HomeMy WebLinkAbout3416 MEADOW BROOK - Building PermitsPflOJECT AODPESS: j� 1 G MEAD�w BR��x
OWNEN'SNPME: VILLAGE CREEK HOMEOWNERS
noonEss: ASSOCIATION
3429 TZMBER LAKE
CM ��A 92626
UNIT:
AflCHIENGINEEF: CHESTER CARVILLE nec.xo.: C18305 .
IIODPESS: 792z ARMOUR ST uNir:
�S.D. CA 92111
PEflMIT1EE: jJHUENIX ENTERPRISES INC, ( 213 ) 690-9559
nooRess: 411 COMERCIAi, WAY
LA HAHRA CA 90631
LICENSEO CONTNACiOfl OECLANATION: I here�y aflirm ��al I am litensed ' re - n5 oi Chaplef 9 �C mencing witn Section
7000) ol �rvision 3 of Ihe Business an0 Pmfessions Code. antl my licens i II r, aM effect. —
ciTruc.:�5 y��jT�ic.:376639 /_
�aie'. E� � p� SignaWre:_ l�L�
WOBKEHS' COMPENSPTION OECIAHATION: I hereby a��itm i I have a ceni aie of consent m self-insure or a ce ihca�e of Workers'
Compensa�ion Insurance. or a certifietl copy �hereo� (Sec�ion 3800. Lab. C).
�POLICYNO.: W%003S4 E%P.OATE: O7I �91
COMPANY: CA COMiP 6 FIRE
� Cetlifietl copy is here0y Wrnishetl. ❑ Ceni�ietl copy is �iled wil ' y Buil g Oiyision. �_/ G .
/. � �,
Da�e: _�' � �//�— Applicant ' �' ���
E%EMPTION FBOM WOflREflS' COMP SEN PTION UECIANRTION: (This sec�ian neetl no� be completeC i� the permit is lar ane h e0 (511q) or less).
I cetlity �hai in �he pedormance ol Ihe work locwhich Nis permii is issued, I shall no� employ any person in any manner so as to become
Su0leti lo Ihe Workers' Compensa�ion LawS o� Calilomia.
Oaie: � Signature'.
NOTILE: It, aiter making Ihis Oeclara�ion, you should become subjecl b lhe Workers' Compensa�ion pmvisions o� ihe Labor
Code. you musl IorlhvnN comply wil� such provlsions or Ihis permit shall be tleemea revoketl.
CONSTflUCT10N LENDING AGENCV: I here6y aflirm ihat Ihere is a conslmction lending agency lor Ihe petlormance of the work for
whiCh Ihis p¢rmit i5 i55ued �5¢L�iOn 3097. Civ. C�.
LENOEF: �
nooness:
OWNEH BWLDEB OELIAHATION: I here�y aHirm i�at I am exemD� <<om the Conlracrors' State License Law br the lollowing reason
(Sec�ion 7031 5 Business antl Pmiessional Cotle: Any cily of coun�y which repuires a permit �o constmci, al�er, impmve, demolish, or
repair any simcNre. prmr to its issuance. also reQuires the apPlicant for such permil to file a signed slalement t�at �elshe is licensed
pursuan� Io I�e pmvisions oi Ihe CamractoK State License law (C�apter 9 kommencing with Section 7000) o� DiviSion 3 a� �he Business
and Pm�essions Catle) ar Iha� he/she is exempt therefmm and'the 6asis for Ihe alleged eremption. Nny viola�ion ol Seclion 7031.5 by
any applican� for a permil sublec�s �he applican� Io a civil penal�y ol nol more than tive hunOreU tlollars (5500).
I, as owner oi Ihe pmperiy or my employees with wages as �heir sole compensation, will tlo �he work, an0 �he
❑ stmcture is no� in�entletl or offereA lor sale (Sec�ion 7044, Business antl Pro�essional Code: The Con�ractors' Slaie License Law
- tloes nol apply �o an owner ol a pmDerty who builtls or improves lhereon, ana w�o tloes such woB himself/hersel� or lhmugh
nis or her own emDloyees. D�ovidea that such impmvemems are not intentle0 or ofieretl br sale. Ii, however the 6uiltling or
improvemen� is soltl wi�hin one year af campletian. Ihe owner will have the bur�en of O�oving he/she ditl not 6uild or impmve
for ihe purpose oi sale).
❑ I, as awner oi the property, am evclusively coNracting with licensed contmctors lo consiNct the Dmject (Section 7044, Business
antl Pmiessions Code: 7he Contractors' S�aie License Law Uoes no� apOty to an owner o( D�operty who builUs or improves ihereon
antl who ton�ratis lor SUC� pmle��s wilh a con[raC�oqs�license pur5uanilo Ihe Con�raCiofs' S�a�e LiCense Law),I am aware
�hal pmol ol iheir WoMer's Compensa�ian insurance shaultl be pmvided �o me.
� I am exempt untler Sec�ion: 9. 8 P. C. .
lor ihis reason�. ,
�ate: Owner
I tlo nereby cenity I�at I am aware ol antl undersiand ihe reQuiremen�s ol Cahfomia Health antl Safery Cotle Sec�ions 25505, 25533, an0
2553G and Ihat I or any iNure builtlmg occupan� wililwill rp� (circle one) need to comply wi�h said stale cotles antl the requiremeni5lor a
permu br con9mclion or modification from ��e Air Ouabry Management Di5lricL Be5i0ential cons�mc�ion applications are exempt �rom
Ih¢SE pfOVI5i0115.
Da�e: � Applicani:
1 �ereby ceriity �ha� I have read Nis applicalion and stale Ihal Ihe a0a om ion is corBct. I agree b c mply wi�� all cily counry •
ordmances an0 siale laws relating �o builtlmg cons�mc�ion antl hereby i rrze rasen�abves oi Ihis cIry �� �Cr upon �he abo -menUoned
pmpeny I///rrryyy inspedio rpos III / / /
�ate', �I�� '� Signaiure: �� ��
orivefs License or Social Securiry a: �
16abA6 Whi�e—Boiltlingl Green—Cotle EntorcemenL Canary—ApplicanC Pink—Revenuel Gol�enrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: H 050576 PLAN CHECK NO:'00138-91 A
CUNSTRUCTION TYPE: V—N PERMIT TYPE: STR
SOH DESCRIPTION
CLAIM VALUE:
: REPAIR 5ETTLENENT DAMAGE
PERM NO: B 05057
GOVT;'N SUPP: N
PURPOSE: REP
S(,� FT: 193 -
14,300.00 CALC—VALUE: 14,300.00 GROUP OCC: R-3 /
COMMENTS: BUILDSNG SETTLEMENT REPAIR/FOUNDATION • •
�t�**�***��r*��+t�c****�*******��t***�t*******�*****x***�u�*u**�r**��******��**x �.a��c-��**
Z O N I N G R E Q U I.R E M E�N T S
5 E T B A C K S
----------�-- MAIN HUILDING ---------- --------�ACCESSORY HUILDING ---------
FR13T; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV•, PARCEL: 93506124 ZNE; R2 REF NQ; ,
PLANNING NiSTES> FOUNDATION REPAIR,
i __
af iE iE M� If if # 1E iE IE iE fF 3FlP iF if if !E 1E iE iE ff� * 3f if ik ff �4 �E 1E �E �IM1 �lf # �E 3E aE iE 3F 3f iE iE jf iE �1E 1P iE af jf �E 1k iF ff aE 3E if 1E 3F if IE 1F iF 7F 1E if iF-16 af 1{� iF )E iE 361F iE iE iE 1f iE
D E'V E L O P M E N/ T S E R V I C E S R E Q U I R E M E N,T S
ZONING APPROVED BY (� � DATE: O//S �/�
BUILDING APPROVED HY : l�il L,J� �� • DATE: ���
APPLICATION ISSUED BY• � DATE;�� �
!F if 3f �3F iE 3F �k 3P 3(� iF 1F jF jF iF �E 1f �E iE 3E 3f 1F �E ii- 3E 1ElF 1F IE 3f iF 1E�K?F )f )E
Ih3E�IEif�E�E3E1EiFiFifif�FlfiEiFiFaEiE�ElElE1E�f1E1E3EifiEdF3E F3fiF Fifif3fiklfafdf3EiE1F3EiE3E3E1f1EiFiEafiEiEiE7f�fiEiElfiF,1f1E3f1FiElFdfiEiFIF3FiElfjf
LEGALZZATION:N F E E S U M M A R Y STRUCTURAli SEGMEIJT;Y
BLDG PMT PLUMBING ELE TRIG MECAANZC FIRE SMIP/RES GRADING
PERMIT , 162,00 e�. 1.00
PTAN 26,33 SMIP/NON—RES
ISSUE � F'EE - -
HUILDING—DIV—> PERMIT ISSUE FLAN—CHECK TOTAL PAID DUE
TOTALS----> 163.00 0.00 26.33 ' 189.33 189.33 .00
I
REVENUE DIVISION TOTALS--> COLLECTED: 189.33 OVER/SHORT; ,'00
' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
162.00 1.00 26.33
3F iF 3E iF iF 1F IF iE jk lE if iF �E 1E if if iF 3F 3f if ib if jE 1F if 3F �f iE �k k iE-1f iE iE af 1E 3E if If 3E �f iF it * iF �E iE iE if iE iF 1f 3f -)F 3E 1f If 36 if �f 3F iF iE if lE iF 1E �lE iF �F i(� IE iE 3f �(..ME iE If 1E
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 � UNZT COST TOTAL COST
5FR 143 STRUCTiJRAL II,Y VALUE PER 5100.00
END OF fiEES
100.00 14,300,00
D1 ��J07L728—DUO"l573i T'lo-F' ?04.�3
DATE: C!i!?3JQ: ;I"IF: 17.�0
CONSTRUCTION AND PLANNING ' � P�v� & SPA �
APPROVALS Permit # - Date Inspector qppROVALS Permit # Date Inspector
�.r
1. Temporary Electrical Service or Pole. l - 52. Pool & Equipment Location 1
' 2. Soil Pipe-Undrgrnd. �� ` � 53. Steel Reinforcement �j
3.'Electrical Conduit Utility-Undrgrnd..'. � 54. Forms ��
'� 4: Electrical Conduit�Undrgrrlcl'r' �� 55. Electrical Bonding �
; 5.'Steel Reinforcement.' . 56. Rough Plumbing�& Pressure Test
6.: Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
� 7. Footings - 5S. Electrical Conduit-Undrgrnd.
8. Foundation � , �j F 59. Gas Pipe, � Undrgrnd., Test ^�;i
9. Water Pipe�Undrgrnd. ��r �N 60. Backwash Lines, P-Trap, O Undrgrnd. �%�i�
r ; -
t0.5tructuralFloor�System� ��/^ �".'��� 61. APPROVALTODECK �,'�;�
11. Property Sewer Line.& �ou'se Connection ��'� 62. Backwash & Receptor-Final �
P f ''- ,/..
12. Sewer Ca , - �, , _ : "1 63. Heater & Vent-Final �
i
13. Roof Drains �� 64. Plumbing SYstem � Final ��
14. Rough Plumbing ^ J� 65. Electrical-Final ����
15. Rough Electriwl-Condyit� �� �,�,� �`i', 66. Solar System-Final ��
76. Rough Electric Wiring u%= • r � 67. Pencing & Access Approval �.�.�''�
�y
77. Rough Wiring Sign �/�� ' 68. APPROVED FOR PLASTERWG
i•
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ��
19. Rough Hea[ing & Air Conditioning FIRE DEPT. REQUIREMEIVT"
- , i • .
20. Rough Factory Fireplace ; . - - APPROVALS ' -Permit # -
27.,�Ducts,in�Structure , .70. Underground.Hydro �
22. Ouas, Ventilating � � • - 71, Product'Piping OGas ❑Oil
23.' Gas Pipe�Rough & Test .' . ._ � - 72. Underground Flush _ � .
24. Roof Framing - - ' � - � '�73.�Undergmd'.Storage.Taok OGas ❑Oil
25. Roof,Sheathing . �_ ", '., � , ��' - . _� ��74.=0verhead Hydro._ .
26. T�Bar Ceiling (Structural) & Monocoat �' � � • 75: �D_ry Chemical - •
27. Frame and Flashin I� - ' '�
9� , , . 76: D'ry Standpipe - =� . ,
28. Lathing & Siding � - - - i � �_: 77, FIXED SYSTEM:E•INAL'
29. Insulation " `- . . � � � �.,; ` 78.�FIRE PREV. FINAL � �
�30. Drywall Nailing ! � �: ; HEALTH DEPT: REQUIREMENT
31. Plaster Brown Coat' � �.� � E. .; .79.� FINAL INSPECTION ,
� 32. Electrical Power Meter�final . �• •� � � �` . 80. FOOD CERTIFICATE ISSUED �
33. Final Electric ' . ' ' ` � � ;� , 'Noies: - � y � .
34. FinalHeating&AinConditioning � . � i �� � '� ��i .�
�.
35.'Final Gas Pipe-Test' _ ' � � - i �' : _: ��/ ' ' '-' v �
;:
36. Hood or=Canopy � . ... � , _ , . � `
� �� _
37. Final Factory Fireplace . � ' � � � �" '_ `_� ••
38: Final Plumbing �� . . � 4• • . • t
39. Water Service�Final• ' � ' "� •
+ �. r .
40. GasService-Final �_ ,�, � � i �. : , � �
41. Solar pomesticFinal � ; � �� ` •a'
' � � . .
42. Backflow Preventer ' _ � ' j j � . � �
43. Backflow Irrigation• " ' ' � ' - -
44. Landscape Irrigation SYstem _� ti � . a� . .:
'•45. Sound Attenuation � ' _ . • '
'46. Handicap Regulations ' ' . � ; ,
47. �FINAL STRUCTURE & BUILDING ��✓•q �- ' � _
48. FINALPLANNING. ., �. - .
�49'..Electric Release to Edison �• • - �
50. Gas,Release to Southem Califomia Gas Cn " j � �
�. ,
`51. CERTIFICATEOF.00CUPANCY � . .
No. Date
OWNER
JOB ADDRE55
G�"ERAL CONTF
/ ��j-
INSPECTIONS
soi�
GAS
WATEIi
ROUGH PLUMBING
PROP. SWR. LINE �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING NND AIR CONOITIONING
TEMPORARV SERVICE OR POLE
UN�ERGROUN� � POWER �
ROIIGH WIRING
TRENCHES � FOFMS � STEEL REINF.
FLOOR SVSTEM
BONO BEAM � STEEL REINFORCE �
SHEFTNING
FRAME AN� FLASHING� �
LATHING — IN OI1T i
PLf ', BROWN COAT
STF �RAL,FINAL
HEATING. VENT., REFRIG. AND A.C., FINPL
PLUMBING. FINAL RND GAS TEST /�'�( p•3
Inc. DATE 4-28-76
BUILDING PER�.11T N0.
nFS('RIPTIfIN nf Wf1RK CS. W at�
SUBCONTRACTOR
_ i -t. ._
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to FiJI in Complete/y
BVILDINCi_�_ .. . _ .
44Y 13-76�v�,CO �s�;M �.k�� z� ae i �
APPLICATION FOR BUILDING PERMIT
RECEIVED BY DATE RECEIVED nnr� icciu
OWNER State-Wide Develo ers, Inc. A.P. NO. � b—
Ao"oRes59461 Grindlay AooR�E s��E
a-rv Cypress No`826-4550 TRAC76�
CANSTRUCTION W ADD
BRANCN
ADDRESS
ARCHITECT TE
o�wus+r.�sw Inhrharh/Pnlacki No..5fi-fi61�
AooREss17848 SkyPark Blvd Irvine
CONTRACTOfl State-Wide.Developers, Inc.
,.00AEss9461 Grindlay
cirv Cyprees
No`. sz6-a55o
STA7E CITV
LIC. NO. 'L2��� (� L1C. NO.
r
SIZE NO.OF BlDGS.
OFLOT ��_�94 arrpc INOWONLOT (�
USE OF
EXISTING BIOG.
SI2E OF NO. OF
NEW BLDG. ROOMS STORIES
EMEPIOR WAL a er ROOF
COVEfiING ��� COVERING Shake
USE OF BUILDING AND WORK TO BE PERFORMED
New construction-Condominiums
1 Residence w/ att gar
I hereby acknowledge thet I have �aatl this application antl stete
that ihe above intormatian ls correct entl agree to comply wlth
all lews raBulaiinB builtlinH consttuction, and I zhall no< amploy
any,person in violetion of the workman's compensetion laws of
the S[ate ot California.
I hereby certify 2hat I am properly Iicensetl as a eonttector untlar
the Stata ot Catltornia Business antl Professio�s Cotle, Divisicn 3,
Chapter.9, and that such licenses are in tull force antl effect, or I
am exampt from the provtzions of the State of Ca tornia Business
and Profassions Code, Divislon 3, ChaPier 9.
_ �—S,tate; Wide Deveaopkr Inc.
Permittee _T �r—e/ K+-- lr
a�rno.i:aaneen< Vice President
X I I I
OWNER �'��' �
„��1 Res w/att
APPROVED
NE NO.Of �/ USE OF NEW�[pp
Z L P�`� y BUILDING
VARDSAPPqOVED VAflDSAPPqO'
MAIN BUILDING ACCESSORV BU1
REAR / � FT. � FT.
DI5TANCE BET. BET. MAIN.&
MAIN BLOGS. ACCE4.BLOGS.
VAR. # DATE
C.U.C.#�%� % APPqOVEDI� �J'
APPROVEDAi , ✓ ./ 2') � !
c.Ri r � �
HOLD FOR ,. ECIAL RE�UIRER"_Ei �"
� ��
1254 SQ. FT
THE AMOUNT S
THE PURPOSE Of
3�AT'ON
p�.��a}�BO�
$�r7'ov'l
J-655 ;
VNDER VALUATION IS FOR '
3LISHING A PERMIT FEE ONLV: ¢
m
=RMIT FEE $ �
�
AN CHECK $ � � �O E
� � � �
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