HomeMy WebLinkAbout2843 VELASCO LN - Building Permits •
CITY OF COSTA MESA
r��� BUILDING DIVISION y
i Nom' 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.0
kf FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBE B08-00150
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 14158203 DATE ISSUED: 05/12/2008
ISSUED BY: KJB
JOB ADDRESS: 2843 VELASCO LN CM Suite/Unit:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Squares: 3200 - - Valuation: . $10,000.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. INSTALL 7/16 OSB OVER SPACED SHEATING.COVER WITH 30 YEAR CLASS A
COMP SHINGLES. ROOF PITCH IS 5:12.800 SQ FT OF BUR ROOFING OVER FLAT AREA.INCLUDES ATTACHED
GARAGE.
OWNER: GYUMDZHYAN,GYULU: Address: 2843 VELASCO LN • Unit:
PHONE: City/State/Zip: COSTA MESA,CA
• I •
APPLICANT: SHARP ROOFING - Address: 10782 S MEADS AV Unit: : • ..
PHONE: 714-771-0118 • City/State/Zip: ORANGE,CA _ •
CONTRACTOR: SHARP ROOFING License No. 571575
Address: 10782 S MEADS AVUnit: PHONE: 714-771-0118
City/State/Zip: ORANGE,CA 92869 CELL:
ARCHITECT: - License No. PHONE:
ENGINEER: • License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $181.25
Reinspection Fee: $0.00
TOTAL FEES $181.25
NOTICE: The work authorised by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODES INSPECTION TYPE DST !NTRIALS CODE/ INSPECTION TYPE D�7 INm1AL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof c ZO-64 6V.Ti 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
WORKERS'COMPENSATION DECLARATION, Owner ID verified by drh. rice. a Yes 0 NO/
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. t xpires:'�
❑ I have and will maintain a certij%ate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
coedit-mance of the work for which this permit is issued.
❑NI 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compens tion Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: S person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffdding,falsework,or demolition
Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need no(be completed if The pe)svlued or one hundred dollars(5100)or less) 2,Art 2,Sec.341,Title B,California Administrative Code).
Policy�Number: /3 0 2 (6 r cO
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not empl. any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compe l.ation laws of California, and agree that if I should
become subj-c`o the . ers'compensation provisions of Section 3700 of Applicant's Signature Date
the a.. C..e/ rk
'.rthwith comply with these provisio s. /
r ossw—
nilIPS 5- r z!U y Division of Industrial Safety Permit Number:
GApdicanl's Signature - Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file:and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license isinfull force and ffect. T(; a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# Jn7� Class# C J'7 exceptions,
25533ere the California HealtheeCode, with somet b
nom^(/— �U eachpbusin requires c registrationat nywithithe CostaonMesa Fire Department y
each business which at any one time has on hand a quantity of acutely
Contractor's Signature gate 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
O I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
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 8. (If"yes",attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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 u
til final inspection.
/) /¢ten. /,��
Lein •• er(s) /pale
Signature Date (j1.,(✓p— 1-1003
]OS]Jfi(3ro7) Andlor Authorized Applicant c Date
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA C WTRU TION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P # Zone '
l8� CO t L n • 24-1 1l S
project Address Z - S Main Building: Accessory Building:
Applicant's Mailing Addre 325•'4 Cit..../e-01(rl /_./I . TYPE OF CONSTRUCTION Ii NEW ❑ ADD LI ALTERATION U REPAIR E Z
r s ❑ CONVERSION ❑ DEMOLISH ❑ OT _ / ' T Front • 0
•t&svne�s Name - i�� )ll Pho e • r
✓�f/�/, ` DESC IP/T�10 O/F�W R S/E BFB CDG. I n i� C B Rear N
Address $'t,� V Q U�d �•� �� V VU ^ L.1! N 0 I cnym s A I
r ' rT? �f C Right N
Arch/Eng. License No. TYPE OF PERMIT U GRADING FOUNDATION LJ sTRUCTUR 471 C N
Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL $ Left
//���� • �n ,,��// ri c � ❑ OTHER / R
Contractor's Name Q IA'1iL9I L3 clic Phone lJ [W+QQ 2 .� S 1L Ping. Ref.# Parking Req./Provided E
z PROJECT DESCRIPTION SQ. FT. 4P OCCUPANCY Q
Address(mailing) ' ��•e-�� U1 C� - Planning Notes: M
CONSTRUCTION TYPE VALUATION$ II.I 44
T
City License No. 2�a6 i ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
with section 7000) of Division 3 of the B1 ess and Professions Code,qand my license is in lull force a ,t. - v V/ ELECTRICAL FEES
License / / Lir b"rile V PLUMBING FEES 0 15-50 KW
�i/0 Automatic Washer Transformer
\ Date �Ff1 Signature -� i����/i
Y WORKERS'COMPENSATION DECLAR ON Construction Pole Sub. 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure •r a certificate Bar Sink Showers
Workers' Compensation Insurance, or a certified copy thereof Section Cooking Unit Meter Duo to 100 amps
30, Lab.•� tia /�/�I�ey-�-��� Backflow Preventer Service Sink
Policy No. �{� S/w GisiQompany )_-. Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
Certified copy is hereby furnished. r Dryers ❑Gas ❑Electric Sub Panel - '
• emits e S ' ' h the city Building niv �.1. —
�// Bathtubs Sewer Connection ,
Date pplicant %' Fan Motors❑O-1HP ❑1h-B
EXEMPT ON PROM WORKERS'COMPENSATI•N DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($10• or F.A.U. Inc.Solar ❑9-15 HP.❑16-154
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is issued I ,
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fixtures Microwave
Workers' Compensation Laws of California. Device Boxes
Date Signature Floor Drains Swimming Pool vv/SpaPole Light
NOTICE:If,after making this declaration,you should become subject to the a Outlets Ran
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal9
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Switches Sign
Gas Service Outlets Water Closet 9
I hereby affirm that therewhiIs a permit
ue (Section
for the performance
of the work for which this permit is issued (section 309] Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION --
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or .
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trats
any structure, prior to Its issuance, also requires the applicant for such permit •
to file a Signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
. the Contractor's License Law (Chapter 9(commenting with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
;::„.fr: refrom and the basis for the alleged exemption. Any violation of Section
"'- ''11.5 by any applicant for a permit subjects the applicant to a civil
.,;:'3 alty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
L, I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date
compensation, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By C. Date
License Law does not apply to an owner of a property who builds or improves /��
thereon, arid who does such work himself/herself or through his or her own Application Issued By Date,/ ��-I'^4J
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ -^7_1t
sale. If, Ippwever,the building or improvement Is sold within one year of com- • - Canopy Type II ❑ $UM ARV OF FEES
pletion, the owner will have the burden of proving he she did not build or Im- Duct-Under Ground ,�•srs
prove for the purpose of sale). - BUILDING PERMIT $ J SMTP $
❑ I, as osdner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK
tractors to construct the project (Section 7044,Business and Professions Code: - $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU
PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such proiects with a con- - -
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $
proof of their worker's Compensation insurance should be provided to me. ELECTfl ICAC $ GRADING $
❑ lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG dk Fire Dampers MICROFILM $
HeatingSystem& Ducting
r Registers PLAN CHECK 50% $ r^
Date O er g g MECHANICAL $ TOTAL FEE $ W D�
I hereby certify that 'hay rad t•" application and state that the above 00-100,000 BTU 0100,000BTL
information Is correct. agr e o •mpl with all ity and county ordinances PLAN CHECK 25% $
and state laws relatin to uil i-• const u .1•s •• ereby authorize r-pre-
sentatives of this cit t e er u•.-�1.i e-mentioned prose
inspection purposes. I •
���
Signature ✓ ,-. Date
Reinspection Fee $15 Issue Fee $ 3
Drivers' License or ss _ �' _ 01 00021992-00021S93 TOT bs.50
DATE: 12/13/88 TIME: 09:09
0865-46,rev.5/88 White - Building; Canar •pplicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOI '.PA
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
76. Electrical UFERGrnd. 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 HodSystem 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 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
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING . 71v
48. Soecial Requirements Completed �l/ _ r "
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CIT OF COSTA MESA, PERMIT NO TRACT NO. LOT NO. BLDG.N0. • - - 75./1
VERA-Sc:
7337 rL
t- CONSTRUCTIOON PEI MIT ASL,/3 r/( i /}Sc� — 9 '36 '
Project Address O edi V l I oSCO- /�. , r TYPE OF CONSTRUCTION ❑ NEW ❑ ADD LJ ALTERATION U REPAIR 4,
Applicant's Mailing Addres1s_• 344 S. et PQn GJC i] 2 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# •
ZO e •
Owner's Name C",1o1n5 Phone _ •
DESCRIPTION OF WORK 74F7 ry 'pFJ.:1U i.
• • S Main Building: Accessory Building: Z
Address Z841P V, I 45 CD - • E 0
TYPE OF PERMIT,,..yy..,,�, GRADING LI FOUNDATION U STRUCTURAL T Front' ' _ N
Arch/Eng. • license No. - ❑ TENANT KELECTRICAL ❑ PLUMBING ❑ MECHANICAL g • - I
Address - - ❑ OTHER - Rear N
- A
Contractor's Name s.qn A T- Fl-ac rri c Phone 6,33.45S? PROJECT DESCRIPTION SQ: FT. OCCUPANCY C •Right K - . ' G
Address(mailing) actiQ S. G tee's Giro J-0 CONSTRUCTION TYPE VALUATION$ _ S Left R
E
ZONE GRADING CU.YDS. ACRES O
'City License No. - Ping. Ref.# Park.Fees $ • •
BP- 8668 "
LICENSED CONTRACTOR DECLARATION Remarks: - •Parking R¢q./Provided -
I Hereby affirm that I am licensed under previsions of Charter.9 (commencing •• - - R
with section 7000) of Division 3 of the Business and Professions Code, and
esUse of Building: E
•my license is in Byi(ll fo��rcce and effect. •
Licenie Class _-- i? Li erase Ne. '/'/4/-n?q , PLUMBING - FEES Planning Notes: M
I
Date- /n//7(p3 Signature ney-.-. ar - E
''ORKERS'COMPENSATION DECLARATION Bar Sink Showers N
T
lereby affirm that I have a certificate of consent to self-insure or a certificate • Backflow Preventer Service Sink $
A Workers' Compensation Insurance, or a certified copy thereof-(Section - - - •- '
3800, Lab. C.) ' Backflow Irrigation ,
9 Sewer Cap ELECTRICAL FEES
Policy No. Company
9 Certified copy is hereby furnished. - Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW •
Certified copy is filed with the city Building Division.
Date Applicant • Clarifiers Solar Collectors Construction Pole Sub. • 050+KW
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher
(This section need not be completed if the permit is for one hundred ($100) or Solar Piping "• . Cooking Unit -' -' I Meter ❑up to 100'amps-- COO
less). -
I certify that in the performance of the work for which this permit is Issued, I Drinking Fountains Solar Tank ^ Dishwasher . Meter ❑over 100 amps
shall not employ any person in any manner so as.to become subject to the ,
Workers' C m ep sation Laws of Califo ia, Floor Drains, ! SwimmingPool w/Spa A
Date /0 11 �3 Signature ]-.. W,4o •r+s p , Dryers ❑Gas ❑Electric Sub Panel ...coo
•
NOTICE: If,after making this declaration, you should become subject to the ' Floor Sinks - Urinal Fan
Workers' Compensation provisions"of the Labor Code;you must forthwith - . - - - _ Motors❑0-1 HP ❑1'/:-8
comply with such provisions or this permit'shall be'deemed revoked. . Gas Service Outlets Water Closet
CONSTRUCTION LENDING AGENCY FA•U- Inc.Solar 09-15 HP 016-15+ •
I hereby affirm that there is a construction lending agency for the performance - Interceptors Water Heater -Fixtures [L,
of the -work for heI h this permit is issued (Section- 3097 Civ. C.) 7� Microwave / r)
•
Lender's Name fV�/�• • Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address - - Lavatories - `
OWNER BUILDER DECLARATION • • - • - I - ', lo' Outlets , Range ' 2 QQ
I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap _
following reason (Section 7031.5 Business and Professional Code: Any city or Switches '
county which requires a permit to construct,alter,improve,demolish or repair - r $ ' Sign - / O�
any structure, prior to Its issuance,also requires the applicant for such permit - Roof Drains ' • Garbage Disposal - Standing Sections
-to file a signed statement that.he/she'is licensed pursuant to the provisions of _ ' - - - •
'
'tee Contractor's License Law(Chapter 9 (commencing with Section 7000)of -
rision 3 of the Business and Professions Code) or that he/she is exempt Generator 00-5 KW❑5-15 KW Trash Compactor
•refrom and the basis for the alleged exemption. Any violation of Section - - - -
.031.5 byany applicant for a permit subjects the applicant to a civil - - - •
ninny of not more than five hundred dollars($500).• ' , • - .Reinspection•Fee. - $25. Issue Fee _ . $ 3 ' -
•LJ I, as owner of the property or.my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3
'compensation, will do the work, and the'structure is not intended or offered MECHANICAL FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENTS:
/ License Law does not apply to an owner of a property who builds or improves Boiler i Hood or Type I ❑ _
thereon,and who does such work'himself/herself or through his or her own Zoning Approved By Date
employees, provided that such improvements are not Intended or offered for - Canopy Type II 0 i ' - , /���g-/�
sale. If, however, the building or improvement Is sold within one year of corn- Duct- Under Ground Application Approved By 4 Date ! !/4 r/,A
pletion, the owner will have the burden of proving he/she did not build or im- ' - ( T Q�
prove for the purpose of sale). - Duct-Structural Refrigeration System Application Issued'By Date
LI 1, as owner of the property, am exclusively contracting with licensed con- .
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
The Contractor's License Law does not apply to an owner.of property who •
builds or improves thereon,and who contracts for such projects with a con- , Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
1 ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# $
l PLUMBING $ -
I Date Owner' Heating System& Ducting ISSUANCE
• PLAN CHECK • $ ENERGY P.C. • $ '
i I hereby certify that I have read this application and state that the above Do-100,000BTU ❑100,000 BTL • OD
information is correct: I agree to comply with all city and county ordinances ' - - - ELECTRICAL $ ��� GRADING $
and state laws relating to building construction,and hereby authorize repre- -7 MICROFILM
sentatives of this city. to enter upon the above-mentioned property for - PLAN CHECK $ !. $ �-•
Inspection rposes. MECHANICAL $ 2.g: $2J
SignaturenDate /0 /7/ci3 TOTAL FEE $
Drivers' License or SS# Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - - - - - \
CONSTRUCTION AND PLANNING PO( .SPA
•
APPROVALS Permit# Egnb 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 LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
18. 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 /p I e L., 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 Faciory Fireplace ' APPROVALS Permit#
i
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 0 Gas ❑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 /9. 71/ plc_ 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
/O//9A -
Kiln -5r_ze• - !'nes PIA
35. Final Gas Pipe-Test
;l62 Tc tick/ E-
36.
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. Special Requirements Completed •
49. Electric Release to Edison - •.
50. Gas Release to Southern California Gas Co , .
51. CERTIFICATE OF OCCUPANCY - '
•
No. Date - .
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. '4 R„ -
•CITY IF COSTA MESA a PER IT NO/10 TRACT NO. LOT NO. BLDG.NO. •
CONSTRUCTION PERMIT w +12_,G ff 1 .3 2 — -
Applicant's Mailing Address '24d'* 1/1%(,ASc c7 LANr TYPE OF CONSTRUCTION U NEW ADD ALTERATION U REPAIR
Project Address SibME AA(3o VE. El CONVERSION El DEMOLISH O ,cvTHER '
Owner's Name DON Cr't Ing S J fZ phoheS45•iO3( DESCRIPTION OF WORK FAM 11-Y fZM 1 IC 11-C,1-te-N
SEM°pmt„ ZONINGyREGULATI NS
Address SA'M�• F4RA V f _ TYPE OF PERMIT U GRADING ® FOUNDATION I �
1 STRUCTURAL A.P.# i--+��2_t NIZONE AK/
Arch/Eng. 1-ON VILST YCn M License No. ❑ TENANT IS ELECTRICAL 0 PLUMBING A MECHANICAL PLNG.REF.SOs BUILDING
/s//
Address 2-7Ii NGi NIW5 15,510 la JtEJo ❑OTHER TO BUILDING / / SE_TBAC+f Cif cT
+ 67)P, - �- Z -R•PE:TY INE /1
REAR YARD(TO P/L) �
Contractors Nam: _.v • - •'hone a PROJECT DESCRIPTION SQ- FT, 4 OCCVPArvC �{p,Jp
r Z CON STRUCTION TVPFTZ' VALUATIONS -2• •IYl) 'SO LEFT SIDE YARD /��y RIGHT SIDE YARD C Z,//
Address(mailinp1 4 '
___d `l q ar - ZONg GRADING CU-YDS, - AC RFS PKG.SPACE REQ. PROVIDED
License No. - —ter 5 e2 • 1_ i�/
LICENSED CONTRACTOR DECLARATION AW� •7 Remarks: /.S •-/,' g , STREET WIDTH ;_ jr: Ai PARK FEE$ '
• I'.hereby affirm that I am licensed under provisions of Charter 9 (commencing -- s —
with section 7000) of Division 3 of the Business and Professions Code,and • SPECIAL CONDITION
' my license Is In ful�si rte nd effect. -
License Cla 1� 4 License No.3 • v - - PLUMBING '
Date a f� Signature t1%i� - V .sa/•LA
""sRKERS'COMPENSATION •� LARATION - , , •
Bar Sink Sewer Cap ELECTRICAL
eby affirm that I nave a cert tate of consent to/INnsure or a certificate Automatic Washer ,Meter Cover 100 amps' '
Yorkers' Compensation Insurance„or,a certified-copy thereof (Section Backflow Prrivanter^ - Sewer Connection'. ,, ,, _ - - '
3e00, Lab. C.) '- B• ackfloiv irrigation Solar Collectors') i - Construction Pole- Sub Panel 1
Policy No. - "Company �, - `-" - -'
Cooking Unit - Sub Pole
8 Certified copy Is hereby furnished. ' I • Bathtubs , Solar Piping ; ! . (s (P' i
Certified copy is flied with the city.Building Division. 't Dishwasher Motors 00.1 HP 01X$ •
Date Applicant - -+ Clarifiers , , Solar Tank . . ' '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Swimming Pool vv./Spa., /• Dryers OGas ❑Electric ,' Inc.Solar ❑9;15 HP'016-15+
(This section need not be completed If the permit Is for one hundred($100)or __ .
less). . - f ,+ Fan . Microwave •' '
I certify.that In the performance of ork for which tins permit is I ed I Drinking Fountains Urinal . .- ',-' rj- .,"� • •
shall not employ any person In any a ner.s s to beco a subje o the - - - - - F.A.U. .Pole Light •
'
Worker Co peosatio s of Calif I Floor Drains Water Closet'
Date • T 1-.-- L?}�'Ignature n>'` Fixtu_es. Range NOTIC If,after making'[his deciarr on,you should come subject to the Floor Sinks Water Heater 9 �
Workers' Compensation provisions the Labor C , you must forthwith ", Device Boxes
comply "with. such provisions or this permit sh be deemed revoked. . • Gas Service Outlets Water-Service • • $190
CONSTRUCTION LENDING AGENCY -- Outlets
• I hereby affirm that there Is a construction lending agency for the performance Interceptors - - Standing Sections
of the work for which this permit Is issued (Section 3097 Civ. C.) . Switches - --
. Lender's Name ' - - - -/ Kitchen Sink ' - - '-� • •r _ _• Trash Compactor
•
Lender's Address Lavatories - • Garbage Disposal
OWNER BUILDER DECLARATIONy. '
1 hereby affirm that I am exempt from the Contractor's License Law for the P-Trap -' . Generator ❑0-5 KW ❑5115'KW'. - •
I
following reason (Section 7031.5 Business and Professional Code: Any city or - - - • _- - - - -
county which requires a permit to construct,alter improve,demolish or repair - Transformer 015YV-50 K - '
any structure, prior to its issuance, also requires the applicant for such permit - Roof Drains - - - '
to file a signed statement that he/she is licensed pursuant to the provisions of - - . ' •❑5U+KW- ' Reinspection
the Contractor's'License Law(Chapter 9(commencing with-Section 7000)of - • - •. Fee $15
Ion 3 of the Business and Professions Code)'or that he/she-is exempt . Showers Reinspection Fee $15„ -
from and the basis for the alleged exemption. Any violation of Section • Meter ❑up to 100 amps Issue Fee $ 3
.5 by ,any applicant for a permit subjects the applicant to a civil -
malty of not more than five hundred dollars($500). Service Sink, - Issue Fee $ 3; r• Zoning Approved By D(n� 1�//y,((� ,Q Date �(
LJ . .
I, as owner of the'property or-my employees with wagesas their sole . ,..,s 1 l_ [/jlJp l �1
compensation will do the work,and the structure Is not intended or offered .- MECHANICAL - - (-�((//LL•, ;7/
0C 3
' for sale (Section 7044, Business'and,Professional Code: The Contractor's • - Application Approved By •
Deta
License Law does not apply lean owner of a property who builds or improves Boiler •
Refrigeration System - . . Application Issued B ' --1/4-74713 Date //z-/p
thereon, and who does;su<h work himself/herself or through his or her own - PP Y ,-
employees, provided that such Improvements are-not intended or offered for ❑0-100,000BTU ❑100,000BTU . _ .y- -
sale, If, however, the building or Improvement Is sold within one year of com- I , Duct-Under Ground ' "' SUMMARY OF-FEES
elation,the Owner will have the burden of proving he/she did not build or im- - . - - : y
prrove for the purpose of sale). .. I Duct-Structural System Repair/Alteration -BUILDING PERMIT ,$ /'`�"r° SMTP ; . $ , f- 6, 9 •
• LJ I,as Owner of the property,am exclusively contracting,wlth'licensed con- - - ' 4. -
tractors to construct the project (Section 7044,Business and Professions Code: ' Duct-Ventilating . _ _'PL'ANfCHECK +•y $ ._ I PERMIT •
; The Contractor's License Law does not apply to an owner of property who - • - ISSUANCE • $
•
' builds or Improves thereon,and who contracts for such projects with a con- : Exhaust System 0 Multiple ❑. - - ;PLUMBING • + •,s =-r--' -
' tractor(s) license pursuant to the Contractor's License Law). - - } GRADING $ ,
_
- .PLAN CHECK' -::$ - -
0 I am exempt under Section B.& P-C.for this reason Firepl/Fact.Bit, ICBG# i - - .T - - $
' - ELECTRICAL• '•$ • •
' Date owner Heating System& Ducting i ' ' - •Y ' MICROFILM ' $
I hereby-Certify that I have read this a••Iication and state that the above ❑0-100,000 BTU ❑100,000BTL— - -PLAN-CHECK $ ^'
Information Is correct- gra to tom. Ith all clty.and county ordinances - TOTAL-FEE $
' and state laws relating b g u•tion,a • gereby aut orize r re- '.MECHANICAL .i. $ • -+ ,
sentatives�gf this c to me tn• ober mentioned ptl�open, �o • Hood or Type ❑• �- ,
Inspection p,Urpos 2` q6/S Canopy Type II 0 - ' Reinspection Fee $15 - LESS
1j-
Signeture ..1_'• Date IK OBJ PLAN CHECK $ ADVANCED PC $
Drivers' License or 55 " '• /' Registers Issue Fee $ 3 FINAL FEE $ 17 7 r,1!
CMF 0865-46 rev.12/82 White-Building;Canary- - •plicant;Pink-Accounting;Goldenrod-Assessor
I, Cr - - - - - - POOL " 'PA - --
CONSTRUCTION AND PLANNING '• , - _ - -
• .-Date ' InspectorDate Inspector
-APPROVALS ' Permit;# : - - ;APPROVALS• 'Penurt#
,-1--7-1--,,*
•1 Temporary,Electrical Service or Poler. - - 521 Pool & Equipment Location ' - - ••
_ 2: (Soil Pipe-Undrgrnd. `:, ' s - `53.Steel Reinforcement - _ •
- '3. Electrical Conduit Utility-Undrgrnd' ,,, i . -- , - 54-. Forms - ., '
'4'. Electrical Conduit-Undrgrnd._ , ;" . = - • . 55. Electrical Bonding -
5, Steel Reinforcement 1. •' i• ' - I '- 11-27 93 '4 p• 56. Rough Plumbing &Pressure Test
'6. ,Electrical LIFER Grnd.',• .•t` 4 2,7-n /11, - 57. APPROVAL TO COVER-GUNITE-
7. Footings • _ ' 58. Electrical Conduit-Undrarnrl.
_ . '. 9 274,Jo
8. Foundation -41-1' - 59. GM Pipe; O Undrgrnd:,Test
•
9. Water Pipe-Undrgrnd. , - _ 60. Backwash Lines,P-Trap, O Undrgrnd. 1- .
10. Structural Floor Systerrl,7:t - 9_27.').- AP 61. APPROVAL TO DECK • ' ,
11. Property Sewer Line &House Connection' :.. ' ,i • 462. 'Backwash &_Receptor-Final • . ' •
12. ,Sewer Cap r .r .i . 63. Heater & Vent-Final t '
� , s
13. Roof Drains g• e-
. r 64. Plumbing System; Final = - -
14. Rough Plumbin �7.-.X17.-.X1 =8"3' _ 65. Electrical-Final •
-
15:.Rdu h ElectricalConduit'(, _. -_`-- ' _ - - - -
9 .. ( 66. Solar System-Final •
-16' Rough ElecL tric Wiring; . • ! i; i'r i'.; - - _ 67. Fencing & Access Approval - - - - -
'17. Rough Wiring Sign_ ' , I '' = ! 68. APPROVED FOR PLASTERING .
18. Rough-Electrical;T'Bar Ceiling ', - 69. POOL/SPA SYSTEMS F I NAL
19. Rough•Heating & Air.Conditioning , I ! 'FIRE DEPT. REQUIREMENT -
20.'Rough Factory Fireplace ,� '' ' . ' APPROVALS' Permit#
21. Ducts;in Structure •1 '
1 ! 70. Underground Hydro
22. Ducts, Ventilating , - I ! 71. Product Piping OGas OOil
23. Gas Pipe-Rough&Test` j t I..... I T - 1 '72. Underground Flush
24. Roof Framing, ' ' i: ; - 732 Uudergrnd.Storage Tank O Gas 0 Oil .
25. Roof Sheathing , I` 1)-2-tj f ; i '74. Overhead Hydro .
26. T-Bar Ceiling (Structural).&.Monocoaf' j : l 75. Dry Chemical -
.27. Frame and FIashing-11/2257 I 1 )1.2:72-V ;TO '76. Dry Standpipe ,
' 28. Lathing& Siding. lII k 77. FIXED SYSTEM FINAL
29. Insulation - ' , Iii_7-S'3 -ilt '78. FIRE PREV. FINAL
30. Drywall Nailing - •� I , ! ! ,Notes:. . ' 0-iO
1 z -� fid': Y I --83 Roof Shy t p„d;? a
• 31.. Plaster Brown Coat. - ' i1 i,2-2.3,.Jr ctt? OO1ters ins±-1I/P,f,'" 1 P }alc -Fe �olf4.M
- 32. Electrical Power Meter-Final ; * 11-Z1813: t" rpt"nino� OH 1 Gt ii la N t
. ) p
33. Final Electric • IH,,.�iritiq yygl( tO ;list's/ateJP,34: Final Heating &Air Conditioning Ir J
I1 743 D/W Nc,i I all but gear,ye
35. Final Gas Pi e-Test ' _ ! 1 }� •
P - is • W411 C-p�UYi'l� t v1t� W/Ar/ ���Y _
36. Hood or:Canopy ' ' 1Con} / 1
"tz -2 -$3 tractor Jahn Yank •
37. Final Factory Fireplace I i . ,S`.+4.1 e 4 - 1 h fit .p ,Jtn h;h g (`.h S pee/)j
OV'
38. Final Plumbing ' r .,a - ' 11/&9/83 de- .flA ft, al ht, . ' 01 / het- etee9
39. Water Service-Final ; '4 �-.' . ' ' ' , I r r s
tat4911 plumb/al, fltcpcetorl and
40. Gas Service-Final r - -'r ; . , s
_ the pILL�naimo woolct .be 1n See 1744
41. Solar Domestic-Final i;"•a „ �/� �l -IP 77 / t y.' frtTel 1h�
-. . � - -, -- . - r - d T'ro't Gt + YY OYe'-1-i5R a
42. Backflovd Preventei ' l• '; 1 ! J t tell
-.{, -I-', I S .2P
• - F. . .- h P , 1 i e net Fe 1 Gen cctc oV'. �h�
43. Backflow Irrigation : ( ,' i- „ ! a
_ See V4zam broke c,_ fry
44. Landscapetlrrigation Systemoy
..rij• iV --- Er /1 :2 Mir- COP(9cam-
45. Sound .Attenuation '. l ' I
46. Handicap Regulations ' f ' ; .
47. FINAL STRUCTURE'& BUILDING i , //gt1/e�604J,
48. Special Requirements Completed 7 7 L - ��
49. Electric Release to'Ediron' I ' . ,- __; - - _ _-. _ - . -
50. Gas Release to'Southern California Gas Co
51. CERTIFICATEIOF OCCUPANCY ,i ' _-• _ -. _ '
No Date '
..
INSULATION CERTIFICATION a ,.
Number ant Street City Co y
X26' 0_ / 3Z
Lot Number
DESCRIPTION OF INSTALLATION
ROOF late
''. o
Material Brand Name a_zot /4.- -Cr* ,
Thickness (inches) CThermal Resistance IR Value) //'.�.
EXTERIOR IAL Y
Material t Brand Name !/—!i"41.....• "'�'•rlil'.'4/lr�
Thickness (inch Thermal TherResistance IR Value) E
CEILING a-teC
Batt or Blanket Type jai .�..r, a Brand Name e- f��
4L/�/7
Thickness (inches) 6 r Thermal Resistance IR Value/
Loose Fill Type Brand Name
Minimum Thickness(inches) Number of bags Weight per bag lb
Area Covered(ft2) Thermal Resistance(R Value)
FLOOR,ELEVATED
_ Material Brand Name
Thickness (inches) Thermal Resistance (R Value)
101. FLOOR,SLAB
Material 'Brand Name
Thickness (inches( Thermal Resistance IR Value(
Width(inches/ _ •
•
FOUNDATION WALL
Material Brand Name
Thickness (inches/ Thermal Resistance (R Value)
DECLARATION
I hereby certify that the above insulation was installed in the building at The above location in conformance with the
current regulations setting Energy Conservation Standards for new residential buildings (located in Title 74 of the
California Ldmiristrat`ve Code/. 7 7 �j
/ / „runner) License Numoer
I
7•n lure erre Title Date
Sue Contractor (Insulation ADDliutop License Number
_ Signature ant Title Date
4
Figure 4 -1 Example of a compliance certificate
4-9
OWNER MESA DEL MAR DEVELOPMENT COMPANY DATE 3-32-62
JOB ADDRESS 2843 Velasco Lane BUILDING PERMIT NO. 16730
GENERAL CONTRACTOR Macco Corp. VALUE $ 17,_333.00
AP No. LOT 132 TRACT 4260 FIRE ZONE DESCRIPTION OF WORK res w/att gar
I 'ECTIONS Signature DATE GROUPI&J TYPE V ZONE R1
Son -h PERMITS ISSUED
Gas lilt 1� SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. ❑ _
Rough Heatingihet
g W .p.i; i Jt e7�-�. �o
Rough Plumb. �� A,,i /i _ 1---, 1-6. . .2' ✓
Miscellaneous„/ n _(�� //7- eV �/ l�i� � LIe _
yU
Prop.Swr.Line p-Hese Con. LCSCSwr. ❑ iti7(6'L 'jam'` C.Q/� G 476 '� `C _ `C
Sprinkling System 4�?((}[jg/ /a-vJ-b)' A�_,em,..; G . 7O.-/563 36'7X l 1
Construction d
Underground ❑ Power E _ _ � O �i//-� /t- �xx
Rough Wiring Q .E7 -rZ Q LC.ti� c.l1. _7—L7-(o_—/7_ _O"\_
Trenches Forms r-Steel Reinf. 0 _, y �-
Floor System
Bond Beam 0 Steel Reinforce 0 _
Sheathing "ea- 7-f-6-y
Frame and Flashing /AK 7 2Q-6'Y
Lathing — In 0 Out 0 / -/ 6L
P; jsr, brown coat +/ i -P-3a -- .,)
g1.':','g, 0 Air Cond. 0 Final
Heating, Final E ie"---
Plumbing Fixtures, Final 70/5---42-13-.0'
A�, _ /r,&-'
Final Gas Test �'/T 7y
Electric Fixtures, Final tQC l0-//-41.
Building, Final c //_7-62,
OCCUPANCY .
man Nn6.SM — l.fl 1 Z72n v'
•
•
16730 r '.� v�uV
COSTA MESA BUILDING•SAFETY DEPARTMENT W MAR 7 196r� .Lot 132 - Tract 4260
EI; I Ii pet Plan 300 AR
P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF Uk7M IIIESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
ADDRESS 28143 Velasco lane
COSTA MESA. CALIFORNIA For Office Use Only
I RECEIPT NO. It'71)
OWNER Mesa Del Par Develonllant Co. EMS)
MAIL 3800'E. Coast Highway RECEIVED BY I DATE JIECHIVE .y.DpT6 I SIj �
ADDRESS ---) 1 hii.�Y'•7�K 11 •-IIS
CITY Corona Del i4ar.Calif. ZTOR1-112M ADDRESS
ARCHITECT Cliff Olsten & TEL-
OR 2 COSTA MESA. CALIFORNIA
ENGINEER C 1..ate.•. NO.viA3-1_21 �/j��/.
ADDRESS 90252 E. Florence Ave. ,Downey, ZONE TYPE GROUP`V 71
Calif. APPROVED U/
CONTRACTOR MaCCO Corporation BY DATE
ADDRESS 3800 E. CoastfHighway ZONING
CITY Corona Del ?Aar,Calif. ZONE , PUOEF USE OF NEW Scfl94-
-r I I BUILDING 4,,/_a-/ y
LIC.TNO. 98808-SB-1 Ng.; OR 3-14220 DESCRIPTIONLEGAL Z0$ !3 Z 77' y z6 Q
SIZE NO. OF
6790 S.F. I NOW ON B'LOTne A.P.NO.
SFFLOT
USE OF NoreYARDS EVES
EXISTING BLDG. _ - _ APPROVED ALLOWED
SETBACK LINE FROM t� I (CENTER LINE ST.)
CENTER OF STREET 541 REAR YARD 23 FRONT .5-1-/ FT. —
IN.
SIDE YARD I LEFT q I I RIGHT 51 R.SIDE --C FT. — IN.
DESCRIPTION OF WORK
L.SIDE sFT. IN.
NEW I X II ALTERATION I II ADDITION I REAR 2. 3 FT. IN/.
REPAIR I I MOVING II DEMOLISH I APPROVED tale PQ A DATE l' (-L I ( E.L
BUILDING 1 501 NO. OF /'
81ZE 6G X ROOMS 7 STORIES 1
EXTERIOR WALL StUCCO ROOF
COVERING 1•7ner7 COVERING Ween
USE OF BUILDING AND WORK TO BE PERFORMED
Si nrwle farnil V riwelli no laving area 1641 S.F.
w/attached garage Garage II 41:3 S.F.
Covered Porch 38 S.F.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION �2
SIGNATURE OF PERMIT FEE $ OI I• (56
PERMITTEE 7('7PC l pro T• nn•rele—^e..+ (In-
By
o
By Ct '/t' " $ 17,333.00 PLAN CHECK $ /gay)
AUTHORIZED AGE 55.50 0
TOTAL FEE $