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2772 TERN CIR - Building Permits
/3 F Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERo T NO. TRACT NO. - LOT NO. UNIT NO:CIT-'i OF COSTA MESA^ CONSTRUCTION PERMIT / A.P.# I Zone • ct Address 9TT7 rX ��in C1rL1 C 3- S SS- p� 11 1 rr II 2r $ Main Building: Accessory Building: /'Applicant's Mailing Address )�paQ, 1���� bl✓C+ Ion I TYPE OF CONSTRUCTION LI NEW u ADD .r ALTERATION H REPAIR E Z �" C ❑ CONVERSION ❑ DEMOLISH ❑ O ER, i T Front • O Owner's Name�11l�^ ES�<1ti� ftV�C FIO1cn7honeil Kms— - DESCRIPTION OF WORK7[USE OF BLDG. t 'l II,�,,rr-� }} B Rear N Address d-T7,; —vV v-\ 1 rrA rc VESV.E-c 3C)Fdi r• SIG SS' , -ter1 L-c✓) f in A 1 Arch/Eng. License No. • TYPE OF PERMIT LJ GRADIFIG ❑ FOUNDATION ❑ STRUCTURAL I C Right N G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $- Left R ' �� •Kl, ❑ OTHER Pln Ref.# ParkingRe /Provided E - Contractor's Na • .Y.---Ata a .PhoneS4-�—« , ! g' q' `1 • PROJECT DESCRIPTION SQ. FT.�S aJ OCCUPANCY Q Address(mailing) gQtD n �Os�# 'et La ^ Planning Notes: M CONSTRUCTION TYPE VALUATION $3. Sl J� T City License No. ZONE GRADING CU.YDS. - ACRES s. LICENSEDCONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I with section 7000) of Division 3 of the Business and Professions Code, and my license is in fu for!.•d effect. ELECTRICAL FEES License Class "" � s• ,• /.�� / Date -- _ —, Signature an i��� • PLUMBING FEES Automatic Washer Transformer 0 15-50 KW - `_ WORKERS'COMPENSATION 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 I %of Workers'CFCompensati on Insurance, or a certified copycothereof (Section Backflow Preventer Service Sink Cooking Unit Meter pup to 100 amps `(� 'Po00,lc Lab. (L) -/���� "r¢ 1 (` _1/\� p �_ Policy No, 111 ompany -�{J Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps Ifl Certified copy is hereby furnished. , Dryers ❑Gas ❑Electric — Sub Panel - I Cei ifigp copy/5 d with the city Byilding glvii :• Bathtubs Sewer Connection bate Jvt- 1t"/ Applicant( w A / Fan Motors❑0-1HP ❑1%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (Thi >s section need not be completed if the-permit is for one hundred ($100) or F.A.U. - - • Inc.Solar ❑9-15 HP 016-15+ less). Dishwasher Solar Piping I Certify that in-the performance of the work for which this permit is issued, I Fixtures Microwave shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California. Device Boxes Date Signature Floor Drains Swimming Pool w/Spa Pole Light NOTICE: If,after making this declaration,you should become subject to the t$ DUtle Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range . comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches , Sign I hereby affirm that there is a construction lending agency for the performance Dis oral of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater GarbageP Standing Sections - Lender's Name Lender's Address Kitchen Sink Water Service j _ Generator ❑0.5 KW❑5-15 KW —Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I.am exempt from the Contractor's License Law for the Lavatories Auto-Wash 'following'reason (Section 7031.5 Business and Professional Code: Any city or - county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays - any structure, prior to its issuance, also requires the applicant for such permit • to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains • t the Contractor's License Law(Chapter 9 (commencing with Section 7000) of sion 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee• $15 Issue Fee e • $ 3 7efrom and the basis for the alleged exemption. Any violation of Section 1.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: • I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date 7 compensation, will do the work,and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By ' Date License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Application Issued By Dat employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ 7 SUMMARY QF FEES • pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • ' o ��}� prove for the purpose of sale). BUILDING PERMIT $ -0SMIP • $ eJ`-' ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMITS tractors to construct the project (Section 7044,Business and Professions Code: - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU PLUMBING $ ISS•UANCE .y...$ builds or improves thereon. and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration • PLAN CHECK 25% $ ENERGY PIC'. 1$ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers GICROFILM $ PLAN CHECK 50% $ ��2 ,s� D Date Owner Heating System&Ducting Registers MECHANICAL $ 146�.s_) I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTU TOTAL FEE $ information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city o rater on the above-mentioned property for Inspection • 59 afture p�rpo:•e�, ' Date _.? - "' 01 0,7026830-00025$31 TOT 63.50 Drivers' License or SS -Accounting; Goldenrod - Assessor 1 ' 1 • 1 c -CONSTRUCTION AND PLANNING 1'POOH!&SPA ( IPPROVALS Permit# Date Inspector APPROVALS Pe et it# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd; 54. Forms 4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5? Steei Reinforcernent- 56. Rough Plumbing & Pressure Test • 6.- Electrical UF ER Grkd. 57. APPROVAL TO COVER-GUNITE• 7. Footing; , . 58. Electrical Conduit-Undrgrnd. 8: Foundation =i 59. Gas Pipe, O Undrgrnd.,Test 9, Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10' Structural Floor System • - 61. APPROVAL TO DECK 11:Property Sevver Line & House Connection + 1 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Rbof'Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval X17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1t3. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .•20. Rough-Factory Fireplace APPROVALS Permit# 21'. Ducts, in Structure 70. Underground Hydro 22. Ducts,-Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough&,Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas CI Oil 25. Roof•Sheathing•�I 74. Overhead Hydro 26. T-Bar,Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame.and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREY. FINAL 30. Drywall'Nailing '. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: QGOr n\"{1:i\l P- t.) tZ-C$\ cwt / 34. Final Heating & Air Conditioning IJ tGQS ')-1..lti S 01 ILE Z-Z3-67, 35. Final Gas Pipe-Test �q c) , 36. Hood or Canopy '3-I1 `S ! Smolee QerecvIJUP 37. Final Factory Fireplace 38. Final Plumbing 2-Iter;hCC;FTS� 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 car Sr'✓fi- - G P6rEGT7.VS O/C�'� 4R. Special Requirements Completed 49. Electric Release to Edison • ,1 50. Gas Release to Southern California Gas Co _- t• 'i 51. CERTIFICATE OF OCCUPANCY I of)No', Date - / Lot 0 • Tr 578r. 24(O .--) _ CITY OF C'�TA BMSA ''COSTA MESA BUILDINL.aArc(Y DEPARTMENT P.O.BOX 517 COSTA MESA,CALIFORNIA MAY 11 1965 For Applicant to Fill In Completely IC 10 •• PERM TYPE OR PRINT YY#` BUILDING -Far-OIl1,o II... 0..{� ADDRESS 2772 Tern Circle RECEIPT NO. Pj�gMIT rvo. COSTA MESA. CALIFORNIA I I,'.�j RECEIV V et RECEhED DATE ISSUED OWNER Pemba Subdividers, Inc . /O/&� NAY 1 3 1965 MAIL MI-REV: UIL NO /J�-7 rl IZ"p / CL2 ADDRESS 2850 Mesa Verde Drive ADDRESS f ( ' G� '(; Si�Y FIRE / ` CITY Costa Mesa o 5490395 ZONE TYPE GROUP ARCHITECT TEL APPROVED DATE OR ENGINEER E .G.Kaltenbach ND.5478046 ADDRESS 1823 E. 17th St .Santa Ana ZONING �Pdm z NO.OR pQ USE OP N CONTRACTOR Pemba Subdividers, Inc . � � PLA""d I B�HrIL-D�I� /1 LESCR 1...23 I-1 ) ,� 1Z / n1 ADDRESS 2850 Mesa Verde Drive DESCRIPTION N' '1 4. CITY Costa Mesa A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LLIIC.TNE O. 187318 TEL L 5490395 SO'TO SIDE B REAR P.L. EAVES SIZE 72x118I NO.OF BLOCS. 0 ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ^ ACCESSORY BUILDING EXISTING BLDG. (FROM C/�L-fSTREET(r)\ ETOACK LINE PROM 20 '' 47 FRONT C I J FT. ( FT. CENTER OF STREET REAR YARD N SIDE YARD I LEFT 11 I I RIGHT 11 ' R.SIDE /I FT. FT. DESCRIPTION OF WORK L.SIDE // Fr. FT. NEW X ALTERATION _ ADDITION REAR FT. FT. DISTANCE B[[[ET. BET.MAIN A . REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS. - VAR.# DATE BUILDING NO.OP SIZE 50x49 ROOMS 10 STORIES 2 C.U.P.# APPROVED EXTERIOR W ft/�L ROOF APPROV / (� LI 7/ COVERING ALUCCO I COVERING WoodSh in '1 BY , Ac)0,A444 DATE 7" yf i / USE OF BUILDING AND WORK TO BE PERFORMED Single family / attached garage pim h aO 9ottHQ.FT. /00 17'1- T I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. 0 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION Q �f'..o (//n/ PERMIT FEE $ S-} SIGNATURE OF / /1// �. 1,m PERM ITTEF /J/J.,1/.� 1. ,vy- / $ /7 �31 PLAN CHECK $ 9 AUTHORIZED AG 000"`"` i n c-(/ 25'. i • TOTAL FEE $ ( Iti !! I, 2505_I) ; CITY OF C3 1 A MESA _ COSTA MESA BUILDING.SAFETY DEPARTMENT• P.O. BOX 1203 COSTA MESA, CALIFORNIA 92020 DEC 3 1 1965 • For Applicant to Fill In Completely APPLICATION FOR PE IT TYPE OR PRINT • L'l�F6 ':O�l II' G ADDRESS r.. RECEIPT NO. 2'3051 COSTA MESA. CALIFORNIA OSeC,,,// /7 R[C[IV Y DAT R[C [D OA ISSUED Migr'tc o4eSQ Rmceo I . tL/4//4,C /2-/31 BUILDING 2 7 7 z //r /� MAIL w not ie h rib,�% ADDRESS .2h( �.� C( �� AODR eS�C _ ?2 Tri-.5416 p FIRE GROW P CI CSB. NO. 6 re ' /J/�-.�t��.// ARC ITECT ,,^^ la pp LL TEL APPROVED ARC � ATE /�/ 1 I� OR ENGINEER I.." // L// NO. // ADDRESSO / /� re,-4 opOle ZONING r-40 ZONE HOOF US[OFN[W /Ten p/ ' ( JJ -.- CONTRACTOR PLANS v PUILDINO CONTRACTOR II.UJ// � LGf (.1 f As7 $ I L[OAL ADDRESS D[DCRIRION CITY A.P.NO. /"l_.(iv� STATE TEL.. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.ATEET�O[q. N .. 80-TO SIDE Q REAR F.L OF LOT "s�x /36.16 �J /J I NNO.OF OW ON LOT VES ALLOWED (U.B.C.REQUIREMENT) USE OP YARDS APPROVED YARDSAPPROVED BUILDING EXISTING BLDQ• G ,Thr MAIN BUILDING ACCESSORY BUILDING (PROM C/L STREET) SETBACK UNE FROM FRONT FT. �/PT CENTER OP SIRE REAR VAR ✓ _ SIDE YARD I LEFT RIGHT R.SIDE PT. 2` DESCRIPTION OF WORK L SIDE FT. V'PT. .....--FT.----. NEW ALTERATION ADDITION REAR PT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVING _ DEMOLISH MAIN BLOOD. ACCESS.SLOGS. BUILDING NO.OP VAR.# DATE SIZE ROOMS STORIES C.V.P.* APPROVED EXTERIOR WALL ROOF APPROVED//'A//(A///J yyy,,......��� i _ 3 / -61' COVERING I COVERING IT yf�✓/' ��E+q•E ( . l Y/J a "OF B INS D ORK TO BE PERFORMED / "OF i �s 9RKT e< r Ty SQ.PT. Z I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION TEE AMOUNT SHOWN UNDER VALUATION IS FOR TIE 2 AND THTN[ PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. PLY WITHSTAT[ALL AT CITY O AE V[,ID ANDCORRECT RAT[AND OYLATNGTOCOY. VALUATION BUILDING CoNDTRU ���p /,/./,� CPO 6� 7 ,2e�'_`/'V'�"T� PERMIT PEE SIGNATURE P PERMITTE _ Z 6 PLAN CHECK E w° AUTHORIZED AGENT 00 ailiniliarF'. T TOTAL PEE S „..ua. As vlYv v? Lti1G Y--Jt-V/ JOB ADDRESS r2772 Tern Circle BUILDING PERMIT NO. 25051 GENERAL CONTRACTOR Owner-Builder DESCRIPTIOI:OF WORK Community Block Wall AP No. LOT ]2 TRACT 5151 FIRE ZONE VALUE $ 90.00 NSPECTIONS Signature Date GROUP J TYPE III ZONE R-1 Soil PERMITS ISSUED Gas SUBCONTRACTOR I Date I Number I Signature Water Plumbing Rough Plumbing Prop, Swr. Line p House Con.0 Sprinkiing System %Miscellaneous ugh Heating and Air Conditioning Temporary Service or Pole Underground 0 Power ❑ Rough Wiring � Heating and Vent. Trenches D Forms 0, Steel Reinf. © 14f�(c- /14., /6”C Floor System Bond Beam ❑ Steel Reinforce 0 Sheathing Frame and Flashing, Lathing— In 0 Out 0 Plaster, Brown Coat Structural, Final - Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final Building, Final jig i/a-5--/ s