HomeMy WebLinkAbout1812 SAMAR DR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•CITY OSTA'MESA CONSTRUCTION'PERMIT ' - PER NO. TRACT NO. LOT NO. UNIT NO. 1670 I Q/DA/B5 JoQli TL
• G �093�
Proje t Address 4a/a �iniA-f/ '---,E.' "
/ I • s _ _
Applicant's MailingpdreessyN1/S3.4' hi LA/1/7/ q'AtIV/k2 TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION- U REPAIR - __
Owner's Name '-f r!! 0P PhoneO J'g/�tp/ ❑ CONVERSION .❑ DEMOLISH El OTHER q,p-# I Zone
r{. e. DESCRIPTION OF WORK/USE OF BLDG.
Address .l • S Main Building:' Accessory Building:
Arch/Eng. License'No. _ ?TYPE OF PERMIT El .
GRADING FOUNDATION U STRUCTURAL E Front - - - p
Address ' ❑ TENANT. ❑ ELECTRICAL PLUMBING ❑ MECHANICAL ' A Rear - • - N
Contractor's Name ' /a /, 4 ' - •'honelt-34/10 ❑''OTHER • - , ; . I
/ � PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right - N
Address l mailing)/f} 13 4.1 X... IV et /%/ �7ti,¢he//I7 '$, s r G
r CON ST RUCTION TYPE VALUATION$ Left
City License No. -4 �•j� - ZONE GRADING CU.YDS: ACRES R
LICENSED CONTRACTOR DECLARATION _ Ping. Ret.# Parking Req./Provided E
13
I hereby affirm that I am licensed under provisions of Charter.9 (commencing Remarks: -• Planning Notes: - M
719 with section 7000) of.Division 3,of the Business and Professions Code, and - T
ymy license is in full fore and effect. T
License Class ' 3 icen - No , 7G . . . _
•-•......
Date_e'c9/ ' .r ' Signature ea., a/Irir ' PLUMBING FEES
WORKERS'COMPENSATION DECLARATION , ' ELECTRICAL i I FEES
I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink' Showers •
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - • Service Sink ` -
3800, Lab. C.)" '/ ^� —7- Automatic Washer ' 'Transformer ❑-15-50 KW
Policy No. 17�FYd Company il�P/-I-f/P h' .1�f/t4 Backflow Irrigation Sewer Cap Construction Pole Sub. I 0 50+KW
Certified copy is hereby furnished.
-
-"Cert- led copy is filed with the city,( Ilding Iv'siorte /lir^� ' Bathtubs ' • Sewer Connection - Cooking Unit •• Meter ❑up to•100 amps(
Date Com.k. — ApplicanVornia. f x' / '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter ❑aver 100 amps '
(This section need not be completed if the permit is for one hundred($100) or
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel •'
I certify that in the performance of the work for which this permit is issued,
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'/z-8
'Workers' Compensation Laws of California. •,
Date- ' Signature Floor Drains Swimming Pool 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 a •
Gas Service Outlets Water Closet Device Boxes '
I 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 Civ. C,) Interceptors - Water Heater ? od I -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 _ 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 ❑O-5 KW 05.15 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 - j
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 '
enalty of not more than five hundred dollars($500). ° •/
I, as owner of the property or-my employees with wages as their sole Reinspection Fee ! $15 i Issue Fee $ 3 '
compensation, will do the work,and the structure is not intended or offered 1 ----- -- Reinspection Fee f $15 Issue Fee , $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's ' - MECHANICAL I 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 goiter Type 0 - DEVELOPMENT SERVICES�R EQUIREMENTS:
I employees, provided that such improvements are not intended or offered forHoodor ypr
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pietion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building'ApproVed By Date
trove for the purpose of sale).
LI I, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System 'Application Issued By J• Date /
tractors to construct the project (Section 7044,Business and Professions Code: ,
• The Contractor's License law does not apply to an owner of property whoJExhaustiSystem
Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU ✓" • SUMMARY OF FEES ' '
builds or improves thereon, and who contracts for such projects with a con- - % '
tractor(s) •
license pursuant to,fhe contractor's License Law). am aware that ❑ Multiple ❑ System Repair/Alteration • BUILDING PERMIT $ SMTPproof off their Worker's Compensation insurance should be prowtled to me. - ciPLAN CHECK $ '1 PERMIT /�( /,�J.!
'❑ i am exempt under Section B:& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers tt SPLA MBING $ Wr/ ISSUANCE $ N "!/-''�
' •
Date • Owner Heating System& Ducting ' Registers • 1'� PLAN CHECK 25% •$ ENERGY P.C. $
I. hereby'certify that I have read'this application and state-that The above . 00-100,000 BTU 0100,000 BT . - .ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances - • ,
and state laws relating to building construction,and hereby authorize repre- • "t 'PL*AN CHECK 50% $ MICROFILM $
sentatives of t is city ,to enter upon the above-mentioned property for r
inspection p sass. .
CMF 0865.46,rev. 10/84- White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
•
CONSTRUCTION AND PLANNING - - POOL &SPA - -
• Date Inspector - Date Inspector
g4PPROVALS Permit# •" - APPROVALS Permit#'
�.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 - -
CS. Steel Reinforcement 56. Rough Plumbing & Pressure Test
' 6. Electrical UFER Grnd.. 57. APPROVAL TO COVER-GUNITE
-.7. Footings - - 58. Electrical:Conduit-Undrgrnd.
1-8. Foundation 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: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 0 Oil
23. Gas-Pipe-Rough & Test ' i 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 PREY. 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:
34. Final Heating & AirConditioning r/-, �7 ,201.e.,../Ail.., ,,.
35. Final Gas.Pipe-Test _ - -`(t / -, f `/ 2.-1,
e c
36. Hood or Canopy Gl
37. Final Fat, • -•lace - " -
38. inal Plum _
39. A ater Sery •-
40. Gas Service-Final
41. Solar Domestic-Final - - . . - - ' ��
42. Backflow Preventer - . 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 - - -- -
I
''50. Gas Release to Southern California Gas Co ' . I
51. CERTIFICATE OF OCCUPANCY - . -- - - - - - "
No. - Date . I . -- -
•
•
OWNER BRADLEY, K. DATE FEB 1 0.1964
0 JOB ADDRESS 1812 Samar Drive BUILDING PERMIT NO. 21571 . -
N GENERAL CONTRACTOR Continental Constr. VALUE $ 960.00 Comm.
`z AP No, 139-253-16 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Block &Ret.Wall
1INSPECTIONS Signature DATE GROUP J TYPE III ZONE RI
Soil PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
k`taWater __ __
Rough Com. Refrig. ❑ Air Cond. ❑ _ _
Rough Heating
.e Rough Plumbing
3 Miscellaneous
.t Prop. Swr. Line 0 House Con. ❑ St. Swr. 0
Sprinkling System
A Construction Pole _ _
Underground 0 Power .0
Rou h Wiring _
Trenches Forms 0 Steel Rcinf.f(fii/..y. -4//e//V
Floor System l'4��
Bond Beam 0 Steel Reinforce ®' *' --13-Gr
Sheathing
Frame and Flashing
Lathing— In 0 Out 0
Plaster, brown coat _
Refrig. 0 Air Con. 0 Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Finalee.-n(gte /W-8 --i7-4y /r#,t9 7-s-6</ — s-e10 --
OCCUPANCY I .
Form BU4- 5M-3-63—S-B P 01 S71
' `" FEE RECEEV co
� 14091 PAR 201969
COSTA MESA BUILDING-SAFETY DEPARTMENT ONANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
ADDRESS 1812 Samar Drive
COSTA MESA. CALIFORNIA For Office Use Only
I RECEIPT NO. I sP4r[T M
OWNER Carriage Ranches Tnc. (QAC
MAIL PO Box 783 RECEIV D BY I9TE RECEIVED{{ TE UED
ADDRESS &"-6/1 ._1' 4
C^
TEL. BUILDING
Mrroeta Mesa NO. TA8778. ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER R.Levanas NO. Or3701 , A n
ADDRESS 2 Via 0 .or.to N.t. ;each ZORNE TYPE 1 GROU[� y%
CONTRACTOR Carriage Constr.Co. APBYPROVED DATE
ADDRESS 119 Cabrillo St ZONING (.47/�J
g:
ZONE NO.OF USE OF NEW
1ngl Law.
CITY R-1 I PLANS 2 I BUILDING att .
- . - r - -: 1 - - ' • . .7.
jjj LEGAL Tract f�(�
LIC.NO. 185-126 TEL. Li87783 DESCRIPTION Lot 56, Tract 3380
OF LOT 75. 58w x 291.70 NOW ON LOOSIZE NO. TS
A.P.No. none
USE OF YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE PROM 22 (CENTER LINE ST.) �)
CENTER OF STREET 301 REAR YARD 8d - FRONT 5731 FT. IN.
TT „!
SIDE YARD I LEFT 51 I RIGHT 1 R.SIDE FT. ':/ IN.
DESCRIPTION OF WORK.
L.SIDE __CFT. IN.
NEW . diI ALTERATION I II ADDITION REAR t- - 0---- FT. 'y/.. IN.
REPAIR MOVING I D DEMOLISH I APBYPROVED I ji DATE -20-61
BUILDING NO. OF 0-r
SIZE 2503 S.ftROOMS 10 • STORIES .1
EXTERIOR WALL ROOF
COVERING - • COVERING - • ; . . -.
USE OF BUILDING AND WORK TO BE PERFORMED
residence - 2503 sq.ft.
egress - 483 sq_$t_ >°4- 3
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION /�
SIGNATURE OF PERMIT FEE $ 4/
PERM ITTEF 0 i �e'(�1�' nst o. ^72. n
�fi ����+ \ $ 25 235.00 PLAN CHECK $ �C oC5-0
AUTHORIZED AGEN
y� l�y 1
go
p
I\\\\\\iii, TOTAL FEE / y
FEE RECEIVED
0 • "15 71 fEtl
10 1964
' COSTA MESA BOIL ING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 917 COSTA MESA.CALIFORNIA
` CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYP PRINT BUILDING
For Office Use Only
BUILDING '..G O..Z 1, Jl
ADDRESS o�yRECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA
iige�(/ �`7` DATE RECEIV ATE ISSUED/
OWNER \�- y�PD�.G.•1� �o �p _ 0-`'`i
ADDRESS ��\-L� a-^^ AD OREICS / lJ /Z art 0,6FIRE
CITY S'.�+ T TEL.
ZONE E / �f le�GROUP `S •
ARCHITECT i APPROVE 1:1717-rte DATE Z"id
OR ENGINEER NO.
ZONING
ADDRESS5:\?
tie,
Z I BUILDING CONTRACTOR\ A: " i- �-a�y
%
C
LEGAL �� �'tQ'o
ADDRESS ` -0--1 -L- �J'-1\\t& O+a
DESCRIPTION R-�. / �a VV
CITY -715r.'" %-"O.... F�1"L1 A.P.NO. /3(7 — 2:3-3 — /Ip
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.TNO.L-a n•-CN C0N NO. SG.-S—1-1QCn 30'TOSIDE ft REAR F.L.
EAVES
SIZE OF LOT I NNO.OF OW ON LOTS, ALLOWED (U.B.C.SEQUIREMENT)
YARDS APPROVED YARDS ROVED
BUILDING USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. ...CS (FROM C/L STREET)
SETBACK LINE FROM FRONT FT. FT.
CENTER OP STREET REAR YARD .,[
SIDE YARD LEFT I RIGHT • /
R.SIDE FT. FT. (
DESCRIPTION OF WORK L.SIDE FT. FT. G
NEW ALTERATION ADDITION REAR FT. FT.
IV II7 DISTANCE BET. BET.MAIN Fe
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLOCS.
BUILDING NO.OF VAR.IF DATE
SIZE ROOMS STORIES C.U.P.St APPROVEDEXTER
IOR WALL I APPROVED �COVERING COVERING e DATE OD 7/6".7-
C
/
_t BUILDING AND WORKT E��MD /49-
` ` i A
l \\la Kms: 1•4'P-.,— N
N�k. I\ ' -1%-o_P 01- Qa`---- SQ.FT. Y
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE z
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CIT RDINANCES AND STATE LAWS REGULATING VALUATION / ��CJ n
BUILDING CONST CTIOcy�' /T PERMIT FEE $�.L/Y
SIGNATURE OF N.
�S\ VO
PERMITTEE ` �J\ K
$ fo.0 G
O
AUTHORIZED AGENT
TOTAL FEE $