HomeMy WebLinkAbout2562 SANTA ANA AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF C€STA MESA CONSTRUCTION PERMIT PEWIT NO. C� TRACT NO. LOT NO. UN-IT NO.
C.M. 0— �UU6 / • 0441 9/ 18/85 t7060 TL
Pro _ct Address 2562 Santa Ana Ave. , rr II r -
Applicant's Mailing Address _J26 Commerc l al Way, C.M. 9262. TYPE OF CONSTRUCTION ❑ NEW Li ADD, L� ALTERATION U REPAIR
Owner's Name Fri Cotton - Phone 642-22C� ED CONVERSION' El DEMOLISH ❑ OTHER A.P.# - Zone
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DESCRIPTION OF WORK/USE OF BLDG.
Address same - S Main Building: Accessory Building:
Re—r a a- -. . a E Z
Arch/Eng. License No. TYPE OF PERMIT t0 G•ADING U FOUNDATION . STRUCTURAL T Front - O
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's NameCCanlC Rrns. Rfo• CO._Phone SH8 5569 b PROJECT DESCRIPTION SQ. FT.—J_ (j OCCUPANCY��/
Address(mailing) 126 Commercial Way, Costa Mesa 9262 ,- s OTHER .
e— !K Righten G
CONSTRUCTION TYPE residential VALUATIONS_2, 125. $ R
City'License No. W5ZONE GRADING CU.YDS. ACRES
889
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
..^ 1 hereby affirm that 1 am licensed under provisions of Charter 9 (commencing • Remarks: Planning Notes: M
`"j0 with section 7000) of Division 3 of the Business and Professions Code, and
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my license is in full force and effect T
'- License Class C-39 Li No._ 77 $
Date_9//8/85 Signature _ PLUMBING FEES i '
I WORKERS' COMPENSATION CLARATION - \ Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a r Irate of consent to self-insure or a Certificate
of Workers' Compensation surance, or a certified copy thereof (Section Backflow Preventer Service Sink - - - '
3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW
' alicy No. P_iata1a1102 Company Home Backf low Irrigation Sewer Cap0 50+KW
Construction Pole Sub.
in] Certified copy is hereby furnished.
Ce rt i fi in cop is filed with the City BuildingD" Ision. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
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Date //R/B5 ApplicantCrank_Bcds. Roofing_CQ.
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 .
Motors 001 HP 01'h-8 • '
Workers' Compensation Laws of California. _
Date Signature Floor Drains Swimming Pool W/Spa F A U
'NOTICE: If,after making this declaration,you should become subject to the - Inc.Solar 09-15 HP 016-15+ '
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 - 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 - -
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standin(Sections
county which requires a permit to construct,alter,Improve,demolish or repair P—Trap • Laundry Trays • Generator ❑45 KW❑5-15 KW Trash,Com Ctor
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any structure, prior to its issuance, also requires the applicant for such permit pa
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 .
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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 - l'
penalty of not more than five hundred dollars($500). 3 _.
1-.1I, as owner of the property or my employees with wages as their hole Reinspection•Fee $15 Issue Fee $
'ompensation, 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 Cotractor'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 0 _ .-
sale. lf, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pietion, 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). �_/0p
(„r
IDI as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System , Application.Issued By Date C -le
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 i ' ❑0-100,00 BTU ❑100,000 BTU f� SUMMARY F FEES _ •
builds or improves thereon, and who contracts for such projects with a con- - '/p '��1 �\
tractor(s) license pursuant to the'Contractor's License Law). I am aware that •
- BUIL ING PERMIT $ i /.0u/ SMIP y $ ��+
proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repr/Alteration
�' I R t D PLAN CHECK $ PERMIT
ID'I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# • Fire Dampers EXPLUMBING $ ISSUANCE $ .
. Date Owner Heating System& Ducting Registers Inc:"
plvte Inspe�Uona PLAN CHECK 25% $ _ ENERGY P.C. $
I hereby.certify that I have read this applica ion and state that the above . ❑0100,000 BTU 0100,000 BTL. • ELECTRICAL • $ GRADING . $
information is correct. I agree to comply wit p 11 city and county ordinances
and state laws re • ing to building struct'•n, and hereby authorize repre- gIQ MICROFILM $
sentatives of th' ity to enter arft!•n theabove-mentionetl property for pate PLAN CHECK 50% $
inspection pure.., - ME ANICAL $ �.CO
Signature _. //L40 Date • a TOTAL FEE $
Drivers' Lief' or SS# ��� • J$/$�_ Reinspection Fee $15 sgue Fee $ 3 • PLAS.yHECK 25% $
CMF 0865-4: ev. 10/84 white - Building: Canary -Applicant; Pink - Accounting; Goldenrod -Assessor H `'.
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CONSTRUCTION AND PLANNING - POOL & S. ,-
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 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 ARE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑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 .r:.
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer EXPIRED
43. Backflow Irrigation Incomplete Inspections
44. Landscape Irrigation System Date 7 - Sig �;�c-a-�"
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
1 51. CERTIFICATE OF OCCUPANCY
No. Date