HomeMy WebLinkAbout1857 Placentia Ave - Building PermitsPir
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
Jr?IOF COSTA MESA CONSTRUCTION PERMIT PEryry I NgTRACT NO. LOT NO. UNIT NO.
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Project Address A'«
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Applicant's Mailin Address, f, O X BOrc 7-i 5.6 ai+Agal>t TYPE OF CONSTRUCTION H NEW H ADD H ALTERATION H REPAIR
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Owner's Name /` /CA ArOf ,Scaler/
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Phone DESCRIPTION OF WORK/USE OF BLDG.
Address
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Arch/Eng. License No. ' TYPE OF PERMIT GRADING FOUNDATION m STRUCTURAL ' ' ' T Front; O
Address
TENANT ELECTRICAL PLUMBING MECHANICAL - B Rear
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Contractor's Name' v^ ' J,/m sT "P Phone 9 1
OTHER A I
p PROJECT DESCRIPTION SQ. FT. _ OCCUPANCY
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Address(mailing) 7 n C }
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CONSTRUCTION TYPE VALUATION $ d Q-C"t•• •, g Left
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City.License No. ZONE GRADING CU.YDS. ACRES C'
LICENSED CONTRACTOR DECLARATION
Ping. Ref. # Parking;Req./Provided
I herebyaffirm that I am licensed under provisions of Charter 9 (commencing 4
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I
Remarks: i I • Planning Notes:M
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with section 7000) of Division 3 of the Business and Professions Code,and
my license is in full force and effect. p
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License Class - E Lic se Nos7 OS' a
Date YGPY/(Jy- Signature ' PLUMBING ' I FEES_
WORKERS'CO MP,ENSATION D ARATION Bar Sink • Showers t-' ELECTRICAL - F ES
hereby affirm that I have a cert tate of consent to self-insure or a certificate
La of workers' Compensation Insurance„or a certified copy thereof (Section I
3eo0, Lao. C c
Backflow Prevenler- - Service Sink Automatic Washer Transformer 0 15-50 KW
Policy No, 60>`yJ2 Company ren-••P-.
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d - Backflow Irrigation
i
Sewer Cap ' D Construction Pole Sub.
50+KW
Certified copy is hereby furnished.
ertif ie/a cop is filed with the,city B ing ivision./9 IIx I
Bathtubs Sewer Connection Cooking Unit Meter up to 100 amps
Date /GI xi rt
I Applicant 7
EXEMPT
on
M WORKE RS'ICOM SATION DECLARATION Clarifiers SOIar Collectors I Dishwasher Meter Dover amps
This section need not be-completed if permit is for one hundred ($100)or"
Dishwasher ' less). Solar Piping, Dryers Gas Electric Sub;Panel I I
I certify that in the performance of the work for which this permit is issued,to1shallnotemployanypersoninanymannersoastobecomesubjecttothe Drinking Fountains Solar Tank Fan I Motors 0-1 HP 1%-6
Workers' Compensation,Laws of California.
Date Signature Floor Drains
i
Swimming Pool w/Spa F.A.U. Inc.Solar 9,15 HP 16-15+
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- L Fixtures f- Microwave -
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet - Device Boxes
I hereby affirm that there is a construction lending agency for the performance
I Pole Light
of the work for which this permit is issued (Section_3097 Civ. C.) Interceptors Water Heater OutletsRangeLender'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. ' Garbage Dis Osal
following reason (Section 7031.5 Business and Professional Code: Any city or
9 p Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair, P-Trap -
any'structure, prior to its issuance, also requires the applicant for such permit I Generator 00-5 KW 05-15 KW Trash Compactor
to file a signed statement'that he/she Is licensed pursuant to the provisions of
ROOfDrainstheContractor'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).
U 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 who does suchworkhimself/herself or through his or her own
Boiler Hood or Type 0
DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for
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
rove for the purpose of sale). 177-
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date/
0-- 9,/
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 00-100,000 BTU 100,000 BTUSUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- J
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration
I
BUI LDING PERMIT • $ /7.5-0, SMIP
proof of their Worker's Compensation insurance should be provided to me.
PLAN CHECK
r'
PERMIT
0 I am.exem pt under Section B.& P. C.for this reason Firepl/Fact.Blt. ICBG#
PLUMBING oA .O 0 ISSUANCE $
Date Owner Heating System&Ducting PLAN CHECK 25% $
ENERGY P.C. $ .
I hereby certify that I have read this application and state that the above - 0-100,000 BTU 0100,000 BT GRADING $
information is correct. I agree to c•mply with all city and county ordinances ELECTRICAL
and state laws elating to bud• onstruction, and hereby authorize repre-
sentatives of ,is city to pan the above-mentioned y property for 1¢
inspection p it! . MECHANICAL 1L. LG/
Signature ., Date"4434.'4>r TOTAL FEE $
Drivers' Li Arse or SS# _
Reinspection Fee 15 Issue Fee . 3 PLAN CHECK 25% $ 3 •(f U \
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
CONSTRUCTION AND PLANNING -
POOL&SPA
APPROVALS Permit#
Date Inspector
APPROVALS Permit#
Date Inspector
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 COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. WaterPipe-Undrgrnd. ' 1
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 t--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 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 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 -- j 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
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
43. Backflow Irrigation „- .
44. -Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUILDING //
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48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF, OCCUPANCY
No. Date