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HomeMy WebLinkAbout106 LEXINGTON LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - -• - "- - • " PERMIT N TRACT NO. LOT NO. - , BLDG.NO. - .81 BH 9/14/84 • I I,•08 IL. . CONSTRUCTION PERMIT m (530 a Project Address /or,"- LEX/N s:-/-0� TYPE DF CONSTRUCTION ❑ NEW H ADD-�U'ALTERATION U REPAIR - - 1 Applicant's Mailing Address t� • • • ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - 1 A.P.- / # • • Zone- - ' Owner's.Name J<Yl- P Ln7-S - Phone�5 "f8 •I DESCRIPTION OF WORK MO /•042)/T7tA/ nil Z Address /OC, L <�s•-r-0a - �!<,\ C3� O • • TYPE OF PERMIT1 PJ GRADING ❑ FOUNDATIQ-NI JLI STRUCTURAL N Arch/Eng. License No. • ❑ TENANT LK ELECTRICAL ❑ PLUMBING L7M ECHANICAL - ❑ OTHER• - - N Address - • '/ �7� -. _ Contractor's Name )I/fps-BATS /tJC ' /Phone S'-/-S8De PROJECT DESCRIPTION. SQ. FT. • . - OCCUPANCY R Address(mailing) L��O 5' Ai "J a "' • CONSTRUCTION TYPE 'VALUATION$ q ''8/ Q E City License No. .DO-446 qg - ZONE GRADING CU.YDS. ACRES a LICENSED CONTRACTOR DECLARATION Remarks: - U 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing _ R ^^ with section 7000) of. Division 3'of the Business and Professions Code,and ' E t'J my license is in full rcia51 effect. I 3 a - M Licens�ef ass GCl (cense N • PLUMBING FEES E Date 4 �� Signature WORK RS' OMPENSATION OE ARATION I Bar Sink Showers T I hereby affirm that I hive a certificate of consent to self-Insure or a certificate . Backflow Preventer Service Sink S r of Workers' Compensation Insurance, or a certified copy thereof (Section- - - - - - — • 3800, Lab- Cayn.-..,its 2� J�,d Sewer Cap Polley No- ,�.l L>YpJ Company �;ertifi d cop Is hereby furnished. I t Sewer Connec[iom • ■ t Cenci d_co is hied with the city ppyelgp4_ - __ I Solar Collectors ■ s Date `/ L. •of Applicant Q�L�i:uir^-- • , -EXEMPTIONRKERS';COMPENSATION DECLARATION - s - -- - -- (This section need not be completed if the permit is for one hundred (5100) or • Solar Piping ■ . 00 i less). ; - I , I certify-that in the perform�n�c¢o the work for which this permit is Issuer. 1 • Solar Tank - IhrL ■ I I .shall not employ any persM id manner so as to become subject to theWorkers' Compensation La s a Ifornia. Floor • • Swimming Pool w/Spa ■ Date Signature • ' NOTICE:if,after making this declaration,you should become subject to the MI Floor Sinks III Urinal _■ /, , ill a �e �ri�r• Workers' Compensation provisions of the Labor Code, you must forthwith- - • comply 'with- such provisions or rthis permit shall be deemed revoked. , . Gas Service Outlets' Water Closet• ' - _ nc. ■• ■ CONSTRUCTION LENDING AGENCY • - - - • ' I hereby affirm that there is a'con"str'•n; lending agency for the performance ' Interceptors - Water Heater of the work for which this ipeZrt is.,issued .(Section 3097 Civ. C.) . ' Lender's Name /`•+ • - Kitchen Sink Water Service '7Device Bakes . , • Pole Light . , ' Lender's Address - Lavatories OWNER BUILDER DECLARATION ' - ' - - - • _ - - I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or P • - - , 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 Roof Drains - - .. - - •Disposal I Standing Sections ' to 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 - 00-5 ■ Division 3 of the Business and Professions Code) or that he/she is exempt - _ Generator. . • 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 I - enalty of not more than five hundred dollars ($500). , Reinspection Fee • II ,$25 , Issue Fee. $ 3 U I, as owner of the property or my employees with wages as their sole - MECHANICAL compensation, will do the work,and the structure is not intended or offered FEES for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: . License Law does not apply to an owner of a property who builds or improves Hood or Type I 0 employes, who does such work himself/herselfents or intended his or her own Canopya. thereon, a, who dthat such orkr improvements are not through offered for Type II 0 sale. If, however, the building or improvement is sold within one year of com- • Date pletion, the owner will have the burden of proving he/she did not build or im- �_� ` • Lirove for the purpose of sale). • Refr ration System L- a. I as owner of the property, am exclusively contracting with licensed con- • •800 BTU ❑100,000 BTU tractors to construct the project (Sectio 7044,Business and Professions Code: 1 s The Contractor's License Law does t poly to an owner of property who builds or improves thereon, and `��`aaaatttt,,,,O c rails for such projects with a con- '■ ■ System Repair/Alteration tractor(s) license pursuant to the ct is License Law). 0 lam exempt under Section B.& P.C.for this reason • B Date Owner He ng System& Ducting • 60 _s PLAN CHECK $ ENERGY P.C. $ • I hereby certify rect haverreadtothismapplication h-alland state that the above P1BB.BBD BTU ❑100,000 BT 1 information Ola is correct. I agree comply lth'all city and county ordinances and state laws relating to building const ction,and hereby autho ize r pre- MICROFILMsentatives of this clt�to enter upo e above-mentioned pryJpertyq for / gt inspection p p, ' /+/`-� /�� MECHANICAL $ . TOTAL 0 Signature /L f' Date ?/ '"Z Drivers' Lie-, or S5 t % ■ Reinspection Fee $25 . Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - • . CONSTRUCTION AND PLANNING ', POOL & SPA - • APPROVALS -Permit# Date Inspector APPROVALS Permit# Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe_Undrgrnd. " �, 53. Steel Reinforcement • 3.,Electrical Conduit Utility-Undrg'nd. ,, 54. Forms • 4. ElectricalrConduit-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.. ✓ h. 60. Backwash Lines, P-Trap, O Undrgrnd. r 10. Structural Floor System61. APPROVAL TO DECK' - • 11. Property Sewer Line & House Cdrinection .. • 62. Backwash & Receptor-Final 12. Sewer Cap - 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 71. Product Piping 0 Gas 0 Oil Q3. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing I 73. Undergrnd.Storage Tank O Gas 0 Oil' • • '25. Roof Sheathing 74. Overhead Hydro 261 T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. 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 N,'80. FOOD CERTIFICATE ISSUED 33. Final ElectricNotes: 34. Final Heating & Air Conditioning • qfr LCp • 35. Final Gas Pipe-Test ! 36. Hood or Canopy 37. Final Factory Fireplace . 38. Final Plumbing _ , 39. Water Service-Final . - 40. Gas Service-Final 41. Solar Domestic-Final - 42. Backflow Preventer ` • . 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 50. Gas Release to Southern California Gas ..Co .51. CERTIFICATE OF OCCUPANCY - - _ . No. Date • - , PROJECT ADDRESS: 106 LEXINGTON LN UNIT: 0 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 049635 OWNER'S NAME: HOP K I N S ADDRESS: SAME AS ABOVE PERMIT NO: P 049635 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 714 /556-1898 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : WATER HEATER REPLACEMENT SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / PERMITTEE: NOCK PLUMBING (714 ) 895-1246 ADDRESS: 11610 SEABOARD CIR COMMENTS: NO STRUCTURAL WORK BEING DONE STANTON CA 90680 *************************+H******%+r%x**Bt******%**%+F --%at*-%***-%***7E*****%**%*-%**aE-%% LICENSEE)CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMENTS 7000)Of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS D :050386 STATE uc.:511971 ss C-36 Date:ate:—�4Q-30• � Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: Iherebyaffirm that l have a certificate of consent to sefkinsure or a cert)rote of Worked FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CT LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PDLIcvIO.: 116799290 EXP. DATE: O3 /O1 /91 COMPANY:STATE PARKING REQ: PROV: PARCEL: 13919219 ZNE: REF NO: ❑ Certified copy is hereby furnished. El Certified copy is filed with the city Building Division. PLANNING NOTES> Date:_to- 31) - 5"0___ Applicant: q. JVVl *****k#*********************** F%* F***%*%**%%**%**i *k*% F%%******** DEVELOPMENT SERVICE $ REQUIREMENTSEXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thisectmit need not be completed if the permit is fora unfired(5100)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 lb me Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE:It.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. / �/ CONSTRUCTION LENDING AGENCY: I hereby affirm That there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; , / E// DATE: /o, 1 which this permit is issued(Section 3097,Civ.C). ********************************************7XMllliiia,),FFFRR%*3F****%3E******)E**** %%%7k.k%.%**** LENDER: ********************%**********************************.************************ ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2,00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% SMI P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 0l the Business PLAN and Professions Code)or that he/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 live hundred dollars(8500). ISSUE FEE 3 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 2 . 00 3 . 00 0 . 00 5. 00 5 . 00 . 00 goes 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 employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 5 . 00 OVER/SHORT: 00 improvement e purpose oisale).lhin one year of completion,the owner will have the burden of proving he/she did not build or improve forthe BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5. 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon And who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ********************************************************************%*)f******** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BR E AKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date:_ owner: PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Salety Code Sections 25505,25533,and END OF FEES 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 for construction or modification from the Air Duality Management District,Residential construction applications are exempt from these provisions, Date:— Applicant: I hereby certify that I have read this application and stale that the above information is correct.1 agree to comply with all city and county ordinancesperlfandipectowpurpose to building construction and hereby oath^ representatives of this put the above-mentioned property for inspection purposes 01 00073216-00073214 TOT T Qq (�//�/ .•.lit, Date: 0 —JD r "V Signature. / DATE: 10/31/90 TIME: 12:95 Driver's License or Social Security 1641-46 White—Building:Green—Code Enlorcoment Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & 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 B. 'Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ 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 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 1=•: • APPROVALS Permit # • 21: Ducts, in Structure - I 70. Underground'Hydro • 22. Ducts, Ventilating i . , 1; , .71. Product Piping 0 Gas 0 Oil . 23. Gas Pipe-Rough& Test , _ 72. Underground Flush I 24. Roof Framing 1. ; 73. ;Undergrnd.Storage Tank 0 Gas 0 Oil - 25. Roof,Sheathing v I 74. Overhead Hydro. 26. T-Bat Ceiling (Structural) & Monocoat ; , i 75. Dry Chemical t. 27. Frame and Flashing . , • • 4 • 76. Dry Standpipe - , ' 28. Lathing & Siding I ' 1 , 77. i FIXED SYSTEM FINAL: , 29. Insulation I 78. FIRE PREV. FINAL ' - . 30. Drywall Nailing . ! ' • . , HEALTH"DEPT; REQUIREMENT ' ' 31. Plaster Brown Coat, . • i )• , 79. 'FINAL INSPECTION 32. Electrical Power Meter-Final, l • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ! - 34. Final Heating& Air Conditioning' �' I , . ,35. Final Gas Pipe-Test. .: .• 36. Hood or Canopy I t ' 37. Final Factory Fireplace.. -r 1' . 38. Final Plumbing 1ukA1la. £. 39. Water Service-Final' i . 1' ; 40. Gas Service-Final o. • , i , 41. Solar Domestic-Final - 1 i 42. Backflow Preventer u 43. Backflow Irrigation • - . 44. Landscape Irrigation System ' . • I . 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING , 48. FINAL PLANNING ' • 49. Electric Release to Edison , , i 50. Gas Release to Southern California Gas Co - • , 51. CERTIFICATE OF OCCUPANCY - --' • No Date 1 it PROJECT ADDRESS: 106 LEXINGTON LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069565 OWNER'S NAME: NOGLE HELEN M 1; ADDRESS: 106 LEXINGTON LN PERMIT NO; B 069565 PLAN CHECK NO: N GOVT: N SUPP: N r COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: ALT ARCNIENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH & REROOF W/COMP & HOT MOP SQ FT: 2, 508 ADDRESS: UNIT: CLAIM VALUE; 2, 508 , 00 CALC—VALUE: 2, 508 , 00 GROUP OCC; R-1 / PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 ADDRESS: P 0 BOX 4309 COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DET, REQUIRED DOWNEY CA 90241 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS clmYLlc.: Q59 STATELIC.: 402536 CLASS: C 39 EXP: 10/95 pl ��7� /)/Vy` — MAIN BUILDING ACCESSORY BUILDING Date: Signature: FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN n certified copy thereof)Section 3800,Lab.C. POLICY NO.: D�u2e or a ce269`9 EXP.DATE: 05/19/95 COMPANY: AIG PARKING REQ: PROV; PARCEL: 41916302 ZNE; REF NO; ❑ Certified espy is he eby furnished. EX Cenilied copy is filed with the city Building Division. PLANNING N TES> > Date. 1 6 61 Applicant: ******************************************************************************* EXEMPTION FRIM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the demi is for one hundred(5110)or less). DEVELOPMENT SERVICES R E Q U I R E M E N 'T S 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. ZONING APPROVED BY ,• DATE; Date: Signature: BUILDING APPROVED BY : NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. t'� Ile - I CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE- • V 1e `•1►' which this permit is issued(Section 3097.Civ.C). ************************** * *********************************** ** LENDER: *************************** ****************************************** *** **** ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 • 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business P LAN and Professions Code)or that he/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(S500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the wont, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 . 00 0 , 00 54 . 50 54 . 50 . 00 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 employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 54 , 50 OVER/SHORT• , 00 improvement e sold eone year of completion.the owner will have the burden of proving he/she did not build or improve fororthe purpose offsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ). I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who buildsorLaw). thereon ******************************************************************************* and who contracts for sure projects with a e License tor(s)license pursuant to the Contractors'State License Law r am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 • 2, 508 , 00 I do hereby cenity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 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 for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspeciio gpurposses. / 01 00170601-00170602 TOT 54.50 Date: I 0 I`��N Signature: a DATE: 10/23/94 T.I1fE: 13:07 Drivels License or Social Security v: 164t-46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & 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 • 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings .'r. 58. Electrical Conduit•Undrgrnd. . 8._Foundation t 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap J 63. Heater & Vent-Final 13. Roof Drains �, °t 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 F;neplace :: 'APPROVALS Permit # ."' ., ,- . - 21.'bupts,in Structuti4 r ° ' , -.70. Undergr0 jtd Hydro 22. Ducts, Ventilating . i • + t %71. ProductPiping Chas 0 01 23. Gas Pipe-Rough &'Test , u , .I, , i 72. Undergro•und Fla{I'q. , n .. 24:,Roof Framing ,, , ,, . , - =73! Undergrn&..Stor e tank 0 Gas 0 Oil 25. Roof Sheathing j"-(q'=9j tubM ' . 74"Overhead Hydro"' • ' 26.tBaf Ceiling (Structural) & Monocoat . h -I.. > 75.'?Dry Chemical 27.,Frame and Flashing+ ! ,•r, .33 r , 76.-biy Standpipe .",: ; ''I 28. Lathing & Siding -- • ,, t:r r: • a. •• • . , 77." FIXED SYSTEM FINAL . 29. Insulatidb ' Y, . " " ' " ' ' ; ; 78;-'FIRE PREV. FINIAL r . 30. Drywall Nailing : i- :Ar - HEALTH DEPT- REQUIREMENT .31. Plaster Brown Colt' ! n - ` r, -°-.,79. FINAL INSP.ECTIO:N 32..Electrical Povier Me,;erFinal - :-•-•-•;g: ° ,80.-FOOD CERTIFICATE ISSUED 33. 'Finl Electric_ ; ' Notes: - 13 I • :34. Final.Heating& qv tond,itioping. „ r 3 - 35.'yinalGas Pipe-Test. •. 36. Hood oi.Canopy - I ,•i . • r 37. -Final'Factory Fireptace r' . r _ I ': 38. Final Plumbing ,, •• ' j .. . • .39. Water Service-Final• - r r ,. . 40. Gas Service'F nal,: • - , 41. Solar Domestic-Final e' 'i I. I '42. Backf low Preventer, •,� I it. . -_, 43. Backflow Irrigation; . .. x . - utt; ,44. Landscape Irrigation Systemt;l,• .,• - i- - 45. Sound Attenuation- -- 46. Handicap•Regglatitins ,� , 47. FINAL STRUCTURE & BUILDING •-P,.,qs 44, a; 48. FINAL PLANNING: •• .• 49. Etec ric Release to Edison . 7'' . + . 50. Gas Release to Southern California Gas Co I'9 L • , 51. CERTIFICATE OF OCCUPANCY __ - , No. Date OWNER SM VISTA Building Co. DATE OCT 2 () 963 JOB ADDRESS 1Q6_igxington Lane BUILDING PERMIT NO. 20619 GENERAL CONTRACTOR San_Vista Building Co. VALUE $ 14,1335.00 AP No. LOT 14.1 TRACT 5 6o FIRE ZONE DESCRIPTION OF WORK Res.x/atLgar INSPECTIONS "nature DATE GROUP T&,T TYPE V ZONE g� Soil /f/ U PERMITS ISSUES Gas #4,.-11;:%1 --c ' SUBCONTRACTOR DATE NUMBER Water i 1 9 G3 Rough Com. Refrig. 0 Air Cond. 0 Rough HeatiPlumbging / 447.-/2 � - Rough Plumbing -/ h(�(� �j�l n 1\-\-lam Miscellaneous Prop. Swr. Line ❑ House Con. Q St. Swr. 0 / 3-/j-/f/ eni-tet an....-{-. NOV 1 3 196311„ „i Sprinkling System / l Construction Pole /. 1 Underground 0 Power ,❑ (,i Rough Wiring 3i-�J4f,•-•nat.% . . /- f-GY A/17/6/6 Trenches 0Forms ❑ Steel Reinf. ❑ � `2 3 Floor System / Bond Beam 0 Steel Reinforce 0 r...-7 Sheathing r, C- 3 - S 7C. I //u, " Frameand Flashi •- 3- z G 6 Lathing Outor l.- ' -- &" Plaster, brown coat . — 710 C Refrig. 0 Air Con. 0 Final Heating, Final p G 2; Li Plumbing Fixtures, Final 4t/ '-pZ/f Final Gas'Test i- 1 1 Pi Electric Fixtures, Final '2 u o.0 6/cy/y 4-66 Building, Final 9 i 32..., bil OCCUPANCY ' Form 13U4-5M-3-63-5-B P HOLD FOR SPECIAL. Rrnr mtt v rc . 20619 , FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT SEN 6 lUOd P.O.BOX 917 COSTA MESA.CALIFORNIA rr''TTFyIINnnANCr�1E��-Q D��EPyyT�..eQe� For Applicant to Fill In Completely `14PPLICI>TTOMTOCA PERMR TYPE OR PRINT Lot 41 BUILDING BUILDING Lexington Lane For Office Use Only ADDRESS 106 ifsabST'$x xBf, RECEIPT NO. 70619 COSTA MESA, CALIFORNIA �L��LLL/ILJ RECEIV6O BY DATE RECEIVED DATE ISSUED OWNER San Vista Building Co. 7d54,3 OCT 3 0 1983 BUILDING /O/ �y _ . MAIL 1166 E. 58th Street ADDRESS /� C�U� ADDRESS ^ FIRE // (//j'rJ—// TEL. ZONE TYPE Y GROUP CITY Los Angeles 11 No.AD 37187 APPROVED ARCHITECT TEL. BY DATE OR ENGINEER Raymond Levans NO.OR 37010 �r ZONING , tat ADDRESS 3432 Via Oporto, Newport Beach ..,-ack—� L. SO K NO.OF USE OP " �- PLANSz BUILD INOur I / CONTRACTOR San Vista Building C.o- LEGAL Tract 5160 - Lot 41 • /1 ADDRESS 1166 E. 58th Street DESCRIPTION (//— 1 j J �( CITY Los Angeles 11 A.P.NO. I/`�f 3— NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL LIC.NO. 192782 NO. AD 37187 90"TO SIDE S REAR P.L. EAVES OSIZELOT NO20 x 70 I NOWON.OP BLDLOTGS.O ALLOWED (U.B.C.REQUIREMENT) F USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. None MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SETBACK LINE FROM l'AI 11 FRONT FT. CENTER OF STREET _ 13 REAR BD 6 l0 SIDE YARD LEFT 0 I RIGHT 0 • R.SIDE FT. DESCRIPTION OF WORK L.SIDE FT. NEW X (ALTERATION _ ADDITION REAR FT. 1 DISTANCE BET. BET.MAIN e REPAIR MOVING DEMOLISHxMAIN BLDGS. ACCESS.BLDGS. BUILDING NO.OP Lan #i VAR.# DATE SIZE 20 x 32 ROOMS 5 $TQRIES.2 C.U.PP..#�///p`J1!'�`. APPROVEDEXTERIOR 9-63 COVERING COVERING I ROOF -COVERING Shingle APER' 1�[`� yy� DATE [ -/ USE OF BUILDING AND WORK TO BE PERFORMED \STN« N"` ���/// Residence_o*ld C rpnrt a.27-4-2446... /3 G gSQ.FT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE E 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 LAWS REGULATING VALUATION ,.l m BUILDING CONSTRU I • G VISTA BUILDING CO. PERMIT FEE $ X SIGNATURE OP ' / O PERMITTEE S// // m '/7 e735--- pLAN CHECK $ 7 p / AUTHORIZED N James N. Starbird TOTAL FEE $ 7a — a