HomeMy WebLinkAbout3241 MONTANA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job nddress: 3241 MONTANA AV
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 13909201
Applicant: STERNBERG, RICK
Address: 8662 DOLPHIN DR
HUNTINGTON BEACH, CA
Owner: SORENSEN, GLEN D TR
Atldress 3241 MONTANAAVE
COSTA MESA, CA
Contractor: CENTURY ROOFING
Address: 8662 DOLPHIN DR
HUNTINGTON BEACH, CA
Zip: 92646
Arch :
Address:
Zoning:
Phone: (774) 966-3233
Zip: 92646
Phane:
Zip: 92626-2245
Phone: (714) 968-3233
License: 674019
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 07/22/2002
Issued: 07/22/2002
Phone: Phone: �
� Zip: License: License:
SCOPE OF PERMIT
REROOF: T/O EXISTING COMP ROOF, REPAIR SHTG AS NEEDED, 2 LAYERS 15# FELT, APPLY "30-YEAR ELK" COMP
SHINGLES. 24 SQUARES
Plan Check: $0.00
P�rmit: $11125
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $111.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSqRY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0
sa,iso.00
sa,�so.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
�� regulations. (Qrd. No. 92-28, § 1, 12-21-92)
IEXPIRATION; This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTION$: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inepectiorts and itnal approval must ba obtained. Failure ro obtain inspections and iinal approval will result in the expiraiion of this permit.
FOR INSPECTIONS CALL: (714) 7545626 .
zaae�as (s�oo)
WORKERS'COMPENSAnON DECLARAnON:
I hereby eHirtn under penelry of perjury one oi Ihe following declarations:
❑ I hava entl will maintain a cert����ete oi consant to seli-Insure for workars' compensetion, as provided for by section 3700 of the Labor Code, for the pertormance of the
rk lor which this pertnit is issued.
I have and will maintain workers' campensation insurance, as requiretl by sectlon 3700 W Ne Lebor Code, for ��e pedortnance ol t�e work for which this permlt is Issued.
My workers' compensetion In urence carrler antl policy num6er ere: ` I /
Carriar. '�i"T_ �-.c �l� y-. � Policy Numher � T l�Z��i (�
(This sectlo�i e'ed nof be completed i! fhe permif is velued et one hundred dollers ($100) or less.)
❑ I certily that in the peAormance ot the work lor which this pertnit is issued, I shall noi employ any pereon in eny mannar so as �o become subjact to the workers'
wmpensetion le of Califorri�a, entl egree thet II I should become sub�act to the workers' compensation proNsions of Section 3700 of the Lebor Cotle, I s�all forihwith
comply wilh the h5wn5. Z,Z o Z
Applicant Signeture: —_ Oete: �
WARNINO: FAILURE TO SECUFE WORKER5 COMPENSATION COVERAGE IS UMAWFUL AND StUl1 SUBIECT qN EMPLOYEP TO CRIMINp1 PENALTIES AND GVIL FlNES UP TOONE MUNDRED
TFiOUSAND DOLLARE (5100,OW), IN A�DmQY TO iNE WST OF COMPENSATION, OAMACaES AS PROVIDED FOR IN SECiION �OB OF THE LABOR CODE, IMEREST, AND AiTOHNEY'S FEES.
LICENSED CONTRACTORS DEC4ARAT�ON:
I hereby ettirm lhat I am Ilcens$ ntler provisions of Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business end Professions Cotle, antl my license is in full
force entl eHecL Lic. a 1���'"FD � 4 Class x i� � 1 S
Contrectofs Signature:�. Date: `i - ZZ' a 7_
CONSTRUCTION LENUING AGENCV: � �
❑ I hereby aKrtn that there is a tonstruction lending egency for Ihe pertormance of the work for which this permit is issuetl. (Sec. 3097, Civil Code).
Lentler's Neme: Lenders Adtlress:
�� Signature: Date:
OWNEA-BUILDER DECLARATIOMS:
I hereby eMirtn Iha� under penalry of Per�ury Ihet 1 em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professions
Code: Any ciy or counly which reqUires e permit to conslruct, alter, improve, tlemolish, or repair any structure, prior to its issuance, elso requires lhe epplicant for such pertnit
to flle a signed stetement thet he or she Is Ilcensea pursuent to the provislons of the Contractors License Law (Chapter 9(commencing with Sectlon 7000) ol Dlvislon 3 of the
Business end Professions Code) ol thet ha or she is exampt therefrom and the basis tor t�e elleged exemption. Any vloletion of Sectlon 7031.5 by eny epplicent tor a partnit
subiects the applicant to e civil penalry ol not more Ihen �ive hundred dollars ($500).):
❑ I, as owner of the properry, or my employees with weges as their sole compensation, WILL DO THE WORK, antl ihe siructure is not intentleC or oHeretl for sale (Sec.
7044, Business antl Professio�s Code: The Contractors License Lew does nol apply ro an owner ot properry who 6uilds or improves thereon, and who does such work
himself or herseN or Ihrough h�s or her own employees, provitletl that such Impmvements are not Intended or oHeretl tor sale. If, however, ihe building or improvement is
soltl wit�in one year of compl6tion, Ihe owner-builder will have the 6urden ol proving Ihat he or s�e did not build or improve for purposa ot sale.).
❑ I, es owner oi Ihe pmperty, am E%CLUSIVELY CONTRACTiNG WITH LICENSED CONTRAC70RS to construct the pmject (SecJ04d, Business and Professions
CoOe: The contractors License Lew does not appty to an owner ol property who bullQs or Imprwes thereon, entl who contracis br such pro�ect with a cantrector(s)
license DurSuant to the Contractors license Laws.).
❑ I em exempt under sec. Business and Prolessions CoOe for this reason:
Signature: Date:
Owner ID verifietl by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Vedticatlon ol Ownership 6y (type ol document, i.e. - property taz bill or tleetl):
DIVISION OF INDUSTRIAL SAFET�' PERMIT CER7IFICA710N:
❑ I hereby certity ihat no excava�ion live (5) or more lee� in depth in�o which a person is requiratl to tlescend, will ba me0e in connection with work euthonzed by this
permit, and Ihat no building sirudure, scaHolding, lalsework, or demoli�ion or tlismantling ihereof, will he mora then thirry-six (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, Title B, Califomia Atlmini4trative Code).
❑ A5 owner-builtler, I will not e�np�oy anyone to tlo work which woultl require e permi� from the Division ol lntlusirial Selety, as noted a6ove, unless such person has a
permit to do such wark from ibe division.
Signature: Date:
Division of Indusinal Safery Permit Number:
CERi1FlCATE OF COMPLUWCE AND AUTHORPA710N OF ENTAY: I certify untler penalty oi perjury lhat I have read this epplication and state that ihe inlortnation given is
correct. I agree to comply with ell slate lews and ciry ordinances relating to building construction, and authonze representatives of lhe Ciry of Casta Mesa to enter upon ihe
above-tlescribed properry tor inspecd� puryoses. I agree not to occupy or ellow occupancy of any building aulhorized by ihis permit until final inspaction.
Of Legal Owner(s)
� . 22 o Z.
CODE M, INSPECiIONttiE
1616 Fizetl System Final Fire Pr��ention
1266 Pool Spa Finel
200 Finel Re-Roof
201 Finel Block/Retaining Well
202 Final Factory Fire Place
203 Final Sign
204 Finel Demolition
Applicant
P9I€ iNrrtu�s
�-.29-Oa ���
CODE� INSPECTIONTYPE
206 Flnal Mechanical
208 Final Plumbing
210 Final Electdcal
272 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
j�j� INTITIRLS
AOD��cant to flll in all spaces except tnose witnin neavy bortler Iines ana sign all approoriate aeciarations.
' CiTY OF COSTA .M�7.E�S�n� CONSTRUC/T1IO PERMIT
ProjectAddress �d•_i� rn�{��Vl �I^�P��
Applicant's Mailin Addre`ss, N ` �I I�` ^n�
Owner'sName `1�� Phone�l'�I
Address ��
Arch/Eng. License No.
Address �/ Vv� • /y nn
Contractor's Name �'�✓µ I �'7,/iI�qtl ���4� P1ho S� �/ �/l/
Address (ma I� g) C �Ah-P ^�— y�^ � V" '
Ciry Licen�P No. �����
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensetl untler provisions of Char[er 9(commencing
wi[n section �000) of Division 3 a 11�Busine5s antl Professlons Cotle, antl
my license is in f�ll rce antl ef! t iJ
License 1 zs • icens No.
� �ale g at __
/, WORKER ' MPENSATION DECLARATION
' h¢reDy affirm that I nave a certilicate ot wnsent to S¢It-insure or a<ertiticate
IWorkerY Com_ IrE{urance, or a certl�iegpg0��� eof (5¢qtion
.00. Lab. C ' t% J)L(� ' P L��`
Policy No. mpany -
I ❑.�ertifietl mpy Is he�eby ( js
B Cer 'fi Is ( I � i 1� i i tli i i I . p� , I
Date p liC nt </�����
EXEMGTION ROM W00.KER5' CO ENSATION DECIARATION
(This section neetl not be com0�etetl it ihe pe�mit IS fo� one huntl�etl (E300) or
iess).
I cer[ify that in Ihe pe�fo�mance of [Ite wo�k fo� whlch this pe�m�t is iSSuetl, I
Shail not employ any Oe�son In any manne� So a5 lo beGome subjeGt to the
Workers' Compensatlon Laws o� Califomia.
Date ' $i9natura �
. NOTICE:.It, after making this tleclaratlon, you should become subject to the
Workers' Comp¢nsa[ion provlsions of the Labor Cotle, you must forthwith
Comply witn such p�ovision5 or Ihis perml[ shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV '
1 hereby atfi�m that [hGre is a Const/uction IenOing agency to� tne pe�to�mance
of cne work (or whicn this permit is issuetl �(Se<tion 309�'. Civ. C.)
Lentler's Name
Lxntler's Atldress
OWNERBUILOER UECLARATION
I hereby atiirm t�al I am exempt from the Conlractor's License Law for the
foilowing reason (Section ]031.5 Buslness antl Professional Cotle: Any city or
counry w�ich requires a permit to tonstruct, alteq Improve, tlemolish or repair
any structure, prbr to it5 issuance, also requires the applicant tor suth permit
to fiie a signetl statement that he/she is IicenSetl Dursuant to the provisions of
the Contractor'S Licenze Law (Chapter 9(commencin9 with Section 7000) of
Oivizion 3 of tne Bu5ine55 antl Profeizlons Cotle) or that he/she is tx¢mpt
`=refrom antl lhe basis for [he allegetl exemplion. Any violation ot $ection
11.5 by any applicant to� a permit SUDjects the aOP���ant to a civil
dlty of not more Ihan five buntlretl t1011ars (§500).
' �J I, as owner o/ the 0/o0erry or my employees with wages as their sole
compensation, will tlo ihe wo/k, antl the structu�e I5 not intentletl o� offe�etl
for 5aie (Section ]044, Business ana Professional Cotle: Tne Contractor's
License Law tloes not apply [o an own¢r Of a pro0erty who builtls o� Imp�oves
thereon, antl wno tloes such work himsel//herself or throu9h his or her own
o.mployees, provitletl [hat zuch improvementz are no[ Intendetl or offeretl for
sale. It, �owev¢r, [M1e bulltlin9 or Imp�ovement is soltl wlthin one year of mm-
pletion, the owner wi11 have tha burtlen of proving he/she tlitl not bW Itl or im-
erove for the purpose of sale). ,
LJ I, as'owner of the proDerTy, am exclusively contractlng with licensetl con-
tractorsto consVuct Ihe.project (Sec[ion 7044, Business antl Professions Cotle:
The ConVactor's License Law does not apply to an owner of property who
builtls or improves thereon, antl who contracts (or such projects wHh a con-
tractor(s1 bcense pursuant to tne Contractor's License Law). I am aware Ihat
p�oof of their Worker'S COmpenSation insu�ance shoultl be provi0etl to me.
❑ I am_exempt untler Section 8. & P. C. tor thiz reason
Oate Owner
I hereby certify tnat 1 have reatl this applicatlon antl state that the above
In(ormation is correcL I a9�ee to comply with all tlty antl county ortlinances
antl state laws relatinq ro builtlin9 �onslru<tion, antl hereby authorize repre-
sentafives Of 1hi5 cilY to ep[cr upOn. the above-mentionea ptoperty fo�
Si9�a[ure �,�
Drivers' License or 55 �
PERMIT NO. TflACl NO. w i rvU. UNIT NO. '
P � 7 �-�' �.
TYPE OF CONSTRUCTION NEW ADD ALTERATION EPAI R
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p �t
DESCRIPTION OF WORK/USE OF BLOG.
S Main Building:
E
TVPE OF PERMIT GRADIrvG OUrvDATION ' STRUCTURAL T Front
❑ TENANT ❑ ELECTRICAL PLVMBING ❑ MECHANICAL B Rea!
❑ OTHER ' . %�
C Right
PROJECT DESCRIPTION 5c?. FT. ' � oCCUPANCV K
CONSTRUCTION TVPE VALUATION $ S Left
ZONE GqADINGCU.YDS. ACRES ping.Ref.#
Remarks: ' Planning Notes:
Bar Sink
Backflow Prevencer
Backflow Irrigation
Bathtubs
Clarifiers
7rinking Fountains
=1oor Dreins
=1oor Sinks
3as Service QUI�ELS
Interceprors
Kitchen Sink .
Lavatories
P—Trap
Roof Drains
Reinspection Fee $15
Boiler
Duct - Under Ground
Duct-Strucmral �
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑6100,000 BTU 0100,OOOeTi
Reinspec[ion Fae � 515
CMF 0865-46, rev. 30/B4 White - Bulltlin9: �anary - Appllcant; Pink - Accountinq; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors ' �
Solar Piping
Solar Tank '
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fae
Hood or Typel
Canopy Type II
FEES
$ 3
Refrigeration System • -
❑o�ioo,000aTu Oioo,000eTu ,
System Repair/Alteration
Fire Dampers
Registers �
Issue Fee � $ 3
Auromatic Washer
Construction Pole Su
Cooking Unit
D ishwasher
Dryers ❑Gas ❑EL
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW
2043 2/09/87
2one
Accessory Building:
_ �Parking Req./Provided
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Momrs DO-1 HP �1Yh � 8
Inc. Solar �9-15 HP 016-1
Microwave
Pole Light
Range
' I , I Standing Sections
5 KW I Trash Compactor
I fieinspection Fee ,� $15 � � luue Fee
DEVELOPMENTSERVICESFE�UIREMENTS:
Zoning Approved By
Building Approved By
Appliwtion luued By
5.00 7L
FEES
$ 3
Z
O
N
1
N
G
R
E
Q
M
T
S
. SUMMARV OF FEES � . �
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ��UANCE' $�
PLAN CHECK 25% $ ENERGV P.C. $
ELECTFi1CAL $ � GRADING $
PLANCHECK 50% $ . MICROFILM $
MECHANICAL $ TOTALFEE $ S��
PLAN CHECK 25% $ ,
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 4':
-; .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �=
,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & PressurC Test `�'
4�
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GIJNITE ri
7. Footings 58. ElectricalConduit-Undrg�nd. r�=
8. Foundation 59. Gas Pipe, O Undrgrnd., l`e4t .?
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, �•�Undrgrnd. i.;
10. Structural Floor System 61. APPROVAL TO DECK i.i:�
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 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 �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
38. Final Plumbing S / �� (��Q
39. Water Service-Final
40. Gas Service=Final
41. Solar pomestic-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. Electrie Release to Edison
50. Gas Release to Southern California Gas Co � .'
51. CERTIFICATE OF OCCUPANCY .
No. Date
�or tg - TR 3403
� � 13'7�)9
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. 60X 817 COBTA M6HA. CALIFORNIA
For Applieanf fo Fill In Completely
324� MONTANA AVENUE
COSTA MESA. CALIFORNIA
KENKOL LAND CO.�INC,
t555 PLACENT IA /1VENUE
NEWPORT BEACH TEL.
TEL.
CONSTRUCTION CO.�INC.
FIRE
APPROVEO
FEE RECEPV�D
��— JAN 3 01301
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
euao�N�
For Office Use Only
neceirr Ho. I ,�a�
er
COSTA MESA. CALIFORNIA
nooRESS �555 P�A�ENT�A AVENUE ZONING
NEWPORT BEACH CAL I FORN I A io NO.OF uae oF �
CITY 7 � � PLANB BUIIDING
B��TNo. 6tt95 No: Mt 6-3227 �eo,� .
oeaca�rr�oN
ScZE NO. OF BLDG9.
.._ 6ox � oo I .._._ _.. . _ o _ _ , ..
HCTBACK LIN[ PROM �]
CENTeN OP BTNeeT Oi REAR YARD LO�
t 1
SIDE YARD LEF7 � IRIGHT S
DESCRIPTION OF WORK
.,�.., � X �� ., r�e.r,,,., � �� ..,.,...,,.., �
BUILDING NO. OF
SIZE � SF ROOMS STORIES �
PXTERIORWALL STUCCO�ROOF ROCK
COVERING COVERING
USE OP BUILDING AND WORK TO BE PERFORME�
SINGLE-FAMILY RESIDENCE AND ATTACH
GARAGE PLAN �-D
(CENTCR LIN6 BT.1 /'—/�
FRONT h `'
R. SIDE %
L SIDE �
REAR D
APPROVED
BY I
I HHP[BY ACKNOWLEOGE THAT I HAVE RGO THIB MPLIGTION THE AMOUNT BHOWN IIN�ER VALl1AT10N IB POR THC
ANO BTATH THAT THE ABOVE IS GONRECT RND AGflEE TO COM- pUppOBE OP EBTFBLI6HING A PERM�T PEE ONLY.
PLY WITH ALL CITY OfiDINANCEe 6ND BTATE 1.�W9 REOULATNO
eultnlNa coN6TRUGT1o�. VALUATION /
PERMpITTEE OF / �4, / � �'ERMIT FEE $ ��"�
3iG
� /�% PLAN CHECK 96 /�
�AUTHORIZED AGENT