HomeMy WebLinkAbout3214 MINNESOTA AVE - Building Permits�
AOPlicant to llll In all spaces exceDt tnose within neavY �ortler Iines anE si9n all aooroprlate aeclanUons.
CITY OF COS7a MESA CONSTRUCTION PERMIT J
Project Address 3� t'-! � ^{'Yl . nn e Cp �e�
ApplicanYs.nlailingAddress 1�•+U3 s�nertor �
/� � �y ��
Owne�'s Name� �% /1 ��! /✓L-�'%��/ p� Phone y'.
Address - 3oZI�I /�'�IA.� ei C.G,:�; %�-✓ � . . %j'i _�/.�
Arch/Eng. License No.
Address
�
Contranor's NamP �e e ��aV�o�.i�_��{y� Phone�ya_.7_a��
Address Imeilingl ��r� _.]' � �' �' : p% �'✓ •/�_
City License No. � (�..� �
LICENSED CONTRACTOR �ECLARATION
I hereby alii�m thal 1 am II<aniatl untler provisions of CM1artGr 9(comTencing
witn section ]000) ot Divislon 3 0! tne BuSinesi antl Protes5ion5 COCe, antl
my license is in t W� rcjay�tl efiect.
License Class Y • License No.
Date—/�09-RR Signatura �
WORKERS' COMPENSATION DECLARATION
�I nereby a(/irm lhat I have a certi(iWte ot consent to seit-insure or a certificate
ot Worke�s' Compensa[iOn Insurance, or d Certltietl coOY ther¢of (Settion
-�uo. t�o. ca �� p� `�, �r. f 9 G.
icy No. �[-m-u.Q_lL Company �
-Certifie copy Is nereby fum�shetl. �-
Certifi tl c Iletl with ihe Nt I mg Iv' Ion.
ate-��� APPIIcan�Y�GG� � �
EXEMPTIO FROM WORKERS' COMPENSATION D LARATION
(This section naetl nol ba complbtatl if the permit Is for one buntlretl (5300) or
Icss).
I certity that In the perfOrmanGe of the wOrk f0� wnlch this pe�m�t i51;5uetl, I
shall not employ any pe�son IM1 dny Tdnne� so as to be<Ome Subject to the
Wo�ke�s' Compensation LawS of Calitomla.
Date Si9ndtura
NOTICE: If, aftcr making Mis qvclaratlon, you zboultl Decome subjett to the
Workers' Compensatlon PmvlSions ot th! l2bor Cotle, you mu5t torthwith
comO�Y wi[h suGh provlsions pr Ibls pe�mit Shall be tleCmeU �Cvoketl.
CONSTRUCTION LENDING AGENCV
I hereby afflrm thal tM1ero IS a con5t�uclion lentling a9ency fo� the pe�fo�mance
of thu wo�k fo� whICM1 [hi9 Oe�mit IS ISiued ($ection 309] Civ. CJ
Lenaer's Name
Le�tle�'s Atltlress -
OWNER BUILDEN OECLARATION
I hereby allirm lhut I dm exerrypt from lhe Contraclor's License L.aw 10/ tne
followin9 reason (Section ]031.5 Business antl ProfeSsional Cotle: AnY clty or
counry wnich requiros u permit lo Construct, altCr, ImO�ove, tltmolish or repair
any structure, ONor to Ils Issuance, also raqWres the applicant tor 5uc0 permit
lo lile a siqnetl Statement that he/she I5 IlcPnsetl pur5uan[ to Ihe prOvision5 Of
the Contractor'z License Law (ChaDter 9(commancing witn Section 7000) of
Division 3 of lha Bu5ina55 antl PrOtOsslon5 COCC) of tllat hC/She is ¢%Cmpt
therelrom antl the basls lor tha allegntl exemptlon. Any violation o1 5ection
7031.5 Oy any apPlicant IOr a pe�mit 5ubjeCtS Ne applicant to a civil
�alty ol not more than tive h�ntlretl tlollars (E500�.
I, as owner OI ihe prop¢r(y or my nmPloyees wilh wa9es a5 lheir sole
.mpan5alion, will tlo th¢ work, dn0 Ihe StrUctur¢ IS nOt Intentlt0 or olteretl
for wlo (Sectlon ]064, Busiqpis antl Profa55ional Cotle: Th¢ ContraG[Or'S
License Law tloas not apply [o an owner ol a property who builas or Imoroves
tpereon, antl who tloe5 sucll Work Illmsetl/IIar501f Or Ihrough hi5 Or hel own
i employees, provitletl tha� such 7mprovamOnlS are nol Inlentletl O/ off¢r¢tl tOr
'� sale. If, however, t�e builtling or ImDrovement is 5oltl witMn one year ot com-
pl¢tion, the Owner will have t�o burtlen OI P�oving he/sne tlltl not bulltl or iT-
�rove lor tho purposo 01 sala).
I, as owne� al the'pro0erty, am ezciusively cont�atting wilh IlcGnsetl con-
lractors to conitruGt lho Projec( (5��tlon ]044. BuSinCss antl Prot¢ssions Cotle:
Thc COnt�acto�R �icense Lnw does mt appty to an owntr o1 propCrty who
builtls or ImprOves lhereon, a�tl who cont�aci5 lor such p�ojects wlth a con-
tractor(sl iicense pwsuant to tpe Contracror'S License Law). I am aware ina(
prooi of thel� Wo�k¢r's Compensation insu�anca Shoultl be p�ovitletl lo me.
❑ 1 am exempt uneer Section B. & P. C. Por Ihis reason
Date Owner
I nereby certiiy Nat I hava �eatl tnls application an
iniormafion is correcL I agree to comply with all city
antl state laws relatin9 to builtling construction, antl I
52f1(dIIV25 O �5 C�ly � �ter ll OO B dbOVB-T�
inspec[ion ur �
� Signature _��^
Drivers' License or 55 � �
TYPE OF CONSTRUC
❑ CONVERSION
DESCRIPTION OF
TYPE OP PERMIT LJ
❑ TENANT ❑ ELE
I� OTHER �
PROJECT DESCRIPTION
CONSTRUCTION TV
ZONE
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Dreins
Floor Sinks
Gas Service
Kitchen Sink
Lavatories
Roof Orains
Reinspection Foo
GRADI
ADD �/Ll ALTERATION LJ REPAIR
BLDG.
1 FOVNDATION L7 STRUCTURAL
7LUMBING ❑ MECMANICAL
- OCCUPHNCV�� %
VAIUATION 5 77�%
GRADING CU. VDS. ACRES
FE
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Pool w/Spa
Urinal
Water Cloul
Water Heater
Water Service
Auto�Wash
Laundry Trays
515 � � laue Fea 5 3
Boiler
Duct - Under Ground
Duct - SVucmrel
Duct - Ventilating
ExhaustSystem ❑ MWtipla
FirepVFact8lt IC80#
Heating System & Ducting
❑0700,000 BTU 0100,000
Reinspection Fee � $15
0865�46, rev. 10/84 Whlte - Bulltling: Canary - Applicant; Pink - Accounting; Goltlenrotl - Asze55or
A.P. qW
5 Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Bui
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW �
Construc�ion Pole $ub. � 50 + KW
Cooking Unit Meter ❑up to 100 amps
Dishwasher Meter ❑over 100amps
Dryers ❑Gas ❑Eleciric Sub Panel
Fan Motors OP7 1%- 8
F.A.U. Inc. S 9-15 HP �16-15+
FixtUres
Device Boxes
Outlets
Switches
Garhage Dispoul
Generator OO-5 KW 05-15 KW
Zane
Pol¢ Li9ht
Standing Sections
Trash Compacror
Reinspection Fee $15 luue Fea
IANICAL FEES
� DEVELOPMEN7 SERVICES REDUIREMENTS:
Hoodor ypol ❑
Cano Type I I ❑ Zonine APProved By
euilding Approved By
� ��
e(riaeration Svstem APPliptian luuad Bv
�0.700,000 BjU ❑100,000 BTU
System Repair/Alteration
FireDampers r�
Registers ' �
$ 3
BUILDING PERMIT $
PIAN CHECK $
PIUMBING $
PUCN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% §
MECHANICAL $
PIAN CHECK 25% $
Z
O
N
I
N
G
R
E
�
M
T
S
FEES
3
F FEES -
% SMIP $ 5'�
_ PERMIT
ISSUANCE 5
ENERGV P.C. $ �
GRADING 5
MICROFILM S
- TOTAL FEE $ �i�
OD19141-OU019142 T�]T 5..`�
� �tmoion rTar. �c.m
CONSTRUCTION AND�P4ANNING POOL & SPA
APPROVALS 'Permit'# Date Inspector qppROVALS Permit# Date Inspector
1.'Temporary ElectricahService or Pole � 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd.' 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Uniirgrnd. 55. �Electrical Bonding
5. Steel Reinforcement � . 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
i
7. Footings � • 58. Electrical Conduit-Undrgrnd.
8. Foundation �. 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trep, O Undrgrnd.
10. Structural Floor System 67. APPROVAL TO DECK
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 F�NAL � �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT , :�
�
20. Rough Factory Fireplace APPROVALS Permit # � •
21. Ducts, in Structure 70. Underground Hydro ' '
�
22. Ducu, Ventilating 71. Product Piping �Gas ❑Oi�
23. Gas Pipe-Rough & Test 72. Underground Flush �' �`� •
24. Roof Framing 73. Undergrnd.StorageTank:OGas ❑Oil �
25. Roof Sheathing 74. Overhead Hydro t�
26. T-Bar Ceiling (Structuraq & 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. Pla"sTer 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 ' �
i 36. Hood or Canopy
3`l��•�nal Factory Fireplace "
38. Final Plumbing • '
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 �tjp115 "
P Ins �
46. Handicap Regulations . � �
47. FINALSTRUCTURE&BUILDING L�'diE �
48. Special Requirements Completed , - , • '.
{. � )
49. Electric Release to Edison � ." , ° , � )
50. Gas Release to Southern California Gas Co
- �•
51. CERTIFICATE OF OCCUPANCY
No. Date _
�aT �H - TRACT 3625
�1�.��3
COSTA MFSA BUILDING-SAFETY DEPARTMENT
P. O. BOX 417 C08TA MEBA. GLIFORNIA
For Applieanf fo Fill In Completely
TYPE OR PRINT
BULLDINc ]2�4 MINNESOTA AVENUE
ADDRE68 J
COSTA MESA CALIFORNIA
oWNER KENKOL CONSTRULTION CO.
wooRE65 ��55 PLACENTIA {iVENUE
c�TM NEWPORT BEACH ;,;o�� 6-32�
ARCHITECT TEI..
,croe K.W. KoLL
�s �555 PLACENTIA /1VENUE
NEWPORT BEACH
6ii95 ;,o:Mi 6-3zz7
64 x�oo ���:.�� a��• o
FIRE
ZONe
�ea��
6 �'� '���,'�1����
�• d. S'Ib-bo
:INANCE DEP�.
CITY OF COSTA P��ES►�
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
nece�vr rvo. .d �yr2eq¢ {�q.
DATE �89UED
CASTA MESA. CALIFORNIA
ZONING
NO. OF � I U8H OP
Pune -7�{-emtom
LIN@ pqOM �0 � 'LO � RHNTBR LIN[ BTq
iR eTRl6T REAR YARD FRONT
� 6�
RD�I�SCRIPTION OF WORK R.SIDE
BUILDING NO. OF 7
g�Zg � Z1 SF ROOMS I 6TOR1E6 1
EXTERioR wA4� STUCCO I ROOF WOOD SH I NGLE
COVEFIN6 COVERING
U88 OF BUILDING AND WORK TO BE PERFORMED
SINGLE-FAMILY RESIDENCE AND ATTACHED
GARAGE PLAN -B
1 HERBBY ACNN�W�mGe �NAT 1 HAVE qB�D TH16 APPLIGT�ON
AND eTAT6 TNA� TM OVe I8 E8 TO COM-
PLY WITH ALL �� � INANLEB 8TAT6 P80ULATINO
BUILDINO CON N.
SIGNATURE 06/ .. _. I/ I A/�M.. _/'
� AUTHORIZED
APPROVED
/�
n
��
TH8 Al10UM BHOWN UNOBR VALUATION IB FOR THE
PURPOSE OF EBTAOLIBNING ♦ PHHMIT FEE ONLY.
VAWATION � /`
c.���j PERMIT FEE S �
S /!G/f ' " `� PLAN CHECK $ ���
�^ �
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