HomeMy WebLinkAbout3166 MANISTEE DR - Building Permits CITY OF COSTA MESA
itat BUILDING DIVISION PERMIT NUMBER
'3 DEVELOPMENT SERVICES DEPARTMENT. /
TA. . PERMIT V
.tbmParawnse BOO-00564
•
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3166 MANISTEE DR Status: ISSUED
Suite: Applied: 04/26/2000
Vicinity: HOUSE&ATTACHED GARAGE Issued: 04/26/2000
Parcel Number: 41801234 Zoning: R1 R1
•
ISSUED BY:
Applicant: MORALES, RICARDO
Address: 146 S SMAIN ST
Phone: (714)693-0724
ORANGE,CA Zip: 92868
Owner DANG, LUAN MINH
Address 1074 TOLARE DR
Phone:
COSTA MESA,CA Zip: 92626
Contractor: UNIVERSAL ROOFING
Address: 146 S SMAIN ST
Phone: (714)693-0724
ORANGE, CA
Zip: 92868 License: 765451
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: , License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(27 SQ).TEAR OFF EXISTING LAYER OF WOOD
SHAKES&RESHEATH WITH 1/2"OSB. INSTALL 1 LAYER OF 15#FELT UNDERLAYMENT&REROOF WITH 35 YEAR
COMP.SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,000.00
Permit: $97.25 Claim Valuation: $4,000.00
SMIP Res: $0.50 •
SMIP Corn: $0.00
Other $0.00
Inspection: $0.00
Total: $97.75
PLANNING & ZONING
SETBACKS •
MAIN STRUCTURE Front 0-0 Rear I 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear : 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not withiri-180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carder and policy number are: .
Carrier: Policy Number:
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
/ I certifythat in theperformance of the work for which thispermit Is issued, I shall not employ any p y onrpro in any manner so the become r det to the workers'
hwith
compensationlyhlawsyrofo ininCalifornia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: L.-alaT /�! i��— Date: Lie 26 m'
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR 000E.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# 7C Yc-�i�� Class# C. 39
Contractor's Signature: .w. ." 7lsrf���� — Date: Y '7_a
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant toe civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
SlureOf Legal Own ) _ Y DateZO
'And/Or tho nt Date
CODE I INSPECTION TYPE DATE INTm11L$ CODEI INSPECTION TYPE PAM INTIRALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
5
200 Final Re-Roof -J po W 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-46
ADDRESS OF BUILDING: 3166 MANISTEE DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT
OAMERSNAIAE IFM1OY(N: DANG, LUAN MINH PERM NO: P 074413
ADDRESS: TRAN, YEN K
• 3166 MANISTEE DR PERMIT NO: P 074413 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
APPL.WULMO ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE : OTH
ARCltrECT OR ENGINEER: LIC.NO.: JOB DESCRIPTION : C/O DISHWASHER SQ FT:
ARCH,OR ENG.'S ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 /
CONTRACTORS ME: DP PLUMBING & INSTAL . ( 714 ) 991-9477
CONTRACTORS KRUNG 220 N. CRESCENT WAY COMMENTS : X
ADDRESS: ANAHEIM CA uc.Mo.: 563793 *************->E**K-***************x-*ic***it**** -****iE-x************* -*******x-itst*****
92801 unT: M Z ONING R EQU IR EMEN TS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury That I am licensed under provisions of Chapter 9 SETBACKS
..•mmencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
C . LIC.NO.: UO.CIASS: C36 ,, i 793 EXP : — MAIN BUILDING ACCESSORY BUILDING
A _ �' �i1.1) FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dae: \'� Contractor: , LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
•WN:R BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
I. - .reason(Section 7031.5 Business and Pmfessioes Owls:Any city or county which requires a permit to constrict,alter.improve, PARKING REQ: PROV: PARCEL: 41801234 Z N E: REF NO:
',mash,or repair any structure.prior I0 its'issuance.also requires the applicant for such perms Io file a signed statement at he or she
licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES>
Jusines3 and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section >
7031.5 by any applicant for a Perron subjects the applicant to a soil penalty of not more than f&e hundred dollars(5500W. *******************************************************************************
❑ I.asowner of the propertyormy employees wih wages as their sole compensation.will do the work.and thesuucture is not intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an in of property
who bolds or isprovee thereon.and who does suds work hmseff or herself or through his or her own employees,provided that such
improvements are rot intended or offered for sale.f,however,the building or improvement s sold within one year of completion,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the property,ant exclusively contracting with licensed contractors to construct the project(Section 7044.Business and
Professions Code:The Contractors License Law does not appy ban owner of property who builds or improves(hereon and who BUILDING APPROVED BY : DATE: _
contracts for such projects with a contractor(s)licensed W rsuanl to the Contractors License Law). 1
o Iamexempt under sagoo. B.SP.C.. «this nason: APPLICATION ISSUED BY: SI! DATE: I 0 �
**********************. . - . . . tJ'. - ' ************ir'3FiF' -r,r Tc-'**
Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGr1ENT:N
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534,and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modification from the Ai u6-Tyyldanagem•r Distna.R•eideniieloonatnrapn applications are exempt from these
provisions. PERMIT 7,00
Dale: Applicant: 25% SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE 20 . 00
o I harm and wil maintain a cenifieete of consent to self-insure for workers'compensalist its prerided for by Sedion 37C0 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the performance erthe work for which thispermit is issued. TOTALS----> 7 . 00 20 . 00 0 . 00 27. 00 27 . 00 . 00
❑ I have and wil maintain workers'compensation insurance.as required by Section 3700 of the Labor Code.for the performance of the
A work foe which the permit is issued.My workers mnpenemi°n insurance carrier and policy number are:
Carrier: FARMERS EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 27. 00 OVER/SHORT: . 00
Policy Number: Nn1 ()7444 L14'1 02 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
,,bis section need nor be completed I she permit is for one hundred dollars/S1001 or lest) 27 . 00
❑ .I certify that in the performance d the work ler which the permits issued,I shell not employ any penin in any manner so a°to
become subject to the workers compensation laws of Calif d I should become subject to the workers' *******************************************************************************
corp` nsation rove lpq�a7 wF�edion 3700 of the Labor Code,I h I wit 1. h those provisions. IND IV IDUAL E E E BR EAKDOWN
Date: \�- -- �l Applicant
W g:Failure to secure workers'compensation coverage la unlawful,and shall subject an employer to criminal penaltisa and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil Rhes up to one hundred thousand dollars($104000),In addition to the coat of eompeeSed0e,damage.as provided for In
Section 3706 of the Labor Code,interest,and attorney'°lee°. PLU 1 DISHWASHER 7 . 00 7 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,CN.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I enn that shave ng this application and state e above information is correct.I agree totcampy with all cityb and- amity ordinances ` -Si
T
and state laws rasing read
to appl construction and hereby authorize representatives of this cily enter upon the above-mentioned properly ifi..sAi 1 1�/9/'/,�
for inspection purpoma. liAil
PATRICIA PADILLA
" 1. /
Print Name DATE
' ^ fir\ Dale:\O-5-`�J 01A E:i0/53 O5 TIME:
TOT 27.00
Signature of Owner/�q}evRAppl�n \,° .araan�\ DATE: 10/53/9`.] TIME: 10:30
,\. I.,5151 d6 WP) Whim-Building&Safe .Green-Re;C ppFamt:Pink-Ravenna;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POO SPA
'APPROVALS Permit# - ; , Date Inspector APPROVALS 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe•Undrgrnd. • 60. Backwash Lines, P-Trap, O Uhdrgrnd,
10. Structural Floor System 61. 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 FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
.y
•+ 7
22. Ducts, Ventilating 71. Product Piping D Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73- Undergrnd.Storage Tank 0 Gas 0 Oil - ,
25, Roof Sheathing 74, Overhead Hydro ;,"
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe `I *,
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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING .
48. FINAL PLANNING _
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY ' --
No Date
ADDRESS OF IMALM% 3166 MANISTEE DR WMT' CITY OF COSTA MESA — BUILDING PERMIT
OWNERS NAME IF KNOWN: DANG, LUAN MINHp, PERM NO: P 074412
ADDRESS: TRAM, YEN K ZSEP
3166 MANISTEE DR PERMIT NO: P 074412 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
APPL.MMuxGADORES": CONSTRUCTION TYPE : V—N PERMIT TYPE: PLO PURPOSE: OTH
ARCHITECT OR ENGINEER: MC.NO.: JOB DESCRIPTION : REPLACE WATER HEATER SQ FT:
ARCH.OR ENG.'S ADDRESS: WIT:
CLAIM VALUE : CALC—VALUE: GROUP OCC: R-1 /
CONTRACTORSNAME DP PLUMBING & INSTAL. ( 714 ) 991-9477
CONTRACTOR'SMMUNG 220 N. CRESCENT WAY COMMENTS : X
ADDRESS: ANAHEIM CA uC.ND.: 563793 ** +E*****ik**+E*et***HESE**********et***+e**1.y*************iE+t*****itiL**** ******* itir****
92801 WIT: M Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I an.licensed under provisions of Chapter 9 SETBACK 5
(commendrg with Section 7000)of Division 3 d the Business end Professions Code,and my license is in fug force and effect.
UC.NO.; (...:16.1C.CLASS: C36 u a . 3 3 EXP : MAIN BUILDING ACCESSORY BUILDING
Ie
at . `.: Contractor: 1 �; FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
R BUILDER DECLARATION: hereby elfirm under penalty d perlaY that I em exempt ttem the Contrmars license law f«the
ol wing reason(Sadon 7031.5 Business and Professions code:Any city or county whim requires a panne to concoct eget improve. PARKING REI: P RO V; PARCEL : 41801234 Z N E: REF NO:
mold:.or rapid any structure.prior to its issuance.also requires the applicant f«such Perna to file a signed sletement that he or she
A licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING N TES>
Business and Professions Code]or that he or she is exempt therefrom and the basis f«the alleged exemption.Any violation of Section > V
7031.5 by any applicant for a permit subjects the applicant to a ova penalty of not more than Ore hundred dollars]3500]3. ********************************************** *******34************************
❑ I.aaowrer oche Pro-etyormyemployeas with wages as Mei sole compensation,will do the work.and the antidote is nes intended DEVELOPMENT SERVICES' R E QI'� U I R REQUIREMENTS T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an owner of property `L
who bolds or improves thereon,and who does such work himself or herself or trough his or her own employees,provided that such n�
improvements are not intended or offered for sale 2 however,the building or improvement a sold within one year of completion,the ZONING APPROVED BY DATE:
coroner-builder will have the burden of proving he or she did not bold or improve for the purpose of sale). • n
❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business and
Professions Cods:The C« m«
nrs License Law roes n M am*to an owner of property who builds or improves thereon and who BUILDING APP ROVED BY 4:4 DATE :
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). I/ / •r
❑ Iemexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY- DATE: J
Date: Owner ********************** ********** *** nr;?**
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT : N
I do hereby certify that I ant aware of and understand the requirements of California Health end Safety Code Sections 25505,25533,end
25534,and that I or any future building occupant will/wit nes(circle one)need to comply with said Nate codes and the requirements for
a permit for construction or moddtmtion from the At Duality Management Diatid.Residential construction appicelons are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 7 . 00
Date: Applicant: 25* v, SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one or the following declarations: PLAN
ISSUE FEE 20 . 00
❑ I have CodeendwiledormancCeneiweofc«eemto self hthispsuretrsued.ecomperwmion,asprovidedforbyRadian370odtheabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
cane.f«mepenarmNradWework f«wcnrtmpam is issued.
TOTALS----> 7 . 00 20 . 00 0 . 00 27 . 00 27 . 00 0 0
C I have and wig maintain workers'compensation insurance.as required by Section 3700 d the Labor Code,for the performance of the T,
work for which this permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier: FARMERS EXPIRES REVENUE DIVISION TOTALS--> COLLECTED • 27 . 00 OVER/SHORT: 00
Policy Number: 4O10744441 02/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
( ' on need not be completed Aute permit is for one hundred dollen.($roof«ass) 27 . 00 '
lv that ine the performance workers'
of the work for coach this penmH is issued, shall not employ should
any coat a in any manner soworkers'as to
fi
object to the corrgensalon bora of C we.t d I N,auld became subject to the wwkere' ***********************************.********************************************
on p Becton 3700 of the labor Coda. n.,• p thpee provisions. /
ate' Applicant: x'► I N D I V I D U A 1� F E E B R E A K D O W N
Imp:FailurefoSeeura workers'compensation coverage Is unlawful,and shall subject an amp/oyer to criminal penalties end TYPE QTY D E $ C R I P T I O 1N UNIT COST TOTAL COST
civil fires r to one hundred thousand dollars(5100030A In eddldon to the COSI of compensation.damages es provided for In I
Section 3705 of the Labor cods,Interest,endartpmey'e less. PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the £fND OF FEES
performance of the work for which the permit is issued(Section 3097,Ce.C).
LENDER'S NAME: 2,7
LENDER'S ADDRESS: l +
/
I certify that I have mad this application and Nide that theall cit
above information is correct.I agree to comply with y end county ordinances
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly —
lar impaction purposes.
(� PATRICIA PADILLA V////
prIppfican Name
� `p1\_\\ Data: \O-3
uredOw5151-45.WP) Whhe-Buildig& Green-RbCanay-Ape/cant:Pink-Revenue:Goldenrod-Assessor 01 C3V711:O-3Djc 261. 73 1 27.00
y0 -
DATE: 1D, a. :rill; i.e. s%
CONSTRUCTION AND PLANNING POO SPA
APPROVALS Permit# Date Inspector APPROVALS 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 UFBR Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. 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 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 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 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:lZ��_5,5_ l, ��
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 1z-4 /39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47, FINAL STRUCTURE & BUILDING -
48. FINAL PLANNING _
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA REQUEST FOR OCCUPANCY �/
TRACT NO. q� 'j�j DATE eree_wd // 7J
LOT NO.
ADDRESS .3/6 40,4
The developer of the above entitled tract desires to sell the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The under 'gned, by executing this agreement , acknowledges that (he-she-they)
(was or were) , ..C/��j4 Q advised that this tract has
not been iven final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
BY / / ,y, , - ••••••
RECEIVED ,j � seri
CITY OF COSTA MESA
PINNING DEPT. Developer and/or authorized
JAN 1 3 1977 representative
MA
PM
71819001111121112131415 16 BY
! Lender
1,
`-^ Faric Mesa Homes UAIt Rini LU 1E1T2
JOB ADDRESS 3166 Mnnigtpe Drives BUILDING PERMIT NO. 41654
GENERAL CONTRACTOR Lucas Development CO- DESCRIPTION of WORK Residence w/att garage
A' '0. alR-oh -07 LOT 5 TRACT 9036 FIRE ZONE VALUES 38,100.00
II iCTIONS Si nature Dote TYPE V GROUP I & J ZONE R-1
SOIL SZ., PERMITS ISSVFD
GAS SUBCONTRACTOR
Date I Number 1 Signature
WATER Plumbing �/ •//
ROUGH PLUMBING 42.E --7-7)--,4y ley 41 9-74 brY9b3•—
PROP. SWR. LINE HOUSE CON. D V. /x Sa
SPRINKLING SYSTEM❑ �' 0e..Z1 6 _a-24. LCI.15 S/'7'
MISCELLANEOUS ' o - _1/ r (]
ROUGH HEATING AND AIR CONDITIONING W ✓� 'IQ .
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER U - ''//
ROUGH WIRING �- 1-)Y/b , r 'Heating a V.
TRENCHES 0 FORMS 0 STEEL REINF. S a . ? -� yE{i�• Ly-9-'?7C /35a3
FLOOR SYSTEM �2.i-9 FFfy 6-if, 4 /a6a1
BOND BEAM l l STEEL REINFORCE n
SHEATHING talc *-
FRAME AND FLASHING 7�73 r
BRLATHING — IN IV OW COAT ^OUT 7t • �/q7 r
PLASTER.
`
S' "URAL. FINAL I /
HI .IG, VENT., REFRIG. AND A.C., FINAL 04143 C ' / ,L_. .'i j%�� 4Lf ?,= ' '
¢
PLUMBING, FINAL AND GAS TEST n G S ib, fjf' e ate/f • _ /
ELECTRIC, FINAL in-12.44q //. k._-: j, 4� /
BUILDING, FINAL
CDrriei ornul CAACNTS • //1 � _-
- 41654PAIL
PR 20-76r—.001029-- ***Z33.67
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP'L A ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only REC • BY DATE RECEIVED
BUILDING / i
ADDRESS • , II_ r� I I
•
OWNER Park Mesa Homes A.P.NO.All 8 -011 -o 1 P R4IT��J4
MAIL BUILDING O
ADDRESS 1451 Quail Street ADDRESS Si lo(, Aga 'ems
CITY Newport Beach No. 833-0018 TRACT 9036 II LOT 5 BLOCK
CONSTRUCTION. Diego Federal S & L NEW ADD ALTER REPAIR MOVING DEMO;ISH
LENDER S8 n
BRANCH San Diego in �e y
OWNER /
ADDRESS 600 B StreetARCHITECT ��J� VALUE�l Q ��aI
44 OR ENGINEER Craig Combs 6 Assoc Nod'645-8040 USE r�/rte 9�/O.�P�
FIRE
ADDRESS 1535 Monrovia, Newport Beach ZONE T PE r GROUP-14179
APPROVED (j DATE 4?/ i/
CONTRACTOR Lucas Development Corp. BY
ADDRESS 1451 Quail Street
TEL.
CITY Newport Beach NO. 833-0018 PZONE m NO.OF USE OF NEW•lCL.
M ',W PLANS 2 BUILDING/..//q- Garg•
F STATE CITY YARDS APPROVED YARDS APPROVED
S., LIC. NO. 257064 LIC.NO. MAIN BUILDING ACCESSORY BUILDING
f.9 SIZE NO.OF BLDGS. (FROM C/ STREET)
C. OF LOT 55s R 901. NOW ON LOT noel FRONT Os FT. FT.
Q USE OF
, .. EXISTING BLDG. none R SIOF 6-FT, FT,
22 Separate permits are required for L.SIDE 5 FT. FT.
1-0
electric,plumbing and heating work.
REAR ZS FT. FT.
' USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q MAIN BLDGS. ACCESS.BLDGS.
3 single family residence a..2... C VADATE
u..P.,w2e-75 77 APPROVED sll-?y 7S
>>-' APPROVED
`!d DATE T --I 9-26
w `OLD FOECL\L REQUIREMENTS
A. I hereby acknowledge that I have read this application and state 0
ce that the above Information Is correct and agree to comply with m
0• all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of o
the State of California. fee ,/ fir
3 I hereby certify that I am properly licensed es a contractor under //4IGo SO. FT. ••j 7D ry
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In fu 'force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON Y: n
am exempt from the pro ions of • •Ste of California Business a
VALUATION PERMIT FEE S /(�
and Professlo te, •RI Ion 3 apter t. 1�J
• IIkit PLAN CHECK S J 7 m
Signature o v , �r�/ S /j �� ( '♦>� u
Permittee _ L// _ �C7J(l TAX S /� Q7s/I f
Authorized Agent TOTAL PAID S / '� G6/�ff►_/7
OWNER STEVE HAAG DATE 5/4/81
JOB ADDRESS 3166 Manistee Drve BUILDING PERMIT NO. 51796
GENERAL CONTRACTOR Solar Energy Equip DESCRIPTION of WORK Solar Rack
A T. 418-012-34LOT TRACT FIRE ZONE VALUES 500.00
IN..ECTIONS Signature Oats TYPE GROUP ZONE
SOIL SUBCONTRACTOR PERMITS ISSUED
GAS • Data l Number I Signature
WATER Plumbing
ROUGH PLUMBING Solar Energy Equip 5/4/81 79397 ✓
PROP. SWR. LINE 0 HOUSE CON. O
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS Li STEEL REINF. LJ'
FLOOR SYSTEM
BOND BEAM ❑ STEEL REINFORCE In
SHEATHING
FRAME AND FLASHING
LATHING - IN in OUT n
PL•`TER, BROWN COAT
S 'URAL, FINAL _ Electric
HEA.INC, VENT., REFRIG. AND A.C., FINAL Je �j Solar Energy Equip 5/4/81 49113 r
PLUMBING, FINAL AND GAS TEST n _ tip 4Z17:
G W LI[Fc/'/
ELECTRIC. FINAL tip
BUILDING. FINAL
IQeh Sm&iso 5.50 TL
. COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI ATION FOR STRUCTURAL PERMIT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECE4 D BYY 'PERMIT 5/19�
For Applicant
to /Fill in Completely —^Use Ink
/]Only
� J� C�1/,1
BUILDING � IL!/ �J ! llilA�/J*YX `,(/L A.P.A.P' NO. y�t�' —O I� — 34-
ADDRESSs�
/(J�IJ , A/n BUILDING 5// / ihm-N sr-at
OWNER OR V, X ADDRESS (�{p
TENANT X ikar
UNIT
MAILING ^ SPACE N NO.
�—
ADDRESS ' �I/ /
TR.NO. LOT 5 BLK.
�/
CITYMI qyO3‘.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER
BRANCH CYC r ^�^
OWNER �TEIt... /1/4A-C7
ADDRESS VALUE
ARCHITECT TEL. USE�LA2.,,,, $ .5-00.—q--
OR ENGINEER NO. /�
ADDRESS 5 D _ / n ,` '/`
/ (isL`, -sAPAPPR TYPE GROUP
OVED
��
CONTRACTOR/Q , i y �� BY DATE
�
ADDRESS 57 "Y 13 .-1 L_p— r- -
CITY e tY 3 /
_
STATE LIC. NO.�3,r8'7/ /// ti� CIC. N�J
LIC. , fl a3 APPROVED SETBACKS
R.1 SIZE INO.OF BL[X.S. (FROM C/L STREET)
e OF LOT NOW ON LOT / ,fRONT FT.
a USE OF � I
EXISTING BLDG. (..A R,SIDF Et
rn
F Separate permits are required for L.SIDE FT.
electric,plumbing and heating work. REAR FT.
F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
Q
/ 5 //LA 4
20' „LGi7L i{4k1 DATE
APPROVED
� APPROVED
r1 [rn ' lys 7 ISS— —RYDATE
...Ilz
m
a • I hereby acknowledge that I have read this application and state N
N
that the above Information is correct and agree to comply with
G. all laws regulating building construction, and I shall not employ i
Z any person In violation of the workman's compensation laws of p o
x the State of California. O ..
I hereby certify that I am properly licensed as a contractor under
SQ. FT. C4-U-J ) t� N
D
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR to
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: —
to
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $
and Professions Cod livislon 3,Chapter 9N
/}�`7,(//� PLAN CHECK $ n
Signature of ! �,aJ 4 V o
PLAN
!J ' n
Permittee $ TAX $
or S‘2_. u
Authorized Agent Date 4 TOTAL PAID $