HomeMy WebLinkAbout2863 SERANG PL - Building Permits / 57 n1 4t4*fr tJ —74i.V
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 2863 SERANG PL CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 064406
ADDRESS: SAUNDERS MALCOLM H
2863 SERANG PL PERMIT NO: P 0 406 PLAN CHECK NO: N GOVT; N SUPP : N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER:
( 714 ) 545-8881 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : WATER HEATER CHANGE OUT SQ FT:
PERMITTEE: CLAIM VALUE: CALL—VALUE: GROUP OCC : R-1 /
ADDRESS: EARL ' S PLUMBING ( 714 ) 642-1753
1526 NEWPORT BL COMMENTS : NO BUILDING PERMIT INVOLVED . PLUMBING WORK ONLY!
COSTA MESA CA 92627 *******ira6�Eyr********yraryr�E*kr*�E*****x*�rk6�ryE�6yr****y ******aLy *****y6**a6*a6***kE*aFiF******y6+e
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of hooter 9(commencing with Section Z O N I N G R E U I R E M E N T S
7000)of Division 3 of the Business and Professions Code.and y license is in full force and effect. S E T BQA C K $
CITY LIC.: 005938 STATE LIC.: 217657 CLASS: C36
Date'.__ Q—n. 0( Signature:..ro ��� MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm Ilia ve a cemficate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Section .Lab.CI LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
POLICY ND.: 1339225-93 EXP.DATE: 03/01 /94
COMPANY: STATE FUNQ , PARKING REQ• PROV: PARCEL: 13932210 ZNE: REF NO:
r] Certified copy is hereby furnished. l4{ Certified copy is filed with the city Building Division. PLANNING NOTES>
IA Applicant: >
Date:�B•I.�'J �' re
***********************************************.********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This need not be completed if the permit is for one hundred 151001 or less). DEVELOPMENT S ER VIC E S • REQUIREMEN T $
I certify that in the performance of the work for which this permit Issued,I shall not employ any person in any manner so as to became
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY .
DATE:
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY :
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. K 7 � DATE:
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; /�` �/J�
� DATE: / �/
which this permit is issued(Section 3097.Civ,C). ************************* .iEfE 4VIlF *** ******/trim
***************�e**** :***
LENDER:
**********************************************' **************************i*E****
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,4BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM IP/RES GRADING
emolish.or PERMIT
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement tat he/she is licensed7,00
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 . 00
I. as owner of the properly or my employees with wages as their sole compensation, win do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 7 . 00 20 . 00 0 .00 27 .00 27 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through 0
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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 27 . 00 OVER/SHORT: . 00
, for the purpose of sale), BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 00
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law).l am aware **,***,*,*** *,*,*,*,*,x,**,*,*,k,**********************************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ lam exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN
for this reason TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 WATER HEATER AND/OR VENT 7 . 00 •] 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Dale: Applicant:
I hereby certify That I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
DaterAQ /2'p Signature: 4/..� 01 00148688-00148688 TOT DATE: 48/18/73 TIME: 113 77,00
Driver's License or Social Security e:
164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POO' SPA
pate Inspector • Date Inspector
APPROVALS Permit # o APPROVALS Permit #
1. Temporary Electrical Service-or Pole % 52. Pool & Equipment Location
z.
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement sivf
3. Electrical Conduit Utility-Uncitgrnd. "' 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 COVE R-GUNITE
IT 7: Footings 58. Electrical Conduit-Undrgrnd. _
i I ' Foundation it v s' P59. Gas Pipe, 0 Undrgrnd.,Test .'
9. Water Pipe-Undrgrnd. r / ..�7f 60. Backwash Lines,P-Trap,0 Undrgrnd. ,is y
10. Structural Floor System /S j71 61. APPROVAL TO DECK
4i
11. Property Sewer Line & HouseConnection %` 62. Backwash & Receptor-Final
c.
12. Sewer Cap
I p • p 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
i 16. Rough Electric Wiring 67. Fencing & Access Approval
r
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:Hytlro
22. Ducts, Ventilating -- - • '71. Product Piping Dtas 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
I 28. Lathing& Siding ' • 77. "FIXED SYSTEM FINAL
29. Insulation - • 78. FIRE PREV. FINAL 1
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31- Plaster Brown Coat -79. FINAL INSPECTION
• r
32.•Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
J
33. Final Electric . ' Notes: - v
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test -
•
36. Hood or Canopy -
37. FinalFactory Fireplace
38. Final Plumbing . - • nalft _
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. FINAL OLANNING •
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co 1
51. CERT)FICATE OF OCCUPANCY
No. Date
Applicant to till in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA M.7E/
E($j A .FOT(I'STRUCTION PERMIT PERMIT NO.�f TRACT NO. LOT NO. UNIT NO. A P # Zone
Project Address • CJ 6-+ -+ e4A. 5 3 `2-
- S Main Building: Accessory Building:
A,pplicant's Mailing Address /s'/.l9J 6., 'tF '0! ) SA. TYPE OF CONSTRUCTION LI NEW IJ ADD ALTERATION U REPAIR
e g/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front Q
AcCKJ
Owner's Name C..4.4./../.1Phone JT ' DESCRI•TION a WOR' /USE OF BLDG. a t I B Rear N
Address � � SE.2/hvl j 11 .. •. _ D i- t e - .asp a�i +
lch/Eng. / License No. TYPE OF PERMIT GRADING I♦ OUNDATION V STRUCTURAL C Right G
Address p ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL $ Left
J/ R
Contractor's Name4/(J/LAdL/rfl/V f cc,C. Phone 5-8-6 .S ❑ 'OTHER Alf 7° R� I Ping. Ref.4 Parking Req./Provided Q
Address(mailing)/59 ti,ne4.a6i )A./ SA. PROJECT DESCRIPTION SQ. FT. OCCUPANCY ^� Planning Notes: M
CONSTRUCTION TYPE VALUATION$ �2 7 SO - ---.- - T
City License No. ��7� � 33�' 2 ZONE GRADING CU.YDS. ACRES
S.
LICENSED CONTRACTOR DECLARATION �7� / /� n //
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �-/1,eE Off' F KS. csh'?�C �� /�`7 /���/t
•
with section 7000) of Division 3 of the Business and Professions Code,and
my license is in full for ffect. a / T �/_ ELECTRICAL FEES
Licen - C .ss ' icense No.Ceread /514"neallui" zeall7 z✓/� LCOS, 3/y7
Date ad .A1 Signature «r /e ✓ PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW
WORKERS' COMPENSATION DECLARATION Construction Pole Sub. 0 50+KW
1 hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Dup to 100 amps
0\ 10, Lab. C.) , d /
\ rolicy No.OGG2te95'4e Company 7 �/N41 Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
Certified copy is hereby furnished. Dryers ❑Ges ❑EI¢ClliC Sub Panel •�
Cer "iJ'etl ppyy..is filed with the cityB�/iltlin9 Iv" ' n. Bathtubs Sewer Connection 'A
\Date 7/��07 Applicant �% �c/Wyam Fan Motors 1 HP ❑1 h-8
A EXEMPTION FROM WORKERS'COMPENSATION EC'D LAARRATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred($100) or Dishwasher Solar Piping F.A.U. .Solar ❑9-15 HP 016-15+
less).
I certify that in the performance of the work for which this permit Is Issued,I Fixtures '
shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California,
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light .-..:-
NOTICE:
.iNOTICE:If,after making this declaration, you should become subject to th0 Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks .4rinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets 7 Water Closet Switches f ,^ Sign
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 Garbage Disposal i Standing Sections
Lender's Name - -
Lender's Address Kitchen Sink Water Service --• Generator ❑O-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION i
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash L
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 Laundry Trays ' ''1,"'any structure, prior to Its issuance, also requires the applicant for such permit
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 .
Reinspection Fee $15 Issue Fee $ 3
, ;refrom and the basis for the alleged exemption. Any violation of Section
,,'IL:1 5 by any applicant for a permit subjects the applicant to a civil
jalty of not more than five hundred dollars($500). 3 DEVELOPMENT SERVICES REQUIREMENTS:
L_1 I, as owner of the property or my employees with wages as their sole Reinspection Fee . I $15 Issue Fee $ Zoning Approved By Date
compensation, will do the work,and the structure Is not intended or offered - i'
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
License Law does not apply to an owner of a property who builds or improves s f e r tT
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By at ^'! !1
employees, provided that such Improvements are not intended or offered for
sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II ❑ SUMMARY OF F ES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground "
prove for the purpose of sale). BUILDING PERMIT $ 90. OD SMIP $ • Sb
0 I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Rypieration System PLAN CHECK $ PERMIT
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 0100,000 BTU PLUMBING - - $ ISSUANCE $
builds or Improves thereon, and who contracts for such oroiects with a con- ENERGY P.C. $
tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System El Multiple System Repair/Alteration I PLAN CHECK 25% $
proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers
PLAN CHECK 50% $ MICROFILM $
Date Owner Heating System&Ducting Registers7'
MECHANICAL e-. $ TOTAL FEE $ 0. SO
i hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL PLAN CHECK 25% i
Information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned pro rty for
Inspection purposes. -•
Signature /•S.4z ed." Lncn._ ' Date 9-a,6, _
Drivers' Lice or SS f "' - Reinspection Fee $15 Issue Fee $ 3 /(-2/497q/
1083
/ Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 E: 04/21/39 T1I1E O : �, j
0865-46,rev. 5 a8 White - DATE: d4/'_+1/�9 TI�1f: X8.17
•
r- r'
CO14STROCTION AND PLANNING POOI 'PA
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 UF ER Grnd.' 57. APPROVAL TO COVER-GUNITE
7. Footings • 58. Electrical Conduit-Undrgrnd.
•
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgfnd.; ' ! 60. Backwash Lines,P-Trap, O 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.El'ectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough'FactoryFireplace 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 PREY. FINAL
30. Drywall Nailing "i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat f • 79. FINAL INSPECTION
r-
32.
32. Electrical Power Mater-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes:Nn e 0cocr
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy -
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final 7-3/-9(- titer a-
. p -G -
40. Gas Service-Final Ge-r-eart
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation -
46. Handicap Regulations
,
47. FINAL STRUCTURE & BUILDING 7-7/1/ 64,46,664,46,6
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Oa
51. CERTIFICATE OF OCCUPANCY
No. Date •
l
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
CITY OF COSTA MESA CONSTRUCTIONPERMIT PERpdI; NO. /- TRACT•NO. LOT NO. UNITS10,- I r' 3071 5/16/85 5.00 IL
Project Address O' G�jo gr, ^ .w�JQ�- ,VE CRYO VJ ,
Applicant's Mailing ••dress • T'�WL .A-- (..1. TYPE OF CONSTRUCTION U NEW IJ ADD U ALTERATION I: 1--REPAIR
/ �� ❑ CONVERSION '❑ DEMOLISH ❑ OTHER A•P•q�, _ Zone
Owner's Name � ��� p Phone , DESCRIPTION OF WORK/USE OF BLDG. -
Address V.VIA r s"` J . ' S Main Building: Accessory Building:
M rrrrrr������111III U STRUCTURAL T Front D
W Arch/Eng. License No.' TYPE OF PERMIT UGRADING�FOUNDATION
I Address WyyII 1,s ` . ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL • B Rear • N
' Contractor's Nam• ,I/ice i •I+,A/lb SgOtS CI OTHER A - •
K Phone C Right N
I �" Y j i f PROJECT DESCRIPTION SQ. FT. ' OCCUPANCY C - _ G
Address(mailing) Y �-• n'vl- dA�•
�- g I CONSTRUCTION TYPE VALUATION$ _ $ Left ' 1
City License No. 1 ♦ ZONE GRADING CU.YDS. ' ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# I Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: I Q Planning Notes: _ M
with section 7000) of Division 3 of the Business and Professions Code,and rt (/��/� -�/� - '
•
my license is in f I f• : and effect. I Ky�/}/f/ t[ .1�/y Y ' I `/�&3C-C`�'1 j�Y \ _ _ S
License C . r .ar teens • s • �'(lV✓V 1 V 1 ��l "I 1N'
Date •"L Signature eSirA i a_/ SIP% PLLMBING FEES - I
JrherWORKERS'CO PI SAT I N D-C e' oION Bar Sink Showers . ELECTRICAL FEES
1 hereby affirm that I have a certificate of consent to self-insure or a certificate _
r.
if Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink ' -- -
3800,-Lab: C.ry�. /'�c fn,(� In o ,,() /� `I f/ Automatic Washer) Transformer ❑ 15-50 KW
Policy No. [ IL.cJ ('�.( QI Company Re ilk i�i1'IVA.I!! • Backflow Irrigation Sewer Cap Construction Pole-Sub. 0 50+KW I ,
�ertified copy is hereby furnished. I _ -
Certi I copy is filed with the city i "si n Y1 Bathtubs Sewer Connection Cooking Unit 1 Meter ❑up to 100 amps
Date 5f Applicant /IC �-
EXEMPTIO FROM WORKERS'CO NSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if t permit Is for one hundred($100) or
less). Dishwasher • Solar Piping Dryers ❑Gas DElectric 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-i HP ❑1%-B '
Workers' Compensation Laws of California.' • I •
Date' Signature Floor Drains ' Swimming Pool w/Spa F.A.U. I Inc.Solar ❑9-15 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 I •- Fixtures Microwave
comply with" such provisions or this permit shall be deemed revoked. - _ _
CONSTRUCTION LENDING 'AGENCY • Gat ServicE Outlets - Water Closet Device Boxes '
I hereby affirm that there is a construction lending agency for the performance f /� Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - , ! Water Heater Oc'V V' Outlets Range
Lender's Name _ -
Lepder's Address _ Kitchen'Sink Water Service Switches n Si
OWNER BUILDER DECLARATION g
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 Laundry Trays Generator 00.5 KW❑5.15 KW Trash Compactor '
any structure, prior to its issuance, also requires the applicant for such permit •
' 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
' 1031.5 by any 'applicant for a-permit subjects the applicant to a civil I _
eenalty of not more than five hundred dollars($500).
LJ I, as owner of the property or my employees-with wages as their sole Reinspection Fee 1 1$15, Issue Fee $ 3
•
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 -
thereon, and who does such work himself/herself or through his or her own Boiler. Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS:
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 corn- Canopy Type II ❑
pletion, 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). ,,fes
El I, as owner of the property, am exclusively contracting with licensed Con- Duct-Structural ' - Refrigeration System Application Issued By �V', 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 . ' - ❑D-100,000 BTU El 100,000 BTU - SUMMARY OF FEES
r-
builds oimproves thereon, and who contracts for such projects with a con-
tractor(s) li
. cense pursuant to the
Contractor's License Law). I am aware that . Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ _a_04). PERMIT
•
0 1 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers— PLUMBING S",06$ 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- 001 00,000 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 S
sentatives of this city to enter upon the above-mentioned propertN for • c..
inspection �tos4`FA / MECHANICAL $ TOTAL FEE '$ 5 )
Signature .. .1411 S Date • Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' L ,)f e or SS YF .
- . _
CMF 0865-46,rev.10/84 White'- Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor
,
CONSTRUCTION AND PLANNING POOL« SPA
APPROVALS Permit# • Date Inspector APPROVALS Permit# Date Inspector
r1. 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. ElectricalUFER-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 Drains64. 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 Structure70. 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:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 4/24d5-
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
1 .
51. CERTIFICATE OF OCCUPANCY
No. Date _ .
r.
13876 Qcflc . Clr � ,�11- 1 E�ItlfGU ��c�/ �
� 2 FEB 2015&11 / ��
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX 317 COSTA MESA. CALIFORNIA
ForA Blicant to Fill In Completely CITY OF COSTA MESA
/ a�P P Y APPLICATION FOR PERMIT
.jjp p e- r2-f TYPE OR PRINT
BUILDING
BUILDING ! 'S
ADDRESS --t---r —���"` M
COSTA MESA. CALIFORNIA1For Office Use Only
OWNER 17AL E; E 7`1'e 1 1 0`" C ci I RECEIPT NO. r/ pJ:RMIT N01' .
MAIL 7 /
RECEIVED BY DATE RECEIVED I TE ISSUED
ADDRES/S to
5'3 7L'L I/j�1I11fF /LA 17 i 2 . IC A- 60-----
TEL.
� / v- &� I %.. 7-(/ •
CITY to L/rA M E his NO. k I g d 344 ADDRESS �/"n �j�
ARCHITECT 1 A M K. No. COSTA MESA. CALIFORNIA
OR ENGINEER _/ I/
ADDRESS `/ - 9 FIRE
ZONE TYPE / GROUPj�/ /� /
CONTRACTOR 14a5 A �JEgoC s7JILw1.I�.S lith__BYPROVED r, DATER v qF/!J J
ADDRESS ICP 6'3 NI itie r &A t7.R. CzoNINGLA.4Uhr7:pa
ZON
GTItt.& Alt E4- /.---1 PNOF BUILDINGNHW n^-
LIC.NO. IQ toti ` nL}
NO. IDESCRIPTION /L tt yQ (r " ci-
o
OZELOT i / y I /LL,..� NO. OF BLOCS. 0
NOW ON LOT
A.P.NO. �/ Q
USE OF YARDS / EVES
EXISTING BLDG, APPROVED ALLOWED
BCTBACK LINE FROM • ,i I i (CENTER LINE ST.) (Fs
CENTER OF STREET L_I REAR YARD �Q FRONT /FT. IN.
I
SIDE YARD I LEFT `J I I RIGHT °J I 6 '
R.SIDE FT. IN.
DESCRIPTION OF WORK L.SIDE L✓ FT. N.
NEW I ,x II ALTERATION I II ADDITION REAR _)\> / FT. 2--ed-
/ IN.IN _t
II MOVING I II DEMOLISH I APPROVED ly �� DATE l/(r b
REPAIRI BY `��\��]�.t /
BUILDINGi ,NO. OF' `'(•
SIZE v ROOMS 67 STORIES_
EXTERIOR WALL Sti) ROOF 9 FI A Kt
COVERING ;i InIAi COVERING Li 1-11111 fp LE.
USE OF BUILDING AND WORK TO BE PERFORMED ����
', iA; toLk. ANI.rt-LI 12E-447C4
IDCC�ea„ndd"�/ o„ dS
Anio 6ARA(oE Oy
'm 6�o C-
I HEREBY ACKNOWLEDGE THA I HAVE READ TINS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT T ABOVE I6 CO GT ND AG TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CI INA EB AND! A E LPW GULATING
BUILDING CONSTR CTlo 1 y1,i}A 9R//t)E VALUATION /J ^/
SIGNATURE OF /A Lir L / (/ (�f PERMIT FEE $ •J / o N
PERMITTEF U y��"i�� m
$ /I PLAN CHECK $ I'�'��3 $
AUTHORIZED AGENSI r1� C'" o
TOTAL FEE $ Q • • J 2 /