HomeMy WebLinkAbout1731 LABRADOR DR - Building Permits el M 9 CITY OF COSTA MESA
mainr.4 BUILDING DIVISION
y' _ , DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
1. 1 !rant I PERMIT
v A 1307-00622
St*Poppr60'"
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.aWLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1731 LABRADOR DR Status: ISSUED
Suite: Applied: 05/08/2007
Vicinity: HOUSE AND GARAGE ROOF Issued: 05/08/2007
Primary Occ: R3U1 Type of Construction: V-N
Parcel Number: 13916518 Zoning: R1
Applicant: LA RUE, CHERYL
Address: 113 SOUTH MINNIE ST �j�y/1��/r
Phone: 714-731-3425 ISSUED B`6
SANTA ANA,CA Zip: 92701
Owner: FELDMAN, HEATHER R
Address 1731 LABRADOR DR
Phone: 714-658-0002
COSTA MESA,CA Zip: 92626
Contractor: WEATHERLINE ROOFING INC
Address: 113 S MINNIE ST
Phone: 714-731-3425
SANTA ANA,CA
Zip: 92701. License: 729560
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF(E)COMP ROOF MATERIAL,REPAIR/REPLACE SHTG AS NEEDED,2 LAYER OF 15#FELT ON A 5:12 PITCHED ROOF AND REROOF IA
"MONIER DURALITE SLATE ROOF"ON AN EXISTING SFD WITH AN ATTACHED GARAGE.
APPROX 24 SQUARES.ESR#1647 5.9PSF
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $10,000.00
Permit: $181.25 Claim Valuation: $10,000.00 •
SMIP Res: $1.00
SMIP Corn: $0.00 -
Other: $0.00
Inspection: $0.00
•
Total: $182.25
• PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
• ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 -""
PARKING Existing: 0 Required: 0 Proposed: 0
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)
DECLARATIONS
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.
44�/2 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 wo rs'c�o efnnfss llom Insure�rl�e carrier and policy number are: O 26'1 —x04"
Carrier: �fAM 1 I I V\ Policy Number: ;O 5-ase 3
(This section need not be completed I(the permit is valued at one hundred dollars(3100)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 of California,and agree that If I should become subject to the workers'compensation provisions of Se on 3700 of the Labor Code,I shall forthwith
comply with thesenlsions. /�
Applicant Signature: \ -�Q D A4x D 5 q I
WARNING:FAILURE TO SECURE WORKS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLIFRE(5100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,NW ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed n r�Covision of Chapter 9(commencing with Section 7000)of Division 3 of the BusinessAnd Wet
ions Code,and my license is in full
force and effect/11.70 C$ t'J Class n 'c7
Contractor's Signature: . G"1"1 .,`- .Date*
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders 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 t0 its Issuance,also requires the applicant for such permit
t0 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 drivers license. 0 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:
0 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 n0 building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)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:
I 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 fled 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 ❑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? ❑Yes ❑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? 10 Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management 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 ❑No
0 (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 COMPUANCE 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.
Sin ur O el Owner(s) 619i�7
And/OrAut orized App leant ate. -
CODE I INSPECTIONTYPf PEEUIQ CODE* INSPECTIONTYPE QAIF MAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof f { f77 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
v /a? dr
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT O. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA CONSTRUCTIONQQ �n,^snnPERMIT �M �O/r 3! �� p A.P.# Zone
Project Address 1,7�� �DSW QQ/C ,�� - u't0 � 0 r / S Main Building: Accessory Building:
Applicant's Mailing Address SRwJ/O TYPE OF CONSTRUCTION H NEW LK ADD H ALTERATION LJ REPAIR
pd ri(� 0 CONVERSION 0 DEMOLISH 0 OTHER T Front O
Owner's Name r • -It C. n-�/I �� Phone-[7�•'9��� DESCRIPTION OF WORK/USE OF BLDG. I B Rear N
Address /731 �'Ag �2 ��
• Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL C Right N
Address ��..��11 ,L �_s.. J{� ❑ TENANT .0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $. Left - R
Contractor's Namo C4 L.h4 iC Co ;tine''c+/'77o " ❑ 'OTHER I Ping. Ref.# Parking Req./Provided E
Q
Address(mailing) a - •5�-e"/to L t, 1S ., / - 7 PROJECT DESCRIPTION SQ. FT. OCCUPANCv Planning Notes:
��s, Ni
1t_ /— CON STRUCTION TYPE VALUATION$ Jl�v T
City License No. '[�I(+D � ZONE GRADI NG CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION ,� ,`}/ �/"/] 1 — ,
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: KO csi f .O✓�`-T wry ' .
with section 7000) of aDivision 3 of the Business and Professions Code,and T-`A�
7.
my license Is In fu force and effect. / p _ Ot , • ELECTRICAL FEES
License Class Li s- �a v'1h,1 dl.•C Wv"1J
/J�1 i e. PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
Date - Signature _ ��._-
WORKERS' COMPENSATIONDECLA�;TION / . Construction Pole Sub. 050+KW
' 'eby affirm that I have a certificate consent to self-in ure or a certificate Bar Sink Showers
lorkers' Compensation Insurance, or a certified copy thereof (Section _Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
_.0, Lab. C.) - _
Policy No. Company - Backflow Irrigatiort• Sewer Cap Dishwasher .-- Meter Dover 100 arnps
8 Certified copy is hereby furnished. Dryers ❑G&s ❑EI¢ctr is Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connec ' n
Date Applicant Fan - Mo rs 00-1 HP 01%-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collo ors
l(This section need not be completed if the permit Is for one hundred ($100) or Dishwasher Solar P. mg F.A.U. c.Solar 09-15 HP 016-15+
I certify that in the performance of the work for which thi permit is issued, I J Fixtures
shall not employ any person In any n r as me subject to the Drinking Fountains• Sol Tank Microwave
Workers' Compen 13pn Laws of Califyryr rosy (y./�/O (�(p/b� Device Boxes
Date I1 -7_ �Y Signature 'r+�( Floor Drains imming Pool w/Spa Pole Light „
NOTICE: If,after making this declaration ou should bec bject to the
Workers' Compensation provisions of th boo Code, y ust forthwith Floor Sinks Urinal Outlets Range
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outle Water Closet •, Switches - Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is Issued (Section 3097 Clv. C.) Int¢ro¢ptors Water Heater Garbage Disposal - Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service • Generator 00-5•KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash ` , • r
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 Laundry Trays
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 • -
rision 3 of the Business and Professions Code) or that he/she is exempt aReinspection Fee - $15 Issue Fee $ 3
refrom and the basis for the alleged exemption. Any violation of Section -
31.5 by any applicant for a permit subjects the applicant to a civil -
genalty of not more than five hundred dollars($500). a DEVELOPMENT SERVICES REQUIREMENTS:
U I. as owner of the property or my employees with wages as their sole Reinspection Fee I '$15 Issue Fee $ 3 Zoning Approved By Date
compensation, will do the work, and the structure is not Intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES. Building Approved By ,i. Date _
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 3.I1 �1
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
Application Issued By - Date '-- I
sale. If, however, the building or improvement is sold within one year of com- Canop Type II 0 9 SUMMA `F FEES TT7
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground 1( J•"
prove for the purpose of sale). — ,BUILDING PERMIT $ SMIP $ V
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Ref( eration System 7
trPLAN CHECK
Thet ors t constructctor's the project (Sectionsriot
7044,Business and Professions t Cotle: $ — PERMIT
The Contractor's License Law does not apply to an owner property who Duct-Ventilating ❑ -100,000 BTU 0100,000 BTU „PLUMBING -, $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple ystem Repair/Alteration ' .PLAN CHECK '25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me, q ELECTRICAL $ GRADING $
0 I am exempt under Section B. & P.C.for this reason I Firepl/Fact.Bit. ICBG#..301 Fire Dampers ! eY
., ,'P.LAN CHECK 50% $ MICROFILM $
.Date owner Heating System& Ducting Registers •2l Lf�
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL • .MECHANICAL $ C 1 TOTAL FEE $
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to buil-i•g • .truction, and hereby authorize repre-
sentatives o t y se. • '• the above-mentionedti /proppeerty for f;
Signature Da[
Drivers' Licen Jr SS#
Reinspection Fee $15 Issue Fee6001J872-000182774=.412.'
— . , �' �i T@�ti
'i .--Ist..21DATE: 11/07/88 TIME: 15:44
65-46,rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
,d I
•�• 1 CONSTRUCTION AND PLANNING POC SPA
ti.! h' Date Inspector Dates Inspector
• r APPROVALS Permit# APPROVALS Permit#
It" ,
• 1. Temporary Electrical Service or Poli I'. 52. Pool & Equipment Location
r
2. Soil Pipe-Undrgrnd. ,r,_ 53. Steel Reinforcement
3�Electfical Conduit Utility-Undrgrnd. i ' .54. Forms
4:' Elect?ical Conduit-Undrgrnd. 55. Electrical Bonding -`,
I
S�Steel•Reipforcement' ! 56. Rough Plumbing & Pressure Test
.
63Ele&ical UFERGr,nd.,l ' 57. APPROVAL TO COVER-GUNITE 9`r C
7t(,Fodti.ngs 1` ; 58. Electrical Conduit-Undrgrnd.
;i -
•
B.Foundation _ ' I . 59. Gas Pipe, 0 Undrgrnd., Test 1 I.
9?Water Pip e-Undr rnd., (- ''
P 9 . ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1
10. Structural Floor Sysfem .! I 61. APPROVAL TO DECK • i
11:rProperty Sewer Line& House Con lection 62. Backwash & Receptor:Final
12. Sewe�;Cap - " •• 63. Heater & Vent-Final ''
I i
le
13. Roof Drains' 11 ! _
64. Plumbing System - Final
14. Rou ' '
,9h Plumbin 9;`� ( 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 (2.--14k L;g/D APPROVALS Permit#
21. Ducts, in Structure - ' .70. Underground Hydro
_ I . .
22. Ducts, Ventilating 71.: Product Piping 0 Gas 0 Oil
23'. Gas Pipe-Rough & Test 1 72. Underground Flush ''
24. Roof Framing , : ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing r� 74. Overhead Hydro .-
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27: Frame and Flashing76. Dry Standpipe '
28. Lathing & Siding • ' 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat' ! 79. FINAL INSPECTION .
32. Electrical Power Meter-Final .. - -.-. 80. FOOD CERTIFICATE ISS .UED ��77 11 - - +
33. Final Electric Notes: W" A+vY\;wi L a . Pe.fa..i.. -
34. Final Heating & Air Conditioning
c.ernp./'.RA o� C\et_ w.v. J d I EL
35. Final Gas Pipe-Test
Fig nr✓1 \.Nsti\40 C NA,N. im w1G'
36. Hood or-Canopy �-
1,2-Cr-a`a
37. Final Factory Fireplace 272-3/A L /z-/6-s8 ['p�(1 f�I /A.5?-tf'oa -?o• .4 p/i-rirka /
38. Final Plumbing OK �11JP "__ JJ'/_
39. Water Service-Final Z-2.2.--Ni Na Orr€ F7onite r 6.50
40. Gas Service-Final
41. Solar Domestic-Final , 1
/ 1 .1
' 42. Backflow Preventer •
43. Backflow Irrigation - •-
44. ,Landscape Irrigation System , )
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 2/`i,/n Lto
48. Special Requirements Completed !r
49. Electric Release to Edison -,
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY , ,
No. - Date •
OWNER MESA VERDE ESTATES DATE 12-9-58
---
JOB
JOB ADDRESS 1731 Labrador Drive BUILDING PERMIT NO. #8153
GENERAL CONTRACTOR L. G. Robinson VALUE $ 15.1195,00
AP. No. LOT 18 TRACT 3115 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar.
GROUP I & J TYPE V ZONE Al PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches //Forms VSteel Ale/3-.14-41-
Floor
fl4'Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam s£ . . g,-,/ 9
Frame and Hashing , A
— -1
Lathing, In" Out'( F; — G-S
Plaster, brown coat / 4 - L -SC
Underground soil/4-IS W/G Pipe TestMn fft.q -s-r
Top Out /1-/6'81/ �/T d �-_�j
Furnace AIlS 2/O'f.9' � ,s4 'gip.. J-�-"/ / e 7 /
Gas Vents �,/ /; J _
Rough Plumbing 4474,5 /-24 ' J� ,t-rtiLL..t 4ir.r /.)--/G-SA._._ . 6 6 6 f- t
Cesspool Septic Tank I J f I
Prop. Swr. Line 4„.-House Con./ /�St: Swr. 2-6-Sy tel. (I 41-3- C7 �r3`6 2a)
Sprinkling System ,1
Heating Final S" L,/-2o-S9 'll)
Plumbing Fixtures, Final .44/c v{-zo-s9
Final Gas Test LI"-- MIs 9-7,0 y�-49 V ,
Construction Pole
Underground - Powers
t
/
Rough Wiring 7/ 3- G_ 1 1.441 upvt- e c- /- aE-sYnclo Jit j b l
Fixtures, Final '�"Jt/" (/ - JJ
OCCUPANCY t- f- 4/� 3/S I
Form 21a--5M-1-57 /
�:. 8153 ui ct h iGE Ek
DEC 9 1958 �,,,
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O. BOX 3 I? ^ MESA COSTA MESA. CALIFORNIA CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ABUILDING
DDRESS 1731 Labrador Dr. BUILDING
COSTA MESA. CALIFORNIA / FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
OWNER Mesa Verde Esates 8153
MAIL / RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS 1701 Gisler ..St. YIEIM - 1D--9 -s`j /a2- 9-Sj
BUILDING
CITY Costa Mesa TNO.%I 5-1751 ADDRESS
ARCHITECT T R. Shelley No. G—a17G COSTA MESA. CALIFORNIA
OR ENGINEER V. /�
FIRE
ADDRESS Long Beach Ge 9-0908 ZONE
CONTRACTOR L. G.Robinson CITY LNO..- 3-- oNEi/ pLq HS TYPE
• --/ � ti
ADDRESS 1701 Gisler St. TEL. %I 5-1751 BY APPROVED DATE
LEGAL LOT ( CORRECTIONS
DESCRIPTION NO. 18 BLOCK TRACT 3115
A.P.NO.
y 1
SIZE
OF LOT X 70 100 N
I NO.DW OFDN B LOGS.LDT none
USE OFCr
-
EXISTING BLDG. T
SETBACK LINE FROM 501
CENTER of STREET plus
REAR YARD 201plus
SIDE YARD RIGHT 51 plus LEFT 51plus
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION
REPAIR Jy- MOVING DEMOLISH
d-/ t3 NO.OF
E DING 1560 q. Ft. ROOMS 6
SIZSTORIES 1
TR
CXERIOWALL ROOF
V
COVERING COVERINGCOVERING Asphalt & Rock
E
USE OF NEW
BUILDING Residence & Attached Garage
I HEREBY ACKNOWLEDGE THAT I HAVE EAP THIS APFCICA ON AND
STATE THAT THE ABOVE IS CORRECT AGREE TO COMPL WITH ALL /
CITY ORDINANCES AND STATE LAW EGULATING B�LDI CONSTRUC-
TION. / VACUATION '�t�
((�� / PERMIT FEE S 3 S• -
SIGNATURE OF iLt .. . /J J ' �.A_�,v.�-•-V
PERMITTEE "% ' 1 ✓✓ GG•/ OV _ CO
SIC '96: .�� PLAN CHECK S / A `7
�/ TOTAL FEE S n ,5 ,�`
AUTHORIZED AGENT •j ./- ./�
iJOBvIUYINLK NEWMAN. ESTELLE 6-5-68
ADDRESS 1731 Labrador Drive BUILDING PERMIT NO. 28653
GENERAL CONTRACTOR Dannv O'Toole DESCRIPTION of WORK Add Bedroom to Res.
AP No.
INSPECTIONS
1,39-169-1811
q_7(S_�$ LOT 38 TRACT X5 FIRE ZONE VALUE$I},000,00
Signature Date GROUP I TYPE V ZONE R-1
SOIL
GASPERMITS ISS ED
SUBCONTRACTOR
Date 1 Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND El POWER 0
ROUGH WIRING �5 7r2"t Heating and Vent.
W
TRENCHES FORMS ® STEEL REINF. Q 7f J., 6-iv-Cst
FLOOR SYSTEM A,n V-it/-6O
BOND BEAM in STEEL REINFORCE n
SHEATHING (vim
- q-6-,T
FRAME AND FLASHING �45 6-s8'-6
LATHING - IN Ffl OUT in 4750/ ''-'-F t' _
PLASTER, BROWN COAT /en 1-(0--&3
STRUCTURAL. FINAL Electri
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92020 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
DUILDINa For Office Us. Only
ADDRESS / 7 / AA/,3e4Pere-
RECEIPT NO. .r ZE T NO.
COSTA MESA. CALIFORNIA ''-'-'- 1/V�`Cl��j
��11 1 R[C IVSD BY ATE RECEIVE DATE ISUED
OWNER �A'.c kr{ TC//e z/eL4rii ^ T-3-mak 6--5- _
MAIL ,f SU IDI-RDI
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ADDRESS .�jv ISS C„.
ADDRESS / 1 U-OCL/7./Y4:0-1 .
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GAs i? 41es D j/ r/)n ZONA �J TYPE //i GROUP -.-•-•-
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CITY L71rL TIL
ARCHITECT TEL _��// APPROVED _ DATE
OR ENGINEER Y MId5CA/eco NO.. 7a id .- BY. / -r a .
IOW
ADDRESS `2 -.774e.,i'93 re.
[ NO. S UBE OP NEW V
7-i
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CONTRACTOR d?•/j )_/5-- -j D
ADDRESS ,,/7 ( "-c1/e 74e-'?� DESCRilmoN/ 6 )9 f/�/ ^ 3//)
CITY (BSJA ,Ml <4, A.P.NO. /3! -/ 4+ S~._ Ig
STATE 9 q /' , THL ;...../ '� '. a., NOT TO SIDE Q REAR P.LE: NO EAVE NG SHALL BE LESS THAN
LIC.NO. /� (17 Ar,tLae`-� S
EAVES
SIZE / NO.OF SLOGS. / ALLOWED (U.B.C.REQUIREMENT)
OF LOT JU r 1L16 a _ NOW/O�N LOT YARDS APPROVED YARDS APPROVED
USE OPEXISTING BLDG. /r e S • v A" ..4/L/1MAIN BUILDING ACCESSORY BUILDING
—�(FROM C/L STRE )�,�{- ,, /
SETBACK LINE FROM CO / D _Q/- t FRONT (j�f{� [ �/1 PT.
CENTER OP STREET REAR YAR v. /'7 /'
/ I 7 / ...SIDE /FT, PT.
BIDS YARD' LEFT ' RIGHf
DESCRIPTION OF WORK L.SIDE q (PT. PT.
/ REAR I/ PT.6// n
NEW ALTERATION ADDITION
RT.
Q— DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING NO.OP VAR.# DATE
SIZE ROOMS STORIES C.I.I.P.# APPROVED
EXTERIOR WALL I ROOF APPROVED /OW ,3/��
COVERING COVERING SY (y`4ATE �>
USE OF BUILDING AND WORK TO BE PERFORMEDV p,
f/, ASL? /, 'e-Ctieo° /IQ . w
Ad A
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I HEREBY ACKNOWLEDGE THAT.I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O
AND STATE THAT TNS ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. I
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING n
BUILDING CONSTRUCTION. VALUATION �r> /,,��/�� 7
��/) j� .�� PERMIT FEE 5 /`-� f// V O
SIGNATURE OF 6// ///7 iy.9 E
I 0J� I�J,`� PLAN CHECK 5 / •50 w
AUTHORIZED AGENT /Uvv ��
aillErISMIKNESSESniEKRIERIFfld TOTAL PEE