HomeMy WebLinkAbout1857 KINGLET CT - Building Permits , f i r
4`, S .' CITY OF COSTA MESA
BUILDING DIVISION
1
F f b.4. !^�,4I DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
PERMIT B06-02092
DUILDI e ERNIT
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 '
Job Address: 1857 KINGLET CT Status: ISSUED
Suite: Applied: 12/12/2006
Vicinity: Issued: 12/12/2006
Primary Occ: R3 Type of Construction: V-N
Parcel Number: 13963204 Zoning: R1
Applicant: RICK MITTELSTADT
Address: 5571 SPRAGUE - /
Phone: 714-995-5072 ---'
CYPRESS,CA —1 -/i; < -2
' 'Zip:_.,,90630 ISSUED BY:
Or
Owner: JERANKO,,STANLEY:MURRAt, 1� '
Address TR -,
.-.1;,..„.»rr
COSTA MESA,CA ` - Pyr, k 4-5'7i:6899
1857•1$INGLET Ct. - hip & 26 .•, < -
Contractor:',/' RICK MITTELSTADT_ROOF - ®'1
Address://557-1 SPRAGUE";.-1'[.<5- •--
/7,k// K / Phone: 714-995-5072 ., ' ;.i .‘ , ,,,,,,
CYPRESS;CA="
�1`//Zip': 90630////:--8License: 433862 ` /
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AdcJress: - / Address: - - •:' -
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/ / ,j�,� _- , Phone Phone.
- ,Zip: /4l`'ri ( License _ �' • License
/Or.1 , A7' ' SCOPE OF PERMIT ` 1, .:' _
T/OFF INSTALL 1-35LB FELT ON-A-4:12 SLOPE WITH 7/16"OSB AND 50 YUEAR COMP.SHINGLES-<-1r '
n't A�_ 1)'F _�' \/ > N V ` yi , ' )
I ! ,,-.1 I(i r �
^' '`.' "'CalcValuation' $14,000.00
i ?tan Check';, $0.00 7 ;r. G -
Permit: ', $237.25 _ :. - '`' -='-' " - Claim Valuation:
$14,000.00
SMIP Res:-,• $1.40
SMIP Com:' `. ' $0.00: /
' r � Other �, $0.00 it ' .. � � °
Inspection , . $0.00 - ._
�\ ' To41, �� $238.65 1 %.� / •
PLANNING & ZONING
SETBACKS ' /,�� ,f rw r
MAIN STRUCTURE
`RUCTURE Front -tw
0 Rear 0-0c,, / .Left 0 0 .` Right 0 /i/
0,
`
ACCESSORY Front.> 0-'0,'., & '---,=Rear '0-.0: hy, .Left -0 0 " '` r Right / /07 0 - ,
\ -vA. /./A, �',"H 2 j;/ ,7 /
PARKING .%\
' Existing 7; 0 ARequired 0. < - .Proposed:` , 0 `r' >-,
N N, N) i. /'/1� , ���,
\.
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
2446-46(6/00)
r •
Esitaassimanim
WORKERS'COMPENSATION DECLARATION:
I 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 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:
Carrier: P Policy Number:
(This(Tsection need not be completed it the permit is valued at one hundred dollars($100)or less.)
Imo[ 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'
�wmpensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
! 4 . LI,:-e- Yate: 1 7 ^ f Z -0-C
WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJE ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
" 'L . D DOLLARE($100.0001.IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR INS ON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereb at I am licensed under provisions of Chapter 9(commencing with Section 7000)of Di - e usiness end Professions Code,and my license is in full
for ' . am.(` 3 g-6 Class 4 -3 -
ature: {ter"' ./'9 W°- --7�--astr_ 9e: 1 2—<7 -0-6
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CONSTRUCTION LENDING AGENCY:
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❑ 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). I
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).)1
❑ 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.II,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 ❑No Driver's 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 Califomia 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? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 Safely 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 a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? UYes U 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 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? 0 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
abov:-.escribed property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
2._
CODE# INSPECTION TYPE am INTMALS CODE! INSPECTION TYPE ` 4.11111111 PATE INm1ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 206 Final Plumbing
200 Final Re-Roof Se, 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 _
�45 Twining Laboratories ETf aotigy=7✓1 ErI I., LE '622.
• `' dr ,01 "iii. 2 P.O. BOX 4p . 33t0 AIRPORT 'A'A` • LONG BEACH. CALIF 2Oa01 • (7 3 4?0-3355 • (213 036-2386 • (/l41 B?B-5432
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September 16, 1974 - Change in Report
September 12, 1974 Examination: SC74-5142
COMPRESSION TESTS ON CON TE CYLINDERS
Hr. Errol F. Heesch
12921 Aspenwood Lane
Garden Grove, California92640 �v/�d/LL�
PROJECT Swimming Pool for STAN JERANKO 3 O v�C.J
ADDRESS 1857 Kinglet Ct. , Costa Mesa
SAMPLE FROM Gunite Swimming Pool
• ARCHITECT CONTRACTOR
0.B.
ENGINEER SUBCONTRACTOR
Grove Gunite
SPECIFIED
MIX 4-1/2 to 1 STRENGTH 2 ,000 psi
DATE CAST 9-5-74 CYLINDER SIZE 5-7/8" x 12"
DATE TESTED 9-14-74 9-13-74 9-13-74
CYLINDER NO.
COMPRESSION 7 Days 8-Day 8-Day
TOTAL LOAD, LBS. 91 ,000 94,500 96,000
POUNDS PER SO. IN. 3,355 3,345 3,395
SIZE: 5-7/8" x 12" 6" x12-3/4" 6" x 12-1/2"
COMPLIANCE
7 Day test complies with specifications .
MADE BY DELIVERED BY RECEIVED ON
CYLINDERS Bobby E. Heesch 9-6-74
DIB FRIBUTION
E.F. Hesch - 2
Grove Gunite BUILDiN( SAFETY DEPT,
Costa Mesa Bldg. Dept.
•
SEP 211914 •
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TESTING
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•
September 13, 1974 Examination: SC74-5182
COMPRESSION TESTS ON GUNITE CYLINDERS
Mr. Errol F. Heesch
12921 Aspendwood Lane
Garden Grove, California 92640
. PROJECT Swimming Pool for STAN JERANKO 38 V6-3
•
ADDRESS 1857 Kinglet, Costa Mesa
SAMPLE FROM Gunite Swimming Pool
ARCHITECT CONTRACTOR
Irvine Pools
ENOINFER SUBCONTRACTOR
Grove Gunite
SPECIFIED '
• MIX 4-1/2 to 1 STRENGTH 2,000 psi
DATE CAST 9-6-74 CYLINDER SIZE
DATE TESTED 9-13-74 9-13-74 9-13-74
CYLINDER NO. I II III IV "HOLD"
V "HOLD"
COMPRESSION 7 Days 7 Days 7 Days VI "HOLD"
TOTAL LOAD, LBS. 99,500 104,000 105,000
POUNDS PER SQ. IN. 3,520 3,680 3,422
SIZE: 6" 12-3/4" 6" 6-1/4"x x 12-3/4" x 12-3/4"
COMPLIANCE 7 Daystest complies with specifications .
MADE 8Y DELIVERED 8Y RECEIVED ON
CYLINDERS Hal come E. Heesch /w• SAFETY
DISTRIBUTION: BUILDINr, SAFE E DEPT,
E. F. Heesh - 2
Grove Gunite SEP 1 G 1974
Costa Mesa Bldg. Dept. y�
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TESTING _
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1nq 53140.5 LoA Beach,QAl 90E01 12131 03t.-2386
September 12, 1974 Examination: SC74-5142
COMPRESSION TESTS ON GUNITE CYLINDERS
Mr. Errol F. Heesch •
12921 Aspenwood Lane
Garden Grove, California92640
PROJECT Swimming Pool for STAN JERANKO 5 8 S3
ADDRESS 1857 Kinglet Ct. , Costa Mesa
SAMPLE FROM Gunite Swimming Pool
• ARCHITECT CONTRACTOR , S
0.8.
ENGINEER SUBCONTRACTOR
Grove Gunite +
SPECIFIED
• MIX• 4-1/2 to 1 STRENGTH 2,000 psi
DATE CAST 9-5-74 CYLINDER SIZE 5-7/8" x 12"
DATE TESTED 9-12-74
CYLINDER' NO, 1 II "HOLD" III "HOLD"
COMPRESSION 7 Days
TOTAL LOAD, LBS. 91 ,000
POUNDS PER SQ. IN. 3,355
•
COMPLIANCE 7 Day test complies with Specifications .
MADE BY DELIVERED BY RECEIVED ON
CYLINDERS • Bobby E. Heesch 9-6-74
DISTRIBUTION'
E.F. Hesch - 2 BUILDING SAFETY DEPT,
• Grove Gunite
Costa Mesa Bldg. Dept.
SEP 1e 1974 ,:;
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r _ . r. )' r . . ti ot• e.¢.. r,. o o..' '0 'S CC 'C-'-L S'C,NS o" r,
. • August 23, 1974 ,- " ' '
•
. • 'Mr. Stan Jeranko _ _ .
- -1857 ,Kinglet Court '
. Costa Mesa, California ' . 92626 ,
Dear Sirt
Y
- A building permit has 'been issued to Irvine .Pools to construct a-. ,
- . private'. swimming pool on r property. ,
- In order that your pool will b • _ safe one and-for the purpose of
advising you of-your'responsibility- regarding the.-requirementsof
'the Costa Mesa Municipal. Code, we refer-you' to• Section 8107, a, -
copy of-which is tacked. . -
-This letter is_'direc to you in order that you will be aware of
. our ordinances and .can make a complete safety check of your pool
area. . ,
' '.',Sincerely yours,
- RICHARD HNNHART . , '
Building Safety Director , •
RH:cb ., ' -
-.
;
1,4
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. 0'46'3 DATE *�U/ 2
LOT NO. 6,3
ADDRESS /es7 ,&c eir CQVig?
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he-s (was o e advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition.
BYe )
�¢urcha�e'r
BY 77,e $&c-c44, Cc•tii1i� 'S
Developer and/or authoriz
RECEIVEDrepresentative
CITY OF COMESA 12��/0 la
PLANNINGINC DEPT.
AUG 10 1972 BY Lender
AM PM
7j8p9i10,11z1211j2i31415,6
A
OWNER 1ST LOS Angeles Corporation DATE 3-13-72
\DDRESS 1857 Kinglet Court BUILDING PERMIT NO. 34312
L £RAL CONTRACTOR The Buccola Co. DESCRIPTION of WORK Res.w/att.garage
APNo. LOT 63 TRACT 6663 FIRE ZONE VALUE $ 427500.00
INSPECTIONS Si nature Date GROUP I&J TYPE V ZONE 11-1
SOIL nr) �)J4'7Z- SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER 'MC 1-1-11-2i- ,A �/ PIu7777mbin,,g,/. /n/za )
ROUGH PL MBING 77 ,/{S PTO -/a- /YDS.7d/O ( i�Z(/9jf � :/-107g 49.0 .. ----
PROP.
PROP. SWR. LINE ❑ HOUSE CON. ❑ ✓IAr. (,--//�/ ///JJ, C J •t_2f_7Z 6////r
SPRINKLING SYSTEM �!" --/ C T
MISCELLANEOUS j11,^r (�L
ROUGH HEATING AND AIR CONDITIONING /14 6 ! O --7L
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING m 07-1---) bf r� r7}.. j -'-
ing and Vent.
TRENCHES yj FORMS ZI STEEL REINF. 2 J�'�" _r3,42.7��En / as7/0.-_>02 7/olFLOOR SYSTEM vrt .. / Y' 7, L-ent CL 470 . i/iy-7A ygJi4-1125'
BOND BEAM n STEEL REINFORCE n o ( ]� ///
SHEATHING / ��', rQ, �• y
.AG ANo INAS OUT Q� 'lf ,Y
PLASTER, BROWN COAT
STRUCTURAL, FINAL /I Z---7
' /JrE f� /[nom �/
HEATING, VENT.. REFRIG. AND A.C., FINAL /v4 r'(�77-- , Xf , tOcrn. ij W. 7 ?$7& .141772 -. --
PLUMBING,
PLUMBING, FINAL AND GAS TEST n s/v15),I �' '7]i �V'V""� / /
ELECTRIC, FINAL i//S /f22-Vpt-
•
PLAN NO. -11DR 34312 • PAID
LOT No. 63 HAP, zz-7?---00 935* ***Z03.98
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RE/3Y DATE REAEIVED DATE U D
ASGY1 K/N6[6T„ a/ ? q 7
BDDRESS/ f . COurt
PERMIT .31
OWNER 1st Los Angeles Corporation A.P. NO.
MAIL BUILDING
ADDAEss#1 Wilshire @ Grand ADDRESS/ocz/ei/VCCS7-- 6l/i2.T
tl L) CITY Los Angeles No..625-7341 TRACT E. 663 I LOT 63 BLOCK
ZZ
a CONSTRUCTIONNEW ADD ALTER REPAIR (MOVING DEMOLISH
N LENDER
O 1St Los Angeles Corporation ✓
am
,J D BRANCH •
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0 OWNER /.f 4
r . doge.
m iii J ADDRESS#1 Wilshire @ Grand E
J Q OR ENGINEER Farl G. Kaltenbach NO. 547-8046 USE �fY /�� v f $�i�^, a
V Q FIRE 0�('
Z C ADDRESS1823 E. 17th, Santa Aria ZONE TYPE GROUP [�C. /��
d w APPROVED
W Z CONTRACTOR The Buccola Company BY . DATE
J Q
03
JCC ADDRESS4501 Birch Street
W w TEL.
Z ZONE/� NO.OF USE OF NEW,c5$.G//q7?.
Cr h
CITY Newport Beach NO.540-8833 --/ PLANS,2- BUILDING2 cAg �..i4A,
-O STATE CITY YARDS APPROVED YARDS APPROVED
ton CL LIC. NO. 146423 .. LIC. NO. 2104 • _ _ MAIN BUILDING ACCESSORY BUILDING
D SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT 77' x 103.' IRR I NOW ON LOT O FRONT CO FT. FT.
USE OF
EXISTING BLDG. R SIDE FT. FT.
F- SIZE OFNO.OF •
Z NEW BLDG?)966 BQ ft' ROOMS 12 STORIES 2 L.SIDE $ • FT. FT.
EXTERIOR WALL
-
V_ COVERING ( ROOF Shake COVERING REARJ. S FT. FT.
-
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
0-
0
MAIN BLOCS. ACCESS.BLDGS.
Q ei-c
' 6/ `r�/ �. VAR.# DATE
O /¢�✓/_�,r C.U.P.# APPROVED y
APPROVED/./�a 6r�� DATE -�� 70
(n ABY rN
z
O • HOLD FOR SPECIAL REQUIREMENTS
•)
I- I hereby acknowledge that I have read this application and state STATE � c / /6
D that the above information is correct and agree to comply with
cc all laws regulating building construction, and I shall not employ `7�7/ (52 / /
l'"
any person tri violation of the workman's compensation laws of 2•( (J9(�
fn the State of California. _ co
Z I hereby certify that I am properly licensed as a contractor under T/qa F o
. the State of California Business and Professions Code, Division 3, THEA T SHOWN UNDER VALUATION IS FOR
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•
Chapter 9, and that such licenses are in full force and effect,or.l THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: cc
exempt from the provisions of the State of California Business VALUATION /�IL
and Professions Code ivision 3, hapter 9. ILS B
PERMIT FEE -$ tv
Signature of J -
Permittee ( �/ $ �j �UOi PLAN CHECK $ 7 E
G
Authorized Agent 0/ LL
` TOTAL FEE $
OWNER JERANKO, Stan DATE 8-13-74
ADDRESS 1857 Kinglet Court BUILDING PERMIT NO. 38853
_,JERAL CONTRACTOR Irvine Pools DESCRIPTION of WORK pvt. Swim Pool
$AP No.139-632-04 LOT TRACT FIRE ZONE VALUE $4000.00
INSPECTIONS Signature Date GROUP TTT TYPE j ZONE R-7
Pool Location • 4.--7 -3 / PERMITS ISSUED
Y SUBCONTRACTOR
Dote ' Number 1 Signature
Forms /2?� / 7-11
Main Drain • fl ).670 •
Steel Reinforce
n!"--5) M•7,./
Elec. Bond 4-10 'S'1-Cy lectric y 4/
Approval to Cover `17i l. 3'N J/411)do (/3-71 5714_—
Underground Electric %l 7 '3 /1.7ii p ///
Gas Piping Test >S Zf q lum•
bing �� g-i�-7�{ �LZP�/.�-�
Filtering System Lines SS 26
Backwash Lines and Recep. {'/2 h')7L(
trical Final a ' t/`' �1 7y
Heater and Vent Final /
Filter System Final
//1( 0
Backwash and Recep. Final
Fonrinn Final
In, 13 74PAIuOO1140• ***t
•
38$53 cB.f 39.50
COSTA MESA BUILDING-SAFETY DEPARTMENT '
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
FororApplicant to Fill in Completely REC• �W�V/E�BY D(/gTE RECEEEIIV D -D.5,TE ISSUED $
ADSS ICES l iC s La- ow' - O 'I —/ 3--/.9-771-
ADDRESS
'�� �,�r�� T �.[A / �t,.,/� E ��-��py,
OWNER ��� S)e-nP.N Cc A.P. NO./5 — v3•G 0y s/r'/V?C
MAIL \Ufl f/kt `E C I P BUILDINGDRS 1867 Hine-�LCCoe.,
ADDRESS U t 1 IV (�'� ADDRESS / �J
d 0 CITY C ��'�.I \ 's NOL5gb'([,j'� I�
TRACT/dS LOT Gs BLOCK
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CONSTRUCTIO - NEW ADD ALTER REPAIR MOVING DEMOLISH
O W LENDER Y
13. 03 •
J0 BRANCH al-An �epcip... `'0
J N OWNER
QW ADDRESS..:...../.........' -
' N (70
-03 OR ENGINEER I Jl tl/l 1\ ](JI r TSNm I"'l yy`%% I USE i'U-J�JLJ VALU$, 600
V Q /1 rye- �` , FIRE �/
W ADDRESS \l.\ l /`n'J1� v l ZONE TYPE /J GROUP
a W RU t ne
W Z APPROVED
—10 O NDER
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Ill uj
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z BUIL DING EW F 0 (
W STATE lr�y'� CITY lYARDS/G "• • YARDS APPROVED
N cc LIC. NO. _. 7`aK 1�5 t UC. NO. • ACCESSORY BUILDING-I
O M C/L STREET/
SIZE Qs
INO.OF BLOTS. 1IF • 7 FT.B�Iiu�
OF LOT �d�{�-� `�-. NOW ON LOTFRONT
•
USE OF
EXISTING BLDG.
qp/(�_.(.y(_�J,l{ E�1� - • 0 �1�`'FT.
I— SIZE OF
NO.OF
Z NEW BLDG. ,90
4V T ROOMS STORIES • I Or LJ /FT.
QEXTERIOR WALL ! ROOF +7
V_ COVERING COVERING / FT.
J USE OF BUILDIN AND WORK O BC PERFORMED
1BET.MAIN&
y ) •e,- By ACCESS. BLPCS.
Q DATE
O _ _ r Re- APPROVED ^� (�
CO T . _ • • rip ATE CS . -/ice-- '2/ q
2
OI hereby acknowledge that I have read this application and state • STATE Dthat the above information is correct and agree to comply with �� R
all laws regulating building construction, and I shall not employ v\�vn\
1- any person in violation of the workman's compensation laws of
(n the State of California. m
TAX e
I hereby certify that I am properly licensed as a contractor under SO. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
• Chapter 9, and that such licenses are in full force and effect,or I' THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: F
am exempt from •a provisions of the ate of California Business 2
and Professions r� Division 3,Ch.• 9. VALUATION / ` m
� •
PERMIT FEE $ eL w
Signature of h qd O
Permittee -7U- ItZ [ $ 100 PLAN CHECK $ /V•
� � a
) `o
Authorized Agent ` 9 it'
TOTAL FEE $