HomeMy WebLinkAbout1555 SANTA ANA AVE - Building Permits Applicant
��Rottofill in all spaces except those within heavy border lines and sign all appropriate declarations. -- —— '-
'F COSTA MESA CONSTRUCTION 'PERMIT - PE11/JY1-.5/� .L� TRACT NO. LOT NO. UNIT NO.
_ .lett Address 1555 Santa Ana Ave. , C.M. •.J T / ff � ��c��11
Applicant's Mailing Address 126 Commercial Way. C.M. 92627 TYPE OF CONSTRUCTION LJ NEW ]UU ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p # Zone
Owner's Name Ri 1 eeen D1nwiddier Phone 645-2423 9 SCR T ON OF WORK/ SE OF BLDG. Remove gravel roof, apply
Address 431 Glouchester, C.M. 92627 CLASS A fiberglass shingles over 15# felt. New metal: s Main Building: Accessory Building:
TYPE OF PERMIT LI GRADING H FOUNDATION ❑ STRUCTURAL E Front Z
Arch/Eng. - License No. T Q
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's NampCrank Bros. Roofing CO-Phone 548-5569 ID OTHER C Right N
126 Cnf11I11Prri al Way C.M 92627 PROJECT DESCRIPTION SQ. FT. 1• 700 OCCUPANCY Single _ N
Address(mailing) Y, CON ST RUCTION TYPE___recidenti al VALUATION$ 1 ,931 .00 s Left
City License No. 005993ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E
I Q
hereby affirm 7 that I am licensedion under provisionsBusnCharter i ns(commencing Remarks: Planning Notes: M
with section ]000) of Division 3 of the Business and Professions Code and
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my license is in full force and efj ct. S
License Classrn, ``�J Lit•,. N•../1" r6
-
Date 7/20 Signature �ti .. iris, - PLUMBING I FEES
WORKERS'COMPENSATION ARATION Bar Sink Showers ELECTRICAL FEES
hereby affirm that I have ace cafe of consent to self-insure or a certificate
Workers' Compensation In rance, or a certified copy thereof (Section Backflow Preventer Service Sink
00, Lab. Automatic Washer Transformer 0 15-50 KW
�2�5 224-88 State Fund 0 50+KW
Policy No. Comp 4r1 Backflow Irrigation Sewer Cap Construction Pole Sub.
® Certified copy is hereby furnished.
Certif76,o(jyis filed with the city • g tuts' /204:2 Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date //LV/o0 Applicant
EXEMPTION FROM WORKERS'CO ENSATION 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❑0.1 HP ❑1'h-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 01615+
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
comply with such provisions or this permit shall be deemed revoked. - Microwave
CONSTRUCTION LENDING AGENCY 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 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 Tray 5 1
any structure, prior to its issuance, also requires the applicant for such permit 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 '
.refrom and the basis for the alleged exemption. Any violation of Section
:1.5 'by any applicant for a permit subjects the applicant to a civil
,atty 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,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 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 ❑
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
prove 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 the pf ope).
❑ I, as owner ct project am exclusively contracting ing with licensedioncon- Duct-Structural Refrigeration System Application Issued By Dat
hetors constructthe project (Sections apply to
Business and of property
Code:
The Contractor's License Law does not to an owner withhta who Duct-Ventilating ❑0100,000 BTU 0100,000 BTU SUMpr)ggV FEES x
builds or improves thereon,to and who contractsfor such w) Iprojects a con- _ LTT//�b , SU
tractor licenseeapursuantrkr'sothe Contractor'stioninsurance
License be I aware thatBUILDING PERMIT $ t SMTP $
proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple❑ System Repair/Alteration
PLAN CHECK $ PERMIT
0 I.am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this applin an/ state that the above CIO-100,000 BTU ❑100,0008711• • ELECTRICAL $ GRADING $
information is co t. I agree to comply wi/ II cit /•nd county ordinances
and state laws r ng to building c• str ion, an, ereby authorize repre-
sentatives of t it to enter 4n e b• e ..entioned property for
•
y� MECHANICAL S TOTAL FEE $
inspection pure• I VS�O
Signature — Date ']/20/f)f; Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' Licor SS# — ,_
X
—0865-46,IP' 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00009925-00009926 TOT 45.50
I
CONSTRUCTION ANPLANNING POOL & SPA
D
A PRO VALS Permit# Date Inspector Date Inspector
• APPR VALS Permit#
1)Temporary Electrical Service or Pole 52. Poo & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Ste I Reinforcement
_{ 3. Electrical Conduit Utility-Undrgrnd. 54. Fo ms r
4. Electrical Conduit-Undrgrnd. 55. EI ctrical Bonding
< 5. Steel Reinforcement 56. ugh Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. PPROVAL TO COVER-GUNITE
7. Footings / 58. Electrical Conduit-Undrgrnd.
8. Foundation 59 Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Und?grnd. 6 . Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System . APPROVAL TO DECK
11. Property Sewer Line & House Connection /2. 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 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.
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Electric Notes: 7`•�
34. Final Heating & Air Conditioning .J,
35. Final Gas Pipe-Test '
36. Hood or Canopy _
37. Final Factory Fireplace
I
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43..8ackflow Irrigation
44. Landscape Irrigation System i - '
45:1Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUILDING 5,L.4P(.I
48:'Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date ?ill
OWNER COFFM4AN, HENRY DATE 10-21-58 _
JOB ADDRESS 1555 Santa Aria BUILDING PERMIT NO. 7tl60
GENERAL CONTRACTOR Romar Builders VALUE $ 9.29li.00
11A7P.Tva-l7 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res. & Gar.
r `up I & o TYPE V ZONE PLAN NO.
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Trenches i#44 Forms t•-""" Steel /'/j/ sv
Floor Sys tm '
Steel Reinforce, Chimney Re-Rod
Be m .,:.., 1 %L-- 0//41-,TP-
Frame
///41-,(-
Frame and Flashing �/ - //
Lathing, In Out /// Z 3 ii
Plaster, brown coat 44'7.]-- /1//rf a
Underground soil -c W/G Pipe Tat,fkr +/-/9-4-ti
Top Out //%racy'
Furnace L W I1'/Y-r /it -` /"2 r 2-7-67. /D_26--,re /G 3 3 7 7 I.
Gas Vents �Y1
Rough Plumbing— A 14, //-/Q-if� //,eT Tre /P 2.37 /l0 3 `a 7
Cesspool Septic Tank � y�
Prop. Swr. Illicit_Hou ''Con. St. Swr. ///,(1,-t t &' JO- ' 14/)-9 I r)-19 n��
Sprinkling System (� 'I
Heating Final G// I`29-4'v • \\
I_'<CT,Zling Fixtures, Final /J.L , /- PQ: 4Q \
I as`it Gas Test /fr /J_pt/ /. 29.449 i M
Construction Pole I �1
Underground Power
Rough Wiring t).:-- i/-lt //9
f.' - . X //-7 v
-5e 7vv `J til
Fixtures, Final -j ..7 .1-1-J7 _ i
OCCUPANCY I
Form 210-5M-1-57 7860
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COSTA MESA BUILDING DEPARTMENT u 07 �� t 1A £
P.O. BOX 317
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING X,��� a A�� BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
/� RECEIPT NO. PERMIT NO.
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OWNER rJC`MlaeV 7d' 6 D
MAIL �y �; R I�VS/D BY DATE RECEIVED DATE ISSUED p
ADDRESS �.7 / �/Y/I/1'7C] AVA g7Ci /O -��I�Y ,® -.'�/-.SO
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TEL. BUILDING
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CITY ./Q NO. ADDRESS
I
ORCHGENE LIC.
OR ENGINEER / NO. COSTA MESA. CALIFORNIA
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ADDRESS -/ � �11/ FIRE
ZONE
{ CI LIC. q 20NE • PLANS TYPE GRO/UP
CONTRACT MA��'LJ IcJ�.3'. 0 pa 6x O .. V -XY
��mm �//q/"J '� TEL [ APPROVE• /��
ADDRESaSea9 A.e.�la%j4cI �t� 1t NO!Sr.-°3,. BY Sr.,. E DATE 1e It _s
DESCRIPTION LOT sail �BILOCK •jI J • CORRECTIONS EE7�f){1'� ■^, ti
A.P.NO. I, , J i2 J7 ® a OV e .
SIZE ` NO.or ELOCG. l 18 :J 8J
OF LOT ��^ �Q NOW ON LOT a. CGSTA MESA
USE OF C11Y Or�
EXISTING BLDG. 171.A/.N' -. PI,At N]hG DEPT.
i� _r.
SETBACK LINEFROM SUBJECT TO BLDG. UEI'I. RE
CENTER OF STREET dim 'EAR Y.RD
SIDE YARD .1.�/ra.�J.Gi1T/fnJ' LETT-. `JL•'V [s4S4
, DATILODE�S/C}RIPTION OF WORKCt�-
/ALTERATION ADDITION
•
REPAIR MOVING DEMOLISH
BUILDING , of aa, NO.OF
SIZE p/l) ROOMS STORIES
EXTERIOR WALL ROOF
COVERING TT COVERING {
BUILDIINGEW O i .e.6.&OH in. C/6/.,
r.'.S� it,a 30 Arr.. cry V _
I HEREBY ACKNOWLEDGE .TTHHAAyTT yII HA'VEE(RE`ADD THI`Sv`A�PPLLICATION AND
STATE THAT THE ABOVE InOM AR i tJ4WERSdNC.WITH ALL
CITY ORDINANCES AND STATGI .VS BLGLLi'.VJC BYI QbIO CONSTRUC.
TION. L.CCJOYSTIYAL'YMYE 'A,, CALIF. VALUATION
PERMIT FEE Sc7,1 V. T:)
SIGNATURE OF PMtcNE LI. 8.9..88
PERMITTEE ' �f��
s %.29 VOW PLAN CHECK $/&, VV
AUTHORIZED A73 �7'� TOTAL FEE 5134 . ,'"E