HomeMy WebLinkAbout237 ROCHESTER ST - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY Of COSTA MESA/'�C(��JISTR CTIO'Jj�Q.P—ERMITJ PERM T.NO. TRACT NO. LOT NO. UNIT NO. BI 48 4/05/811 45000 TL
Proiie{ct Address _�3 L rt['JCi /""� `•5 r t�,s 531890 ,,./
�.tNplicant's Mailing AQdress !. �S. a •At rYT TYPE OF CONSTRUCTION U NEW Li ADD U ALTERATION PCS-PAIR
i/- I/ . .'Tet " I a-- f ❑ CONVERSION ❑ DEMOLISH ❑ OT •- 'r' i A.P.# Zone
Owner's Name ��'�-a' Qu?'S Phone 0- AP fa I.ry+
DE CRIP ION OFWOR K/ EOF BL G.
Address 23 0 tl-�.�- SA e,� ,s �,a°ufr, r F C�.SS �r S Main Building: Accessory Building: Z
Arch/Eng. License No. TYPE OF PE IT ❑ GRADING FOUNDATION U STRUCTURAL T Front o
Address /�•�-- /__- - A_-n G ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N
Contractor's Name&t4H-2 - `�'� ""�CI-Phone .3' r�Y ❑ OTHER ,,te�t1 C Right N
PROJECT DESCRIPTION SQ. FT..�lJ W OCC P C K G
Address(mailing) `�� 09 'n�
s Left
3 c� CONSTRUCTION TYPE GRADING CU.YDS.VALUATIO 111
City License No. ZONE - ACRE$ R
LICENSED CONTRACTOR OECLA TION - Ping. Ref. # Parking Req./Provided E
I hereby affirm that I am licensed u d r pray ons of Charter (c mencing Remarks: Planning Notes: M
with section 7000) of Division 3 Co the Bu ess and Proles n Code, and T
my license is in full force a s.�ifect• Q / S
Licens 1ajs G--..5. tu Li nse o. ✓ 1�
Date...7. J '6-5 Signature .. - PLUMBING FEES
WORKERS' COMPENSATION DECLAR ION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of nsent t• self-insure or a certificat>
-1 Workers' Compensation Insurance, r certif[• copy thereof (Sect'/ Backflow Preventer Service Sink
00, Lab. C.) r�17 Automatic Washer Transformer 0 15.50 KW
',alley No. ,+ -27-3 Con any S - , Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
fCertified copy is hereby furnished,
Certif}ed pep_yt.f ,0 with the city !ding Di sion Bathtubs Sewer Connection Cooking Unit Meter (pup to 100 amps
Date 1 17 C 7 Applicant '
EXEMPTION FROM WORKERS'COMP SATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(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 Fan Motors 00-1 HP 011/2-8
Workers' Compensation Laws of California.
(Y Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP 016-15+
ar) NOTICE:If,after making this declaration,you should become subject to the —
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
1 comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance 9
I of the work for which this permit is issued (Section 3097 Civ. C.)
Interceptors Water Heater Outlets Range
Name an 9e
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
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 00.5 KW 05.15 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
Division 3 of the Business and Professions Code) or that he/she is exempt
-efrom and the basis for the alleged exemption. Any violation of Section
'.5 by any applicant for a Permit subjects the applicant to a civil
.Icy of not more than five hundred dollars($500).
Li 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, anq 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 SERVICES REQUIREMENTS:
employees, provided that Such improvements are not intended or offered for Boiler Heed 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
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale).
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By S-3. Date 1-rte
ells
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 00100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- Sb
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ 4'5 �T SMIP $ °—
proof of their Worker's Compensation insurance should be provided to me. _
PLAN CHECK $ PERMIT
❑ I am exempt tler Sects•/•
B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers
PLUMBING $ ISSUANCE $
Date I .caner _ Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. S
I hereby certif hat I e r tl this application a state that the above ❑0100,000 BTU 0100,000 BTL GRADING $
information is ect. I • ee t com•I ith all i�4 and county ordinances ELECTRICAL $
and state law- :ting is buil ng co•-, r action, : hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
inspection
fives of city i• en er up, he ab•.:-mention.. property_ f _
inspection pu s. _ ��ti�� MECHANICAL $ TOTAL FEE $Si4 c&2
Drivers' _� Date V Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivero' License or$5 a
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor
I.
CONSTRUCTION AND PLANNING POOL &SPA
APPROVALS .Permit# Date Inspector APPROVALS Permit# Date Inspector
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t.--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. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings I 58. Electrical Conduit-Undrgrnd.
8. Foundation r • 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 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 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-I Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • i
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 i
25. Roof Sheathing74. Overhead Hydro I
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 SSUED '
33. Final Electric Notes: /� As a JC P� A� .l X
34. Final Heating & Air Conditioning (�/v0 01 1 /s'..ylv``
35. Final Gas Pipe-Test ��J
36. Hood or Canopy '
. .1
37. Final Factory Fireplace - -
38. Final Plumbing _
39. Water Service-Final •
40. Gas Service-Final I -
41. Solar Domestic-Final • '
.
42. bckflow Preventer ( ,
a
43. Backflow Irrigation I .
44. Landscape Irrigation System i ' I
45. Sound Attenuation . l. '
46. Handicap Regulations I
47. FINAL STRUCTURE & BUI LDI NG ��/�
I (
48-Special Requirements Completed - I
I
49. Electric Release to Edison . ' •
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50. Gas Release to Southern California Gas Co - •
51. CERTIFICATE OF OCCUPANCY L . -
No. Date !_I•
44v