HomeMy WebLinkAbout2789 WAXWING CT - Building Permits ,Y3 ' 9 S31TY COSTA MESA .
4 @ BUILDING DIVISION
F • „,,, 4. EVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
'4"m x PERMIT `.
�gttobtunw � t� M05-00552
•
(714)754-5273 • Fax(714)754-4856 • www.cicosta-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 2789 WAXWING CI Status: ISSUED
Suite No Applied: 09/27/2005
Issued: 09/27/2005
Vicinity:
Parcel Number: 13962130 /,
ISSUED BY: •"'
Applicant: HEIBERGER, FRANKS TR
Address: 2789 WAXWING CIR
Phone: 714-979-1739
COSTA MESA,CA Zip: 92626-4850
Owner: HEIBERGER, FRANK S TR
Address:
Address: 2789 WAXWING CIR �w
Phone:
COSTA MESA,CA Zip: 92626-4850 DA
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: •
License:000000
• SCOPE OF PERMIT
REPLACE EXISTING SWIMMING POOL EQUIPMENT AND REPLACE GAS PIPE.
' FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00. 0
Inst FAU>100 k BTU $18.20 1 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0
- Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00, 0
Appliance $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp ' - $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $41.70
COMMENTS/SPECIAL CONDITIONS
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
2446-46(6/00)
•
DECLARATIONS I n • ,
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: :AM't esd Ix,: Policy Number:
s section need not be completed it the permit is valued at one hundred dollars($100)or less.)
CYI certify that in the performance of the work for ch this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
Ricompensation laws of California,and agr a tha i I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these proves' nmo
Applicant SIgnMure: r 1 e t/ i,p A` Date:
`WARNING:FAILURE TO SECUR RKERS'COMPS TION COVERA NLAWFUL 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 COMP,y ON,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.x Class ft
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 Code).
Lenders Name: Lenders 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 OMsion 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).):
❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). '
r 0-1„as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
L -----Code:The contractors License Law does not apply t•an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursu:: to the Contr.,tors License Laws.). �f
❑ I am ei der sec. ;' siness and Professions Code for this reason: 9.-'2 / ` 0 S
-Signnen-a-%�._ �I '-
Expires: /.-2r?
``
Verification of Ownership by(type of document,i.e.-progeny tax be :.d)('-
'
a);
' 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 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greeter than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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? 0 Yes 0 No
(If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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 0 ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agreecomply with II state laws and city rdin noes relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-despCribproperty for i pectioses occ y or allow occupancy of any building authorized by this permit until final inspection.
-Pt( Signature Of Wgal Owner(e Date
And/Or Authorized Applicant Date
'COPE I INSPECTION TYPE DATE IftTIDALS CODE I INSPECTION TYPE PAU RILL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
I N
CITY OF COSTA MESA
o rf �1�
0 BUILDING DIVISION
H I B DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
ERMI
.4* R. 1 r P05-00737
(714)754-5273 • Fax(714)754-4856 osta-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 2789 WAXWING CI Status: ISSUED
Suite No Applied: 09/27/2005
Issued: 09/27/2005
Vicinity:
Parcel Nunmber: 13962130
Applicant: HEIBERGER, FRANKS TR ISSUED BY: .
Address: 2789 WAXWING CIR
Phone: 714-979-1739
COSTA MESA,CA Zip: 92626-4850
Owner: HEIBERGER, FRANK S TR sits
Address 2789 WAXWING CIR r
Phone: DAIS
COSTA MESA,CA Zip: 92626-4850 •
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
REPLACE EXISTING SWIMMING POOL EQUIPMENT AND REPLACE GAS PIPE.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) _ $0.00 0
. Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain,Floor $0.00 0 Sewer Conned $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 -0 Water Closet(Toilet) $0.00 0
' Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial. $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $9.80 1 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 . PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0 .
TOTAL CALCULATED FEES: $33.30
COMMENTS/SPECIAL CONDITIONS
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
244646(6/00)
/ 1
DECLARATIONS
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:;,, ,`
Cartier: Y+a #zr _ Policy Number:
(This section need not be completed If the permit is valued at one hundred doll ($100)aghss.)
iST/I "'At
I .I certify that in the performance of the work for w ' this p:mi is issued,I shall not employ any person in any manner so as to become subject to the workers'
-compensation laws of Cal omia,and a• ee that .hould •e ••me su•act to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these• • • s,
Applicant Signature:. ' L . ./ % 41 I —A 4 C ate: '7' 1 7—Q�
/
, WARNING:FAILURE TO SECU. ' ORKERS'COMPS• .TION CO RA• IS UNLAWFUL: •SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
' -THOUSAND DOLLARE(5100,...,IN ADDITION TO THE COST OF COMPENSATION.D ' ES•-PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
force and effect.tic.4 Class N
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 Code).
Lenders 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).):
❑ 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.).
❑ I am,exe • nder sec. Business and Professions Code for this reason:
�' , FJ
Expires: r' _ ...
Verification of Ownership by(type of document,Le.-property to r r deed):-
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file end 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 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aEermit 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 1131 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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 :• :: o comply Ith all state laws an, city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abo - •escrib'• •roperty ••r inspe +(n pu •..-..I agree of to occupy or allow occupancy of any building authorized by this permit until final inspection.
.44'
a V i J.. ., Ad- t r -/._'•. I u
'-• Z ----.Q
- " - 'Si :ture Of :hal•wner(s) I • t Date-,
And/Or Authorized Applicant ' Date
CODE I INSPECTION TYPE DATE MALS ODE INSPECTION TYPE Prig MALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical _
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
I
P� CITY OF COSTA MESA
'
4
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
l� PERMIT
4'-`"�+la►o.'ar1zso m�` B02-01458
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2789 WAXWING CI Status: ISSUED
Suite: Applied: 09/11/2002
Vicinity: ROOF Issued: 09/11/2002
Parcel Number: 13962130 Zoning: R1 R1
Applicant: MCCLURG, KENNETH ISSUED BY:
Address: 9661 CAITHNESS
Phone: (714)964-1762
HUNTINGTON BEACH,CA Zip: 92660
Owner: HEIBERGER, FRANK S TR
Address 2789 WAXWING CIR
Phone:
COSTA MESA,CA Zip: 92626-4850
Contractor: KENNY MCCLURG
Address: 9661 CAITHNESS
CA Phone: (714)964-1762
HUNTINGTON BEACH
Zip: 92660 License: 356431
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 7/16 OSB SHEATHING,30#FELT, ELK PRESTIQUE AND ADD 3 NEW SKYLIGHTS
(ICBO#NER216).3900 S.F. INCLUDES ATTACHED GARAGE.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $11,000.00
Permit: $195.25 Claim Valuation: $11,000.00
SMIP Res: $1.10
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $196.35
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
NOTES: KENNE_S 09/11/2002 PER CAC, DO NOT STAMP ROOF SKETCH.
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
2446-46(6ro0)
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 wo�rker Ico an on In/s/I�ance carrier and policy number are: j
t�Carrier� `/`� r7.2 PclicyNumber: / dC//(/,r
(This'section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
❑ 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 workers'
compensation laws of Cal' •rnia,and agree that If I should become subject to •:workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
pi comply with these prov • s. 9
App1lceTSlgnaNre I,_-- Date:. —v� c2Z
E,�
WARNING:FAILURE TO SECURE W0-*
ERS'COMPENSATION COVE• - S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS($100,OW),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
(forn'end erWcuc.-a. -grog 7/ Clasen) a- .7S'
Coniractods Signature: ./—y Date:— - 9-- !/ r�Z
—
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
—
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom end 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).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed): _
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,faisework,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, 1 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,ore 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 0 No
(Section 25533 of the California Health and Sefety 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 en 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 the subject of this a plication a2Permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes L-I No
(Section 65850.2 of the California Govemment 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
Of yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 IT—a pemlit from the•South Coast Air(Duality 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 Callfomia Health and Safety Code Section 42303 been made? 0 Yes 0 No
6 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is
correct.I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal• ner(s) t
' it • r•Ire r'Authdrized'�ttitan Date-
CODE I INSPECTION TYPE Y MAIE fIMA45 CODE! INSPECTION TYPE MI6 INSIDALI
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical
1266 Pool Spa Final _ _/(_9. y 208 Final Plumbing
200 Final Re-Roof 10 T. / % 210 Final Electrical
201 Final Block/Retaining Well _ 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
DIVISION OF BUILDING SAFETY
CITY OF
.
Date 4
By a ,' ST be kept onthsjobatalltimesanditisunlawfu to
maThik set y+hplans and specifications ons Wit w en pemiisswn hem the Division of Building ��� �'
makeanyaz 'xeleatanonsa,•
and Saiety,City otCosta Mesa. tUNOTba By top wind or y
These violation
of o is n') and sons c t ys i I stat sa Ortho nce an or State aw
of the violation of any nrovislons rt any fy P Co '�'of issu nca.
These plans and pa"na t1'ali mile b'1 C. ?lotion and bee me nulltd void it a bulldi,g or
work is nil,commenced and maia'taineda'�APmUNzr 31d)
I
X jx
1.
i l
r . _ —Sew--
ROVE I.
CITY OF COSTA MESA
PLANNING
SUBJECT TO BLDG. DEDIV.ET. REG.
BV.v DATE/// 'Oc
. )
ADDITIONS, DELETIONPTE RRECTI
BE APPROVED BY THE PLAAivlf,i6 DIuIS SHALL
07 ss u3k\\L„3 .
1(\
`�o2 - 01465
Ce Y
� 2
fA
_ z� ' A Twining Laboratories L,i.��,uuthEz,= CAIL,=izia, Inc.
�2� ot
a Ink 'O BC' a • . . A . . .S BE ACA. ('A • 2,1, 42L 3iSS . 2 3' 03L2350 . 114) s?E 0412
.A•.C.. ..r.CE'.
TESTING 4 .
. •I 1.. .p •C�T N. 1e.., ,.. (a •v„ •2 tIL nee
1:4•1
1
April 5 , 1973 Examination: SC73-2053
COMPRESSION TESTS ON GUNITE CYLINDERS
L. E. Sprague
5041 Roanoke Avenue
Irvine, California 92705
PROJECT Swirtming Pool for HEIRSBERGER Permit 1136252
ADDRESS 2789 Waxwing Circle, Costa Mesa
SAMPLE FROM i -IA Bond Beam: 2-2A Deep End: 3-3A Shallow End
ARCHITECT CONTRACTOR
• California Pools
ENGINEER SUBCONTRACTOR
Grove Gunite Co.
SPECIFIED
MIX Gunite STRENGTH 2,000 psi
DATE CAST 3-29-73 SLUMP
DATE TESTED 4-5-73 4-5-73 4-5-73
IA "HOLD"
CYLINDER NO. 1 2 3 2A "HOLD"
3A "HOLD"
COMPRESSION 7-Day 7-Day 7-Day
TOTAL LOAD, LBS. 112,500 116 ,500 109,000
POUNDS PER SQ. IN. 3,820 3,954 3,550
SIZE: 6-1/81Y x 12-1/4" 6-1/8" x 12-3/4" 6-1/4" x 12-3/4"
COMPLIANCE 7-Day test compiles with specifications.
MADE AT DELIVERED BY RECEIVED ON
CYLINDERS L. E. Sprague LES 4-2-73
DISTRIBUTION:
a esa Bldg. Dept. QUILD!nt(; SITE'Y EL: . .
California Pools
Grove Gunite Co.
L. E. Sprague - 2 13.
•LL REPORTS ARE SJBM,TTI D AS THE CONI IDENTIAL PROPERTY Of CLII NTS AUTHORIZATION FOR PUBLICATION OF OUR REPORTS CONCLUSIONS OR EX
TRACTS FROM OR REGARDING THEM IS RCSFRVEO PEND NC OUR WRITTEN APPROVAL AS A Mu TUAL PROTECTION TO CLIENTS.THE PUBLIC AND OURSELVES,
33012
‘. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. •
..OF COSTA MESA CONSTRUCTION PERMIT I MIT N TRACT NO. LOT NO UNIT NO. A
2189 wAXW11s3 C% 3772- 9 497 SS Zej A.P.# /39— &V'030 IZone — 1
Project Address Sue.‘
- S Main Building: Accessory Building:
-' Applicant's Mailing Address S.A M E TYPE OF CONSTRUCTION N NEW LI ADD L ALTERATION LL REPAIR E Z
'�p� �/ r ❑ CONVERSION CI DEMOLISH LI n T Front '-- Q
O Owner's Name �trsSAN`,1•4�IAEA 5U Phone 979-►139 / 1. OTS 11/tB N
O \W-14X MGDESCRIPTION OF WORK/USF,OF`B`DG. ID/ j%• C I A Rear �11
Address �� `+�lri� Ott /N/0/ a 6 A r a
TYPE OF PERMIT GRADING ❑ F L-STRUCTURAL K Right I-� N
ArchlE:g. License No. OU NDATION K 1 G
Address ,^q ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ • Left R
Contractor's Name n/1✓ . Phone ❑ OTHER Ping. Ref.# Parking Req./Provided E
�( PROJECT DESCRIPTION SQ. FT. OCCUPANCY 3 i Q
AddreS(mailing) �,6 i Planning Notes: 1 0 Ir D}` ��1 ( M
} CON ST RUCTION TYPE
=-_Ai VALUATION$ 7..C7v oz.s l`� - { ,s f I �✓/ '> (�
City License No. /I ZONE GRADING CU.YDS. ACRES L,4%v oujei k2VL/tt IN`Q / T
LICENSED ONTRACTOR DECLARATION S.
I hereby affir et I em licensed under provisions of Charter 9 c•�.'1denting Remarks; Q tel C t�.�+"rE TDR, HAVE 5E W. I.
with section 7000 • •'vision 3 of the Bus'. - o 'Elde,and U I , KE 1/f� L�1A
my license is in full force an• .. cjo` 11� ?E ry ',M EP ELECTRICAL FEES
License Class icense No. «l1 V S�� vW C�
Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION _ Construction Pole Sub. 0 50+KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter pup to 100 amps
0, Lab. CJ - Backflow Preventer Service Sink ,
•
Riicy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
Certified copy is hereby furnished. a—�
Cert' 'e copy is fled with the city a�t Ildinq 9i Isiq Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel
•a Applicant Al f/f�//'1 pr,K/ Fan Motors 00-1 HP ❑1'/z-B
EXEMPTION COMPENSATION DECLARATION Clarifiers Solar Collectors
Tleshis section need not be completed if the.permit is for one hundred ($100)or Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP 016-15+
I certify that in the performance of the work for w this permit is issued I Fixtures -r
shall not a pl y•any person in any ma •, bec• a subject to the Drinking Fountains Solar Tank Microwave
Worker ' tion Laws of Cali •rnl' Device Boxes Pole Light
.Date Signature L/ Floor Drains Swimming Pool w/Spa 9
NOTIC If,of er making this declarat •n, ••1 sho d become/Object to the Outlets Range
Workers' Compensation provisions of the Labor Code, you st forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections
Interceptors Water Heater
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00.5 KW ❑5-15 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 Trays '
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(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee I $15 Issue Fee $ 3
- -refrom and the basis for the alleged exemption. Any violation of Section
1.5 by any applicant for a permit subjects the applicant to a civil
alty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQ REMENTS:
��I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By - •
Eompensation, will do the work,and the structure is not intended or offered ,��+ DateS. i
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES Building Approved By A -�%l Date r�/��/�
License Law 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 Boiler Hood or Type I ❑ r. Application Issued By a ��,__a. Dat: Irene
employees, provided that such improvements are not intended or offered forYP /
sale. If, however,the building or improvement is sold within one year of com- Canopy Type II 0 SUMM9BY OFF ES _
pietion, the owner will have the burden of praying he/she did not build or im- Duct- Under Ground �,S .a
I prove for the purpose the of oe). BUILDING PERMIT $ SMTP $ S
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ 7 PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not applto 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 projects with a con-
tractors) license pursuant toe Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
r proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
(\ ❑ I am exempt under Section B. & P. C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers
�� �� PLAN CHECK 50% $ MICROFILM $
Date Owner id--- (11-6 66�/[6i� Heating System&Ducting Registers MECHANICAL $ as-. 2.r-
, MECHANICAL
hereby certif that have read this application and state that the above ❑0.100,000 BTU D100,000 BT TOTAL FEE $
information is correct. I agree to comp) with all city and county ordinances r PLAN CHECK 25% $
and state laws relati g to building co truction, and hereby authorize repre- ;
sentatives of .�!y to - ter the above-mentioned propert for
inspection p.••••:.�j /....
� ,- AI, " ib M _
\ SiriverrSS* �: Date /// ib Reinspection Fee $15 Issue Fee $ 3 , fn
Drivers' License :r SS#, 01 00040_C?-000 4019* TOT 2s2.2.5
fDATE: OD/14/89 TIME: [8:20
LN, 0865-46,rev. 5/88 While - Building; Candry - Applicant; Pink - Accounting; Goldenrod - Assessor .
- N . \ \ \
CONSTRUCTION AND PLANNING POOL °A
Date Inspector Date Inspector
APPROVAL` Perwit# APPROVALS Permit#
1. Temporary Electrical Service or Pole ^% 52. Pool & Equipment Location �'--
2. Soil PipetUndrgrnd. `f, 53. Steel Reinforcement 1, -(,
acElecvic I Conduit Utility-Undrgrnd. -', 54. Forms �i
4Electncal Conduit_-Undrgrnd. 55. Electrical Bonding
82)/Steel Reinforcement 56. Rough Plumbing & Pressure Test � �
�. Y 1
6r EleFfrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . -
L
7:j;F�ofl,, St �j/( (%( p�j/ 58. Electrical Conduit-Undrgrnd. ! I +s:
8. Foundation I . / e -vr. XI 59. Gas Pipe, O Undrgrnd.,Test `A
9-W3tPipe-Undrgrnd. 717Aja 60. Backwash Lines, P-Trap, O Undrgrnd. .A i
10-0Struct ru el Floor System ,: _. 61. APPROVAL TO DECK 11
11. Property Sewer Line & House Connection - ,, 62. Backwash & Receptor-Final - _
12.teeer'Cap ,Mr c ' 63. Heater &Vent-Final '�' • c ,11
ii
13.`Roof Drains 4 64. Plumbing System - Final ") , ',`
14. Ro wgh Plumbing ; ( 65. Electrical-Final
15. Rou&Fi Electrical-Conduit 66. Solar System-Final
46' Rough Electric Wiring lir- 67. Fencing & Access Approval
17': Rough Wiring Sign ` 68. APPROVED FOR PLASTERING
x.18. Rough Electrical-T Bar Ceiling :- 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditibr g FIRE DEPT. REQUIREMENT
20.,Rough'Factory Fireplace Z APPROVALS Permit#
.
21. Ducts, in Structure ' 11.4. 70. Underground Hydro
22. Ducts, Ventilating• , i F' 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe;Rough & Tat (" 72. Underground Flush
•: rn
24. Roof Framingc.'. 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing t,1 L-\ 74. Overhead Hydro
26. T-Bar-Ceiling (Structural) &,Monocoat 75. Dry Chemical
27. Frame-and Flashing76. Dry Standpipe
28. LatFiing &Siding 1'! 77. FIXED SYSTEM FINAL
29. Insulation !r: 78. FIRE PREY. FINAL
30. Drywall Nailing ji7 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' r�•.. 79. FINAL INSPECTION
32. Electfical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
r.
33. Final Electric - Notes: q- ��- -17-fa- �j
34. Final Heating & Air Conditioning i'--' `- 0
35. Final Gas Pipe-Test
•36. Hood or Canopy
;37. Final Factory Fireplace
38. Final Plumbing
39.'Weter Service-Final
,e;
40. Gas Service-Final
41. Solar Domestic-Final
'42. Backflow Preventer4' . 7
43. Backflow Irrigation. �, o ;; v-+
44. Landscape Irrigation System .1.4§1 r. V
45. Sound Attenuation . ' j }✓
46. Handicap Regulations /z-ç% '
47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed "
;49. Electric Release to Edison • - . (,)
50. Gas Release to Southern California Gas Co - '/..- .. (u
'51. CERTIFICATE OF OCCUPANCY - .'/;^f .0 ti
No. Date : -V i•
D
PARTY WAIL MRF 2T1r ,
THIS AGREEMENT, made and entered into this 10 1-k day of
AUF?US-r . , by and between FRA1A u E j u&e€
hereinafter referred to as 'LAND C$IWR', and eli AP � S it" 4217A M'"-
hereinafter referred to as 'ADJACENT PROPEROiINER".
It is hereby agreed that a party wall will be constructed on the
Property line between 27(act cul u> e le
(Address o Adjoining Properties)
Z.71a R<-0W tNs
in the City of Costa Mesa, Canty of Orange, State of California, as per map
recorded in Bock — , Page_ of Miscellaneous Maps, in the office of the
County Recorder of said County. The party wall shall be permitted to encroach
IN b TNLSS WCREOF, the parties have entered into this Agreerrent the
day arra year first above written.
•" ADJACENT -4• .YCIY OWNER
(SiAdradif
,.r ature) I% ( ' na ,.
w 9 - ) 1
(RZANK El BOReg2 S _/J4 a/ 0- deA om,
Name (Typed or Printed) Name (Typed or Printed)
2-7 Oil wAAJtR6 (IQ 2.742. TEDwiNe GIR
(Address) (Address)
AU6 1 4 1989
APPROVED
1� d . n
Permit 3 372 an, oFRQ`,; Dc 'l'(�
City of Costa Mesa Building Depot. # PLANNING DEPT. W Q_
THIS NUMBER MUST ACCOMPANY
SUBJECT TO BLDG DEPT, REp
BY DATE `�/�/ 191fALL INSPECTION REQUESTS ,ar
THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE -----DATELUa
NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT I orRAW
I
THEI ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF ;
PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A
PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION Of ANY OF
THE PROVISIONS OF THIS CODE.NO PERMIT PRESUMING TO GIVE
' AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF THIS
CODE SHALL BE VAUD, EXCEPT IN SO FAR AS THE WORK OR USE ' �-
WHICH IT AUTHORIZES IS LA'iFJL. _ 79
THE ISSUANCE OF A S ERMIT EASED UPON PLANS AND _1 ����
'EECI5ICATIONS CLIME LIOi PBEYSN7 THE BUILDING OFFICIAL {.,C�1W IN& ADDITIONS, DELETIONS, OR
'FROM 1':HEREAE ER 'ccUP.'dC THE CO SECTION OF ERRORS IN
SAID FLANS AND SPFC;FICATICNS OR FROM PREVENTING CORRECTIONS SHALL
• BUILDING OPTh.ATICNS cE:NG CARRED ON THEREUNDER WHEN BE APPROVED BY THE PLANNING DEPARTMENT
FOLAf ON OF THIS CODE OR OF.ANY OTHER ORDINANCE OF
; THE CITY.
r .
loL / / -
•
•
•
'6
4
1
1111t10tQt IItt1O{IICt 11010tUttggNCt
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it 2?eq z7 q3 it
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1
VJ PX\Q I NC neer 4
TYPICAL 611 CONCRETE BLOCK FENCE
a _
Cement Coping Optional '71 GENERAL- NOTES
Channel Block With 1.3/80 i'S I I .11-'.
Horizontal Top of all N I I L
Fences MORTAR: One Part Plastic Cement, and
. Three Parts Sand
For-Fenai 5'or Les !e GROUT: One Port Cement Thee and
• Q! a 1 il . 1, One Half Parts Sand
Vert.Bars 3/8"¢at 4'.0"O.C. d a x COPING: One Part Cement, Three.
For Fences Higher Than 5' ,` u I • Parts Sand
Vert.Bars 3/8"O at 32"G.C. • & W CONCRETE: Well Mind 1:2-1/2: 3-1/2 -
x
Fill Cells Solid With Grout N > ZII Max. of 7-1/2 Gallons ofWater Per Sack of Cement
Where Reinforcing Steel
u I��� ■
Steal Shall 'O I GROUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A•15.39 W O in UM p OCCURS.
A.S.T.M. IZ ~ [ I CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL BE CLEAR,CLEA
All Steel to be Lapped pe W LL FREE OF ALL MORTAR OEBR S ETC.N&
24"or to Code
NATURAL GRADE �i
•d
TWO 3/e"t/BARS '�` a , • • ♦ . •.. - ♦ .
CONTINUOUS TOP II
. &BOTTOM -- ..-2.-1F' -0—WIDTH - TO 16' 0 C. MAX.
SEE CHART •♦ ♦ n_
j1pQ17LSTEEL MUST BE TIED IN BELOW DE PTH OF E 4RTHTCOTH
PLACE AT TIME OF TRENCH I ♦ t 211 THE HEIGTH OF FENCE
INSPECTION. •♦' •• 1 j I L� •• .BELOW BOTTOM OF FOOTING
•
1...p2',..11 1 �„�. SCALE: I/2" a l'
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6' 5' ! 4' 3' I
• WIDTH 14" 14" i _12'.,_, . . .• . . 12" -
• THICKNESS 10" 10" 8" • 8 "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . . .20" 16" . . . 12"
SPACING OF EARTHTOOTH. . 12' 14' 1611'''. . . I. . . - 16'
OWNERS NAME: _FAA H CiutGd
City of Costa Mesa, California PERMIT JOB DNU MBER _ _ ea _WLXW .— _ —
Building Department SIGNATURE. ; - r
•
OWNER HEIBERGER, F.-S. DATE 4-24-73
JOB ADDRESS 2789 Waxwing Circle BUILDING PERMIT NO. 36530
Gr"ERAL CONTRACTOR owner-builder DESCRIPTION of WORK Patio Cover
a. 139-621-30 LOT 28 TRACT 6758 FIRE ZONE VALUE $ 1400,00
zINSPECTIONS Signature Date GROUP TYPE ZONE 21
e SO!L PERMITS ISSUED
GAS SUBCONTRACTOR
t/y,, Dote I Number Signature
CAS
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE fl HOUSE CON. E
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER fl
ROUGH WIRING1�'} n� / Heating and Vent.
TRENCHES El FORMS STEEL REINF. ,4 Jv� 7 r_ "r/'<
FLOOR SYSTEM
BOND BEAM E STEEL REINFORCE ❑
SHEATHING
FRAME AND FLASHING
LATHING — IN ❑ OUT ❑
P ER, BROWN COAT
5, .TURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL 17i,71"
PalP
3b5 SO 'pr 211-7-3100 11-11-15: ..
5:= - :**20 CC
COSTA MESA BUILDING-SAFETY DEPARTMENT '
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ��/ •
. AP LliTION FOR BUILDING PERMIT
For Applicant to Fill in Completely
R CEI ED Y D TE RFjCEIV D E ISSUJ:D��
BUILDING /w• LII �A�'J[
ADDRESS aC�By CO0Yreyt yl " rr ^ 7Np
OWNER Rr 5. f4Q i (7G_rW,I12-r � A.P. NO. (•361- 6a-I-3o Pcif-ReaAl ill
(f
BUILDING 2- ( el
MAIL p o_' J �• n
Z ADDRESS lig 737 1 v0.X UJ i VIJn EL,' 1 • ADDRESS ) q ��(r�� l`1 t'C
Q- Z CITY (a -) 1- ,M 0 /NI NO. 779-17,32 TR ACT`�Sn ( LOT,rte BLOCK
z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING f1FMOI ISH
O H LENDER :xC
am
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J m ARCHITECT TEL. USE /(rq( Ernd
Q OR ENGINEER NO.
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Q FIRE
w cc ADDRESS ZONE TYPE GROUP
aw
APPROVED
J Q CONTRACTOR /.a///t ASUl LDEYL BY DATE
m Z
J K ADDRESS
W W TEL. ZONE _ NO.OF USE OF NEW r�` '�rte
Z H CITY NO. (PLANS '� BUILDING [ OV C'//`—
W- 0 STATE CITY YARDS APPROVED YARDS APPROVED
to¢ LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
O (FROM C/L STB T)
SIZE r NO.OF SLOGS.
.y/r F,� -
OF LOT NOW ON LOT FRONT C. FT.
USE OFECt tti-
EXISTING BLDG. . Q'_k e Q R.SIDE FT. FT.
I- SIZE OFNO.OF 8
ZNEW BLDG. a V ROOMS STORIES L.SIDE FT. F
Z
EXTERIOR WALL ROOF yy jj� /'
_ COVERING COVERING ShG., k€ REAR 3 FT. T. 1
V
J USE OF BUILDING AND WORK TO BE PERFORMED
a DISTANCE BET. BET. MA &
CL _MAIN BLDGS. ACC �.BLOCS.
Q VAR.#
DATE
O Q. --1r] V . - G.U.P.# APPROVED
I- APPROVED LuqJ l , DATEL/p
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Z
O
VI hereby acknowledge that I have read this application and state ,✓//
D that the above information is correct and agree to comply with `r
Ir all laws regulating building construction, and I shall not employ JNi LS
I- any person in violation of the workman's compensation laws of 'IX-
tp the State of California. to
to
Z I hereby certify that I am properly licensed as a contractor under SQ. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that su h licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
cc
em exempt from the rovisions of the State of California Business ��
and Professions Cn<Ie 45ivision 3,Chapter 9. VALUATION 'w
t p.���ERMIT FEE $ j
Signature of �J,t/' `/!� ,,rr,,pp�'�L // // E
Permittee u/'y Ci`xa�� $ i '�-� PLAN CHECK $ (9
J/ FEE q s� Li-
Authorized
AutM1orizetl Agent ` / -
TOTAL $
LOWNER NFTRFRCER FS DATE 10-11-73
JOB ADDRESS 77gq Waxwing Circle BUILDING PERMIT NO. 37423
G' RAL CONTRACTOR- Owner/Bldr. DESCRIPTION of WORK 6 Block Wall
A J.l39-621-30 LOT 28 TRACT 6758 FIREZONE VALUE $ 200.00
' Z INSPECTIONS Signature Date GROUP J TYPE III ZONE RI
3 SOIL PERMITS ISSUED
SUBCONTRACTOR
GAS Date Number Signature
4 WATER Plumbing
ROUGH PLUMBING •
PROP. SWR. LINE Q HOUSE CON, 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER El
ROUGH WIRINGHeating and Vent. -
TRENCHES yl FORMS (TI d}TECL ROW- f ite a
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE I^J
SHEATHING , •
FRAME AND FLASHING
LATHING — IN In OUT n
PI '.R, BROWN COAT
ST._..FURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
e."n nmuc r'u A. 'Sea-, 17_7e7%
7CT 11-73PA�00 1477* *****5.50
37423 `
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
. ATION FOR BUILDING PERMIT
For App�liic�ant to Fill in Completely
BUILDING -•� 8 WAX`U /NC� REifetrzAp
V LfAEDVATE
- P F3
ADDRESS L /����J ( /''1 'jq 10-11--/,�j /fna-pT]
OWNER /` ' S. P /I3 Elea--et A.P. NO. I �+ l �(92j _JOERS 4L `,
MAIL I ' /� BUILDING �7��'y���/ 1�/ ''I /J
Z • ADDRESS Z78 9��7G�V AXW IN(J ADDRESS ZQ/ V ! �v�XWI�Q I/L
a U CITY COSI/4 r /t5 ' nN O. 979-/73`) QTR I�� LOTZ�J BLOCK
HZ
Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH
Z
O V) LENDER
0. CO
J D BRANCH
J f=
OWNER S • NEl 8(=RE612 .
Q W ADDRESS
CO J it its / VALUE ,0_,
J a3 ARCHITECT TEL. USE 6 01-00 C 1046(-- $ GffV
OR ENGINEER NO
U'n FIRE
ZONE Lh/L
TYPE ZGROUPCL 14IADDRESS 1fI -r�jJCONTRACTOR � BVPROVED DATE/0•'/'- / '7
co
JK ADDRESS J A'ri
W W TEL. ZONE NO.OF USE OF NE
Z= CITY Z NO. � ' 'PLANS BUILDING Lt( ���_
H l/1
W
CITY YARDS APPROVED YARDS APPROVED
(n cc LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D SIZE NO.OF BLDGS. (FROM C/L STREET) t�
OF LOT
GS- / /SCC^ I NOW ON LOT
�7 / FRONT FT. 10 c FT. T/L
USE OFEXISTING BLDG. .Jr X•(��L FA/� ,Ca R SIDE FT. SStT.
I— SIZE OF NO.OF �+�
Z NEW BLDG. ROOMS STORIES L.SIDE FT. -C> FT.
UEXTERIOR WALL ROOF ,t,is�� •
_ COVERING COVERING REAR FT. A- FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
n-CL MAIN BLOCS. ACCESS, BLDGS.
Q r/ VAR.# DATE
n6
0 ` , C.U.P.# APPROVED
2I- 2o. ///1)
(_C —BY ROVEDW, >^J DATE IQ - II �3
o I/ / \ 1�' gTATE
UI hereby acknowledge that I have read this application and state 0
7 that the above information is correct and agree to comply with
cr all laws regulating building construction, and I shall not employci
I- any person in violation of the workman's compensation laws of
N the State of California. AX m
e
ZI hereby certify that I am properly licensed as a contractor under SQ. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ¢
am exempt from the provisions of the State of California Business
and Professions Cnue, Division 3„Chapter 9. VALUATION
^ n� � PERMIT FEE $ aCe e'
m
S ignatura`of, �� //�� �� ,s PLAN CHECK $ E
PermitteaY $ /1/�
\ �V / o
Authorized Agent ..0•"......"
u.
,, TOTAL FEE $ L7
.OWNER 1st LOS Angeles Corp. DATE 8-7-72
c� ing ADDRESS 2789 Waxwing Circle BUILDING PERMIT NO. 35047
ERAL CONTRACTOR The Buccola Co. DESCRIPTION of WORK Res.w/att.garage
AP No. LOT 28 TRACT 6758 FIRE ZONE VALUE $ 42,500.00
1 INSPECTIONS Signature Date GROUP I&J TYPE V ZONE R-1
SOIL /j4S p//-72— PERMITS ISSUED
GAS SUBCONTRACTOR
•Y. Date Number Signature
fr7
WATER
frith 74, Plum•in•
ROUGH PLUMBING J/'9-7Y .r r -2/7- ‘//G or
PROP. SWR. LINE OUSE CON. k'L-c-q (As,s �� ,�(/ 4,,' o �/
SPRINKLING SYSTEM l TJ r 6^ j �'/0 �
MISCELLANEOUS w_ �I C� Cr�
ROUGH HEATING AND AIR CONDITIONING MSid-ILO�72.--'
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER 0
ROUGH WIRING
� ati nd¢nl.
TRENCHES FORMS STEEL REINF. ot__pK / /. �€ t�iY
/Q-1'7"y
ffaQ�
FLOOR SYSTEM tiR ,
BOND
BEAM n STEEL REINFORCE n
SHEATHING Ask a /o-3- 7 Y
FRAME AND FLASHING ,a).4.tiL rp -]n ' Yy--'
!NG — IN n OUT n y
F-...ITER, BROWN COAT /.4rn P 7/- :11--7 7.-- _
STRUCTURAL. FINAL
HEATING, VENT.,'REFRIG. AND A.C., FINAL /Nc/).'ypw d� E c ric R'-28-7 G/ /I
PLUMBING, FINAL AND GAS TEST n n....-2-0-)4 lc�-3
ELECTRIC, FINAL 4g/4e /a.?/-^$
�,Qi/ A '
P ,UC –7-72cMSA00 438* ***203.98
or35047
COSTA MESA BUILDING-SAFETY DEPARTMENT
, P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
-
For Applicant to Fill in Completely PP IC ION FOR BUILDING PERMIT
R EI D Y D RECEIVED TTE fff S U D
BUILDING rj7 '9' r// S
BUIL ADDRESS L/�� 7 "650A.-�ep,�G CYC CCC.//�•W'.
OWNER/`n-� L.9 C'�/- A.P.NO. PE `-' 7
MAIL //���� �^ BUILDING �j ,�//
ADDRESS
�/ rt�7L�i/re 4' (4`494)0 // ADDRESS Z�/O� 7 '/`�J' ��.�L/J�' �I Prr�
0-tli
0 CITY Zar."4L-�S r6 r TNOLpTS7.3�y TRACT Y>��� LOT G 8 BLOCK
I— Z
CONSTRUCTION/a-7 NEW ADD ALTER REPAIR MOVING DEMOI ISH
O-N LENDER /�L ! Cara? NEW
CL 03
J r BRANCH
JNA OWNER / G. •/� G-2ae4?
Q LO ADDRESS �/ GL-/fZscne ire Gr'e (/�-7
m-CO Q OR ENGINEERS Com- 'ern r z/ �"/NO...;---
7.)W
OL�97 f� USE/`E/ !/�7T. (1Y! VALUE �� r
U Q 7 ' FIRE / , i✓�
W [Y ADDRESS /O�./ �� cry: are_/72) ZONE / / TYPE /GROUP
a w /� APP R o (Fy/ ,(/J,, eQ �7-2�
W Z CONTRACTOR T�iE- �U«aM "� BY TES,J j 11
J O
m Z �J
J ADDRESS -jlSo/ ,o�%G"% L�- �.e •
W W ZONE NO.OF USE OF N
Z F p��p
TEL. ,L� PLANS BUILDING �/ (�/� r
CITY/ , ---64//e2,49•22.- !/�' NO,./ - (per I I `�iN .(/YL
W- O STATE CITY �j� V YARDS APPROVED YARDS APPROVE%
• O LIC.NO. /• ,i. 2 g LIC.NO. <,6� MAIN BUILDING ACCESSORY BUILDING
(FROM C/ STREET)
SIZE NO.OF BLDGS. sL�� .Q
OF LOT_6:.. -X�,7 • NOW ON LOT d FRONT /�iJ FT. 0�/4.-- FT.
USE OF
EXISTING BLDG. ��NI R.SIDE CFL FT.
I— SIZE OF
2 NEW BLDG. 2, 9•'b�yROOMS �2 STORIES 2 L.SIDE SFT. FT.
EXTERIOR WALL ROOF // �^ I.\
c� COVERING COVERING (ffr/NG�E REAR 40 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
C
a MAIN BLDGS. ACCESS.BLOCS.
ATE
Q ,{���` - "/ c . VAR.# APPR
0
4//� c_ C.UP-# q APPROVED
APPf10y,ED // t -7 -1,7).--
2
Y
fn �Y L_ c DATE 6�
O I hereby acknowledge that I have read this application and state U
•
D that the above information is correct and agree to comply with r��-.�t�L� T$
all laws regulating building construction, and I shall not employ �1IREM
F-„ any person in violation of the workman's compensation laws of SrMO- R'�Q m
N the State of California. 'tl�f ?; t9
ZI hereby certify that I am properly licensed as a contractor under ��{` '� SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS 5
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON Y' o
am exempt from the provisions of the State of California Business
and Professions Code, D' ision 3,Chapter 9. VALUATION p�,��1 2 y
PERMIT FEE $ / N
Signature of , ��'� �� Sao / l� m
Permittee / $ PLAN CHECK $ /V, el.—
E
/ / . a
Authorized Agent `�- u.
TOTAL FEE $ e
OWNER AETRERGER, F. DATE 3-81-73
m JOB ADDRESS 2789 Waxwing Circle BUILDING PERMIT NO. 36252
IERAL CONTRACTOR Calif. Pools DESCRIPTION of WORK Swim Pool w/ spa
r+r No. 139-621-30 LOT 28 TRACT 6758 FIRE ZONE VALUE $ 6,1400.00
C INSPECTIONS Signature Date GROUP J TYPE III ZONE R1
kL
Pool Location f� 3Jt73 SUBCONTRACTOR PERMITS ISS ED
\C \) Date Number Signature
Forms _
C
� Main Drain •
Steel Reinforce
Elec. Bond 77,2-- 31 73 Electric /
Approval to Cover ,t394 3 I '/�,(i. 3-,2/-73 36-5`63 "--
Underground
Underground Electric '2 y °"
Gas Piping Test Plumbing6> p g o
Filtering System Lines
34/7 ),9-42c, J 73 /o.�7a��
Backwash Lines and Recep. ,fie <�/0-23
Electrical Final ) P1k?3
Ler and Vent Final I
Filter System Final
Backwash and Recep. Final
^ 144
Fencing Final 5
36252
COSTA MESA BUILDING-SAFETY DEPARTMENT ?177cF)nW 897 ;:,„ ,r-53.nn
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LI ATION FOR BUILDING PERMIT
For Applicant�r_ to Fill in Completely
���/(J RE EI E Y DATE RECEIVED DATE ISSUED
i��j
BUILDINd7S! . ///AA/ /� // C�� ' / 5' V- // PE_ 1/
ADDRES G/// 6/s/ /� (3
OWNER F- r _ Aior e.r • ,Fe •
A.P.NO. • -bC z/-3O . .
AMAIL DDRESS _ f� BUILDING , 7jJ7,1, XV�/�C R J
-r ADDRESS
LOCK
0- 0 CITY
Z < CONSTRUCTION �F�4 NOL/ NEW •DT ALTER REPAIR OM G f)FMOI ISH
O y LENDER
am
J D BRANCH f/ /� '�/��,,//
Jfn OWNER �' / /// j([/!�/V
Q W ADDRESS ,7f/ �/
m J `/' VALUE / D J
ARCHITECT L - TE //�j� USE /�l?T ABS ${Q V(/
J Q OR ENGINES' •of S�� �7 %��
U Q GFIRE
w w ADDRESS �,/ fJ / � iic' ZONE / 4 /TYPE GROUP ^/�y
JOCONTR ACTOf ���O�f/� d BBYPROV ED/ ,f / •D DATE 2`�//
m Z (d(( /// CCC///
J c ADDRES:y)C/X0" ,.4'27.-)„.60:.„a„,/ _
W W (/ J ZO NO.OF -USE OF NEW (yYl
O CITY TEL
/Q PWN57� BUILDING �4����
2 i ___Lina' o �. N
w- 0 STATE CITY YARDS APPROVEDYARDS APPROVED
to K LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING :Y/
O O SIZE INO.OF BLDGS. (FROM /JET Q'^
OF LOT NOW ON LOT _FRONTFT. /
USE OF V
EXISTING BLDG. - e eV-cat-FT,
�I-C/�� /FT,
F. SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES a FT.
EXTERIOR WALL ROOF ,
ao COVERING I COVERING (S//FT.
J USE OF BU ING AND WORK TO BE PERFORMED DLSTANCE BET. BET.MAIN&
a
Ct /J •w ACCESS.BLDGS.
OPROVED
I- 3 :2-1-73
U) us-
DATE
DATEpsl lIc •
f..1 I hereby acknowledge that I have read this application and state ,
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ 1�
any person in violation of the workman's compensation laws of • /
y the State of California. - m
yDto
z I hereby certify that I am properly licensed as a contractor under SO. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
am exempt from the v ions of the State of California Business
VALUATIO m
and Professions C D' Sion 3,Chapter 9. .� w
EMIT FEE $
Signature of o ///�/y//� ` �^ / m
Permittee L llW i��V.((�/�// $ PLAN CHECK $ E
l�� sKK{ p
Authorized Agent n ��
\ TOTAL FEE $