HomeMy WebLinkAbout1933 SUNDANCE LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
OF COSTA M(EESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 7058 I /<)JI ba . .- .
Protect Address L �er� �l�2d ',s ,R^�'^ 0- ZZ��Z- ��� •
1
Apolicbnt's Mailing Address T`'� �F• Jt t 0V�+�1jL'��_N6TVPE OF CONSTRUCTION NEW U ADD lJ ALTERATION 0 REPAIR '
♦� ' /' err ^✓ 0 CONVERSION 0 DE OLISH 0 OTHER
Owner's Name CAL /.�-4 '\�IF5.1`Y� 3-"Phone65r' - a ' G 4 �7 A.P.#/f.c._ •SD� - aq ZoneAnn-:-D
DESCRIPTION OF WORK/USE OF BLDG. • te{ —
Address S Main Building: Accessory Building:
Arc /Eng. `' License No, TYPE OF PERMIT U GRADING FOUNDATI STRUCTURAL E Front t O
Address 11 a6 �' ' G - ❑ TENANT ELECTRICAL PLUMBING ECHANICAL B Rear jaN
AZO ' . ❑ -OTHER /��J 9
Contractor's Name 1/ 004' 4IT Phone l-� • PROJECT DESCRIPTION SO. FT./.'Ir/ TIONOCC $ N V �') C Ri ht - - G
Address(mailing) OhyD. f ZZ / CONSTRUCTION TYPE y VALUATION$ '�� s Left
City License No. j//7R
• ZONE GRADING CU.YDS. ACRES $ 1E
LICENSED CONTRACTOR DECLARATION • Ping. Ref.#p US —7O Parking Req./Provided
I hereby affirm that am licensed under provisions of Charter 9 (commencing Remarks: �P n _/S !1,(% $ ` Planning Notes: 7 c �„r�, •r,.� .1 q t,1 0
with section 7000) of Division 3 of the Business and Professions Cotle,.antl �, l _� w' • • - — 4— (,V�pT } µTS T
my license is in full rce and effect. l/ 1Vl\ J4 WILI egaN I .L,
License GClass__ � lcersall r -amh /j /�� _J. 1 `?�/ Ad
Date l /'r, •Signature i `� PLUMBING FEES -
/C-I�' WORKERS'COMPENSATION D LA TION Bar Sink Showers
•
I hereby affirm that I nave a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section ' Backflow Preventer - Service Sink
3800, Lab. Automatic Washer Transformer 0 15-50 KW -
C`, Policy No. ys Company 5-
Policy Backflow Irrigation Sewer Cap Construction Pole Sub. - 0 50+ KW
�7\ ,��•q►��rtifietl copy Is hereby furnished. _
IYCertifi/ed copy is flW
ed with the city BI ing iision,. , -2..Bathtubs / Sewer Connection / Cooking Unit / Mete up to 100 amps
Date L —f—7( Applicant 5 `f 7 -
•
EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONClarifiers Solar Collectors Dish Washer Meter Clover 100 amps •
(This section need not be completed if the permit is for one hundred ($100) or
less). / Dishwasher / Solar Piping • a`` -77
/ DryersJGas ❑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 00.1 HP ❑1%-8
Workers' Compensation Laws of California. - _ -
Date Signature _ - Floor Drains Swimming Pool w/Spa / F.A.U. ~- Ina Solar ❑9-15 HP ❑i6-15+
'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. Microwave 3 /
CONSTRUCTION LENDING AGENCY / Gas Service 3 Outlets Water Closet gr /
I hereby affirm that there Is a construction lending agency for the performance qq Device'Boxes Pole Light
of the work for- /P' NN tAi trplyi�/(�Jissuetl (Section 3097 Civ. C.) • Interceptors Water Heater p' �}! Outlets! - Range S r
Lender's Name �L`` p
Lender's Address - , '/ Kitchen Sink . / Water Service .%' /4, Switches Sign 3 , 0
OWNER BUILDER DECLARATION -
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 ❑0-5 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 - •
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
penalty of not more than five hundred dollars($500). .
OI, 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 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 • DEVELOPMENT SERVICE REQUI EMENTS:
thereon, and who does such work himself/herself or through his or her own Boiler Hood or TypeElemployees, provided that such Improvements are not intended or offered for Zoning Approved By ObC -� Date/- 9- J L;
sale. If, however, the building or improvement is sold within one year of com- — Canopy Type II ❑
pletlon, 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 Approved By Date 17 -I (9/'
etiTEl i, owner of property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date •/ / 7 ec
tractorsrs to constructct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SIA/131/OF FEES �' 4115'---
tractor(s)
builds or improves thereon,and who contracts for such projects with a con- -• s r/
tractors) 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 to me. PLAN CHECK $ PERMIT
❑ am exempt under Section B.& P.C.for this reason / (-;,,,PIlf..,.t.DI.. 00 6 Fire Dampers PLUMBING $ 2 -- ISSUANCERMIT $
Date owner ' Hefting System& Ducting Registers 114' -- PLAN CHECK 25% $ O r ENERGY P.C. $-
I hereby certify that I have read this application and tate that the above / 0-100,000 BTU El 100,000 BTL O. GRADING $
information is correct. I agre- o c• ply with all c :nd • ty ordinances / ELECTRICAL $
and state laws relating to,, '•' • constr lo .-a •. :•y authorize repre- - PLAN CHECK 50°,6 + rf MICROFILM - $ /
sentatives' of this city ,zr.... —mentioned property for,
inspectlan -. r.Oses. MECHANICAL 3`�y ? TOTAL FEE
Signature / Date /-9-4 8 A� ,./ sr
Drivers' Li ense or SS* «./ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% 'a�� a Z,
,MF 0865-46,rev.10/84 White - Building: Canary -Applicant; Pink -Accounting: Goldenrod - Assessor
F'' CONSTRUCTION AND PLANNING POOL &SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
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 r'
5. Steel Reinforcement 56. Rough Plumbing & Pressure.Test
6. Electrical UF ER Grnd. f" (
f 57. APPROVAL TO COVER-GUNITE
7. Footings /8 , ^- S 58. Electrical Conduit-Undrgrnd. •
8. Foundation 59. Gas Pipe,0 Undrgrnd.1:4Test
9. Water Pipe-Undrgrnd. //77/y( 4L ' 60. Backwash Lines, P-Trap, 0-Undrgrnd.
10. Structural Floor System 61. APPROVAL TODECIK ' C. '
11. Property Sewer Line & House Connection 710/06 �/ ec 62. Backwash & Receptor-Final ,
12. Sewer Cap 63. Heater & Vent-Final Ip ,
13. Roof Drains 64. Plumbing System - Fin.I '
14. Rough Plumbing 4/7/pg SIP° 65. Electrical-Final • .n - • - • -
15. Rough Electrical-Conduit 66. Solar System-Final it
16. Rough Electric Wiring it/ t�,+�rij X67. Fencing & Access App oval .
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 (Afy'
20. Rough Factory Fireplace APPROVALS Permit# (�1� .
.y
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas U Oil
23. Gas Pipe-Rough & Test 72. Underground Flush .
24. Roof Framing 73. Undergrnd.Storage Tank U Gas 0 Oil
25. Roof Sheathing 5(251ak 05 74. Overhead Hydro .
26. T-Bar Ceiling (Structural) & Monocoat 1 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 Brovvn Coat in,' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: .1 A V4A kS ( 0)
34. Final Heating & Air Conditioning gal*. L� �� ) � Jce AM
35. Finel,Gas Pipe-Test f(-y���(, tP -Q Y
36. Hood or Canopy '
., .....
37.,Final Factory Fireplace Q-24-bG (-go '�• / 3/8.1 ., .N
DDOIIIMMM!!! -l.I�--� - -.
38. Final Plumbing 4-2.9-aa CLO BOLD FOR SPECIALBEQUIREMEI:'r1"".
39. Water Service-Final 47 z.Vt caEO -•i, - t -
40. Gas Service-Final i •
41. Solar Domestic-Final . '
42. Backflow Preventer V '
43. •Backflow Irrigation - I,
•
44. Landscape Irrigation System _" .
45. Sound Attenuation .`
. ;
'46. Handicap Regulations I ,• ' - -
47 FINAL STRUCTURE & BUILDING IZ/yy �y-jJ�, _ . '- h
48. Special Requirements Completed I r • .
•, r
49:_Electric Release to Edison - -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY '
r
No, Date ,
" Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT RMIT NO. TRACT NO. LOT NO� UNIT NO. -
''OO99 2Z 3n 2 r - 5710 5%21 /86 18:00 TL
Project Address 1!J• 3 s P0. fNCN taw LJ ADD U ALTERATION U REPAIR _ +
RO ,805( 3/VO Gcvrctenr 6rnye TYPE OF CONSTRUCTION U NEW
Applicant's Mailing Address ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# Zone
Owner's Name .Cal A/VT. cm/a.7✓G1�/. Phone 638-3coo DESCRIPTION OF WORK/USE OF BLDG.
Address ' S Main Building: Accessory Building:
Arch/Eng..6 ,1 _ L6'F/ety License No.L
TYPE OF PERMIT ❑ GRADING 0 FOUNDATION U STRUCTURAL E Front o
Address _//$O //�V. PC.H. Lik-UNA st//• ❑III TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BB Rear N
Contractor's Name4 eye v / so/Yrc Phone Jfl 7yo3 C Right N
Address(mailing) /et aI IC ! 6 7 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K g
CityLicense No. T I n CONSTRUCTION TYPE VALUATION$ S Left G
ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req,/Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: Cl
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is In full force and effect. T
License Class_L=Z6/ License No. 3572 y S
Oates_-7— 8'L Signature 7PLUMBING I FEES '
WORKERS' COMPENSATION DECLARATION Bar Sink Showers
1 hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section
Backflow Preventer Service Sink
3800, Lab. C. Automatic Washer Transformer 0 15-50 KW
Policy a. 17y23 FG Company 57 Y'ar Backf low Irrigation Sewer Cap ❑ 50+ KW
ertified copy Is hereby furnished. _ j Construction Pole Sub.
Certified c py Is filed with the city Building wisio . Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date s-copy
Applicant Clarifiers Solar Collectors Dishwasher . . . Meter Cover 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❑0-t HP ❑1'A-B
Workers' Compensation Laws of California. _
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. —
Inc.Solar ❑9.15 HP ❑16-15+
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. - Microwave
CONSTRUCTION LENDING AGENCY - Gas Service . Outlets Water Closet _ Device Boxes
1 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
Lender's Name .i&B OWNCr Range
Lender's Address - Kitchen Sink Water Service Switches •
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 ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair PTTrap . Laundry Trays
any structure; prior to Its issuance, also requires the applicant for such permit y - ., Generator ❑0-5 KW❑5-15 KW 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 g (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 t
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty 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 • I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's ECHANICAL - Reinspection Fee $15 Issue Fee $ 3
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 sunn 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 ❑ 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).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data 5-'2'/—IND
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner je property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU �,", •_ _it `I SUMM Y OF FEES
builds or Improves thereon, and who contracts for such projects with a con- {J Wa'r J$ / 1. SMIP $
tractor(s) license pursuant to the Contractor's License Law). I am aWare that Exhaust System ❑ Multiple❑ System Repair/Alteration UI LOIN PE MIT
proof of their Worker's Compensation insurance should be provided to me.
ID IF LAN CHECK $ PERMIT I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
HeatingSystemDucting Registers •
PLAN CHECK 25% $ ENERGY P.C. $
Date owner & .
I hereby-certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT GRADING $
information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for $
inspection purposelyy Date R
Signature_ - ��9 pG TOTAL FEE $ �[S
..
Drivers' License or SS# _ ReinspectiMECHANICAL $on Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ '
CMF 0665-46.rev. 10/84 white - Building; Canary -Applicant_Pink -Accounting; Goldenrod - Assessor
•
fr
a CONSTRUCTION AND PLANNINGPOOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
' 1.,Temporary Electric& Service or Pole 52. Pool & Equipment Location
• 2. Soil Pipe•Undrgrnd. 1 - '-' ' 53. Steel Reinforcement
3. Electrical Conduif.utility-Undrgrnd'(' - r-,• 54. Forms
4. Electrical Conduit=Uhdrgfnd. 55. Electrical Bonding
5. Steel Reinforcement-r 56. Rough Plumbing & Pressure Test 1
• 6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
7. Footings - ' r • r r 58. Electrical Conduit-Undrgrnd.
•
• 8. Foundation �r � 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System ,1 '+ 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 %r
1flough 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-Ficial - / ]/��/�-� 80. FOOD CERTIFICATE ISSUED
33. Final Electric /12 /I/✓ Notes:
34. Final Heating& Air Conditioning ICJ J J. MI/- ct°a, I GO
35. Final Gas Pipe-Test c'-zq-gti 1.47.2 UQ
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'a Landscape Irrigation System
45- Sound Attenuation
40nHandicap Regulations / !/�-
4723FINALSTRUCTURE & BUILDING / pag e4
48. Special Requirements Completed
49. Electric Release to Edison
5gGas Release to Southern California Gas Co
51r_CERTIFICATE OF OCCUPANCY
No. Date
_ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
clrY OF COSTA Mesa ' CONSTRUCTION PERMIT - REMIT _ l(� TRACT NO. LOT No. 'UNIT NO. 3510 9/22/86 12.00 TL
Project Address \S33 Sla,.,o.._•.r Lu. 1' 1 16 Ta \2b�''I -' • .... .-
• A)Splicant's Mailing Address elePiPle PO a%t10 TYPE OF CONSTRUCTION H NEW 1-J ADD H ALTERATION ❑ REPAIR - -• -
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - .' Zone
Owner's Name C'AvH� lLr:rwto CtAL Phone • DESCRIPTION OF WORK/USE OF BLDG.' .. .. .. -
' Address P,gQYE S Main Building: . Accessory Building:
Arch/Eng. (eta' (INUC:M� License No. - • TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION T O
1 .'!_y1 ❑ STRUCTURAL Front
Address . t%V) .0 P1,T 44,t�si P..Pt Nig • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear i N
Contractor's Name SAe c CC so r-tvu.•r Phone -"•4k-w? ❑ OTHER _- A •- _ ..
p� PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) 121,,W ( t (ti.T d• - K G
City License No. •1 i1o919 CONSTRUCTION TYPE VALUATION $ .S Left •-
• ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION - Ping. Ref. •# Parking Req./Provided • E
1 hereby affirm that I am licensed under Urovisions of Charter 9 (commencing Remarks: Planning Notes: - Q
..33.4
with section 7000) of Division 3 of the Business and Professions Code,and G a��G12 M
•
my license is in full force and effect. ( , , T
License Class Q4-1 ( License No.•TC3A CCC.% S
Date �1r+`1(!r. Signet NA.__- PLUMBING . FEES I '
WORKE S' COMPENSATIO D t/ARATION
-
ZBar Sink Showers ELECTRICAL FEES ..
I hereby affirm that I have a c•rti to df consent to self-insure or a certificate I
of Workers' Compensation I. - rance, or a,certified copy thereof (Section Backflow Preventer Service Sink - _
3800, Lab. C.) �•.�� Automatic Washer T• ransformer_❑ 15-50 KW •
Policy No. Ul) S-B'S Company V\r'TZY Backflow Irrigation - Sewer Cap u - - .. Construction'Pole Sub, ❑ 50+KW .
® Certified copy is hereby furnished. ' -
1/certifiep copy is filed with the c A+) . Division. I Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps
Date 1/A iAl. APPI'�.n - -•
EXEMPTION FROM WORKS' 'Cer4 NSATION DECLARATION Clarifiers - - Solar Collectors . , ' Dishwasher _ Meter Dover"100 amps '
(This section need not be compete• f he permit is for one hundred($100) or
less). Dishwasher 1 I 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❑0.1 HP ❑1'/:-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 ❑9-15 HP ❑16-15+, _
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCY I GasService 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 '
Lender's Name. SFE BVIAGt.- Range
Lender's Address • • Kitchen Sink Water Service - -- - - '
OWNER BUILDER DECLARATION Switches 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,improve,demolish or repair P-Trap _ Laundry Trays Generator 00.5 KW ❑5-15 KW I
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 _ - - -_ - _ _ __
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 - -
penalty of not more than five hundred dollars ($500). 3 -
❑ 1, as owner of.the property or my employees with wages as their sole Reinspection Fee I $15 . Issue Fee $
compensation, 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 Contractor's - i MECHANICAL FEES I
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 ❑ '
sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II ❑ Zoning Approved By 'Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground _Approved By Date
move for the purpose of sale). - - �1
LJ 1, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System Application Issued By - Date ' 7�19'f�rJ
• 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 • ❑o-100,000 BTU 0100,000 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 ❑ Multiple System Repair/Alteration BUILDING PERMIT $ SMIP $ -
proof of their Worker's-Compensation insurance should be provided to me. PLAN CHECK $' •
PERMIT
❑ I am exempt under Section -, B.& F:C.for this reason I. Firepl/Fact.Bit. ICBG# Fire Dampers - PLUMBING $ ISSUANCE $
Date • •
Owner Heating System& Ducting Registers ' : PLAN CHECK 25% $- • ENERGY P.C. $ -
I hereby certify that.l have'read this application and state that the above - ❑0.100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances -
•
and state I laws•r rating.to building construction, and hereby authorize repre- _ N CHECK 50°k MICROFILM '$ •
sentatives of s city to enter upon the above-mentioned property for - $
. inspection p est •
Signature • Date r'I�w`vL ._ �CHANICAL $ I�-t/T. TOTAL FEE $ �Z-✓`�
Drivers'}-ic n r SS# : ' • • Reinspection Fee . $15 ' Issue Fee = $ 3 PLAN CHECK 25% '$ (4.0
CMF 0865 ,rev.10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor •
ZT
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
u"
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 OF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7,. Footings 58. Electrical Conduit-Undrgrnd. c)
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 •
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:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace ,p/LJ/S1 Appf'
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
0-tort s CITY OF COSTA MESA
CALIFORNIA 92626 P.O. BOX 1200
0!
tom,
6
tfic ? -' ' FROM THE OFFICE OF THE DEVELOPMENT SERVICES DEPARTMENT/
Oypo OO' PLANNING DIVISION
October 28, 1985
•
To: /
Building Safety Division l Pacific Bell (2)
Business License Division Police Department - Ping. S Research
Camtunications Santa Ana Heights Water Caipany
County Administration Office Sanitary District Engineer
County Clerk/Board of Supervisors Southern California Edison Co.
County Registrar of Voters Southern California Gas Co.
County Tax Assessor State Board of Equalization
Engineering Division (2) Street Division
Finance, Revenue Division United States Post Office, Adams Avenue
Fire Prevention United States Post Office, Santa Ana
Manager, MID Zip 4 - Santa Ana
Mesa Consolidated Water District File (2)
Newport-Mesa Unified School District (2)
The City of Costa Mesa wishes to advise you that in revising street addresses,
the following addresses have been changed:
OLD ADDRESS NEW ADDRESS A.P. NO.
None 1930 Sundance Lane 115-502-29
1931 Sundance Lane.
1932 Sundance Lane.
1933 Sundance Lane
1935 Sundance Lane.
1937 Sundance Lane,
1939 Sundance Lane.
1941 Sundance Lane.
1943 Sundance Lana.
1945 Sundance Lane
1946 Sundance Lane
1947 Sundance Lane
1948 Sundance Lane
1949 Sundance Lane
1950 Sundance Lane
1951 Sundance Lane
77 FAIR DRIVE 1714) 754-5245
1951
-1
049 1950
1947 1940
r
se_
1945 194 i
1932 1939
•
1943 j 4 ( 1439 191 1935 Z I°l39 I Ig3I
CI
SU 1%0463/4 s
LANE-
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