumbin�' . � 65. Electrical-Final �
15. Rough Etectrical-Conduit ' 66. Solar System-Final . -
16. Rough Electric Wi�ing' - � 67. Fencing & Acces's 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 $tructure 70. Underground Hydro -
22.� Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test �� � � 72. Underground Flush
24. Roof Framing �, � 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing . ' � 74. Overhead Hydro � �
26. T-Bar Ceiling (Structural) &�Monocoat 75. Dry Chemical '
27. Frame and F.Iasbi�g • � 76. Dry Standpipe .
28. Lathing & Siding . . 77. FIXED SVSTEM FINAL
29. Insulation . . . 78. FIRE PREV. FINAL
30.. Drywall Nailing . HEALTH DEPT�. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32: Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUE
33. Final Elec[ric Notes: 6 � � u
34. Final Heating & Air Conditioning -"
35. Final Gas Pipe-Test
36. Hood or Cariopy .
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final _ . .
42. Backflow Preventer
43. Backflow Irrigation �
44. .Landscape Irripation System
45. Sound Attenuation � �
46. Handicap Regulations '
47. FINALSTRUC7URE&BUILDING
48. Special Requirements Completed . , .
49. Electric Release to Edison - -- ' ,
,, 50. Gas Release to Southern California Gas Co
� � 51. CERTIFICATE OF OCCUBANCY - � _ .
Nn. � ' Date � � � �
�