HomeMy WebLinkAbout1803 TANAGER DR - Building Permits )
CITY OF COSTA MESA
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BUILDING DIVISION
v ^� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.Oov
FOR INSPECTIONS CALL:(714)754-5626
4"%soiniO4.. PERMIT NUMBER: E11-00271
r, •
PERMIT TYPE ELEC STATUS: ISSUED
APN: 13963113 DATE ISSUED: 12/15/2011
ISSUED BY: CAC
JOB ADDRESS: 1803 TANAGER DR CM Suite/Unit:
Vicinity:
•
SCOPE OF WORK: REPLACE SERVICE METER.
O1
OWNER: CHUN, MICHAEL M S TR Address: 1803 TANAGER DR Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: MO KACHKOU Address: 30 PEBBLEWOOD Unit: •
PHONE: 949-679-6665 • City/State/zZip: IRVINE,CA
CONTRACTOR: KIT ELECTRIC INC License No. 935289
Address: 30 PEBBLEWOODUnit: PHONE: 949-679-6665
City/State: IRVINE,CA ZipCode: 92604 CELL:
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ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00
Reinspection Fee $0.00
TOTAL FEES $54.00
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OTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
;regulations. (Ord. No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
(INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
Tequired inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
VIDE$ INSPECTION TYPE pALE IN¶11AL5 COPE, INSPECTION TYPE INTI1ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
;1266 Pool Spa Final _ 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical X I a-a a If a
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: Owner ID verified by drivers license. ❑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.
❑ 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
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
(has section need not be p)mpteted d the per=t is valued at one hundred cbaars(4100)or less)
2,Ant Sec.341.Title 8,Califomia Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
K..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 subje t to the workers'comp-•+-tion provisions of Section 3700 of Applicant's Signature Dale
the Labor, it hwit iO4 itth these provisions.
����� /� /20e7// Division of Industrial Safety Permit Number:
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 CINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 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 7011) of Divisi•n 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
m s i />/rye• � L-, Oq/, /• a registration form for acutely hazardous materials? 0 Yes 0 No
�!/ �J. ler _2:4
6g C.�� (Section 25533 of the California Health and Safety Code, with some
�i/��� � / exceptions, requires registration with the Costa Mesa Fire Department by
vain %/ /2/� tZ // each business which at any one time has on hand a quantity of acutely
err�'hteran.ure Dam r 1 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
Lenders 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 Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 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
that he or she is licensed pursuant to the provisions of the Contractors (Section 6n be hi of the Califomia Government Code requiresbuilding thnt the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be(umished on applications for non-residential permits).
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
8. (If"yes',attach certificate of compliance from the appropriate air pollution
employees. provided that such improvements are not intended or offered for
• sale. If, however, the building or improvement is sold within one year of control 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
properly, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
❑ I, as owner of the
LICENSED CONTRACTORS to construct 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 CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city
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.
JS grf 1 �
3057-45Dale f///Signature Date / �
(3/07) y
]) / ied , .lit /2a
CITY OF COSTA MESA
BUILDING DIVISION
triwiFll 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
ir
virita1 FOR INSPECTIONS CALL: (714)754-5626
° PERMIT NUMBER: P11-00082
PERMIT TYPE PLUM STATUS: ISSUED
APN: 13963113 DATE ISSUED: 04/27/2011
ISSUED BY: KJB
JOB ADDRESS: _?8�, D3-TANAGERCM`] Suite/Unit:
Vicinity:
SCOPE OF WORK: CHANGE OUT 40 GALLON WATER HEATER.
OWNER: CHUN, MICHAEL M S TR Address: 1803 TANAGER DR
PHONE: 714-662-3397 City/State/Zip: COSTA MESA, CA
APPLICANT: ATANASOV,STOIL Address:
PHONE: 866-692-5273 City/State/zZip:
CONTRACTOR: CALIFORNIA DELTA MECHANICAL INC License No. 811114
Address: 1235 GRAND AVENUE PHONE: 800-898-0008
City/State: SPRING VALLEY, CA ZipCode: 91977 CELL: 866-692-5273
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
•
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80
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.
CODER. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical ',1�,(� l/
1266 Pool Spa Final 208 Final Plumbing J c 1 0 — i 1 m
200 Final Re-Roof 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
WORRERS'fCOMPENSATION DECLARATION: ��'' Owner ID verified by driv !'llCense. ❑Yes ID No
• I hereby affirm under penalty of perjury one of the following deLrarations1. Driver's License No. Expires:
❑ have andjwill 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 '
performanceof the work for which this permit is issued.
pi 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' compens tion 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
Carrier:--� i Q, Fu KI by this permit,and that no building structure,scaffolding,falsework,or demolition
(This section need not be completed n the permit is valued atone hundred dollars($f00)or less) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
Y y 1Wel 7 32,Art 2,Sec.341,Title 8,California Administrative Code).
Polis Number:
o As owner-builder, I will not employ anyone to do work which would
O 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 Applicants Signature Dale
the Labor Co , shal forthwith comply with these provisions.
If/2 7 I it Division of Industrial Safety Permit Number:
Opp)_Iwmssignature I Dat fl—Cr_ 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? 0 Yes 0 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 in full forte
and effect. a registration form for acutely hazardous materials? ❑Yes 0 No
Lich# ( f Class# — (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
r—oontrSignature rate 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 Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 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 0 No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for 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? ❑Yes ❑No
thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for control officer).
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 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
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct 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 CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
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.
Sr't r -ofp /7 L-gal Owner(s) / I I Dal
Signature Date k it r' / J 7 //
3057-46(3107) YY"
C_.•'.cc.' lhonzed Applicant D3teZ__
• ft •
491tr50 r2>
Prescriptive Certificate of Compliance: Residential Water Heating CF-1R-ALT-WH'
General Information
Site Address: ) ' 03 /-y-
meq Dr\ climate Zona: 4 _ Date: y—)I --I �
NOTE:This torn is only used for alt anon or addition of inter heatingsystems.
WATER HEATING
List water heaters and boilers for both domestic hot water(DUFF)heaters and hydrant°space heating. IndNidual dwelling DEW
heaters must be gas or propane fired, and may not exceed 50 gallons. Ifot water pipe insulation from the DEW heater to the
kitchen's)and on ail underground hot water pipes is required in all componentpackages in all climate zones.
Energy Factor or
Water Heater Type/ Distribution Type Number of Tank Capacity Thermal. External Tank
Fuel Type' (Standard) System (gal) Efficiency IasulationR-Value3
-24 v935 Standard .110 _ .0 6 2— ZD
1.Indicate Pips(Storage Gay,Haat Pump,Instantaneous,etc,) —
2,Raefr adating systems serving multiple dwelling units shall meet the recirculation requirements of 150(n), The Preseripjhve reeuireinepts 42
not allowfe tnstalkelion a£a reghfreulglh g water healing a ware for skate dweilinz onto
3. The water heating tank andAm"shall be insulated to meet the requirements of1500).
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• I certify that thio Certificate of Compliance documentation is actuate and complete.
• I am eligible nosier Division 3 of the California Business and Profsaiona Code to accept responsibility for the building design Identified on
this Ceattticate of Compliance.
• I certify that the energy features and perffitmanee speeifioet ono for the building design identified on this Certificate of Compliance confirm
to the requirements of Tide 24,Parts I and 6 of the California Code ofRegulafons.
• The building design,features identified on thio Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forme,worksheets,celcuisdons,plans sad specifications submitted to the enforcement
'
t Agee fora royal with this buil din ctmiti+a-� _hcation.
�Namo�:l. 4b#ptrltL//i"�J W 4, Signature.
emnimu'Cailfomia Delta Mechanical Date: rJ' /J
Addrest8058 E.Baseline Rd.,#166 LiCense:811114 i
City/State/ZiP:Mesa,AZ 86208 Phoae:868-892-6273
•
•
2008 Residential Compliance Forms March 20/0
7 >nCQ 3/131S wv«:a L O '9 id
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CIS;OF CtSTA MESA
pE BUILDING DIVISION
>• a i 8 DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
4. 'K2 J PERMIT
B05-00878
, ro
Ranole
(714)754-5273 • Fax(714)754-4856 ci.costa-mesa. aLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUIJob Address: 1803 TANAGER DR Status: ISSUED
Suite: • Applied: 06/01/2005
Vicinity: ROOF Issued: 06/01/2005
Primary Occ: R3 Type of Construction: V-N
Parcel Number: 13963113 Zoning: R1 ,(�yf�
Applicant: YOLANDA HUAPAYA ISSUED BY: r 0
Address: 4091 E LA PALMA
SUITED Phone: (714)630-5543
ANAHEIM,CA ' - Zip: 92807
Owner: CHUN, MICHAEL M S TR
Address 1803 TANAGER DR •
- - -
Phone: • -
COSTA MESA,CA ? Zip: 92626 -
•
Contractor: MC CORMACK ROOFING
Address: 4091 E LA PALMA
SUITED Phone: (714)630-5543
• ANAHEIM,CA
•
Zip: 92807 License: 643700
. Arch : Eng:
Address: Address:
Phone: .Phone:
Zip: License: License:
SCOPE OF PERMIT'
TEAR OFF SHAKES, FILL IN SPACED SHEATHING WEAR NEEDED.1 LAYER 30#FELT, FIRE FREE FIBRAMS CEMENT SHAKES(22 SF)ICBG
#5075.5.75 P/SF,MODIFIED BITUMEN ON 33 SF, FLAT.
FEE SUMMARY
Plan Check: $0.00 _ Calc Valuation: $8,400.00
Permit: $167.25 Claim Valuation: $8,400.00
SMIP Res: $0.84
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00 '
Total: $168.09
• PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 , Rear 0-0 Left 0-0 Right 0-0
•
ACCESSORY Front 0-0 Rear 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 automaticallyexpireand 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 tw bw considered legal, such work•must.comply with all applicable codes, and all
required Inspectionsandfinal approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)7545626
2446.46(6/00)
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. .
�1'tia 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.
L. My era'compee/n�sya�tllCCCnf�/nsur1ti carne d porN,_�(npmb,E s
Carrier: lWl V� Uep L� Vl hundred
(,J.L Policy'Nurnber:�,�v 9/0‘04 Jl.(/lll
(Thissech'O sed not be completed if the permit is valued at one hundrdollars($100)or less.)
❑ I certify that in the perf.rmance 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•:Horn.- and a. .e that if I should become subject to the workers'compensation provisions of Sectign 37 of th�bor Code,I shall forthwith
comply with N:pr. ions. ' /1 r p `�(
ApplicanlSignaturz-. �,, , a 111 . _IAA,
L Date:- (A 1 V
WARNING:FAILURE 0 SE• RE WORKERS'COMPENSATI• •VE- GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLAR- $100,..,),IN ADDITION TO THE COST• •• P:NSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am license. u•.:r• ov: m . pl�apter 9(commencing with Section 7000)of Division,3 of,the Business a Pr fes,pjons o ,and my license is in full
force and effect:Lie q A - ,a • LI 'Class k //l
Contracto`r's SigneWre.IAR�f ��/�_►, ,�/ Data
CONSTRUCTION LEN• E• 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).
Lender's Name: Lender's Address:
Signature: Date: _
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ 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 driver's license. 0 Yes 0 No Driver's License No. _ Expires:
Verification of Ownership by(type of document,i.e..property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled 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 0 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 Califomia 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? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application ap_ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ 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 Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
ft1 It Sign-t .Of to, (L,,egg��a',.Qww1 ner(s) V l \DKe cAnd/'-ul on`zel App-l. 1 '-_.:Date_:.-
cm. _r•. •'. t INTRUL$ CODE 1115PECPON TYPE gaff.' =AU '
1616 F1ystem Final Fire Prevention '' _ - ' 206 Final Mechanical '
1266 Pool Spa Final 208 Final Plumbing
200 Final Re=Roof S' Si' - ' 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 '
' Its CITY OF COSTA MESA •
ja.... BUILDING DIVISION
> DEVELOPMENT SERVICES DEPARTMENT PERMITNUMBER
F 1 iia PERMIT
v !P'eno.di /P01-00040
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1803 TANAGER DR Status: ISSUED
Suite No Applied: 01/25/2001
Issued: 01/25/2001
Vicinity: WATER HEATER
Parcel Nunmber: 13963113 ISSUED BY:
Applicant: STARK, CHRIS
Address: 7229 VARNA AVE
Phone: (800)444-8865 ,
NORTH HOLLYWOOD,CA Zip: 91605
Oviner:' „CHUN, MICHAEL M S TR ,
Address 1803 TANAGER DR
Phone:
' " COSTA MESA,CA Zip: 92626 -
_ -
Contractor: ALAP ASSOCIATES GP -
Address: 7229 VARNA AVE - '
Phone: (800)444-8865
NORTH HOLLYWOOD,CA Zip: 91605 '
- License: 771905 --
Arch / Eng: � - - •
Address:
- Phone: ,
Zip:
_ License: ,; .
,
SCOPE OF PERMIT - '
WATER HEATER CHANGEOUT. ',,7'% - ' /
-FEE SUMMARY „ . .
/
AMT QTY.. - _ , / - - _• / AMT QTY
ISSUE FEE". \---,', ' "$23.50 - ' '- ' Laundry Tub/Washer " - $0.00- 0 ,' - - -Sump,Pump ' '- %7/$0.00 0
Backflow irrigation'. $0.00 v-0 Landscape Irrigation , '$0.00 0 Swimming Pool $0.00 0
Backflow Preventer/\ ;,,$0.00/� 0 '' , PrTrap - $0.00 - 0 ..-_,,,,i,,,,Trap Prime j- /7 1 $0.00 0
Bathtub �v $0'700 , 0� '- -Pressure Regulator , $0.00 0 Urinal - (7/ /�,' $0.00 0
Clarifier System N ' $0.00 /' 0% --Process-Piping(per 10 ft) $0.00 _-0 "i /Vacuum=Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc)\ $0.00 . . 0 1 ` - Receptors - $0.00 - 0 ',�v Vacuum Brkr Bkflovi(5+) $0.00 0
Dental Units v$0.00- ''0 -_ 7 - Septic Tank $0.000 , Wash Basin. j $0.00 0
Dishwasher $0.00 -. 0 '' Sewer Cap for Demo, -$0.00 '0 ;.. '' Wash Basin Set $0.00 0
Drain,Floor $0.00 - ;"0--- , Sewer Connect - - '$0.00 0 7 Waste end Vent System $0.00 0
Drain, Rainwater $0.00 .0 ' Sewer Private Line $0.00, .0 - Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0''--"._ Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 - Sink;bar , $0.00 '0 " " " Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial _ _ $0.00- - 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 - REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $35.80
COMMENTS I SPECIAL CONDITIONS
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 expirationof this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6'00)
DECLARATIONS j
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O I have nd 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
_ or which this permit is Issued.
__,I•have' • II maintain wo .- • •-n��.•n In- rance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
"My w•rke .'compensatlo Ins . f an.policy number are: �� _
C � ^ �[)
o
Carrier:- - an t I� policy" um
Nber: (o4 J0G0t2o S Jl2
'(This section need not be templet:•d the valued of one hundred dollars($100)or less.)
O I certify that in the performan•s of for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation law- •• II' —• : that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these _
�_.
-A nt Signature: mo �— Date: �� �-� ��/
WARNING:FAILURE TO S;•'f!I:li'' NSATION COV E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOUARE(S100,.", ADDITION TO THE COST OF • PEN-•TION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed n r•r• of Cha• er 9(commencing with Section 7000)of Division 3 of the Busines antlessions Code,and my license Is in full
force and effect..LJc.p rs Class q -&�'�
Contractorssignatur0: i�7J, 'G _ pate:___' /- 7S't /
CONSTRUCTION LENDING AGENCY:
9 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 to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
9 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 protect(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. ❑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:
9 I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Wit 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? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 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? 0 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 a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? IYes 0 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 duality 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? ❑Yes ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: _ Date:
CERTIFICATE OF COMPLIANCE AND '• •R TI•NOF 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 s:le laws :nd •1 ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property forriiinnsAppee•ion •u ••.es. .gree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Ir
t. [1`i(� • ner(s) Dade_
'I171• �zG(� a /
•CAuthodzetl:••plicant _ -Date=
CODE I INSPECTION TYPE (AIL• UITITIALE CODE( ItlSPECTIONTYPE Dia RiIMELS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing 2-21-0( d 4
200 Final Re-Roof 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
I
2 11,0
.o /'
----4°
x,_4
4,1 _ �o Twining Laboratories 7f G1`ou1I L2 Ca[ifoz,zia, fine.
W2 A A ''7L 2 PO BOL 47 . 3310 AIRPORT WAY . LONG BEACH. CALIF. 90601 . 12I 3; 476-3355 . 12131 636-2386 . 17141 6788431
BOAMCN OFFICES
TESTING 1514 .1otl1 H,,0..S•...• •yL
Sir..Ana Ca do.,;.92703 �• 21 S5 e.de.ec Ave 10 Bo 47
171.1511 7064 'w' L 1.-q B.e:F Ce0 ?CEO 1713)de 21te
-
October 2, 1973 Examination: SC73-6637
COMPRESSION TESTS ON GUN I TE CYLINDERS
Mr. Errol F. Heesch
12921 Aspenwood Lane
Garden Grove, California 92640 7
PROJECT Swimming Pool for K. W. RASMUSSEN / ���
ADDRESS 1803 Tanager Avenue, Costa Mesa
SAMPLE FROM Gunite Swimming Pool
ARCHITECT CONTRACTOR
•
ENGINEER SUBCONTRACTOR
Grove Gunite Co.
SPECIFIED
MIX 4-1/2 to I STRENGTH 2,000 psi
DATE CAST 9-24-73 -. CYLINDER SIZE
DATE TESTED 10-1-73 10-1-73 10-1-73
CYLINDER NO. I 11 111 IV "HOLD"
V "HOLD"
COMPRESSION 7-Day 7-Day a 7-Day VI "HOLD"
TOTAL LOAD, LBS. 99,500 96,000 93,000
POUNDS PER SO. IN. 3,520 3,395 3,285
•
SIZE: 611 x 12-1/211 6" x 12-1/211 6" x 12-1/211
COMPLIANCE 7-day test conplles with specifications.
MADE BY DELIVERED BY RECEIVED ON
CYLINDERS - - - Dave 9-27-73
DISTRIBUTION
E. F. Heesch - 2 BUILDING SAFETY DEPT,
Costa Mesa Bldg. Dept.
OCT 4 197
:- ---_�-- --�
L .I.00 ♦ ul s >r •(0 S .•F r `. Dc•.. a PO .u(•. . . o .. .. .00 J...7 p.. or 0.. or P0'TS Co•KL.s'o..s r4 E.
_.y reFu ,.. .r ..o e.. ..ru s c(sI c-.(D er•.c n e . .. . y Pona C- 7•. 'O r., F•.-s Twl eue.K .wp o.vv µf
OWNER RASMUSSEN, K. W. DATE 9-5-73
• JOB ADDRESS 1803 Tanager BUILDING PERMIT NO. 37247
GENERAL CONTRACTOR Aquatic Pools DESCRIPTION of WORK Swim Pool
APNo. 139-631-13 LOT 6 TRACT 6663 FIRE ZONE VALUE $ 5,000.00
INSPECTIONS Signature Date GROUP TYPE ZONE Rl
Pool Location 11,4 ?lg.-23 SUBCONTRACTOR PERMITS ISSUED
Dote I Number I Signature
Forms
Main Drain •
Steel Reinforce
•
Elec. Bond Electric n s-
Approval to Cover eZe `7- 5°'23 ita-6A• 4"o.erQ.n , 9. 73 34.4-c934.4-c9Underground Electric Mo gri_cl3 N. //��.
Gas Piping Test ,i°, 7.7?7,41 Plumbing--- ( /� n
Filtering System Lines �1// / as:,, tir. Fo-a-QO-, �-S= /3 6'/233—'0--
Backwash
33 '
Backwash Lines and Recep. e' raj 7IS �
Electrical Final 6/i $ro°'?3
Heater and Vent Final _
Filter System Final / / •
Backwash and Recep. Final
s • - - 37247
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECE De TE CEIVED Dr ELSSUE•
BUILDING /,..- ,(J
ADDRESS L• - •- • -
OWNER K. W. Rasmussen A.P. NO./3"7-631— /3 P X24..7
MAIL BUILDING
Z
ADDRESS - rr- ADDRESS - •- • -
FZ TRACT CITY No.979-9987 666LOT 6 BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMOLISH
-I- LENDER CASH SALE
a CO y
J D BRANCH
J to OWNER
CO J ADDRESS K. W. Rasmussen UE
J
CO ARCHITECT TEL. SE swim pool $
Q OR ENGINEER Ti (inl-Pr NO. 876-7212
U ft FIRE
W K ADDRESS1710 N. LaBrea Hollywood ZONE TYPEGROUPGRODUP
4' w APPROVED
W /Zit
9-6:7,..?
/ '-]Z CONTRACTOR Aquatic Pools BY //(N DATE J�/
J Z
Q]
J Er ADDRESS 1345 S. Anaheim Blvd.
w W TEL. ZONE� W�
J NO.OF USE OF NEW S �
_
/ -/ PLANS 2 BUILDING s.2
Z1- CITY ism;haim • NO' 833-0680 rept
—0 STATE CITY YARDS APPROVED YARDS APPROVED
LLI
to CC LIC. NO. 786-745 LIC. NO. MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STRE
J SIZE I NO.OF BLOCS. 51(1;7444'r-*
T'-^^'
OF LOT NOW ON LOT FRONT F
USE
EXISTING house & garage
BLDG. R.SIRE FT. 9 FT.
I- SIZE or NO.OF `/tom
Z NEW BLDG. 563 ROOMS STORIES L.S E FT. (% FT.
UEXTERIOR WALL ROOF C
_ COVERING COVERING EAR FT. S FT. ,
-I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 swim Q1 MAIN BLDGS. ACCESS.BLDGS.
Q VAR.# DATE
O _C.U.P.# APPROVED
CO APPROVED � r / // K
—ELY DATE 9/5/The
Z
O CATt
I hereby acknowledge that I have read this application and statethat the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employany person in violation of the workman's compensation laws of
to the State of California. � m
Z SQ. FT. ti
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
Chapter 9, and that such licenses'are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
cr
am exempt from the provisions of the State of California Business
and Professions ncie, Division 3,Ch pt VALUATION OO $ at
n 03
N
PERMIT FEE /yN
Signature of •..---. 5r0 B
Permittee /J-4,, "_" $ ���Q PLAN CHECK $ , '-0 E
l /// ✓ o
Authorized Agent - L/ �� LL
TOTAL FEE $ T
. • .
•
• • .
. •
• 23 2',in-'
••1 - L-...):1;;;;•:i
-.
• .1 DI; 1<-
•
•
. . • ..
• •
• •
•
•
OWN ER RASMUSSEN, KEN DATE 9_17-73
';;JOB ADDRESS 1803 Tanager Dr. BUILDING PERMIT NO. 37288
.t GENERAL CONTRACTOR Hertz Masonry DESCRIPTION of WORK Retaining Wall
SAP No.139-631-13 LOT 6 TRACT 6663 FIRE ZONE VALUE $ 400.00
INSPECTIONS Signature Date GROUP TYPE ZONE R1
SOIL SUBCONTRACTOR PERMITS ISSC�ED
4GAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING I I I J
VPROP. SWR. LINE HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND q POWER D
ROUGH WIRINGHeating and Vent.
TRENCHES ►i FORMS _ STEEL REINF. j7..Zf.l_'
FLOOR SYS EM
BOND BEAM I STEEL REINFORCE dl neda,
SHEATHING
FRAME AND FLASHING
LATHING — IN fl OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Elertric
-
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST fl
ELECTRIC, FINAL atAl a,
BUILDING, FINAL J
3728.8PAID ��***5.5
SEP 17-73 .0t) 549* 0
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
BUILDING /-q ,s� �/�a RECEIL{IfA �� gj
OWNER 1ST LOS Angeles Corporation DATE 3-13-72
JOB ADDRESS 1803 Tanager Drive BUILDING PERMIT NO. 34255
GENERAL CONTRACTOR The Buccula Co. DESCRIPTION of WORK Bes.w/att.gar. ,
AP No. LOT 6 TRACT 6663 FIRE ZONE VALUE $37, 350.00 T
INSPECTIONS Signature Date GROUP I&J TYPE I ZONE R-1
SOIL 44537v->2, SUBCONTRACTOR PERMITS ISSUED
GAS Date I Number I Signature
WATERSjgMS'yf q-n. Plurrilaingirn i
+�
ROUGH PLUMBING /1297 tl C f� ll .[ J�p(jry/Ltatitielaerd. `-I?4-72 /Goof 77—
/JSPRPROP, SWR. LINE Q HOUSE CON. Q ��� //7. at� J� O-,H/-72 rp/�l 17/e--
SPRINKLING
INKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING 445 gl-'77. L
TEMPORARY SERVICE OR POLE
UNDERGROUND Ej POWER ❑
ROUGH WIRING tt //^7y/�7/////� //ea inq�a�ngd../Vent. �/ JqTRENCHES [] FORMS [] STEEL REINF. �` 0'/ . _". .G / 7-,41.e/N 4/�SL.�FLOOR SYSTEM
BOND BEAM El STEEL REINFORCE n
SHEATHING C
FRAMEHIAND FLASHING,., py..
LATHING - IN IT OUT � C-' �', � "J�
PLASTER, BROWN COAT / C_ P'•' 1 ?.-
STRUCTURAL. FINAL ,r. trl ` -
HEATING, VENT.. REFRIG. AND A.C., FINAL Y 7 ��/'1(JI-( / �p/�� 1�j�ij i
PLUMBING, FINAL AND GAS TEST f �' ��"yyl�J�
ELECTRIC, FINAL 1,2/7-2 /�'I- ??-
PLAN Nr.. 1.OA .3.4:25.7
LOT NO• 6 PAIR
COSTA MESA BUILDING-SAFETY DEPARTMENT '"' 7?-7? 00 877* **-4184.87
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
jr Applicant to Fill in Completely RECEI DJ3J{ DgTE RSC IVSD DAT
E�I UEDBU �
ADDRESSI , /f'O3 Tanager Drive i LDING '� i-] 7 -3 . 7
PERMIT N43.A qtr 5
OWNER 1St. LOS Angeles Corporation A.P. NO.MAIL J4!
BUILDING
Z ADDRESS 1 Wilshire @ Grand ADDRESS/1/0//3 TA/A66/- Q,e/vE
Lulli TEL,
-U CITY Lod Angeles No.025-7341 TRACT fj 6 O? I LOT 6 BLOCK
CONSTRUQCION / NEW IAD• ALTER(REPAIR )MOVING DEMO,LSH
2 4 LENDER �LS'TG, Los Angeles Corporation ✓
am /
J D BRANCH A �/
-JN OWNER^ /ST G,N. GO/Q/e,
ADDRESS4 iii ENGINEERT E rl Wilshire. Grandco _1 ad , „/". /4 3� 3,�
J m ARCHITECT / TE USE 6 ALU$^ r
Q OR Earl G• Kaltenbach ND``J47-8046
U„\I-
FIRE
w K ADDRESSIS23 E• 17th, Santa Ana ZONE TVP GROUP 4
C w
/ APPROVED
mO CONTRACTOR The BUCCOLa Company By DATE
2
71r ADDRESS 4501 Birch Street
IL W TEL. ZONE NO.OF USE OF NEW get, /,r//nr
z F CITYNewport Beach No.540-8833 ,-/ PLANSa_ BUILDING"deloeGn,c,
STATE CITY YARDS APPROVED YARDS APPROVED
N CC LIC.NO. 1 146423 LIC.NO.2104 MAIN BUILDING ACCESSORY BUILDING
DO l ,[ (FROM C/L STREET)
SIZE
OF LOT 6,5 I X 100 1 I NOW ON LO S 0 FRONT (—y— FT. FT.
USE OF -
EXISTING BLDG. R SIOF S FL FT.
2 NEW BLDG2f465 Sq. ft ROOMS 11 STORIES2 L.SIDE FT. FT.
Q EXTERIOR WALLROOF
V COVERING t COVERING Shingle REAR 2/ FT. FT. f
.J USE OF BUILDING AND WORK TO BE PERFORMED
1 DISTANCE BET. BET.MAIN&
a s{j MAIN BLDGS. ACCESS. BLDGS.
VA
.# DATE
O /'/�r 1.41/1/47 C UDP.qW ow
APPROVED` rJ�I
I— "" //' _BAPYPROVEp iLO DATE d� /d�
a HOLD FOR SPECIA REQUIREMENTS
t~.1I hereby acknowledge that I have read this application and state C \\ y .2 91
that the above information is correct and agree to comply with A:"T�Tt - �/\
li all laws regulating building construction, and I shall not employ ;if / 7e
I"' any person in vlolati9n of the workman's compensation laws of LO
CO the State of California. co
zI hereby certify that I am properly licensed as a contractor under T�ySt(0. FT. o"
the State of California Business and Professions Code, Division 3, THE U HOWN UNDER VALUATION IS FOR '5
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0
CC
am exempt from the provisions of the State of California Business
and Professions Code, Di 'sion 3,Chapter 9. VALUATION /�/,`D CO
ti
sioI''r{-,mss` PERMIT FEE $ / J
Signature of ( \ r /t 352)--
D 6D E
Permittee \ yY 7711 C' N $ PLAN CHECK $ /7 o
Authorized Agent f 02` LL
TOTAL FEE $ /o