HomeMy WebLinkAbout3174 MADEIRA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
BUILDING PERMIT
Job Address: 3174 MADEIRA AV
Suite:
Viciniry: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 13913203
Applicanr. BEATTY, G. PARKER
Address: 22029 S FIGUEROA
CARSON,CA �
Owner: MARX, STEVE
Address 3174 MADEIRA AVE
2oning: R1 R1
Phone: (310)320-0224
Zip: 90745
Phone:
COSTA MESA, CA Zip: 92626
Contractor: A-1 ALL AMERICAN ROOFING INC
Address: 22029 S FIGUEROA
CARSON,CA
Zip: 90745
Arch :
Address:
Phone: (310)320-0224
License: 642945
Eng:
Address:
Phone:
77 FAIR DHIVE, GO51A MESA, GA 92626
Status: ISSUED
Applied: 08/04/2004
Issued: 08/04/2004
ISSUED BY:
Phone:
Zip: License: License:
SCOPE OF PERMIT
RE-ROOF OVER ONE LAYER OF COMP SHINGLES. COVER WITH 30 YEAR COMP. INCLUDES ATTACHED GARAGE.
Plan Check: $0.00
Permit: $125.25
� SMIP Res: $0.56
SMIP Com: $0.00
Other: $0.00
. Inspection: $0.00
Sotal: . $125.81
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0-0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
left 0- 0
Left 0- 0
� Proposed: 0 �
Calc Valuation:
Claim Valuation:
Right 0-0 - �
Right 0. 0
$s,sao.00
ss,sao.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
E%PIRATION: This parmit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned
tor a period of 1 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, anC all
requlred inspeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2b6&d6 (8/00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby eflirm under penalry ot parjury one of Ihe toliowing decleretions: �
❑ I heve and will maintaln e certlficete ot consent to seli-Insure tor workers' compensation, es provided tor by aection 3700 ot t�e Lebor Coda, br the pertortnence oi Ihe
ork lor wNch this pertnit is issued.
I heve end wlll meintein workars' compen58tion Insurence, e5 repuired by section 3700 oi the Lebor Code, for the pertortnante of the work tor whlth Ihl9 permit Is Issued.
My workers' compensetion Insurance carner antl policy num6er are: �a., ,
Carrier: Policy Number:
(Thls secNon need nof be cromplefed 1! fhe permit is veluetl et ane huntlretl dallen ($f 00) or less.)
❑ I certiy that in Iha pedortnance ot fhe work tor which this pertnit is Issueq I shall not employ any person in any menner so es to become su6�ocl to tha workers'
compensatlon lews of Celitornle, end egree that If I should become sublect to Ihe workers' compensetlon provislons of S tlon 3 0 of ihe Lebor Cotle, I shall fonhwlth
complywiththeseprovisio�� ���0, /
ApplicaoLSigneNre:+ � Dete: �I
WARNINO: FAILURE TO SECUPE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMGLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE MUNDRED
THOUSAND OOILARE (5100.000). IN ADDITION TO THE COST OF CAMPENSATION, DAA41GE5 AS PROVIDEO FOR IN SECTION 3'lO60F THE LABOR CADE, INTEREST, AND ATTOiiNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aMirm ihat 1 am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Olvislon 3 0l the Business entl Prolessions Cotle, end my license Is in lull
torCe entl effect. Lic. N Cless #
CaniraGods�Si9nature / Dete: _ . (.( /1� (
CONS7RUCTON LENDING AGENCY:
❑ I hereby aHirm that t�ere is a wnswction lending agency for the peAormance ol ihe work for which Ihis pertnit is iuued. (Sec. 3097, Civil Cotle).
Lende/s Nema: Lentler's Atltlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:� -
I hereby eflirtn thet untler p nelry�of,perjury t6a41 am EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe lollowing reason (Sec. 7031.5, Business antl ProfesSlons
Code: Any ciry or caunty which reQuires a pemiit to construct, elter, Improve, tlemolish, or repeir eny strucWre, O�or to its issuance, elso roqulres Ihe epplicant for such permit
to tlle a signetl statement Net he or she Is Iicensedpursuant to Ihe proNsions oi Ihe Contraciors License Lew (C�epter 9(commencing with Sectlon 7000) of Dlvision 3 ai Ihe
Business end Professions Cade) or Ihet ha or she Is'exempl therefrom an0 the Dasis lor ihe elleped ecemption. Any violatlon a� Sedion 7031.5 by eny epplicant for e pertnit
subjecis ihe applicant to e civil penelry of not more t�en five hundred dollers ($500).):
❑ I, es owner ot the property, or my employees wlth wages es Ihelr sola compensatlon, WILL DO TME WORK, end the structure Is not intentletl or oflered iar sale (Sec.
7044, Business and Pratessions Code: The Contradors Licensa Law does not apply to en owner ot proparry who builds or Improves Ihereon, entl who does such work
himsetl or herself ar through his or her own employees, provideA ihet suc� improvements are not intended or oXered lor sale. If, howeve�, the building or improvement is
soltl within one year of completion, Ihe owner-builder will have the burden ol proving that he or she did not builtl or improve lor purpose of sele.). '
❑ I, es owner of the property. am E%CLUSIVELY CONTRACTINC WRH LICENSED CONTRACTORS to wnstruct the pro�ect (Sac. 7044, Business antl Professions
Code: The contractars Licensa Law does not apply to en owner ol propeny who huiltls or improves thereon, end who conlrects lar suc� project wl�h a contractor(s)
license pursuant to Ihe Coniractors License Lews.).
❑ I am exampt under sec. Business and Professions Code for this reason:
Siqnature: Dete:
Owner ID verifietl by driver5 licen5a. ❑ Ves ❑ No Drivefs LICen9e No.
Venfication ot Ownership by (rype of document, i.e. - property teu bill or deed):
E:pires:
DIVISION OF INDUSTRIAL SAFETV PEflMR CERTIFICA710N:
❑ I hereby cenify Iha� no excavation five (5) or more feet in depth into which e pereon is required to descend, will be made In connection with work auihonzetl by �his
pertnit, and that no building structure, scaHolding, falsework, or demolition or dismantling thereof, will be more than thlrty-six (36) feet high. (Chap. 3.2. Grp 2, Ar12, Sac.
341, Ttle B, Califomia Adminisirative Cotle).
❑ As awner-builtler, I will nat employ enyone to tlo work which would require e permit from Ihe Division at Indusirial Safery, es notatl ebove, unless such person hes e
permit to do such work trom �he dihsion.
Signature: Date:
Division of Intlusinal Safery Pertnit Number:
ICERi1FlCATE OF COMPLJANCE AND AUTHORVAl10N OF ENTAY: I cerlify under penelry of perjury �ha� I have read this epplication end stata that the Information given is I
correct. I agree to comply with all stete laws end city ordinences releting to building consimction, entl emhoriza representatives of the Ciry of Costa Mese ro emer upon Ihe
ebove-descnbed property for inspeciion purposes. I egree not to occupy or ellow occupancy of eny building authorizetl by this permit umil final inspection.
COpE I, INSPELTIONTYPE
1616 Fixad System Final Fire Prevention
1266 Pool Spe Final
200 Final Ra-Roof
201 Flnal BIaklRetaining Wall
202 Flnal Feciory Fire Placa
203
204
Final Sign
Final �emolition
•_ 1 .111�_
G' /. �ii
I � � //. , t1.��
�"� ate
U
ate
4pDE� INSPECTONTYPE
208 Finel Mechanicel
208 Finel Plumbing
210 Flnel Electrical
212 Final Fire Preventlon
220 Final Plenning Approval
222 Final Si�e
250 Finel Building/Occupancy
PEffi I[�ELS
aooeEssaem�axc: 3174 MADEIRA �AV uxT:
owueasru,xe�c�wwm: MARX, STEVE
eooxEss: MARX, LAURIE
3174 MADEIRA AVE l��
COSTA MESA,CA 92626
APPL. AUI4NG ADDIIE55:
MCNRECT OP FNC�NEEfl: �C �:
IJiCN.OF ENG.'S AOOME55: UNT:
cormu,cTarsrUue PRO-FORMANCE INCORPORATED ( 714 ) 779-6868
ca+m�croAs�uuxc 4 0 8 S E LA PALMA
�ooxess: ANAHEIM CA uc.ra.: 483411
92807 uwr: B
LICENSEU COMRACTOPS DECLAXRTION: I hereby eRvm under peneNy ot pe�jury thet 1 em liceneed under provisiona d Gheqm 9
(c«nmenarp xi1M1 Sec�ion J000) d Oirovn 3 d Ne Businm eM Pmleasiana Cade, ard my liwree ia in II Iwca eM eHe %
aTruc.no.:04070 uacuss: C 20 uc.N q8341 �EXP• 4/96
,Deie: I � � � Coniredor: �%
OW H BUILDEP DECL/�NATION: I hereby elfirm unEer penelly ol perN�Y �hal 1 em avempt Ir radaa Liceme Lew br ihe
w*q reaaon (Sedpn )031.5 Buairoas aM %desvona Code: AnY cN rc caun�Y xAich reCuirea a permil �o mnsWCY. ellx, impwe.
mdoh, or repair eny siiudure, prior lo ila asuenca, eho requires �ha epplireni la auch peimn �o fib e sigrred ate�ement �hm he or eM
licensed W Bueni lo tM Wa+siona d Na Comreaore License Lew �Chepter 9(mmma�ip wnh Seaun )000) d Div'sbn 3 d the
ausinem aM PrWeseons Coda� w thet he or aM ia exemq �herahom eM IM bavn la IM elbged exemqion. My violetion o/5edion
)03t5 by eny appliceni far e permd suEjede Ihe epplirait m a uNl penelry W nd more �hen frva hundrad dollan �$5W�).
❑ �.esowriermu»nowroamv�oM�M+n.w�?%+�ne:eaemmva�.��.mneomaxork.endub.i�ucwre:�imandea
w oXared br ule (Section 904a. Buvneae arM Prdesaiona Cade: The Conveews licenne Lew tlaes ewl eppyto en owner ol DropeM
wM WiEs w inpmvea ihereon, eM rfio does euch xak NmseM a MneO a IMaph he or her own empbyeas, prmkad thel euc�
imprwemenu ere rat intended a oltereE for aele. H, howevec ihe builCinB or unpovemenl ia eok wilM1in ma yeer d rompblian, Iha
ow�roma�. �;n na.e ma wro� d p,�,�,q ns «.ne a�a na a,�m or �m� i� ma Wm� a�).
� 1, ea ohner d Ihe pmpeM� � eMNusivety oonlreclmB �h licensad conlreclon lo crosUud �he DrojeQ (Sedion )OCO, Bueiiwan vM
amressions com: rna cmvma, uceose �a. dom � wvN �o e� ovn,e. d wwahv •mo w�e. « imwwm mereo� e�e .+�o
comrana 1« wch propaa wi�n e mntredor�s) IicenseE Ours�an� to iha Comrae«s Liceroe lew).
� I am evemp urdn Seciion: B. d PC., la Nn imeon:
Dale: O�mer:
I do Mreby ronAy thei l em eware of e�M underslend IM reQuiremenle M CelAamie HeeM1h end Sefery COCe Senions?5505, 25533, eM
2553C, eIW ilai I a eny Mure Wikinp om�pent xill / wll rwi (a�cb ore) med lo comply wih aeid smta mdas vM tM repuiremenU lur
epeimniorwnsiruciionwmadRraionhomlheAi u�e�iiy%f-arepemeniDis�np.qeaideMielmnalrudioneppicelbmertezemqirom�hese
a��a.
Dele: Appliceni:
WOflKEN'S COMPENS�TION UECLAN�TION: I Mreby elfiim uMer penelry d psrjury ore d the Idlawiip Aeqemtom:
� I heve eM xJ meinien e canE'rste d consant Io aeNJm�n lur xakert mmpenaelion. ea pwkeE fa by Setlion �100 d Ihe Lebor
COEe. lor iM perlam�ence d tlw work lor wluch Min permil ia iaued.
� i n� d,a w�� �m�.«ee�� �v�o� ��.�. m�amree sr saa� a�ao a ina �e« cod.. r« ma wdo,m� a ma
xroA lor which ihis parmil ia i»uee. My wakeii mmpenaeiion inaurenca u' eM pdiry number ere:
c�«: PA[ILA INS mC0 EXPIRES
aoicyNumtar. AW('S(1(1Q7RA 09/12/96
�m:.,nn� �d �or m�dsrae � rne w�x r.. b, o�s n��e.ee ea� (sioo/ w�,.�
❑ I cMAy thet in ihe pe�lorme'rw d ihe wak br whkh ihie pertnil is i»ued, I ahell nd employ erry pereon in eny menrim so
become subjeq ta iM xvrken' compenae�ion lewe d Celibmia, rae ihm A I ehouM � coma e jed io �h n
ompan ulio rovieio-5 al,$pdion 3)OU M Ihe Lehor Coda, I ehell f M1' h mmpty w�h Ifroae p�'siwre
• ii � ,
D ie: ' �'� AoWcene.
lnp: Fellun ro sxun worken'rompwuatlon caverap� b unMwNl, mtl �lull wb/�cf en �mp ctlMn�l psmMu enJ
civll flma up ro ons hunaretl fMuurM Gollare (S1 W,000), In xMlHon ro Me ro�t ol rompewH tlerrrpu s� prov/0ed br In
Sxtlon 3]O6 0/ M� LeEor COW, InMs�f, mtl ertamsyS Isu.
CONSTNUC110N LENDING AOENCY: I hereby eifirm under penelly M perN�Y �he� ihere ie e mnabuqbn IeMinO eO��Y �or tha
performerea al �he MvM1 lor xfiiM Ihb peemi re esued (Seeion �08). Civ. GI.
LENDEH'S NAME:
LENDEP'S ADDPE55:
�[BIVh' �� � �1BVB fBBf� �h198{'�KeiKKl Blb 5191B ��19� 1�18 B�MIVB �II�OfTB1101119 NIIBd. � BQRB �O Mfll�/ WIIh 911 MY dld COIII1�Y OI��IIBIICB9
anE slalelavnrelatirp�obuild'mg wnslrudion eM herebyemMrizerapreeen�alivea o/lhis cuyto anteruponthe ebove-menlioned pmpery
lorinsv�ion vurposes.
�, DARR£N S�fiWARTZ /
(S15t�d6.WP�
Dete: —�-=Q��
GreamFle:Cenary-r1DPtirsni; Pmk-Favenue;Goldenrad-Rsseesw
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: M 076202 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; MEC
PERM NO: M 07620"
GOVT: N SUPP; N
PURPOSE: OTH
JOB DESCRIPTION : FURNACE CHANGE—OUT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
+�**�**���**�**�**�****�rx � ����**�*�******+�**�*�*��x x *�r�**�*+�*��r�***+�*��**�*�*� �*
Z 0 N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BOILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13913203 ZNE: REF NO:
PLANNING NOTES>
� �/\.
D E V E L O P M E N T
ZONING APPROVED BY .
BUILDING APPROVED BY :
APPLICATION ISSUED BY
3E 1E 9E iE IE fF'!F iE 1E if 1E iF 1f if 16 jElFlk 1k 3f !E 3E 1E iE iE iE jE fE fE 1E �E if if iF iF 1E iklE 3E 1E jF 1E if 1E iE fE IE �E
S E R�U I C E S R E Q U I R E M E N T S
/�� DATE:
/ y I DATE;
�i��''
— DATE:
�T�F�F i��F �iF7��r�*�F��T���+t3F'iF**�*****x-*x� �r *
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9.00
�� 258 SMZP/NON-RES
PLAN .
ISSUE F'EE r 15.00
BUILDING-DIV-> PERMIT ISSUE PL'AN-CHECK TOTAL PAID DUE
TOTALS----> 9.00 15.00 ;., 0.00 24.00 24.00 ,00
REVENUE DIVISION TOTALS--> C
,.-' BLDG PMT PLUMBZNG ELECTRIC
dE ih iI' i%i4 if iF ik iI' iF iE ii' ih ih ii-ih 1f if if 1h i61(' i41f i('!E iE 1E ik iE fE iE iE if
I N D I V I D U A
TYPE QTY D E S C R I P T I
MEC i INST FORC—AIR/GRAV
24.00 OVER/SHORT: ,00
C FIRE SMIP/TOT GRADING PLAN—CHECK
0
�ElE �E 1E 1E iElf iE if !F jE iE 1E fE 3E fE iE fE 1E fE 1E iE iE iE 1E IElE 3E 16 iE IE 3F if iF dF iF fh iE 1E 1E k
F E E H R E A K D O W N
UNIT COST TOTAL COST
N<= 100 K BTU 9.00
OF FEES
�' l�l','_. ' _ _ ___ __
��� � v �I . ' .. .
• 1�
�' CONSTRUCTION AND PLRNNING � GOG SPA ��
, APPROVAIS Permit # - Date Inspector qppROVALS Permit #' Date tnspector
i, Temporary Electrical Service o� Pole 52. Pool & Equipment Location
2. Soii Pipe-Undrgmd. - • 53. Steel Reinforcement ��
a3. Electriral Conduit Utility•U�drgrnd. 54. Porms
4. Electricai ConduibUndrgrnd. 55. Elecirical Bonding � `�
5. Steel Reinforcement:. 56. Rough Plumbing & Pressure Test �
��_6. � Electrical UPER�Gmd. 57. APPROVAL TO COVER-GUNITE
7�,-Poo2ings _ 5S. E�ectrical Ct�nduit�Undrgrnd.
8. Foundation -� - - - 59. Gas Pipe, � Undrgmd., 7est '
9. �Nater Pipe�Undrgrnd. _. � 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Structural Fioor System 61. APPROVAL TO DECK
11. Property Sewer �L'ine & House'Connection 62. Backwash & Receptor-Final
t2. SeWer Cap - � .� 63, Heater & Vent-Final
13. Roof Drains _ � 64. Plumbing System � Finai
t4. 8ough Plumbin� - . 65. Electrical-Final �
15.'Rough Electricai�Coriduit ' 66. Solar SYstem�Final
16. Rough Electric Wiring �, 67. Fencing & AcceSS Approvai
77. Rough Wiring Si"gn , 68. APPROVED FO#?�PLASTERING
78. Rough Elecirical=T $ar Ceiling 69. POOUSPA SVSTEh-0S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _
20. Rough Factory Fireplace � � ; _ _ , :. . - AppROVAL5 _- Permit #
27. Ducts,in Strueiur� •: '� � 70. Underground HYdro �
22. Duc!s, Ventilating-, � -� .. , - � ��- 77, �Produet�?iping O Gas � Oil
23. Gas Pipe-Rough & Test '' � r. � � � 72. Underground Fl�sh ' �
24. ftoof- Framin9 ' ' - ' - 73. Undergrnd. 5tora9e Tank• O Gas ❑ Oil
25. Rooi�Sheathing . - - 74. Overhead Hydr� _
26. T-Bai-Ceiling (Struc.ural) & Monocoat � _. - 75. Dry Chemicai . � -
27. Prame and Flashing - : ��� - � 76. Dry Stan_dpipe � C' �
28. l.athing & Siding ,:.:� `' �`�� = � ' `' ' �'�- 7Z. FIXED SYSTEM FINAL - �
29. Insulation � � .. .. .. . � �. ' ' 78, FIRE PREV. FINAI ' � =- , '
30. Drywall Nailing :':'; � ` . � HEALTH DEPj. REQUIREMENT
31. Plaster Brown Coaf ' . 79. FINAL INSPECTtON .
c-
� 32. Electricai Powzr Meter-Final ' : 80. fOOD CERTIF4CATE ISSUEp '
33. Pinal,-.Electr.c � � � Notes:3J�:.��-. � . _ � �(�',
� 34. Final.HeaTing & Air Conditioning " 4, ��Sy� - � ; �1���Z _
�
35. Final Gas Pipe-Test . . , � " . � �
'36. Hoad or Canopy ' - . �' ` , � ` _. - " ., -
- 37. F.inal �F;ctory FirePlace :- - - � � - �. .
3$. Final Plumbing . : . � � � � . . - - --_--
� + t
39. Water Service-Finai - - �� � � �
40. Gas Service-Flnai � � � � � -
r • -
41, SolarpomesticFinal� � � e . � .
A2. Backflow Preventer � _ - _ :
43. 8ackflow irrigation '' � :. � � : � -�
44. Landscape Irrigation System , . �' ". .- � �. '
45. Sound Attenuation . - � ' � � - . �
46. Ha�idicap Regulations - . '" , � .
«
47. FINAL STRUCTUA� & BUILDWG i` r��
48. FINALPLANNWG - - '• . _; ; � � �
49. Electric flelease to Edison � , ,,;
50. Gas Release to Southern Califor�ia Gas Co � - ' � _
51. CERTIFICATE OF OCCUPANCY
No Date
MAIN OFFICE
1635 N/EST GAYLORD ST.. — P.O. BO% 9005
LONG bEACH 10. CAIIFORNIF
HEMLOCK 5�]99]
SPRUCE 5-2081
�v�rina�e�
Labarato�i�s
BHANCH OPFICES
93� Sl�NT1AG0 ST.. SpNTq ANA
KIMBERLY 7-fi648
3]815 N. 6TH ST. EAST — p,0. BOX 9�B
pALM�qLE — WINDSOF >-5911
Ot C�OU.El2EZ12 (_QLCtOZ)tLR� JI2C.
GUNITE
R�PORT OF �'XE TEST CYLINDER
Examination No. C60-Ij63
Project For - Fieste Pools
5141 Imperiel Higliway, South Gate, Celif.
Sample fram
Archicect
Contractor
nT�X
lVater; gal./sk. cement
wSd�tet�t}t S i z e
Date cast
Date tested
Cvlinder No.
JOHN 0'PRIEN RESIDENCE - 3174 Madeira, Costa Mesa, Calif.
6unite Swim Pool
Fiesta Pools
61�� x ����
4
4-20-60
4-2'7--60
I
COb4PRLSSION TEST '] Days
Total load to destruction, lUs. 29,000
Pounds per square inch
Cylinder made by
Cylinder delivered by
Cylinder received by
�
Henley
4-2i-6o
'" RECEivEO �
MAY 9 19�u
City of Cpst•a hlesa
Bwlding U.;:..
: .•
3 „No�d��
28 6ays
Note: Deposit of Rebound on bottom
of Cy l i nder ��
/ � J
� �
n'� � �
cc: Fiesta P�Is �
John 0�8r,ien— �� �
Costa Mesa BIdg.Dept. TWINING LABORATOR S OF SO �RN CALIFORNIA, INC. �/�'^,V
SA Lab . � J � �yt�� ��
.iCiyst.a�/'
aLL REPOftTS qFE SUBMRTED RS !HE CDNF�OENTIAL PROPERTY OF CLIENTS, TVTHOR�ZATION FOR Pt1BLICAiIOr. OF OUR REPORTS. CONCWSIOHS. OR EX�
TRPCTS FROIA Oft flEGRF�ING TXEM IS qESERVED PENOING OUft WRITTEN APPftOVAL AS F MUTUAL PROTECiIOR TO CLIENTS, THE PUBLIC AN� OUftSELVES.
OWNER SYCA*�_OHE� ;.,AND CO DATE 6-29-59
SOB ADDRESS 7 Madeira Ave. BUILDING PF.Ri\fIT A�O. 9�12✓
CONTRACTOR
AP. No. LOT 3 TRACT 3363 FIRE ZONE DESCRIPT[ON OF R'ORK Re5 8tt
NS � DATE I GROUP ""` " TYI'E
:1 Soil js1l�jf�U.G. Watcr (�/ �
. .. �I St16CONTRACTOR I—
h' `C
L n�
Plas[er
Form 210-3M-4-59
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31'1 GOSTA MESA. CALIFORNIA
FOR APPUCANT TO f/LC /N COMP[ETELY
. TYPE OR PRINT
COSTA MESA, CALIFORNIA
MAIL 10835 Santa Monica Blvd,.
ADDRE55
� Los Anqeles 25 TEBr23287
11015 S. Paramount Blvd.
Ma gren Const. sTarE1533
aLEGAL ILOT '3
� DESCNIPTION NO.
SIZE NO.OF 9LDGS.
OF LDT � i�I aR Y%Q G�S NOW ON LOT
SETBACN LINE FROM '3f1 JV
CENTER OF STREET REAR YAI
SIDE YARD ILEFT IRIGHT
� DESCRIPTION OF WORK
REPAIR I IIMOVING I cIIDEMOlISH I
BUILOING 1693 NO.OF V 1
SIZE ROOMS STORIES
EXTERIOR WALL ROOF
C�I$OVERIN8G COVQERING crush roc
LWe�11iiQN IleW COI]SLUC��.ORMED
I MEREBY ACKNOWLEOGE THAT I HAVE NEAD TM19 APPLICATION
/ND STFTE THAT THE ABOVE IS CORRECT RND RGREE TO COM�
plY WITH RLL CITV O OINANLE9 AND STATE LAWS qEGULATING
6UILDING CONSTRU O . ' _ �
SIGNATURE OF ///
�, �. ct �_ V�.I U i� t�
`j'' � :. , 1959
FIN�II�CE DEPT.
n� i �, n[ !•(�CTl1 hAFCII
APPLICATION' FOR PERMIT
BUILDING •
fa,e officE usF aNcy
I HECEIPT NO. I PEPMIT
FIRE
ZONE
(CENTER LINE
FRONT
R.SIDE
� I��'��',s� I 6 a 9- s"
�
COSTA MESA, CALIFORNIA
I � �
DATE
ZONING
I NO.OF I fI6E OF NEW
PLANS BOILDING
DATE L /_
EVES
ALLOWEO
��� FT. IN.
,� FT. IN.
S � FT. IN.
ZJ� FT. IN.
THE AMOUNT BHOWn UNDER VALU/.TION 19 FOR THE
PURPOBE OF EBT/�BLI6MING A PERMIT FEE ONLY.
VALUATION �
! PERMIT FEE $ �
$ /// ��v PLAN CHECK $ �O
F
TOTAL FEE $ ,��'
� : i �71\ • I
INSPECTIONS
i- �rground &
� .reround G
OCCUPANCY
T1tACT 336j FIRE
� DATE I GAOUP
SUBCONTRACTOR
OF WORK
TYPE ZONE n—�.
� PERMITS ISSUED
Form 410—SM-11-59 5-8 P - 11666
.;
-�: � - A �G���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 97] C08TA MEBA. CALIFORNIA
Fo� Applicanf fio Fill in Complefely
TYPE OR PRINT
ADDRE86 � £r R A _i
COSTA MESA CALIFORNIA
�
oWNER � I`1e. r�
MAIL
ADDRE55
TEL. .
■ AR'
� BeTOACN LIN! PRON
BU
FIRE
-3�� I O n- / I c
IQ (]] e—
J D NO. � Q� ���J G� LHaAt
OHeCNIP
I NO. OP BtDG6.
� NOW ON LOT
^ p A. P. N<
P��/l�%.�(/G( . YARDS
IRIGHT ��
OF WORK
BB ZE DING 5� �� RQOMS STOF
EXTERIOR WALL ROOF
COVEAITIG COYEHING
USE OP BUILPING AND WORK i0 BE PERFORMED
,=�E �tC�.�lJ��
�. \
�(� ao�c. � ��� �
FINANCEcDEP Fcp
APP.LICA�TION�'FOR �PERM IT
BUILDING
For Office Use Only
NECEIPT NO. P!p IT NO.
/
� BY DATE RECEIVH O E � UED
� ,3_,3�-�v .3 � GD
�.3/ /�,9 e ,e E.
COSTA h�ESA. CALIFORhf�A
tYONING � �v�
wo. ov uee ov rvew �� �
PLANB ,i� 9UILDINO �
LIN6 6T.1
APPROVEO
('�^� DAJTE S �
� V– —
1 HePeBY ACKNOWLtO08 THAT I HAVH RGD TH�B APPLIWTION TMg AMOUM 6XOWN UNOER VALIIATION IB FOR THC
�N� 9TATE TH�T TH6 A80VE IB CORR¢LT AN AORBH TO COM• pUIiP08¢ OF QBTABLIBH�N6 w P¢pMIT FH8 ONLY.
PLY Wlill I1L4 CITY OHOINANCEB O HTATB W8 R86UL�TIN6
euILDiNa coNeinucTlon. / VALUATION
HIGNATURB OP a� PERMIT FEE S �' N
PBRMITTE
S � OD' p{,AN CHECK $ `r- �
AUTHORIZHD AGENT � /� ` p
TOTAL FEE v
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