HomeMy WebLinkAbout607 LASSEN LN - Building PermitsCity of Costa Mesa Plar �, Department
Post Office Box 1200
77 Fair Drive
Costa ��esa, Califomia 92626
(714) 55fr5245
REQUESTFOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. ����f� '— �
Lot No. �%
Address�
Date _��� r� 9 �7
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, she, they)��(was or were) �� advised that this tract has
not b�en given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval evhich were imposed by the
City at the time the final tract map was approved.
The City assumes no liability for tl�e enforcement of the conditions
r 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.
� RECEIVED
; CITY OF COSTA M11ESA
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AU G 2 � 1977
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CatF 0569-26
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Pu¢haser
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Tustin, California 92680
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City of Costa Mesa Pla� � Department
Post Oifice Box 1200
77 Fair Drive
Costa Mesa, California 92626
(714) 55&5245 �
REQUESTFOR OCCUPANCY.
(Single Family Residential or
Condominium Units)
Tract No. �o� ��- � Date � .3 U - % 7
Lot No. � �%3
Address 6 O% � A SS e N L-A /v � LO ST1� i� C
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, she, theyl��was or were) /,rJ-Q�-� 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 c� io
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THE COLbVELI COfl9PANY
?773i IRVINE BOULEVARD, SUITE 210
TUSTIN, CHi.IFORPlIA 92680
0
- .
Pfl0.1ECT RO�flESS: [ O J LASSEN LN
OWNEH'S NRME: CTIRLEY PATRICK
� �aooncss: 6�7 LA�SEN LANE
CUSTA MESA, CA
556-5848
AflCHIENGINEEfl:
FUOflESS:
PEG.NO.:
UNIT:
UNIT:
PEPMITTEE: F.I�ECT'RTCAL SY�TEMS TEST. ( 714 ) 898-5113
HOOflESS: 1 SS I3 COMMERCE LANE
HUNTINGTON 6EACH CA 92649
ULENSEO CONTBACTOB OECLAFATION: 1 �ere�y atiirm l�al I am IicenseE un0er provisions al C�apler 9 �commencing wi�� Sec�ion
7000� of Oirsion 3 0l ��e Business anE Pmlessions Catle. anU my iicenu is in lull force anU ellect.
ciTx uc.: Q 219 3 sm.E uc.: 31170 9 ,,� A,wss: C 10�yh �
Oa1e: ' ' � Signature: _d�'�U �1/�� �/_�. ���%��
WOHREBS' COMPENSATION �ECLRNATION: I hereby allirm Inat I nave a cenilicate ol consent �o self-inmre or a certilica�e oi workers'
Compensation Insurance. or a cenihed coOY ��ereol (Section 3800. La�. CI.
Poucrxo.:1042904-90 E%P.DATE: O%IOSI91
comraNr:STAT£ FJND
] Certi/hed capY �5 �ereby �umished. � Cerlilie0 copy is liled w,/ilA t�e ciiy Building DiNsion.
oace: 7"���� APOlicani: /"�' i�/�//,A l/�. ���d��<�/�
E%EMPTIONFflOMWOPREBS'COMPENSATIONOECUflRT10N: �T�isseclionneeOnolGecomDletetlilthepermilisloronehundreA�5100�orless�.
I Ceriity Iha� in t�e perl0�mante ol Ihe work lor whiC� thi5 permii is i55uetl. I 5hall noi em0loy arry person in any manner 50 as lo b¢tome
su0lecl lo Ihe Workers' Compensation Laws al Cahfomia.
Date: SignaWre:
'�. NO7ICE:II. atler making ihis eeclaratian. you shoula eecome suUiect lo ihe Workers' fAmpensation prWiSions oi the �ahOr
� Coae. you must fonhwit� compty wit� su[� piovisions or ihis Oermit shall be Oeemetl revokeG.
LONSTflUC7lON IENOING PGENCY: 1 hereby alfirm that inere is a constmction IenAing aAency Ioi ihe peharmance of Ihe work for
w�ic� Ihis Dermit is i5sue0 (Seciion 3W7. Civ. C�.
LENDFfl:
aooxess:
�i
OWNEH BUILDEB DECLABA710N: I hereby alfirm �ha� I am eKempi tmm i�e Contractors' State License Law lar t�e tollowinp reason
�Seclion 7031.5 Business antl Pmtessional CoOe: Any dty ol counry which repuires a permi� b tonstmct. alier, imprwe, Oemolisn, or
repair any slmcWre. Orioi lo ils fssuance. also requires Ihe aDDlican� for suc� permii Io tile a 5igneU statemen� thal he/5Ae is Iicen5e0
pursuam Io I�e pmvisions o� Ihe Conlraqo�s' S�a�e License Law �C�apter 9(commencing vn�h Settion 7000) o� Division 3 ol ��e Business
and Pmlessions Code) or Ihai he/she i5 exemp� Iherelmm and the basis �or �he allege0 exemp�ion. Nny violation o� Setlion 7031.5 by
any applicant tor a permit suUlects the ap0�icant lo a civil penalty ol not more tAan live hunGreO tlollars (35001.
I. as awner of tAe Dropeny or my emVloyees with wages as iheir sWe campensation, vrill Oo tAe xrork, anE tAe
O stmcture is noi intenAeO or offeietl for saie �Section 70ad. Business antl Prolessional CaUe: T�e Coniractars' State license Law
Ooes no1 apo�Y �o an mvner at a pmpeny wlw builes ot impmves thereon, an0 wM Ooes such xrodc himselllh¢rsell o� Ihrough
his or her own emplayees. O�a'^Oe0 Iha� su[h imprwemems are noi inlentled or oll¢r¢G lor saie. IL twwev¢r �he 6uilding or
impmvemenl is soltl vnt�in one year ol campletion, the own¢r will Aave Ihe bu�tlen o� O�oving he/5he Uitl nol builU or improve
. br Ihe pwpo5e 0� sale�.
I, as owner ol IAe pmpetly, am eMcluSively conVaciing wilh licensed conVac�ors lo conslmcl t�e pmiect (Section 7604, Business
❑ an0 Profes5ion5 Cotl¢: The CaniraclOrs' Sla�e Litenu Law tices n0tapplylo an Ownero�pmperiy who �uAAs orimD�a�eSlhereon
and who convacts lor such pmjeas witn a comracmqs) license oursuam to ine Comractors' State �icensa Law�. i am aware
thai D��� al iheir Worker's Compen5aiion insurance S�ouIC Ce O�ovi0e0 ro me.
n I am exem0� un0er Setlion: B. 8 P. C.
for inis ieason:
Date� Ownec
I do �ereby cenify Nat I am aware ol an0 un0erstand t�e reQuiremenis o� Califomia Heall� antl Salely Cotle Section5 25505, 25533, an0
25534 an4lhai I or any Iuiure �uilaing acupaN wilVvnll not (tircle one� neeC to compN wit� SaiE sta�e c00e5 antl Ihe reQuiremenis lar a
permit �or conslmclion or modiiicatmn tmm �he Air Oualiiy Managemeni Oislricl. FeSiEenlial conSlmction applications are exemp� imm
�nese o�ov67ons.
Date: Ap0licanl:
I hereby certifyihal I�ave iead�his application ana slalethalihe above inlormationis correcl. I aAree Io camply vnl� all ciiy anU counly
o�dinanq95a�dstalelawsrelaling�obwltliqgconslmctionandhere�yaN�orizerepresenta�ivesollhisciryioenlerupon�hea�ove�menlioneC
pm�,�tl(�.linspeciionpurposes. i/_G L�/
on�Pi ,�/ J I �fJ ,Q�ji�
��� �X! Y Signa�ure: '�(.�- /i( i"f"'-" �
�uver's License o� Soua� Securiry v:
t64t�<6 WM1ue—Bmltling: Green—Code EnbrcemenC Canary—ApPI¢anL Pink—Revenue: GOICenroG—Assessor
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: E 0513?4 PLAN CHECK NO: N
CONST'RUCTION TYPE: N—N PERMIT TYPE: ELE
PERM NO: E 0513:.
GOVT; N SUPF: N
PURPOS�: OTH
JOB DESCRIPTION : INSTALL Ei,ECTRICAL SWZTCH FOR AIR COND, SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS; INSTALL ELECTRICAL SWITCH FOR AIR COND.
1E �7(� ff if iF ie 1F 1F )f if If iE if i6 k if 161E� M� If �l} aE iF 7F IE # iF iE 1E 7F K if iE iE IE If 7E N� iE lf if �16 iF if if 1(� iF iF iE 1F iE M IF ie 1E � 3F iE 1f iE 1E If If if R�E ��F if �e Y.K iE i: 3i If � iE if �lE
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S ``
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: F'T IN REAR; FT SN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ � PROV; PARCEL; 93405193 ZNE: RcF NO;
PLANNING N(STES>
i
iE if i! iE if 3E lE k 3f ib k if 3E lf M if�if IF 3f R IF if it 1F iE if ±E iE iE % lk aE iE f(� iE if ie iE iE if � aE 1E iE 1f 7E if 1i i(� iF ib �f if i!� iE if iE iF iF }'. 3E if if iE ih �E iF if if fE 1f �li� %i'r iF 3F �Y.Y i4 �7(�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
7..ONING APPROVED bY UATE:
BUILDING APPROVED BY ; DAT�:
APPLICATZON ISSUED BY: DAiE• /
i!-jE iE iE *?F �lf 1E !F �1p iF 1F if� if iE if iE i(� iF iF iE 1E±FiF7FiF riR3 iF iFif . iF ifTf7FiF?F7F ;r)7F i: iFY�F iFgTt7F3t7FiF if iE i(� if +E ih iE ic ar- i!� .���'�F 1c.1F
iE i! iE 1f iE?!� iF !F 1E fF If 1f iE if iE If if �lf ih If 1f 1E iF k#� IE 1E 1! 1E 1klF +F iE iE if �lf �1E 1E 1F iF i%1F�M'if if iE if ?F if fE if if if �K i(. 34 df iF if �f i! iF�7E iF iF iE±E If � iF i4 i!� 3F if 3F iE )t R�)f
LEGALI7,ATION:N F E E S U M M A R Y STkUCTURAL SEGNENT;N
BLDG PMT PLUMHING ELECTRIC MECi�IANiC FIRE SMIP/RcS GkADING
PERMIT 11 00
�0� SMIP/NON—RES
PLAN
ISSUE FEE 15,00
HUILDING—DIV—> FERMIT ISSUE PLAN—CHECY. TOTAL PAID DUE
TOTALS----> 11,00 I5,00 0,00 26.00 26.00 ,00
REVENUE DIVI3ZON TOTALS--> COLLECTED; 26.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TUT GRADSNG PiAN—CiiECK
26.00
af 1l� it iF iE �1f� if� iE i' iF if if if iF if if iF iklf fF 1E f! 1f if if if iE 1F iE iE ih iE ik 1! 1f if 3E iE � iP if 1F )k If if if iE if iF ik 1F Y.� if if if s iF iE �if i4 iE Y-! �Y.Y 1F iF iF i4'If iF aE 1f iF a4! iF k�E i:
I N D I V I D 0 A L F E E B R E A K D O W T3
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QTY D� S C R I P T I O N UNZT COST TOTAL COST ',
1 MISC APPARATUS NUT L'ISTED REQ PERMIT I1,00 11,04'
END OF FEES
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CAT�: G3; i:� "1 T_i;t; _;;G�
CONSTRUCTION AND PLANNING �� SPA
� APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
+.,
1. Tempo�ary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Und�grnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrqrnd. 55. Electrical Bonding
5. Stee� Reinforcement " 56. Rough Plumbing & Pressure Test
6.� ElectriGal UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footinqs 58. Electrical Conduit-Undrgrnd.
�8. Foundation 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structural Floor System � 67. APPROVAL TO DECK �-
17. PropertY Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Finai
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final ,
I6. 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�Structuie. . 70. Underground�Hydro �
22. Ducts, Ventilating � 71. Product PiPing O Gas O'Oil
23.�Gas Pipe-Rough 8i Test " 72. Underground FlusFi
24. •Roof Framing �� 73. Undergrnd. Storage Tank O Gas ❑ Oil •
25. Roof Sheathing � � 74. Overhead Hydro ,
26. T-Bar Ceiling (Structuraq & Monocoat • � 75. Ory Ghemical -�
27. Frame 8nd Flashing � .' 76. Dry Standpipe '. �
28. Lathing & Siding - � � •- • 77. FIXED SYSTEM FINAL �
29. Insulation � � � � 7$, FIRE PREV. FINAL
�30. Drywall Nailing • ./ HEALTH�DEPT. REQUIREMENT
31. Plaster Brown Coat. ,. 79. FINAL INSPECTION
32. �Electrical Power Meter�Final '� 0. FOOD CERTIFICATE ISSUED
33. Final Electric '� , �JC ' Notes: ,
34. Final Heating & Air Conditioning � � ' �• . � � _ -
35. Final Gas Pipe-Test ' ' ' � •
36. Hood or Canopy ' . �' . "
,,
37. Final Factory Fireplace • ` '
38. Final Plumbin9 � , -
39. Water Service-Final � � ,� !
,40. Gas Service-Final . .
=41.SolarpomesticFinal� •
42. BackfloW�Preventer � '
43. Backflow Irrigation -
44. Landscape Irriga[ion System. � � . , .
.45._Sound Attenuation ''� • � �
' 46. Handic2P Regulations � � � " � ,
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING � � _ .
49. Electric Release to Edison ;� ��,
50. Gas Release to Southern California Gas Co � '
/
51. CERTlFICATE OF OCCUPANCY _
No. Dare
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to FiII in Completely — Use Ink Only
ADORE556d ba��os�o��o96i� SSE
OWNER Eir7� E.Vf7F�IA0�,L D/1/�dli�
MAIL �/_ �/ / _ �AI�
ADDRESS f'O /V L.Q �G�
CITY
L /L .l'i on ��P' No`.
BRANCH
AODfiESS
ARCHITECT
ADDi7ESS
CONTflACTOR
ADORESS
CITV
STATE �
LIC. NO.
SI2E
OF LOT
USE OF
TEL.
TE�.
NO.
CITY
LIC. NO.
Separatz permits are required for
elec[ric, plumbing and heating work.
OF BUILDING AND WOflK TO BE PERFORME
, � - — 'n•� : c; . . ^ rr
. . . ..,. . .. :t' ... �i.!._�
APPLICATIUN POR S?RUCTURAL PERMIT
RECEIVE�BY DATERECEIVED nercicciicr
A.P. NO. �f /O � (J�� �
ADIDFES�I—IAII iR
OWNER �yEcrZE2 �
USE (%��I� dNY VALUS � oa�
FIRE
ZONE TV E GRO
�APPROVED ��r� �2�d,��C
� NO.OF �
Pu+r�s G
VAROSAPPROVE�
/ (
L. SIDE �,
REAR FT.
DISTANCE BET.
MAIN BLOCaS.
VAF..�`
C.U.P, qy. �
APPROVED J
iV'� � i'.�...`. ...,.
USE OF NEW (p UI
6UILDING ��^
VARDSAPPROVED
ACCESSORV BUILDI
&
:. :L..,....._...
� hareby acknowietlge thec I have reatl tM1is appliwtion antl stote
tha� the above 7ntormation is correct and agree to comply with
all laws ragula[ing builCinB cons[ruction, antl I shall not amploy
A�V person in violatfon ot il�a wo�kman's compensntion laws of
Me Stata ot California.
hereb certit that 1 am SQ. GT.
I V Y properly Iicansetl as a contrector vnEer
�he Siata ot California Businass antl Profesaions Cotle, Divislon 3, THE AMOUNT SMOWN UNDEF VALU
Chapter 9, ana tnat such licenses are in fvll forca antl eftect, or I THE PURPOSE OF ESTABlISHING A PERP
am exampt from Me provisians of iha State of Californla Businass V ALUATI ON
a�tl Protassions Cotla, Division 3, Chaptar 9. PERMIT FEE 5
5�9�eture ot /. � `�Z t� � a '/ w ^/
PLAN CHECK E
Parmittee CfJ c e� wf $/G�J�'ODD TAX $
T /
Au[horizetl ABant TOTAL PAID §
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'- �rvrvcrc HSLTZSR ENTSRPRISES __._-- ---- .. _ unit 8-20-76
UJOB ADDRESS 601-611 Lassen Lane BUILDING PERMIT N0. 42505
�G
�-saw
`W
ROUGH HEPTING ANO AIR CON�ITIONING
TEMPORNRY SERVICE OR POLE
UNOERGROUND LI POWE0. �
ROUGM WIRING
TRENCHES �T FORMS STEEL RE
FLOOR SYSTEM
BONO BERM � STEEL REINFORCE I
SHEATHING
FRqME AND FLASMING�
LATNING — IN � OUT
PLASTER,BROWN COAT
STRUCTURAL FINAL
MEFTING. VENT., REFRIG. ANO A.C., FI
PLUM6ING, FINAL AND GAS TEST �
ELECTRIC, FINAL
6llILDING, FINN�
SPECiAL REOUIREMENTS
lyl:7
SUBCONTRACTOR
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