HomeMy WebLinkAbout212 MAGNOLIA ST - Building Permits v CITY OF COSTA MESA
4/ BUILDING DIVISION
4 -i
r.,,� i DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER
vi y PERMIT
.F B04-01245
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 212 MAGNOLIA ST Status: ISSUED
Suite: Applied: 07/12/2004
Vicinity: ROOF Issued: 07/12/2004
Parcel Number: 42540203 Zoning:
Applicant STEVENSCHNIERER - ISSUED BY:
Address: - - --
, - Phone: 714-719-1689
. • , Zip:
Owner STREET;CYNTHIA " - -7
Address /212.MAGNOLIA ST- - _ -
%r : \�
,COSTA MESA,CA Zip: 92627-2805 _ , /
Contractor FONTAINE AND ASSOCIATES �''� , �•'.y,
Address: 23482 PERALTA '� /
SUITE F Phone:, (714)598-8360
LAGUNA HILLS,CA
Zip: 92653' •,_License: 708917, .
`- ,a
- ' Eng:
Address: - , ... . - Address:- v -
Phone: . '� Phone: '
.
Zip:- License: License:
„ - SCOPE OF PERMIT- - -- -
TEAR OFF EXISTING ROOF. INSTALL-30#FELT,.LIFETIME COMPOSITION SHINGLES,CERTAINTEED,AND REPAIR/REPLACE SHEATHING
AS NEEDED.2,400 S.F. INCLUDES ATTACHED GARAGE. - - ,
' - FEE SUMMARY .!.
• Plan Check: $0.00 - ' Calc Valuation: " $6,000:00
Pefmit: $125.25 Claim Valuation: c - - $6,000.00
SMTP Res: ' • $0.60 -- ,
'SMIP Corn: ,$0.00 . - '/'" ,
Other." .',$0.00
`Inspection:- -$0.00 . ��
j
'Total:' ' $125:85 _- ,�� ,
PLANNING &ZONING 41:,,,12' 7,4, ��C
SETBACKS'? :›..' . • / ..-, „1
MAIN STRUCTURE Front 0-0 N Rear 0 0' Y Left 0--0 Right 0-`0" ,��'
ACCESSORY Front, 0-0 Rear 0-0 Left -0-,0 - , Right' 0.:0'27
PARKING Existing: 0 Required: 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
2446-4616/00)
WORKERS'CO PENSATION DECLARATION:
1 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 pe ormance 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.
J� My workers'compensation Insurance carrier and policy number are:
Carrier: Si' Policy Number: 0902IH
(This sect/on need not be completed if 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• alifomia,and a• •e t at if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these.•ro slop
Applicant Signature: ri Date: 7/1 Z ICX-1
WARNING:FAILURE Ti SECURE WORK--5'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND rri I ARE($100,900),IN AD.TION 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.# 70891 Class# G�4
Contractor's Signature: Date: 7) /z)n4 j
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).):
❑ 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 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 under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑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,Grp 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 California Health and 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 apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ID Yes L i 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(Duality 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? ❑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.
' al Owner(s) Date
IZJa+
n r Authorized Applicant Date
COPE t INSPECTION TYPE PdTE INTIIALS CODEQ INSPECTIONTYPE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �f ,1 208 Final Plumbing
200 Final Re-Roof I -I to-69 -\ 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
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. i _.
ib— Cq nESA ' CONSTRUCTION PERMIT PE MIT NO. TRACT NO. LOT NO. UNIT NO. •
Project Address •
^" 21� M�}Cant al l A CeSR IYKSf1 `��E/47 `� ! y 6713' @/21 {EG I r1I'4 7!'
- V \ / 1 * // TYPE OF CONSTRUCTION- KNEW U ADD U ALTERATION U-REPAI R
Ahdl'cant'sitiailmg Address ' JFi.aa 'GrFG ary I+-ti-9.,72(n'r4 - /
!❑ CONVERSION ❑ DEMOLISH O OTHERq t -
,Oivner's Name I Dim - Kc E-FF< - Phone /•+Y-2. O.? A.P.•i# ;, 4a.S ". .4 (� Q3 • Zone ;�� 1t .
r -i
DESCRIPTION OF WORK/USE OF'BLDG. ' �I
' Address , •JI a I MRC P3& i!9 ) G,.-r11. �• -a I _ S. Main Building:, Accessory,B9:-
es: -r `,x ,
I 1 i • , 't l
Arch/Eng.��+OrdIIJe en l'Jc rye l.� License No TYPE.OF PERMIT .13 GRADING YtFOUNDATlO ❑.STRUCTURAL - •+ T Front I ' - 1^ `- 'O
Address I, / 1 a (rc C,nr/ t4 ,6 I` el'2(o ‘ ' I ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear _ - - 2 t_ �Lt• b..2-Q--I1
/2.�-/ ' N ;
Contractor's Name�I hi- • epoL n R h3,7T- 1 •Phone 9/O`i'Lr7O.O _❑.OTHER I - ' - 4 J f !r I '
O I I C Right ' _ 0.1._ uCi _ �r� N
�' PROJECT DESCRIPTION; So. FT _ •occuP rvcv G '
Address(mailing) 1893,E G;c-ECHO r ' H. Q . 926 . � - - K' - '1 -
• .. _ Y ` CONSTRUCTION-TYPE ' - ' VALUATIOfs IU/.0 o L , T f ,Ss—nLf _ - R
City License No. • • - _ Acis b D ' ZONE GRADING CU.YDS. (ACRES S ' I E
LICENSED CONTRACTOR DECLARATIO�•1 1 - ' ' . : Ping. Ref.# I Parkirig'Req./Provided
4 I herebyatf irm that I am licensetl under provisions of Charter„9 (commencing Remarks: - ///i G { �`-•. P,Ia nning Notes: - M
with section 7000) of Division 3 of the Business and Professions Code, and �`l ` 1+ , ( ����+ `` (� T
my license is in full torte ar d'ef fact. I _ - / I .S"j r3_,.. SVVCi� }( 4C�� - S. .
License C -ss / - Licen . 'A • - I r � - •c -tc„.-OnCix
Date -- f • ' Signature -/:�� - � PLUMBING ' FEES _ � 'CST c rk —M11M r/C�1 elti is +^. �
WORK RS' •MPENSATIO �CLARATION , /• Bar Sink Showers ELECTRICAL J FEES
':,hereby affirm that I have dc- tificate of consent to self insure or a c-rtificate .
-C.' workers'Workers' Compensation Insurance,•or a certified copy thereof (Section ' •
”"800, Lab'- c. ,a . / ,, J Backflow Preventer - Service Sink _ Automatic Washer - . . . _ _ 'Transformer ❑ 15-50 KW _ __ _ - ,
Policy No. r�t-•�a'Is�e�'l Company � 7CG%tCGC-/ • Backf low Irrigation Sewer Cap ' ❑ 50+ KW '
9 Construction Pole Sub. •
8 Certified copy is hereby furnished. •
—
Certi�r.,un�jfiop /(spSlle .with the city Ming Division. 7 Bathtubs Sewer Connection ' Cooking Unit I ,Meter [lop to 100 amps
Date +•z6• ` v Applicant=r J a -_ _S.J./,- - ,
EXEMPTION FROM ORKERS• PENSATION DECLAR•-ION . Clarifiers Solar Collectors Dishwasher 1 'Meter Dover 100 amps' I
(This section need not be completer the permit is for one hu •red ($100)pr- - -- _ - _ -- - _ ._ _ . _ _ _
less). Dishwasher . Solar Piping Dryers ❑Gas' ❑Electric Sub Panel 1 1
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 Fant I Motors DO-1 HP ❑1'/x-8
Workers',Compensation Laws of California-
DateSignature Floor Drains Swimming Pool w/Spa F.AiU. Inc.Solar 09-15 HP 016-15-k
NOTICE: I1,after making this declaration, you should become subject to the ' • _
Workers'. Compensation provisions of the Labor Code, you must forthwith Floor Sinks • . . .. Urinal - . _ Fixtures • I 'Microwave
comply with such provisions or this permit shall-be'deemed revoked. - ' .. . -' _ . . . .. - -
CONSTRUCTION LENDING'AGENCY, CO . 'i ' " Gas Service .•Outlets _, Water Closet - Device Boxes '
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work .for which this permit is issued (Section 3097 Civ. CJ\. Interce tors' Water Heater ' '
Lender's Name - _ - p Outlets Range •
_ - Switches
Lender's'Address ` ' - - Kitchen Sink - Water Service Sign
OWNER BUILDER DECLARATION •
. . .
•
I hereby affirm that I am exempt from the Contractor's'License Law for the Lavatories t 1 dpi ' ' I0L� Garbage Disposal 'Standing Sections • '
following reason (Section 7031.5 Business and Professional Code: Any city or ' - -
county which requires a permit to construct,alter,improve,demolish or repair. P-Trap , 7- _ - -- _• Generator ❑0-5 KW❑5-15 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. _ I ' .27
• - �p� g
•;Division 3'of the Business and Professions Code) or that he/She is exempt •
- .
+,'aerefrom 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 I
J'enalty of not more than five hundred dollars($500). - - - 1
-I, as owner of the property or my:employees.with wages as their sole Reinspection Fee. , $15 Issue Fee - $ 3
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (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 dot intended or offered for Boiler _ • Hood or Type I• ❑ \14�/2-4-,-Th
� / I��� •
sale- If, however, the building or improvement is sold within one year of cam- , CanopyType II ❑ Zoning Approved By '�.t Date_ � .17" -
pletion, the owner will have the burden of proving he/she did not build or im- Duct-- Under Ground ypBuilding Approved By 1 ' Date
rove for the purpose of sale). �J '''".2-9/'-',VY
�7 �jC/
D 1, ai owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ' /2/Li Date H—0 7 •
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 : • ❑O-100,000 BTU 0100,000 BTU SU MARV OF FEES
builds or improves thereon,-and,who contracts for such projects with a con- '- • - - ry
tractor(s),licence-pursuant to the,Contractor's License Law)..I am aware-that IBUILDING1PERMIT $ i-� SMIP , $ z 7a
ofExhaust System D Multiple ❑ System Repair/Alteration
proof their Worker's Compensation-insurance-should be provided to me. - PLAN CHECK $ `�� PERMIT '
❑ i am exempt under Section B. & P.C.for this`reason,~ Firepl/Fact.BIt. ICBG# PLUMBING $ f'00 ISSUANCE $ •
t
Date -� • ' ` Owner" " - - Heating System& Ducting •
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above D0-100,000 BTU 0100.000 BTU - _ ELECTRICAL $ ��,J•��ADING $
Information is correct. I agree to comply with all city and county ordinances r•'� L /tell
and state laws relating to buildingrconstructlon, and hereby authorize repre- - - ' MICROFILM $ 5 S'T
sentatives v his"city-'to-ante pon the above-r•'ntionetl ;property f9 r PLAN CHECK '50% $
inspection poses. 1 / �� �/�� - MECHANICAL $ TOTAL FEE $ I
AL.
Signa[ur �.•�1]//.—i .bate G !r/ //IK •
Driver ' icense or SS+ Reinspection Fee $15 Issue Fee $ 3 PLA N.CHECK 25% $
.-.
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - -
i
{-
, _ POO._ SPA
' CONSTRUCTION AND PLANNING Date - InspectorInspector
APPROVALS Permit# - - Date APPROVALS Permit#
I. Temporary Electrical Service or Pole • - -52. Pool & Equipment Location T(2Vffl ,I/
2.rSoil PipetUndrgrnd..- - - 53. Steel Reinforcement
//3. Electrical Conduit Utility-Undrgrnd. 54. Forms
/ / 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56: Rough Plumbing & Pressure Test - _-
6. -Electrical UFER Grrid. • - - 57E APPROVAL TO COVER-GUNITE i2.1111 VC.,/,
V�
7. Footings . • 58. Electrical Conduit-Undrgrnd. If 1
8. Foundation ', ' .
59. Gas Pipe, 0 Undrgrnd., Test• (-
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System ` ' - 61. APPROVAL TO DECK chi)f VC-, •
al.;Property Sewer Line & House Connection • 62. Backwash & Receptor-Final '7Z2 9 LA/
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 ea {/6{ „Lc--
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ! It .SPAq Ve----
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
z. 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
i
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 oi'Canopy , - - • '
37. Final Factory Fireplace - -
38. Final'Plumbing - -
39. Water Service-Final , - '
40. Gas Service-Final . . '
41. Solar Domestic-Fin& - ' '
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 '1 ' - - - - '
50. Gas Release to Southern California'Gas Co - ' .
51. CERTIFICATE OF OCCUPANCY • _
No. Date ' .
- 1
20 Z1,
� ,dhh •
„F�, Twininq Laboratories of aou zn eacifnnia,or or d
fina.
02
3310 Airport Way / Mailing Address P O.Box 47 / Long Beach.CA 90801 / (213)426-3355 / (213)636-2386 / (714)828.6432
TESTING BRANCH OFFICE: I 514-D North Susan Street / Santa Ana CA 92703 / 17141 554-2645
September 10, 1984
Examination: SC84-5894
COMPRESSION TESTS ON GUNITE CYLINDERS
Max Sitter
P.O. Box 3454
Fullerton, California 92637
PROJECT SPA
ADDRESS 212 Magnolia, Costa Mesa
ARCHITECT CONTRACTOR
Shoreline Pools Shoreline Pools
ENGINEER SUBCONTRACTOR
B.C. Adams Gunite Unlimited
SAMPLE FROM Main Drain
SPECIFIED
MIX 4.2-1 STRENGTH 2,000 psi
DATE CAST 8-29-84 SLUMP SIZE 5" x 12-1/8"
DATE TESTED 9-7-84
SPECIMEN NO. 1 2 & 3 "HELD IN FIELD"
COMPRESSION 9-Day
TOTAL LOAD. LBS. 41,000
POUNDS PER SO. IN. 2,090
28-DAY AVERAGE, PSI
COMPLIANCE 9-Day test complies with specifications
MADE BY DELIVERED BY RECEIVED ON
SPECIMENS Lou Max 8-31=84
DISTRIBUTION:
Max Sitter - 3
Costa Mesa Bldg. Dept.
is Hyden 1/
ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS AUTHORIZATION FOR PUBLICATION OF OUR REPORTS.CONCLUSIONS.OR EXTRACTS FROM
OR REGARDING THEM Is RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS.THE PUBLIC AND OURSELVES.
330.12
Gunite ). Post-Tensioned Concrete ( )
REPORT OF INSPECTION P. Masonry ( ) Fireprc ig ( )
Concrete ( ) Reinfor j Steel ( )
4 TO: Ca.� fDles6a —_—__ F R rr . „ —
CITYOFCOST
Address: {{tt BUILff�'r r •
OWNER: �tTSeti cFt A 1984 --._
�r a
PROJECT: . CytrA pgtls.:rt,ra,ttylm..>Y`infidteport No.
Address: (Lia mq (pval-a A:. Permit No. fij r-n4,
Architect: Shoisoh,,.z LS contractor: <).pa.c. h..e �tii1S
Address: Address :
Engineer: I .C . Clo '' 1, Subcontractor: (-ni,_-\ }r
(Gunite)
Address: Masonry or
Concrete)
Inspector: Mcz 3.. ' Address : •
Mix Used: t} - )
Slump, inches: 1)
•
Admixture: - •
•
Designed Strength, PSI :`) Late
The following inspection was performed in accordance with the approved drawings::, .
Cu.Yds. No. of
DATES Placed Cyls. Remarks
�,: 1Csvo�S � D Q'_�L • SD6�') pee-Ac.— CT1 \../d 0 •
t.vl. 1
•
•
•
Copies of Reports to: (Indicate which Bldg. Dept. G furnish address of any not listed) 1'77'*
Si
•
CITY C' STA MESA
PA..__ FEES N° 1 5 4
Fee Payment
Receipt
Project Address 212 !V Cs e�,�L A Park Area 3
A. P. No. In - l72 —off.,
Building Permit No.
Owner's Name {foto 4 ASS 0CAKE'S
Mailing Address o.3�J'7b 2
FEE
20
Single Family * No. of Units / @ $455.20 = 955.
. Multiple Family ** No. of Units @ $321.32 =
Total Fee
�� -514f (2-'0S to
Planning Department Approval ate �'� By •`Aj'� Tv
r': Applicant's Signature
* city Ordinance 72-44
** City Ordinance 72-45 •*** City Resolution 7442 pito
U 7 ���
White-Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174.26 L Jq
s••
OWNER HOOD & ASSOCIATES DATE 2_13-76
JOB ADDRESS 212 Magnol i a Street BUILDING PERMIT NO. 41787
GENERAL CONTRACTOR same DESCRIPTION of WORK Res. w/att. gar.
AP No. 1 17-172-03 LOT TRACT FIRE ZONE VALUE $33,300.00
._ SiSPECTIONS nature Date TYPE "V GROUP I 8 J ZONE R-1 _
SOIL �/4" 2'>9-% SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
,4�
WATER R � cis 'a /9.7` Plumbing
ROUGH PLUMB! G // Z%Y 3- -7G fd'13 liftere2 •i�D6 Ls5a6 /
PROP. SWR. LINE /R HOUSE CON. 133.."' 2 O t 3 •/ -74 S.F. e/r._'73•F 3-'5-'74 G n 79�
SPRINKLING SYSTE �`
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING -4:1,54-.74-74
TEMPORARY SERVICE OR POLE '.4-0 7G
UNDERGROUND ❑ POWER Ile-Wi_ (.
ROUGH WIRING 3-14,9f, Heating and Vent.
TRENCHES X FORMS Ex STEEL REINF. ® 2,Le 74:.
4..,tjA t,,d,,,�/ 1Ja,(,�6 3„at/)4 i a,.344 7
FLOOR SYSTEM -2 r•/'C
BOND BEAM n STEEL REINFORCE f
SHEATHING Ca •'14e4(.
FRAME AND FLASHIN r oat
LATHING — IN OUT S++•76
PLASTER, BROWN COAT i^ 94
STRUCTURAL, FINAL //_ '�W 't EIICt�Jt - ,y
HEATING, VENT., REFRIG. AND A.C.,/FINAL yyy S-/2 •7p O /RYitfiL • 02-/ '94 0(J� �,
PLUMBING, FINAL AND GAS TEST E 5 "V o:74 4A.0un. C�i7j�4 3.026-76 'W C�S,_I' '
ELECTRIC, FINAL / \ el / r 1
BUILDING, FINAL f'
PAID
41287 SER, 13-76�r,5f00 519* *ksf 210.83
n4•'
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely�} ple — Use Ink Only �r �r F,fJ/
S 2ttMA-7 O///`t .5V;c,-6 RECE V DBY o/ �D�07 S144
V ED
•
BUILDING //--�� .c,// ,r',/�/ �''t/J I`�//Q /
OWNERADDRES ike:3 7 r AsS6C/Z as A.P. NO. I IBUILDING ll— /a 03 we,
MAIL �j 7 ADDRESS 2-It // 1'
ADDRES�S//�) Q x 3 / ‘ i A
/�C- o is
CITY ! /" S. 71/ Cwt//F No.fyg-g3.5:5cr TRACT574 LOT Al BLOCK if
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH
LENDER /
BRANCH I'{l /
ADDRESS OWNER� /
et/I Car/4-5 SQc i#./LIS'
VALUE
ARCHITECOR ENGINEER W(,# M6t y.4A/ NO. )�18–YN2�USE �E $
FIRE
ADDRESS /Q `jA— /l9/f.fi✓Srr GrR^/�„6— ZONE • T PE ' GROUP •�
APPROVED �J '�J
CONTRACTOR hie°b NA j� „/y'rO S BY DATE `^/9r-/
ADDRESS - ,&ox 3 2G —. III"'
,�'
TEL 2ON NO.OF USE OF NEW
CITY '/4. 5.7 A// c/-//F NO.$J j-y,iSS I, PLANS BUILDING t.r/
f^ STATE CITY YARDS APPROVED YARDS APPROVED r •
LIC. NO. 02 7 2 / div . LIC.NO. MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
' 0.. OIF LOT -5-0/74/x J2t7/b ft I NOW ON LONa OF TS4/�,4 FRONT' OD FT. _ FT.
a USE OF `
�. EXISTING BLDG. RESIDE V FTFT.
rA
9 Separate permits are required for L.SIDE O FT. FT.
w electric,plumbing and heating work. REAR el.J FT./plr FT.
(. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
OMAIN BLDGS. ACCESS.-BLDGS.
/ N/t•r 47///d> 1A- 1."
— VAR.# DATE
Q f ( C.U.P.# APPROVED
7 APPROVE 1 _DATE
2- y; 7.-2/0_
cg HOLD FOR r PECI,kL REQUIREMENT`;,
x
o I hereby.acknowledge that I have read this application and statea. 'n
11! that the above information is correct and agree to comply with n
m
C. all laws regulating building construction, and I shall not employ
Z any person inviolationof the workman's compensation laws of
y the State of California. / )3 SQ. FT. f 47� w
I hereby certify that I am properly licensed as a contractor under ( N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR az
Chapter 9, and that such licenses are jrnusins
and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the ovisi s of the p
pVALUATION PERMIT FEE $ I and Professions Code ivi 3,Chap
fro �^w n
el
' Signature of $ TAX CHECK $ • .7 U I
Permittee 3'3 z(/I r 41 U
Authorized A nt V
TOTAL $�` /It S3
�. GGGLLV!!( C{
OWNER KEEFER, Tom DATE 11-23-76
IJOB ADDRESS 212 Magnolia Street BUILDING PERMIT NO. 43089
DGENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK patio Cover
'AP No. 117-172-03 LOT TRACT FIRE ZONE VALUES 750.00
INSPECTIONS Sig Data TYPE V GRGRUP J ZONE R-1 _
ciao
SUBCONTRACTOPERMITS ISSI/ED
As
Data Number Signature
ATER Plumbing
i ) ROUGH PLUMBING
X41 PROP. SWR. LINE[0 HOUSE CON. E
2 SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
(1 UNDERGROUND 0 POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS U STEEL REINF. n
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING •
FRAME AND FLASHING
LATHING - IN n OUT n PLASTER. BROWN COAT
STRUCTURAL. FINAL Electric _
HEATING, VENT.. REFRIG. ANO A.C., FINAL
PLUMBING, FINAL AND GAS TEST in
ELECTRIC, FINAL .
BUILDING, FINAL 2�2!- e
\ 1 089 v._,.;OTI . F t';r t *,-,.2
,. .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
R E•r'
A LI A I ON FOR STRUCTURAL PERMIT
• For Applicant t I Fill in Completely — Use Ink Only
BVILDING �� .��RI gal°.
ADDRESS _ ?,J•l�. sic i 'fI' • .. . .I�I'1I '�.1�rIY%J�:
Qn P •'
;` OWNER ' h s/=c 12- A.P. NO. I I ... I.
-Q3 �, '
MAIL ,t BUILDING 2 2 .
• ADDRESS ' t v- &,/(7 Ll/'T a ADDRESS �� �� v
4111
( CITY C .W'A 1 IIS h NOL(gt,.ZS ..- TRACT„Jr,..-411 LOT BLOCK S
CONSTRUCTION W ADD AL R reMIuIMIN • ix* .
LENDER 1 a-
0
, BRANCH
'I' ADDRESS (L/� //tom, .�../r VALUE ��
ARCHITECT TEL. 1, U5� w O L.L�� 1� $ JLJ
OR ENGINEER .a
FIRE �{j
• ADDRESS ZONE TYPE - y GROUP 494.1
T r
z (-I
q I
APPROVED It .7:3 -7-4
CONTRACTOR ( �.rQ /L\Q.(fTh �(� (LD'2.l--• ! BY DATED
: ADDRESS `L. . •, NO.OF pi., USE OF NEW��`7 b
PLANS BUILDING Ar,Wei7`,s�
CITY Cs .eSA NOL IS - C •-
r-: STATE CITY YARDS APPROVED YARDS APPROVED
$a : LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
std :i SIZE NO.OF SLOGS. (FROM C/L S :EET)
L . OF LOT NOW ON LOT FRONT SI FT. FT.
Q USE OF
.p.. EXISTING BLDG. Fl.SIDEFT.
F ;F, Separate permits are required for FT.
G electric,plumbing and heating work. t, _ .� FT.
[..., USE OF
BUILDING AND WORK TI/,BE PER,F9/RMED _. , • BET.MAIN&
Q i' pil 4 t O l fe-0 Cif S .2.171-0 X .J , = ACCESS.BLOCS.
_ Ir VAR.# • DATE
r - C.U.P.# APPROVED
7 ''" /'6- 9 APPROVEDCI$II�t ./ r Z3 - C
2' i' _BY �/_vt( r DATE " �v •
C V
0 f IF hereby acknowledge that I have read this application and state 0
pv 'f that the above Information Is correct and agree to comply with
w
a' is all laws regulating building construction, and I shall not employ
Z I any person in violation of the workman's compensation laws of m
"1 i, the State of California. I'�1 m
P
I hereby certify that I am properly licensed as a contractor under /1(/ SQ. FT. - N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F ONLY: "
am exempt from the provisions of the State of California Business �O
p p VALUATION aJ PERMIT FEE '$ p
and Professions Code, Division 3,Chapter 9. I"V �- '^
y ✓ m
' / a PLAN CHECK $ ro
0
{, Signature of CT O Q 1/ 7 o
', Permittee rpt C P < - $ `5TAX - $ 5� 2
/ U
71 Authorized Agent TOTAL PAID $2. SD