HomeMy WebLinkAbout212 SIERKS ST - Building Permits COMPLAINT INVEST! TIONMC' COSTA MESA BUILDING SAFETY DEPARTMENT
P. O. BOX 1200
/ COSTA MESA, e—/7-7/
Received by w , 646-2411A, CALIFORNIAC Date:
Made by: Address .c` Ph. No.
Against: Address "��/] 5 e h-/ s
Directions: •
//� ,E//y/ ,/` �J /���j��
Nature of Complaint: 6"' 7 f -'` _ ` t`'�/ "e/�,y%'K'�-�I--
1
Action taken: • Q 1, r —Lit y c// 8.17/• ' • '/
a 20 r • el, 37 • T.-AS- nitre«//// ....2.0,t p.�' f�' i,
�Ca r ye A A�d�s a. /04,
/Lei
' / //L ✓��N
Complete: Yes V Complainant Yes / By �(/l /l•'/('�
No Interviewed: No (// Date: ` // r 7/
FORM 13041-2M-5-64-CP
.. ° , 10385 FEE RECEIlt D
COSTA MESA BUILDING-SAFETY DEPARTMENT •��,v C / 7. s
P.O.BOX 317 COSTA MESA. CALIFORNIA '
• FINANCE DEPT.
FOR APPLICANT TO FILL /N COMPLETELY APPLtt ATI164O 'TBI P 'RMIT
TYPE OR PRINT /%� /// BUILDING
BUILDING / "L 3�CS//yC',, . � _
ADDRESS /COSTA MESA. CALIF RNIAi YYII
FOR OFF/ E USE ONLY
OWNER 06GQt S 64 [Nt/4 61
R EIPT O. PER IT
! 1_
MAIL /1 I 3 A _ / /A` Dd 4- IM'EYED BY �/ I ��^6F D
ADDRESS d� f" //JR—J o/1JC- �y� (/ 7 f J /7 ' 1
CITY (3 4t�d I TEL
ADDRESS / !
ARCHITECT LIO.
OR ENGINEER C.
COSTA MESA. CALIFORNIA
ADDRESS - ZO TYPE GROUPJ/n STATEIR
ifCONTRACTOR to ` LIC.NO. g� DATE 9 /7
ADDRESS /IL/ `�L} 1 /ZONING
LEGAL I LOTS I _- ZONEile NO.OF a) USE OF NEW -
DESCRIPTION NO. ,I BLOCK / J(��TRA(:T /T ! G PLANSP� . ILDING 9--
,n// / A !
A.P.NO. 1 �� k ^ in o r I 'J ABYPPROVE!/1 / I DATE /�-��� .
OF LOT J 1 , x to a I NOW ON LOTS YARDS OEVLCti
REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. k.e_s.b e,-.3c `` FRONT A (' ' FT. IN.
SETBACK NE
CENTER OF STREETFROM (�l�i/L REAR YAR �p, R.SIDE +r / FT _ IN.
SIDE YARD I LEFT t".,'S I RIGHT Lie.-5 J- L.SIDE FT. IN.
DESCRIPTIONIPOF WORK
REAR FT. IN.
NEW I II ALTERATION I II ADDITION
REPAIR IX IM VING I DEMOLISH I
BUILDING? 0 ROOMS 4EXSTORIES
SIZE .S�-"%�",(/gyp
COVERG.), ROOF %� �
COVER IN ' P COVER IN Ody
US .OF BUILDING AND WORK TO BE PERF RME
/ O 19 Ant, /3Gc/LD/SVG Gc-p %71
SAF /V ' '7 di::t.h.,.."/y-�/'�'s� "H:" ge.7
�HERhY As 0.LiLEDGET HATIHAVCAD THIS nee( -
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL GMT ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE NLY.
BUILDING CONSTRUCTION. ( O, //A ' VALUATION CO
SIGNATURE OF/�- J `�/J 1, - / PERMIT FEE $
PERMITTEE //'V'!dertt. Al1J /
$ lb PLAN CHECK $ /I/Qif.Q-
AUTHORIZED AGENT tier TOTAL FEE $ 06 /\
`. 4281.1 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT � --S
P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Co letel CITY OF �nQT� M��p
pp � p Y 7�7PCICJ4ITON FOR PERMIT
• TYPE OR PRINTQ4 42
BBUILDG UDREIN 4 � ///�/� C . Al
BUILDING
COSTA MESA. CALIFORNIA For Office Use Only
/�f--q RECEIPT NO. PERMIT NO.
OWNER /\ 6. ��,�edij v L • L /" 28 1
MAIL I ,/ �t RECEIVEy BY I DATE��/REC[EI^V1ED /O'ATE,'QQ/�gY'4,
S,LE9
ADDRESS L . A I "JJ J� / /. [/��C�_•/' 7'-/x-6 L ( -/ 7' ,0
CITY /Ea NO eirig/ BUILDING
A ADDRESS
ARCHITECT - TEL.
OR ENGINEER NO.L. COSTA MESA. CALIFORNIA
FIRE ,/
ADDRESS y/JJ.�y// ;� �/!�/�� ZONE TYPE Y GROUP// //
CONTRACTOR��7 "r "`��I ia�y�! e _ `� APPROVED 1� DATE 97 9/ 6D
ADDRESS ICG I I'
CITY ZONE y� i/ I
PLANS _G_ BUILD HG EW I
STATE TEL. DEGAL�K\-/ NO.OF!�/�_� A !!!
LIC.NO. j� //�I NO.(J /) LEGAL Pn ON r /L4
S
OF LOT / /1, -/� /�'8•� 7 I NOW ON LOTS / A.P.NO. 1/ R /0 - "- D 7 U \
USE OF `�,j// \\�
EXISTING BLDG. D✓I - APPROVED ALLOWED �Y
SETBACK OFLINE FROM (CENTER LINE ET.) �/� ,•,/�/r,_��
CENTER STREET REAR YARD FRONT , "J t FT. LO �'"- e N. L�
SIDE YARD I LEFT I RIGHT R.SIDE 0 FT. /IN. `\
DESCRIPTION OF WORK
L.SIDE 2.�FT. {� // IN.
NEW I VI/ALTERATION I II ADDITION I REAR /O CTT /3//(,/ '/IN. /
REPAIR V MOVING I I DEMOLISH I BYI'ROVED; // /� (DATE y� `(�O N.
BUILDING �iJ•F1/ (/NO. OF W v ,Q�
SIZE ,j 371/lei/NO.
-1 ROOMS STORIES / AI07 & 'J\re/-ELL414: ces- \
EXTERIOR WALL IROOF R Sn_CLAX., R.t•QUI RI"A"' .. . ...-
COVERING COVERING ,l.I \
USE OF BUI4�Le/Dr/tNG AND WORK TO BE PERFORMED'
/1�i/� / /� / ..
41//9% d 4d ,
I HEREBY ACKNOWLEPGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS Port THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM•
PURPOSE OP, ESTABLISHING A PERMIT FEE ONLY.
PLY WITHALL CITY RDINANCES AND STATE WS REGULATING
BUILDING CONSTR TION. VALUATION -/ �/
SIGNATU N.
���/ ,Ji�/J�/,y/� PERMIT FEE 5 ".' ‹
PERMITTE !(a C/0 �f !w"/' et/ $ /,4/� // m_
PLAN CHECK s /7 4;
AUTHORIZED AGENT /4/�i. o `
TOTAL FEE $ 7 4
• Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY'OF COSTA MESA PERMV NO. - TRACT NO. LOT NO. 'BLDG.NO. -- - ' - •
.CONSTRUCTION PERMIT P-/S99
•
'Project Address j,).2. 0 {. 1 TYPE OF CONSTRUCTION ^ a i ��,14 f I/02/8I _24_ 00 . TL
.Owner - 7` I Phone '" ❑ NEW ADD ❑ ALTERTION •
'AddTEss - '31S'rtr ' -"Jr -d 0 REPAIR ❑ CONVERSIONEMOLISH-
Arch/Eng. -- - ' License NO. ' - 0 OTHER A
AMA.P-$ AS
Address - DESCRIPTION OF WORK _ — ' `�-
^ •
. (^, . / at-'Contractor /4,...",___' ZONE •
` i4 Z�Ytbne LJ (,3 t, - PE OF PERMIT
cx .Address 7i-J•t f-.4 - �� .. ■ • . ■ • •` ■ • • •
•
-
ll
"'4 LICENSED CONTRACTOR DECLARATION - ■ TENANT ■ ELECTRICAL OPLUMBING ■
I hereby affirm that.l am licensed under provisions of Charter 9 (com-
mencing-with section 7000)"of Division 3 of the Business and ■
Professions Code, andAmy license is In full force and f _ -
License Class ` • y / /1 Icense No.�UIC so • •• • SPACE e PROVIDED
Date )i A •X Signature I C ! .'n4 e STREET • -
• WORKERS'COMPENSATION DE ARATION - OCCUPANCY 1CONSTRUCTION _
I hereby affirm that I have a certificate of consent to self-insure ora 'VALUATION ♦ , • • • a �E �/ �- •- l
certificate of Workers' Compe ifR Ince, or a certified copy
417
thereof( c,,{tttan 38191 b.�5 • (/ /
1, Policy(itl /-[)-Y k omppa�
• Certified-copy is hereby furnished.
1 11 ertified copy Is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSAT DECLARATION
,• t (This section need not be completed.if th mit is for'one hundred
t
($100) or less). - - -
I certify that in the performance of e work for which this permit is
issued, I shall not employ any p n in any manner so as to become
• ELECTRICAL - PLAN CHECK
subject to the Workers'•COmpe tion Laws of California. UWtLLIN(WERS
BATHTUBS SHa - • (aAHA(aL -
Date Si ture • •
NOTICE: If after maki this declaration, you should become subject TOILETS
GENERATOR TRANSFORMER 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must LAVATORIES DOUBLE APPLIANCE 10=50 KW_50+ KW '
forthwith comply with such provisions or this it shall be deemed
revoked-: - ---' - -
CONSTRUCTION LENDING AGEN SINKS DISHWASHERS- MOTORS -- 0-1 HP' HP
I hereby affirm that there is a ruction lending agency for the per- (INC.SOLAR) 10-50 HP SO.+ HP -
formance of the-work for h this permit is Issued (Section 3097 •
Civ. C.). FLOOR ••• • 'FIXTURES • OUTLETS - SWITCHES
• • Lender's Name •
-
Lender's Address •• • • GAS 7U BE'SIG NS . .
OWNER BUILDER DECLARATION - ` ' - ' ,. INTERCEPTORS POLE LIGHTS • - - - -
I'hereby-affirm that I am exempt from.the Contractor's License Law for
the following reason'(Section'7031.5 Business and Professions Code: SWIMMING POOL' P TRAP ' - . LuNs I KULI'UN - - . -. -..-
Any city orcountywhich requires a permit to construct, alter, POLES METERED SUB
improve, demolish or repair any structure, prior to its issuance,also re- • PANELS MAIN SUB -
quires the applicant for such permit to file a signed statement that he •
is licensed pursuant to the provisions of the Contractor's-LicenseSFORLETs
1 SERV ICE- ' - - - AMP - -
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or-that he is exempt therefrom and the - - - .. . . - - - -
basis for the alleged exemption. Any violation of Section 7031.5 by A I 11 •
any applicant for a permit subjects the applicant to a civil penalty • • -- • - -
of not more than five hundred dollars ($500).
❑ 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. (Section 7044, Business and Professions Code: The .eta,.. ISSUE FEE '•Contractor's License Law does not apply to an owner.of a property
who builds or improves thereon, and who does such work himself or APPLICATIONAPPROVED BY - DATE
through.his-own employees, provided that such.improvements are notIntended or offered for sale. If, however, the building or improvement SUMM • •issold within one year of completion, the owner will have the burden ' BUILDINGof proving he did not build or improve for the purpose of sale).
BTU PERMIT $ .SMTPs •` •••❑ I, as 'owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business • 000 PLAN CHECK $ 'PERMITantl Professions Code: The Contractor's License Law does not apply to • ISSUANCE $
an owner of property who builds or improves thereon, and who con- • . r• r s• PLUMBING $ •tracts from-such projects with a contractor(s)-licesnetl pursuant-to _. .GRADING $ ' ' _the Contractor's License Law). s s• PLAN CHECK $ _ •
IDI am exempt under Section _ B.& P.C.for this MICROFILM $ "' i N_ ELECTRICAL $ $ �ff
-
reason ' PLAN CHECK $ - -
ALTERATIONSYSTEM REPAIR, TOTAL FEE$ -
Date "'Owner - - - - MECHANICAL $ '- I
I hereby.certify that I have read this application and state that the above 'LESS AD- _
Information is correct. I agree to comply with all city and county 'PLAN CHECK $ VANCE PC $_ ' -
ordinances and state laws relating to con truction,and hereby authorize - - .• I
representatives this city to en r upon the above mentioned - A4 es N
property -for I s ern.p o ..
•
Signature. Date/1-.1-O4 1 ®® . FINAL FEE $
Drivers' Licen or SS / - - - - 4
CMF 0865.46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING ,&SPA ..
jY APPROVALS IE \ }['\ . l pemrit# Date • Inspector I - Date - , Inspector
APPROVALS Permit# •
1. Temporary Electrical Service or Pole _ !. 43. Pool & Equipment Location `
2. Soil Pipe-Undrgrn 44. Steel Reinforcement - • ` - -
3. Electrical Conduit Utility-Undrgrn' 4.--, • - 45. . Forms . .
4. Electrical Conduit-Undrgrn '\- "._ 46. Electrical Bonding -
5. Steel Hemforce - --- 47. Rough Plumbing& Pressure Test - - - - • •
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ).
7. Footings49. Electrical Conduit-Undrqrn •
8. .Foundation . 50. Gas Pipe, ❑Undrgrn,Test .
9. Water Plpe-Undrgrn 51. Backwash Lines. P-Trap. I Undrgrn • " •
10. Structural Floor System52. APPROVAL TO DECK
11. '-Property Sewer Line,&,House Connection -53. Backwash & Receptor-Final '
12. Street Sewer i„/' ' /dy/p, r 54. Heater & Vent-Final
13. Rough Plumbing 55. Plumbing System -Final - '
14. Rough Electric-Conduit - .56. Electrical-Final - . . -
15. Rough Electric-Wiring - 57. Solar System-Final
16. Rough Heating&Air Conditioning • _ b8. Fencing & Access Approval ..
17. Ducts, in Structure - 59. APPROVED FOR PLASTERING •
' 18. Ducts, Ventilating - _ _
19. Gas Pipe-Rough &Test • - 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing - . • -
21. Roof Sheathing .
22. Frame and Flashing NOTES: • ' •
•
23. Insulation
24. Lathing & Siding • - -
• 25. Drywall Nailing - . ' - . , ' •
' 26. Plaster Brown Coat. ' -
27. Electrical Power Meter-Final - • . -
28. Final Electric - • . .
29. Final Heating & Air Conditioning -
30. Final Gas Pipe-Test . . '
31. Final Plumbing • - ..
32. Water Service-Final _ - - •
33. Gas Service-Final -
34.-. Solar Domestic-Final -,.
35:" Landscape Sprinkling System.
36. Sound Attenuation
37. Handicap Regulations . ' •
38. FINAL STRUCTURE & BUILDING .
;r, 39. Special Requirements Completed "
• - 40. Electric Release .to Edison - -
41. Gas Release to Southern California Gas Co. • - -
42. t CERTIFICATE OF OCCUPANCY .
•
No Date - •
.