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Home My WebLink About3056 MADEIRA AVE - Building PermitsJob Address: 3156 MADEIRAAV Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 13913206 Zoning: R1 R1 Applicant: IOFI, SEMI Zip: 92626-2324 Address: 3315 E MIRALOMA SMIP Com: Address: SUITE 114-C#5 Phone: 714-337-5674 $0.00 ANAHEIM, CA Zip: 92806 Owner: RICHARDS, JOHN T Address 3156 MADEIRA AVE License: 785463 Arch : Eng: Address: Address: Status: ISSUED Phone: 10/15/2003 COSTA MESA, CA Zip: 92626-2324 Contractor: IOFI ROOFING CO SMIP Com: Address: 3315 E MIRALOMA Other: $0.00 SUITE 114-C#5 Phone: 714-337-5674 $0.00 ANAHEIM, CA Zip: 92806 License: 785463 Arch : Eng: Address: Address: Status: ISSUED Applied: 10/15/2003 Issued: 10/15/2003 ISSUED BY: 61 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF, REPAIR AND REPLACE SHEATHING AS NECESSARY. COVER WITH 40 YEAR COMP. INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.59 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.84 SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 FEE SUMMARY Calc Valuation: $5,900.00 Claim Valuation: $5,900.00 PLANNING & ZONING Left 0-0 Right 0-0 Left 0-0 Right 0-0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 ?46646 (&W) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirn under penalty of perjury one of the following declarations: ❑ • I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. , + ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Leb3r Coda, for the performance of the work for which this permit H issued. My workers' cram� n19N8��tip9n Insurenca car nd policy number are: Carrier. �Q Policy Number. (This ction need not be completed if the pe it is valued at one hundred dollars ($100) or issa.) 1 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 that If I should become subject to the workers' compensation provisions of Section 37pp of the Lal{{ Godo, I shall forthwith comply with these provis - �� / / `I Applicant Signature: _ Date: /I J / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML 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 ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Uc. It Class A Contractors Signature: C21 SteDate: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Data: OWNER -BUILDER DECLARATIONS: I hereby affirn 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 B (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).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property talc bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feel in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B. California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a Permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the appllcant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reponed 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 if and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑No (Section 25533 of the California Health and Safety Code. with some exceptlons, requires registration with the Costa Mese Fire Department by each business which e1 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 loot of compressed gas at standard temperature and pressure). 3 Does or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing With the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject ofthis application a ertnit for such construction or modilitatlon from the South Coast Air Quality Management District or from any other air pollution control district or agency? jJ Yes � No (Section 65850.2 of the California Government Cook) requires that the requested information be furnished on applications for non-residential building permits). .............................. ......................................................... _.........._............... .__...._...._.._......................___....................__..................................................................................................................._...........__.... _............. _...... _.._._........... . 8 WIII any part of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑ Yes ❑ No (Il W, the facility must meet the requirement of Sections 25534 and 42303 of the CaliloIT, la Health and Safety Code). 7 a a permit from the South Coast Air pr=l Management a Heal Or other air pollution control distract or add? 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? ❑Ves ❑ No B (If 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: 1 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. �ature 01 gal Owners) 0 ( / Dgle/ :; An l/Or Authorized Ap 'camr Dald—� CODE I. INSPECTION TYPE Ulu ILLS CODE r INSPECTION TYPE PATE ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocIdRetaining Well 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval - 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Buildingl0ocupancy Applicant to fill in all spaces within heavy border lines and sio ' 'CITY OF-COSTA MESA PERMIT NO- ' - TRACT NO. - L o. 10/04/82 16.00 CONSTRUCTION PERMIT E^•S ,.8634 _ - TL '•+•• Project Address Q TYPE OF CONSTRUCTION Owner `-Phone,557, 0 ❑ NEW ❑ ADD - ❑ ALTERATION Address - - --- --- - ❑'REPP.IR ❑CONVERSION_❑OEMOLI$H_ ' 'CI OTHER ' 1-" ' •_. ZONING REGULATIONS '-.. Arch/Eng. - - - - License No: - - - _ - - - - - - - - - - DESCRIPTION OF WORK- r A.P. of - ,-Address' -' - ^ 'r ^" ' - -' 'J-. --- - _ _ -,• _ - - _ _ - - ZONE `" .-PLNG. REF.,' -- - - -- Contractor - - - •Phone s': TYPE OF PERMIT)-" --'- '- '-' BUI DING-. ------ To L W I _ _ Address [FJ� - '.. BS 1 •�� ! -❑ GRADING ♦- O FOUNDATION ST11 RAL rI` +SETBACKC LST. ERTV'LINEr - SID TYARO- - - - -- -I - -' LICENSED CONTRACTOR DECL ATIO - " I herebyaffirm that I licensed LEF -� TENANT ELECTRICAL- ❑PLUMBING- ECHANICA IDE YAR 55 am under provisions cam- rt., - ❑OTHER- RIGHT th Rusin ss mofessi with - section-7000) ,Division 3-of-the tha Business and 'an ice Professions Cotle, my license is in full fort ono effect. 1 REAR YARD (TO P/L) "- '---Cr7o' O' - - -- J3/q -' License 1 License --PROJECT DESCRIPTION _ ss , _ •• r I,-rPKG: __ SPACE REO PROVIDED Dale SQ. FT' - I STREET WIDTH' FEE NAECLARA ON _- - 1•__ ,WORKERS' CO ATIO - 'OCCUPANCV_CO NSTfiUCT10N TYPE _ ,PARK ,I hereby affirm that have a certificate of consent to self-Insure ora_ that I have - VALUATION ' ZONE ZONING-APPROVED BY - DATE r ce to of Workers' Compensation-insure n e, or a certlf zed-copy _ _ :thereof (Si n 380Q,�.a�. C.). GRADING CU. YDS. ACRES- •SPECIAL CONDITIONS: - --t 'cy Nov,7r ComPan :ert lfietl.<opy is hereby furnished., _ _ _ - _ -17, REMARKS: I: 'i, Certified copy is'filed with the city Building Division. (EXEMPTION FROM'WORKERS'"COMPENSATION-DECLARATION 1' (This section need not be completed, if the permit is for one hundred,rBATT _- _ - - , n• - •,. r G, 1 ($100) or Iessl. 1 -'- __ . _ _ __ - _ _ _ _ _ _ _ _ __ _ - -. _ _ _ _ - -. Il certify that in theperformanceof the work for which this permit Id manner 'as,to - -� - '- -issued, I shall not employ any person In any so becomeBING: ❑y' ,' 1_AN-CHECK'• ' ELECTRICAL" PLAN CHECK subject.to the Workers'_Compensation Laws of California.' TUBS- '-- --- SHOWERS" -'- "`- - ! - - -' -' -_- - -'} •• Date Signature -" -- ----- -' NOTICE: If after making this declaration, you should become subjectTS- 1 • URINALS"-'-- "_+ -!GENERATOR -- -- -- --I� 07KW1-10'KW" qrto the Workers' Compensation provisions of the Labor Cotle,-you must'-' comply with such provisions or this permit shall be deemedTORIES DOUBLE CAV$ - -- ;- - -' iTRANSFORMERh',forthwith - - - •APPL'IANCE" 10-50'KW_50 +-KWINKS-----`--- ',CONSTRUCTION LENDING AGENCY DISHWASHERS--"'-- 1 - -' 'MOTORS- I "-0=1-HP_1�10'HP - - ,I hereby affirm that there is a construction lending agency for the per-ICE -- SIINKS_,:; � - - - - - - (INC..SOLAR)__30-50 HPy50-+ Hp' J• ).---- I ,formance of the work for which this permit is Issued (Section 309] f, .SUMPS ^r-' - Civ. C.).- _' ___ .... -. �_.-. - "--- ___ - ..__ ..- _ . - - __ _ - `FLOOR SINKS ---F' INS ''FIXTURES-- OUTLETS--SWITCHES '- --- - ' Lender's Name Lender's Address r-___ DRINKING FOU NTA ,-' "" -� ,GASTUBE'SIGNS '------ - - - --- - -- --- - OWNER BUILDER DECLARATION - __ - --- ---- -- - - ` IfJTEREEPTOR ERS -'- - POLE LIGHTS - -- -- - - -- - I hereby affirm that I am exempt from the Contractor's License Law for t he-fol lowing- reason (Section 7031.5-Business-and Professions-Code—SWIM - NG'POOL - - - -.SUB Any city or county which requires a permit to construct, alter, ' 'POLES METERED improve; demolish or repairanystructure,-prior to its issuance; alsore-' VyATER -''PANELS"' -- "MAIN" --' -SUB--' -' -- "— quires the apllicant for such permit to file a signed statement that he 1 is licensed pursuant-tothe provisions-of the-Contractor's-License-taw-GAS SERVICE OUTLETS'-"_"-�('-- -'SERVICE'---------� --AMP - --- - (Chapter 9 (commencing with Section 7000) of Division 3 of the r Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS --' BTU OUTPUT -1 -- - - br.Y for the alleged exemption. Any violation of Section 7031.5 by I .,.,„pplicant fora permit-subjects' the applicant-to a-civil penalty "bt SEWER CONNECTIONS-- 1 - ---J c more than five hundred dollars ($500). 1_ _ _-_ - _ -.._ __ _ _ , a5 owner of ltie property, or their stru tura wages SOLAR TANK-- -' "COCL'ECTO RS--- so , a d the t will do the work, and the structure is not or r- offered for sale. Business and Professions Code. The or offered far sale. (Section de. The- _ _ SOLAR PIPING SVS. - - ”` ---ISSUEFEE' - - - •' ' -_ -- - j es n 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 ISSUE FEE - "- 'APPL'ICATION' APPROVED BY - - DATE through,his.own employees,-pro vided.,t hat such improvements are not- f ./G intended or offered for sale. If, however, the building or improvement" is sold completion, the owner will have the burden MECHANICAL PLAN CHECK I SUMMARY OF FEES_. j �;..� within one year-of he did not build or improve for the Sale).. BUILDING- ^-- -- - --- -- ----- -.-I of proving purpose of contracting with I, -as-.owner of-the-property,-am Bectu( HEATING SYSTEM 0-100,0008TU �Q I AND DUCTI NG" -- - ^-- - -- -- •PERMIT $-$'.--- - L -M1 --- - -- -- - -` '- licensed contractors to construct the project (Section ]044, Business (Section 100,000;+BTU (PLAN CH ECK $ and,-Professions Code:-The-Contract or's License Lawdoesnot apply to improves COO ,•PERMIT.. ISSUANCE-$. '„ -r,[r . an is from- of spropert echo bus tls or mpr oes thleresn, and who con- c O pursuant-to REFRIGERATION 0-100,000 BTU (PLUMBING $ •, - - - 'GRAD�ING.'_$- projects the Contractor's License Law). SYSTEM- 100,000+ BTU 'PLAN CHECK $ l arnexerript under'Section"'- B:&"P. C. for this 'ELECTRICAL BOILERS BTV reason I Date Owner SYSTEM REPAIR, ALTERATION mic ROFILM'$' �•� - PLAN CHECK- $ --- -- --- TOTAL FEE $'.''• Certify that I have read this application and state that the above information EXHAUSTSYSTEM MULTIPLE -MECHANICAL $ • tr LESS AD- Information is correct.' I agree to comply with-all city and county 'PLAN CHECK $ - - - VANCE'PC -$'_ ' ordinances and state laws relating to construction, and hereby authorize r or \; - representatives of this city to enter upon the above- Bobo ed' property/s,e/cf r1 p S ignatur "-""--' Date w�L Drivers' License 0r � .% - ISSUE-FEE -- - - - - .- - - _ _ FINAL FEE��y`'-L! •- CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA -. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. - Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings _ 49. Electrical Conduit-Undr rn 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test - 9. Water Pipe-Undrgrn 51.- Backwash Lines P-Tra "E] Undrqrn - 10. Structural Floor System 52. APPROVAL TO DECK 11.. Property Sewer. Line & HouseConnection53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing - _ _ _ - - 14. Rough Electric-Conduit - -- -56. Electrical-Final - 15. Rough Electric-Wiring - - 57. Solar System-Final - - 16. Rough Heating & Air Conditioning - - - - encing & Access Approval 17. Ducts, in Structure* 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe=Rough'&Test 20. Roof Framing 21. Roof Sheathing- - -- NOTES: 'r 22. Frame and Flashing 23. Insulation - 24. Lathing & Siding 25. Drywall Nailing - '- 26. Plaster Brown Coat 27. Electrical Power Meter-Final- 28. Final Electric - 29i Final Heating & Air Conditioning - 30. Final Gas Pipe-Test - - - 31.. Final Plumbing 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 39. Special Requirements Completed ' 40. Electric Release to'Edisun 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. - Date OWNER CLARE GONSER DATE 9_25_75 JOB ADDRESS 1056 Madeira Avenue BUILDING PERMIT NO. nRaf. A t. 11Q- 771_()7 LOT 56 TRACT 1161 FIRE ZONE VALUE $ 1 nnn nn Ih_. ECTIONS Signature Dwe ITYPE GROUP ZONE BI SOIL SUBCONTRACTOR A PERMITS ISSUED GAS Dote Numbar I Si nature WATER Vlumbin ROUGH PLUMBING ..Ll Y I -'r' PROP. SWR. LINE Q HOUSE CON. ED > >Q t5• eo J• -r SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE ._.---"—'-'-' � J_ ., T L FA 11 1 SHEATHING C. )o-14 FRAME AND FLASHING r,-rH t •LJ LATHING — IN OUT PLP°TER, BROWN COAT _ -- S" 541-, FINAL HE.. ANG. VENT., REFRIG. AND A.C., FINAL - a 3 - 3 -7S Vs PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL G .J R.CLi� V�tII-L'II BUILDING. FINAL R(� _�� 7 4058 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING — s V < < aw tr OWNER 61.H2c MA— CITY I MAIL h—._. MA— CITY Wm CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECT PA1� **** ,FP �5-�S�P� OOl lr,tr.� 36.50 APPLICATION FOR STRUCTURAL PERMIT OUR FIRE SS ZONE T GROUP /�� n CTOR /Vin G• �- K'�. APPROVED —� BY DATE s m i 0 TEL, ZON NO OF USE OF NEW the State of California Business and Professions Code, Division 3, CITY �� N j 3z2 Chapter 9, and that such licenses are in full force and effect, or I PLANS BUILDING 1 hereby acknowledge that I have read this application and state FIRE SS ZONE T GROUP /�� n CTOR /Vin G• �- K'�. APPROVED —� BY DATE 'l S Z 3 f7N .F m i 0 TEL, ZON NO OF USE OF NEW the State of California Business and Professions Code, Division 3, CITY �� N j 3z2 Chapter 9, and that such licenses are in full force and effect, or I PLANS BUILDING 'ABLISHING A PERMIT FEE A5NLY; !!��'' Z� / I /j CITY . L b ij 1 LIC. NO. YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING ` NO. OF BLDGS. (FROM C/L S EET) [ADDRE 7O u p.p NOW ON LOT OMT FT. LL TAX E BLOC, I � FTSeparate U permits are required for L SIDE FT FT. electric, plumbing and heating work. REAR T. FT. BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. . 906 DATE C.U.P.R 10 APPROVED �Z X 9— , APPROV/442 i 1 hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with n all laws regulating building construction, and I shall not employ any person in violation of the workmen's compensation laws of m i 0 the State of California. I hereby certify that 1 am properly licensed as a contractor underFVALUATION the State of California Business and Professions Code, Division 3, N Chapter 9, and that such licenses are in full force and effect, or I FOR am exempt from the provisions of the State of Calif r a Businessentl 'ABLISHING A PERMIT FEE A5NLY; Profession tle, Div(d Cl ap9.Signature PERMIT FEE $ _ ` V ut of c Permittee Authorized Agent TOTAL PAID E��s S� n m i 0 m N VN UNDER VALUATION I§ FOR m 'ABLISHING A PERMIT FEE A5NLY; PERMIT FEE $ _ Q� V ut PLAN CHECK E 2, Or c LL TAX E f U TOTAL PAID E��s S� JOB ADDRESS 'if [A Afnfleirn Ave- BUILDING PERMIT NO. Y(34 GENERAL CONTRACTOR Malgren Const. VALUE $ 1Y,322 AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK res att Lar INSPECTIONS ?�i_t-p 1 y✓, DATE GROUP l & j TYPE 11 ZONE 1�.;{,rgr0und 5011 /y)4s U.G. Waled/•- Q/ _ SUBCONTRACTOR PERMITS ISSUED round Gas foe DATE NUMBER Overhead Water and Gas Rough H e 3 0 99/'4 Rough Plumbing _ _ % ��i :i/� � htiscellane0us Prop. wrLine House corr sc. swi-L Sprinkling System fM4,7tV c' _ c�n e = •—'_�i= Heating, Final Plumbing Fixtures — — —i Final Gas Test Construction Pole Underground Power Rough Wiring _ Trenches,Q Forms ly "teel %f Si -7-E-iX ,,L Floor System Steel Reinforce Chimney Re -Rod Bond Beam Sheathing I ' _b'�/Ih' F.*,,cne and Flashing �ag, In Out - p, Plas�Ler, brown coat }J"N- �- '7" Plumbing Fixtures, Final ,(w Electric Fixtures, Final - O Building, Final ,y OCCUPANCY I Form 210-3M-4-59 A' I 9`34 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL /N COMPLETELY . TYPE OR PRINT w COSTA MESA, CALIFORNIA III ■ OWNER ESS 10835 Santa Monica Blvd.. Los Angeles 25 - TEL.Br232 ARCHITECT LIC. OR '[NEER L C Majnr NO. ADDRESS 11015 KKK201XX S- Paramount ___ Malgren COnStBTATE153335 N A.P. NO. 56 [BLOCK ITRACA36: NO. OF BLDGS. SETBACK LINE FROM CENTER OF STREET 50 REAR YARD 23 v 1 5 5 DESCRIPTION OF WORK NEV I XII ALTERATION I II ADDITION BUILDING 1746 NO OF 61 SIZE ROOMS STORIES EXTERIOR WALIStUCCO ROOF wood. shingle COVERING I COVERING USE OF BUILDING AND WORK TO BE PERFORMED Att. Gar. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LA REGULATING BUILDING CONSTRUC ICN[ SIGNATURE OF PERMITTE X3 0 1959 1> "IPS"INCE DEPT. •rr: Pi'cn APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. -ERM3IT NiO. . RECEIVED Y I DATE RECEIVED DATE ISSUED BUILDING ADDRESS COSTA MESA, CALIFORNIA FIRE ZONE TYPE GROUP APPROVED BY DATE ZONING IONEZ?j I NO. OFI PLANS USE OF NEW BUILDING APPROVED BY DATE J YARDS EVES REQUIRED ALLOWED (CENTER LINE ST.) FRONT FT. IN. R.SIDE FT. IN. y� L. SIDE J FT. IN. REAR FT. IN. THE AMOUNT SHOWN UNDER VALUATION PURPOSE OF ESTABLISHING A PERMIT IS FOR THE FEE ONLY. VALUATION L $ ` 7� 31 � PERMIT FEE $ �� PLAN CHECK $ TOTAL FEE 5 or J Q i } J cc W CL O Cr IL Z W COSTA MESA BUILDING—SAFETY DEPARTMENT P.O. BOX 1200 Costa Mesa, California PA SEP 75-75c;s,,IL OO1159Rv*****4.99 F I s s t s s I TRACT NO. ELECTRICIAN ELECTRICIAN 7)4o Fn r, . YIf1erte'r- LOT NO RECD BY- Y PERMIT��'NNrO�. , e�5 y"y'e DAT SSUED ADDRESS X32 -;z Lr 1r)LC— C-,DACJ i*U4 BUILDING USES CITY (7DrS7"A 2i —q A- TEL. NO. S'VS977C, 1 STATE LICENSE NO. Z y Z i7 G CLASS /S l BUILDINGlosses ADDRESS �rr�D�` (elyi` CITY LICENSE NO. NO. ITEM EACH PIIS r COSTA MESA LIFORNIA � l ' Dwelling, Sq. Ft. f f NEAREST h CROSS ST. Garage, Sq. Ft. ! OWNER First 20 Gullets, each F MAILADDRESS�a.6nC !/—o Outlets, Additional q .rS/ CITY i <FJ yE; JJ TEL. NO. "l 3210 First 20 Fixtures, each HER EBA&NOWL EDGE THAT I HAVE READ THIS APPLI. ION A� ANDASTATE THAT THE ABOVE IS CORRECT AND AGREE O�COMPLYyWITH ALL CITY ORDINANCES AND STATE LAWS REG- UILATING ELECTRICAL WIRING. CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF FjCALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF ' THE SINGLE FAMIILLYRE/ESSIDENTILL-PfROOPEERR/TY(^�DESCRIBED ABOVE. Signature of PERMITTEE Fixtures, Additional Dryer .py.l .e C Fon •^- Heater ,a N Oven, Domestic rC NO. ITEM EACN FIEF Pole, Construction �,� . �f �, Sign & 1 Trans. 2.00 Range, Domsstie� Transformers KW Misc..( -V%l� Nf� Generators KW Motors (See Sch ule( His HP HP Sub -Total Fees APPROVALS Meters, sa. . Ists"CTOE DATE TEMP. POLE Permit Fee 3 00 . UNDERGROUND CONDUI T ROUGH � I Sub -Total Fees FIXTURES POWER Total Fees /] (/ T' //////,yj T %�+j ` i UTILITY CO. NOTIFIED FINAL CMF 0313-46, rev. 7/75 For items not listed refer to Fee Schedule BLDG. PERMIT NO. Q �� 0 W t— Q Y J LLI W Q. O a Z W S Lu W LL c D COSTA MESA BUILDING—SAFETY DEPARTMENT P.O. BOX 1200 Costa Mesa, California iFF `L5 75�;5'001160gL ra'� 1.00 ,[/ CONTRACTORO lY3 G - /T A�Til6 PERMIT NO. TRACT NO. RECD. BY'�'^ I iy I a LOT NO. DATE ISSUED BUILDING USE ' �+, �7 Address 32-3q I.'JIeie i;QA/ yqo City (` r�S]`� i C f} Tel. No. f�' 2` \.KJ�I t1 tt IF BUILDING /Jf dS� ADDRESS State License No., 2t(2 776 Class. / COST MESA. CALIFORNIA CROSSNEARESST. fl "A H Lr//Y 4 City License No. / OWNER C� k'r YC1 NUMBER TYPE OF FIXTURE OR ITEM FEE lL3.G.'Ia'e MAIL J S� ADDRESS130-T& jdhl J Y Water Closet (Toilet) y� p CITY t Fm 1�, i /%' �R TEL. No.—k—f'7 JL%0 Rath Tub Shower ereby acknowledge that I have read this application d state,t6aV thel above is correct and agree to comply Ih, aH! City Ordinances and State Laws regulating plumbing; '' V I certify that I possess the above valid state of Cali- fornia classification or I am the legal owner of the resi- l property described above. :Signature o/ SignaT Permittee - Lavatory ('lash Basin) Kitchen Sink ... / Laundry Tub or Tray "'; /� r I Serviee sink Floo, sink itl Floor 'S". ��?� Drum _ Dishwasher �E' tl 'yjY Drinking Fountain Urinal INSPECTION RECORD Garbage Disposal /- Automatic Washin,,M_, ti. %- ` --5 ! -(.i Water Softener., III R ; ' Water Heitc, &''Vent Rece torn % ^ Swi`MtPo'nl Filter System Gas System . Outlets Lawn Sprinklers Instillation or Alter ion Water Pi in APPROVALS Back Flom Prev ter Sewer ft s INSPECTOR DATE —Prop, U/G Soil I I Cess ool tic Tank U/G Water I I Services—Water ❑ Gas O I I scell aneous Rough Plumbing I I Sprinkler System . Gas I I Property Sewer I I Pool Receptor I I Filter System I Pool Heater I I <". Miscellaneous I I Issuing Permit .^21 00 I _ TOTAL FEE t I i/ I /`) ? Final Gas I I Plumbing Final I I Utility Co. Notified FORM eu-x+ BLDG. PERMIT NO. ' , -