HomeMy WebLinkAbout3238 MICHIGAN AVE - Building PermitsAop�Icant to tlll In all spaees exceo� those within �eavy bortler Ilnes ana sign all aoo�opriata aeclantlons.
CITY OF COSTA MESA ��� I Z -
CONSTRUCTION PERMIT
P�o�ec� ndd�ess tigan Ave. Costa Mesa. Gi 92625
ApplicanYsMailingAddreu29S2 � �*'Y P1ara C'nc a Nt:�-a CA
Owner's Name�`� i'�1"S 'T� �n Frecic ' kSnp ahone y+�154�
Address ��� hli rhi_�an 4.�P ('nGta M=ca � 92fi7fi _- __
Arch/Eng. License No.
Addreu
Contractor's Nam 'r'r2i"LN�1 �7'OthPS'S+ s�. phone �1553
� Addreu (mailing) 2952 Ce�rtury Flace; Costs P�hsa, CA
( City Cicense No. ��3
� LICENSED CONTRACTOR DECLARATION '
!�"� I hereby affirm tnat ,t am litensetl un�er provislons of Chart¢r 9(commencing
Vu with section 7000) of Division 3 ot the Business antl ProfeSsions Cotle, antl
my Iicense iSln ful,�f r e antl etfect. ,
LJcense Ciass �� cense
oate ' Sl9nature
WORKERS' COMPENSATION DE RATION � �
I hereby affirm that I have a certificate of consent [o selt-iniure or a certificate
� l Wo�ke�s"CompenSatiOn �nsu�ance,� o� a ce�Ufietl tOPy the�<ot'(SecOon
34'^900, Lab. CJ
"'6olicy No: ��-�I�'�2} Company � �_
�Certifietl mpy is hereby fumishetl ,
Certi 'etl copy i fi tl with the ' y Bu' ivisi 'n.
�ate Applica
E%EMPTION ROM ORKENS' COM NSATION ECLARATION
(This section neetl nat be completetl it the permit is for one huntlretl (SI00) or
less). • '
I certify�that in Ihe p¢r(O/mance of Ihe work fOr whi<h fhis pCrrlirt I5Js5peQ I
zhall not employ any person in any manner zo as to become subject to the �
Workers' Compensation Laws of Califomia.� ,
Oata � Si9nature
NOTICE: 1f,'after making [his tleclaration, you shoultl becoma subject to the
'Workers' Compensatlon provlsions of the Labor Cotle, you mus[ fort�with'�
comply �with suc� provislons, or this-permit shall be deemetl revoketl.
CONSTRUCTION LENOING AGENCV '
I hereby aftirm tnat tnere is a consiruction lentling agency for tna performante
af the work �tor which thl5 permit •Is luuetl .(SecHon 309� Clv. C.)
Lentler'i Name
L.entler'S Atltlress
OWNER BUILDER DECLARATION � ' ' '
I hereby afflrm tnat I am exempt trom the Contractor's License Law for�the
followinq reason (Section 7031.5 Business antl Protessional Catle: Any tlty or
county w�icn reqwres a permit to construct, alter, Improve, Cemolish or repair
any strutture, prior to its Issuance, alio requlres the aoP�itant for such permit
to tile a signntl statement t�at he/she I5 Iicensetl pursuant to tho provisions ot
the Contractor's Llcense Law (Chapter 9(commencing wlth Sectlon 7000) of
�Ivision 3 ot the Business antl Professions Coae) or that no/she is exempt
therefroin Sntl the basis (or the alleged axampllon. Any violation of $ection
'131.5 �by'any applicant for a permibsubjects'the applican[ to a civil
malty of not more than tive huntlretl tlollars (y500).
J I, as� owner of the property or my employees with wages as their iole
compensation, will tlo the work, antl the�structure is not intentletl or offeretl ,
:0! Sd�2 ($8CL�00 JOGO� BIISI0055 d0(1 PiO�essional Cotle: The �OlIIfdCIOf'S
License I.aw tloes not apply to an owner ot a property who bullds or improves
tneroon, antl.wno aoes such work himself/herself or-through hIs or ner own
employ ee5, Orovltlatl [hat such improvemants are not int¢ntletl or of(aretl tor
Sale. If, howev¢r, [he bulltling or Improvem0nt IT 501tl wlthln one y¢ar o( COm-
pletlOn, the owne� will M1ave th< bu�Aen of p�oving he/she Eid not build o� Im-
�fOve'fol tlle pulp05¢ of Sale).
I, as owner ot lhe property, am exclusively con[racting wlth licensetl con- •
[ractors [o construct the project (Section 7044, Business an0 PrOfesSions Cotle:
The Contractor's License !2w does no[ dpP�Y to an owner� ot property wh0 '
Gulltls or improves thereon, antl who coniracts for such proje<ts wl[h a con-
tractor(s) licenso pursuant to'the Contra<[or's Llcense LawJ.
❑ I am exempt untler Sectlon B. & P. C. for this reason
Daie ' ' Owner
I herebvi certify that I have rea�
n antl
citY a
antl he
�
TYPE OF CONSTRUCTION LJ NEW LJ AD� LJ ALTERATION LJ REPAIR �
❑ CONVERSION ❑ DEMO SH ❑ OTHERC,� ` q,p, q�6 �
DESCRIPTION OF WORK ���CJy� C�� �
�Q�"�, `^ �� , E MainBuilding: •
!�6}
TYPE OF PERMIT U GRADING FOUNDATION STRVCTURAL � T FrOnt
❑ TENANT ❑. ELECTRICAL ❑ PLUMBING � MECHANICAL . A Rea� � '
�� �OTHER ' C Right
PROJECT DESCRIPTION 5�. FT. -ocCUPArvCV K
CONSTRUCTIONTVPE VALUATION$ g �eft
� ZONE � GRADING CU.Y�S. ACRES Ping. Ref.'/� �� '��
Remarks: ' � Parking Req./Provided '
� Use of Building:
� - . PLUMBING FEES Planning�Notes:
$ink
Preventer
L•rigation
, '
, I I Showers
Service Sink �
Jrinking Fountains
Floor DFains �
FloorSinks �
uas Service � �Outlats �
Interceptors ��
Kitchen Sink -
Lavatories � �
P—Trap
Roof Dreins ' �
Reinspection Fee $25
Duct- UnderGround ,
Duct - Structural
Duct - Ventilating
Ezhaust System ❑ Multiple
Firepl/Fact.�Blt. ICBO #
Heating System & Duc[ing .
�100,000 BTU 0100,000
� �iae� uY��� au�vv-���e�ia�Vi�eu V��Vc��y ���
Inspectlan rpoze .
Siqnahre Oate,�L��
Drivers'�Lice o 5� Reinspection Fea
CMF 0865-46 rev. ]/63 "�^/hi[e - Builtling; Canary - Applicant; Pink - Accountinq; Goltlenrotl - Assessor
$25
Sewer Cap
Sewer Connection ,
Solar Collecmrs �
_ . ... .._ _' _ ' ♦
Solar Tank
Swimming Pool wlSpa
Urinal
Water Closet � �
Water Heater
Water Service -
laue Fee I $ 3
iANICAL , ' FEE
Hood or Typel � '
Canopy Typell ❑
Refrigeration System '
❑0.100,OOOBTU ❑100,OOOBTU �
System Repair/Alteration �
Issue Fee � � $ 3
` Automatic Washer
' ConstructionPoleSub. �
� Cooking Unit � ' '
Fan'
F.A.U. '
Pixtures
Device Boxes .
Outlets
Switches
Garbage Disposal
Generemr �0.5 KW
0
5-15
'25S2 6/20/84
Zone
Acceuory Building:
Park.Fees $
ELECTRICAL
'Transformer ❑ 15-50 KW
o so+Kw .
� Meter ❑up to 100 amps '
Meter �over 700amps, .
Sub Panel . �
Motors D O-1 HP � 1 Y, - 8
'Inc.Solar �9-15 HP �16-75+
1 nn:........�..'e
Pole Light
Range
Sign �
Sianding Sections
Trash Compactor
7ofl',�
�
Z
O
N
I
N
G
R
E
O
U
�
R
E
N
E
N
T
S
ES
T
I qeinspection Fea I$25 � �ssue Fee I'$ 3 I
PUBLIC SERVICES RE�UIREMENTS:
2aning Approved 8y Date
Application Approved By Date
Applieation luued By rn'-�b Dat�
G�
SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT '
PLUMBING . $ ��UANCE $
PLAN CHECK $ ENEFGY P.C.' $
� ELECTRICAL § GRADING $
PLAN CHECK $ � ' MICROFILM $
. MECHANICAL $ 7 oD TOTAL FEE �$ �.�Q__
PLAN CHECK � , $ � �
' ' /i
� CONSTRUCTION AND PLANNING � � POOL t A
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 '
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. '
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. ." 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System i 61. APPROVAL TO DECK
� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap '- 63. Heater & VenbFinal �
13. Roof Drains 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�Elecirical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Fieating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough F.actory 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. UndergroundFlush
24. Roof..Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheaihing 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
39. Water Service-Final �
40. Gas Service-Final � •
41. Solar pomestic-Final
42. Backflow Preventer '
43. Back'flow 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 Southem California.Gas Co
51. CERTIFICATE OF OCCUPANCY .
No. ' Date
/
Lor 3� - TR 2
• �����
C057A MESA BUILDING-SAFETY DEPARTMENT
P. O. 60X 917 C08TA MEBA. GLIPORNIA
For Applicanf fo Fill In Complefely
TYPE.OR PRINT
;ya
BUILDING 323g a�A AVENUE
ADDRESS
COSTA MESA CALIFORNIA
FE� RECEIVED
FINANCE DEPT.
CITV OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
aTY NEWPORT BEACH CALIF. N�J��I G ZP BUILDING
ADDRESS
ancHi7ecr. TE�. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRE55 FIRE 1
ZONE TYPE GROUP P
CONTRACTOR K W KOLL CONST. CO. INC. APPROVED
BY DATE
ADDRESS 'I QLACENTIA AVENUE ZONING
ZONE NO.OF IIBC OP NEW '
aTY NEWPORT BEACH CALIF. Irur+s rZ eui�o�xa
�`c No. 61 � No: M � 6- 22 LeO"` 4
oescairrwN
SIZE 6� x� OQ I NO. OP BlDG6.
OF LOT HOW oN LOT O A. P. NO.
U6E OF yARDB EVES
EXISTING BLDG APPROVED ALLOWED
BS�BACK LIN6 PROM �Q � '�Ot ICCNTeP LINe pT.l
C¢NTeft Ov eTneei REAR YARD FRONT FT. IN.
6� 5� �-.
SIDE YARD I LEFT I RIGHT R. 91OE FT. IN.
DESCRIPTION OF WORK /
I L. SIDE N FT. IN.
NEW K IIALTERATION I IIADDITION I REAR FT. IN.
REPAIR I' II MOVING I II DEMOLISH I BY�'ROVED W. L. D. DATE 3-16-6i
6ZE��NG�S"JSF ROOMS � STORIES �
EXTLRIOR WALL ROOF OOD HINGLES
COVERING STUCCO COVERING
USE OF BUILDING ANO WORK TO BE PERFORMED
SINGLE FAMILY RESiDENCE AND �
ATTACHED GARAGE •
PLAN NO. 3-C
1 H6RHBY ACKNOWLEDGC TXAT 1 HAVE R6AD TX19 APPLIWTION THQ AMOUNT BHOWN UNO6R VALUATION IB FON TH6
AND 9TATE TMAT TH¢ ABOVH I8 COliRECT M1D AGRCE TO COM- pUliP09C OP EBTABLIBHING q PHRMIT FeE ONLY.
PLY WITH ALL CITY OPOIN�NCE9 ANO BiAT � WB MOUTATINO
BUILDINO CONBTRUCTIo . VALUATION
SIGNATURB OP / PERM17 FEE $.� G�
PERMITTE $ /�/ ��/ PLAN CHECK $ (�
AUTHORIZED AGENT � /t�/� �
TOTAL FEE ��