HomeMy WebLinkAbout2829 LA SALLE AVE - Building Permits ' CITY OF COSTA MESA '
Sil` BUILDING DIVISION
)•• ilk*''\ 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
•
4. - FOR INSPECTIONS CALL: (714)754.5626 Nsameso�
PERMIT NUMBER: B08-00277
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 14167214 DATE ISSUED: 10/03/2008
ISSUED BY: YH
•
JOB ADDRESS: 2829 LA SALLE AV CM Suite/Unit
Vicinity: HOUSE&GARAGE - _ •. - "
Squares: 0 - . .Valuation: ', $8,651.00
SCOPE OF WORK: REROOF. HOUSE&GARAGE-TEAR OFF COMP. SHINGLES,NEW 7/16".OSB,1 LAYER"OF 30#FELT&INSTALL
31 SQR'S OF GAF ELK TIMBERLINE COMP.SHINGLES ON 4:12 PITCH ROOF. .
OWNER: CROWE,JOHN W . Address: ..-2829 LA SALLE. - Unit:
PHONE: 714470-1100 City/State/Zip: COSTA MESA,'CA�
APPLICANT: EVANS,SUZANNE . '` Address: - - :=' Unit: :
PHONE: City/State/Zip: :•
CONTRACTOR: SCHILLER ROOFING m. ._ _ License No. _- 692490
Address: 1529 W ORANGEWOOD AVEUnit: - - -PHONE: - ' ' 949-476-2674
City/State/Zip: ORANGE,.CA 92868-` CELL: '
ARCHITECT: - - '-License No. ' PHONE.i f •
ENGINEER: License No. - PHONE •
FEE SUMMARY
.L,,,,ii:s4T/ALL:- ,.
Reroof Plan Check: $0 00
Reroof Permit Fee: $167 25
Reinspection Fee: $0 00
TOTAL FEES $167 25
•
t.l'rn_,7,
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CODE/. INSPECTION TYPE DATE INTRIALS, CODEI INSPECTION TYPE DATE 'INTRIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical `'LL
1266 Pool Spa Final � /,���Q/// 208 Final Plumbing -
f/
200 Final Re-Roof /9— o8 b ' -' 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
WORKERS'COMPENSATION DECLARATION: , - , Qwner ID verified by driv... ..cense. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's•License No. - Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property•tax bill or deed):
compensation, as provided for by section,3700 of the Labor Code, for the
performance of the Work for which this permit is issued.
(/`-r 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: •
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
` �v W ]-. r.�F 0by this permit,and that no building structure.scaffolding,falsework,or demolition
Carrier: $ lee�� lYl--.QY� or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
C--
Policy
section need not ae^mm el epe svalued al one hundred dollars($100)or 2.Art 2.Sec.341,Title 8,California Administrative Code).
Policy Number: �CR 9'-
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Dale
the Labor Code,I shall forthwith comply with these provisions.
{[,� P ^a J 1 r"�l aA 1 Division of Industrial Safety Permit Number:
d pp man's Signature 1j , ��ADate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds. or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is inn/��full
lfyforce and effect. a registration form for acutely hazardous materials? ❑Yes 0 No
Lic_ff..' 0"l Oz�t�O
1 Class#—C, (Section 25533 of the California Health and Safety Code, with some
„�,"'�� Lo ,,nn S---- exceptions, requires registration with the Costa Mesa Fire Department by
lz fvfP Q. 4fl2 �i VG' 3—Deach business which at any one time has on hand a quantity of acutely
SVT Contractors Signature —Dale 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature • S 1,: Date,
e 4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE' LAW for ,the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:•Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct,:alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or.she is licensed pursuant to the provisions of the Contractors information be furnished on applications fix non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own B (If'yes",attach certificate of compliance from the appropriate air'pollution
employees, provided that such improvements are not intended or offered for control
sale. If, however, the building or improvement is sold within one year of officer).
completion. the owner-builder will have the burden of proving that'he or she . CERTIFICATE OF COMPLIANCE: I''certify that under penalty of perjury the •
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ,
city ordinances.regarding Hazardous Materials and Emissions. '
❑ I, as oWner of the property, am EXCLUSIVELY CONTRACTING WITH ' - -
LICENSED CONTRACTORS to constmct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date . •
•
property who builds or improves thereon,and who contracts for such project with
a contractor(s)license pursuant to the Contractors License Laws.). 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 •
❑ I am exempt under sec. ordinances relating to building construction, and authorize representatives of •
Business and Professions Code for this reason: 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.
Signature of Legal Owner(s) Date
Signature ' - • Date \ L2 to
305]-6613/0]1 nt / fiO ll
Au on p Date-
-
• ►/
ifplicant to fill in all 5.. s except those within heavy border lines and sign/ill appropriate declarations.
CITY OF'COSTA MESA CONSTRUCTION,PERMIT /, �RMIT NO. TRACT NO. LOT NO. UNIT NO. -
¢ ,� � A.P.# Zone •
Project Address V g e v - I
IS Main Building: Accessory Building:
1 •
- TYPE OF CONSTRUCTION NEW IJ ADD U ALTERATION' U REPAIR � E - Z
Applril`.ant's Mailing Address _^ Front
1, <� +/ ' ❑ CONVERSION ❑ •.MOLISH ❑ OTHER Q -T T - O
Owner's Na,e • S L.L. f Phone tare*" DESCRIPTION OF Wo-K/USE OF.BLDG. L �G� / � A Rear N
Address
Arch/Eng. • License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL C Right • G
' Address 7`.� (,�p� L,,- ❑ TENANT ❑ ELECTRICAL ❑ PL/ BING ❑ MECHANICAL s • Left R
4. I M hone 1C a Og(40 ECTt(CR 2-r f ' I Ping. Ref.# . Parking Req./Provided E
Contractor's Nam
Address(mailing) 3a- -/ •• ' - OO, PROJECT DESCRIPTION SQ. FT. . OCCUPANCY 6�' Planning Notes: M
i 2 CONSTRUCTION TYPE • VALUATION$ .F
City License No. i ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I'am licensed under provisions of Charter 9 (commencing Remarks:Tea`r a WOOD 'e-i t Z/ ly ?oJ ' - -
with section 7000) of Division 3 of the Business and Professions Code, and III /
my license is in full f e an f t. y ELECTRICAL FEES
License s_ Liz `� `O�i� �`• ewer t� -/VW�s
Date / Signature— PLUMBING 6 FEES Automatic Washer Transformer 0 15-50 KW
WORK RS'C MPENSATION DECLARATION Construction Pole Sub. • 0 50+KW
•
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certifi d copy thereof (Section Cooking Unit Meter ❑up,to 100 amps
Backflow Preventer - Service Sink
'9lic Lab. C.)ti/ 22 o� Dishwasher Meter Dover 100a
licy No. �/7 tJ7 Company `-T/'• L Backflow Irrigation Sewer Capamps _
—
Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified Js with the city Iain Div on. Bathtubs Sewer Connection Go'
ate T-(_�/ Applicant��. _ Fan Motors 00-1 HP ❑1%.-8
EXEMPTION FR M WORKERS'COMPENSATION DECLAR TION Clarifiers • Solar Collectors
(This section need not be completed if the permit is for one hundred ($100) or Dish Wash¢r F.A.U. Ina Solar ❑9.15 HO-016-15+ '
less). Solar Piping
I certify that in the performance of the work for which this permit is issued, IFixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date _ Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light It -'
NOTICE: If,after making this declaration, you should become subject to the Outlets Range J.Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal g - '
comply with such provisions or this permit shall be deemed revoked. -
a CONSTRUCTION LENDING AGENCY Gas Service Outlets 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 Civ. C.) Garbage Disposal Standing Sections
Lender's Name Interceptors Water Heater -
e3Lender's Address - Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories -- Auto-Wash .i • 'D
following reason (Section 7031.5 Business and Professional Code: Any city or
Q county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays : i •
-
v 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 - `a
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt 'Reinspection Fee '` $15 • issue'Fee ' ‘41 --j$ 3
therefrom 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 -
ally of not more than five hundred dollars($500). I DEVELOPMENT SERVICES REQUIREMENTS:
as owner of the property or my employees with wages as their sole Reinspection Fee ` $15 Issue Fee $ 3 - _ " '- )
Zoning Approved By ,Date
° sale tio'1 will do the work, and the structure is not intended or offered - -•
io.:'saie (Section 7044, Business and Professional Code: The Contractor's MECHANICAL e t. ,Date 1 ai
FEES Building Approved By„r
License Law does not apply to an owner of a property who builds or improves :� L'is. �„ ip
thereon, and'who does such work himself/herself or through his or her own Application Issued By' 7 L--- --Date t.J
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 -
sale. If, h�i+eber, the building or improvement is sold within one year of com- Canopy Type II 0 , • SUMMARY OF FEES \ "I
pletion, the•oh-ner will have the burden of proving he/she did not build or Im- Duct-Under Ground - �y l=
prove for the purpose of sale). --- BUILDING PERMIT $ —I2 SMIP `_$ '� & ---
0
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System I - • '
tractors to construct the project (Section 7044, Business and Professions Code: ,PLAN CHECK $ PERMIT--•
The Contractor's License Law does not apply to an owner of property who ' Duct-Ventilating 00-100,000 BTU ❑100,000 BTU 'PLUMBING $ • ISSUANCE $ - __
builds or improves thereon. and who contracts for such orolects with a con- —
- 1 .
• tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust SystemMultipleSystemRepair/AlterationPLAN CHECK 25% $ F�I•ERGY P.C. $ _
of 0 0 GRADING $ _
proof their Worker's Compensation insurance should be provided this reasonto me. ELECTRICAL $ ' •
❑ I am exempt under Section B.& P. C.for this Firepl/Fact.Bit. ICBG# Fire Dampers •
PLAN CHECK 50% $ • MICROFILM $ -.�7 n
Date Owner Heating System&Ducting Registers MECHANICAL , $ - TOTAL FEE $ 1 L.\2)
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,00067E " ,PLAN CHECK 25% •
information is correct. I agree to comply with all city and county ordinances $ '
and state laws rel. g to building construction, and hereby authorize repre- -
inspettios of f to e¢n[erg above-mentioned prgpErty, for '.
inspection cur.`. ' OGI//C1�9
Signature A Nf _ D •
_ _
Drivers' License or SS �_-- Reinspection Fee I $15 Issue Fee $ 3 01 Ca042735-00042736 T OT -i
DATE: 04/13/34 TIE: 12:01
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor _
or _ S
CONSTRUCTION AND PLANNING 21c POOL i '
AFV'ROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
h
2. Soil Pipe-Undrgrnd. - -.1, •Pc 53. Steel Reinforcement ij
3. Electrical Conduit Utility-Undrgrnd. ',,� r"' 54. Forms -..{ ,
4:teo Electrical Conduit-Undfgrnd. '� 55. Electrical Bonding • q
. 5_/Steel• Reinforcernent•t-' "_ - 56. Rough Plumbing & Pressure Test -
6' El4tricalUFERGrn5lL i 57. APPROVAL TO COVER-GUNITE I21f,
7:, Footings v • .. 58. Electrical Conduit-Undrgrnd. . '464
_
8! Foundation ', 4- 4:: ,i ar t � 59. Gas Pipe, O Undrgrnd.,Test %
9:;Watef Pipe-Und gr d.rh7�' ?6,1. • . 60. Backwash Lines, P-Trap, O Undrgrnd.
10: Structural Floor System Yi 7 61. APPROVAL TO DECK _ U
11. Property Sewer Line & House Connection .:'.A 62. Backwash & Receptor-Final
t
12. Sewer Cap /7-i. ,./ - 11 .X 63. Heater & Vent-Final
X13. Roof'Drains • )� 64. Plumbing System - Final ,
' 14. Rough Plumbingc) ' f
- 65. Electrical-Final
( 15. Rough Electrical-Conduit 66. Solar System-Final
,/ 16: Rough Electric Wiring ,''r.' 67. Fencing & Access Approval
1 171-Rough Wiring Sibn -1^ 68. APPROVED FOR PLASTERING
1 18. Rough Electrical-T Bar Ceiling-i-• 69. POOL/SPA SYSTEMS FINAL
19T Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
2-07-Rough Factory Fireplace ,a. ti APPROVALS Permit#
21. Ducts, in Structure C- t� 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough,& Test CT 72. Underground Flush
a• -.
24. Roof Framin " y i
g• 73. Undergrnd.Storage Tank ❑Gas ❑Oil '
i
25. Roof Sheathing _i-e- .' „Lir •
74. Overhead Hydro
26. T-Bar Ceiling (Structural) &-Mo ocoat 75. Dry Chemical
27. Frame-and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL .
29. Insulation "L' 1.' 78. FIRE PREV. FINAL '
9
30. Drywall Nailing ^I r .'-. HEALTH DEPT. REQUIREMENT
• 31. Plaster Brown Cost'I� 5.-4.7... . 79. FINAL INSPECTION
32. Electrical Power Meter-Final -' 80. FOOD CERTIFICATE ISSUED
33. Final Electric "I Notes:
34. Final Heating & Air Conditioning .
35. Final Gas Pipe-Test •ni
36. Hood or Canopy
37. Final Factory Fireplace /O -KC-$// /f
38. Final Plumbing �9 �/ /
39. Water Service-Final //a 3 r'I�,
// u f`- s d� 36 16- f-e:i/-
40. Gas Service-Final • k
!Nl et/' rr=J 7., c-os-d/ SA.r
�41. Solar Domestic-Final 3O/ op I -f jf
42. Backflow Preventer
Jr "'•'
43. Backflow Irrigation u
Vr
44. .Landscape Irrigation System Q (/ `_:
f
45. Sound Attenuation 4
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING '11' '-
EXPIRED / •
: 4
A
48. Special Requirements Completed Incomplete Inspectl•n5 _ ' .,r
•
49. Electric Release to Edison r' 71/St 98a- I
Odle '
50. Gas Release to Southern California Gas Co c ��� 1 t!t
51. CERTIFICATE OF OCCUPANCY -1
No. - Date
•
C 'ER TSA DEL MAR-DEV. CO. 'DATE 9-10-63
J. ADDRESS 2829..La Salle Ave. - BUILDING PERMIT NO. 20519 ' •
GENERAL CONTRACTOR MaCco Realty Co. VALUE $ 20,288.00
AP No. • LOT 1 TRACT 5252 FIRE ZONE 3 DESCRIPTION OF WORK Res.&At.Gar.
INSPECTIONS Signature _ DATE GROUP I&J TYPE V ZONE Rl
Soil d// /0-3-c.5L ,-,, - PERMITS ISSUED
V — SUBCONTRACTOR -
Gas r DATE NUMBER
Water tic.4-9-c-30k..„..,/ w,-,^ /
2.G-63 ,
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating c /212-62' sLna. OCT 2 19b5 Z. :{i —
Rough Plumbing -e /7--4-G3 X.,e(iffyi, e. •EP 1 7 196311.04 Me
Miscellaneous ��q� 011111111111k .
Prop. Swr. Line 0 House Con. ❑ St. Swr. 0 aei..✓ /0-3)-Gy 7 GVH*:-oX OCT 2 8 1963 ',V!. 4,
Sprinkling System r'»v 3 it-cy �-'\?f n ..{tV'-
Construction Pole 10
Underground 0 Power 0 — . ..,
Rou h Wiring //f".. /1'/1-43 ginner £ /o1-'2 40 ra " ---
Trenches Li- Forms C9^'Steel Reinf. <}- AV-sly /O.C -b.
Floor System ,1 s/ /0-tO--6?
I Beam 0 Steel Reinforce 0
S_ ..ping 4'✓f9 //-29e3
Frame and Flashing 41 ,¢_'3�;;
Lathing — In ICY Out [y— .g/ent 0-3 b--C,3
Plaster, brown coat /Q,y/S 1-yy-by
Refrig. 0 Air Con. 0 Final
Heating, Final , - ,,/ 3 -/= -*y
Plumbing Fixtures, Final
a-
Plumbing _7-ii-6..
Final Gas Test 457A: iti J—'o --by
Electric Fixtures, Final _ FeLL-,.. .3•";;-Cys-V6L3 377-C44
Building, Final w,/ 7-Yr-Cg'
OCCUPANCY •
Form HU4-5M-3-63—S-B P
liii.. 3 20519
FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT e /1�ppp���
P. O. BOX 917 COSTA MESA. CALIFORNIA F� S C� y,JQB7
For Applicant to Fill In Completely APPLIC{�+LyT O n aTIiEeA
TYPE OR PRINT BUILDING
BUILDING „ p p
ADDRESS.1p�I 2.4 �jAAj.t. iQ I'E
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. j O n.o
OWNER Mesa Del Mar Development Co. oath://
MAIL g y RECE Y I DATE RECEIVED�I DATE ISSUED
ADDRESS 3800 E. Coast Highway Std 1 u'ty63
city Corona Del Mar, Calif.
TELDr.34220 ADDRESS
ARORCHiTECT ENGINEER Macto Realty CO. TEL,. .../.
COSTA MESA. CALIFORNIA''eO (1�1++
FIRE
�
ADDRESS 3800 E. Coast Highway ZONE TYPE •�OROUPL .
CONTRACTOR Macco Realty Company APPROVED
BY
DATE ``VV
ADDRESS 3800 E. Coast Highway ZONING ✓
NO.OF BD,LD UEE OF NEW
ZONE
cny Corona Del Mar, Calif. I P ANB 2 ( 8vw u!
STATE 207343-SB-1 TEL. LEGAL y �(I/yLr.
LIC.NO. 98808-SB—L NO. DESCRIPTION Lot #1 Tract 5252
SIZE
OF LOT 85 x 94 NO. OF BLDGyLN
NOW ON LOTI,One A.P.NO. 0
USE OF None YARDS EVES
EXISTING BLDG APPROVED ALLOWED .
SETBCENTECK R OP UNEFROM
IA 6NT O' REAR YARD 18'101 FR NTERUNC ST.)r7 O FT. IN.
SIDE YARD I LEFT 71 - I RIGHT 12' R.SIDE ' 2..'7 FT. IN.
DESCRIPTION OF WORK
L.SIDE FT. IN.
NEW I X II ALTERATION I II ADDITION -I REAR �/I`` FT /0 q IN.
', APPROVED CC _ /7 /6 7
REPAIR I II MOVING F ILDEMOLISH BY DATE �} O- (J J
SIZE DING '6" x 54'2"ROOMS 6 STORIES 1 Living area 1896W
EXTERIOURIWAII,,``wood 61 I ROOF shake
COVERING SLLICCO COVERING stint shinae Garage area 403.SF
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence w/attached
garage Plan X400-C
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION AO
SIGNATURE
OF MesalDel Mar-Development' Co. PERMIT FEE $l s AO .
\PERMIBy : c 6/2 7yJ --� $ 20,288.00 PLAN CHECK a 38. (/0 4'
ITHORIZED AGENT` / . .( (/� di) g
TOTAL FEE $ % / 4
1
OWNER COPPENBARGER, A. E. DATE 9-30-76
JOB ADDRESS 2829 _Lia Salle Avenue BUILDING PERMIT NO. 42797
GENERAL CONTRACTOR Michael Sulipeck DESCRIPTION of WORK Brick Pilasters for Fence
AP No. 141-672-14 LOT TRACT FIRE ZONE VALUE S 320.00
INSPECTIONS Si Dore TYPE v GROUP T ZONE 12_1
SOIL
' SUBCONTRACTOR PERMITS ISSUED
GAS Date Number I Signature
WATER Plumbing
ROUGH PLUMBING
^
.PROP: SWR. LINE IJ HOUSE CON. 0
4SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER fl
ROUGH WIRING Heating and Vent.
• TRENCHES [s FORMS CI STEEL REINF. [Li' QL io-s-n,
FLOOR SYSTEM
�u
BOND BEAM 'STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN C ^1 OUT I I
PLASTER. BROWN COAT
STRUCTURAL. FINAL Elartrie
HEATING. VENT., REFRIG. AND A.C., FINAL _
EI PLUMBING. FINAL AND GAS TEST L I
ELECTRIC. FINAL .I.
BUILDING. FINALR/- leg 1S'�.( ,
42797 F1 30-7Fr-Irs;Qui E191'
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LIC AjFlON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
REC IV D:BY DATE RECEIVED DATE ISSUED
BUILDING ADDRESS �'] Ali Lx S cl `, e A V Q ( ! %//611 of-�fT
• OWNER \ e s • s r A.P.NO.
it!IlolZ—�4 PERMIT NO.
MAIL1.,..(R1.°1 j BUILDING �2_Pj lam` w.
ADDRESS a. ,5j)- N t-
ADDRESS /�7 f.{NF-
TEL. 4 TRACT i5Z15Z LOT I BLOCK
CITY toc) M t C � NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH
LENDER /
I
BRANCH
OWNER :'� t ;SS(
ADDRESS
or I A.UE Sol A c
ARCHITECT TEL. USE - i is
OR ENGINEER NO. . " •
_
FIRE +%
ADDRESS ZONE I I (TYPE /
G— GROUP
p Cl ^ 1
CONTRACTOR Mtcl.a c I Sk.t.-' tpe C-14. 1.1A
1.1A l '- DATE 1 ':�i' --/1 .
ADDRESS clic ID S } 1\1 - ZONE I NO.OF USE OF NEWIS
TEL.
CITY Goy {'3. I \ C ac ND.; S )3b922 r' PLANS 2..., BUILDING F=
(-•
• STATE ^ CITY YARDS APPROVED YARDS APPROVED
LIC.NO. 314. 1 g LIC.NO. MAIN BUILDING ACCESSORY BUILDING
s (FROM C/L STREET/ 1 II
ly SIZE INO.OFBLOGS.
a OF LOT NOW ON LOT FRONT FT. D FT.O
Q USE OF f /I
EXISTING BLDG. R,.5IDE FT. E % O
T.
CII
F (fi
Separate permits are required for L.SIDE T. a-r. t 1
G electric,plumbing and heating work. REAR FT. 12FT.011
(W.: USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
QMAIN BLDGS. ACCESS. BLOCS.
•
/ x !I VAR.+ DATE
Q (� - icAk Pt\'t dc.-s to I L f' C.U.P.# APPROVED
(+ \ APPROVED rv�/ -yh' `^�
F�apte S },v,, Gkn-�WC-C r4 , �Y r •A DATE
I _ {�
IX I
w
a
O I hereby acknowledge that I have read this application and state vs
a4 that the above Information is correct and agree to comply with -
co
a all laws regulating building construction, and I shall not employ .
Z any person In violation of the workman's compensation laws of ti
. the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business so
VALUATION PERMIT FEE $ T- riv ct
and Professions Code, Division 3,Chapter 9. ,-r WI
CI
• fig/ PLAN CHECK $ c
Signature of' / 0
Permittee ,�`i.JQ L- $ 9 / f.� TAX. $ iL
!]� 2
l U
Authorized Agent - TOTAL PAID $ 53