HomeMy WebLinkAbout1625 WHITE OAK ST - Building Permits -
:�,�'�5`s'P CITY OF COSTA MESA
171.7)1 BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER
PERMIT 00-00915
•
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1625 WHITE OAK ST Status: ISSUED
Suite: Applied: 06/21/2000
Vicinity: HOUSE&ATTACHED GARAGE Issued: 06/21/2000
Parcel Number 13921402 Zoning:
Applicant: FARMER, FRED ISSUED BY:
Address: 915 W COLLINS
Phone: (714)997-4541
ORANGE, CA Zip: 92667
Owner: OBERST, DENNIS
Address 1625 WHITE OAK ST
Phone: (714)429-9277
COSTA MESA, CA Zip: 92626
Contractor: CHRISTOPHER ROOFING CO.
Address: 915 W COLLINS
Phone: (714)997-4541
ORANGE,CA
Zip: 92667 license: 624118
Arch : Eng:
Address: Address:
Phone: Phone:
•
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(26 SQ).TEAR OFF EXISTING ROCK ROOFING,
INSTALL 2 LAYERS OF 15#FELT UNDERLAYMENT,&REROOF WITH 25 YEAR COMPOSITION SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,120.00
Permit: $97.25 Claim Valuation: $3,120.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
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:
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
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
rk for which this permit is issued.
1 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 er end policy number are: z��)OV ‘2-,rCarrier: (en% Cf 17 �N,D Policy Number:
(This section need not be completed it 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 California,and agree tif I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply
nawith
e: provisjOns.) ? -2/—ob
Applicant Signature: `i1/`I ..,x Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 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.Lie.N C.< Class k C 3?
Contractors Signature: V F �ZA4 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).
Lender's 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 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.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. Q Yes 0 No Drivers 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Gm 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 tile 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 Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the 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.
._..__.f. _.. M presently fully
complied
............. .........."-_
4 If an RMPP is required,has Section 25534 of the California Health and Safety Code been fully cwish? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air(Duality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the Califomia 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 ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Ouatity 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 agree to comply with all state laws and 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.
9,4:2get Legal Owner(s) Date
And/Or Zithorized Applicant Date
CODE I INSPECTIONTYPE DATE INTMALS CODE1 INSPECTION TYPE LAME Ni rnuy,4
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final a 208 Final Plumbing
200 Final Re-Roof lP a7'an C A7Jf__ 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
2446.46
'manna' 1625 WHITE OAK ST WIT: CITY OF COSTA MESA - BUILDING PERMIT t
OWNERS NAME IF KNOAN: MILA GRAVES J,PERM NO: P 080016
ADDRESS: SAME
1625 WHITE OAK ST lq - H PERMIT NO: P 080016 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA, CA 92626
APPL.MAILRIO ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT ORElalEER: UC NO.: JOB DESCRIPTION : GAS REPIPE SQ FT:
ARCH.OR 0110.1 ADDRESS: WIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /
CONWACTaNSNAga: JOE CARLOS PLUMBING ( 714 ) 548-5558
CONTRACTORS MAROC 1675 SUPERIOR COMMENTS : NO ' B ' PERMIT INVOLVED / GAS REPIPE ONLY
ADDRESS COSTA MESA CA ucHD_ 385443 *******+E*SEN**************,E***** -*i<-***********+E****x**+r***sr******+EA<-** -*sr**+A*****
92627 an: ZONING R EQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby dim under pen*y d Perjury that I am fcrmd under provisions of Cheer 9 SETBACKS
immersing with Section 7070)of Onkel 3 d the Business end Prtlwdan Code,and my license is in fru fare end dfea.
CITY UC.No.: 0 2579 3 L1C.CLASS: C-36 LIG.NO.: 443 EXP: 12/96 MAIN BUILDING ACCESSORY BUILDING
OOP Ire t^ - FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
P COri°a LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under portly of ' ash exempt from the Ccaavam License Lar for the
. meson demd;h,orepa( ynr structure, �,w,e�"he lotathse Seny city county Midi roman=•Permit a signed tenement he"nwe or she
PARKING REQ: PROV: PARCEL : 13921402 ZNE: REF NO:
. licensed pursuant to the mations of the contractors License Law/Chapter s(commencing with Section 7700)at Division 3 of the PLANNING NOTES>
'sinew end Professions Code]or that he or Me is exemp therefrom end the basis for the alleged exemption.My vidrirn d Sees, - >
.031.5 by any applicant for a permit subjects the applaud to acvi penalty of not mm then Ore hundred dollen 15500fl. *******************************************************************************
❑ orofaeredlasale( 7044.Bu ner of the PmcOrli or my aeasandPrdeeMImes with saorntCode�TheContr0ensatman icereeInddwork.se Bpthe*tan ;d"prop'n"'eny DEVELOPMENT SERVICES REQUIREMENTS
who bolds a improves thereon,end who does such work lensed a hersel a through he a her am employees,provided that such
—
improvements axe not intended or offered fa sale.t,however,the building a improvement is said within one year of completion,the ZONING APPROVED BY DATE:
owner builder will have the burden of proving he a she did of bald or improve la the purpose of sale).
❑ I.as owner of the popery,am exclusively contacting with licensed oataclon to construct the pond(Section 7044.Business end
Professions Coda;The Contractors Laer,es Law does not apply to an owner of property who builds a impress thereon are who BUILDING APPROVED BY : - - DATE:
co \ b
I
convects fa such Projects with a contracta(s)Inroad pursuant ant to the Comrepas License Law).
Section: for til
❑ IamexemptunderS. h: B.AP.C., thnaason: APPLICATION ISSUED BY: DATE:
Date: Owner: ************************************** ************************** in .*
I do hereby certify Naw
Nat Ien aware of der, b the requirements d d
Cal/a .Heath and Safety Cale Sections 25505,5,25533,end LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT:N
25534,maandfor thsetlaay Mon bdGgoocpassSWnot(dale onnt e)need boomplywihwilon appkesand the requirementsIce
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
2tamat I or analis bialinocupani mepeeloe) ee.R®omply aih id Nate
codeianare tewnpemnNose
provisions. PERMIT 1425
.
Date; Apprra,1: 2 51 SMIP/NON-RES
WORKERS COMPENSATION DECLARATION:I herebyaMash underpenaby d perjury an a the followingdederatum: PLAN
❑ Ihove and wumein.:tecentime acontuse tose/-Poore for waLrs'measnman.apaadedlotbySwan37000the Labor ISSUE FEE 2200
Code.tothepenamancedunwokforwithwISSUE BUILDING PERMIT PLAN-CHECK TOTAL PAID DUE
ec I have and MI maintain workers'ownpensation insurance,as required by Section 3700 of the Labor Codefor the perfonnence of the TOTALS----> 14 . 25 22 . 00 0 .00 36 . 25,,, 36 . 25 . 00
•
work which the s panne is issued.My workers'compensation Insurance carrier end panumber are:nber e:
Carder: CAT. (-OMP EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 36 . 25 OVER/SHORT: 00
Poky Number: QQAC140SSF 06/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
in nation need not be corn ntad I the pease is for one hundred dollars(5100)a.Mae 36 . 25
0 I candy that in the performance of the work for with this permit is issued,I that employ e y person In any manner so as to .
-43.1he wwken' ***********************************.********************************************
✓ o
pnee6satanim1uun�S�mon 3700 the Labor •
.... J I. 1� .•/ provisions.tem, , _ .t_
/amg:fnoun rortent'compensation coverage is and shall subject an employer to
criminaldaleTYPE QTY I N D I V I D U A L
DESCRZPTIO
N F E E BREAKDOWN
UNIT COST
TOTAL COST
civil fines es toone hundred thousand dollars($100,000).it,edgfbn •me cost of compensation,damages asprotkdd ttor In
Section37aofofN.c.borcoa hre.,Lae.mmy.fwa
PLU 1 GAS PIPING SYS OF - , l. TO 4 OUTLETS 5 . 50 5 . 50
• CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of Perjury that them u a oat tinction lading agency for the PLU 1 GAS RE-PIPE 8 . 75 8 . 75
perlonmame d the work far which the panni is bund(Sedan 3081.Civ.C).
LENDERS NAMEND OF FEES
LENDERS ADDRESS:
•
1 certify that I have reed this application end state that the above idamdun is comas.I pee to campy with el city and assay ordinances
and stats laws rebel);to building mhmemm end hereby auaabe npemeaataee of this thy to enter upon the aboamaatuned progeny
fp Iropedan s a s s. . ��/k
1 2-9f--cwPT ^C S;s4A Ire ooa(-15 (..--
Fire Print Name ,^ • 01 00217334-00217334 TOT 36.25
• 1 .,a,� D.:ID_\1 i� DATE: 10/17/95 TIME: 09:54
Sigmma dGewy .. ._ ,
(5151.46.W) White-Building A Safety;Green-Fla;Canary-Applicant Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNINGPOOL °A
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 s.
4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding -•x
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, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System t 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 OGas OOiI
23. Gas Pipe-Rough& Test Kj_f8_Q6 (Z N 72. Underground Flush
24. Roof Framing U 73. Undergrnd.Storage Tank 0 Gas ❑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
� 1 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning /0 q6 22
�'`'
35. Final Gas Pipe-Test )o4%-(1661,1_
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
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 COST 'M�E-S1 AA CO�N1STRUCTIO PERM PERMI O. TRACT NO. LOT NO. UNIT NO.
Prc nct Address 1�as ti1'N�t\`cC� ` K �a(cale 3 3 779J
Applicant's Mailing\.�ddre55 1533 w. 1" O L't.3 TYPE OF CONSTRUCTION ❑ NEW U ADD LJ ALTERATION U REPAIR
Owner's Name •-` t\lQS �raa OQ S PhoneS145• 1-I2I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
�� mP DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building:
Z
Arch/Eng. _License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front 0
N
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B I
Address - 7 �y�� A Rear
�e&1?tS ufYl 11})( Phoned/a JY70 111 OTHER C Right N
Contractor's Name cc G
Address(mailing) I 33 1. �V'��C�C':l_V� PROJECT DESCRIPTION SQ. FT. OCCUPANCY - K
((�]3W CONSTRUCTION TYPE VALUATION$ s Left R
City License No. l f5 ZONE GRADING CU.YDS. ACRESE
LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Parking Req./Provided
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 1(794 M
with section 7000) of Division 3 of the Business and Professions Code, and KC(�_IV D MAY 2 7 1388 T
my license is in ful or • .nd effect. II
��� LIaL Y L
Lice e C . s • Lir n e N
Date - - Signature' a n ' t _-i.. .. PLUMBING FEES
WORKERS'COMPENSATION DECLARATION
\".. I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers - ELECTRICAL FEES
I'f Workers' Compensation Insurance, Or a certified copy thereof (Section Backflow Preventer Service Sink ❑ 15-50 KW
c 800, Lab. C.)/�t 1 [/ Automatic Washer Transformer
v Policy No. .)0a 42(10 Company"1 e UP_2 Backflow Irrigation Sewer Cap Construction Pole Sub, 050+ KW
Certified copy is hereby furnished.
iete t'fi oq.Y sjfiled with the city BWlgi D' Isi n{�I Bathtubs Sewer Connection Cooking Unit Meter' 0 u to 100 amps
Date -Nes Applicant Y.'K. lYY1
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 1 Fan Motors 00-1 HP 01%-B
Workers' Compensation Laws of California. . _
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑915 HP 016-15+
NOTICE:It,after making this declaration,you should become 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 �1
of the work for which this permit is issued (Section 3097~Civ. C.) Interceptors / Water Heater a DO Outlets Range '
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign '
OWNER BUILDER DECLARATION •
I hereby affirm that I am exempt from the Contractor'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 Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor
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
'herefrom and the basis for the alleged exemption. Any violation of Section
031.5 by any applicant for a permit subjects the applicant to a civil
¢nalty of not more than five hundred dollars ($500). $ 3
IDI, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not intended or offered -- Reinspection Fee $15 Issue Fee $ 3
for sale (Section 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 0 Zoning Approved By Date
plebe r h owner will have the burden of proving he/she did not build or Im- Duct- Under Ground Building Approved By - Date
shrove for
for tthe purpose of sale).
U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
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 0100,000 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 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 l am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ S•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 ❑6100,000 BTU ❑100,00067 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 repro- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter upon the above-mentioned propertty, for h
Inspection purpgsg MECHANICAL $ TOTAL FEE $ OO
Signature yC
•
��
Drivers' License or SS# - .� Dater 19-d % Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK ?5% $
a
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor
• n, nnnnea 1 n_nnnneem -2-.ir e ",
CONSTRUCTION AND PLANNING POOL&SPA
Date Inspector Date Inspector
APPROVALS Permit'# APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
r.
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. Footingsh• •
58. Electrical Conduit-Undrgrr 1
8. Foundation (' . 59. Gas Pipe, 0 Undrgrnd., Test'
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, QOndrgrnd.
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 PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT J •
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 6/�le (-to
39. Water Service-Final *-1 O '
40. Gas Service-Final
41. Solar Domestic-Final -
. 42. Backflow Preventer
43. Backflow Irrigation -
44. Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ' '
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
5,y CERTIFICATE OF OCCUPANCY
No. Date _ •
w` • • 100''7® _L Y ...
AUG 7 1959
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA. CALIFORNIA . _ _ - ,
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 1625 White Oak St.
ADDRESS t�
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
OWNER Rosslane Land Co. RECEIPT NO. I pmmyptio.
iii ti 70
MAIL E. 17th St. RECEIVED BY DATE0-6—s
�RECEIVED DATE ISSUED
ADDRESS 419 , �f Jf—6—S/J nub/1.///0�1�59/�-
CITY Costa Mesa TEL
LI81159 UILDING
ADD ESS // 15--/a-4:41 //CL�GU 1
ARCHITECT Carlson & LIC. COSTA MESA. CALIFORNIA `"_'.l
OR ENGINEER NO.
haddlebrudn
FIRE
ADDRESS p Gard e4 O ZONE TYPE GROUP
CONTR'AWR& Colegrove, Inc. STATE 167293 APPROVEDBY DATE
ADDRESS 419 E. 17th St. , Costa Mesa ZONING
LEGAL LOT f� 2822 ZONE NO.OF USE OF NEW �{yJ��
DESCRIPTION I NO. 1"6 I BLOCK I TRACT �/ I PLANS `/ / , I BUILDING J1l�(a
APPROVED // yy {/ )4j �1/4.-,
�
BY (..ay
DATE O FJ t�- I/
SIZE /^ No.OF BLDGB. YARDS EVES
OF LOT 6D JC 101 NOW ON Loi none REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT L"') FT. IN.
SETBACK LINE FROM59' 31'
CENTER OF STREET REAR YARD R.SIDE 5— FT. IN.
.
SIDE YARD LEFT 5' RIGHT 5' L.SIDE (' FT. IN.
DESCRIPTION OF WORK .' ✓� FT IN.
REAR
NEW I x II ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
S ZIE DING 1365 NO.OF ROOMS 6 STORIES 1
EXTERIOR WAL16tUCCO I ROOF rock
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage.
Plan 110CR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN
UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AN•� . • ATING PURPOSE OF ESTABLISHING
A PERMIT FEE ONLY.
BUILDING CONSTRU £PN.
VALUATION
SIGNATURE OF ( / PERMIT FEE $ 32.00
PERMITTEE SPA.. La _ A- . - -
PLAN CHECK $ 16.00
D e & Colegrove, Inc. s 13,715
AUTHORIZED AGENT TOTAL FEE $ 48.00
, _
OWNER FRANCIS, JAMES F. • Ad61 0 1961 DATE 8-3-60
JOB ADDRESS 1625 ?White Oak St. BUILDING PERMIT NO12638
GENERAL CONTRACTOR Admiral Bilt Const. VALUE $ 111 .00
AP. No. LOT 186 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK Block Wall
IN. -ECTIONS DATE I GROUP I TYPE ZONER]
trA&Vground Soil U.G. Water PERMITS ISSUED
Zl uzrgronnd Gas SUBCONTRACTOR 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 %J orms Stee G=_
Floor System
Steel Reinforce Chimney Re-Rod
1„Q' Bond Beam
be AA Sheathing _
y'F^r:;:ne and Flashing
1 L f.st,ng, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final
OCCUPANCY G( ee9.- 9 Sim/J-60 '.
Form 210-5M-11.59 S-B P 6' - 12638
L.: 12638 F t . h�>e�.d-- V. _.
AUG 1960
COSTA MESA BUILDING-SAFETY DEPARTMENT OP. AUG
DEPT.
P, O. BOX 917 COSTA MESA. CALIFORNIA
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING L'i1r
ADDRESS k.'i Acre O/1 R.. ST-
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. BH),IIT Nq-
OWNER �nNE`-� F. FRANC C30y�
s
MAILS.D,Pt C RECEy�ED BY I DT R3rl p.DO I / 18., a
ADDRESS ` [ eD,.� /T V Oak.,A� TEL.ki faYC BUILDING / ,/�//)L t' A/iLL /jam
CITY rts. Y R /t_S A NO.ll�� TTo ADDRESS/((J��K /�.-L/�C/ CCC✓✓✓CLIt_i
Ili
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS FIRE
��TT �^,y / f y ZONE TYPE GROUP
CONTRACTOR a a...„40;1/44. - ^12.1 £-D....ta .Z APPROVED DATE )
ADDRESS I I V W . 5 2+ ZONING
! ZO NI.O. UB8 OR NEW
CITY /-41-1 .•-t- U_4'.- k ms( I PLANS ��I BUILDING vc /
STATNO. I7 ! J ( NO.TEL �1 7-V `� LEGAL iGti
DESCRIPTION LU t (?6 � <)--P-)-
OF . �
SIZE Y I NO. OF BLDG'S.
LOT (C) G r` NOW ON LOT _ A p NO. �) {J
USE OF YARDS' EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT IN.
SIDE YARD I LEFT I RIGHT F17IN.
DESCRIPTION OF WORK
�/
L.SIDE — IN.
NEW Ix II ALTERATION I II ADDITION I REAR //FT. a IN. II
REPAIR I II MOVING I II DEMOLISH I APPROVED (, /�-j/ DATfly -- el
BUILDING; - NO. OF A/ (/ /�
SIZE ROOMS STORIES
EXTERIOR WALLROOF
COVERING I COVERING
USEIO, c BUILDING AND WORK TO BE PERFORMED
') x (.( ' (In' (0MMuM ,-rq
It,tvCK (='v CE
I HEREBY 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 COY• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONBTRUQION. ` '/� VALUATION 7
SIGNATURE OF 1//AyJ -�\' YJy/P/ / / efPERMIT FEE $ F�
PERMITTEE ^^r�" /�/ �( a
,1) $ / /` PLAN CHECK $ 7 47,AUTHORIZED AGENT T — Z
E
TOTAL FEE $ O
S.