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2618 SANTA ANA AVE - Building Permits
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. , I . • CITY OF COSTA MESA C�N,S•-T�,_UCTION PERMIT • P RMIT NO. TRACT NO. LOT NO. - UNIT NO. Project Address p(/O�R' /��/TGS. !, Zl ild •• �� ,l' • •• 6056' 1x/27/86 5 DD • TL fine� 'Q TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION REPAIR Applicant's Mailing Address • �) / ❑•CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# , Zone Owner's Name �/(/1 Phone DESCRIPTION OF WORK/USE OF BLDG. Address W-/r 'e_ l ') ✓I _ 111---ill S Main Building: Accessory Building: Z Arch/Eng. - License No. ',TYPE OF PERMIT 111 GRADING FOUNDATION ❑ STRUCTURAL T Front • O Address ///� �7� /]nr�l�✓24 $❑.ENANT ❑'ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N /L� ��/Phone W�71rt 1J'. .❑ OTHER A1 Contractor's Name '/U' C Right N Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY -CONSTRUCTION TYPE VALUATION$ K Left G City License No. ' - S R ZONE- GRADING CU.YDS. ACRES ping. Ref. # Parking Req./Provided E LICENSED CONTRACTOR DECLARATION _i •'1 � 1 _ - O I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 7 771 Planning Notes: `�.,,se`I M with section 7000) of Division 3 of the Business and'Professions Code, and �'(-`��jp� R�yq� '�(E'�,j •©rr '2 4 198 my license is in ful • : and effect. • f. / —Y T N.Licens: L- 1 - S Date x 1$ fz. Signature 15.1.e/aft(15.1.e/aft( .ice -_/ J . rSe • . . PLUMBING FEES - WORKE -S' OMPENSATION DECLARATION Bar Sihk, Showers 'ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES 1 Workers' Compensation Insurance, or a certified copy thereof (Section - - Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW s800, Lab. g /'�,t \ Policy No. 90�'�� Company 1 / Backflow Irrigation Sewer Ca • _ 1 0 50+KW - - 2 Qertified copy is hereby furnished. / _ - p l Construction Pole Sub. - C-Certip tl p iced with the city d' vi ipn.�/y�///� Bathtubs Sewer Connection Cooking Unit _ Meier ❑up to 100 amps •• Date , Applicant L' r!7 UC! EXEM TI N ROM WORKERS'COMPENSATION DECLARATION ,Clarifiers Solar Collectors. ' - Dishwasher ' Meter Dover 100 amps • • • (This secti n need not be completed if the permit is for one hundred ($100)or - • less). + Dist-washer - ' Solar Piping • Dryers ❑Gas •DElectric ' Sub Panel - - • • ' I certify that in the performance of the work for which this permit is issued, I - . - I shall not employ any person in any manner so as to become subject to the . .' Drinking Fountains Solar Tank - Fan l ' ' Motors❑e ❑ -1 HP 1'/a:8 Workers' Compensation Laws of California. - Date Signature s Floor Drains Swimming Pool w/Spa • F.A.U. NOTICE: If,after making this declaration,you should become subject to the . _ - Inc Solar ❑9-15 HP:❑16-15+• 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 • I hereby affirm that there Is a construction lending agency for the performance Pole Light. I of the work for which this permit is issued (Section 3097 Civ. C.) I Lender's Name interceptors ` Water Heater ,a i Outlets Range - • I Lender's Address _ • - Kitchen Sink Water Service- Switches - • Sign - - . . ' OWNER BUILDER DECLARATION Disposal I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage • 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 ❑O-5 KW ❑5-15 KW - any structure, prior to Its issuance, also requires the applicant for such permit 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). I 3 ' . , 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 I Issue Fee $ compensation, will do the work, and the structure is not intended or offered r 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 ' employees, provided that such improvements are not intended or offered for Boiler ' Hood or Type I 0 ' , , ( sale, If, however,-the-building-or Improvement is sold within one year of com- -- Canopy Type II 0 ' 'Zoning Approved By Date • pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date Trove for the purpose of sale). C �l �� U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By cJ u Date 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 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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT I: l'am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ' � - • PLUMBING $ aS.O'`c�ISS UANCE $ 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 0o-100,000 BTU 0100,000 BT 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 thi city to enter, upon the above-mentioned prop rty for $ inspection pot' / /4l _ S_ $ TOTAL FEE $SS ad, JJ (// ULA MECHANICAL Sao Drivers'Signer /I e !�.' ' Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&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 e.- 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,i 9. Water Pipe-Undrgrnd. . 60. Backwash Lines,P-Trap, DThdrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK r;) 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 D 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 jJ 33. Final Electric Notes:j./`r_0 a1 „ /�1 e(,/Ll7/ /, 4 t 34. Final Heating & Air Conditioning ii f , XD, I -/�*-f `� ' //- 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. 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 ( • / I