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HomeMy WebLinkAbout1777 SANTA ANA AVE - Building Permits 1 ADDRESS OFBUILMND: 1777 SANTA ANA AV uMT: CITY OF .COSTA MESA - BUILDING PERMIT _-__ -JWNEWSNAMEIFaU*11: BAY APARTMENT COMMUNITIES PERM NO: E 082874 ABDRESS 4340 STEVENS CREEK *275 SAN JOSE,CA 95129 PERMIT NO: E 082874 PLAN CHECK NO: N GOVT: N SUPP: N I APPL.MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ALT ARCHITECT OHENf91EER: MUSSER ARCHITECTS uc.No.: C15234 JOB DESCRIPTION SITE LIGHTS / BATH S KITCHEN REMODEL SQ FT: ARCH.OR ENG.'S ADDRESS: 151 KALMUS DR uw: D-103 C.M. CA 92626 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-1 / CONTRACTOWSNAME R W ELECTRIC INC 714 ) 631-4291 c0TRACroWSMMUNO 14818 MARQUARDT AVE COMMENTS : BLDGS : 10,C-5 C-6 ADDRE53: SANTA FE SPRINGS CA ue'•.:. 685218 *****�t�ERtRt+E�EitRERE�E**ftitRtstititlrRE******RERtfeit*itft�EAL•At*****iE�ESE** �ERs�tx*�EaE*********ttit+t*+ERti **** • i . i J WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby (ism under penal,,o perjury gal I am I' -.•under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 d the: -.mss and Proles:: -Code,and my r.• ,• in fug force and effect. CITY LIC.N .: 06 595 uc.ClAss: , -10 uc 'o.: 68i 18 , E : : li • /98 MAIN BUILDING ACCESSORY BUILDING V e. FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: 13- �' co — LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER ggg ILDER ECLARATION:I hereby elfin under penalty of rimy that I . exempt from the Contractors License Law for the followingasonfSedion Tans Busies,and Professions Code:Any city or county id,requires a permit lo construct,eller,improve, PARKING REQ: PROV: PARCEL : 42546217 ZNE: REF NO: demolish.or repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES> is licensed pursuant to the provision of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > y 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars[S5001). *********************************(iF**.******************************************* ❑ I,as owner of the phopenyormyempoyeeswith wages astheir sole compensation.will dothe work,and thestructure anolintended DEVELOPMENT S EeR V I C E S REQUIREMENTS or offered for sale(Section 7044,Business end Professions Code:The Contractors Welds ors License Law does not apply to an owner of properly who ds or improves thereon. such andwho does wok or or himselfherselfThrough hi or her own employees,provided the such ne improvements ere t intended or offered for sale.If.however,the building or improvemem is sold within me yeas of completion,the ZONING APPROVED BY -- DATE: owner builtler will have the burden d proving he ar she did not build or improve to the purpose of sale). - ❑ I.as ownerof the property.amesdu'i✓ycontradmgwith ecmaed contractors to conmmme°rajas(Section 7044.Business and BUILDING APPROVED BY : ,J LS DATE: e Professions Code:The Coat/Haanwaitc LicenseadoLaw does ml apply to owner of popnn License L buw). o imprwee theren end who ��� riF J l Professio t edit poe Co a mLicen s) dWrspply to the wner pr PertY w Law). _ _ ❑ I ern exempt under Section. B.AP.C.,ttisreason: APPLICATION ISSUED BY: DATE: ** owe, Owner LEGALIZATION:NF E-E', SUMMARY STRUCTURAL SEGMENT:N I do hereby cents that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505,25533.and 25534,and that l or any future building occupant will/will nal(circle one)need tocomply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit forconetnictin or modification from the Ar Quality Management District Residential construction applcatons are exempt from these provisions. PERMIT 251,00 Dale: Applicant: , 10% SMIP/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:thereby affirm under penalty of perjury one of the following declarations: ISSUE FEE 22/.40 o Ihave and wdmainsail aunilcaedconsent toself-insure for workers'compernetion,as •far bySarlion3700othe Labor BUILDING-DIV-> PERMIT ISSUE PLAN/CHECK TOTAL PAID DUE Code,line performance of the work l«whish this n permit is issued. TOTALS----> 25 . 00 22 . 00 0 . 00 47. 00 47. 00 . 00 rl thaws and oil,maiMaih workers'compensation insurance,as required by Section 3700 o ,tabor Coda,for the performance ol the X' work for which this penit is issued.My workers'compensation insurance carder and.: mber are: Carrier: SATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECtED : 47 . 00 OVER/SHORT : 00 Policy Number: 'Ilal4Sd7:li 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed A the pend is for• hundred dollars 1$1 •]or less.) 47 . 00 �,f/ ❑ I panty the in the performance o the work for h this permit is ad • I in em•icy any parson n any manner n as to become subject o the workers'compensation - of Calltnia. : ag r I e outs becoj: subject Io the workes' *************************************************************** **************** consosions 9ofSction3700ofthe .•. m , : :I hwhh ,• , INDIVIDUAL /FEE BREAKDOWN Data: ln APP - V TYPE . QTY DESCRIPTIO N.N. UNIT COST TOTAL COST Warning: Wiwi *stun°workeri ronpruationtowage IsunNWNl,and Ie!/clanemployer tocriminal awaitlaand civil tines u to one hundred thousand dollar(S100,000),In addition to the cost of compensation,damages as provIdsd for In I Section 3705 of the Labor Coda,,infant,andattomey's fen ELE _ 18 FIXTURES, LIGHTING 11' ST 20 EA. 1 . 00 18 . 00 CONSTRUCTION LENDIN.i GENCY: I hereby affirm under penalty of perjury that there is a construction ding agency t the ELE 5 _ _, RECEPT/OUTLET 41 ST 20 EA. 1 . 00 5 . 00 pedormame of the work far .ids,this pond i issued(Section 3097,CW.C). ELE __ 2 RECEPT/SWITCH _ • ', 44 ST 20 EA, 1 . 00 2 .00 LEND'R•-NAME: ENOF FEES LENDER- A.DRESS: I terry the I hove reed tit::•:loaand n ticn aate that the above information is coned.I agree to comply wdth all dry and county ordinances END reenterlating to: ildi .construction and hereby authorize representatives of this city to upon the above-mentioned property oinspect on I K WHITE 905-13-199711C:17 Ah/Eli].ea KW11:61-888621] . Print Name PERMIT 9X82874 %-..........%-.......... ' Data: Signora. . -vnVAppimnUConlracto (515148 W P) White-Building&Safety:Green-File;Canary-Apptc°M;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & SPA -APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or POIe 52. Pool & Equipment Location ' ' _ _, 2. Soil Pipe•Undrgrnd. _. - • 53. Steel Reinforcement i - 3- Electrical Condui_:Utility-Undrgrnd. • 54. Forms - 4. Electrical Conduit-i drgrnd. 55. Electrical Bonding - S. Steel Reinforcement,_ . 56. Rough Plumbing & Pressure Test - -6. Electrical'UFER di-rid. 57: APPROVAL TO COVER-GUNITE _ -- T. Footingsr 7 : 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 QECK -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 f1'Gas 0011 23. Gas Pipe-Rough & Test - - ' _ 72. Underground Flu>h 24. Roof Framing _-- - ' - - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. RoofSheathing 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat _ •-• _r 75. Dry Chemical 27. Frame and Flashing - - 76. Dry Standpipe 28. Lathing & Siding - - - 77. FIXED SYSTEM FINAL _ ' 29. Insulation , ` 73, FIRE PREY. FINAL - - - 30. Drywall Nailing .- _ • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ` - 79 FINAL INSPECTION - _ 32. Electrical Power Meter-Final n 80. FOOD CERTIFICATE ISSUED 33. Final Electric _ _ 311 V' Notes: --(rt. 7 ea_ a_f:ifts. 34. Final Heating& Air Conditioning_ - 35. Final Gas Pipe.Test . - ' _- - 36. Hood or_Canopy '. - - , ._ ' _ : '_y - 37. Final Fireplace - 1,Factory - 38. Final Plumbing - ,.. . `• . 39. Water Service-Final I ' c - 40. Gas Service-Final . - . . 41. Solar Dornestic•Finai - - • • -- ' 42. Backflow Preventer - - - - 43. Backflow Irrigation- " - _ , • 44. Landscape h'rigauop System- - - -' . 45. Sound Attenuation' - " - -' . _ • r 46. Handicap Regulations - - _ 47. FINAL STRUCTURE & BUILDING - _ 48. FINAL PLANNING, _ i 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - .- 51. CERTIFICATE OF OCCUPANCY - No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • • Clry OF COSTA MESA 'CONSTRUCTION PERMITeyelorol.J PERMIT NO v TRACT NO. LOT NO. UNIT NO._ non 5.a. ... 6444_ ' - S y 7 Project Address Applicant's Mailing 'ddre .0 i• /g. -�.._ '� - TYPE OF CONSTRUCTION ❑ NEW LIADD ❑ ALTERATION REPAIR 9(177 7/71 /R7 17,f111 TL • ' oqL S ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.94 Zone Owner's Name ' <–ter Phone 77�/ i /n� OESCRIPTIQN OFWORK/US OF BLDG f'••.-- •1.•– Address ry0/ / , C�sLC.._ 1 ,L4' ain, yaar / .r" ,sWS W • – S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT GRADING •/OUNDATION • STRUCTURAL T Front o Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear -- N Contractor's Nam- 4 �& /fie IF : • I. Phone 2- V///C El OTHER M �/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY e C .Right N Address(mailing) a TO "77 �s/4i'<t°Lit - to - STC% 03‘2C.13.4... CONSTRUCTION TYPE VALUATION$ S Left G City License No. — ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION I� Ping. Ref.# Parking Req./Provided E I hereby affirm 7 0 that I am licensedion under provisionsnCharterroi9 nsCode,(commencingRemarks: /� �` 1 ` r Planning Notes: 5 with section 7000) of Division 3 of the Business and Professions e, and 9 '1•\/�` my license is in full fOlce .n• effect. • T �+ License lass i e e No. • Dater Signature — �_ . 7 PLUMBING -FEES I _ WORKERS' COMPENSATION DE ARATION / Bar Sink Showers ELECTRICAL 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 (Sectio Backflow Preventer Service Sink -..y Automatic Washer Transformer ❑ 15-50 KW 3800, Lab. C.) �/0 70'piJn ' •• Policy No. Company Backflow Irrigation Sewer CapConstruction Pole Sub. ❑ 50+ KW . kkCertified copy is hereby furnished. Cerlifipp�copy is filed with the city Building Diviio�re Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps ' Date •/—I—Y 7 Applicant sq - - EXEMPTION FROM WORKERS'COMPENalON DEC ARATI N 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 1%-8 , Workers' Compensation Laws of California. - - . Date - Signature Floor Drains Swimmin. -ool w/Spa F.A.U. Inc.Sola 9-15 HP 016.15+ NOTICErlf,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urin. Fixtures • comply with such provisions or this permit shall be deemed revoked. M" wave CONSTRUCTION LENDING AGENCY Gas Service Outlets ..ater 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 Lender's Name _ _ Outlets Range Lender's Address. - Kitchen Sink Water Service - Switches • OWNER BUILDER DECLARATION Sign 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 / Laundry Trays Generator ❑ KW 05-15 KW Trash Com actor any structure, prior to its issuance,also requires the applicant for such permit ` P to file a signed statement that he/she Is licensed pursuant to the provisions ofi 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). LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $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 dues.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 ❑ Zoning Approved By ,f—� 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). /// 3/.y//�� • ❑.I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigera ' n System Application Issued By Date 7 !! 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 ❑ 0,000 BTU ❑100,000 BTU SUMM RV OF FEES builds or improves thereon;and who contracts for such projects with a con- COtractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ 0• SMTP $ s b proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ - 6, PERMIT ❑ 1 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG e Fire Dampers PLUMBING $ ISSUANCE • $ Date • Owner - _— Heating System& Ducti Registers PLAN CHECK ' 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 00,000 BT - ELECTRICAL $ GRADING $ information is correct. 1 agree to comply ith all city and county ordinances and state laws relating t• building cons ction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ zentatives of this city 8. e - upo• the abve-mentioned property for �/ Inspection purp• s. �e� MECHANICAL $ TOTAL FEE $ /'(•O� Signature ./`V '• Date�/'�T!'4,7 Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ 'Drivers' jffIse or S _•• �__. - _ CMF 0865-46,rev. 10/84 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 UFER Grnd. 57. APPROVAL TO COVER-G UNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 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 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 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 NgS-Y7 Con 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • i No. Date - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. , CITY OF:COSTAI1/1 ESA CONS RUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. /4/ ,7_,_a_,, / 0 , 2195—cf /S/ T�3 /;7 5074 3/31 /87 36pB0 TL Project Address - i . Applicant's Mailing •ddress . a♦� �'/�iff TYPE OF CONSTRUCTION ❑ NEW ❑ ADD L I ALTERATION REPAIR - ` /./� CI CONVERSION CI DEMOLISH CI OTHER A.P. # ' (Zone ;,Owner's Name •I. ♦ Phom . `/ DESCRIPTION OF WORK/U OF BLD, ./�' • v - - - s Address •,� i / £_ C.�J > z s/ �J� J _ �� S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE •F PERMIT "DI GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front O Address - / El TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • B Rear N Contractor's Nam- i la /f ' ♦ d •A 'hone' 7V �(/�� CI OTHER »» _ A — R - I Address(mailing) •� /• .:u.- vv ' // , PROJECT DESCRIPTION .SO. FT. OCCUPANCY a��/ C Right G /1 �J/ �/ • CONSTRUCTION TYPE VALUATION$ g Left • R City License Nb. [ 7[o G� ZONE GRADING CU.YDS: ACRE'S E LICENSED CONTRACTOR DECLARATION P Ping. Ref.# • Parking Req./Provided Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 4 • . Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and C I- S (,A ,1 �J'J �J T my license is in full for" a ieffect. %�%7 L�� S License la ense o. Date 0 Signature ��� • PLUMBING • I FEES - rs WORKERS'COMPENSATION DE �A RATION Bar Sink Showers' • ELECTRICAL FEES Q I hereby affirm that I have a certificate of consent to self-insure or a certificate - of Workers' Compensation Insurance, or a certified copy flier f (Seco Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW • Date Lab. CJ-2/O SSC `� Policy No. / ( Company l Q� .ru • Backflow Irrigation Sewer Cap0 50+KW ertified copy is-hereby furnished. Construction Pole Sub. _f Certified copy is filed with the city Buildin Divisio Bathtubs Sewer Connection - Cooking Unit Meter ❑up to 100 amps fV\`' Date /-y7 Applicant / EXEMP ON FRO WORKERS'COMPENSATION DE AF/AT N Clarifiers Solar Collect s Dishwasher Meter Dover 100 amps (Thissection need not be completed if the permit is for one hundred ($100) or . less). Dishwasher Solar Pi.'g Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for Which this permit is issued, I I shall not employ any person in any manner so as to become subject to te Drinking Fountains Sol. ank Fan Motors 00-1 01%-8 Workers' Compensation Laws of California. - _ Date Signature Floor Drains wimming Pool w/Spa F.A.U. Inc.Sol 9-15 HP 016-15+ -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 Fixtures M' owave - 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 g of the work :for which this permit is issued (Section 3097 Clv. C.) Lender's Name Interceptors Water Heater Outlets Range Lender's Address Kitchen Sink Water Service • OWNER BUILDER DECLARATION Switches /- Sign • . 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 Trash Compactor any structure, prior to its issuance, also requires the aplicant for such permit / to file a signed statement that he/she is licensed pursuant to the provisions of Roof D ns / ' 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). U 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 1,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 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 pletion,the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground • Building ApprovedBy Date�j rove for the purpose of sale). 3 J/�� 9 I, az owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date ) 1 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 000,000 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 the Contractor's License Law). I am aware thatBUILDING PERMIT $ 122'.61° SMIP $ ' S proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 y5tem Repair/Alteration PLAN CHECK $ I/, 7v Si) PERMIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# IIIII Fire Dampers PLUMBING $ ISSUANCE $ — Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 010 00 BTL • GRADING $ information is correct. I agree to comply w' h all city and county ordinances ELECTRICAL $ and state laws relating to building constr tion,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city t 'en r upon he above-mentioned property for inspection our o � . `� t/� (O aMECHANICAL $ TOTAL FEE $ • D Signature _ Date ia - Drivers' License or SS Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, D Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, E 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 DOiI 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 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 I 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation .t. t.- 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING •{-C:in L LO 48:Special Requirements Completed • '49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51.. CERTIFICATE OF OCCUPANCY , No. Date - N AHied © esinng [laboratories, Inc. 11 I ? MOBILE LAB. • SOIL • CONCRETE • STEEL • WELDING ": ' GENERAL OFFICE 1309 EAST FIRST STREET • SANTA ANA, CALIFORNIA • TELEPHONE Kimberly 7-8287 September 7, 1962 Job No . 62-274 REPORT ON GUNITE TESTS Job Name : Sherwood Forest Development #3 Job Location : 1777 Santa Ana , St . Costa Mesa, California Contractor: Tahitian Pools 1622 East 17th St . Santa Ana, California Engineer: F . Weaver Inspector: Charles E. Hyde Charles E. Hyde Lab No . : 152334 152334 Mark: 1777 1777 Location in Deepend - Deepend - $ 9 Structure: 24" from Top 24" from Ton /p Date Made : 8/8/62 8/8/62 qf(F Date Tested : 8/15/62 9/5/62 'Ca' 6‘..4(-, keg t Diameter: 6 x 12 6 .03 x 12 � 4/� -7JZ Area , Sq. In . : 28 .37 28.56 1 : gu°jCsy� "' � h Max Load : 55,270 52, 640 NIA��4fey� Compression BAt, Strength, PSI . : 1935 1843 "�'JE Design Strength: 2000 - "��JE Age at Test : 7 days 28 days Respectfully submitted, z, ALLIED TESTING LAB. , INC. By: eCir: iC :6E._ i% Charles E. Hyde Y President CEH: sk cc : City of Costa Mesa Tahitian Pools TESTING TO A. 5 T. 1.1.. A. A, 5. H. O. AND STATE HIGHWAY SPECIFICATIONS OWNER SHERWOOD FOREST DEV.#3 . . • DATE 2-5-62 JOB ADDRESS 1777 Santa Ana Ave. Units 132-115 BUILDING PERMIT NO.16219 GENERAL CONTRACTOR George D. Buccola VALUE $44,844.00 AP No. 117-202-36 LOT TRACT FIRE ZONE DESCRIPTION OF WORK 4 Unit Apt.Bld INSPECTIONS Signature DATE GROUP H TYPE V ZONE R4 Soil nL te. O76o.� SUBCONTRACTOR PERMITS ISSUED Gas � J' zfr` - DATE NUMBER !"/ Water Rough Corn. Refrig. D .Air Cond. ❑ f•-y Rough Heating J . y •�e�r ,_. t, i [L( 2 - ,./Rough Plumbing /VMS 4?6s�z 4r • -'; avi-.-ird s/ -4P-6a] .3 .TSa('/Aa.7.•-), Miscellaneous / ( prp��9 Prop.Swr.Line p'House Cote, ❑ S�Swr. [ �� �f b-�y 7yp �`7y4,ed,2{[„ GI r S/6(... e S Sprinkling System /'✓ Construction Pole / , '.f"-la-Cal', /., _/ C .-._,2Y_-:6. 1, — 14 /61,N Underground .0 Power "i F.,: , �'y7 . ftE-v 6-a 7- /?,P6, IJ IS Rough Wiring •• 0 �2,C. -F6 i c-c.cC/ ‘-/-61.--- /7$th 1 ro-mate.0 Trenches 0 Forms 0 Steel Rend. C C /PI- -3-0 -- --2.— Floor System ' in' = 3 — 6 .2— Bond Beam 0 Steel Reinforce❑ n Sheathing 47 .frn` (4 - y — C,y Frame and Flashing /,?j/n 3 Lathing — In [{ Out 11 m c'" 3--Z_3 -�Ze Plaster, brown coat nit— 9— g. C y Refrig. 0 Air Cond. 0 Final Healing, Final ,s Plumbing Fixtures, Final (� j.:1 i f'y Final Gas Test IE ,j, tO •''i:~ce(ea Electric Fixtures, Final V / Building, Final q ® �j A, i OCCUPANCY W J ((( MORA RI til_51A - ].fl 1 42 I 0 FEE RECEIVED ` ' 16219 iV JAN 221%2 • COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely ,,0¢//1 APPLICATION FOR PERMIT TYPE QR PRINT4y / / BUILDING BUILDING f 777`> ADDRESS COSTA MESA. CALIFORNIA For Office Use Only RECEIPT ND. PERMIT NO. OWNER Sherwood Forest Developers #3 R1� MAIL P.Y. RECHIVFp BY I DA IRECEI E�I N ! - - MDDRESS OX 1937 Virc Y 1/G 5'UL CITY Newport Beach NO`-PR 31240 BUILDING ADDRESS ARCHITECT Cared 5bni,th TEL ML 6-85 COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS 2043 Westcliff Dr. Newport Beh FIRE ZONE TYPE GROUP ji CONTRACTOR George D. Buccola APPROVED BY DATE ADDRESS 3700 Newport Blvd. ZONING J. ZONE�� I NO.OF 01„......-=. OF NEW CITY Newport Beach PLANSING STATE .TT NO. OR 3-1240 LEGAL �P�+�� LIC.NO. 171' 84 DEECRIPTIfjy��'-' o[ 1 2Y-J nob SIZE J�nL"/, J/, JO/ Q, I NOWOF ON LOTS None O 0 A.P.NO./I .J-�z -36 37-�3- 3( ,/ OF LOT/! (CGU ? C ({j USE OF YARDS EVES EXISTING BLDG. ' APPROVED ALLOWED SETBACK LINE FROM 4,0 E t,I x (CENTER LINE ST.1 �j� G CENTER OF STREET ^7 REAR YAR!}J`L�/�V FRONT 142 "ICS, i ff. IN. SY SIDE YARD I LEFT /� r I RIGHT ..J V F R.SIDE sr FT. t/.+, � �'/{--� IN. DESCRIPTION OF WORK "?"/FT. g ,IN. L.SIDE NEW I X II ALTERATION I II ADDITION I REAR 8c�r(n����J FF 0 Q IN. REPAIR I II MOVING I I DEMOLISH I BBYPROVED RTI- DATE )-9-6 z— BUILDING NO. OF e�'��[[�A� SIZE ROOMS STORIES �/ EXTERIOR WALL ROOF COVERING Stucco I COVERINGCOEIpositiOD p USE OF BUILDING AND WORK TO BE PERFORMED �� iin/i7 fi//PACT M CVr &D a y1 j I - //2 i,.3 114 /!o • I HEREBYACKNOVDGEAT I HA .; READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ANDPLY WITH STATE THATCITY T ABI OV SB CAO ETA.AND . REGULAREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. ALL BUILDING OONSTR ON T VALUATION / SIGNATURE i', PERMIT FEE $ (D 7 PERMITTEF $ �]" ��/ L/ PLAN CHECK $ 3a — r AUTHORIZED AGENT / / 6 0 N (TOTAL FEE $ u 17632 FE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT AUG 2 1962 P. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely CITY OFTA MESA PP P Y APPLICATION FOR PER TYPE OR PRINT BUILDING f//J BUILDING ADDRESS J 77, 'N"F�+-�� f"'v COSTA MESA. CALIFORNIA For Office Use Only //J' / RECEIPT NO. PERMITT NO. OWNER te__7v.p-04•-ree # , &3 2- MAIL //��,, /' 1 C IVSD By DATE RECEIVED DATE ISSUED ADDRESS] AG . •. • ,(�/jJG���-e/ 77 o ' rI I �J�i�)j'{��9��t-J--- 8-2, - 6 >- TEL. CITY , /1..E�C-(.�-�L /sCiP"� NO. ADDRESS / / 7 / /�YIC//F72 UCCA(+, i"t'y ARCHITECT �' TEL. OR ENGINEER wtBI t'') NO. COSTA MESA. CALIFORNIA -/�� FIRE CONTRA6 P "` .r/ ZONE TYPE ILS A GROUP(17/2.- L�� ! . CONTRALTO / .T yy ,gyp / APPROV ADDRESS /G 7' - IO / / Com' ZONING 1 /�/ �� IO NO.OF UEE OF NEW O CITY ''''S0-0--a "2^LN r-L/ I PLAN; Z BUILDING foul T3v STATE TEL. `` LEGAL 7•✓ �o�/��� erOMn ' -` LIC.NO. NO. f•[..` 7�47DESCRIPTIONr .tom.( SIZE �,�`//// I NO. OF SLOGS. 1/7 a01 - -33 OF LOT C'-^t NOW ON LOTJ A.P.NO. USE OF v A�J � YARDS EVES EXISTING BLDG. F�7/t • APPROVED ALLOWED SETBACK UNE FROM j` •VVVV,,,, ` • FRONT(CENTE5' LINE Sr.l FT. oy- IN. CENTER OF STREET V / REAR YARD J �l8 L!i!{y�¢n SIDE YARD I LEFT 7.33 I T - I RIGHT g • - R.SIDE (J FT. IN. DESCRIPTION OF WORK2 , NEW I ',II(� L.SIDE s r FT. CKS, IN. - II ALT-ERATION I II ADDITION I REAR S— FT. IN. REPAIR I II MOVING I II DEMOLISH I APPROVED /I / Cy BY DATE DATE /L c, S ZE DIN//J`� `'i y ROOMS STORIES HOLD FOR SPECK Rt.QU(I(FML i,I J EXTERIOR WALL I ROOF ••••/� ��77 COVERING COVERING //O -z. e 6/y it 7 fore Q/-4_ USE OF BUILDING AND WORK TO BE PERFORMED encla-al •.4i7T76 • -c4 Ye // Cr/ /i f--e7 //a.— //a. .L /G4 q 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 9 '7 SIGNATU E OF zPERMIT FEE $ [ PERMITTE a a L 5 PLAN CHECK S V. / 41-. A' I AUTHORIZED AG4NT �� y�y -1-... --�. TOTAL FEE $ /(I l D LL