HomeMy WebLinkAbout1103 VISALIA DR - Building Permits Ill
-CITY OF COSTA MESA
`' BUILDING DIVISION
Fy' .AI. 77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL:(714),754-5626 •
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etb..0- A' A
c" 41ERMIT NUMBER: B07-01009
. 4441
PERMIT TYPE B_ROOF2 STATUS: ISSUED
DATE ISSUED: 11/05/2007
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ISSUED BY: SOK .
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JOB ADDRESS: 1103 VISAlf DR CM= ' ,i Suite%Unit
Vicinity: �t _ `•:,,i .. , - .‘;
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Squares: 0 i, ; , ,-: f.- - .Valuation =: $7;600.00
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SCOPE OF WORK: TEAR OFF EXISTING ROOF:.INSTALL 1 LAYER OF 30#FELT, 5:12 PITCH REPAIR/REPLACE SHEATHING AS
NEEDED, 50 YEAR COMPOSITION'SHINGLES;ji_7"SQUARES FOR FRONT PORTION OF S.F.D.'ON'LY:-/' :.:,t
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OWNER: BURKHALTER,STEVEN`P Address: , 1103 VISALIA-DR.,-k -, Unit:
PHONE: i • - City/State/Zip: COSTA MESA.CAS ,'A
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APPLICANT: RICK STERNBERG. I t r ,...'17 'Address :8662 DOLPHIN DR"7. til 1',( Unit: :
PHONE: 714-968-3233 ,�; _ City/State/Zip: HUNTINGTON BEACH iCA --; , ,
CONTRACTOR: CENTURY ROOFING .. . ... License No. el 674019
Address: 8662 DOLPHIN'DRUmt ' - _ -PHONE:,+ i 714'-968 3233 _
City/State/Zip: HUNTINGTON BEACH'CA - - - ..., _ -92646 CELL i
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•ARCHITECT: - ` - License No. I PHONE e,i!
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ENGINEER: License No. •
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FEE SUMMARY
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Reroof Plan Check:
Reroof Permit Fee: $153 25 y. -
Reinspection Fee: $0°00,•. - '='t
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TOTAL FEES $153 25 'T,_I
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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.
CODE P. INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS
1616. Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa FinalA. 208 Final Plumbing
200 Final Re-Roof (/ 7 '/ 210 Final Electrical
eri
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:di Owner ID verified by drive. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: _ Driver's License No. Expires:
❑ I have and will maintain a certificate 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
performance of the work for which this permit is issued. .. - -
- -pLE•,q-,_I/have and will maintain workers'compensation insurance, as required by _ � .
"'s�clion 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' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
numbeCare: "� person is required to descend,will be made in connection with work authorized
r }L -r ,y 5uy�a by this permit,and that no building structure,scaHdding,falsework,or demolition
,Carrier:_ 14k \ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(ihrs sedan nese rate mlmld�eledalne pCe�rme[i?s valued al one hundred dollars(Stoo)orless.) 2 Art 2,Sec.341,Title B,Califomia Administrative Code).
CFolicy Number:kr.•• � T L�O -1 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 employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the •rkers' compensation laws of Califomia, and agree that if I should
become v.ubjecl to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
t •e, s . -•rwith comply with these provisions.
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••\• , . _ `'1, ) _ O", Division of Industrial Safety Permit Number:
h - Applicant's Sienaw,6�, -n'.afr ^1-- Date .:.�h�
l -�---- "'� s"'" ,,,;,,}-' 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? ❑Yes ❑ 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 fled 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 iis1�in'full forceand effect. C a registration form for acutely hazardous materials? ❑Yes ❑ No
=tic.li__�h 1 T V 1 '-Class# ,- I � 1 (Section 25533 of the Califomia Health and Safety Code, with some
T —� ` � - exceptions, requires registration with the Costa Mesa Fire Department by
' C-^-Vfl each business which at any one time has on hand a quantity of acutely
Lr._______ a are=; .`trig ittate _� 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
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Lender's Name: hazardous materials)? ❑Yes ❑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 ❑ 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 Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications far ran-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 ❑ 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).
❑ 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 Califomia
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No
thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
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
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did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
• city ordinances regarding Hazardous Materials and.Emissions.
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH _ .
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professbns 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 Ucense Laws.). certify under penalty of perjury that I have read this application and state that
❑ 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 until final inspection.
_ i.nature of Legal Owner(s) Date
Si nature Date _ \'-- -. On
3057-46(3107) g � :�-__I1 ro J �' 1
Anew Autnunzee'•pp scant' - - y t Date. Tel?,
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PATIO COVER DETAIL 6/1/67TYPICAL JOIST ANCHOR
J •.,.
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.- -
SIZE aniriSPA SPA , —! .�,;'
STATE
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Nt
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OVERHANG r t `
„ RAFTERS:® t _,
_ .- .._SLOPED FOR DRAIN--;
STATE LENGTH
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MAXIMUM /s J t r #i O
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CONTINUOUS ei,
r3/gx5logs 32% . LEDGER i'�/Blocking: ��4, ,..._4' % MAXIMUM Predrill Ledger Predrill Existing ANG Deep ,
tsar JOIST HANGER
BEAM Or other approved methods
of support .tie. , NOTE USE REVERSE SIDE FOR PLOT PLAN.
STATE SIZE I No I RAFTER — CHART NO 2
ALL LUMBER DOUGLAS FIR FOR OPEN EGG CRATE FOR SOLID SHEATHING.
3/16X2'-T-STRAP
'CONSTRUCT ION. GRADE . ALUMINUM OR PLASTIC SHINGLES OR BUILT UP
.410141V ROOF COVERING ROOFING.
t MAXIMUM, SPAN SIZE SPACING MAXIMUM SPAN
1.7.' 0" 2"x 6- - 12% 15' I "
s 16' 0" 2'x 6" ' I fi% 13' 3"
Z POST-BEAM 15' O " 2"x 6" 24% 10' II"
f CONNECTION 12' O' 2"x 4" 12% 9' II"
1\17
I I ' 0' 2"x 4" 16% 13' r
.- Posr 10' 0' 2'z 4" 24% 7' I"
'? x NOTE : FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
.r SHOW SIZE HOW SPACING WALLS ARE TO BE BUILT. USE NO. 2 CHART ONLY.
I -F- SHOW LOCATION ON REVERSE SIDE. I.-
WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
ti ^_ SPACING ONLY. ,
DROP PATIO FLOOR FOR PROPOSED OR FUTURE ROOM OR :WHERE PATIO
PLAU f- SLOPE TO DRAIN
WALLS ARE TO BE BUILT SUBMIT • COMPLUF }LOUSE
6. :.• ? AND ADDITION PLANS
ft ` </ PUDDLED SAND FILL _.6. r I
�x 2. i �Itt -smoke ' Remove Grass And Weeds Down To Natural Grade
°t CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT '
POST ANCHOR I _ 1... -a: 7# GALLONS PER SACK CEMENT. -
1
For Pipe Post. Embed r12--1 Provide 26 Ga G.I. Flashing At Woad FIOOr COnst. COSTA MESA BUILDING -
DEPT. ',
Pipe In Footing.
Provide Flange Or Weld Plate Screwed Or Bolted To Frame. ]] FAIR DRIVE 834-5273
Id
FORM BU-40
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'\.\1/4.1% � 08TA MESA
\r PLANNING DEPT.
B-�s �'r ( W�JBCT i0 BLDG. DEPT. AE6.
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eta -'
/41 OF PLANNI1413
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ae asapcji
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T`1 city
�! ^� of Costa e a Building Dept. •
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APPROVED
t ` ......_......_..........._DATE..._.-19_
T THESE PLANS MUST BE ON JOB AT ALL TIMES
tie
eI MAKE NO CHANGES WITHOUT PRIOR APPROVAL
6 7.. OF DEPT.
/ THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
-;C? TO BE APUBSAND PERMITSFOR, OR ANAPPROVALAPPROVAL OS SHALL F, ANYC VIOLATION
OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE-
_ •` op SLIMING TO GIVE AUTHORITY !0 VIOLATE OR CANCEL THE
PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO
o C7 O I ¢~L�m W
J �_ o "J �s n J FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL
QI ` :_iUp ;1 =1 _
�=C 1c3,_?:. Z y THE ISSUANCE OF q PERMIT BASED UPON PLANS AND
-- Ic_ ° Cow FROM 1-
SPECIFICATIONS SHALL NO1 PREVENT THE BUILDING OFFICIAL
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d _ - 0 :. � iI_I ';_ U-1 IN SAID P THEREAFTER REQUIRING THE CORRECTION OF ERRORS
CD
I- .-- __ i•I PLANS AND SPECIFICATIONS OR FROM PREVENTING
C c; •-- ¢ -
- =: _? BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
w - *c' I L -.-1:1:2. IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE
Cl-CC w G7 ey r_cn ?0�• cS OF THE CITY.
Eu w - iu �r o;���R¢
~ I- I- --J _i_s
I U a 4 � ._J .-i� i=0
‘00 00 CC
i-- CZce 0_ a -± ouwi`�o
Cn H u_coco Z¢
DAVID •
FREEDMAN , A . I . A .
A R C H I T E C T
SUITE 306, 113 NO. SAN VICENTE BLVD., BEVERLY HILLS, CALIF., OLive 3-3852 -
May 4, 1973
To Whom this may concern:
Refering .to the fire damage to the house on Lot Ac Tract 6245
Costa Mesa, California .
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It was necessary to break open a fele small sections of the
footing walls to replace damaoed pipes. In as much as the
existing horizontal tie steel was undisturbed the replacing
of concrete by roughening the joining existing concrete
walls to obtain a. positive bond, and the replacing of the
concrete with a richer concrete mix will not destroy the
structural value of the foundation- for the rebuilding of
the original house designed for said lot .
Sincerely,
1 g
,42AA C.)74
David rreedman H. l.A. Architect
$rian L. Cochran Structural Engineer
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MEMBER OF AMERICAN INSTITUTE OF ARCHITECTS
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CITY OF COSTA MESA REQUEST FOR OCCUPANCY
,.
TRACT N0. Gg7G/ $' DATE /9/.1y/27
LOT NO. 5-6
ADDRESS // 0 3 i-[-,--e[�icrct 17.--+ .
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 undersigned, by executing this agreement , acknowledges that (he-she-they)
„4- ` C (was or were) _......,,cd-cce_ advised that this tract has
not been given 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.
f
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 �lr ,.,-C.)/1_,-.Purcha er
RECEIVED
.. - r^.c,A i,1F.3;1 BY / -at—rt-.e...-at—rt-.e... � WC
„Tr' a/
Developer d/or au :.. 'zed
representative
AIS PM
718191100111%,11121304516 BY
Lender
/a
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PROJECT ADDRESS: 1103 VISALIA DR UNIT: CITY OF COSTAMESA — BUTt:ur...,_�___
UMEASNAME BURKHALTER, STEVEN P - —71 ..BURKHALTER VERONICA M PERMIT NO: P 051073
; PLAN CHECK NO: N GOVTa'N--Suri--.- ...__
1103 VISALIA DR '—
COSTA MESA,CA • 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
549-0374
ARCH/ENGINEER: flEG.NO.: JOB DESCRIPTION : CHANGE OUT WATERHEATER • ,SQ FT:
-
ADORESS: UNIT: 'r
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: NOCK PLUMBING ( 719 )895-1246 r • ..
I , ADDRESS: 11610 SEABOARD CIR COMMENTS- CHANGE OUT OF WATER HEATER .
STANTON CA 90680 • aE�ERE*:E:E+P:E*:ESE:E*SERE:E:P:E*:ESE:E �P:E:r***** �ERERE*:E:ESE*:ESE:E:E:E****:P:E:r:PRP�E�E�r*�E * �P**�EaP:ERE:ERE�E�E*iP +�*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T $
70001 0l Division 3 of the N DECLARATION:
and ProON: II hereons code.and t I license is in full force and meet. - S E T H A C K $
clTvuc.: 050388STATELIC.: 511071 CLASS C— 6
ofiffriate: 7G�—�11 signature: MAIN BUILDING ACCESSORY BUILDING —
WORNERS'COMPENSATIONOECIAflATION: Iherebyaffirm ihallhav a enificateofconsent losel6insureoracertificate ofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation ylyra e,,Qc t ef�copy mereor(section 3800, Loa f4LEFT: FT ' IN RGHT: FT IN LEFT; FT IN RGHT: FT IN •
POLICY NO.: L �/J�`JV EXP.DATE: V3IO1/91
COMPANY: STATE , PARKINGPARKING REQ: PROV: PARCEL: 41210427 ,ZNE: REF NO:
IE Certified copy is hereby furnished. X Certified copy is plea • th city Building Division. PLANNING NOTES>
f pp'' /] yyy'�At/gA,, F('�/ yII�J^/ >
Date: 21 at I"1I Applicant: / / " &eft IElf BFlFaE iFIFiF 1FiFff 3F iF BElk�flf3ffF3f iF1FfF3F ik iFlFif fFlF1F IF3k, BE:f iE iFIf 1E1E1F1f If ifiE ff iFlf#if ifffiPlflf iE iE if 9FlflFyE iF1ERE if if fFiklEaE•F BF if itlEiFlF
----EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S E R V I C E S REQUIREMENTS
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 '
1 subject to the workers'Compensation Laws of California. ZONING APPROVED BY - DATE: •
Date: Signature: BUILDING APPROVED BY : DATE:
NOTICE:If,alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor
Cotle,you must forthwith comply with such provisions or this permit shall be deemed revoked. (it"
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a constructidn lending agency for the performance of the work far APPLICATION ISSUED BY- - :'' - DATE- 2 �'
which this permit-is issued(Section 3097, Civ.C). ************************** * * * **** *************iF if'3�iFiF N• lE 3F
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LENDER: *********iE1flFlPiEiFlFiEiflFiF1F9E1fiFlFiFiF****iF*iF***** ' IfiE**1f#3E***If****iFiE1F#3f3PiF#IflfaFlE3PiF****aE***
ADDRESS: LEGALIZATION:N - FEE SUMMARY ' STRUCTURAL SEGMENT:N '
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OWNER BUILOER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason- BLDG PMT PLUMBING ELECTRIC MECHANICFIRE $MIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or PERMIT i 2 00 1 I
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed2 5 Z SM I P/NON—RES ,
nursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN .
id Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by '
,y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3. 00
I. as owner of me property or my employees with wages as their sale compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2. 00 3.00 0.00 5.00 ' 5.00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or.through - '
his or her own employees,provided that such Improvements are not intended or offered for sale.If however,the building or REVENUE DIVISION TOTALS--> COLLECTED• ' 5. 00 OVER/SHORT'• 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for.the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK
5. 00
I.as owner of the property,am exclusively contracting with licensed contractors to construct the protect(Section 7044,Business r
❑ and Professions Code: The projects
ale License Lawdoespursuaot apply nt
to the Cerofpropenywho kens Law).oI a thereon *******************************************************************************
and who contracts for such Contract with a State
La license pursuant a the Contractors'State License Law),I improves
aware _
that;wool of their workers Compensation insurance should be provided to me. I �N D I V I D U A L F E E B R E A K D O W N .
❑ I am exempt under Section B.8 P.C. ' • i •
• lot this reason: - TYPE QTY DESCRITTION UNIT COST ' TOTAL COST
Date: Owner: PLU 1 WATER HEATER AND/OR VENT • 2. 00 2 . 00 .
I do hereby certify mal I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES •
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 a .
permit for construction or modification from the Air Duality Management District,Residential construction applications are exempt from _ 1
these provisions, /,V//
Date: Applicant: '
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county '
ordinances and slate laws relating to building construction and hereby authorrze representatives of this oily to enter upon the above-mentioned i
properly row inspectionlIpurposes. 01 00082411-'00042411 T coo • 5.^u 1
2�2� `q'
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1641-46 Whne—Building,Green—Code Enforcement:Ganarv—Applica=L Pink—Revenue'Goldenrod—Assessor --
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CONSTRUCTION AND PLA•Lv..NG POOL & SPA -
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Serener Pole 1: 52. Pool & Equipment Location - -
2. Soil Pipe-Undrgrnd. <.: •r=s 53. Steel Reinforcement
`.."aligigttr cal Cond_wi.btilityrUndrgrnd;111 54. Forms it
;_:ri:zElectrtFal ContiuiYUndrgrnd. a 55. Electrical Bonding
%' 5 SjeA'Reinforcemen: .yr 56. Rough Plumbing & Pressure Test ,'_
:y•6: Electrical UFERtGrnd. 57. APPROVAL TO COVER-GUNITE a� •
7. !`ooii ng Sel 58. Electrical Conduit-Undrgrnd.
a'C : _
Apundation 59. Gas Pipe, O Undrgrnd., Test 4
Tt9.'sUJater Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
i-'
OgStructural Floor System „rte
l • 61. APPROVAL TO DECK
11 Property Sewer Line & Hobse Connection I 62. Backwash & Receptor-Final
.o Cr ..-
12.
12. Sewler Cap ;J ;� a� 63. Heater & Vent-Final
13. Roof Drains 'e 64. Plumbing System - Final
14. Rough Plumbing C 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rough Electri&Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricrl-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
I 20tr.RoGgh Factory Fireplace i WM se:.-7: ` O �, I'* A ''APPROVA-L5%OPeiiiit# ? > "7
L• '4 :b .1. >.;'*.; i ,Sm 2tf, :. L'� '+. l r.. '2NHF- 1
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'RTIFICATE OE:OCCUPANCY ' ,. •
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�- Date 0
OWNER HELTZER ENTERPRISES DATE 8_28_72
JOB ADDRESS 1103 Visa? Drive BUI IG PERMIT NO. 35300
GENERAL CONTRACTOR Heltzer DESCRIPTION of WORK Res_ watt_ gar
AP No. LOT 56 TRACT 6245 FIRE ZONE VALUE $ 33,700.00
INSPECTIONS S/ cir2ature Date GROUP T x .T TYPE 5 ZONE La
A
BOIL Sie 77-,y SUBCONTRACTOR PERMITS ISSUED
GAS Date Number I Signature
WATER iI gel/1cmr2+�7Y __.._. Plumbing
ROUGH PLU BING —� / 7
/ %�.�.��//l u �.ci` L /_ 2`�/7
PROP. SWR. LINE HOUSE CON. (: i a - /ii//SW.7/iM t�� --t3i i
SPRINKLING SYSTEM , tel) -Pe 44)/1"."/2- -, ,��/-ti 6�/3Di r�J/ 1JJ
MISCELLANEOUS / '
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER El �n�
ROUGH WIRING C r�� Y� � _ Heating an Vent.
TRENCHES V, FORMS 21 STEEL REINF. Olft17 - Alain 77f1C ' 26, y --�
FLOOR SYSTEM la-3/4-ny 4/6-75 tqq/
BOND BEAM STEEL REINFORCE . ///�����`
SHEATHING - rage/ '-
FRAME AND FLASHING -1--2--- g )Z V
LATHING — IN (x OUT /-/ 3
PLASTER, BROWN COAT ��/-{ .
STRUCTURAL, FINAL / , Iec r1{
HEATING, VENT., REFERS. AND A.C.,,I FINAL 4,- - ,� `� � /.�/WM) �P�� 3a a1.'2,J 3�j TB/'
PLUMBING, FINAL AND GAS TEST ` 1 v!� - S+�9+ :-.,'_ T
ELECTRIC, FINAL ,/-2- — ' dd/t-,2.1,54-
1'Y/ wj.
rami nwa GINAI \1
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35� ✓L Crier,
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COSTA MESA BUILDING-SAFETY DEPARTMENT
.P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
n R`EC�EIj�V/�D BY DATE RECEIVED DATE ISSUED
BUILDING)�D� U7s 4.1. rer // au l�W' O �L//'�72
ADDRESS /
PERMIT NO,
OWNER Heltzer Enterprises=Costa Mesa A.P.NO. "'- 6-1 nr.
MAIL BUILDING
Z ADDRESS 740 N. La Brea Avenue • ADDRESS// eta V 5a4.(4 D MCS i
(213)
a U IT
CY LOS Angeles, CA 90038 . TEL
937-2171 TRACT 6245 LOT 56 BLOCK
I-Z
ZQ CONSTRUCTION NEW ADD ALTER(REPAIR (MOVING OFMOI ISH
a m LENDER United California Bank - .
c
J 7 BRANCH Main Office s, / •
J(n - OWNER. � , � �/J'�/Y:
<Illco_i ADDRESS 600 S: Spring St: , LOS AnInS1 VALUE
JN OR ENGINEER David Freedman • NOLOL.3-31852 USE 4 .r $
O - FIRE II ((^^//
W¢ ADDRESS 113 N. San Vicente, Beverly Hill ZONE TYPE v GROUPIa+21
0-111 'APPROVED
mO CONTRACTOR George J. Heltzer BY DATE
Z
Ec ADDRESS 740 N. La Brea Avenue
UJ 1.1.1 (213) ZONE NO.OF l� USE OF NEW 51yVFf-t+N (/
z i CITY LOS Angeles, CA 90038 NO. 937-2171 12( PLANS /� BUILDING INV/17T 6
ILO STATE CITY YARDS APPROVED YARDS APPROVED
LO¢ LIC.No. 3144 LIC. NO. 1900 MAIN BUILDING ACCESSORY BUILDING
7 O (FROM Cn.STREET)
SIZE - INO.OF BLDGS:
OF LOT NOW ON LOT FRONT SI FT. FT.
USE OF
EXISTING BLDG. R SIDE,_...5 FT. FT.
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES . L.SIDE O FT. FT.
VEXTERIOR WALL ROOF
!_ COVERING I COVERING REAR JS S FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Cl. MAIN BLDGS. _ACCESS. BLDGS.
CL _
Q Single Residence Plan 408 D CURP# APPROVED
O �, )/_ rti APPROVED- ' b 8/l.)/) Z
(n Cl LC t. 0_,_,/ _BY r-'LJ DATE -1 •
Z t/ STAT(H e -
O �ss� 'D FOR Dan,.,
UI hereby acknowledge that I have read this application and state 9 di, , W Ct QUM r:�1F(`r-..S
that the above information is correct and agree to comply with �l�
all laws regulating building construction, and I shall not employ
Fany person in violation of the warkman's compensation laws of TAX
the State of California. /f l/aa m
N
ZI hereby certify that I am properly.licensed as a contractor under a3 / SO. FTIr� - *Pco o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION 1S FOR i
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
CC
am exempt from the provi ions of the State of California Business
co
and Professions Code,Div .n 3,Chapter 9. VALUATION PERMIT FEE $ /// ‘..CD j
Signature of 04 „.,_......-.?..r m
Permittee .83 7,00 --- PLAN CHECK $ 0iJ E
, 6gir
/ // LL
Authorized Agent TOTAL FEE $ /� .2
OWNER SNIDER, KEMPTON - DATE 10-1-73
JOB ADDRESS 1103 Visalia Drive BUILT PERMIT N0. 37342
*GENER'AL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK i so Footings only
P No. 412;104-27 LOT 56 TRACT 6245 FIRE ZONE 3 VALUE $ 200.00
`{ INSPECTIONS Signature Date GROUP I TYPE VN ZONE R-1
SOIL PERMITS ISSUED
SUBCONTRACTOR
GAS Date Number ISignature
WATER Plumbing
ROUGH PLUMBING
PROP, SWR. LINE Q HOUSE CON, ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER
ROUGH WIRING Heating
Heating and Vent.
FOORTRENCHESSYSTEM15FORMS y STEEL REINF. �� Ae 2.-73
BONO BEAM n STEEL REINFORCE (� _
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.G., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL
37342 PAW
y COSTA MESA BUILDING-SAFETY DEPARTMENT OCT -1-7s�,15,OQ 008 *' *****S.SO
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
• For Applicant to F_illl iin Completely RECEI EB DATE R CEIVED DATE ISSUED
ADBUILDING
DR ESS //O..S V/S0•4 �F//✓''G. �_ j /O/—/
OWNER 4tepr�T�XD J V,tiCe A.P.NO. // -70,77,77 PE HA�FTj i1fJ42
MAIL / r BUILDING /A 2 / !G A „CA `]`
Z ADDRESS SoiMC ADDRESS /�7Jc"//<Uy�/S/' �/j
d(Wj Y M ^ TEL. T6-4,2 ✓ I �6
CITY �pS 4 /'`�S•'1 NO. TRAC LO BLOCK
ZQ CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH
O I--
LENDER
0- 03 •
J r BRANCH //_
J N OWNER M Slit O-C—Z
CO —I ADDRESS VALUE '
-CO
ARCHITECT TEL. USE $
Q OR ENGINEER NO, •
Z
Q FIRE Z
' •
•
<CC ADDRESS ZONE TYPE /Y GROUP
d w APPROVED r / 3
JO CONTRACTOR 04,0/111-7 2.17.14/ _ BY /G'(Y DATE O /—�
OD Z ^�
J 2 ADDRESS
LL Lu TEL. • ZONE NO.OF USE OF NEW �+r70
Z CITY NO. �� ' IPLANSBUILDING
�
STATE CITY YARDS APPROVED YARDS APPROVED
L1.1
K LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
D O —" - - (FROM C/L T ET)
SIZE INOF BLDGS.
SI LOT NOW ON LOT FRONT FT. FT.
USE OF
EXISTING BLDG. •
R,_$IpF / FT. FT.
I— SIZE OF NO.OF �f
2 NEW BLDG. ROOMS STORIES L.SIDE o"- FT. FT.
< EXTERIOR WALL I ROOF l O
_ COVERING COVERING REAR d� FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN R&
CL
a MAIN BLDGS. ACCESS.BLOCS.
Q �. /' _ VAR.# DATE
0 Tdd C� C.U.P.# , ,n APPROVED 7 •
y �O/ O/ /tlbJ O/lJ LY flPPROVED�,� DATF /O//.J
z / �/C
Jr0
O I hereby acknowledge that I have read this application and state) eSTATE0that the above information is correct and agree to comply with~
CC all laws regulating building construction, antl 1 shall not employ`I— any person in violation of the workman's compensation laws of;fn the State of California. ��0 co
co
Z I hereby certify that I am properly licen ed as a contractor under„ SO. FT. o
J
the State of California Business and Pr•I-ssions Code, Division 3,3,;L- THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that uch li enses are iull force and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY: of
am exempt from tt prov . ons of the r ate of fornia Business ri Q
VALUATION m
and Professions Cr .e, ,•n 3,Chafer 9. PERMIT FEE $ db N
Signature of /` .� / m
Permittee _`, _� $ 2(J PLAN CHECK $ E
6.:-OE;
Authorized Agent � u
TOTAL FEE $