HomeMy WebLinkAbout229 WELLESLEY LN - Building Permits a
CITY OF COSTA MESA
It QQQ BUILDING DIVISION
F• dna , 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
4. /1411 FOR INSPECTIONS CALL:(714)754-5626
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PERMIT NUMBER: B08-00343
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 14139534 DATE ISSUED: 12/17/2008
ISSUED BY: RMD
JOB ADDRESS: 229 WELLESLEY LN CM Suite/Unit: `
Vicinity: HOUSE AND GARAGE ROOF:r:" - - "
Squares: 2400 • ' -Valuation: $5,860.00
SCOPE OF WORK: REROOF OVER 1 LAYER COMP SHINGLES WITH 30 YEAR COMP SHINGLES ON'AN ATTACHED HOUSE AND
GARAGE,
APPROX 24 SQUARES.
OWNER: DALTON,GREG . Address: 229 WELLESLEY LN ii, ii i 1 i Unit:
PHONE: . ' City/State/Zip: COSTA MESA,CA .
APPLICANT: HUFFMAN,;RICHARD - Address: 1181 ATLANTA WY • Unit :
PHONE: 714.397.4707 City/State/Zip: COSTA MESA, CA
CONTRACTOR: HUFFMAN CONSTRUCTION I. - License No. "427295
Address: 1181 ATLANTA WYUnit: , - - ' PHONE: 714.397.4707
City/State/Zip: COSTA MESA, CA 92626i . CELL:
ARCHITECT: - .. - License No. " PHONE:
ENGINEER: - License No. PHONE:
FEE SUMMARY •
•
Reroof Plan Check: $0.00'.. " r
"
Reroof Permit Fee: $125 25 _ -
Reinspection Fee: $0.00
•
TOTAL FEES $125.25 - - . .
. aftip
4 .
•
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 S. INSPECTION TYPE DATE INTITIALS CODEC INSPECTION TYPE DATE INTITIALS
1016 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 74-07 &44[ 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
•
4
WORKERS'COMPENSATION DECLARATI Owner ID verified by 'cense. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. .
❑ 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
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
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
(This section need not be completed i/the permit is valued at one hundred dollars($100)or less.)
2,Art 2Sec.341,Title B,California Administrative Code).
Policy Number:
0 As owner-builder, I will not employ anyone to do work which would
ry�g(. '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 Applicants Signature Date
the bor Qo e, I shall forthyrith comply with these provisions.
.I 7J.l(/�. I - 17 -42a. Division of Industrial Safety Permit Number:
Applicant's Signature r Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be fled with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Lic:# 42 2.?' Class# ir} (Section 25533 of the California Health and Safety Code, with some
( 14—,1
_ exceptions, requires registration with the Costa Mesa Fire Department by
// 12,r ' aeach business which at any one time has on hand a quantity of acutely
r'C(lntractor's Signature rte-- Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 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 fumished 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? 0 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? ❑Yes 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify'that under penalty of perjury the
did not build or improve for purpose of sale.). - information given above is correct. I agree to comply with all,state laws and
city ordinances regarding Hazardous Materials and Emissions.
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH - .
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ 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.
�1
Signature of Legal Owner(s) Dale
'Signature Date --O/ 4[-- Jy it-r7,J2C •
3057-45(3/07) /�h/� �`-w��`v uiawu^^n"' --_ HHH"""_-----
A dlorr Authorized Applicant Date
CITY OF COSTA MESA
Neighborhood Improvement Program
Work Write Up
Bids due to City 10/31/2008
Name: Greg& Kim Dalton Home Phone: 714-979-3564
Property Address: 229 Wellesley Work Phone:
All work is to be done per City of Costa Mesa Building, Planning and Public Works Codes. In order to establish
standards of quality, the detailed specifications may refer to a certain product by name and/or from a major
manufacturer. This procedure is not to be construed as eliminating from competition other products of equal or better
quality by other manufacturers. The Contractor shall furnish the list of proposed desired substitutions prior to signing
the contract. All items listed on the work description, unless otherwise specified, shall include all patching and finish
work, including trim, hardware, patching and finish painting and/or staining. The Contractor is responsible for all
permits,fees,City business licenses,plans,etc.
City of Costa Mesa Standard Rehabilitation Specifications applies to all items listed on work description.
Estimate:
Lead Work
The painted bricks in the kitchen and living room contain lead. Using lead
safe work practices install furring strips around all brick surfaces and $
provide and install new drywall per industry standards. Paint to match
kitchen. Additionally, remove bricks that make up barbeque and prepare
area for cabinets.
Roof: Remove and dispose of ALL existing'roofing material down to the
sheathing on (both the house and garage). Install new 1/2" structural grade $
sheathing to current U.B.C. Code. Install A.S.T. waterproofing felt as
required per U.B.C. and a new 30-year architectural laminated shingle
roof (Owens Corning brand or equal Class A fire rated to current
U.B.C. Code and manufactures standards. Include new drip edge and
flashing. Install new metal valley pans. Install new metal flashing on every
pipe and vent. Seal and paint all vent and pipes. Replace all damaged
starter board and fascia with in kind material. Homeowner to select color
of roof from samples provided by the contractor.
Alternate pricing: Confirm one layer of roofing material and provide $
pricing to reroof over existing roof.
Skylight: Remove existing skylight and provide and install new skylight. $
New skylight to match existing opening.
Front Door: Provide and install prehung metal entry_door. Owner to $
choose style of door. Fanlite glass is allowed. Hardware to include new
hinges, weather stripping, threshold, Kwikset deadbolt and entry lockset.
Material allowance not to exceed $175 for lock set. After installed, prime
and paint door with acrylic primer and exterior semi-gloss Dunn Edwards
paint or equal.
Side yard kitchen door )Provide and install exterior grade pre-hung door)
leading from side yard to Kitchen. Installation complete with hardware $
that includes new hinge veather stripping, threshold, Kwikset '"adbolt
and entry lockset. After ,..stalled, prime and paint door and new . .n with
acrylic primer and exterior semi-gloss Dunn Edwards paint or equal. Door
to be same style as existing door.
-Provide and install motion security sensor light outside of side yard $
kitchen door.
Interior Doors: Replace all hollow core doors throughout house with new $
six panel doors hollow-core doors. Installation to include all new hardware
and trim molding if applicable. After installed, prime and paint door and
new trim with acrylic primer and exterior semi-gloss Dunn Edwards paint
or equal.
Garage: Repair open area of drywall in_1 hour wall near dryer. Provide $
and install .outlets? for all appliances currently utilizing extension cords
including garage door opener.
Kitchen: Provide material and labor to install new modular cabinets (owner
to select style) complete with knobs and pulls, per attached specifications.
Install free standing range. Installation to include new Bager 5 garbage $
disposal new enameled double bowl cast iron sink, Price Pfister two handle
faucet and Kitchenaid dishwasher. Additionally, Provide and install new
prefabricated granite countertops (owner to select color from samples
provided by contractor.&alto be installed with new angle stops, flex water
supply lines and drain lines. Kitchenaid micro ciao to be installed over free
standing range. Prime and repaint kitchen and dining area with Dunn
Edwards, Sinclair, or Vista paint. Paint to be semi-gloss. Owner to select
color of paint. Prep area as needed to remove all imperfections to assure
smooth installation surface.
Appliances:
Kitchenaid range, model KGSS907SSS $
Kitchenaid microwave, model KHMS1850SSS
Kitchenaid dishwasher, model KUDK03FTSS
-Include price for additional outlets and all electrical upgrades including $
GFCI as required by building inspector
-Provide and install Ceiling—fan'at center beam in kitchen. Make all $
necessary electrical connections per current electrical codes and supply
switch for operation.
Kitchen Flooring: Prepare floor and provide and install new porcelain tile
in kitchen area using accepted trade practices. Owner to select style. $
Material allowance not to exceed $4 per square foot.
Dining Room Flooring: Prepare floor and provide and install bamboo $
flooring in dining area. Owner to select material to be used. Material
allowance not to exceed $4 Per square foot.
Baseboards: Provide and install new baseboards in kitchen anu dining $
area. Owner to select style.
Beams at entryway:) Cover beams and columns at entryway with
appropriate (drywall_ and =bull nose corners. ) Include baseboards if
applicable.
Central heating furnace: Provide material and labor to replace existing
furnace and thermostat with new furnace (Carrier or equal) to same location. $
New furnace is to have the minimum BTU rating per size of the home. Use
existing registers and ducting where possible. Obtain permit
Water heater:lRemove existing water heater and install new 40 gallon
water heater to code with approved type pressure relief valve with
discharge line, seismic strapping, and new gas line as needed. Also include
all plumbing hardware, water inlet lines as needed and shut-off valve. Due $
to location of water heater, a Watt 210 valve will most likely need to be
installed and a pressure valve will need to be installed at the hose bib.
Obtain permit.
Carpeting: Provide material and labor to remove and dispose off-site
existing carpet and pad in master bedroom. Install medium grade pad and
carpeting ($ 40 /yard installed) where removed including closets. Install $
carpet with minimal splices and properly hot taped. Owner to make final
approval on carpet, pad, and color.
Guest Bathroom: Take all necessary steps to epair drywalllin front guest
bedroom caused by prior leak in guest bathroom. $
Smoke Detectors: Check smoke detectors, if missing or not working, $
install to code.
Planter: Remove all dirt from existing planter that rests against back wall
of home. Repair all damaged stucco and prime and paint area to match $
existing surrounding color. Repair any and all loose bricks if applicable.
TOTAL
TOTAL $
I have reviewed the above work description and understand that any changes, additions or
deletions shall have prior approval by the City of Costa Mesa Neighborhood Improvement
Personnel.
Greg & Kim Dalton Date
229 Wellesley Lane
CITY OF COSTA MESA
��E`z%.44 BUILDING DIVISION
4 4f
i 4 ..w,� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
I . :
4. fl , FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: BC08-00580
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES_RRIP DATE ISSUED: 12/17/2008
ISSUED BY: RMD
JOB ADDRESS: 229 WELLESLEY LN:CM Suite/Unit:
APN: 14139534 _ - . Zoning: ,
Vicinity: THROUGH OUT HOUSE ' Primary Occ: R-3
Const Type: V-B SQ. FT: 0 Valuation: $20,900.00
SCOPE OF WORK: INTERIOR NON-STRUCTRUAL RMODEL. WORK TO INCLUDE: DRYWALL REPAIR IN ENTRY WAY,
BATHROOM AND GARAGE, CHANGE OUT EXTERIOR DOORS, CHANGE OUT 1 FAU < 100 K BTU, 1 HOOD EXHAUST, 1 LIGHT
FIXT, 1 CEILING FAN, 3 OUTLETS, 2 SWITCHES,2 DEDICATED CIRCUITS, EL CONDUIT FOR GARAGE OPENER, 1 KITCHEN
SINK, 1 WATER . , --
HEATER, 1 DISPOSAL.
OWNER: DALTON, GREG Address: 229 WELLESLEY LN 'Unit:
Phone: , I -City/State/Zip: COSTA MESA, CA ,
•
APPLICANT: HUFFMAN, RICHARD Address: 1181 ATLANTA WY Unit: :
Phone: 714.397.4707 ' City/State/zZip: COSTA MESA, CA
CONTRACTOR: HUFFMAN CONSTRUCTION License No. 427295 . .
Phone: 714.397.4707, . Address: 1181 ATLANTA WYUnit:
Cell: • ._ City/State: COSTA MESA,CA ZipCode 92626
ARCHITECT: •
License No. PHONE:
ENGINEER: License No. PHONE:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $0.00
Building Fees: - $335.25 _
Electrical Fees: '--$34.50
Mechanical Fees: - • $49.15
Plumbing Fees: $43:10y
SMIP Residential: $2:09 ,4„:„.
Frigi
SMIP Commercial: $0.00 s irs
f
TOTAL FEES: $464.09 C u t: '"° '
**Refer to fee receipts for all fees paid for project
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE P. INSPECTION TYPE DATE INTmALS CODEX INSPECTION TYPE ATE INTITIaL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 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 Sign222 Final Site
204 Final Demolition 250 Final Building/Occupancy r �I
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive,_ ..cense. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
O 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.
O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
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
by this permit,and that no building structure.scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed A the permit is valued at one hundred dollars($100)or less.)
2,Art 2,Sec.341,Title B,California Administrative Code).
Policy Number:
❑ 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
tissued,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
Applicant's Signature Date
the Labor Co e,I shall forthwith comply with these provisions.
�� _,/-[ /J _ _ (247'o7 Division of Industrial Safety Permit Number:
A(fpliwms Signature Et— Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
,-Lic.# °/z 7'7-.9 S Class# 3 (Section 25533 of the California Health and Safety Code, with some
_ 7 vr� exceptions, requires registration with the Costa Mesa Fire Department by
,.,y( 7 7-�✓v-�w !Z feach business which at any one time has on hand a quantity of acutely
cjntractors Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons. or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work far which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished 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 penally 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).
❑ • 1:-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 ❑No
thereon,and who does such work-himself or herself or through his or her own 8. (If'yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for ,
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE:')'certify that under penalty'of perjury the
did not build or improve for purpose of sale.). information given above is correct. 1 agree to comply with all state laws and
1:1I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
• Signature of Legal Owner(s) Date
Signature DateI'2-17_Li�
3057.46(3/07)
A /or Authorized Applicant f"" Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•CI u OF COSTA MESA CONSTRUCTION PERMIT PERMIT rO. TRACT NO. LOT NO. UNIT NO: •
• ect Address A Ef�E s<t he. •4 - 8834 12/17/86 30.50 TL
Applicant's Mailing Address 17922,_ S ry f4//' /1'SAN/ /,r,/ TYPE OF CONSTRUCTION NEW . ADD I♦ALTERA .ON . REPAIR
/^7{'Ea��m �%- - 7- 71. 9' �" ❑ CONVERSION la DEMOLISH ❑ OT R 4_ of AP # Zone
• Owner's Name Phone -3.+6y — - - - . -
DE RIPTIIN OF WO•K/USE OF :LDC. Ara- •"-
Address .2.0 Co' W GAS FS�Cc`Y d - . - -. �✓ wjT.!-/ S Main Building: Accessory Building:
rsi, Arch/Eng: License No. T'E OF PERMIT I♦ GR•DING ❑ FOUNDATION . STRUCTURAL E Front p
•F/ Address - ❑ TENANT, ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear N
V �1 - ❑ OTHER A I
Contractor's NamarANvh AdA oz1r ' • /'✓2 Phone?"'6 F
Address(mailing) /7 gJ? .3 &7q4 Js /�x) r S`,�i✓TA�g. '7.2 •S•PROJECT DESCRIPTION 5c;;-,FT. 0� w OCCUPANCY e'c' C Right - G
53 {� CONSTRUCTION TYPE VALUATION$ .2780•OO s Left R
City License No. 30 D
LICENSED CONTRACTOR DECLARATION ZONE GRADING CU.YDS. ACRES g_, eq./Provided E
I� Pln Ret.# ParkingR
^1 - Q
hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
.W with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full Lorce and effect. •
• T
1 License Class ` 3 0. License No. �- g S• ^co •
• S
Date/. '/ -. Signature .a1 /,---^- -. ' PLUMBING FEES •
WORKERS'COMPENSATION DECLARA ION Bar SinkShowers •
. 1 hereby affirm that I have a certificate of consent to self-insure or a certificate , ELECTRICAL FEES
\ ?' Workers' Compensation In urance, or a certi d 'cop ther of (Section Backflow Preventer Service Sink - -
"00, Lab. rrc� rTT /;- Automatic Washer Transformer ❑ 15-50 KW
olicy No...Z1.(5" 15 /' /Comp.. "'�` Backflow Irrigation I ❑ 50+ KW '
n 9 Sewer Cap Construction Pole Sub. •
P certified copy ii hereby furnished. - - -
Certified copy taped.with the city B ng Div Bathtubs • Sewer Connection
4P } �� Cooking Unit , - Meter' ❑up to 100 amps
Date 72 - Apogean .i & -
EXEMPTION FROM WORKERS'CO PENSA ON DECLARATION Clarifiers Solar Collectors DishwasherMeter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or -
less). • Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel • -
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of California. _ Motors❑0-1 HP ❑1'h-R
. .
—
Date Signature Floor Drains - Swimming Pool w(Spa F.A.U.
NOTICE: If,after making this declaration, you should become subject to the Inc.Solar 09.15 HP 01615+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures •
' comply with such provisions or this permit shall be deemed revoked. Microwave •
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
Device Boxes Pole
•
I hereby affirm that there is a construction lendinge agency for the performance - Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets
Lender's Name - Range '
•
Lender's Address Kitchen Sink . ' Water Service -.
- OWNER BUILDER DECLARATION Switches Sign •
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 Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair , P-Trap LaundryTrays
any structure, prior to its issuance, also requires the applicant for such permitGenerator ❑0.5 KW ❑5-15 KW Trash Compactor
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 - . - - - - . --
'•erefrom and the basis for the alleged exemption. Any violation of Section • . -
31.5 by any applicant for a permit subjects the applicant to a civil - -
.nalty of not more than five hundred dollars($500). I - ' - -
U I, as owner of the property or my employees with wages as their sole Reinspection' Fee ! $15 Issue Fee $ 3 • ••
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee ' $ 3
for sale (Secion 7044; Business and ,Professional Code: The Contractor's MECHANICAL FEES
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 • DEVELOPMENT SERVICES REQUIREMENTS: . - .
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0
sale. If, however,the building or improvement Is sold within one year of com- Canopy Type II ❑ • Zoning Approved By Date
pletion, the owner will'have the burden of proving he/she did not build or im- Duct-Under Ground • Building Approved By Data
prove for the purpose of sale). /��
❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System - Application Issued By CZ' Oat: L// ./
•
tractorsto construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who - Duct-Ventilating , ❑0-100,000 BTU ❑100,000 BTU SUM RV FEES
builds or improves thereon,and who contracts for such projects with a con- C
tractor(s) license pursuant to the Contractor's License Law). I am aware tnat ❑ . . BUILDING PERMIT $ SMIP $ r Cos
us ❑Exhat System 'Multiple System Repair/Alteration
proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT'
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BR. ICBG# Fire Dampers PLUMBING $ ERMIT ISSUANCE $
• Date - Owner - Heating System& Ducting Registers - PLAN CHECK .25% $ ENE RGV P.C. $
I hereby certify that I have read this application and state that the above ' "00-100,000 BTU ❑100,000 BT • GRADING $
information is c rect. I agree to comply ith all city and county ordinances ELECTRICAL $ -
and state laws a ting to build' g constr tion,and hereby authorize repre-
sentatives of hi city to en r upon a above-mentioned property for • PLAN CHECK 50% $ �m ch
inspection p oases. > i
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25%. $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting: Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
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& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank OGas DOiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test •
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing • •
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final -
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDINGI2 7/2" �A}- •
48. Special Requirements Completed 6
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PE•RMIT 3 7 ` TRACT NO. LOT NO. UNIT NO. f ( I�B'I2 2/05/87 8.20 TI-
'Project Address Gfl WELL FSI€M �G e9- !Nn
Applicant
♦s MailingTYPE OF CONSTRUCTION El NEW ❑ ADD H ALTERATION LI REPAIR
anAddress (9.4L Q. F. Qp re.nl 8�-
Owner's Name MR 'C.Rii, OtlJSON7 Phone 97Q-3T64/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.4 Zone
DESCRIPTION OF WORK/USE OF BLDG. /llv
Address C7a9 /Jr,.Jot CSLCy S Main Building: Accessory Building:
Arch/Eng. License No. 413024 TYPE OF PERMIT�l�t ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front 0
Address gngqr /Yf�KL✓lW-.IC ❑ TENANT LJ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear A _ N
Contractor's NameOa0 L4-'h/198Car)L Phone 300 ❑ OTHER C Right N
Address(mailing)Peng a S ro.sJ sr PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G
L1 bG t9 C O N ST RUCTION TYPE VALUATION$ S Left R
City License No. ZONE - GRADING CU.YDS. ACRES E
LICENSED CONTRACTOR DECLARATION Ping. Ref, # Parking Req./Provided
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in II force and effect. /� /// T
License Class Licen O L11�,nAb $
Date 9-5- Fie. Signature n PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink ShowersELECTRICAL FEES
, -hereby affirm that I have a certificate of consent to self-insure or a certificate •-
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
Automatic Washer Transformer 0 15-50 KW
.600, Lab. C.) - — _
Policy No. Company IYBackf low Irrigation Sewer Cap - a -- Construction Pole Sub. 0 50+ KW
Certified copy is hereby furnished.
_ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter 0 u to 100 amps
Date Applicant '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors . Dishwasher Meter Dover 100 amps
(This section need not be completed If the permit is for one hundred ($100)or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I _
shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors❑O-1 HP ❑1%-8
Worker Corlyoiensathen Laws of Califon ` —
Date ' 9 77 t1 Signature �[.�..q��tS.�J Floor Drains Swimming Pool w/Spa F.A.U. • Inc.Solar 09-15 HP 016-15+
NOTICE: If,after making this declaration, yo ould stoma subject to the
-
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance g
of the work for which this permit is issued (Section 3097. Civ. C.) InterEdptore Water Heater Outlets Range X91
Lender's Name _
Lender's Address - ._ Kitchen Sink - Water Service
OWNER BUILDER DECLARATION Switches Sign
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 Garhage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit P
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
'ivision 3 of the Business and Professions Code) or that he/she is exempt - •
-
arefrom and the basis for the alleged exemption. Any violation of Section
.31.5 by any applicant for a permit subjects the applicant to a civil
j.enalty of not more than five hundred dollars($500). -
' 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee i $15 Issue Fee - $ 3
compensation, will do the work,and the structure is not intended or offered Reinspection Fee f $15 Issue Fee - $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES
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 DEVELOPMENT SERVICES REQUIREMENTS: •
employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 • Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By — CD. Date ?
tractors to construct the project (Section 7044, Business and Professions Code: -
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a'con- _
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUI LDING PERMIT $ SMIP $
proof of their worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ 1 am exempt under Section B.& P.C.for this reason - Fir-col/Fact.Bit. ICBG# Fire Dampers I— PLUMBING $ Sr 00 ISSUANCE $
Date Owner Heating System& Ducting Registers
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTL _ ELECTRICAL $ �•� GRADING $ -
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize repre- MICROFILM $
sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $
inspection purpgOs. „A //— a,Y 97 MECHANICAL ' $
Signature C! /Y/L+f� Date TOTAL FEE $
Drivers' License or SS !!!��/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ /
/'CMF 0865-46,rev.30/64 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL &SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical'Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
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, O 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 & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil . '
25. Roof Sheathing 74. Overhead Hydro •
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE 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 ;/.4i/a7 Notes:
•
34. Final Heating & Air Conditioning
J
35. Final Gas Pipe-Test
36. Hood or Canopy ,
37. Final Factory Fireplace , ,
38-. Final Plumbing 0.117
•
39. Water Service-Final
40. Gas Service-Final •
41. Solar Domestic-Final
42. Backflow Preventer
•
43. Backflow Irrigation ' •
44. Landscape Irrigation System I
•
45. Sound Attenuation t '
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -
48. Special Requirements Completed ••
49. Electric Release to Edison 'r '
50. Gas Release to Southern California Gas Co -
•
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF-COSTA MESA PERM NO. TRACT NO. • L T N •BLDG.NO.
CtiNSTRUCTION PERMIT A— 5-14 71/Y-7-- �fj
Project Address ' 2.2I wELL ESLEV i 3 88 9/ 0/61 64•C2 TL OF CONSTRUCTION
Owner DpU-6".1 Phone779-may 0 NEW 0 ADD ❑ ALTERATION
Address SAntE 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS
Arch/Eng. License No. 0 OTHER / ,1 -
Address - DESCRIPTION OF WORK A.P.$ � y...._ ) 73 1 ? l
ZONE f/V�IG•/ PLNG. REF.86 e'
Cdniractor O/S,- Phone - 1 , BUILD! TT°pBgUl1I LDING
TYPE OF PERMIT SETBACK C/LST. P ROPERTY LINE
Address ❑GRADING 0 FOUNDATION �STRUCTU RAL SID TVARD /�/
LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING ❑MECHANICA LSEpF
I hereby affirm that I am licensed under provisions of Charter 9 (corn- i > ) gIIGHTAR D
•
mencing with section 7000) of Division 3 of the Business and 0 OTHER �,
Professions Code, and my license is In full force and effect. REAR YARD(TO P/L)
PROJECT DESCRIPTION .
License Class License No. PKG.SPACE REQ. PROVIDED
Date Signature SQ. FT. _
WORKERS'COMPENSATION DECLARATION OCCUPANCY �7 CONSTRUCTION TYPE STREET WIDTH PARK FEE$
I hereby affirm thatVALUATIONhave a certificate of consent to self-Insure ora ( 19Z• ZONE ZONING APPROVED BV Ariowaw DAT AsAr )
certificate of Workers' Compensation Insurance, or a certified copy i _ f, 1/s���7 �f GT/
thereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
Policy No. Company - •
/
❑ Certified copy is hereby furnished. - REMARKS: 6�(� n,�//�'"-�` ''-
on.
EXEMPTION FROM.Certlfled copy Is IWORKERSed with the<COMPENSATIOity Building N DECLARATION (p / o&f.ktl-ILW�f..a.— 137 ,
(This section need not be completed if the permit is for one hundred .. - .
($100) or less). Z-04/6
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 PLUMBING- PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers'Compensation Laws of California. uwtLLlrvie - VU
ARRt
Date Signature BATHTUBS SHOWERS • 0
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+ KW
revoked.
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-30 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+ HP
formance'of-the work-for which this permit Is.issued (Section 3097.
Civ. C.).
N. FINKS FLOOR DRAINS FIXTURES OUTLETS . SWITCHES -
Lender's Name - ^ t; '" .,., - - LOOR S-
Lender's-Address - - ` . • - .. - , DRINKING FOUNTAINS. GAS TUBE SIGNS •
OWNER BUILDER DECLARATION r INTERCEPTORS ,CLARIFIERS POLE LIGHTS -
I hereby affirm-that I am exempt,from She Contracto['s-License Lawlfor
the following reason (Section 7031.5.eusiness and Professions Code: SWIMMING POOL l .P TRAP WryU
SI FMK- ' N
Any city or county which requires- a permit to"cohstruct, alter .. - POLES METERED SUB
Improve,demolish or,repair any structure, prior to its issuance,also-re- WATER-SERVICE ', ALTERATION PANELS MAIN SUB
quires the applicant for such permit/to file a signed statement that'he., _
is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE - AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the -
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT ' -
basis for the alleged exemption. Any violation of Section 7031.5 by
sny applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS
',not more than five hundred dollars ($500).
is I, as owner of the property, or my employees with wages as their .SOLAR TANK COLLECTORS
sole-compensation, will do the work, and the structure is not intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR
Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who does such work himself or • • aDATE
through his own employees, providedthat such Improvements are not
intended or oned for sale. If, however,
ver, the building or improvement MECHANICAL PLAN CHECK En
is sold withinn year of completion, the owner will have the burdens,yinARY OF FEES -
2( �'
of proving he did not build or improve for the purpose of sale). _
HEATING SYSTEMs rs r•r a / Sta
0 I,- as owner of the property, am exclusively contracting with
/� licensed contractors to construct the project (Section 7044, Business • DUCTING 0 . LAN CHECK $ ♦ '
(9antl Professions Code: The Contractor's License Law does not apply to
, PERMIT
an owner of property who builds or improves thereon, and who con- • 0-100,000 a
tracts from such projects with a contractor(s) licesned pursuant to
the Contractor's License Law). 100,000
L! 0 I am exempt under Section B.& P.C.for this BOILERS
n reason MICROFILM
PLAN CHECK $
Date OwnerTOTAL FEE 8 '
MECHANICAL $
v
I'hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE t" LESS AD- '
information is correct. I agree to comply with all city and county
ordinances and ate law elating to construction,and hereby authorize
representatives of thi city enter upon the abov mentioned ■,
property for l sped —
p es. y
/
Signature A Date
ISSUE FEE
Drivers' License S
CMF 0865.4 White-Bulltling;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
•
CONSTRUCTION AND PLANNING POOL&SPA , - • ..
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soirpipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn-- ' 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. SteeTReinforce s.. , g_qj 21/ 47. Rough Plumbing & Pressure Test -
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings" So Kn`�e s -b_/3_g/ _ A-74 49. Electrical Conduit-Undrgrn
8. Foundation `�' 50. Gas Pipe, ❑ Undrgrn,Test
9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap ❑ Undrgrn
10. Structural Floor System 52. APPROVAL TO DECK '
11. Property Sewer Line& House Connection _ 53. Backwash& Receptor-Final
12. Street Sewer Connection 54. Heater &Vent-Final
13. Rough Plumbing _ 55. Plumbina System - Final
14. Rough Electric-Conduit - 56. Electrical-Final
15. Rough Electric-Wiring • 57. Solar System-Final
16. Rough Heating & Air Conditioning b8. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathing /
22. Frame and Flashing - NOTES: Nl)ssi j tit/47oc) T u/ard 6o eT by tdooa
23. Insulation P-ern(.¢- . , So wn a. vert; ca/ rm./ nrif C@n 1-proc/
24. Lathing & Siding _ n21.erL ?Ah
pY in 7h7Po A Not pN ONait rA4r4no
nee.
25. Drywall Nailing •.h a o k 4,vtts or yeti ecif s eo 6/ Many J a t,,,s,ed
p
26. Plaster Brown Coat - ;let pH o q a`ouw d - • h T 6'/
7 - B-/2.
27. Electrical Power Meter-Final ):2- -$-13-g/ `1 GewtaeerG•.., ,ws.e(O '- tort liat.
28. Final Electric A
29. Final Heating & Air Conditioning "':,;. ‘',,., 'r .. ..
30. Final Gas Pipe-Test ' •
31. Final Plumbing t -
32. Water Service-Final ,.
33. Gas Service-Final - . .
34. Solar Domestic-Final • -
_ 35. Landscape Sprinkling System
36. Sound Attenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING /0_5--3/ 7
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co. •
42. CERTIFICATE OF OCCUPANCY
No Date
Applicant to fill in all spa es within heavy border lines and sign all appropriate declarations. .
CITY OF COSTA MESA PERMIT NO.Cif TRACT NO. LOT NO?. BLDG.NO. .
CONSTRUCTION PERMIT S� 318'1 3 1 •
iProlect Address 29 ()JELL ESL&`/ LAN. TYPE OF CONSTRUCTION . 8085 7/02/81 184.43 TL
Owner Co'cle . CAL-1-00Phone97, 3,S(tf f NEW ❑ ADD 0 ALTERATION
Address Oa C{ (,U&u.eSLe I C- }'IPSIN ❑ REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS
Arch/Eng.Rpcnn 0.5-Kfl'tA (/ License No.SEZ Uc/ 0 OTHER
./ DESCRIPTION OF WORK F
Address 45( 1' i 0rnr/liin. 0 ^.l,T`5.7 PLI ZONE yi�i 1 PLNG. REF.IA
Contractor tcW eLLFi rn'—zS l(S Phone/$yk,, ( TYPE OF PERMIT BUILDING Tp BUILDING
• Address ac ' - JSE
IN t - 0 GRADING 0 FOUNDATION Er STRUCTURAL SIDE YARD
SC LST. PROPE RTV LINE
LEF
LICENSED CONTRACTOR DECL•RATION 0 TENANT Il ELECTRICAL IIPLUMBING OMECHANICA SIDE VAR•
I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code, and my license is in full force and effect. REAR YARD(TO P/L)
C-53 Qy)T7g•7 PROJECT DESCRIPTION
License Class p License No.- SQ. FT. LI in(� PKG.SPACE REQ. PROVIDED
Date 'l-��I Signature 1L-�Li'{n f Lin
WORKERS'COMPENSATION DECLARATION " OCCUPANCY_CONSTRUCTION TYPE .STREET WIDTH PARK FEE$ ,
I hereby affirm'that I have a certificate of consent to self-insure or a VALUATION IR MO- ZONE ZONING APPROVMY /' 7
I DATE/r ra
certificate of Workers' Compensation Insurance, or a certified copy - F71QC l L
Policy -1Q .". 1 •Lab.CJ. c•• ply A GRADING CU.YDS. ACRES
SPECIAL CONDITIONS:
Policy No. `^' "1 �7i7 Companyrjll � w' `LY Fret...
Certified copy Is hereby furnished. - REMARKS: . -
:edified copy Is filed with the city Building Division.
_XEMPTION FROM WORKERS' COMPENSATION DECLARATION '
(This section need not be completed if the permit is for one hundred .
($100) or less).
I certify that in the performance of the w rk for which this permit is
Issued, I shall not employ any perso _
a y manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subje CL I12_oO� rkers COmPensafi0 O} California.
LEA/USING GARAGE
Jj�'(�� BATHTUBS SHOWERS
Date - Signature • •
NOTICE: If after making this declaration, yo hould become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers;-Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such-provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+ KW
revoked. .
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP
I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC.SOLAR) 10-50 HP 50+ HP
formance of the work for which this permit I.Issued (Section 3097
Cl v. CJ. �l'70�t)-1 _,QU A FLOOR SINKS FLOOR DRAINS - FIXTURES OUTLETS SWITCHES
Lender's Name •4-1*-0/54'
Lender's Address)`i'-(O I G.i)'---+ o—, ' s .(":., J..+ DRINKING FOUNTAINS , GAS TUBE SIGNS
OWNER BUILDER DECLARATION -
INTERCEPTORS CLARIFIERS POLE LIGHTS - •
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP / LUNSI Fut.HUN
Any city or county which requires a permit to construct, alter, (O (..` POLES METERED SUB
improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE - ALTERATION PANELS ' MAIN SUB
quires the applicant for such permit to file a signed statement that he
Is'licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT 9
basis for the alleged exemption. Any violation of Section 7031.5 by 1 Q� 5�A
a" ' applicant for a permit subjects the applicant to a'civil penalty SEWER CONNECTIONS
it more than five hundred dollars ($500).
as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS
sue compensation, will do the work, and the structure is not Intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE
'I Contractor's License Law does not apply toessuch
owner a property 3 APPLICATION'APPROV ED BY `"77/5 DATE 70/
who builds or improves thereon, and who does mph work himself or ISSUE FEE ,t
�. through his own employees, provided that such Improvements are not
Intended or offered for sale. It, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
Is cold within one year of completion,the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING o
I ❑ I, as owner of the property, am exclusively contracting with _HEATING SYSTEM 0.100,000 BTU PERMIT $ 1J9J)S6 SMIP $ r 1
licensed contractors to construct the project (Section 7044, Business AND DUCTING PLAN CHECK $.( .Oa,. PERMIT
100,000 +BTU
and Profeof Code: The build Contractor's is LicenseoveLaw does not apply to /a ISSUANCE $
towner of property who builds improves thereon, and whoacon- REFRIGERATION 0-100,000 BTU PLUMBING
tractsC from such projectsL with a contractor(s) Ilcesned pursuant to SYSTEM $ GRADING $
the Contractor's License Law). 100,000+BTU PLAN CHECK $
[) I am exempt under Section B.& P.C.for thisBOILERS BTU ELECTRICAL $ 'R.00 $
reason MICROFILM $
SYSTEM REPAIR,ALTERATION PLAN CHECK $ rr
ihr ate Owner MECHANICAL $ TOTAL FEE$ UV
Ihereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE •
nformation is correct. I agree to comply with all city and county PLAN CHECK $ VAN E P
ordinances and s to laws relating to construction,and hereby authorize VANCE PC $_ _ \
tr%presentatives O ithi city to enter upon the above mentioned
(b operty for s urposes.I
_
FINAL FEE $ s n
Signature _ �� Date '� t 84 4/3I
Drivers' License or SS g• / \ ISSUE FEE
CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL&SPA ,
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location62.3.-�,/
•
2. Soil Pipe-Undrgrn 44. Steel Reinforcement /)
3. Electrical Conduit Utility-Undrgrn • 45. Forms \ !
4. Electrical Conduit-Undrgrn 46. Electrical Bonding l )
5. Steel Reinforce 47. Rough Plumbing & Pressure Test '/
6. Electrical UFER Grn • 48. APPROVAL TO COVER-GUNITE q-i-';:il '4Ghi
7. Footings49. Electrical Conduit-Undrgrn 'Li-h1 At.-
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 7-L-ff Rci
9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑ Undrgrn 'Y-L-51 '
10. Structural Floor System 52. APPROVAL TO DECK - 9'-t-q ieci
11. Property-Sewer Line& House'Connection 53. Backwash & Receptor-Final /m-b-f) ,ft/
12. Street Sewer Connection 54. Heater &Vent-Final
13. Rough Plumbing 55 Plumbing System - Final
14. Rough Electric-Conduit -56. Electrical-Final
15. Rough Electric-Wiring -- 57. Solar System-Final
16. Rough Heating & Air Conditioning b8. Fencing & Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
/o -4,- ) /it'
21. Roof Sheathing
22. Frame and Flashing NOTES:
23. Insulation
24. Lathing &Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. i Final Heating & Air Conditioning .
30. Final Gas Pipe-Test •
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Final - J
34. Solar Domestic-Final
35. Landscape Sprinkling System' `
36. Sound Attenuation •
37. Handicap Regulations ,
38. FINAL STRUCTURE & BUILDING
• 39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY ,-1
1,
No Date
.
I APPROVED ONLY §T �
City of Co Mesa Building Dept. _ STRUCTURAL APPROVALPtAMN E> T
5'i.9" (� �^ SU1tECT TO BLDG. D�7, R
BY L/1! 2. DATE.2:--R1-/o w2i OB AT ALL TIMES SEPARATE PERMITS ARE REQUIRED
FOR ELECTRICAL PLUMBING, >>Y �DAT lCO-/
MAKE NOTHESE PCHANGES WITNOurLANS MUST BE ON , PRIOR APPROVAL HEATING, VENTILATING AND OtR" OB O! PLANNINQ
OF DEPT. REFRIGERATION WORK
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED �4 yLsG
TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION Peat
OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- THIS NUMBER MUST ACCOMPANY
SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE ALL\ jsPEcTt2._____9......._._._iNN UESTS • •
PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO
FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL.
THE ISSUANCE OF A PERMIT BASED UPON PLANS AND FOR BUILDINGS WHERE PERSONS ARE TO
SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL - BE EMPLOYED, WE SUGGEST THAT THE
• FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS $TATE OF CALIFORNIA DIVISION DF
IN SAID PLANS AND SP CIFICATIONS OR FROM PREVENTING BE CONSULTED FOR
IN VIOLATION
OPERATIONS BANG CARRIED ON THEREUNDER WHEN
ADDITIONAL REQ IU REMENTS
IN VIOLATION OF THIS CIOE OR OF AM OTHER ORD' • CL
OF THE CITY.
vevt, . iti ,
6S' YdP
I • AIt � tEVA •
� rn0/ c
cdoti
Nyik ib-ww 1 1
1147
,N1`� \1 '•�V �„�I RESIDENCE RESIDENCE I 1
Cei
it
itS424d 11 ei a/WS
y �,�, ,,T
y lbw,"w
�_ _ ..t d ti
,_..._` /tat. _.
t y
I
ZliiPs/r
— _ �___$TREEr �E
_� _ _ _
TYPICAL 611 CONCRETE BLOCK FENCE
Cement Coping Optional — -� '��- GENERAL= NOTES
Channel Block With 1.3/8 —� ,�, _�I;� .�,'
Fences Dotal Top of all I HE MIN MIS
MORTAR: One Part Plastic Cement and
�' _ '� '� �I1=_ Three a Sand
For Fences 5'or Less GROUT : One Pmt Cement Three and
f � One Half Parts Sand
Vert. Bars 3/8" 0 at 4' -0"O.C.. oo s via_ _ COPING: One Part Cement, Three
cc'd ■I I� BI—*
. Parts Sand
For Fences Higher Than 5' c� ■I
Vert. Bars 3/8" Dat 32" O.C. > w _ CONCRETE: Well Mixed 1:2- 1/2 : 3-1/2
cc _ Max. of 7- 1/2 Gallons of
Fill Cells Solid With Grout > z ' ' '' Water Per Sack of Cement
Where Steel Occurs s- - p
Reinforcing Steel Shall — �, It
• �� I • GROUT MAY EBE POURED S R THE TOP
IIII OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A-15-39 too �L —= - ^' -- - - — OCCURS.
A.S.T.M. Z ~ CELLS AND AREAS OF HORIZONTAL REIN-
All Steel to be Lapped Lai m _ --II _ _ _ FORCEMEN7 SHALL BE CLEAR,CLEAN&
f- -- -- FREE OF ALL MORTAR DEBRIS,ETC.
24"or to Code PROVIDE CLEAN-OUT AND INSPECTION
�_I— _ �_ -___.,� . _ __� __I. HOLESATTHEBOTTOMOFCELLSCON-
NATURAL GRADE • TAINING VERTICAL REINFORCEMENT.
—_--1F— _ BONDSSHALLST ETCHERIDED S LAVING
<¢-"�����',+;:�'�j "`� t.79� • ♦ _ _ 1121 ' III_ _ , BLOCKS IN STRETCHER COURSES SO THAT
'.',' V (�;
OWNER COLLEGE PARK_ NO. Jt DATE 9-2.6-57
JOB ADDRESS 229 Wellesley Lane BUILDING PERMIT NO. 5765
GENERALCONTRACTOR Harbor Construction VALUE $ 12,h00.00
AP No. LOT 31 TRACT 3187 FIRE ZONE DESCRIPTION OP WORK Res. w/att. gar.
C JP I & J TYPE V ZONE Rl PLAN NO. 57146
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
,� e DATE NUMBER
Trench '(yam/%F/�orms Steel /O-'S'-,1
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing ,'Z
a-, -fJ
Lathing, In Out ,./ -'
� - F IJ _may- "/
Plaster, brown c9 t,, ., t ---- %E /_ -St jr
Underground soil W/G Pipe Ta405 /0-y-47
Top Out _ __
Furnace :991) M-4-S7.JJ2att ho . Lr-3/-r7 //13'3 ✓
Gas Vents V
Rough Plumbing 44115 /7--4' /�A-57 `(
.et-vit.-.•_hi, 9---2-&-s 7 / I/S 3 ✓
Cesspool Septic Tank /
Prop. Swr. Linea(CHuuse CorC(Jb St. Swr:$ Ii...el-5-7 o.9.,,,-,e,7 (�,>,- - w_ 70 mar-t2_ // 723 ��/i
Sprinkling System rr�P y��
kq" );�g Final /LJfS "NA- ere'
l/
Fi">"aing Fixtures, Final /NIfC .4-.rq-S-JY �/
Final Gas Test /.5— 144 H.! 4-/O-Sr/
Construction Pole 1 1
Underground Power �J �/ '
Rough Wiring 1 fL-IL. t Ageta-,,t 2r-- /2-9-5J 3-739 % J
Fixtures, Final y / \� -
-OCCUPANCY - tF/ Cf /!.dl I /
Form 210-5M-1-57 /
FEE RECEIVED
5746
SEP 1 3 1957
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O.BOX 3IZ CITY OF COSTA MESA
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING BUILDING
ADDRESS 229 I/F L L F S L F Y I A N E
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. 5765
OWNER COLLEGE PARK ND, h
RECEIVED BY qDATE RECEIVED DATE ISSUED
MAIL
ADDRESS 216 So . MAIN ST . /l-.j° 7-iv7- 1 7 SEP 2 6 1957
TEL. ADILDING
SANCITY SATA AN A , CALIF . NL.K I 55577 ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER /O/f,,� ��r NO. i/�/,�(\
CONTRACTOR� LA/u/c ITY NIOC / ZONE FIRE
ZONE
f l FIZZ
TYPE 2/1 ceou b l/,J�J
TEL. APPROVED //
ADDRESS NO. BY DATE (/
LEGAL LOT CORRECTIONS
DESCRIPTION NO. 3 I BLOCK TRACTS 1 O7
A.P.NO.
SIFZELOT /6NO.OF SLUGS.
O5 X 1 i 5 NOW ON LOT
USE T
UI ONG BLDG.
11
SETBACK LINE FROM
c ENTER of STREET 5 z U REAR YARD /LI.
SIDE YARD RIGHT 10 LEFT 5
DESCRIPTION OF WORK
NEW x ALTERATION II ADDITION
REPA, MOVING DEMOLISH
BUILDING NO.OF
SIZE 1524 ROOMS STORIES
EXTERIOR WALL ROOF
COVERING COVERING
USE OF N
BUILDING RESIDENCE & ATTACHED
GARAGE
• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC'
'TION. VALUATION n �
SIGNATURE OF L PERMIT FEE $ SV
PERMIT .E COLLEGE PARK No .
PLAN CHECK $ /3
(//,. $ 12,400.
AU I G NT ' TOTAL FEE $ 5 ^ 4'4`
/or 60
OWNER CARD, CHARLES E. - DATE 6-2 ?-6o
JOB ADDRESS 229 Wellsly Lane BUILDING PERMIT NO. 124.11
GENERAL CONTRACTOR owner VALUE $ 300.00
AP.No. 113-395-06 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK awning over ex.
4Y+2
In�,;�a�s,.cnoNS DATE I GROUP J TYPE Id ZONE Rl slab
Uii`ag[ound Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED
Underground Gas - DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Spthing
TS :�.e and Flashing t.71-M -R- '--4a
li
ILa ng, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
CIL
Building, Final r%S -1 E-&r2
OCCUPANCY
Form 710-5M-11-59 S-B P 12411
' FEE RECEIVED
II 22 ¶8O
COSTA MESA Bo DI le-SAFETY DEPARTMENT ,0 ,
U
. P. O. BOX 817 COSTA MESA. CALIFORNIA CITFINANCE DEPT.
For Applicant to Fill In Completely APPLICATION FOR SP RMIT TA A
TYPE OR PRINT BUILDING
BUILDING Ac A9 /..)€ t,CsI y AAtve
ADDRESS
COSTA MESA. CALIFORNIA For Office Use Only
Ci14 A `es " CA ^ .` I RECEIPT NO. ^ M RgI1T NO.
OWNER f!+_ IGJ! 2 •Rq
MAIL RHCE D EY� I RE ,EDDD I DATE. � 60
ADDRESS 5 A ,+- ✓� J' " ` "- ith��
CC TEL. IesuEllB / w� �J1.
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR c'NGINEER O µl N NO. /7
AD__+SS 41 11/ Q /Z IcJPY/.pc R FIRE
ZONE TYPl GROUP 1ld
CONTRACTOR BYPR / rig° DATE /— et.. e
v
ADDRESS
ZONING 4,0 ,�.��`�
CITY ZGRE — / I PLANS I BUILDING e OP E
STATE TEL. L1IIE/GGAAL / a/'1 fPP"/✓�����9
LIC.NO, �/' _�{��a N`O. DESCRIPTION ,3 ( , f'\.y�.//�f' (/
512E ter X P NOW ON LOTS l / J -39,4 _ V `I-i
OF LOT �l' A.P.NO.
USE OFn Q
EXISTING BLDG, tl IN- APPROVED ALL
A OWED
SETBACK UNE FROM (CENTER LINE BT.1 n
CENTER OF STREET REAR YARD FRONT o IL-) -007 IN.
SIDE YARD I LEFT I RIGHT R.SIDE 510 FT. /J IN.
DESCRIPTION OF WORK
L.SIDE ./ FT. IN.
L5—/'
NEW I ✓II ALTERATION I II ADDITION I REAR /,J ///��1FT. IN. _
REP..... I II MOVING I II DEMOLISH APPROVED (�L /2 DATE �(pa
BUILDING NO. ` / a.....„......„/
BROOMSOF STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
U OF BUILDIfica,,AND WORK TO BA P€RFORMED
A�,4dI,() Fr Or e2 CALM,il.,C
Coal cee?e ; LA e,
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY INANCES AND TE LAWS GULATING
BUILDING CONSTRU O ` • ` VALUATION
SIGNATURE OF I \ , ' A. ` PERMIT FEE $ O . �-O
PERM ITTEF lll"'lll V' �1 - �1 0
I $ /{SGA/ — PLAN CHECK $ 4
AUTHORIZED AGENT TOTAL FEE $ tom( •• ` I