HomeMy WebLinkAbout2445 RUE DE CANNES - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
STA MESA CONSTRUCTION PERMIT - PEItT N TRACT NO. LOT NO. UNIT NO.
oject ddress �•4.44c €A)C -nnE c pC3ei q 3 30./ �T o f". : �� ^/
pplicant s Mailing at
- (t.IPS``,, Q UP_ ae 0Bsr.hQ� TYPE OF CONSTRUCTION ❑ NEW LJ ADD H ALTERATION U REPAIR
Owner's Name C1' &ze AR. _'cy ..,N(ILA.Phone SAO 7207 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address ZCF.�S ``(1 n.,&2 CCVt`Ae S r �e...2 7 S Main Building: Accessory Building:
Arch/Eng. License No. _ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front O
Address ❑ TENANT IX ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B A Rear N
Olt
❑ OTHER
Contractor's Name / / e. , Phone C Right N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
lJ
Address(mailing) v K Left • G
CONSTRUCTION TYPE VALUATION$ $
City License No. ZONE -- GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
Q
I hereby affirm 7 that0) I am licensedion under provisions f Charter i (commencing Remarks: Planning Notes: M
with sectionis n full of a 3 of the Business and Professions Code, and
my license is in full force and effect. T
License Class License No. S
Date Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink ShowersELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate •
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 0
3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company _ Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION 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 i. Sub Panel -
I certify that in the performance of the work for��LL ch this permit is issued I
shall not employ any person in anyo come subject to the Drinking Fountains Solar Tank Fan i o0
Worke rqq Comp pantos Laws of Calif• __ Motors I�40-1 HP ❑1%-80) 3
Date C '2-' Signature • 1 - L Floor Drains Swimming Pcfol w/Spa F.A.U.
NOTICE:If,after making this declaration,you should become subject to the Inc.Solar 09-15 HP ❑16-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name
-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 •
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
salty of not more than five hundred dollars($500).
I, as owner of the property• Reinspection Fee $15 Issue Fee $ 3
� p
mm�encatip , will do the work,and the structure is not intended or offered Reinspection Fee $15 Issue Fee t 1s':CX� eA
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 Boiler Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered foryp Zoning Approved By Date
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0
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). / Is\ irr
❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By V Date 5/Z-'.DD
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 ❑4100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT
❑ 1 am exempt under Section f6� c %•.C.for this reason Firepl/Fact.Blt. [CBO# Fire Dampers PLUMBING $ ISSUANCE $
Date —7—�� Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read t is application and state that the above ❑0.100,000 BTU 0100,000 BT --1-7.00 GRADING $
information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre-
sentatives of t ell o en{pr upon the above-mentioned property for
inspection pur•.Ns�i MECHANICAL $ TOTAL FEE $ S• DO
Signature ---
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
POOL& SPA
CONSTRUCTION AND PLANNING •
APPROVALS Permit# Date Inspector :APPROVALS Permit Date Inspector
1.-Temporary Electrical Service or Pole 5L:`Pool & Equipment Location
2. Soil Pipe-Undrgrnd. `�• 537 Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. �, 55. Electrical Bonding
5. Steel Reinforcement - 'r 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57N APPROVAL TO COVER-GUNITE
7. Footings / • 58. Electrical Conduit-Undrgrnd.
8. Foundation t 59. Gas Pipe, 0 Undrgrnd.,Test
9. WaterPipe-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 X67. Fencing & Access 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 Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 /1 otes:
34. Final Heating & Air Conditioning
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 •
l i
43. Backflow Irrigation
• 44. Landscape Irrigation System
•
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING •
48.:Special Requirements Completed •
-
49!Electric Release to Edison
50. Gas Relebse to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Si
LIMITED STATEMENT OF RESPONSIBILITY Bldg. Permit #
TO WHOM IT MAY CONCERN: This Permit #
Street Address AP Number
I, T'" Vetlu� l'") I NDC- , as Owner in Title of the above referenced
property, do hereby authorize:
?vv.- Q L-A..fo- iS.CI (1)q32
Name Telephone No.
444- Cab RA(ir
Street Address
CO dt-o u ar C\Cl. Met 2 GV+ - CO-6 LC
City State Zip
i
to obtain permits in my behalf, as owner/bttilder, for tt:Cc-rt-tc#t_ PeamtT_
at the above referenced property.
Should any person become an empinyee engaged in the improvement of the property, I shall
immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties.
Prin d Name Date
nl U. /a�
.' Signat re
0779-46,rev.6/87
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. -7 TRACT NO. LOT NO. UNIT NO.
i
Project Address s?S R`--- C L C 4`n1� H 0
S titovi- 33 S8
1 ,-1 S2 TYPE OF CONSTRUCTION ❑ NEW 4°i 'ADD H ALTERATION ❑ REPAIR 9548 4/�C/ (..1
Applicant's Mailing Address O-V 4' r Co -Ph ne L ❑ OTWER A.P.q#. Zone
C D-�� ❑ CONVERSION ❑ DEMOLISH `{
Owner's Name u-� 1'1 LB-,0 L...-f- Phone 54(1 DESCRIPTION OF WORK/USE OF BLDG. I -la er- }''"- A.
Address 1"Y4 S R4..- co CA 4Vty-„t C. M . Ci2G1-1- Cssvtd.t•-hrnr S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMITID L I FOUNDATIONN El E
Front O
Address El TENANT 139+ELECTRICAL El PLUMBING 5?MECHANICAL B Rear N
����
(�
Contractor's Name�tralr . AlaPhone ❑ OTHER C Right N
Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G
CONSTRUCTION TYPE VALUATION $iii 0139 $ R
City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION D
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and professions Code, and
my license Is in full force and effect. -, S
License Class License No.
Date Signature PLUMBING FEES .
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section
Backflow Preventer Service Sink
U Automatic Washer Transformer 0 15.50 KW
3800, Lab. C.) 0 50+ KW
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub.
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
. Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION 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 th- work for which this per. it is Issued, I
shall not mploy any person in any,s�.nner s• as to b:%*o f object to the Drinking Fountains Solar Tank Fan
q (( (+ `• / Motors ❑0.1 HP ❑1'/:-B
Workergns♦l9ps�jgn Lays of Cali nia. _
Date 7� -[[DD1I 0 t _�5ignature b. Floor Drains Swimming Pool w/Spa F,A.U. Inc.Solar ❑9-15 HP 016-15+
NOTICE: If,after making this declaratio•, • should beco . subiect to the
Workers' Compensation provisions of t e .bor Code, you ust forthwith Floor Sinks Urinal Fixtures -
Microwave
comply with such provisions or thi pe It Shall be de- ed revoked.
CONSTRUCTION LENDING AGENCY tGds Service Outlets Water Closet Device Boxes
1 hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Clv. C.) -
- Interceptors Water Heater - Outlets Range Lender's Name .
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
following reason (Section 7031.5 Business and Professional Code: Any city or 1 Garbage Disposal Standing Sections __
county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays
any structure, prior to Its issuance, also requires the applicant for such permit y Generator 0.5 KW 5-15 KW 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 -
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil - -
penalty of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3 ,
compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $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 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 Hood or Type I 0
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
diction, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By _ Date
Crove for the purpose of sale). �`�
I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Systema Application Issued By '/. Dat
tractors to construct the project (Section 7044,Business and Professions Code: q� Q
The Contractor's License Law oes not apply to an owner of property who i Duct-Ventilating I IXO-100,000 BTU 100,000 BTU t SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ _ _ SMIP $
proof of their Worker's Compensation insurance should be provided to me. Exhaust Systempy p
0 I am a empt under Section B. P C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLAN CHECK $ PERMIT
�ylj� W 1� (ZZZ����\{n/' PLUMBING $ ISSUANCE $
Date4 _Avner 1 v ✓�-y-�` Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
.I hereby certify that I havearead thi ap icatiOn ad sta that t e above ❑Of00,000 BTU 0 100,000 BTU GRADING $
•, informatio is correct. I agree to com y w th all cityand Dunt ordinances ELECTRICAL $
• and state ws relating to building co struction, and hereb9puthorize repre- PLAN CHECK 50% $ MICROFILM $
sentalives f this of to ent an the above-mentlondd pope y for �,�- �,�
ao
inspectio urpose J{ yJ Y— MECHANICAL $ 1-4,----•°41 TOTAL FEE $
Signature \
• Reinspection Fee $15 Issue Fee _L,J� `AN CHECK 25% $ , z4 r.+
CMF 0865-46,rev. 0/84 White - Building: Canary -Applicant; Pink -Accounting: Goldenrod - Assessor
• .CONSTRUCTION AND PLANNING POOL &SPA
'APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
• 1
1:'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 UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8.:Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9: Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O 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-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 D Gas 0 Oil
23. Gas Pipe-Rough &`Test 72. Underground Flush
•
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 ��py. Notes: 57 re- p' ��0�sI�1'�3 •
34. Final Heating & Air Conditioning 470/Y,,)/` md � ibrzeez1L-/�"
35. Final Gas Pipe-Test /
36. Hood or Canopy •
37, Final Factory Fireplace
8,7 Final Plumbing •
.39. Water Service-Final
40. Gas Service-Final
. 41. Solar Domestic-Final
Backflow Preventer
Is
"43. Backflow Irrigation
•
44. Landscape•Irrigation System ,
45..Sound Attenuation
461 Handicap Regulations
47. FINAL STRUCTURE & BUILDING
'48. Special Requirements Completed
49. Electrib•Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No._ 'Date