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HomeMy WebLinkAbout2489 SANTA ANA AVE - Building Permits 341• Mss, CITY OF COSTA MESA _ ' ik BUILDING DIVISION PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT �• PERMIT P99-00617 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2489 SANTA ANA AV Status: ISSUED Suite No Applied: 10/27/1999 Issued: 10/27/1999 Vicinity: Parcel Nunmber: 43933322 ISSUED BY: G4-bo.lZLF�i Applicant: NOCK,RON Address: 11612 KNOTT ST CA Phone: (714) 895-1246 GARDEN GROVE Zip: 92841 Owner: BOLANIS, LILLIAN M Address 2489 SANTA ANA AVE Phone: COSTA MESA,CA Zip: 92627 Contractor: NOCK PLUMBING Address: 11612 KNOTT ST CA Phone: (714) 895-1246 GARDEN GROVE Zip: 92841 License: 707775 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT WATER HEATER. FEE SUMMARY AMT QTY AMT QTY ' AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub 50.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) 50.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units 50.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain SD.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00. 0 VIOLATION $0.00 Gas Service 50.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) 50.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) 50.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. • INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS . WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I hand will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the rk for which this permit is issued. ia I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insura{'ce carrierandpoli umber are: �+ �� �-7p / / `�y/� Carrier: ext ( J (�/ Policy Number:A koc-4 / C 3 '1" ( 0 / (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Calif la,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision 3 Applicant Signature: J Date: / � '- L$ —C, WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed u py[�jvisl'Qis-Qf ha (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# U / / Class# r,3 4 Contractor's Signature: tNy- Date: /O- 2-7 c, S CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER=BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,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 is licensed pursuant to the provisions 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.Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): o I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the properly, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release nr threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a_aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? PI Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ' 'nature Of Legal Owner(s) /o ,_Deja , __c 5 - And/Ort orized Applic' Date CODE r INSPECTIONTYPE CLAN IHRTIALS CODE INSPECTION TYPE PAH INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing is-i 3 -79 t 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. GTY OF COSTA MESA CONSTRUCTION PERMIT P MIT NO. TRACT NO. LOT NO. UNIT NO. 29't9 Sc,,lc IA.c /i.. % �� b • • 2382 12/32/87 280b0 TL Project Address 11�� Applicant's Mailing Address 7925- _ Ae;.#. Sr) •� TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR r p ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,p_# - I Zone • Owner's Name Ars .fes C/a'r^ r • Phone 65'6 $3 'DESCRIPTION OF WORjj��/tJSE OF BLDG. F��+r���-� s/"^'S��� oma^ . Address `��E • o^ve'/a .-. .30 Nr/ our., oAu /�en 4-00 v. 4 • S Main Building: Accessory Building: , EZ ' Arch/Eng. License No. TYPE OF PERMIT . GRADING . FOUNDATION 111 STRUCTURAL T Front O Address 0 TENANT ❑ ELECTRICALo ❑ PLUMBING ❑ MECHANICAL B Rear N /l 229 ❑ OTHER T.E/2oa� A _ I Contractor's Name �i72 S°7a> 'S," Phone 8W 2se - _, C Right N Address(mailing) , (2 est Sit"'4 S� S MS. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K • g CONSTRUCTION TYPE VALUATION$ 2i'..76-.°0 Left G City License No. Vf6 d y2'G 3�+ S R ZONE GRADING CU.YDS. ACRES . Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION Pinga I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I%Agh C L4;s it` "I Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and my license is In full force and effect. T License CI a C Se 39 License No. ✓ Seo ,/ T Date /2/3/18? Signature PLUMBING FEES . WORKERS'COMPENSATION DEC LA RABar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate -,• Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink " .B, Lab. C.) Automatic Washer Transformer 0 15-50 KW • Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW - BCertified copy Is hereby furnished. Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection Cooking Unit Meter Dui)to 100 amps • 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 DGas DElectric i 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❑O-1 HP 01%-B Workers' C mpe�l�ation Laws of California �_ Date /WY'•3/ Signature Floor Drains Swimming Pool w/Spa • F.A.U. Inc Solar ❑g-15 HP 016-15+ NOTICE:If,after making this declaration, you s 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 ' Lender's Name - p Outlets 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 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 Laundr T any structure, prior to.its issuance, also requires the applicant for such permit yra ys Generator 00-5 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 - -- •erefrom and the basis for the alleged exemption. Any violation of Section . 131.5 by any applicant for a permit subjects the applicant to a civil - vnalty of not more than five hundred dollars($500). I $ 3 • 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 • Issue Fee compensation, will do the work, and the structure is not intended or offered 1 - 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 DEVELOPMENT SERVICES REQUIREMENTS: ' thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 employees, provided that such improvements are not intended or offered foryp 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 J2. Date prove for the purpose of sale). • r 12-31-4 / 0 I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: ❑0100,000 BTU ❑100,000 BTU The Contractor's License Law does not apply to an owner of property who Duct-Ventilating SUMMARYpOF FEES ' builds or improves thereon,and who contracts for such projects with a con- o 0x-0 St,tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ J SMTP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT - ❑ t am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ HeatingSystem Ducting RegistersPLAN CHECK 25% $ • ENERGY P.C. $ Date Owner y em& I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTU ELECTRICAL $ - GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives 'of this city to enter upon the above-mentioned property for inspection purpos s. MECHANICAL $ TOTAL FEE $ �^' '�� Drivers' ��"'"�""'-L Dau /24.24&? Drivers' License or / Reinspection Fee $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 Date Inspector - Date Inspector APPROVALS Permit# APPROVALS Permit# 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, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 OGas DOH 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 f 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 • 381 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 Ov ,/k/t,6 48. Special Requirements Completed- C - • 49. Electric Release to Edison , - - - 50. Gas Release to Southern California Gas GD • • 51. CERTIFICATE OF OCCUPANCY - No. Date - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. • BLDG.NO. ,L -O I /^ry/ :DC ' I! CONSTRUCTION PERMIT • fa — ?Fez ' Project Address 2 4'1 "q 5. ,n 4-n At',a P -e, TYPE OF CONSTRUCTION U NEW LI ADD LI ALTERATION LI REPAIR Applicant's MailingAddress Se`M'e ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone p Owner's Name L7 0, s r & S j L Phonecy6-833, DESCRIPTION OF WORK S Main Building: Accessory Building: Z Address -- a V‘e"e TYPE OF PERMIT LI GRADINcG�FOUNDATION LI STRUCTURAL T Front • 0 Arch/Eng. - License No. N 9 El ❑ ELECTRICAL PLUMBING III B Rear I Address 0 OTHER p' N �� Q t t,4S*flj '5t/73 YI3 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Contractor's Name p C Phone K - �' 5 W ' C O✓rLG./ck CON STRUCTION TYPE VALUATION$ S Left R Address(mailing) E City License No.sac 94 3 ZONE _ GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ - 0 U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided • I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: E my license is I I force and effect. • License Cis �7 1_1,9sp�o. �J g9 g PLUMBING FEES Planning Notes: E Datela I Zr signature �1 % `RKE 5'. OMPENSATION DECLARATION. Bar Sink Showers T reby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S Workers' Compensation Insurance, or a certified c y thereof (Section 3800, Lab. ! '/7-� ' Backflow Irrigation Sewer Cap ' , ELECTRICAL FEES Policy No. �Q�r/' Company -+— ! 8 Certified copy is hereby turn ishod. Bathtubs Sewer Connection Automatic Washer' Transformer 0 15-50 KW tertifi}�Q y�Lls filed with the city BuiJ4Ing glon,/�/ ❑ 50+KW Date!a-(f�`3 f Applicant r) °`-�/ moi Clarifiers Solar Collectors Construction Pole Sub. E%EMP I N FROM WORKERSCOMPENSATION DECLARATION - Dishwasher Solar Pi • (This section need not be completed if the permit Is for one hundred ($100) or P 9 1 Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is issued I Solar Tank Dishwasher Ir • Meter Dover 100 amps •shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric 'Sub Panel Date Signature NOTICE:If,after making this declaration, you should become subject to the Floor Sinks • Urinal Fan Motors 00-1 HP ❑1'/x-8 ' Workers' Compensation provisions of the Labor Code, you must forthwith - - s - comply with such provisions or this permit shall be deemed revoked. ' • Gas Service Outlets Water Closet VIN F.A.U. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION- LENDING AGENCY • '1 I hereby affirm that there is a construction lending agency for the performance Interceptors . , Water Heater • Fixtures Microwave ' of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink Water Service - Device Boxes Pole Light Lender's Address Lavatories - OWNER BUILDER DECLARATION - Outlets Range I hereby affirm that I am exempt from the Cd Professional pr's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or P Switches Sign • County which requires a permit to construct,alter,Improve,demolish or repair 'any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains. Garbage Disposal Standing Sections • to file a'signed statement that he/she is licensed pursuant to the provisions of _ •ys • Contractor's License Law(Chapter 9(commencing with Section 7000)of � Generator ❑Q5 KW ❑5.15 KW Trash Com actor 'vision;3 of the Business and Professions Code) or that he/she is exempt - ` p .erefrom 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 Reins action Fee - $ 3 penalty of not more than five hundred dollars($500). P $25 Issue Fee - U I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work, and the structure Is not Intended or offered FEES for sale (Section 7044, Business and, Professional Code: The Contractor's - - -- - -- - -- PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 . thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date employees, provided that such Improvements are not intended or offered for Canopy Type II ❑ - sale. If, however, the building or Improvement Is sold within one year of corn- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- ,,,,/ 4W- S-- orrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By • r "I Date LJ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES The Contractor's License Law does not apply to am owner of property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUI LDING PERMIT $ SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑dam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ .'J r` ISSUANCE $ Date - Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above , ❑0-100,000 BTU ❑100,000 BT GRADING $ - - information is correct. I agree to comply with all city and county ordinances • - ELECTRICAL $ and state laws rela 'ng to b ding construction,and hereby authoriz repre- - PLAN CHECK •' $ . MICROFILM $ sentatives of thl ity onto f e above-mentioned prop for _--tion pure �� Signature (�-- Date MECHANICAL - $ TOTAL FEE $ , Drivers' License or 55# Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ • • CMF 0865-46 rev. 7/83 -Applicant;Pink-Accounting;Goldenrod -Assessor - - • ,- CONSTRUCTION AND PLANNING4 PO< <SPA APPROVALS' Permit# ( lar? 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 &I-Pressure Test 6. Electrical .UF ER Grnd.- , 57. APPROVAL TO COVER-GUNITE 7. Footings - • 58. Electrical Conduit-Undrgrnd. 8. Foundation • r 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.I 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 I 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 2.2--a-c55 � '( , 39. Water Service-Final - / '��-p� , 40. Gas Service-Final - -I 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations , 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 ' . OWNERKOSHMAN, W. H. & TOWNSEND, G. R. DATE 5-3-62 / JOB ADDRESS 2489 Santa Aria Ave. _ BUILDING PERMIT NO. 169119 GENERAL CONTRACTOR Gwner-Builder VALUE $ 16;21117e-00 AP No. 119-140-44 LOT TRACT FIRE ZONE DESCRIPTION OF WORKReS.Att.Gar. INSPECTIONS Signature DATE GROUP I & J TYPE V ZONE R-1 S • / S' 5--/./��i2 PERMITS ISSUED G, �f.c , -'— SUBCONTRACTOR DATE NUMBER Water A1!-S !%/o -41. -- Rough Corn. Refrig. ❑ Air Cond. o Rough Heating 44 ,j-/I Ga- `fes k 7 6`,'6Y SGS �f i Rough Plumbing / .S G-/1-013 ,ie, n*i/i S"9"4'2.- 3373 V r Miscellaneous —/ - 1, i Prop.Swr.Line [-house Con. E-St-Swr. 0 Tr� g"r/7(&t. 14- .'.(� 5ri--741-- gin ' Sprinkling System f�ry Construction Pole Underground El Power Ely —11� Rough Wiring 1267-iC i -a-4-Z 71iw -.c. fife, 6 -6-6Y /7 ..'3 Trenches Er Forms ®-- Steel Reinf. © pt/YL R^/b 1.94'. Floor System r+X C 8 /,"-/6 - 6 r. Bond Beam D Steel Reinforce 0 Sheathing _____ QM e-- j 1 kyr. Frame and Flashing �Jz 7 2 6 ,S'L 6` ) _ Lathing — In EV Out (S ' G —=m — 6 Plaster, brown coat 0 i- In . 7—] .!,G , -s..--- Barig. ❑ Air Cond. ❑ Final ing, Final ,IHS 7-4z ....thing Fixtures, Final Final /1/7/Lf --,172-69/ Final Gas Test/- Electric Fixtures, Final -7-2• 7-7.e 42- Building, Final 7 r 7-yn ..r \ , OCCUPANCY I FORM 8114.5M - 7.61 1'(^1+9 • 1E5949 FE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT R DEPPTT iSI E FINANCE D . P. O. Box 817 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 2489 Santa Ana Ave ADDRESS COSTA MESA. CALIFORNIA For Office Use Only OWNER W.H.Koshman & G.R.Townsend I RECEIPT NO. PERIf1y'NO� � MMAIL ADRESS 284 East 23rd Street, RECH/�y/E�D BY RECElIVEg�/ DAT//!'1l/)SSSUED CITY Costa Mesa NO BUILDING `b46 5264\ ADDRESS ARCHITECT T� TELCOSTA MESA. CALIFORNIA I OR ENGINEER BOt1Ch& MUnnS NO.T�rr2-4376l ADDRESS FIRE 1./ AnaheimFIRE ZONE TYPE GROU el CONTRACTOR.,�Y ..H Kot main • APPROVED L / ADDRESS . 284 East 23rd Street BY ( N NG TE JI L ZONE NO.OF JIHE OP NEW 1A. . CITY Costa Mesa Q•-� I PLANS BUILDIN,{ a IAAF LIC.TNO. NO. 646-5264 \ DESCRIPTION Aa7" \\ SIZENO. OF BUDGES. I tC_ ( j `' C* SFF LOT 59 x 102 I NOW ON LOT - A.P.NO. o " ' ~- (*fib . e /1J1 USE OF YARDS EVES (EXISTING BLDG, APPROVED ALLOWED SETBACK LINE FROM50 (CENTER LINE ST.) co CENTER OF STREET ft REAR YARD FRONT .� FT. IN. SIDE YARD I LEFT 5 ft I RIGHT 5 f t R.SIDE 5 FT. IN. DESCRIPTION OF WORK L.SIDE FT. IN. NEW I * I ALTERATION I II ADDITION I REAR n µL 6 FT. ' IN. REPAIR I II MOVING I II DEMOLISH I AAPPROVE�n r c , OATE��//{s`i‘ SIZE 1463_50 146350 1 RNO. OF OOMS STORIES 1 �`"'/ I • • ?' EXTERIOR WALL COVERING S tuC C OIROOF Rock i COVER I NG .� USE OF BUILDING AND WORK TO BE PERFORMED /N L/ n, Single family r-sidence ).. / if • P.1 •C�- • �.�' 'i Y I HEREBY ACKNOWLEPGE THAT I READ THIS -PLICATION V THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THIS -• E IS ORR AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI C-• N N • AND ATE LAWS REGULATING BUILDING CONSTR 0 VALUATION (-zi SIGNATURE OF I. it `„ Li t / 1-ERMIT FEE $ 4 7 PERM ITTE \� .` 7 $ /g, ot � / PLAN CHECK $ P// AUTHORIZED AGENT E TOTAL FEE •--- 0