HomeMy WebLinkAbout213 MAGNOLIA ST - Building Permits ADDRESS OF BUILDING: 213 MAGNOLIA ST WIT: CITY OF COSTA MESA — BUILDING PERMIT
OWNER'S IF KNOWN: STROLLO, RICHARD T PERM NO: B 075803
ADDRESS: STROLLO, DIANE FRASER
213 MAGNOLIA PERMIT NO: B 075803 PLAN CHECK NO N GOVT: N SUPP: N
. :OSTA 4ESA,CA 92627646-1766
APPL.MAIUNGADDRESS: CONSTRUCTION TYPE: V—N • PERMIT TYPE: SIR PURPOSE: OTH
. ARCHITECT OR ENGINEER: UO.NO.: JOB DESCRIPTION ' : T/OFF /SHEATHING / 25 YR COMP SHINGLE SQ FT:. 4 , 800
. ARCH.OR ENG.'S ADDRESS: UHT:
CLAIM VALUE: ' 4, 800 .00 CALC—VALUE: 4, 800. 00 GROUP OCC: R-3 /M-1
CONTRACTOR'SNAME: BRENT OWENS ROOFING ( 714 ) 978-2075
CONTRACTOR'SMAIUNO 12901 BUBBLING WELL RD COMMENTS- REROOF. RESIDENCE / SMOKE DETECTORS RE UIRED PER . 1994 UHC
ADDRESS: SANTA ANA CA uc.NO.: 600402 ########*######################################*## ######### ###################
92705 Si: Z 0 N I N• G REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions of Chapter 9 " SETBACKS .
(cominendng with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
CIF;LIC.NO.:061174 LIC.CLASS: C 39 LI�NO.: 00 02 EXP: 01 /96 MAIN BUILDING ACCESSORY BUILDING
\ I I _ Z_gC, SIL FRNT:' FT IN REAR: FT IN FRNT: FT - IN REAR: FT IN
/? Contractor LEFT: FT IN RGHT: FT IN LEFT: - FT IN RGHT; FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the '
following reason(Section 70313 Business and Professions Code:Any city or county which requires a permit to construct,alter,improve, • PARKING RE PROV: PARCEL: 42540121 Z NE: _ REF NO:
• demolish,or repair any structure,prior Io 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 PLANNING N T E9>'"'' '
Business end Professions Code]or that he or she is exempt therefrom end the baso for the alleged exemption.Any violation of Section >
7031.5 by any applicant for a permit subjects the applicant to aoally M wl pennot more thanf.ve hundred dollars(S500)). {(##{D{(.##.####.#.{E•{E.#.####### ########################################'################
o I,as owner of the properly or my employees with wages as their sole compensation,will do the work,and the structure is not intended DEVELOPMENT SERVICES R 'E Q U L R E M E N T S
or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of property
who builds or improves thereon,and who does such work Nmsell or horseff or through his or her own employees,provided that such
improvements are not intended or offered for sale.I,however,the building or improvement is sold within one year of completion.the ZONING AP PROV ED• B Y' DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I.as owner of the property,am exclusively contracting with licensed contraclom to construct the project(Section 7044,Business and
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE: '
convects for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ lamexemptunderSection: B.AP.C..for this reason: APPLICATION ISSUED BY: � �7/ DATE: 2'9�
Date: Owner: • ################################################# ########################Hx'## r •
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certiry that I ern aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and
25534,and That I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for
a permit forconstruction or modification from the An Dually Management DMrid.Residential construction applications are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ' GRADING
provisions. PERMIT , 72 . 00 . 50
Date: • Apploa t SMIP/NON—RES
•
WORKER'S COMPENSATION DECLARATION:I Iereby affirm under penalty of perjury one of the following declarations:• PLAN '
' 1 ISSUE FEE
• I have end we maintain a certificate of consent to thiseel psure lersued.workers'compensaton,as provided for by Section 3700 of the Labor BUILDING—DIV—> PERMIT ISSUE . PLAN—CHECK • TOTAL. PAID DUE •
Code,for the pedormarwe of the work for which permit is issued.
Y+ Ihaveandwillmaintainworkers'compensationinsurance,asrequiredbySection3700oftheLaborCode,fortheperformanceothe TOTALS----> 72 . 50 0 .00 - 0 .00 72 , 50 72 . 50 .00
A work for whits This permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier: STATE FUND .tEXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 72 . 50 OVER/SHORT '; . 00
f policy Number: 7gs—q'TTTNTT /44 01701 /97BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADTNG 'PLAN—CHECK
(This section need not be completed d the permit o for one hundred dollars JSIOOJ or less.) r 72 .00 . 50
0 I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner iso as to -
become subject to the workers'compensation laws of California,end agree that B I should become subject to the workers' ###################RE############################################lE##############
15 compensation provisions of Section 3700 of the Labor Code.I a all wth com�.wtny provisions. I N D I V I D [J A L F. E E BREAKDOWN
Data 1 -2: 9 6 Applicant: `�b-,._q-7 w1/4..,__.____:_ •
Warning:Failure to secure workers'compensation coverage Is unlawful,end shall subject en employer to criminal penalties end TYPE QTY DESCRIPTIO N UNIT COSTTOTAL COSI'
•
civil fines up to one hundred thousand dollars(Sf00,000),In add/tion to the cost of swmpensation,denser.es provided for In
Section 379sofine,
the
eeendarorneysT«e. SFR 4800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 800 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the I - END OF FEES
performance of the work for which this permit is issued(Section 3097.Civ.C).
LENDER'S NAME: -
•LENDER'S ADDRESS: •
I certify that I have read this application and dale that the above information is correct.I agree to comply with all city and county ordinances • PJAN
/�► �J l •
and state laws relating to building construction end hereby authorize representatives of this'dty to enter upon the above-mentioned property - • •
Cam ®�' �g� irr.rKKKJJJ
for inspection purposes. �
-
BRENT OWENS c
0 2 1Q3 T .,_
��i. • .
Signature o ownar/Agent/ApplicanuContrador Date: - �.- •
CITY OF COSTA MESA
(5151 d6.WP) White-Building&Safety Green-file:Canary-Appicat:Pink-Revenue:Goldenrod-Assessor
9636 2/24/66 500- Ti.
,_• _ _. . -- a Applicant to fill In all spaces except those within heavy border.lines and-sign all appropriate declarations. _ _ - - _ -- -- -
CITY O,F'COSTA
7MESA�/CONSTRUCTION PERMIT , ' PER-•f/y9NO: •p' o_ TRACT,NO. LO`NO.• I UNITNO., : ' _ +• - I f: - - i '' - ! ['
Project• Address �/5/'�a /fAl/� -ST.CC•tT t• •
(; h - rr � ff � ) _ _ - , •
•Applicant's Mailing Address � ' TYPE OF CONSTRUCTION' ❑ NEW-LJ ADD U:ALTERATION- L�.REPAIR' ; ° -
/� ❑ CONVERSION t❑:DEMOLISH ❑ OTHER -
A.P.# n g Zone - • •
Owner's Name Praise -DXetce , onnee/T2An327 r DESCRIP,T ION OFWORK/,USE OF BLDG. ' - • '
Address ...7/4 ./iM;le�/� )c> '.—c,' C-•/S7 ' c . - t - 1 - - S Main Building _ Accessory Building'_
•
�p '/ r i:''l E .. Z. r
Arch•/Eng; - • - ` License No. [" /Z2Vj' i TYPE OF PERMIT -❑ GRADING" Li FOUNDATION ,LJ STRUCTURAL T Front - 4 - . . z - . _ 0
Address •
//JJ,�.. ' • f ❑'TENANT`•❑ ELECTRICAL^❑ PLUMBING 1❑ MECHANICAL • .B Rear 1 ! _ 1 t - N
Contractor's Namu(//rM�fuh16K•y t�.�(iRT/fy //L�honetrYS3/ I ❑ OTHER' ` I '•• 1 •A -
// / / PROJECT DESCRIPTION SD. FT. OCCUPANCY 'C Right •-
Address'mailing) /P. /✓/OX 2-2-1111/•�•s G' ''r,�/7 Z'7 7 „ 'IC ` „ ; G
�./kS�A1 '�i2 (�r2'� f•ev�-�"'-`-T 7 CONSTRUCTION TYPE - ,VALUATION $ 1 S Left
•• R
LCE City-License No. f>°�� / ZONE' GRADING CU.VDS. ' ' ACRES Ping. Ref.# •, l Parking Req /Provided " i •;._ ;• E
LICENSED CONTRACTOR DECLARATION - - , - • - - I
Q
I hereby affirm that''-I am licensed under provisions of Charter 9 (commencing 1 Remarks: • - , , 1 Planning Notes: , ' • - - - Mi
' with section 7000)'of,Division 3 of the Business and Professions Code, and - i ' T' •
my license is in full force and effect. �, , ' - ' 4 , ,
tense Cass' ' -20 ' License No. • "' ' I I ' • ' S:
' .ate I�/l'!- •Signature' de�-r fl1' ygt�, ' ' ' I ' , PLUMBING' - I I ;FEES 1 i : , '
WORK RS• SATION DECLARATION. , , , j )
I hereby affirm that I have a certificateiof consent to self-insure or a certificate I Bar Sink Showers ELECTRICAL I I, r FEES
of Workers' Compensation Insurance, or a certified copy thereof.(Section , - - ` -+ -;- - - ,- ' - _ . r
3800, Lab. CJ Backflow Preventer l IService Sink - _Automatic Washer Transformer 0 15-50 KW
Policy No. Company 1 ' Backflow Irrigation 1 Sewer Ca ' '� 1 ❑ 50+ KW .
8 Certified copyI - , p Construction Pole Sub. v.., , •
1
is hereby with tha cit
Certified copy is filed the city Building Division. Bathtubs 1 • Sewer Connection ICookin• g Unit. 'j., Meter ❑up to 100 amps
Date 1 1 . Applicant - .-
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION .- - . Clarifiers _- _ : _... - Solar Collectors '. -. - _ .- .Dishwasher �_ . __- . - Meter Dover 100 amps - -•-
(This section need not be completed if the permit is for one•hundred ($100) or ; 4
less). - Dishwasher - ' Solar Piping i i Dryers ❑Gas ❑Electric;Jr Sub Panel
I certify that in the performance of the work for which this permit is issued, I , - - -
shall not employ any person in any manner so•as to become subject toithe - Drinking Fountains l I Solar Tank : i I 1 ; Fan . SC". Motors Lb -1 'HP 01'/x'8 '
Workers' Compgn ticu Laws of Calif ornia/J / �,�..,/ - __ . • _
Date m-1. &6 fs Signature ' /yl�"� �f+"'✓\ Floor Drains Swimming Pool w/Spa FA.U. 1 • Inc• Solar,09�15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to.the __ _ ' _ _ - __ _ _ ___ _- _ 1
Workers' Compensation provisions of'the Labor Code,'you must-forthwith - - ' Floor Sinks Urinal ' Fixtures • - '
comply'with such.provisionsor this. permit snail be: deemed revoked. - �xy� _ , I M iCrowaV¢
CONSTRUCTION LENDING:AGENCY, _ f ': ,i as'Service - Outlets 'Water Closet t '- I a.1 W Device Boxes ' POI¢ Light
I hereby affirm that there is a construction lending agency for the performance - _ - ' `
of the I Work -for which this permit; is. issued-:(Section 3097 Civ. C.) • ' Interceptors .. • . ••Water Heater " _ 7. Outlets Ran•
ge r
Lender's Name. - _ _ - .
Lender's Address • - ' - - Kitchen Sink ; Water Service
OWNER BUILDER DECLARATION I - T. Switches' Sign , -
I hereby affirm that I amrexempt from the Contractor's License.Law for the ' Lavatories: . - Auto Wash • ' - - 1
'allowing reason (Section'7031'.5 Business and Professional Code: Any city or. - - Garbage Disposal ;Standing Sections
fumy which requires a permit to construct,alter,improve,demolish or repair' P i Tra . - '
iy structure, prior to its issuance, also requires the applicant for such permit p •• _ Laundry, Trays _ Generator DO.5 KW X5.15 KW Trash Compactor ,
' .w file a signed-'statement that he/she is licensed pursuant to the provisions of - - - -
-the Contractor's License Law(Chapter 9(commencing with Section 7000)'of l Roof Drains _ - ^- I 1 , '
Division 3 of the Business,and Professions Code) or that he/she is exempt .. - _ • -
therefrom and the basis for,the alleged exemption. Any violation.of Section • _ - I ,
•7031.5 by, any- applicant for a permit subjects-the applicant' for-a civil - '-' - • - ' • I .
enalty of not more than five hundred dollars($500).. ' f I '- V - '
LJ $
1'; as owner of the property or my employees with wages as their sole JReinspection-.Fee•; V ' $15 Issue F¢e_ 3 - r ,
compensation, will do the Business
th Professional
is not intended or offered • - Reinspection Fee 11 $15 • Issue Fee , ' $ 3
for sale (Section{7044, Business.and Professional Code: The Contractor's MECHANICAL I FEES - - _
License Law•dohonot apply to an owner-of a property who builds orimprove5 -
thereon, and who does such work himself/herself or through his or her own e ' Hood Or T DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not'intended one r oftl for • Boiler ' ype I, ❑ ' ' - • ,
sale. If, however, the building or improvement is sthin one year com- - DarioType Zoning Approved By ' Date
prove ,the owner will have the burden of proving-he/she did not build o i im- Duct`-Under Ground I py 11! ❑ t 1 Building Approved By ' ' Date
prove for the purpose of sale). ' / 11\ , - [•1 ��_p/
❑ I,-as owner of the pr , am exclusively contracting with licensed con-. Duct-Structural , Refrigeration System Application Issued By - 1`Cl lsl Date �t CIFj
tractors to construct the project (Section 7044,Business and Professions Code: , ' '
_The Contractor's License Law does.noLepply.to an owner of'property who Duct-•Ventilating - • - - 00-100,000.BTU-. 100,000 BTU _ - 'SUMMARY OF FEES
builds or improves thereon,at h;who contracts for such projects with a con-. — - , - r ( t 1
tractor(s) license pursuant to the Contractor's License Law). I am aware that, ' • BUILDINGIPERMIT $ l EMIR, , i $
proof of their Worker's Compensation insurance should be provided to me: Exhaust System 0 Multiple 0, System Repair/Alteration I I
PLAN CHECK ; 1 $ I PERMIT ,
❑ I am'exempt under Section ' B.& P.C.for this reason , Firepl/Fact Blt. ICBG,# 1 I . Fire Dampers A ISSUANCE $ '
— • I PLUMBING $ 5 ,no
PLAN CHECK .25%' $ I ENERGYIP.C. $
Date Owner' 1 • Heating System& Ducting Register's ,
i
l'hrmatioce is corrhat I have red d-this'd with tien and state that the above ' ' 00-100,000 BTU 0100,000 BTC— ' , i ELECTRICAL • $ GRADING ; $ _ '
information is correct.Ii agree to comply uctM1 all city and countyritrepre-
ordinances - ' ' .
and state laws relating to building construction,and hereby authorize r - I I I PLAN CHECK 'S0%' $ ,MICROFILM $
sentatives of this city, to enter upon the above-mentioned property for _ , ; I : e
inspection purpose p � I f MECHANICAL $ ' . J 1�y
Signature city,
•/��'1 Dato;-s241-74 'TOTAL FEE $ - V�
Drivers' License or SS# _ - _ Reinspection Fee $15 r Issue Fee $ 3 PLAN CHECK• .25% $ • . 1 r
_ -- - _ . . -
CMF 0865.46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
-
CONSTRUCTION AND PLANNi._ •- JOL &SPA . . .
Date . Inspector' Date Inspector
APPROVALS Permit# APPROVALS Permit# -
.1. Temporary Electrical Service or Pole 52.- Pool & Equipment Location c .
' 2. Soil Pipe-Undrgrnd. . - 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 Grnd. - 57. APPROVAL TO COVER-GUNITE ,
7. Footings 58. Electrical Conduit-Undrgrnd. - '
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 - .
11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final
12. Sewer Cap - ` 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing System - Final. - i
14. Rough•Plumbing - 65. Electrical-Final -
15. Rough Electrical-Conduit - - - - • • 66. 'Solar System-Final - - • - 1
16. Rough Electric Wiring67. Fencing & Access Approval . -. - --
17..Rough Wiring Sign - ' • 68. ,APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL -
19. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT'
•
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure . ' , 70. Underground Hydro ' ,
22. Ducts, Ventilating. 71. Product Piping 0 Gas 0 Oil ;
23. Gas Pipe-Rough& Test - , 72. ,Underground Flush •
24. Roof Framing 73. Undergrnd.Storage Tank O Gas '❑Oil
25. Roof Sheathing - 74. Overhead Hydro .
•
26. T-Bar Ceiling (Structural) & Monocoat 1 75. Dry Chemical •
27. Frame and Flashing 76. Dry Standpipe -
• 28. Lathing & Siding 77. ' FIXED SYSTEM FINAL , y
' 29. Insulation . 78.-FIRE PREV. FINAL
30. Drywall Nailing ' ,' , • I HEALTH DEPT. REQUIREMENT -
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 _ , • . I T -. ,
36. Hood or Canopy . .
37. Final Factory Fireplace . ' ••
38. Final Plumbing i - .
39. Water Service-Final • - .
40. Gas Service-Final. pe�o)c 4:0ic c /fi/� e t - .
41. Solar Domestic-Final ✓ _
42. Backflow Precentor ' - , -
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 i - - . - . . •
50. Gas'Release to Southern California Gas Co , ' 1 • '
51. CERTIFICATE OF OCCUPANCY- •
No. - -- -Date
RE$$OF BNLNNC:I 213 MAGNOLIA ST WIT: CITY OF COSTA MESA - BUILDING PERMIT
AN ER9IOMEIFIMOWN: STROLLO, RICHARD T
PERM NO: B 075803
A ADORES': STROLLO, DIANE FRASER
213 MAGNOLIA PERMIT NO: B 075803 PLAN CHECK NO: N GOVT: N SUPP: N
OSTA MESA, CA 92627646-1766
APPL.MAILINGADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF /SHEATHING / 25 YR COMP SHINGLE SQ FT: 4 ,800
ARCH.OR ENG.'S ADDRESS: UHT:
CLAIM VALUE: 4 , 800 . 00 CALC-VALUE: 4 , 800 .00 GROUP OCC: R-3 /M-1
CONTRACTON'sNAME: BRENT OWENS ROOFING ( 714 ) 978-2075
ClkITRACTORS MMUNO 12901 BUBBLING WELL RD COMMENTS: REROOF RESIDENCE / SMOKE DETECTORS REQUIRED PER 1994 UBC
ADDRESS: SANTA ANA CA uc.No.: 600402 ****************** Est***************************g*************S6*****************
92705 UHT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I sin licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code.
�and
.myy license b in lull force and effed.
1 CITY UC.NO.:061174 UC.CLASS: C 39 LI : 0+J \`-=`"EXP : 01 /96 MAIN BUILDING ACCESSORY BUILDING
' 1.. QCy comacl«: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I ata exempt from the Contractors License Law la the
' 'Meowing reason(Section 7031.5 Business and Professions Code:Any cry a°aunty which requires a permit to construct,alter,improve, PARKING REQ: PROV: PARCEL : 42540121 Z NE: REF NO
nnols
h.or repel any structure,prior to its issuance.also requires the applicant for such pelma to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Law)Chapter 9(commencing with Section 7C00)of Division 3 of the PLANNING NOTES>
sliminess 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 penally of not more than five hundred dollars[S500]). ********************************************************************,***********
❑ I,as owner of the properly or my employees with wages as their Bole compensation.will do the work,end the structure is not intended D E V E.-L OP MENT SERVICES R EQU IR EMENT S
or offered for sale(Section 7044,Business and Professions Code:The Contactors License Law does ml apply to an owner of property
who bolds or improves thereon.and who does such work Nmsel or herself or through he or her own employees,provided that such 'W
improvements are not intended or offered for sale.ff.however.the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: '?
ownerbuiler will have the burden of proving he or she did not build or improve for the purpose of sale).
n 0 I,es owner of the property.am exclusively conlradig with licensed contractors to construct the project(Section 7044.Business andt
Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE: %
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ I am exempt under Section: B.S P.C..for the reason: APPLICATION ISSUED BY: DATE: I-T27-9w
*************aE;'*'********************************** * ***************************
Dale: GTeC LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I da hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533.and
25534.and that I or any houre building occupant will/win not(circle one)need to comply w'h said slate codes and the requirements kr
a permit or modification fromi iy an
from the AagemenlDistrict.Residential applications are exempt from these BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 72 . 00 . 50
Date: Applicant: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm
under penalty of perjury am of the following declarations: PLAN
ISSUE FEE
❑ I have Code, ndwaeaintantcateofconsenttohispeureforwrkeracompensation.asprovidedforbySection3700oftheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,for the performance of the work for which this permit is issued.
TOTALS----> 72 . 50 0 . 00 0 00 72 . 50 72 . 50 . 00 00
r'1 I have and wit maintainworers'compensation insurance.ea required by Section 3700 of the Labor Code.for the performance of the ,
g work for which this permit is issued.My workers'compensation insurance tamer and policy number we:
carder STATF. FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 72 . 50 OVER/SHORT: 00
Policy Number: 9AS-95UNTT799 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed I the permit is for one hundred dollars($7001 or less) 72 . 00 . .f . 50
❑ I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to
become subject to the workers'compensation laws of California.and agree that if I should become subject to the workers' *************************************'*************************************ori****
1
compensation provisions W Section 3700 of the Labor Coda. wen comp with h ere prowianm. INDIVIDUAL ' FIE-
F I'E E BREAKDOWN
,D Date: 1 -.Z-9 6 Appticant: dweS •
Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penelDes and TYPE QTY DESCRIPTIO N UNIT COSTTOTAL COST
chill fines up to one hundred thousand dollars($1040),In 00addition to the cost of compensation,damages as provided for In 4�I
$ection3105o/the Laborcode Interest,end attorneys feet SFR 4800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 8C0 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a constnsdion lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C),
LENDER'S NAME:
LENDER'S ADDRESS:
I coni that I have mad thisapplication �
yncoeMs a tel ha tebeuthezeecoes t thissreeto comply dlyer'menttned properlyroperly '
and sale ewe reetnp to building conalrlMon and hereby authorize representatives of city to amen upon the above-mentioned 0'
for inspection purposes.
BRENT OWENS 777
,Name JAN 0 2 ices
x Dale: 1 -2-947 ... M
Signature AgentyAppT l cent eiTY OF ° i, '.:1: , ^'.ESA•
(5151.46.WP) White-Building&Safety;Green-Fb:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor
r
--arCONSTRUCTION AND PLANNING POG SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
-
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe•Undrgrnd. 53.-Steel Reinforcement • ' •
.3.'Electrical Conduit Utility-Undrgrnd. 54. Forms - ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 1
•
- 6. Electrical UFER Grnd. [ 57. APPROVAL TO COVER-GUNITE
7. Footings 56. Electrical Conduit_Undrgrnd. .
'8. .Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
_
9. Water Pipe-Undrgrd.
n 60. Backwash Lines, P-Trap, ❑ Undrgrnd. '
10. Structural Floor•System 61. APPROVALTO'DECK '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
I
fr
-
12. Sewer Cap - l 63. Heater & Vent-Final
13. Roof Drains _ 64. Plumbing System - Final
14. Rough Plumbing . 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final ,,
16. Rough Electric Wiring, 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
' • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -
20. Rough Factory Fireplace -. - :'APPROVALS ,:-Permit# -
21. Ducts, in Structure . •• 70. Underground Hydro
22. Ducts, Ventilating r •- - • 71. Produoi-Piping ❑Gas 0 Oil
23. Gas Pipe-Rough & Test _ - L " - 72. Underground Flush -
24. Roof Framing' , , ,73:.Undergrnd.Storage Tank•0 Gas ❑Oil
25. Roof Sheathing , /....3,q6": l'(,vlr. ' 74; Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat • 76. Ory Chemical -
27. Frame and Flashing , - -- 76. Dry Standpipe t •
•
28. Lathing & Siding - - ' 4 : " ' ". 77j FIXED SYSTEM FINAL --
29. Insulation' : 78. FIRE PREY. FINAL
' 30. Drywall Nailing - _ HEALTHbEPT. REQUIREMENT
31. Plaster Brown Coat _ ,X79. FINAL INSPECTION
. _ .
32. Electrical Power Meter-Final .' - 80.'•FOOD CERTIFICATE ISSUED
33. Finat;Electric - Notes: ///�- // y
? 34. Final Heating & Air Conditioning' /6/111/c - 1/�{-�` / 6i -
35. FinalGas'Pipe-Test /� ` -`
_,
•36. Hood or Canopy - (�
37. Final Factory Fireplace -. -- .. - .
- 38. Final Plumbing • • - '..
39. Water Service-Finaf T - r -- ^.,. , ,"
-
40. Gas Service-Fi al ..i- ''`•
' 41. Solar Domestic-Final - - -
.
42. Backflow Preventer •_ - - 7.
43. Backflow Irrigation , ' • c
44. Landscape.IrrigationSystem • - - - -
45. Sound Attenuation " - ,
46. Handicap Regulations - - - - .
47. FINAL STRUCTURE& BUILDING 0..0 Ci671t^'W'" - -- _ _
48. FINAL PLANNING . - f - -
49.. ElectricRelease.to-Edison • • I - I•
0. Gas Release to Southern California Gas Co - -
51. CERTIFICATE OF OCCUPANCY ,
No. Date
TT
CoS- lIiYI
► ii ;. 2.1.,.;:litt_.,____i r.
i
Iv -o" I.A ►
10 I
. • � ()STA MESA J
PLAN ING DEPT.I I1 I ! I I I I 1
SUBJECT TO 'LDG. DEPT. REG.
BY 6.Oel ; DVATE.IL-
NO
DIRECTOR OF ; NNI
.
1 I I I I I n
HOLDI FOia' SPECIAL REQUIREMENTS
a
f 4
r-4) 1 1 , pele-e-c7 I Tie: a
I �
j j . 1 Fra4- v e'
1 (
•
j •
I . •.
j I STRUCTURA I '
APPROVA LY
. f i SEPARATE PERMITS qRE 'L..�� 1 I I
FDR ECECTR CAL, 'PLUMBING IRED
APPROVED
HEATING,
CI I NTIL TIN ND I
City.of Costa Mesa Building 'Dept.I I I REFI ICER TIOry� yy RK
i I I I
1. . JJJEKK���'"P�____I-A.+r r __-_DATE_L. 19Yq I I I T��I QER II. QST , I I
MAKE Ntl MUST BE ON JGIe AT IA TIMES i r
OF DEPT. b CHANGES I WITHOUT PRIOR ; ALL INSPECTI� AC"D PANY I I
!tvPxovAe N REQUESTS I
I
TME ISS AJ CE CR GRANTING or A PEIMIT OR APPROVAL j I. • I I I 1
es A,tO SNEiNRCATIINS SMALL NOV BE OONSTRUEO • BE EMP10yEpi PERSONS
To. B>: a PERl.;tT Eat DR a RE L F ARE ' I '
OE ANI OF T+4E FISChISIONS Ail:
FATHIS CODE]• O R I AN PjE4 STATE pF WE SUGGEST' THAT TO
Cg11FOR IA DIVISIOry THE
I
IOW+wN SNE n n+TY. VolNO PERMITepE; INDUSTRIAL SAE,ETY pp
PRoWsIONs. mir v+D.VALI OR;DIST
I THE:
ADDITIONAL REQUIREMENTS.CON IULTEDI FDR ;
FAR AS.'myE '�'� CODE �HAeu BE: VALID.,EJ(CEP.r IN�,$Q QUIREMENTS.
' us utcai ni AUTHOB1zEs;IS=L4wFUL. • I I
TIRE Swam.CFA PE11
II I In
r I I I
S PECIF,iGAVppNS1 SHAM! RMIP BASED)UPON'PLANS;A , •
I F9Oai:T:I lIONSI S RE "0n P(EVEND 1TNE BOILDINGIGFEICIAL
1RVNG: THE
IN SAID RiuYNfi AHO,, or, E CORRECTION OF�ERROR'S
r '
B°II!DIN°pR bWIOUATIONs OR FROM PRLVENTiNO I I '
•
61N.VJDMTIIDN'DFTNIS �pM6•CbRR/ED�bN.THEREUNDER-WNEN�
OH T4c.'miu, Ox' OF ANY. Muco .............. I I r
uwivrrs VIC UARUNNA DATE Jtx..—
JOB ADDRESS 213 Magnolia BUILDING PERMIT NO. 24329
GENERAL CONTRACTOR C M L Co. DESCRIPTION OF WORK Patio Roof
AP No. 117-171-21 LOT TRACT FIRE ZONE 3 VALUE $ 790.00
I- ECTIONSI Signature Date GROUP I TYPE V ZONE R 1
_
S, PERMITS ISSUED
k_Gas • SUBCONTRACTOR i Date
Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con. 0
Sprinkling System •
Miscellaneous ,
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 i Power 0
Rough Whin � �9 f� Heating and Vent.
Trenches p' Forms 0 Steel Reinf. ❑ C
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing— In 0 Out 0
Plaster, Brown Coat �,
Si Pan^tural, Final .2 S-' Electric .
1 ag, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final rn 7- /y
_$_
CITY OF COSTA MESA
94V9P •
COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 23 1965
P.O.BOX 317 COSTA MESA,CALIFORNIA
For Applicant to Fill In Completely /DC111Z PERM •
TYPE OR PRINT.
BUILDING /� �+/ / '` A For Office Use Only
ADDRESS /y27 VIr'hC�fy Cil (A
'RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA Arici ����'p���
('`sem [� .. /� • 1/F`� i V EV F'zATT23=�sI
OWNER v/�I.aC• Cita .E�/.w A.
ADDRESS L„` b 6, 0 Co—i BUILDING
MAIL ADDRESS 2 /1 �� -
(� FIRE f
O .( / TELNO. ZONE E GROUP
APPROVE V4E
/ LL
ECT TEL. BY � 6 JC. JINEER • �� NO. G
ADDRESS ((pper� EON[(A)�� PLANS NO:OF �BDE�OFNyj�N/IC
CONTRACTOR INS l- \,_4') 1 V• I ( I BUM
LEGAL � / & / 1Q`•gp y9µ
ADDRESS1�� S-Vpad_0(Z,� DESCRIPTION
CITY eVpv^
I
NOTE: NO EAV E OV ERHA G SHALL BE LESS THAN
STATE nom" / - TEL. 90'TO SIDES REAR P.L.
EAVES
LIC.NO. �^y-('/10 Tilts4-1(
OF LOT w7 O I ] &( X 12S.D NOW ON LOT I�
SIZE NO,OF BLDGE. ALLOWED (U.B.C.REQUIREMENT)
USE OF (1�� n�j YARDS APPROVED YARDS APPROVED
EXISTING BLDG. tn.°C—t.a.- C. N'1` / (FROM C/h, MAIN BUILDING
ACCESSORYFTBUILDING
SETBACK LINE FROM
FRONT (�C N%{FT lTU •
CENTER OF STREET REAR YARD
SIDE YARD I LEFT I RIGHT R.SIDE Ili FT. it N FT.
(d/
DESCRIPTION OF WORK L.BIDE Sri'. hri6 444 Fr.
?r6(
NEW - _ ALTERATION _ ADDITION REAR
y6 FT. 9Y(
------����II// DISTANCE BET. BET.MAIN S
REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.BLDGS.
BUILDING NO.OF VAR.# DATES
SIZE ROOMS STORIES C.U.PP...# APPROVED/` �y-Z .
EXTERIOR WALL ROOF ����e ,BYF W' 1 0 ` DATE {(9 p J40C.
COVERING COVERING V. J (Ar�','M`
Sec1 '
USE O °NDWORK T�OBE PERFORMED
•
2 CS SQ.FT. u
C.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE S REGULATING ' VALUATION I
BUILDING CONSTRUCTION,( \ PERMIT FEE $ j
SIGNATURE OFI' /Lt\1e . � n) I�w. , y�. -
PERMITTEF ��,'} 1 rLGG�V� A^!/IMI G
$ PLAN CHECK $ • E
AUTHORIZED AGENT _ 4 cic9 E
TOTAL FEE,
OWNER HOUSEK, Mike DATE 11-19-76
JOB ADDRESS 213 Mal olia S re- BUILDING PERMIT NO. i
GENERAL CONTRACTOR 'l,rr - DESCRIPTION of WORK - ,q t
'°Y?; ).117-171-21 LOT TRACT FIRE ZONE VALUES 130.00
tW
Y"n`t:`: CTIONS Signature Dote TYPE V GROUP ZONE R-1
SOI -
SUBCONTRACTOR PERMITS ISSUED
GAS
I WATER PlData Number Signature
umbiinQ
ROUGH PLUMBING^ O /A(J,/��/,( /�_�a' 706 ��
PROP. SWR. LINE LJ HOUSE CON. 0 ,-'�'` 7,
SPRINKLING SYSTEM - ..
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE l S ...... '
UNDERGROUND POWER I N ^1 II N� n d� U
ROUGH WIRING H titail Vdtn���*.' H N i;`s' tf
• TRENCHES E FORMS LI STEEL REINF. I.F��I ti N ., 4 h Ij
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n p qC ee
SHEATHING
FRAME AND FLASHING DATE ' r---V L .tI IC
V] ', .ct
-
LATHING — IN n OUT n ...
F TER, BROWN COAT
TURAL, FINAL Electric.
h-..,ING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC. FINAL
BUILDING. FINAL '
43074 . , iq-7.� -t; ;1?,;n-} .... .. •....-3o
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
' .C• TION FOR STRUCTURAL PERMIT
For Applicant to Fill
,�in Completely —Use Ink Only
' BUILDING 213 HaanU Ila ST'. RE,i1�� ���
ADDRESS
1* JJ
4. OWNER MI� �USQIC A.P. NOJ/7—/7/-2/ PY �,,s" l�
r. MAIL BUILDING 9I ACJcIIa 1---
I ADDRESS
Same ADDRESS
�/ �/ p ADDRESS (� J V A
CITY Ct�a�-a Mesa NO. ant TRACT �7 LOT' BLOCK
i CONSTRUCTION ,, 11 NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER ryDhe X � f
{ BRANCH OWNER MI if.
I4OU',F lC •
ADDRESS • �C�C//��)� VALUE art C04--•: ARCHITECT TEL. USE I � $
OR ENGINEER NO. Fr
; FIRE
ADDRESS i ZONE IvioT PE GROUP fr
'1 APPROVED 0y 7i
" CONTRACTOR QWAt'/'� I7ctl I�,. s BY DAT 1.- I 1
II ADDRESS ZON! 'PLANS
OF. USE OF NE
TEL J� / PLANS/„/�� BUILDING
? CITY NO. !\
F iSTATE CITY YARDS APPROVED YARDS APPROVED
`' LIC. NO. LIC. NO. t. MAIN BUILDING ACCESSORY BUILDING
/ / NO.OF BLOCS. ,./ : (FROM C/L STREET)
4 I
OF LOT 50 X 12,GNOW ON LOT .1 RONT FT. QQ
USE OF
-'' EXISTING BLDG. R,SIDE FT. /o 7atn;..c._
rA .
` ' Separate permits are required for L.SIDE FT. /6 FT.
electric,plumbing and heating work. f
.1 3 REAR FT. ol FT./
I.. ' USE OF BUILDING ANO WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
-C ., MAIN BLOC'S. ACCESS.BLOCS.
' /^ 7 ( � (( VAR.# DATE
-▪ f Cerawi L kiln 40 be C,Ot7$'fYNc-tNd C.U:P,# r,n APPROVED
APPROVED 0 Cr� _
' /-1-7=-74-
,4
X9-7 ..
RY— i-/✓`-�R �pATE�I -- 47-
BOLD-FOR SPECIAL REQWREMENTJS
r in f�c.l; ya
I hereby acknowledge that I have read this application and state tic . - in
-
atiCd ? that the above Information Is correct and agree to comply with
co
L - all laws regulating building construction, and I shall not employ `,yr r�r,r q os
Z any person in violation of the workman's compensation laws of ('� r/v/�a.r L�Q/1j� wrJ �
W ' the State of California. ✓ _ —
,: I hereby certify that I am properly licensed as a contractor under SQ. FT. of
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
ii Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE N r: e
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $ A Y
and Professions Code,Division 3,Chapter 9.
A CJ J PLAN CHECK $ ea
1 Signature of /tte- Z /,f J fl4�,_ /� o
Permittee z�/Y(,/Z� �T"I{NLtf(i/ $ I/g7f ' TAX $ Lv u
i Authorized Agent (f TOTAL PAID $ ql Jco