HomeMy WebLinkAbout2215 SANTA ANA AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 84L9_ 9/19/84 r - PERMIT O. TRACT NO. LOT NO. UNIT NO. - I vein `•
/ JCITYOF'COSTAMESA CONSTRUCTION PERMIT �� 3 I '
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r TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION U REPAIR
Applicant's Mailing Address 3'20 7..poi e@ Audi _
El CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#. Zone
Owner's Name /Pin N/mss �j)feI.livnT Phone s, 7-n DESCRIPTION OF WORK/USE OF BLDG.
Address t-Z15' Jawf� 4-O• Woe- S Main Building: Accessory Building:
TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL E Front Z
Arch/Eng. License No. T O
Address /// �^ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear • N
/1 i) fl $je/T/•y/ Phone Zy/-/(1�
CI OTHER A Right • I
Contractor's Name N
• Address(mailing)- 320204.1rdt ALG PROJECT DESCRIPTION 5Q. FT. OCCUPANCY K
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CONSTRUCTION TYPE VALUATION$ S Left • R
City License No. ZONE GRADING CU.YDS. ACRES - -
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes: • M
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. e • T
License Class /may-L�C¢nSyONi�QB] • $•
Date -IY�F Z Signature /�:e/'j /Jrid� PLUMBING FEESI.
WORKERS'COMPENSATION DECLARATION 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 (Section Backflow Preventer Service Sink
3800, Lab. C.) - Automatic Washer - Transformer 0 15.50 KW
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. • _Bathtubs Sewer Connection Cooking Unit •v 'Meter ❑up to 100 amps 5 cc
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - Dishwasher • Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). Dishwasher •• Solar Piping • - Dryers ❑Gas ❑Electric ✓ Sub Panel
I certify that in the performance of the work for which this permit is issued, I — —
shall not employ any person in any manner so as to become subject to the ' Drinking Fountains Solar Tank . ' - . - Fan
Workers' ComPy ation Laws of Califor9'W. Q /. r1 Motors ❑0-1 HP ❑t Ya-B
Date 7 1 ,rn Signature tLrit. Floor Drains Swimming Pool w/Spa e• F.A.U. .
09-15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to the - -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • Fixtures •
Microwave
comply with such provisions or this permit shall be deemed revoked:
CONSTRUCTION LENDING 'AGENCY - Gas Service Outlets Water Closet Device Boxes • Pole Light
I hereby affirm that there is a construction lending agency for the performance -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name '
Lender's Address - Kitchen Sink - Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Ti-ap _ - - .. Generator ❑D-5 KW ❑5-1$KW Trash Compactor
any structure, prior to its Issuance, also requires the applicant for such permit - ' r - - - ' - ' -
•
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 -
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). •
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 $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
pletion, the owner will have the burden of proving he/she did not build or MI- Duct-Under Ground Building Approved By Date
orove for the purpose of sale). ,(
I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By `Q}_1 Dat
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 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 that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ lam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ •
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 ❑0100,000 BTU 0100,000 BTL $ �3 'L� GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM ' $
sentatives of this city to enter upon the above-mentioned property for
inspection purposes //, a //'' MECHANICAL $ CO
Signature IN/f. £.. S Date ,P-•lR'in TOTAL FEE $ I 5I'
Drivers' License or 55 7F Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
rONaTRUCTION AND PLANNING POOL& SPA
KPPRDVALS Permit# Date Inspector. APPROVALS Permit# Date Inspector
. temporary Electrical Service or Pole gl. 52. Pool & Equipment Location
2.7 Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3.,Elechical Conduit Utility:Undrgrnd. 54. Forms
4.-ElectFical Conduit-Undrgrnd. 55. Electrical Bonding
-5. Steel Reinforcement- 56. Rough Plumbing & Pressure Test
6:'ElectricalUFERGrnd- 57. APPROVAL TO COVER-GUNITE '
7:-Footings. 58. Electrical Conduit-Undrgrnd.
B. .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 & AirConditioning 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 9/ LL_ 80. FOOD CERTIFICATE ISSUED
33. Final Electric Q sit eta Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
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38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final • -
42. Backflow Preventer r�'
43. Backflow Irrigation .
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations , I
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed •
49. Electric Release to Edison
. 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. • Date
COUNTY OF ORANGE D 2:••••••BUILDING DEPT.- Permit No _--..
636 No.Broadway
Santa Ana,California Application for Building Permit ,
Phone:Kl 2-6211 AND FOR A
Certificate of Use and Occupancy Date A-74,,-- ///p //J�/
I. OWNER'S NAME F'!"/• ._ (� `1rj 0 V PHONE- J-�'il J S
MAILING ADDRESS 02.2. O/ v A-'te51 /PAPA( CITY
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Name Name 1NNFR•
(Architect or Engineer) (Contractor) ,�I
Address Address 5 1. o / CfAa s.s d �y/Q,vvE
City City -
State State
Lic. No Phone Lic. No....6 / 92 2 Phone_°, r .7--
PROPOSED
PROPOSED USE S/€7 r.4'c. 4 ,9 /7 c Ai 6719,-.4 c,c
2. JOB LOCATION 01caA, c-& '7,c "Ai %rte 0°fes"' �dt#
(House No.) / (Name of Street) (Town or School District)
3. LEGAL DESCRIPTION: Lot -p2-C:[.. ziEe Block Tract J re' 144± e
(Metes and Bounds Description—Use reverse side o form)
4. CORNER LOT ( ) INTERIOR LOT ( )( ) THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OF BLDG •3&0 ic_git' AREA- 10-43 SIZE OF LOT- /9J7c 390 AREA- r6' D 0
6. HEIGHT OF BLDG • i3 r /CEILING HEIGHT- I NO. OF STORIES
.r
7. NO. FAMILIES / Size of Smallest Bedroom- /O X /s.3 Size of Kitchen I'r X /3 /---
8. EXTERIOR WALL CONSTRUCTION- -5-7/Uca o INTERIOR WALL COVERING P%J"-Cr
(Frame, Stucco, Etc.) / (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Street 4'4/
Nearest Side Yard 7 Rear Yard.... .tf.0 Distance in Feet Between Bldgs. on Same Lot -7-1/61/2 e--
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
n a11. For (a) Footing: Width •/`/ Depth in Ground / 7-- Width of Wall G
Accessory
Bldgs. and
0
iv
f
Similar (b) Size of Studs- 2 7 T Spacing .4 "CC Material of Floor...r...72:/i ,40.- # Dsti(.
Structures: r p / i'
(c) Size of Floor Joists- 2 X 4 Spacing /Sr "CC
r
(d) Size of Rafters Spacing "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ 2 co°' b 0
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLIC LERETO. /
Signed:.. .. . _
Plans Filed- C / / ` 5— ? Owner)
By•
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: , LLLL��-� C�KING BY `
Bldg. Permit $ /C� r-_ T GROUP -Z"211.1„7"
`� 7/ APPLICATION HEALTH t
�
Plan Check - $ -3- -TYPE ZONINGG �/,
C. FIRE
Total - $ L� MAP C ,� PLANS AND MARSHAL
Receipt No. - .._._..�... L _ _ SPEC'S STATE
Paid to - - A Cs t -' SHEET NO C CORRECTIONS ENGINEER .v
Date -1— / il - 17_/. VERIFIED CAL
,,,„r
PERMIT.Loa a' COUNc' OUIIDING
q / /'�!� IN P-CTOR
DATE �J / / - �r �, �n-
t i .
5M-2-51
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METES AND BOUNDS DESCRIPTION: S G(,/L ci e 0-' S rt I Co S a r-' At Ei� •
/7^`1' o •S, F. ,3 3 a ,, y° oC 44, 02.9*
1�0 2,0 3'0 4,0 _ 510 610
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