HomeMy WebLinkAbout2289 SANTA ANA AVE - Building PermitsPlrApplicantto fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESACONJS//T11 RU/CTI N PERMIT p�q T 4'Z TRACT NO. LOT NO. UNIT NO.
6986 2/04/8b 59J- TL
Project Address 2, R9 % Ai/A HAM f ,
Applicant's Mailing •ddrgss TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR
�, —�• = _Ill_ a, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ - - A.P.fit, I Zone
Owner's Name /IPh0'' t/a �1�]Jr' �7 DESCRIPTION OF WORK/USE OF BLDG.
Address / , dnA ' osk Q Y,�l ra� / 5 Main Building: Accessory Building:
Arch/Eng. License No. Li STRUCTURAL T FTYPE OF PERMIT U GRADING U FOUNDATIONE Zront O
Address /�'� CI TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL BB Rear • - N
•Contractor's Nam i 7 / tty 7 • as a .aa one 0 OTHER I
—r— :den
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right _ N
`t1 Address(mailing) ���10 La �/^§� Q2�� alLaen �Z CONSTRUCTION TYPE VALUATION§ -- S Left G
,..7xC City License No. oc17>J 02- ZONE GRADING CU.YDS. ACRES E
1 )W1 LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided
1 I hereby affirm that I am licensed under provi5lons of Charter 9 (commencing Remarks: Planning Notes: 0
I with section 7000) of Division 3 of the Business and Professions Code,and
my license Is In full f. ce an• e tett. ♦. T
License C .ss a LIC rs• o. • a)a S
pate 1.• Signature �A / • .' ;WI PLUMBING I FEES
'ORKERS'COMPENSATION DECLARATION Bar Sink Showers . FEES
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. 'I I nn Automatic Washer Transformer 0 15-50 KW
Policy No. fl Keool�lf Company /JOrfn/7 Cade Sns Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
Certified copy is hereby furnished. -
Certified copy is filed with the city id'n Divisi99J��pp ((((��������JJJJ ��1�/� Bathtubs Sewer Connection Cooking Unit • Meter ❑up to 100 amps
ate Applicant I� 4•ti• _
EXEMPTION FROM WORKERS'COMPENSATION DECLA ATION 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 •
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 Drinking Fountains Solar Tank Fan A - Motors 041 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa- F.A.U. - 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 .
comply with such provisions or this permit shall be deemed revoked.
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 -
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,im rove,demolish or repair P-Trap LdTa
any structure, prior to Its Issuance, also requires the applicant for such permit • aunry rys Generator ❑0.5 KW❑5-15 KW Trash Compactor
'O file a signed statement that he/she is licensed pursuant to the provisions of •
Roof Drains
he 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 -
peenalty of not more than five hundred dollars($500). I / ,
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 1 Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL r FEES
License Law does not apply to an owner of a property who builds or Improves ' i
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 0 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 By Date
prove for the purpose of sale).
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By • ' Data Ae
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 ❑100,000 BTUSUMMARY 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 tome. _ PLAN CHECK .• $ PERMIT
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact,BIL ICBG# Fire Dampers PLUMBING 'ix $ .5-.0(r) 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 ❑4100,000 BTU 0100,000 BT ELECTRICAL $ GRADING §
information Is correct. I agree to comply with all city and county ordinances
and state laws relati.-s to building construction,and hereby authorize repre-
sentatives of this c y to enter upon the a•'ye-mentioned pr per for ,[
inspection purposes. ) LIP../mss/ MECHANICAL $ TOTAL FEE $ ' �+'�a
' Signature �i e. .. .- ��•' /•. a .n Date (.
Fee $15 Issue Fee $ 3 CHECK 25%
- --CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
- CONSTRUCTION AND PLANNING h . -�& 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, 0 Undrgrnd.,Test
9.-Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
.
10;'Structural Floor System • 61. APPROVAL TO DECK
11. Property Sower Line& House Connection 62. Backwash & Receptor-Final
• 12. Sewer Cap i - 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: if fie,a Ho kyr PtuwtPilE2 &.EQ
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. anal Plumbing 44M/Fr
39. a ervice-Final ,t1-44 O . C,to AV0 as -/ ileP
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
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY •
No. Date
•
DJP;,1.X: . 2 G&i.E.
e , 1
POST IN CONSPICUOUS PLACE
• ON THE JOB
DO NOT OCCUPY THIS BUILDING UNTIL THE
FINAL INSPECTIONS HAVE BEEN MADE
AND THE CERTIFICATE OF OCCUPANCY
IS ISSUED
City of Costa Mesa
Building Inspection Department
STREET NO 2289. A & B Santa Ana Aye,
PERMIT NO 6887 DATE ISSUED 6-16—D5D8��
OCCUPANCY I &..AI......_... TYPE..._ V ZONE RI4
OWNER Rasmus Rasmussen
10'BetSETBACHS 41'Bet.
Front Yard TG' .Side Yard R.10!__ 1 L21s 'r y� 270_3G'
. • SIGN NAME_BELOW:
• •,PCONTRACTOR, t? • i PERMIT NO.
General !)i (, L - • - . li',rt,er •1 h -f
/
Electrical .._
Plumbing
Cesspool or
SepticTank ......._.._.._......_......_.._...
Furnace —_.._..__......_...._......_......_-
BUILDING INSPECTIONS
Approved by..._ Date
PLUMBING: /,�/� �y
Underground Soil " �... �(l_r5. --4' £
Rhg. Water " Q.. .Ah .. 6'ttr
Gas Pipe 'est >Imo �.- �I'� ---.—.
Top Out [ - AA�
UT
Furnace ` rte..._ Nig "7-0 it
Gas Vents IS L]-- -- --foal'
.... --- ••
Rough Plu . . - Z... foaT... '7;l"St
Cesspools, .•ti — ;;..,,��(( J -/
Property Se• i ° .14tiliGr
Hou:�e Sewer Con. l� ` �{
SprinWer Sys m C� '-'' .•
Heating P'.:. 0 .V... ..
Plumbing Fix• esr , w.._.
Final Gas T-t M+otl
Plumbing F.: -2... "
ELECTRICAL: `
Construction 'ole 0e. "
-
Underground
Rough W
Power "
Fixtures se 2-t ..f ......._.._.._. • "
BUILDING: ... .... Steel -..." .- �.
Trenches " ._. ....
•
Floor System -
Steel Reinforce " "
Bond Beam "
Chimney Re-rod " " ......_.._d
Sheathing .' ..1 4r 2.-/_Y._s_>.l_..-.
Frame and Flashing '-
Lathing
Lathing " In Out..._.._.....- .x
Plaster, brown coat '
Building, Final • " -
• ' Notify the Inspection Department when the job
Notice 3 ready for inspection.You must furnish PERMIT
NUMBER and the JOB ADDRESS FOR EACH
RESPECTIVE INSPECTION.
Form 208-5 M-1-57
" e
S
.42,tt --- ,./(7 /I' 3 0
oa
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• 0 -
OWNER RASMUSSEN, RASMUS DATE 6-16-58
JOB ADDRESS 2289 A & B SANTA ANA AVE. BUILDING PERMIT NO. 6887
GENERAL CONTRACTOR RAY COAST RUH DFRS VALUE $ 18,646.00 -
AP. No.118-160E67' 324 TRACT NPT FIRE ZONE DESCRIPTION OF WORK DUPLE% & "AR.
GROUP 1 & J TYPE V ZONE H4 PLAN NO. 6887
PERMITS ISSUED
INSPECTIONS - DATE SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel 4j f,—. '.
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam t
Frame and Flashing 11/-- (////
•
Lathing, In OJJ '
rOut .c. ,Pi'/ /S
Plaster, browdj oat v � � agyj/s!
Underground soil o�ftj WIG Pipe Test/Mc j.(9--3-y.
Top Out t"�'
Furnace /41wc ) -/ )-A-t-' --/22,-. yeast • .b/.P".C2 /S42 3o —
Gas Vents 44,Q-S 7 -/7-67 `
Rough Plumbing --pJ4_. Znw . e - 79-t? /,1 3 0
Cesspool Septic Tank
Prop. Swr. Line Houedrgz St. Swr. Wm(re it c-a..' 7(L)/rs,- t 77
Sprinkling System ,Mil. q
Heating Final , . /-2.915—r [r
Plumbing Fixtures, Final .. S 9j9-9 Sr P f N rl3 P.o.4-1.K. 9 - 2.9' ) / ¢®V `^
_
Final Gas Test/S-/S' 441-5 9�6t , /r/
Construction Pole
Underground Power k
Rough Wiring . AJ7/h 7.//.s o {'_Y -x c-746-c . 7-/G--SR o4 4 9 I t
Fixtures, Final TY'4ri'f� e,—4e,1$ (,n
OCCUPANCY ,44/-S q-7-7 Or / - 1
Form 210-5M-1-57 / 7
I.
,'. .-- „ 6887 : : t. Gje'i'u�.u d L
COSTA MESA BUILDING DEPARTMENT (r - ', -.C' V L\
P.O.BOX 317
COSTA MESA. CALIFORNIA FINANCE DEPT.
T%d nC onSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT •
AB
UILDI B 2 2(7 /I ,FR Sf,,Nrig 4%f. Iii-Ort BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
,,/)�J�S �� C ,,, / RECEIPT NO. PERMIT NO.
OWN E'3' / Y 4S fV7 V5S cet (Ajcg e7
MAIL ) o �'` /7 RECEIVED BY DATE/ RECEIVED, DATE ISSUED /�
ADDRESS -2-2 Q / Sie nr 42/7/9 4c ✓7-e-72-1 {� 6 —7/-,c2I G6 -/4i-• S O
CIT�J/Q •.S mt1,4 TEL. BUILDING -2...z " I /Ty ✓ c,q-,✓/I�}' /al'I} /(
NO. ADDRESS
ARCHITECTTINCTER DC.LIC.
ENGINEER COSTA MESA. CALIFORNIA
$• T/git L/fC, FI
ADDRESS /'72 2. S /c.. ZORENE 3
20N NO.OF TYPE OUP GR
c1 //C((�TY LIC. PLLL AAANNNSJffyvc
ADDRESS 2C 2/ Zied.TM/TEL.efe_/ccr7 DVPROV •010,7/ ATE 6 Ty
/ K
LEGAL
DESCRIPTION NO T L y/ JK L'C,P rR
ACNy465 CORRECTIONS
A.P.NO. , / 5' '- 74. I7 -/ 1.�/)
f�T/�'r+� R
SIZE Imo(% y NO.WO F BLDGS. �J APP �� O V �~.D.
OF LOT /'6a 3C n i� S-/ NOON LOT J +,�1 l!
usE o 2. CITY OF TA MESA
USE 005 �r f/9M' <' �c:�cL/A• OC3A EK LINE FROM /go .....-d R i�.yy. J . It A DEPT.V
CENTER
SETBACOF STREETEA YA D �B.J SUBJECT TO G. DEPT. REG.
/ / I ///'�y/
SIDE YARD RIGHT /O LEFT •'14 /5-----/-///0el � Y/ / / I�
DESCRIPTION OF WORK U pA1e
l/ LA Te 6l/7—n
NEW {- ALTERATION ADDITION / (+ At 6//5?
REPAIR MOVING DEMOLISH
5 ZIE GING _lg./ 1.0 ROOMS STORIES /
_COVERINGEXTERb
OR
BUILDING WALLSTUCLL COVOER�IING to
cie.
USE OF NEW JI�/9 JPX < 6A-P/g 6or
/d' c9 `— j
4/7s_ PQ_
I HEREBY ACKNOWLEDGEEABOVE THAT HAVE READ E THIS OMPICATION AND
STATE THAT THE ABOVE IS CORRECT AND AG E TO COMPLY WITH ALL
CITY ORDINANCE STATE WS GULATI G BV ILDING CONSTRUC•
TION. C. VALUATION p
PIGNATURE O PERMIT FEE $ U
PERMITTEE /y/f/1
/ //i PLAN CHECK 5 /
'AUTHORIZED AGENT TOTAL FEE $ S-2
',Mb
1 `J
BENNETT. Robert L. ""' b-11-76 Y
JOB ADDRESS 2289 Santa Ana Avenue. Apt. BomBUILDING PERMIT NO.
GENERAL CONTRACTOR Oer/Bldr. DESCRIPTION of WORK Legalize Lndr Rm. Addition 42140
APNo.118-164-28 L07 TRACT FIRE ZONE VALUE $1,600.00 ,
ii INSPECTIONS Signature Date TYPE GROUP ZONE R-1
.4 sow SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING /A /c. . 7_ 4271 e�Q'���
PROP. SWR. LINE HOUSE CON. (fj(f� terx..0-4`4 %/4- hi �(fpJYy'�J'
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND [l POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS n STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT n
PLASTER. BROWN COAT
STRUCTURAL. FINAL El IC �r.�
HEATING. VENT., REFRIG. AND A.C., FI y ( Q� b-/I X WO/a� _
PLUMBING. FINAL AND GAS TEST j _..c. �� /� ,-6 0y krObb37—
ELECTRIC, FINAL Q. L.. 7As#IV
• ' .- 42140 P,11L
11-7r�,;�:00 737 *-:.**14 0.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely—Use Ink Only
RECEE RECEIVED a. z_
BUILDING
ADDRESS et
/ • /LyAsa. 1_ P - h
/
OWNERUaftht e /nzA.P. NO. 1IE7-I • • /5 PEAT,
MAIL BUILDING
I �2 �Qy�"� 1/4 "�
ADDRESS
ADDRESS 4,20 ouL.S11.I42.
aa• �s /r�y'
CITY l .a � < O .,Q7eJJ, NO.
TEL.
.-7 S?• TRACT LOT BLOCK
CONSTRUCTION 6 //\`NEyj! A ALTER REPAIR MOVING OFMOLISH
LENDER /Xv
BRANCH 1 { . ��y err I
OWNER , L �
ADDRESS '� ��,, 1lLL,,11��,,// RA VALUE
ARCHITECT TEL. USE✓AI\V7--•� $
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPzdi GROUP /
<
� u&AA,/
. APPROVED _ /Q� //J
CONTRACTOR / BY DATE Y `
ADDRESS
TEL. ZONE e INO.OF n J USE OF NEW .
CITY NO. 1.,„...••••PLAN$ BUILDING IVI be
s"1"'a•—
f^ STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
w SIZE NO.OF BLOCS. (FROM C/1/}L�'�STs,1R.1�EET)
LL OF LOT NOW ON LOT A— FRONT r V TIAMI s7 FT.
aUSE OFcon
r
1# EXISTING BLDG.
R.SIDE FT. FT,
FEP Z Separate permits are required for L.SIDE ,T. FT.
electric,plumbing and heating work.
WREARFT. FT.
i.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& `
C • MAIN SLOGS. ACCESS. BLOCS.
Q _ I _0 l— � e// 10 C U.P.# 11 11 APPROVED i ( �
RY
j �� ) /G� APPROVED ; ` DATF (y- I1-7&'
w
o I hereby acknowledge that I have read this application and state
N
IX that the above Information Is correct and agree to comply with
L all laws regulating building construction, and I shall not employ m
Z any person in violation of the workman's compensation laws of
w the State of California.
+ I hereby certify that I am properly licensed as a contractor under trO SO. FT. Yj ufy FBF w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE/ONLY: —
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ 3G•00
and Professions C .Division 3,Chapter 9. Q� J,
. . ' L�. - U.
Signature of / QD�� PLAN CHECK $ Q /0� o
Permittee $ / TAX $ /SB 2
w U
Authorized Agent TOTAL PAID $ O)sO
Oi