HomeMy WebLinkAbout2241 WALLACE AVE - Building Permits 43/4;.-, Crf'v OF COSTA MESA
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BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
le. W41 ARol 06-01653
%/Pomo)`4° 2
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.13UJLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
•
Job Address: 2241 WALLACE AV Status: ISSUED
Suite: Applied: 10/02/2006
Vicinity: ROOF Issued: 10/02/2006
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
• Parcel Number: 42241202 Zoning:
Applicant: LA VERE, JOHN W
Address: 2241 WALLACE AVE .1
1.
Phone: 949-515-8092 ISSUED BY: L
COSTA MESA,CA Zip: 92627-2912
Owner: LA VERE, JOHN W
Address 2241.WALLACE AVE
Phone: .949-515-8092
COSTA MESA,CA Zip: 92627-2912
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
• Zip: - License: . . - License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF.INSTALL 2 LAYERS OF 15#FELT,3:12 PITCH,20 YEAR COMPOSITION SHINGLES FOR S.F.D.W/ATTACHED
GARAGE.25 SQUARES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $11,500.00
Permit: $209.25 Claim Valuation: 511,soo.00
SMIP Res: $1.15
SMIP Corn: $0.00
Other: $0.00 -
Inspection: $0.00
Total: $210.40
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 • Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§ 1,12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-48(6/00)
DECLARATIONS ti
CI
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: .
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is Issued.
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
C �I certify?Fiat 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 workers'
'..........-compensation laws of California,an. '•ree the I uld beco Oct to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with th:.: •vi I
Applicant SS'. • Date:--- € 0 • Z• b(p
.-----
WARNING:FAILURE TO SE URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.A Class A
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cale).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
CZ^ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
�7044'Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.). C O•Z•D
I a e•r•t u er seo. _ Business and Professions Code for this reason:
(' "Sig tura: . , A ,...7
/ j/t` Date: Y
-Owns Ir------
verifier •y dnver's ense. ❑Ves 0 No Dnvels license Noss
'
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code),
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number: •
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is Ile subject of this application a_nermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state la,s and cit • • , ces relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described• .'=rty NS sea. • rp, :s.I :• ee n• to• r•• . allow occupancy of any building authorized by this permit until final inspg2tio/A-
I•n: re• e-—O :r(s) (�'Date�"
And/Or Authorized Applicant Date
ODE• INSPECTION TYPE - all INITIALS CODE• INSPECTION TYPE 2(I1 INImALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof /0r� 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-
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
COSTA MESA ONSTRU TION PERMIT • PERMIT NO.
/,, )/ TRACT NO. ' LOT NO. UNIT NO. 9105 12/22/86 7.00 TL
'1 �1 �
) � 2 C0
Project Address OV Q _ I
Int" OF CONSTRUCTION ❑ U NEW ADD U ALTERATION U REPAIR
Applicant's Mai1i99 Address anH L.l 1.`etUOIr C o u A.P.# Zone
❑ CONVERSION DEMOLISH El
1 Owner's Name Inn h f. �'L, Phone
4J IA I Ai( e._ -. LCSI /1'1 g4 (p4I-3'51.78 DESCRIPTION OF WORK/USE OF BLDG.
Address 8 t S Main Building: Accessory Building:
E Z
ArchlEng, License No. TYPE OF PERMIT El GRADING 111 FOUNDATION El STRUCTURAL T Front ' Q
Address 'I• 11 //��..rI fI� � / ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N
Contractor's Name 14 kin 4tct TheeiWn.T Phone 635-6r84.� El OTHER
��11 4 n lt4 PROJECT DESCRIPTION SQ. FT. OCCUPANCY_
` ,�' C Right G
CityAddLicense ling)ll dl W+ W-S e pn i G. e- b. K
c�,:/)?
'' LL CONSTRUCTION TYPE VALUATION$ S Left
City License No. �� I / d? ZONE _ GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION Ping. Ret.# Parking Req./Provided E
I hereby affirm that I am licensedunder provisions of Chatter 9 (commencing Remarks: • Planning Notes: Q
M
win/ section 7000) of Divisionsion33 of the Business and Professions Code, and • T
my license is in f II force nd of act. po $
_I Licens Class - -I - • _LI en No. -I'll°1�
'r to Signator PLUMBING FEES
JRKERS' COMPENSATION LARATION Bar Sink Showers ELECTRICAL FEES
i hereby affirm that I have a cer ficate of consent to self-insure or a certificate • _
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Provental • Service Sink - - -
3800, Lab. ) Q �{''' -
Automatic Washer Transformer 0 15-50 KW
Policy No. 1:7 35 �• Company E LO-L Backflow Irrigation Sewer Cap0 50+KW
• Construction Pole Sub.
Certified copy Is hereby furnished.
C¢ filtl cop filed with the ci IdlO Div' o�IQ Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
atel
Applicant
EXEMPTION FROM WORKERS'C ENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps _
(This section need not be completed if the permit is for one hundred ($100) .r •
less). Dishwasher Solar Piping ' Dryers ❑Gas DElectric Sub Panel
f
d
1 certify that the performancepersonin the work for aswhich othis permit e t I
ort ' employompeany person of any manner so as to become subject the• Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1 Y.-8
Workers' Compensation Laws California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+
'NOTICE: If,after making this declaration, you should become subj. t to the
Workers' Compensation provisions of the Labor Code, you mus forthwith Floor Sinks Urinal - -- Fixtures - -
comply with such provisions or this permit shall be deem:• revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for t.- performance 9
of the work for which this permit is issued (Section 097 Civ. C.) Interceptors • Water Heater ., Outlets Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor License Law for the Lavatories Auto-Wash -
following reason (Section 7031.5 Business and Proles onal Code: Any city or Garbage Disposal ;Standing Sections
l
I county which requires a permit to construct,alter,-i prove,demolish or repair P—Tra
wstructure, prior to Its issuance, also r quires the applicant for such permit p Laundry Trays Generator DO-5 KW ❑5-15 KW Trash Compactor
I 1 file a signed statement that he/she Is 1 ensed p•rsuant to the provisions of Roof Drains '
e Contractor's License Law(Chapte omme•cing with Section 7000) of
Division 3 of the Business and Profe L ns Co.e) or that he/she Is exempt
. therefrom and the basis for the allege exem, Ion. Any violation-of Section
7031.5 by any applicant for a permit su•1is the applicant to a civil -
peenalty of not more than five hundred dollar. ( 0)._
U I, as owner of the property.or my plr� s with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work, and th struct re is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and •rofessional Code: The Contractor's MECHANICAL FEES -
License Law does not apply to an ow r of.a property who builds or improves •
thereon, and who does such work • mself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
Boiler Hood or Type I 0 -
C le, if,
employees, ever, that such im• ovemenproven is are not tor offered for yp ZoningApproved ByDate
sale. If, however, the building o ment Is sold within one year of com- Canopy Type II ❑ pp - )
prove the owner will have t• burden of proving h¢/She did not build or In- Duct-Under Ground Building Approved By Dat
prove for the purpose of sal
I ❑ I, as owner of the pr••erty,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
tractors to construct t project (Section 7044,Business and Professions Code:
The Contractor's -ase Law does not apply to an owner of property who Duct-Ventilating _ 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
) builds or impro thereon, and who contracts for such projects with a con- _
tractors) lir- e pursuant to the Contractor's License Law). I am aware that• Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP • $
proof of --u Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
I
0 I a xempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
P to OwnekHyeating System& Ducting e../0 Registers PLAN CHECK 25% $ ENERGY.P.C.' $
I hereby certif hat I have r ad th's application and state that the above ( I up 0-100,000 BTU D100,000 BTL s/ ' CX) GRADING $
information is o,rect. I agree 'n o p with all city and county ordinances P ELECTRICAL $
and state law r' at' 9 to bu Idi.g o•struction, and ere. authorize repro- MICROFILM ' $
sentatives f t•ls !ty t• -n r •-.n the ab.^n•ly: ed property for • PLAN CHECK 50% $ J
i Signature
f , 1 �' ie.-
\_44-
,
_ MECHANICAL $ •G� TOTAL FEE $ •O
Signature s p/ �-• �T/•
'
CMF 0865-46, ev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
rir
r-. ;ONSTRUCTION AND PLANNINC -& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
,�. 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final •
13. Roof;Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough&Te'st 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 PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning ///q/; �j •
35. Final Gas Pipe-Test �r
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
vflI ,r,n n. I. n. r ru
JOB ADDRESS 2241 Wal lace Street BUILDING PERMIT NO. 42326
GENERALCONTRACTOR OwnFr/Hi dr DESCRIPTION of WORK patio Cover
AP No. 1Tq_Sg7_p0 LOT TRACT
FIRE ZONE VALUE $SDO.00 _
INSPECTIONS Signature Date TYPE v GROUP J ZONE R-1 _
SOIL PERMITS ISSUED
As SUBCONTRACTOR
Date I Number Signature
—
WATER
WATER Plumbing
. `ROUGH PLUMBING _
V PROP. SWR. LINE LJ HOUSE CON. D
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
EMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT n
PLASTER. BROWN COAT
STRUCTURAL, FINAL Electric -
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n .`/f
ELECTRIC, FINAL ///�//f������
BUILDING, FINAL /1144..$6 3..-24,
SPECIAL REQUIREMENTS •
•
42326
1;II Erfrn71* t***.*5.50
• COSTA MESA BUILDING-SAFETY DEPARTMENT
p.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
P t ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
/` /J/ /(�/' R E BY DATE RECEIVED D T IIS//SUE-DD
ADDRESSG as9"// 14.14 ./J/7[ t, ,57"/ OIC !l
///t -7��`� '�qt �� I l�� sel2 "C I PE(((���MIT NO.
OWNER V/7i tIGIC @l e !-'/ r 6 • A.P.NO. _/ (/(.r
MAIL BUILDING 22 cu I / A ' • _c Sr
ADDRESS -5ADDRESS G�/CJ� l/\//"4a..�(-
CITY C05/�- /If4s�9 TENOL, O� TRACT 3O( .
/ LOT BLOCK
CONSTRUCTION /(7.4. NEW ADD ALTFR REPAIR MOVING DFMOI ISH
LEBRANCH OWNETRA (' tz'nIk (/'c
ADDRESS �//'J /,f /,/ VALUE .12,0
ARCHITECT TEL. USE / Aho ( -41:1/t) $ - J!//) —
OR ENGINEER NO
FIRE
ADDRESS ZONE / TYPE// GROUP `
CONTRACTOR toe-ob./fie- ,0,5,4yL1�6e
APPROVED ' rt^I/ DATE 7.i2/-1J
ADDRESSTEZOpI� I 66/1 IIN_O/O(((F USE OF NEVA a0
CITY NO. �1/` PLANS Z BUILDING nt,/gg.,_
EH
STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
b.1 SIZE I NO.OF BLDGS. (FROM CA.STREET)S'
0. OF LOT NOW ON LOT FRONT /'{t,( FT. FT.
Q USE OF
EXISTING BLDG. R.SIDE 5 FT, FT.
CA
F Separate permits are required for L.SIDE /[r/ FT. FT.
electric,plumbing and heating work. REAR 3HS FT. FT.
Lt7 USE OF BUILDING AND WORK TO BE PERFORMED
F
DISTANCE BET. BET.MAIN&
7 O
ff.
Q 4�� do/ (' `j/ P//r / r C.U.P.# APPROVED
APPROVED( t> AV iDATE r2 1-/ Y-
..1
C
GU
0.
I hereby acknowledge that I have read this application and state n
n
C that the above information is correct and agree to comply with m
L all laws regulating building construction, and I shall not employ
Z
0
any person in violation of the workman's compensation laws of
W the State of California. '
y�
I hereby certify that I am proper . licensed as a contractor under v /�SO. FT. n
the State of California Business nd Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR CO
Chapter 9, and that such liven-:s are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisio s of the State of California Businessr .t
and Profosalo�ode, sivisl• 3,Chapter 9. VALUATION PERMIT FEE $ 5— N
Signature of / / PLAN CHECK $ enoo
Permittee //- r 5 -� $
f-s�' TAX $ W f
L U
Authoriz . Agent .. TOTAL PAID $ 5V
OWNER KOLL CONSTRUCTION CO., INC. I1 DATE 3-6-57 . ,
JOB ADDRESS 2241 Wallace Ave. BUILDING PERMIT NO. #11518
GENERAL CONTRACTOR Oygter Bldr. VALUE $10,301 .00
LOT 2 BLOCK TRACT 3065 Res. w/att. gar.
GROUP I & J TYPE V ZONE FIRE DISTRICT 111170
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench 0214-1-- 3,Q/5-9
r
Foundation Forms and Grade to Garage
Rough Framing .0/.-:-/f-7
Plumbing,Rough to Slab ,1,{I d_ d//,�•S7 ,I f C`Ly12 1 a • -1 - e scc)
Plumbing,Rough Complete 4-2`.JI(7
Temporary Pole ����r! •
Wiring, Rough ,.99A • Iii �,i�I,d•Q(7•/Qr /,.1.Y'. i' 7/ 7 f
Heating,Rough C ii YI" vI$f T. NMI • , t. -,g 2- 57 8a 07
Heating,Final / , MY S-9-37 �
�Be yer Houses 1/„y y1Sewer,St. A(JS 6 L-67 e0 A a ), ;,,to� ' - at-s Cf. 7 (�3
Septic Tank or Cesspool '/
Lathing, In Out Vim- - 1.7 r
Plastering f/0 $"I •
Plumbing,Final,Fixtures Complete 1115 4.4/.67 //JJ Aff -, ��)7
Plumbing, Final Gas Test/r APS f-S7G I ' C/�,n- �•/ _ ,i/ir
Wiring,Final fit 1951 .
Occupancy /{)/f 5 -4-3-,7
FORM 210 3M 10.55
Costa Mesa Building Department 11 1-, APPLICATION FOR PERMIT
�. . 111 EAST 20th STREET BUILDING 1
_"` COSTA MESA, CALIFORNIA
r
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. I Permit No.
Building
Address 2243. Wallace 4.4,.-e.� I 451 S
Costa Mesa, California Received by i I Date Rec'd. Date Issued
Nearest �` -aS.C.-S.- MAR 6 1957
Cross St Wilson Building
Address
Owner K.W.Koll Construction Co. , 'Inc. Costa Mesa, California
Mail
Address 2826 Newport Blvd., Nearest
Tel. Cross City Newport Beach, Calif. No. HA5201 Zone St.
INo.of I Type / Group
EngineArchiter t or Carlsson and Tfiddjsbrook Approved Plans c..'�. ,-`
by Date
Address Garden Grove, California CORRECTIONS
City Lic.
Contractor owner No.
Address 5alll0
Lel Lot
I
De crption I No. 2 I Block I Tract 306;
(Attach Metes and Bounds)
No.ofSize of Lot 60 X 100 I Now on Loth none
Use of No.of No:of 3.3f 0
Existing Bldg. I Families I Rooms 2
Setback Line from Rear Yard 2
Center of Street 50 Side Yard 2.
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
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Repair I I Moving I I Demolish I `a
Building No.of
Size 1188 Rooms 5 Stories
Exterior Wall I Roof
Covering tuCCo Covering rock APPROVALS I
Use of New
Building Ted cienco `�t - • Foundation Location Inspector Date
3/ Forms,Materials,
VI/ Under-Pinning „a
Frame: Fire Stops,
Bracing,Bolts i--,
I hereby acknowledge that I have read this Application p
and state that the above is coiled and agree to comply Lath. Int.
with all City Ordinan,- and Statc a;ws regulating Al
building construct.n, Lath. Ext
Signature of V
Permittee 2,99 L/LieL/ Plaster,Int
W
Os
Authorized Agt. .. i /
/ Plaster,Ext.
11.-
Valuation
Valuation Permit Fee $ ,2..6 — Masonry Reinforced os
$ /o, 3o i / Ploan tal Check$ /3 '- gond Beam
•`i O
Fee $ 37-_ FINAL
FORM 204 5-13P 2M 0-55
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PLOT PLAN
Show location and distances from •-
CO property line and between buildings.
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