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HomeMy WebLinkAbout248 WAKE FOREST RD - Building Permits CITY OF COSTA MESA BUILDING DIVISION F`! ,I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca. • T, FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBE . B08-00112 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 14146210 DATE ISSUED: 04/02/2008 _I -ISSUED BY: RMD JOB ADDRESS: 248 WAKE FOREST RD CM Suite/Unrt Vicinity: HOUSE AND GARAGE ROOF:. Squares: 2700 °r r J' Valuation: , $6;673.00 vc SCOPE OF WORK: TEAR OFF;(E)ROOF MATERIALS, INSTALL 2 LAYERS OF 15#FELT ON A-LESS THAN A:12 PITCHED ROOF AND REROOF WITH 30 YEAR COMP,SHINGL•ES ON ATTACHED HOUSE AND GARAGE,APPROX:27-SOUARESREPAIR AND REPLACE SHEATHING AS,NEEDED ,`4;d- is /_ OWNER: TRANG, KIM KIEN I - - .Address: 248 WAKE FOREST-RD Unit: PHONE: 714-545-2315 3 • -City/State/Zip:;COSTA MESA CA APPLICANT: ISFELD,JOEL _`,. , _ Address: 8941 MINT AVENUE �4 +(:' Unit : PHONE: 714-847-7653 City/State/Zip: WESTMINSTER,.CA 1 +, CONTRACTOR: CALIFORNIA ROOF LIFE CO INC - - - License No. 509623 Address: 8941 MINT AVEINUEUnitr'1 ‘ •PHONE: 714-847-7663 - City/State/Zip: WESTMINSTER CA 92683 _- CELL ARCHITECT: +;„ • License No. PHONE: ENGINEER: ; License No. PHONES' FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: Reinspection Fee: $0 00- 1 +, TOTAL FEES 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: 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 C. INSPECTION TYPE DATE IN1111ALS CODEC INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Finaly 208 Final Plumbing 200 Final Re-Roof ti-7 C k4'Lry,(/- 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 WIRKERS'COMPENSATION DECLARATION Owner ID verified by dri .icen, ,Yes 0 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. . ❑ I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code.for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a• number are: person is required to descend,will be made in connection with work authorized Ca`rrieri---- C% [''r✓ tietuP by this permit,and that no building structure.scaffdding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (Thissedon need not be competed Ithe penn4 is valued al one hundred dollars($100)o-feu) 2,Art 2Sec 341 Title S,California Administrative Code). Policy Nurntie: /76 399)9 - .2e0 ❑ 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 workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of --- -- the Labor Code,15 •ro.. : r comply with these .ro jsions.SApplicant's Signature Date o2 ser Division of Industrial Safety Permit Number: �, Uf ��riTe Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: F'.y,� 'lECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAW .J,�AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), I" 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 is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No CLic.-#' , COnZ 7i Class# C- 3 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by _- d> 41, each business which at any one time has on hand a quantity of acutely • ewe Dale 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 CONST•kqur DING AGENCY: temperature and pressure). ❑ I here. affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performs ' of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender' 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? 0 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? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment 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). ❑ 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: a contracla(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 until final inspection. Si..lure of L-..l Owner(s) Dat Signature Dale — // Aee- 3057-46(3/07) LJ (/D • rid/. •ulhonzed Appirant to PROJECT ADDRESS: 248 WAKE FOREST RD UNIT' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064520 OWNER'S NAME; TRANG, KIM KIEN ADDRESS: N . 248 WAKE FOREST DR COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT ,� ARCH/ENGINEER: flEG.NO.: JOB DESCRIPTION : T/O COMPO & APPLY NEW COMPO ROOFING SQFT: 2, 000 ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: 2, 000 . 00 CALC—VALUE: 2, 000 . 00 GROUP OCC: R-3 /M-1 ADDRESS: ; NEWPORT COAST ROOFING ( 714 ) 631-6991 • 817 W 17TH ST COMMENTS : SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC COSTA MESA CA92627 **+r***** -*****+ **ak************************aE*aE***aa****sir*ac*************** **+r*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O NI NG R E UIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBQA C K S ia CITY uc.:.759165 STATE LIC.:65 3 2 01/� CUSS: C 39 • Date- /9eQ3 Signature: ` o MAIN BUILDING ACCESSORY BUILDING --------- WORKERS'COMPENSATION DECLARATION: Ihereby affirm that Ihay certificateol nsenttoself-insureoracertificateofWorkers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OLICY ND.: 1315 9 0 9-93 EXP.DATE: 1 0/0 1 /94 COMPANY; STATE FUND PARKING REQ; PROV: PARCEL: 14146210 ZNE: REF NO: ❑ Certified copy is hereby furnished. Certified copy is filed with the city Building Division. PLANNING NOTES>, Date: !D/(Q�¢,3 Applicant: /W�2/'yew ************* ..>************** *************************************t********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This se n need not be cam eted lane permit is for one hundred(3100)or less). D E V E'yL OPMENT /// SERVICES R E Q U I R E M ESN`T S 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 / i subject to the Workers'Compensation Laws of California. 4 ZONING APPROVED: . BY DATE: Date:„kgkkg__— r 7. NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: ' '! Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. f CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for ' _ _ DALE L 1,� which this permit is issued(Section 3097.Civ.C). APPLICATION •ISSUED BY: _ ��_ /, ' � !v LENDER: ********************************************'m+.**********************it********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or p ERM I T4 5 , 0 0 5 0 repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business •' . SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN ' I any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(3500). ISSUE FEE - 4/ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN;CHECK TOTAL PAID DUE 7 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 45 . 50 0 . 00 '( 0 . 00 45 . 50 45 . 50 • 00 does not apply to an owner of a properly 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 1 t r improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 45 . 50 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 00 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. *'*'**********************************tetee et*ye'*********'**'*'**'***'*** *'N'*'**'M**'x'**** *'** N' am exempt under Section: B.8 P.C. I N D I V I D U A',L/ FEE BREAKDOWN for reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I" I do hereby certify that I am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505,25533,and SFR 2000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 000 . 00 25534 and that I or any future building occupant win/will not(circle one)need to comply with said state codes and the requirements for a 'END OF FEES permit far construction or modification from the Air Duality Management District.Residential construction applications are exempt from r . these provisions. .7 Date: Applicant: I hereby certify that I have read this application and slate that the above inlormalian is correct.I agree to comply with all city and county ' 1 ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property tar inspection purposes. ,y •y Date, /0//9/4'3 Signature. �J ti -4C/-'0xt, ` 01 00144172 Ti 45.50 Driver's License or Social Security 4: (/ e .- 1 DATE: 10/19/93 TIME: 13:35 1 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor I . _ CONSTRUCTION AND PLANNING L & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector . 1 1. Temporary Electrical Service or Pole - - 52. Pool & Equipment Location 2.'Soil Pipe-Undrgrnd. 53.-Steel Reinforcement 3. Electrical Conduit-Utility-Undrgrnd. l 54. Forms 1 . 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, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewei Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final ', -1i4. Rough Plumbing 65. Electrical-Final ./15. Rough Electrical-Conduit 66. Solar System-Final •• . .`,.--, .. 16. Rough Electric Wiring 67. Fencing & Access Approval J 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, Ventilating71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test • - 72. Underground Flush 24. Ro f Framing -73.'Undergmd.StorageTank 0Gas 0Oil • 25. Roof Sheathing 1�A- 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 !""r,- 78. FIRE PREV. FINAL 30. Drywall NailingHEALTH DEPT. REQUIREMENT -31. Plaster Brown Coat_ _ --J ' 79. FINAL INSPECTION 32. .Electrical Power Meter-Final . �:M, 80. FOOD CERTIFICATE CERTIFICATE ISSUEED I 33. Final Electric r J. 'Notes: a .55774/6� ../(161-7e( ed 1 34. Final Heating& Air Conditioning • /0 r/�ps,'OlC �` VVV 35. Final'Gas Pipe-Test C•�+ C d 36. Hood or Canopy . ';.!r - 37. Final Factory Fireplace 38. Final Plumbing 1- - 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 / %I; 48. FINAL PLANNING ! " 49. Electric Release to Edison - i- 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date OWNER PASADENA BUILDERS, INC. DATE 1-28-58 _ JOB ADDRESS 248 Wake Forest Road BUILDING PERMIT NO. 6351 GENERAL CONTRACTOR Dike & Cnl egrove, Inc. VALUE $ 13,690.00 AP. No. LOT 83 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Residence w/att Garage r ThUP I & J TYPE V ZONE R1 PLAN NO. INoPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED ,� DATE NUMBER a{J Trenches �-Forms Steel d /'1;yam, Floor System _ Steel Reinforce Chimney Re-Rod Bond Beam �J ` • 'Frame and Flashing '' /)- Y/�,{� Lathing, In / Out c ' glint' ' Plaster, brow coat i✓ g , .5,-.2l- ' V Underground soi1I 4*/ay/G Pipe Test.). //3'X7 Vv Top Out ' q"Y Furnace 4,444 Ai-lea-57?cc-get-Per-fit,-tl&: hr-i: FEB 2 0 195j-112-9_2 Gas Vents Rough Plumbing rilh'S H-/e-r-t'Y a".41.1..v - a,... ___/- ?9-.S /046/r2.- 77,E)• Cesspool Septic Tank Prop. Swr. Line°k House ConA1//-,{St. Swr. 3-7,5-.1�p�' P,�i --w L�c„�v = a--/`f-sr /3.2-44Sprinkling System JHeating Final 4 VIA7-� .,�Sing Fixtures, Final ,i/f L W i— Ij '+Q 1. . Gas Test b'-'i" L W '7- g- Construction Pole / 'A/ ,(� j Underground Power /F'(fy�'//'I( Rough Wiring 2 Q�„pGgA, y OAR 1 1 1953 uv-� 4 ( i , Fixtures, Final /�� =.5R / OCCUPANCY L �/. ---2.AL , g, Form 210-5M-1-57 - / 6351 A EV�� J= .E RECEIVED COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. P.O. BOX 31Z COSTA MESA, CALIFORNIA CITy 'OF COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING248 Wake Forest Road BUILDING ADDRESS COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PE 'y 1 OWNER Pasadena Builders, Inc. 4`/ MAIL 1 RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS 419 E. 17th St., .. — L,'- -r :N 2 : 195':: CITY Costa Mesa, TEL LI 8-1159 BUILDING - ADD ESS • AR .EER d,al Drook NO. COSTA MESA. CALIFORNIA Garden Grove FIRE ADDRESS ZONE ZONE NO.OF TYPE GROUP �ike Colegrove, Inc. CITY L O 7333 / PLANS �E. i, C NT R A C,,OIl ftp NO. ADDRESS419 E. 17th St., G.M.CNO. Li 8-1159 APPROVED DATE `EGA` LOT 83 2955 CORRECTIONS EswIPnoN NO. BLOCK TRACT A.P. NO. SIZE X T1GG NO.OF SLOGS. OF LOT NOW ON LOT none . USE OF f EXISTING BLDG. none ' SETBACK LINE FROM CENTER OF STREET 55' REAR YARD 271/ A SIDE YARD • RIGHT 5' LEFT p/f L5'/ DESCRIPTION OF WORKN" but- CS- — NER X ALTERATION ADDITION afiq REPAIR MOVING 6DEMOLISH • M BUILDING 1601 sq. ft.ROOS STORIES 1 EXTERIOR WALLROOF _COVERING StUCCO COVERING Comp. USE OF NEW BUILDING Single family residence andf garage. Plan 750B I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STAA>AW5 ' ULATING LDING CONSTR C. TION. VALUATION SIGNATURE OF / PERMIT FEE S 32.00 PERMITTEE a IN $ 13,690.00 PLAN CHECK S 16.00 AUTHORIZED AGENT DIKE & COLEGROVE, INC. W TOTAL FEE $ 48.00 Vo.i 'i' ,; COSTA MESA BUILDING DEPARTMENT COSTA MESA CALIFORNIA V- EF RECEIVED I 8662 11" v- lit 195 FOR APPLICANT TO FILL IN C.L. OF STREET F NANCE DEPT. BUILDING ADDRESS o2f k Glyea 1, // PROP LINE CIT OF C( 'AI MESA Owner��Dlt�QAl�/ //�� • 11 ___ —_�-- — — T — — 12 FT. 6 1N. FOR //��a� �!?�12a lrr� / II 10 FT. FOR 60 FT. STREET "5O FT. STREET Mail Address, 1/ez 2 d I City c 74 iota, • Ph. No. 1 I I • ' I Contractor. .,..,. ...c.,/ �:_-. Ph. No. 1 ' Q/A. A I Address/10 _V / / /✓ • _ ROVED 50 TIIF FRONT ry1 "rm�g 0 Vii _ j A ' City Lic. No.11/ State Lic. No. , I IOF PROP. F 150 FT CITY C : COSTA MESA w Mt rPu' T d 9SC P', e tiING DEPT. w Size of Lot �OX/b0 AP No. 1- SUBJECT f BLDG. DEPT. REG. K /!' w LI/ t N Setbacks: C/L Street ✓ Rear 1 ____ z ` D ii ,�Lf. � � � , ` i CC JI � w Side Yard - Right Left [/ I N r /*LAN TcCH. a. p Type of Fence ///1 /' //a " U. , ALLEY QR PROF! LINE ¢I �j l.G� 4 ' .1 ,y ' ''eg° 0 a. \ a1 r F= X ti`��j¢i9/{ \ -7 u I hereby acknowledge that have read this application and state J m Z �7p I �( that the above is correct and agree to comply with all City Ord- It Ny /� inances and State Laws regulating building construction. U � o -- n p y0 I0I Signature ^ _ ee �/,.. al r/� of Permittee�� !/ .[.c2rnest" 7-,0 I Agen� 57 6 IN. FOR OFFICE USE ONLY FT. w I 40 zI FT 1 J Permit No. a I 8662 e 60 FT ST 4 Received by Date Received Date Issued I II50 FT. ST. ��a. I 1= �- //---.1-7 -// 3/ J,iPROP. LINE -- — 1` — — i - _ _ - - _ / VALUATION Permit Fee $ • o�-e� \ In / 6 I II \ / I a_ $ �d U — Plan Check $ -- I C.L. OF STREET, J - I 1.--.ti TOTAL FEE $ MAXIMUM 4 FT. FENCE MAY BE PLACED ONL DOTTED LINES -- - --- MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS • -OWNER JORGENSON, CHAR LES T. DATE 2-11-59 - - JOB ADDRESS 248 Wake-Forest Rd: - BUILDING PERMIT NO. 8662 GENERAL CONTRACTOR Safeguard Const, VALUE $ 220.00 AP. No. LOT 83 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Block Wall Gnr)UP TYPE ZONE PLAN NO. 8.•2 PERMITS ISSUED 'ECTIONS DATE SUBCONTRACTOR DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam __ Frame and Flashing Lathing, Out Plaster, brown coat Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating Final P' Sint Fixtures, Final ias Test (.,......,ruction Pole Underground Power Rough Wiring Fixtures, Final "OCCUPANCY /`/� ,.��_77ji X61 Form 2111-5M-1-57 /�' 8662