HomeMy WebLinkAbout3022 LANGS BAY - Building Permits PROJECT ADDRESS: 3022 LANGS BAY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 060578
OWNERS NAME:NANCY BLANKENBURC>
ADDRESS: 3009 DAIMLER ST PERMIT NO: B 060578 PLAN CHECK NO: N GOVT: N SUPP: N
SANTA ANA
CA 92701 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: REP
(714 ) 660-0777 EXT, 239
REG.NO.: JOB DESCRIPTION : REPLACE DRY ROTTED MEMBERS ON STAIRWAYS SQ FT: 2, 500
ARCH/ENGINEER:
ADDRESS: UNIT:
CLAIM VALUE: 2, 500.00 CALL—VALUE: 2, 500. 00 GROUP OCC: R-1 /
PERMITTEE: NANCY BLANKENBURG ( 714 ) 660-0777
ADDRESS: 3009 DAIMLER ST COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 UBC IN EACH DWELLING.
SANTA ANA CA 92701 **************************** **********�t�t�E�E�P�t�r�t�t�r+E�E�E*+t�P+Eyr**�E*�r�P�P+r*�P�r4**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in lull tome and¢Ilett. SETBACKS
CITY LIC.: STATE LIC.: CLASS:
Date: signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cenilicate 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 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
' COMPANY: PARKING REQ: PROV: PARCEL: 93768068 ZNE: REF NO:
J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS
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 thee d Workers'CompensationCLaws of California. ZONING APPROVED BY DATE;
Date: l74n• I ?4" Signature: s� /!/-f
NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE
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 APPLICATION ISSUED BY: 1 DATE.
which this permit is issued(Section 3097.Civ.C). ************************* ***** ** *** ****************** *. *2*
**
LENDER: ******************************************* **********************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMI P/NON—RES
pursuant to the provisions of the Contractors'State 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 Oasis for the alleged exemption.Any violation o1 Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty Of not more than live hundred dollars(S500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
pT
q� structure is not intended or altered for sale(Section 7044,Business and Protessionat Code: The Contractors'State License Law TOTALS----> 54 . 50 0. 00 0,00 54 . 50 54 . 50 . 00
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.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• 54 . 50 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 54 . 00 . 50
❑ 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 contractor(s)(cense pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance shoultt be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: �/ D TYPE QTY D E S C R I P w Tr I O N UNIT COST TOTAL COST
Date: �/J` 993 Owner: 0� �1 "' SFR 2500 ALTER BY VALUE'4 RESIDENTIAL NOZONE 1 . 00 2, 500. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533•and END OF FEES
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
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from EXPIRED
these provisions. I • pl:to Inspections
IDate' Aancsa: 1s �/rC,'/�/
hereby certify that I have read this application ion and state that Inc above information is correct.t agree ttoo comply with all city and county vq{e �4
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned -' Sig
property for inspection purposes.
Date: (.7�✓! !f /9/3 Signature: 'e
V
Driver's License or Social Security a:
1641.46 White—Building:Green—Code Enforcement:Canary.-Applicanp Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING Pk. - & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector;
1, Temporary Electrical Service or Pole 52. Pool & Equipment Location t
2. Spil Pipe-Undrgrnd:,_ 53. Steel Reinforcement
3.-Electrical Conduit Utility-Undrgrnd. 54. Forms
' 4,FPectr1cal ConduittUndrgrnd. 55. Electrical Bonding
.=5 tQd Reinforceine, 56. Rough Plumbing& Pressure Test
~
t' 6`-Electrical UFER•Grnd. 57. APPROVAL TO COVER-GUNITE ••=-1
-•t.`Footings 58. Electrical Conduit-Undrgrnd.
-St-Foundation _ 59. Gas Pipe, 0 Undrgrnd„Test '
ll_
,9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1
1
10. Structural Floor System 61. APPROVAL TO DECK
Li
11. Property Sewer Lirt & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap a. 63. Heater & Vent-Final
13. Roof Drains .� •• 64. Plumbing System - Final
14. Rough Plumbing 65, Electrical-Final
I
15, Rough Electrical-Conduit 66. Solar System-Final
16. Rough ElectriaWiring 67. Fencing & Access Approval I
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING I
18. Rough ElectriCaj-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEp_T. RZEOUIREMENT
n r 1 r .ra ... c a.- _ _ r.
20 flotgh FctY }i•ePlace 1p -� L i _4, K APPR�iVAf. •_--Perm_ rt# '; _.
21.-Ducts,in Str:4ct e" •• •• - S - • t70. Y7ndergrouncq Hyro x
22.puctis, Ventilating c° r ,- _ . $71. Produce-Poing `ur' as `Oil 30. .
23. GasPipe,Rough & Test r:•; - 7 c.: "" 72. UndergrounU Flusli- -
r. : , .-yr •'•ti r- - .- ✓ - -- - L- 1
24:rRoA Fi7amirig 5" ' -r ' '4' * C; ~ 73t'�Undergrnd'.Storag �;nk V'•Gas ❑Qil
C.:, ' ; "t L
25. Roof Shgathing - . V r _ > _•. - 74GOverhead Hydrov_~
26.:AT-Bar Ceiling (Strructural) &`fvlw gcoat a -L " ," 75.',•Dry Chemical -
27:.Frame and FlashiFig, -c;r, - .11:-. • 76. Dry Standpipe i - • - I
28. Lathing& Silting_* = ,.„24.--_ '" •• 77 FIXED yfltEP(I,C�y'INA[:
29. Insulatiin .. N 'k '(i 78F.FIRE PREY. FINAL s > •a - J
30. DrywalLNail ng ,F;` I li s HEALTH3JEPly REQUIREMENT
' t I i . K r79.rFINAL INSPECTIB.N ._
31. Plasterovtn Cqa& ( .
• 32.Electrics] Power'MaterFinal i ..,'- x ^80 rFOOD CERTIFFC trE I`gS ED- j
33:;Final E(ectri5•. r, I t • Notes: x -- c ,.r,
.-34. Fina] Heating& Air ConditionFngs - r -^ g 5 (..t R 'S = - I
135.-Final Gas Pipe-Test. .-,s'� `A _ (+ lL o `` .
�
•36. HoSd 'or:Canopy - '-) r 7 -u r �� I , c t
.37..Final Factory Firryplace- •1 J..: - .4 r I -; tl >'- -_ _---
-
38. Final PI'umbing I- ''
r ti F
"39. Water Sgrvicp,Firt(r`. >_ • S
( t}.. r.
-40. Gas Servipe-Final _z r .- - I l ��^_ _ x -
' I - I I Ni'- ..
• 41. Solar Dd7netic-Fet j.l • -3 I I .� • _ > i
s
42.�Backflovv Preventgr: J i - • • - _ -
r. 4 . , r -r-,
43. Backflow Irr'hatian• 4.g.S ' • y t •-'
if-44. Landscape IreigaYlonSystem.' r.� '7. • ;T C. - •7' .-u Y.; t. jj J
:45..-.Sound Atteauatiorri' - r. •• r by - - -C •
' -.
._46.•Handicap Regulati3ns - 6 =
. ` - -:� , .,, . _ k
47.-FINAL STRUCTURE & BUILDING I is%I� • - '"''
`FJ.INAL PLANNING. , � .. 1. -1-
48. -r i
_49::Electric Release to'Edison - I ':"•{` x '
r
.50. Gas Release to Southern California Gas Co I 1 -
t-
'51. CERTIFICATE OF.00CUPANCY c' -
No. Date
LIMITED STATEMENT Or RESPONSIBILITY Bldg. Permit #
TO WHOM IT MAY CONCERN: This Permit S g&c6'76
Croyden Bay
Wesleyan Bay
Grayling Bay and Elmira Bay •
Street Address AP Number
*
f, Nancy Blankenburq , as Ownerirriitle of the above referenced
property, do hereby authorize:
Bob Rice (714) 642-6413
Name Telephone No.
352 E. 19th Street
Street Address
Costa Mesa, Ca. 92626
City State Zip
• * •
to obtain permits in my behalf, as-ownerfbuilder, for Pentridge CoveI Hom own ra Assoc.
at the above referenced property.
Should any person become an employee engaged in the improvement of. the property, I shall
immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties.
k . . - . - s . January 7 . 1991
Printed Namet Date
a. Can/ •JiiterZ—
Siaature V SIGNATURE WITNESSED BY
// J . OUELLETTE — OTARY ON
*Account Executive JAN 7 , 1993
�'`"'""'• NOTARY PUBLIC
_ t �4 STATE OF CALIF
County of Orange
\•� J. OUELLETTE
rev.os-as. 6/87 ,,,, Commission Exp.Jan. 16, 1993
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�� COSP.TA
MESABOX COSTAMESA,BUILDING-SAFETY A9 see APPLICATTONFo+�`�IRI I�i�AlPERMI7683.50 TL
For Applicant to Fill in Completely -Use Ink Only REP �yJfv'�(yQpy� 'PERMIT
c a t O
BUILDING ,�/ A.P.�N O. -09I48762-N9'O 11 +412.1-121-2.7
ADDRESS Tract 10626 It1/({alt(, 1 BUILDING /'
OWNER
OR M.D. Janes Co. . Inc. ADDRESS`�1W 9'Q0 y/,V9 � .
• UNIT ORMAILIN
ADDRESS 2950 Airway Ave. , D-9 SPACE NO.
TR f O6-t/ LOT 1BLK.
TEL.CITY Costa Mesa NO. (J Lb
979-3 NEW ADD ALTER REPAIR MOVING DEMOLISH
' CONSTRUCTION
LENDER Not selected
BRANCH N/A
OWNER
ADDRESS N/A VALUE '
ARCHITECT TEL.
USE S
OR ENGINEER Danielian & Assoc. No. 546-3693Fla a
\ ADDRESS 3848 Campus Dr. , N.B. ZONE TYPE V GROUP i3---
I APPROVED
CONTRACTOR owner BY DATE .
ADDRESS e
•
TEL.
CITY a NO. e
1F1. STATE • CITY APPROVED SETBACKS
LIC.NO. e LIC.NO. e
Lu SIZE NO.OF BLOCS. (FROM C/L STREET)
o. OF LOT 5501 x 334' NOW ON LOT a FRONT FT.
Q USE OF ft
ro EXISTING BLDG. N/A R.SIDF a T. _ f// r,
Separate permits are required for L.SIDE ,1 EIt$ . '�
electric,plumbing and heating work: 1 REAR I Fr. _
E... USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION •
'C
a 22
> it 22Nco 7Q-or?A APPROVED 2--16
71
RS6 � AQ '
1/ Art` G02LYCf. C —B_Y DAT/2 (y/
a
w
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I hereby acknowledge that I have read this application and state o' (�
a that the above information is correct and agree to comply with ,v�J
d ell laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of o /�•
,(Tzt the State of California. Z�.t3� (j 3 SL m 1
3 I hereby certify that I am properly licensed as a contractor under • 7"� SQ. FT. N 4
the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m (v`
Chapter 9, and that such licenses are in full force end effect,or I t THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
I am exempt from the •rovisions of the State of California Business •
PERMIT FEE _(
•
and Professions Cod: Divi '• 3,Chapter 9. In VALUATION $
PLAN CHECK S/-EH 1n
Signature of � (S'Y�/1 �,J �{/.j��
Permittee !/� $ G-971319-"D 'JAN
or i TAX S r �` Fel,
•
Authorized Age a• 8 s TOTAL PAID Sb 3 •��
d