HomeMy WebLinkAbout2176 SANTA ANA AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
Ot1COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
'pct Address 2176 Santa Ana Ave. , C.M. 92627 :3 4 g 2S' •
plicant's Mailing Address 126 Commercial , G.M. 92627 TYPE OF CONSTRUCTION ❑ NEW CJ ADD ALTERATION U REPAIR
Robert Walker Phone 642-7681 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER .
-.I Zone
Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Remove existing, instal! '
Address 2776 Santa Ana Ave. , C.M. 92627 1-rosin, 1-28# - i is II. • II I . -el S Main Building: Accessory Building: Z
Arch/Eng. License No. TYPE OF PERMIT GRADING El FOUNDATION El STRUCTURAL E Front 0
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N
Contractor's Name Crank Bros. Roofing Phone 548-5569 El OTHER C Right N
Address(mailing) 126 Commercial Way, C.M. 92627 PROJECT DESCRIPTION SQ. FT. 3,b00 OCCUPANCY 8O%QO Sgt. G
005993 CONSTRUCTION TYPE residential VALUATIONS 6.100.00 $ Left
City License No. ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Q Planning Notes: Ni
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full f•rc- .nd effect. T
L Cenjp.ClasS — e , License N. A-4867 '_ $
Date Jj�Q•- Signature v - _ /� PLUMBING I FEES
`"•'R ERS'COMPENSATION DEC - •TION Bar Sink Showers ELECTRICAL FEES
eby affirm that I have a caroti•: of consent to self-insure or a certificate
.Yorkers' Compensation Ins e, or a certified copy thereof (Section Backflow Preventer Service Sink
3400, Lab. C'1/49/224-88
Automatic Washer Transformer 0 15-50 KW
Policy No. �A5 274-A8 Company State Fund Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
Certified copy is hereby furnished.
Cele-f'Rited cyp is fi lth the city��, l Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date
red
0� ApplicantOMPEs/ j �: s
E%E TION FROM[•be RKERS'COMPENSATION DECLARA Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred 00) or
less). Dishwasher Solar Piping Dryers OGas ❑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 00-1 HP ❑1ids-S
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa ` �_F.A.U. Inc. lar 09-15 HP 016-15+
NOTICE: If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwithFloor Sinks /Urinal Fixtures icrowave
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 Civ. C.) Interceptors Water Heater Outlets
Lender's Name Range
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 a Garbo9 Disposal osal
following reason (Section 7031.5 Business and Professional Code: Any city or Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator
any structure, prior to its issuance, also requires the applicant for such permit 170-5 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
vision 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
31.5 by any applicant for a permit subjects the applicant to a civil _
penalty of not more than five hundred dollars($500). 3
1:1I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $
compensation, will do the work, and the structure is not intended or offered -- Reinspection Fee f $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 I I El Zoning Approved By Date
pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved B - Date
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ,—..—._41111.41111/4.:..........__...—....... Oat: 1 in 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 0-100,000 BTU ❑100,000 BTU 5 ' ARV 0• FEE 4
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 BUILDING PERMIT $ ?r,'0"-- SMTP § ' 5/9
Exhaust System ❑ Multiple System Repair/Alteration t
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK S - PERMIT
0 I am exempt under Section B.8. P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ ISSUANCE $
g System Date Owner & Ducting Registers PLAN CHECK 25% 5 ENERGY P.C. $
I hereby certify that I have read this apps' ation a , state that the above 00-100,000 BTU 0100,000 BTUGRADING $
information s correct. I agree to comply all cit and county ordinances ELECTRICAL §
and state la le, relating to building cons ion, am hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of\his city to ente upo, abor-mentioned roperty for
inspection pur•'s , '/ r •,�(�, MECHANICAL $ TOTAL FEE $ /%y°'SU
Signature eta (-.0.
/ - .1f Date /6 O
Driverstse or SS � — l Reinspection Fee §15 Issue Fee $ 3 PLAN CHECK 25% $
_in •
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CMF 0865 rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00011692-00011693 TUT 90.50
UATr: DR/in/R2 T7Mrs in:17
CONSTRUCTION AND•PLANNING POOL &SPA
�• rDate Inspector Date Inspector
APPROVALS Permit t APPROVALS Permit# -
1.:1-emporary 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 - l' 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd\, i % 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor Sys'tem 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. Backf low Irrigation ,
44. Landscape Irrigation System
45. Sound Attenuation
46: Handicap Regulations
47. FINAL STRUCTURE & BUILDING /�q,/0
48. Special Requirements Completed ` !` .
49. Electric Release to Edison
r
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -
No. Date