HomeMy WebLinkAbout3069 MADEIRA AVE - Building Permits t r
CITY OF COSTA MESA
t BUILDING DIVISION
>:J- ,' ,� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT I( /805-01805
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cBt/ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 3069 MADEIRA AV - Status: ISSUED
Suite: Applied: 10/07/2005
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 10/07/2005
Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N
Parcel Number: 13916308 Zoning: R1
Applicant: THOMAS, BILL
Address: 3069 MADEIRA AVE
Phone: 714-557-5821 ISSUED BY:
COSTA MESA,CA Zip: 92626-2321
Owner: THOMAS, WILLIAM ROY TR
Address 3069 MADEIRA AVE
Phone:
COSTA MESA,CA Zip: 92626-2321
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000 .
Arch : Eng:
Address: Address:
Phone: Phone:
•
Zip: License: License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE:T/0 EXISTING COMP ROOF,REPAIR/REPLACE SHTG AS NEEDED,1 LAYER 30#FELT,APPLY
"40-YEAR COMP SHINGLES."APPROX 2000 SQ FT
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $7,200.00
Permit: $153.25 Claim Valuation: $7,200.00
SMIP Res: $0.72
SMIP Corn: $0.00
Other $0.00 •
Inspection: . $0.00
Total: $153.97
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
R
itt
Ip
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 it work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754.5626
2446-48(CUM
DECLARATIONS' - °
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and'Ill maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is Issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑)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 Califo la,and agree that If I should become subject to the workers'compensation provisions of Section' ti3700 of the Labor Code,I shall forthwith
comply with these prowls `C9<Z Q�� rDete:ti Ge 7 /
�IkSigneture:�ant o r
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYE TOR CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
c�,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt sec. Business and Professions Code for this reason: ,r��
�SlgriatureP' 'e7<` �� (Dater.-- (Yr / 7 or
Owner ID verified by driver's license. 0 Yes ❑No ('Odea?i L-i race a No. . Expires:
'�
' 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:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the Califomia Health end Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appernit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? lYes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management Districtwr other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescnbed by Califomle+Hea(,,and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance IrortNM 'aliP
'appropriatep IIO on control officer).
CERTIFICATE OF-COMPLIANCEt I mento 1p81,1nder penaltytof Airy the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions•. -/
a
1 •_1 •v '.LC id
Signature: +., -I•' A, .;LI 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 arty for specti p rposes.I agree not to occupy or allow occupancy of any building authorized by this ermit until final in pection.
1� r� this ermit
S
ig ature,OfLegaLOwriei(sf 1,,zalated
And/Or Authorized Applicant Date
CODE t INSPECTIONTYPE PAR 1NTRIALS CODE( INSPECTIONTYPg ME INTTALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �,/ 208 Final Plumbing
Q
200 Final Re-Roof / '14--O 6' 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 •
• .1 I
l''�►"'_ OWNER-BUILDER
VERIFICATION
•
Addres : 304‘?' nekt E//4 Carta Mtu4 Permit#:
A city or county,which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the return of, an owner-
builder verification. '
Attention Property Owner:
An `owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildint;permit will be issued until this
verification is received.
I. I personally plan to provide he major labor and materials for construction of the proposed
property improvement. Yes ❑ No
2. I keihave not) Ne44/E signed an application for a building permit for
the proposed work.
3. I have contracted with the following person(firm)to provide the proposed construction:
Name
Address City
Phone( ) Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone( ) _ Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone .Type of Work
1042.46 (Rev.11/04)
•
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of
California Health and Safety Code and have completed the above information to the best of my personal
knowledge, in compliance with this State law.
Signed: it \ SJ ‹. _ Date: "7- 421-
Name: /-"V/4-4/474-1 , i/`TcNfi
(Printed or Typed)
C.D.L. # '''-77-47.7.
For more information call City of Costa Mesa Building Division at (714) 754-5273.
1042.46 (Rev.11(04)
rill
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - -
C'ti."Y OF COSTA MESA a PE IT NO. TRACT NO. LOT NO. BLDG.NO. '
CONSTRUCTION PERMIT • • ,'7, / 0 -
Applicant'sAddressSOt9 117cds'et, Chit.' TYPE OF CONSTRUCTION UNEW UADD ❑ ALTERATION UREPAIR - 211 50 .TL
PP Mailing1568 7lllll3
Project Address /•1A n`G - ❑ CONVERSION 0 DEMOLIS0 OTHER
Owner's Name Svc.r- s (e s't ft/Mn Phone >5 H Ina OESCRIPTION OF WORK CO' C � GC.Ot-'tP d J
J / ZONING REGULATIONS
•
Address 5 A 1"''e- •
TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL A.P.W+ ZONE
Arch/Eng. License No. 0 TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL PLNG. REF,* BUILDING -
Address ❑ OTHER TO BUILDING ccTgACW oft $T
Contractor's Name O W' C
Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY PROPERTY LINE REAR YARD(TO P/L)
CONSTRUCTION TYPF VALUATION$ 33 OU ° • LEFT SIDE YARD RIGHT SIDE YARD '
Address(mailing) I
• ZONE GRADING CU.YDS. ACRFc PKG.SPACE REQ. PROVIDED • r "
License No. _
LICENSED CONTRACTOR DECLARATION Remarks: -4.4:2211STREET WIDTH PARK FEE$
I hereby ionaffirm that I am licensedision3 under provisions of Chartessi (commenting
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS:
my license is In full force and effect.
License Class License No. PLUMBING
Date Signature -- '
""-1RKERS'COMPENSATION DECLARATION - --
Bar Sink Sewer Cap ELECTRICAL •
reby affirm that I have a certificate•of consent to seif4nsure or a certificateAutomatic Washer - Meter Dover 100 amps' -
Norkers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Sewer Connection
-00, Lab. C.) Backflow Irrigation Solar Collectors Construction Pole Sub Panel
•
Policy No. Company - I - '- - Cooking Unit Sub Pole
y Certified copy Is hereby furnished. Bathtubs Solar Piping
U Certified copy Is flied with the City Building Division, Dishwasher Motors ❑D-1 HP 01%-8
Date Applicant Clarifiers Solar Tank EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONDishwasher SwimmingPool w($pa Dryers OGas ❑Electric Inc.Solar 09-15 HP 16-15+
(This section need not be completed if the permit is for one hundred ($100)or -�
less). Fan Microwave
I certify that in the performance of the work for which this per it Is issued I Drinking Fountains Urinal
shall not employ any person In any magnep SO,a to bete subject to the - F.A.U. Pole Light
Workers' 7-/- s atian lawsof aCalltooTfa.if v� � Floor Drains Water Closet
DateO7'I-if S his decry ln�+Y v Fixtures
NOTICE:If,attar making this of the you shell become subjadt to the Floor Sinks • Water Heater - Range - _
Workers' Compensation provisions of the Labor Colle,.you must forthwith Device Boxes comply ,wltn such provisions or this permit shall be deemed revoked. Gas Service 'Outlets• Water Services
Sign '
CONSTRUCTION LENDING AGENCY Outlets
I hereby affirm that there is a construction lending agency far the performance interceptors • - _ $tending Sectiop5
of the work for which this permit Is Issued (Section '3097 Civ. C.) ,
Lender's NameKitchen Sink ' - Switches Trash Compactor
Lender's Address - Garbage Dis osal
OWNERBUILOER DECLARATION Lavatories
,
I hereby affirm that I am exempt from the Contractor's License Law for the P-Try Generator 00.5 KW 05-15KW
following reason (Section 7031.5 Business and Professiorral.Code: Any city or P _ ,
county which requires a permit to construct,alter improve,demolish or repair Transformer 015.50 KW
any structure, prior to Its issuance, also rogt fres the applicant for such permit Roof Drains .
to file a signed statement that he/she is licensed pursuant to the provisions of 050+KW
the Contractor's License Law(Chapter 9(commencing-with Section 7000)of - - Reinspection Fee $15
r bn 3 of the Business and Professions Code)'or that he/she is exempt - Showers - Reinspection Fee $15 - .
'om and the basis for the alleged exemption. Any violation of Section - Meter ❑up to 100'amps Issue Fee- i -$ 3
.5 by any applicant for a permit subjects the applicant to a civil
penay of not more than five hundred dollars($500). - Service Sink' - Issue Fee $ 3 -
O I, as owner of the'property or'my employees with wages as their sole nDate
.
Zo Zoning Approved By
compensation will do the work,and the structure-is not intended or offered - - MECHANICAL pp
Alication Approved By Date
1 for sate (Section 7044, Business and Professional Code: The Contractor's - --- - - - - -- -- ---- -- --- - --------- ------- - - - I �Y
License Law does not apply to an owner of a property who builds or Improves , Boiler Refrigeration System • /_—y
thereon, and who does such work himself/herself or through his or her own - Application Issued By • t 'Date F}
employees, provided that such improvements are'not Intended or offered for • , Duct Under Ground ❑0-100ADOBTU ❑100,000BTU
' sale. If, however,the building or improvement is sold within one year of com- , ' '
pletlon, the owner will have the burden of proving he/she did not build or im- SUM ARV OF FEES
move for the purpose of sale). Duct-Structural System Repair/Alteration BUILDING •
PERMIT $ rel•at) • SMIP $ - .1/45—(/
u I,as owner of the property, am exclusively contracting'withuicensed con- • -
tractors to construct the,project (Section 7044,Business and Professions Code: Duct z Ventilating_ . PLAN CHECK • $ - ' PERMIT
The Contractor's License Law does not apply to an owner of property who 1 ISSUANCE $
builds or Improves thereon,and who contracts for such projects with a con- ' Exhaust System 0 Multiple 0 PLUMBING $ '
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ GRADING $ •
0 Lam exempt under Section ' B.& P.C.for this reason Firepl/Fact.Blt.ICBO#
Date - Owner Heating System&Ducting 1 1ELECTRICAL $ 1 $
' P hereby cars t )-have read this application and-
andacount t the above ❑0100,000 BTU 0100,0008 - - -
PLAN CHECK $ MICROFILM ' $ •
' Information Is correct. I agree to comply with all city and county ordinances TOTALFEE $
and'state laws relati to building con uction,and hereby authorize repre- Hood o! Type I ❑ MECHANICAL $
, sentatives of j(rl le;to enterupthe above-mentioned property for YPi Reinspection Fea" $15 LESS —
Inspection Du es Canopy Type 11 ❑ PLAN CHECK $ -
Signature ' Date >- /7$"'1 - ADVANCED,PC $
' Drivers' License or SS# : Registers • Issue Fee $ 3 -�lJ-
FINAL FEE
CMF 0865-46 rev.12f82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod•Assessor ' �—
-,'CONSTRUCTION.AND'PL'
ANNING' - - : • i Slit . ' , ' ; POOL ° CPA - " - - - ' -----
>�,i,APPROVALS Permit " •;' '' - °_ ', '•`Date - Inspector .. -APPROVALS,.' Pe..-..c# - - Cate .
Inspector. ;,
' ,1, Temporary,Electrical Service orPole c'. `• 'f -i 52 Pool &-Equipment Location:- • - : '' J
2: Soil Pipe-Undrgrndi. .-c _ , -, `- : , ' 53.' Steel Reinforcement -
3: Electrical Conduit Utility Undrgrnd' .•, - , 54. Forms:' - , . , . - ,
i 4: Ele•ctrical Conduit-Undrgrnd:-`> ▪ t', 55` Electrical Bonding . ' .
5: Steel;Reinforcement• I I ;, -1. ! z7. -sr ri o- - - 56.- Rough Plumbing & Pressure-Test '' ..•.,;:., ` .
6. Electripal LIFER Grnd.', 2 --` ' , i; - o'..: . 57'. APPROVAL•TO;COVER-GUNITE . •
7. Footings I I 1 _ - " I .' a ▪ , . '58. ElectricalConduit-Undrgrnd: . •
8. Foundation ` _ _ = 59. Gas Pipe, 0 Undrgrnd .,Test"• -
9. Water Pipe-Undrgrnd. - ' - "60. Backwash Lines;P-Trap, 0 Undrgrnd.. .
10. Structural Floor System l 5" s - ' -II I' 161. APPROVAL TO DECK .: . - _ • 4 - _
11. Property Sewer Line&,House�Connection, i. _ ' . ; 62. Backwash &:Receptor-Final -•
-
12. Sewer Cap ' - - - `
I f _ '63. Heater&-Vent-Final _ - . ,
13. Roof Drains i , ' -,>. I • ;o :64. Plumbing System ;Final- .• - .
14. Rough Plumbing I I _L. ' : E - 65. Electrical-Final - i , C
" '-15 �Rough Electrical=Conduit r �- � _, l ";r i '66.�Solar System-Final - �- � -" -
q_ _ I 1 I T� � 1 _ '
- 7i16. 'Rough Eledttic Wiring I i . -fit . ;-r •
!- ' X67.'Een- . - .-- .-
' r •I - ci'ng & Access�Approyal' .
17. RoughyWiringSign;.y :1 l •. ' I•_ I : I. V ' I -i '68. APPROVED FOR PLASTERING - 1 I -
LI „18. RBugh-Electncal:T'Bar Ceiling ` ` I ,
_ - I I'' , I . ' 1 :_ 1 '' , 69.'POOVSPASYSTEMSFINAL .
- : 19.'hough Heating& Air Conditioning , I ; ' ., I I I i I I FIRE DEPT. REQUIREMENT, 1 -
_ , 1 . I. ..
20. ,Rough;Factory Fireplace I I I I I APPROVALS Permit# •
21. Ducts,in S(ructur�e•- ' •; ii 'I I l , I I I 7 .0.1 Underground Hydro •- • : ,
e X22. Ducts, Ventilating ': . I 11 .I I I I 1 ; i i I •71.,Product Piping 0 Gas 0 Oil '
23. Gas Pipe-Rough& Test o I ', -1-1---I F-1---.1-, . 72.E Underground Flush : T '
24. Roof Framing; ' c 'I n , 1 , ; , 1.: I , 73.' Under rnd.Storage Tank'D Gas ❑Oill
tl' � I 1 li' .I, � , . ( 1 . g s ,
25_'Roof Sheathing 1 I _ I 1 :h 1i: 1 I ' I ' I r. V E I . 1 ,! 74.1 Overhead Hydro i " -
11-26. �T-Bar Ceiling (Structural).& Monocoat`- ! I II 4. I 75.,Dry Chemical ' . .'
27. Frame and Flashing • . j . .! 1 I I i I I , I 1 76.! Dry Standpipe
` 28. ;Lathing &Siding 1 - i- ' . iI it I I 1 .
y I I i-. I 77. FIXED SYSTEM FINAL ,
G 29ylnsulation ; r '', :' I tri i1 I I ! 1 I! I I '78.; FIRE PREY. FINAL - '
_30. Drymiall Nailing ! j + " � . N C I ; I 1 i 1 I 'Notes:, 3/...,09/M--' Cj /ug4,4,•4,
31. Plaster Brown Coat I I Ij i 1 i ! I 1 / r �a{
�- �,'�IeSAt/�.� !3� jK`is{� /nV/r�l� lK.2T'
-32. Electrical Power Meter-Final Ii 1` I i i i t I ! !
2
33_ Final Electric '' 1 I I
U,i• : -I - - -
. 34. Final Heating & Air Conditioning U ' ' 1 • ' r 1
35. Final GaS•Pipe°Testi '_ 1` I ^ ` :i.,' 1. 1" :•, ! . • ' - -
36. Hood or Canopyoi".1 ' I . i "I 1 _ - . i _
`.
37. Final Fadtory Firep _
lace I IIIri I 3� I I . ' -' I I-N I ! I
38. Final P.Iuinbing I • •.i I 1; ' ' ♦ 1 1 1
I • 1 1 i
39. Water Service-Final) I f J 1 I .� ,
1 I
40. Gas Service-Final 1 -• '
41. Solar Domestic-Final I ! ; , • H l- _I`I__1 * __I_ - _ !__,'_ ,__ _ _ __ y
42. Backflow!Prdveriter' I 'hI i i •
' '
L ; g I '_ I e 1 71' "•, i ...
i
43. Backflow Irrigation. i I
44. Landscape Irridatiph System I I ,• •Ir 1I ` I `. 1 I c-
444751
1 • u; I f _
45. Sound1.:!P7'
ttenuation at at1 I I - ! c1 - - ^'46. Handi 'Regulations' . i ; -! ' , ;. _ - F-
47. FINARUCTURE & B,UILDING i •
8. Special)Requirements Completed) Y 1 I i =I i I I • ,
9. Electric Release to Edison I I I f��. i- _! _ i_ i-` __ - -. • 1
50. Gas Release to Southern California Gas Co I I , 1 - '
[ N!'-
CERTIFICATEOFOCCUPANCY I.__ 4_ , " ik
s . I I Date ' I' Hti* •
OWNER SYOAI'IORE LAND CO DATE 6_99-59
JOB ADDRESS 3069 Madeira Ave. BUILDING PERMIT NO. 9747
GENERAL CONTRACTOR Malgren Cont. VALUE $ 16,936
AP. No. LOT 69 TRACT -336 3 FIRE ZONE DESCRIPTION OF WORK res att gar
V
IF 'ECTIONS ) -0-411 DATE GROUP I & J TYPE ZONE HI
L. ,rground Soil /on U.G. Water L.A././629•37 SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER
Overhead Water and Gas _
Rough Heating 7 ti zJs , ; L „ ,f-dS-59 O L/:� Tr
Rough Plumbing _V-Y�/p/r/ 0 . , 2-/..S9 i 'Y,:2_ �_= b
Miscellaneous , dr�
Prop. Swr. Lint/ House Co 'n, St. Sv"� 9./639 S,./a.`-y (`'.,Gr Z %-/6 -57 /sir.'-
Sprinkling System (/ _.� 2
Heating, Final (�f'�2 CO /
Plumbing FixturesL/— L!/fr-14'rep
Final Gas Test /6-/, ` /.ter,9-1/,%474
Construction Pole
Underground Power
Rough Wiring /27.0.-. 9./G 5-4s l d.7i-tez, 7-./ -SY /64 /g
i
Trenchese5lB'h/ Forms(i'tVStee1/'j ro-. `_
Floor System - 7-7-e- 1_.
Steel Reinforce Chimney Re-Rod
Bond Beam
Sh4nthing ,f' U- 4`H-al'
I`_:'t:a and Flashing In ii,- 9-' -
LaLi ing, In I� Out R/ 10-51
Plaster, brown coat errOihr /,_e/
Plumbing Fixtures, Final R W of„/, Q
Electric Fixtures, Final / '` /fLO q h r/Z ba
Building, Final (
OCCUPANCY
Form 410-3M-459
9747 ., ! .. .r l-e'. .:
COSTA MESA BUILDING-SAFETY DEPARTMENT "'30 1959
P.O.BOX 317 COSTA MESA, CALIFORNIA ;j% ,I':r,r DEP(.
•
• 'FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDINGJD f .44D�/4 /4,7 .ADDDRESSRESS( COSTA/ MESA, CALIFORNIA
• .FOR OFFICE USE ONLY
RECEIPT NO. I Y7 —7
. OWNER-SyCdRlOre LanD CO. Y
MAIL 10835 Santa Monica Blvd_ RECEIVER BY I DATE RECEIVED DATE ISSUED
ADDRESS J Y S9 `--1'l /
• Los Angeles 25 gr23287 Co
g TE . BUILDING
CITY NO. ADDRESS
ARCHITECT
OR •NEER L. C. Major NO. COSTA MESA. CALIFORNIA
RE
ADDRESS 11015 S . Paramount Blvd.. Z NE y� -�7% .11--;7_
Malgren Const STATE 153335 APPROVED
; CONTRACTOR LIC.NO. BY • DATE
ADDRESS 10835 Santa Monica Blvd. ZONING
LEGAL LOT ZONE NO.OF USE OF NEW
DESCRIPTION NO. 6 I BLOCKI TRACT336. �, PLAN9 BUILDING -(/D _
l A.P.NO. APPROVED // ph
BY DATE i
. OF LOT 100 95 X 70 33 NOW ON LOT SIZE NO.OF SLOGS.
REQUS EVES
0 REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. _ p FRONT SSD FT. IN.
SETBACK LINE FROM 50 28
CENTER OF STREET REAR YARD ��
R.SIDE 6 FT. IN.
• SIDE YARD I LEFT 5 I RIGHT 5 L.SIDE e' FT. IN.
DESCRIPTION OF WORK
REAR ..„249 FT. IN.
•
NEW Ix II ALTERATION I II ADDITION I '
REPAIRREI II MOVING II DEMOLISH I
cF4 bICJG NO.OF
1707 IIRO MS 6 STORIES 1 •
EXTERIOR WALLStUCCQROOF wood. shingle
'. COVERING ICOVERING
• USE OF BUILDING AND WORK TO BE PERFORMED .
Dwelling new construction
2CCR Att. Gar.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
. PLY WITH ALL CITY O INANCES AND STATE LAWS EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRU I N. // VALUATION
SIGNATURE OF n ,_ J///��(', PERMIT FEE $ ��
• PERM ITT EE��� {>E/7Q�7C 6lr-OLID `�' / /
/_ PLAN CHECK $ /Op,/
"//
;' AUTHORIZED AGENT • ft Y/
// .. / . $/ / 0� TOTAL FEE $