HomeMy WebLinkAbout3217 MONTANA AVE - Building PermitsApplicant to flll in all spaces except ihose within heavY border Iines ane sign all aovrooriate Oeclaralions.
'CITY OF COSTA MESA CONSTRUCTION PERMIT PER T NO TRACT NO LOT NO. UNIT NO
"�,Project Address 3z� � �bntlRd AV2
ApplicanYs Mailing Address "�S W
Ownei'sName�le E11�S Phone�40-6J.98
Address 3217 Nbntzna Ave
Arch/Eng. License No.
Address
Contractor's NamP �� P�.Q &Ht4 IS1C. , phon�$ — 1
nddreu (mai�ingl—_5457 (72T15hdW B1VC� (a. � �
City License No. _�30203 � � G ��
LICENSEO CONTRACTOR DECLARATION
1 hereby attirm thal I am licensetl under provisians of Charter 9(commenCing
with section 7000) oi �IviSion 3 of Ine Busine55 antl Profe55i n5 Cotle, dntl
my license is in IulUeGrbe ana ettect. 2 1H6
�License Class �' Lice o
� oate � %-2931�Bture
\WORKERS' COMPENSATION DECL A O
i hereby affirm tnat I have a certifiwte of consent to self-insure or a certificate
'i Workers' Compensation Insurance, or a certifietl copy ihereof (Sectlon
� �00, Lab. C.)
1 . Policy No. —��.C�87� Company
:� 8Certitietl <opy is hereby fumishetl. ///111
Cerlifletl copy is illeC with the dty iltlin � n
Date� �'}Q 8mTn plicant �
EXEMVTION FTt�MZNORKERS' COMPENSATION DECLAR TION
(ThisSection neetl not ba com0�etetl It the permit is tor one huntlretl ($100) or
Iess).
I certify Ihal in [h¢ Parlo�mance of th¢ wark for which this pe�m�t is issuetl, I
shall no[ employ any pe�son in any manne� so as to become subject to thC
Workers' Compen5ation Laws of California.
Oate $i9nature
NOTICE: If, afte� making [his tlecla�atlon, you shoultl become subject to tlte
Wotkers' COmp¢nsalion provlsions of the LabOr Cotle, you must torthwilh
comply with SucM1 p�ovision5 or [his permit snall be tleemetl revoketl.
CONSTRVCTION LEN�ING AGENCV
I hereCy afil�m that there i5 a con5tructlon lentling a9ency tor the performance
ot the work tor which [his permit i5 issu¢tl (Section 3097 Civ. CJ
LentleYs Name
Lentler's Htldress
OWNER BUILDER UECLARATION
I nereby aHirm that I am exempt irom the Contractor's License Law for the
toilowing reason (Section 7031.5 Buziness antl Profeszional Cotle: Any city or
wunty whicn �equires a pe�mit t0 const�uct, alter, Imp�ove, tlemolish or tepair
any structure, prior to its issuance, also requires t�e applicant for such permit
to file a si9nCtl statement tha[ he/sh¢ I5 licensetl pursuant to tne provizions of
the Contractor's License Law (Chapter 9(commencing witb Section 7000) ot
Divizion 3 0l the Business antl Protessions Cotle) or that he/she is exempt
'-=refrom antl lhe basis lor the allegetl exemption. Any violation of Section
1.5 by any applicant for a permit subjects [he applicant [o a civil
alty o( not more than live M1undretl tlollars (y500).
�.J I, as owne� of the Property or my employees with wa9es as their Sole
compensation, will tlo the work, antl lhe st�ucture i5 mt intendetl or of/¢retl
for sale (Sectlon 7044, Business antl Professional Cotle: The Contracror'S
License Law tloes not apply to an owner of a property wno bulltls or improves
chereon, ana who tloes zuch work himself/herzetl or throu9n his or her own
2mployees, provitletl Iha[ such improvemenis a�e not intentled o� ofteretl tOr
sale. H, Itowever, the bullCin9 or improvement is Soltl within one year of com-
ple[ion, [be owner will have Ihe burtlen of proving he/she tlitl no[ builtl or Im-
�rove tor Ihe purpose of sale).
I, as ownm of tM1e prOperty, am exclusively contrat;ing with licensetl con-
Iractorsto conslruct lhe project (Section ]044, Buziness antl Professions Cotle:
Tne ContraGtor'S License Law tloes nol ap01y lo an owner ot P�operty who
builtls o� Improves [hereon, antl who conVacti tor such Orojects with a con-
tractor(s) �icense pursuanl to the Contractor's License Law). I am aware that
proof o( their Worker's Compensallon insurance shoultl be O�o�itletl to me.
❑ I am exemp[ untler Seclion B. & P. C. for thi5 r¢asOn
Date
1 hereby certity t
Information is mn
antl state laws rel:
sentatives of lp
inspection pur se
Orivers' License or 55
_ Owner
have reatl this application antl
agree to compl`/� wyh all city a
o buildinq contLlUC��on, ar}tl ht
oate 19-7Q—RQ
l� �l58 3a
TVPE OFCONSTRUCTION NEW ADO ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH�' ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. P _
TVPE OF PENMIT LI GRADING LJ FOUNDATION IJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING � MECHANICAL
❑ OTHER
PROJECT DESCRIP710N SQ.FT. OCCUPANCV_
CONSTRUCTIONTVPE VALUATIONS��� _��.
ZONE GRHDINGCU.VDS. ACRES+
Remarks:
Bar Sink
Backflow Preventer
Backflow Irri9ation
Bathtubs
rinking Fountains
loor Dreins
loor Sinks
asService Outlets
Sink
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Struciural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/FacL Blt. ICBO #
Heating System & Ducting
❑ P 100,000 BTU � 100,000 BT
80-M F/A Furn
Reinspection Fea $1b
Whlte - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor „
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Au[o-Wash
Issue Fee
Hood or Type I ❑
Canopy Type I I ❑
Refriqeration System
❑aioo,000sru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
A.P. �
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Zane
Accessory Builtling:
Parking Req./Provided
ELEC7RICAL
Automatic Washer Transformer ❑ 15-50 KW
Canstruction Pole Sub. ❑ 50 + KW
Cooking Unit Merer ❑up ro 100amps
Dishwasher Meeer ❑over 100amps
Dryers ❑Gas ❑Electric Sub Panel
Fan Motors �0�1 HP �l Y. - 8
F.A.U. Inc.Solar �9-15 HP �16-15+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches Si9n
Garbage Dispoul Standing Sections
Generaror DO-5 KW OS-15 KW Trash Compactor
$ 3
Reinspection Fee $15 Issue Fee
FEES
�DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved ey
Aooliratian Issuad BV �
IssueFea tsl $,�
SUMMARVOFF�ES
BUILDING PERMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PIAN CHECK 25% 3 ENERGV P.C.
ELECTRICAL S GRADING
PLANCHECK 50% $ �ICROFILM
�1 O�
MECHANICAL S —_�_0 •'7pTAL FEE
PLAN CHECK 25% $
Z
O
N
I
N
G
R
E
Q
M
T
S
FEES
$ 3
5
$ /�'�"
S
5
$
s �n nn
��.ue
�-� POOL & SPA
CONSTRUCTION AND-PLANNING
APPROVAL'S Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electricat Se�vice or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
�v
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & PressurTTest �
6.�ElectricalUFERG�nd, 57. APPROVALTOCOVER;GUNITE
7��Footings � 58. ElectricalConduit-Undrgrnd.
8: Foundation 59. Gas Pipe, O Undrgrnd., Test
N.
9.' Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,�0� Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK ��
71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap _ y Y '� 63. Heater & Vent-Final L
t,
13. Roof Dreins 64. Plumbing System - Final �
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
76. 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 O Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structurap'&•Monocoai - '� "� ` -- ' � 75. DryrChemical ` ' � �- � }'�' � � - " ' '
27. Freme 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 r��
:7
33. Final Electric Notes:
34. Final Heating & Air Conditioning 3� ��� '�
35: Final Gas Pipe-Test
36. Hood or Canopy � '
37. Final Factory Fireplace -
38. Final Plumbing • _
39. Water Service-Final � ,. ' 1 , �_� , � � _ ', . �� f,, . ,
40. Gas Service-Final ' � �
41. Solar pomestic-Final , �- /,
42. Backflow Preventer �
/�
43. Backflow Irrigation i '
i
�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. CERTIFICATEOFOCCUPANCY �
No. Date i ,
� �
OWNER KITI.BER.G, D. 'v. DATE 5-1-61
JOB ADDRESS 3217 Montana Ave. BUILDING PERMIT N0. 1�-1395
GENERAL CONTRACTOR ��ner-Rldr. VALUE S �-�-2,CO
AP. No. LOT 21L TRACT 3110i FIRE ZONE DESCRIPTION OF WORK (lrnam_ Wall
'EGTIONS I DATE I GROUP J
SUBCONTRACTOR
_.► :����:�
C✓JSTA''MESA BUILDINGSAFETY DEPARTMENT
� P. O. BOX 977 COSTA MEBA. CALIPORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
Aoo E'ss 32i7 Mo�rraN� Au6�'
COSTA MESA. CALIFORNIA
TEL.
NO. OR BlDGB.
USE OF
EXISTING BLDG.
6ETBACK LINB FROM
DESCRIPTION OF WORK
BUILDING
SIZE
EXTERIOR WALL
NO. OF
ROOMS .STOF
ROOF
COVERING
WORK TO �E PERFORMED
0
/t � �/
.aG .r:1'
1 HEPEBV�.AGKNOWLEO6E THAT 1 HAVE
AND 6TATE THAT THE qBOVE I6 CORRI
PLY WITH ALL CITY OPOINANCEB ANV-
BUILDINa CON9TRUCTION. ,
� AUTHORIZED AGENT
F�REc�,�v��
� 0.Y 2 1°6
FINANCE OEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
suaoiN�
For Office Use Onl y,
PHCEIPT NO. 9EPM�T NO. �
PECEIV�q BY
`�.
COSTA MESA. CALIFORNIA
FIRE
ZONE TYPE GROUP
APPROVEO
BY �ATE S /
'/� ONING
ZONy / / I puNB � I HUILDIN6' ��/
1�
OEBCRIPTIONL'L(7 � � • r� 3 4
A.P.NO. �ON�
YARDS - ' EVES
APPROVEO ALLOWED
t¢emw uHe e'r.) _ �'
�/
FRONT ,� 4�T.
R.SIDE FT. ` %
1 SIOF �"� cT �
� / /� . ___ __
i �
, ..
THIB APPlJGT10N }HE AMOUNT BHOWN IINDER VALURT�ON 19 FOR THE
D AGREE TO GOM- pUPP06¢ OP ¢BTpBLIBHINa A PERMIT FEE ONLY. "
LhWe RE6ULATING
VALUATION
�Q PERMIT FEE :$ � ^
/ ,!
S `/� X PLAN CHECK $
�or z4.- rR 40
. � 13'7��
C,QSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 377 C08TA MEBA. GLIPORHIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
BUIL�ING 32j7 MONTANA AVENUE
ADDRESS
COSTA MESA. CALIFORNIA
oWNER KENKOL LAND C0. INC.
MAIL t555 PLACENTIA I�VENUE
ADDRE6S
r�rv
NEWPORT BEACH uEn�Fi_�'�'�7
L CONSTRUCTION CO.�INC.
T BEACH� CALIFORNIA
� S�ze bOX 7 00 I NO. OP BLD69. O
' 68TBACK LINB FROM 50 ` __. _... __ 25
' I LEFT S� I RIGHT �
DESCRIPTION OF WORK
�597•5SF ROOM6 � STORIES �
.LL TUCCO IROOF OCK
1NGLE-YAMILY ttESIDENCE AND ATTACH
ARAGF PI AN %-F
I HlPH6Y �CKNOWLEDOe THAT I H�V6 R6AD TMi9 APPLIWTION
AND BTATE THAT THB ABOVe IB CORP¢LT AND AGqE6 TO COM-
PLY WITH ALL CITY ORDINANCHB � D 8TAT8 I.�WB p6GULATING
BUII.DINO CONBTRU/CT'�ON.�J
SIGNATURE OF / {^� //j �`s , ilat�,., �r .� _
■ AUTHORIZEO AGEN7
FEE RECEIVED �
��AN 3 0 ��;,f
FINANCE DEPT.
CITY OF COSiA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
av
COSTA MESA. CALIFORNIA
APPROVED
ZONING
m _ I NO. OF I use oc n
PL�NB BUIIDING
LEGAL
DHBCPIPTION �
A. P. No. n�-a�---�-
VARDS EVES
APPROVED ALLOWEC
IClM[P LIN6 YTJ _
THE AMOUNT 6HOWN UNOER VALUATION 18 FOP THH
PUIiP086 OP EBTABLI6HING A PERMIT FE8 ONLY.
VALUATION
PEftMIT FEE $ � � �
S •' � �/� PLAN CHECK $ /d, /
_ YY �