HomeMy WebLinkAbout3150 MANISTEE DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address: 3150 MANISTEE DR
Suite:
Vicinity:
Parcel Number: 41801226 Zoning: R1 R1
Applicant: GUY GALITSKI
Address:
Phone: 714-965-2387
Zip:
Owner:
TYSSEE, MARK
Applied:
10/20/2003
Address
3150 MANISTEE DR
Calc Valuation: $6,400.00
Permit:
$139.25
Phone:
Claim Valuation: $6,400.00
SMIP Res:
COSTA MESA, CA
Zip:
92626
Contractor:
G G ROOFING CO INC
Address:
19792 POTOMAC
Inspection:
$0.00
Phone:
(714) 965-2387
Total:
HUNTINGTON BEACH, CA
Zip:
92646
License:-
364151
Arch : Eng:
Address: Address:
Status:
ISSUED
Applied:
10/20/2003
Issued:
10/20/2003
ISSUED BY: ?�
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
T/OFF, SHEATH AND REROOF 2300SF RESIDENCE W/COMP SHINGLES.
NOTES
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL; (714) 754-5626
2"6& W00)
FEE SUMMARY
Plan Check:
$0.00
Calc Valuation: $6,400.00
Permit:
$139.25
Claim Valuation: $6,400.00
SMIP Res:
$0.64
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$139.89
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0
Rear 0-0 Left 0-0
Right 0-0
ACCESSORY
Front 0-0
Rear 0-0 Left 0-0
Right 0-0
PARKING
ffxistin : 0
Required: 0 Proposed: 0
NOTES
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL; (714) 754-5626
2"6& W00)
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the fallowing declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 the Labor Code, for the performance of the work for which this permit is issued.
My worCkers' compo tion Insurance carrier and policy number are: 1
Carrier: _ �"TA'il,er t'Jvl)q Policy Number: 1 �fl
(This section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
❑ 1 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 workers'
compensation laws of California, and agree that if I sho subject to the wo s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these prove s. iC7 ^ 2Q —O
Applicant Signature: Date:
WARNING: FAILURE TO SECURORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provi ions of Chapter 9 (commencing with Section 70 f Division 3 of the Business and Profsgsions Code, and my license is in full
force and effoct. Lic. # y Class # C-3
'L
Contractor's Signature: / Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code),
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or 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).):
❑ 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 (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
............................................................. .................................................................................................................. ........................ ......................................... ............................................................................ .......... ........ ....................... ............... I......
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
..................................................................................................................................................................................................................................................................................................................................................................... I .....................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire ...... Department.
......................................................................................................................................................................................................................................................................................................................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully Complied with? ❑ Yes ❑ No
.............................................................................................................................................................................................................................................................................................................................................................. _.........................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? LJ Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
............................................................................................................................................................................................................................................................................................................................................................................................
6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................................................................................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
.............................................................................................................................................................11ut................trol....................................................................................................................................
attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Si a Ot Le al Owners C —2
Date�
And/Or Authorized Applicant Date
INSPECTION TYPE !LATE IWMALS CODE 4 INSPECTION TYPE PAN Its
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final� 208 Final Plumbing
4
200 Final Re-Root & 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final BuildingrOccupancy
0
l\
PROJECT ADDRESS: 3150 MANISTEE DR UNIT:
OWNER'S NAME: WATTS, JAMES L
ADDRESS: 3150 MANISTEE DR
COSTA MESA,CA 92626
ARCHIENGINEER: (714)757-5700 flEG.NO.:
ADDRESS: UNIT:
PERMITTEE: JAMES L, WATTS (714)757-5700
ADDRESS: 3150 MANISTEE DR
COSTA MESA CA 92626
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect.
CITY LIC.: STATE LIC.: CLASS:
Oad _.— Signature'
WORKERS' COMPENSATION DECLARATION:hereby affirm that I have a certificate of consent to self insure or a certificate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C.
'POLICY NO.: EXP. DATE:
COMPANY:
J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date'. Applicant.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($1170) or less).
I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: It after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: 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).
LENDER:
ADDRESS:
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 Cade: Any city 01 county which requires a permit to construct, alter, improve, demolish, or
repair 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 the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Cade) or that he/she is exempt therefrom and the basis tot 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).
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 Professional Code: The Contractors' State 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 employees, pr0vided that such improvements are not intended or offered for sale. If, however the building Cr
Improvement is sold whim one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose at sale)-
L as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
® and Professions Code'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a ConVactor(s) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation Insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason//:
Dale: �7 �! Owne
I do hereby comfy that I am aware of and understand the requireme rfornia health an7CodeSections s 25505, 25533, and
25534 and that I or any future building occupant will/will not Iciel eed t0 comply with she requirements for a
permit for construction or modification from the Air Quality Manag r n District. Residential ons are exempt from
these provisions .I 1
Date: '-L — J —� Applica
hereby certify that I have read this application a slat at the above in motion is correct I agreeto comply with all city and county
ordinances and state have
relating 10 building con , on and hereby au n . representatives of this city to enter upon the above mentioned
property for inspection purposes.
Date' 14^ Ll —D Signature'
0river's License or Social Security #:
164146 White—Boddmg: Green—Come Enforcement. Canary—Applmant Pink—Revenue: Goldenrod—ASsessoi
CITY OF
COSTA MESA - BUILDING PERMIT
PERM NO: G 05156:
PERMIT NO: G 051563
PLAN CHECK NO:
01152-91 S
GOVT: N SUPP: N
CONSTRUCTION TYPE: 5-N
PERMIT TYPE:
ELE MEC PLU
STR PURPOSE: ADD
JOB DESCRIPTION ; ADD FAMILY RM G BED RM TO
EXISTING SFD
SQ FT; 300
CLAIM VALUE: 20,000,00
CALL -VALUE:
20,700,00
GROUP OCC: R-3 ;
COMMENTS: SMOKE DETECTOR(S)
REQUIRED IN HOME.
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------- --------- ACCESSORY BUILDING -------- --
FRNT: 60 FT IN REAR: 20 FT IN FRNT: FT IN REAR; FT IN
LEFT: 5 FT IN RGHT: 15 FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 4180,1226 ZNE: PDR- REF NO: PA -90-109
PLANNING N 7TES> PROPOSED 300 S.Q. BED ROOM AND FAMILY ROOM ADDITION TO
> EXISTING S.F.
###3('##IEK'####%#%'#}F##########%%•#.kaC#####If###3E'######%######!?-.X..iE###'%###%##iE ii'if'#'3lii-#dr#J{. 7q.X.
D E V E L O P M N-1 SERVICES R E Q U I R E M E N T` S
20A?LNG APPROVED BY:� DAT•E;
BUILDING APPROVED BY _ _ _ DATE:
APPLICATION ISSTUED BY: DATE:
y .
#
LEGAL.IZATION:N F E E S U M rM A R Y STRUCTURAL SEGM,Eil
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 216.00 4,00 15.00 9.00 2,07
25% 50% 25% SMIP/NON-RES
PLAN 1.40.40
ISSUE FEE 3.00 15.00 15.00
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 246.07 33,00 140,40 419,47 419.47 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 419,47 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC: MECHANIC FIRE. SMIP/TGT GRADING PLAN -CHECK
216,00 7.00 30.00 24.00 2.07 140.40
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 300 DWE-TYPE V -WOOD FRAME -GOOD 69,00 20,7U0,00
ELE 4 FIXTURES, LIGHTING 1 ST 20 EA, .75 3.00
ELE 11 RECEPT/OUTLET 1. ST 20 EA, ,75 8,25
Ei,E 5 RECEPT/SWITCH I ST 20 EA. ,75 3,75
MEC I REPAIR/ALT HEATING UNIT/SYS W/CNTLS n 9,00
PLU 2 INSTALL/REPAIR WATER PIPING ^Q7IP, 06
END OF FEES D
TIARR Os
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
P. & SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location ""
F
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. APPROVALTO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
f
i
8. Foundation
59. Gas Pipe, O Undrgrnd., Test
, j
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P-Trap, ❑ 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
APPROVALS .Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure .
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping ElGas 0Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24. Roof Framing
73.Undergrnd. Storage Tank []Gas ❑ 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 Electric52
Notes:
34. Final Heating & Air.Conditioning
35. Final Gas Pipe-Test
'
36. Hood or Canopy
'lei "
37. Final Factory Fireplace
y _
38. Final Plumbing
{p�2i"4r�f
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 PLANNING
r.
t. •_
49. Electric Release to Edison.�`�
_• -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. 1'e4 3 Z DATE 1d
LOT NO.
ADDRESS✓O l/�%� /r/ 1�,
The developer of the above entitled tract desires to sell the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned,
by executing this
agreement,
acknowledges that (he -she -they)
(was or were)
advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
RECEIVED
CITY OF COSTA MESA
FI .A iwgi ' Pr,DT.
AMOCT 28 1976
71819i]OillX91112131415i6
ueveloper ana/or auznoriz
representative
BY
Lender
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT
Project Address 3150 Manistee Dr.
Applicant's Mailing Address4572F. Fi a nhOW –Anti et m
Owner's Name Jim Watts Phone 966-1788
Address 3150 Manistee Dr. -Costa Mesa 92626
Arch/Eng. License No.
Address
Contractor's Name PRO—pORMMICE. INC. Phone 779-686$
Address (mailing) 45_72_ EE;!apnhOWr Cr. -Anaheim 9 807
City License No. 40702
LICENSED CONTRACTOR DRCLARATION
1 hereby affirm that 1 am licenged under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. l 'I
Dal- a Class r-20 Lice 483411_
Date COMPENSATION
J �¢�
WORKERS' mthatI have
I ON DECLARATION
Hereby affirm that I have a certificate of consent self -insure or a certificate
Workers' Compensation Insurance, or a certified
ietl copy thereof (Section
.400, Lab. C.) andS
Policy No.
ie 6WC686780 Company
Certified copy is hereby furnished.
cit
Certified copy is filetl with the city Building Division.
Date F,/7A/RA Applicant PRO–IFCIRMANCR INr
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section need not be completed if the permit is for one hundred ($100) or
less).
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
\Workers' Compensation Laws of California.
Date Signature
NOTICE: If, after making this tleclaratidn, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, demolish or repair
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
y„ivlsion 3 of theBusiness and Professions Code) or that ne/she is exempt
1, 'erefrom and the basis for the alleged exemption. Any violation of Section
ss��. 31.5 by any applicant for a permit subjects the applicant to a civil
'v'aenalty 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 Professional Code: The Contractor's
License Law tloes 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
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-
pletion, the owner will have the burden Of proving he/she did not build or im-
rova for the purpose of sale).
I.
as owner of the property, am exclusively contracting with licensed con.
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
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
proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. & P. C. for this reason
TYPE OF CONSTRUCTION LI NEW `ay' ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. rhangpnnt PATT- Add C—
TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL
11TENANT ® ELECTRICAL ❑ PLUMBING W MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SD. FT. oCCUPANCv_
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCU.YDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P=Trap
Roof Drains
Reinspection Fee $15
Date Owner
I hereby certify that 1 have read this application and state that the above 1
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 *is city to entail upon the above-mentioned property for
inspection p �f "s06/29/89
Signature Date
Drivers' License or SS a
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Bit. ICBO #
Heating System & Ducting
Q0-100,000 BTU 13100,000BTI
Reinspection Fee 1 $15
CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto -Wash
Laundry Trays
Issue Fee
Hood or Type ❑
Canopy Type 11 ❑
Refrigeration System
W0-100,000BTu ❑1oo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
N
A.P. #
S Main Bui
E
T Front
B Rear
A
C Right
K
S Left
Ping. Ref. #
Planning Not
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elecn
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 1:10-5 KW ❑
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL FEES
Transformer ❑ 15.50 KW
❑ 50+ KW
Meter ❑up to 100 amps
Meter Dover 100 amps
Sub Panel
1 Motors 00-1 HP 1X1''A-8
Inc Solar 09-15 HP 016-15+
Microwave
Pole Light
Range
Standing Sections
5-15 KW Trash Compactor
Reinspection Fee I $15 I I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By
Application Issued I
Z
O
N
1
N
G
R
E
Q
M
T
S
SMIP
SUMMARYrOFI
BUILDING PERMIT
$
PLAN CHECK
$
PLUMBING
S
PLAN CHECK 25%
$
ELECTRICAL
$
PLAN CHECK 50%
$ +y'
MECHANICAL
$
PLAN CHECK 25%
$
Z
O
N
1
N
G
R
E
Q
M
T
S
SMIP
$
PERMIT
ISSUANCE
$
ENERGY P.C.
$
GRADING
$
MICROFILM
S
TOTAL FEE $
CONSTRUCTION AND PLANNING'
APPROVALS Permit # s
Date
Inspector
POOL & SPA
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
9l. 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
I.8. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0Gas 000
23. Gas Pipe -Rough & Test
72. Underground Flush
.
24. Roof Framing
73. Undergrnd. Storage Tank O Gas 0 Oil
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
t ,
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:8%(0_j*jt
34. Final Heating& Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
i
i
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
X
•• earK Mesa Homes uAle " "11
JOB ADDRESS 3150 Manistee Drive BUILDING PERMIT NO. 41662
r FMFo AI rnAlTDnrTno ._ _ .. nCcroleTln.•_l wnnu .. _ , I_« ------
AP No. /,i u—ni i_nT LOT 13 TRACT 9036 FIRE ZONE VALUE E 30.800.00
IIACTIONS
Si
nature
Deft,
TYPE v
GROUP I
6 J ZONE R-1
'"fnT
SUBCONTRACTOR
MI 5
GA
GAS
Dvte NVmber Signature
WATER
PI
.bin
ROUGH PLUMBING
_
PROP. SWR. LINE MOUSE CON.
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SPRINKLING SYSTEM IN
Z.
MISCELLANEOUS
'Y
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND C3 POWER Ej
ROUGH WIRING
Heoting
and Vent
TRENCHES 0 FORMS Ej STEEL REINF.
FLOOR SYSTEM
t
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME A FLASHING
O
LATHING — IN OUT
PLASTER. BROWN COAT
114
STRUCTURAL, FINAL
HI G, VENT., REFR16. AND A.C., FINAL
Z
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It
PLt-. ING, FINAL AND GAS TEST
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ELECTRIC, FINAL
BUILDING, FINAL
WQ
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sa
P,
41662
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADDRESS
OWNER
MAIL
ADDRESS
CITY
Park Mesa BOmes
CONSTRUc"O
LENDER 8n
BRANCH .San
ARCHITECT
CONTRACTOR Lucas
ADDRESS
1451 Qu
CITY
Newport
uc NO.
257064
SIZE
BUILDING
ADDRESS31O
OF LOT
55 X 90
Beach NNOL'833-0018
o Federal S 6 L
O
'rept
L.
I ill � AAAtle No. 645-8040
Irovia, Newport Beach
Development Corp.
lil St.
TEL.
Beach NO. 833-0018
CITY
LIC. NO.
NO. OF SLDGS,
NOW ON LOT none
UI- none
TING BLDG.
Separate permits are required for
electric, plumbing and heating work.
OF BUILDING AND WORK TO BE PERFORh
0
PA1
ITR 20-7E,cai�•J001021* *r** 1°7..0
AIP11CATION FOR STRUCTURAL PERMIT
RE /BV
L
DATE RECEIVED
D
E IS�,�/QE
A.P. NO. —d
I"( 2
O
BUILDING
ADDRESS31O
TRACT 9036
LOT 13
BLOCK
W
ADD ALTER
REPAIR
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Coda, Division 3,
Chapter 9, and that sus licensee grit In full f9" and effect, or I
P pp 9.
-
N
ro
X
am exempt fr the prbvicions the State o C Iiforn le Business
ems
end Professi ns od Ivision fiepter 9.
Signature of / '
Permittee
^+
C
VALUATION
�-Iw1
W
�•LL
PER itE $ (/ri
OWNER anow Ara
SE
FIRE
ZONE
APPROVED
BY
ZONEI�I�1 NO. OF
W a
PLATS
YARDS APPROVED
MAIN BUILDING
(FROM C/L STREET)
FRONT 3 SFT.
e cinc S cT
DISTANCE SET.
MAIN BLOGS.
A 'VAR, t1`-
FF
APPROVED
RY WA
TOLD FOR PI
DATE
USE OF f
BUILDING
DATE
APPROVED
FT
I hereby acknowledge that I have read this application and state
In
n
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
m
any person In violation of Me workmen's compensation laws of
a
C
SQ. FT. J
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Coda, Division 3,
Chapter 9, and that sus licensee grit In full f9" and effect, or I
P pp 9.
-
N
ro
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt fr the prbvicions the State o C Iiforn le Business
ems
end Professi ns od Ivision fiepter 9.
Signature of / '
Permittee
^+
C
VALUATION
�-Iw1
W
�•LL
PER itE $ (/ri
PLAN CHECK E ��I
r W
TAX E
TOTAL PAID $
Authorized Agent /
1-7