HomeMy WebLinkAbout125 THE MASTERS CIR - Building Permits •
CITY OF COSTA VESA
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CITY
DIVISION
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..�•6 DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER
1 % t PERMIT
° �CO; 03-02030
%bonito(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.G7.tL5
CUALDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 125 THE MASTERS CI Status: ISSUED
Suite: Applied: 11/21/2003
Vicinity: Issued: 11/21/2003
Parcel Number: 11939143 Zoning:
Applicant: WOLCOTT, L JEROME JR TR ISSUED BY: (Arc
Address: 125 MASTERS CIR
Phone: 714-957-5883
COSTA MESA,CA Zip: 92627
Owner: WOLCOTT, L JEROME JR TR
Address 125 MASTERS CIR
Phone:
COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF CONC.TILE AND INSTALL DURA LIGHT 4.7PSF ICBG 2656.AND NEW FELT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $7,200.00
Permit: $153.25 - - Claim Valuation: $7,200.00
SMIP Res: $0.72
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $153.97
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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 expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS ( _./( J• ("'j
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.
❑ 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 permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit Is valued at one hundred dollars($100)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 to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.a Class M
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Coda).
Lenders 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 fore 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,end who does such work
imself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.It 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 Li ense 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 toaI •ntractors License Laws.).
❑ 1a�exempt unijT.: Business and Professions Code for this reason:
g " / -R - 0 7 ,,,/�-
Owner ID verified by driv.f's license.-3s Drive' ense No F®s: 3...../z
�� ex;
Verification of Ownership by(type of docu ent,i. ill 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 6,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 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 hes 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 0 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 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 appermit for such construction or modification
from the South Coast Air Quality Management Olstdct or from any other air pollution control district or agency? Yes L_I 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 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? ❑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 COMPLIAN•% AN' AUTHOR •TION 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 w'Ig*II .te laws anIcy ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described pr•perty •'•ns•• tion pua•'s{f'.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ,
Se nature•f Legal'I ner(s) Date
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE DATE INT-MAI S CODE I INSPECTION TYPE DATE INIIDALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final / 208 Final Plumbing
200 Final Re-Roof /L�7� 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
4
PROJTi.TAODREsS: 125 THE MASTERS CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 066558
OWNER'SNAME: WOLCOTT, L JEROME JR TR
ADDRESS: 125 THE MASTERS CIR PERMIT NO: B 066558 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
957-5883
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF WITH BUILT UP ROCK ROOC SQ FT: 2, 787
ADDRESS: UNIT:
CLAIM VALUE: 2, 787. 00 CALC—VALUE; 2, 787.00 GROUP OCC: R-3 /
PERMITTEE: CRANK BROS ROOFING CO ( 714 ) 548-5569
ADDRESS: 126 COMMERCIAL WAY COMMENTS: SMOKE DETECTOR REQUIRED IN BEDROOMS & HALLWAYS —1991 UBC
COSTA MESA _ ************+tEEiE+E****aEytEE�P****EE***�E**********�E�rEt****�r****�EEt�E*************Ec*******
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am li ensed under§3261217
9(commencing with Section Z ON I N GS ERTEBQAUC I SETBACKS EMENTS
7000)of Division 3 of the Business and Professions Code and my 1e : is in f
CITY LIC
00O 993 STATE LIC.: 408 7 C 'SS:
.ate'✓,(iX_ oEq Signator - _� MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMP NSATION DECLARATION: I hereby affirm t 1 I ha 'a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation 1p,gtauce_gl aa°AT)jfipirgpyto¢r;ol(Section 3 O.Lab.W LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
•POLICYNO.: Ltbi tltl UN 1L19 EXP. DATE: 1 /01 /95
' coMPANr. STATE FUND PARKING
PARKING REQ: PROV; PARCEL; 11939143 ZNE: REF NO:
❑ Certified copy is h reby furnished. lc Certified co. i 'led with $ity Building ivi PLANNING NOTES>
EXEMPTION ROM WORKERS'COMPENSATION DECLARATION: (This s' tion an d not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS
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 A' DATE: _
Date: Signature:
NOTICE:If.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. lialir
r
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE; 3
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 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 five hundred dollars($500). ISSUE FEE
I. as owner of Inc property or my employees with wages as their sole compensation, will do the work, and me 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'Stale 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
purpose of sold within one year of completion the owner will have the burden of proving he/she did not build or improve
forthedBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/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 SO .
❑ and Professions Code: The Contractors'Stale 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 *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 2787 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 787 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safely 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 in ormation i r . .gree to comply with at city and county
ordinances a slate laws relating to building construction and -reby aid(i eprese Lives:•ars city to enter upon the above-mentioned
propertvyr nspeclo purposes. 01 00157845-00157846 TOT 54.50
—
ilk DATE: 03/28/94 TIME: 11:37
Dale. Signature •
1l�.�f�
Driver's License or Social Security
1641.46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
ba
CONSTRUCTION AND PLANNING Pt._ & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Serv,ee'or Pole 52. Pool & Equipment Location ,
r.s-•
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
j.11.4''}ctiical Cond it,ci.kility=Undrgrnini:' " 54. Forms
Rj(4e-Ekectri.cal ContFplhlZndrgrnd." Z3h' 55. Electrical Bonding
C w
F.rS Steel'ileinforce+7i,�t • 56. Rough Plumbing & Pressure Test r.:
•I w - :-r r< i...-
,-,
,6 ectrical OF ru el td. o .:. 57. APPROVAL TO COVE R-GUNITE
� '
•G,_-3 f�F�aotings ,,,n n' 58. Electrical Conduit-Undrgrnd. -_w
';:,c 'Foundation :i.±-1/4t . 59. Gas Pipe, 0 Undrgrnd., Test - •`
Water Pipe-UndTQnd• • . 60. Backwash Lines, P-Trap, 0 Undrgrnd, •"'
.75tructural Floor.‘stern •_., 61. APPROVAL TO DECK
ta.. Ptoperty Sewer`Lirte,& House Conagiction 62. Backwash & Receptor-Final
12. Sewer Cap - v 63. Heater & Vent-Final
13. Roof Drains 'o 64. Plumbing System - Final
-
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrich-Conduit 66. Solar System-Final
16. Rough Electric:Niring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18, Rough Electric9l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
cy
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20rf;oaylh FFctony. Fitepiece i srr cy- 0 * l' TAPPROVAY.S%y1CPerliait # -- v rr
t' S' r, rt. , X'r 0' x •c; r.. C'* -/ C tJ - y' C" 'T•
-d *' i-- - :C s t' - `3 '71* i' .Z .-,�7 r T. t, rr,
21.rDu' s,io.5tr*ctU I.* ., r,} : C �.. t -70- undergn`gcrnci Hy.S�ro
22. Duc s, Venttiatir R tdS ' _1 r S y: `71. Product' ing OIG s Doi
23`Ga f?Ipe toah &'Test .r I. n ~r r -'72. Under P S1 _,y i * ,�,'
-I h -'i a 7 v' <i, J x -+ g On Flusti
C. .. •, A tot,. 4....:•-• x •+.
24„-o¢J Frcming 1 r-;. .•F. - C' _ * > S73rUndergrnd:Storage:Tank OGas 0 0
25. Ro t SFicathing + is-z 1- qe f (�„ -74, Oyerhead'Nvdro7�-'
265, C A r1 t . C' Y r, .. .« S. _ I
-Baf Ceiling (Strpotural) &dylengcoat >- + 75c Dry Chemical "y ' ^+ - _ l
27.'Frameand Flashirt" a:{^ . m a , 76E-'p� Oma• y S ^% tc
n T• ; : _ } tz n . Y Stantie r7
kaxLatking-ASidin 4. ;, F aS ••t ,' r 77P'FIXEDSi5TEMIMINAL. r
,29. Insulati6n 4v ` S ' ;• G1• I, r 78rFIRE PREV. FINAL X ;Ci.
Et
;F30. Drywall,.iyailmg rn* , : 1'. I I Ir HEALTH•DEPT*REOLARBMENT
X31. Plaster 84owA Coit'` S i 1-,t” * • , ,j" < 7,79PFINAL l eECTIOiN i' c' 7'
r. c..,
_32.rElectrical Poyer Meper;Finall `' , ;� I • F < :rf0;rfOOD CERTIFICATE ISSUED
C :. :-' i , .. - M
3.�`'Fin l Elpctri H* I a' ' m ! �" » '1"Noies: C it t` _ 'q
ri * I( r r -t .7 r ,;to
,rj34. in2.1 H2ating:&A�r;Cohditiojt4j !`. r { . - r" "" J'.
35.7F inai GaPipg-Taut -4- ^ t ` h T ,'` t� a•' .r ..i..M,
-� r x t- ,ti 7: I �I�� < •
p, ' ..t : * ri
to36'Hooi or:Canopyp:r :+ r7 -., f, ..r � .4' Z _ z '.o .a.,,
1-87.-Fin'af Fatory Fireplace I 5.7 Cr. I a �c e- 'a
C38. Final-PIt tubing :* 'n. > I ' .Ix c.• c y
T - t'y - ,w J
:39. Water Service-Firtalk w . ( I l;• a 1 i� ru:.' x z1 0
T .. CZ - CH - 'Y1.
-I a c-1 * '' ' * •-ou • *, 1-/
X40. Gas Sery ce-final, m -.r, ts �c , Ca. ti,
v
Z41. Solar Domestic-Final S •• r J: I I t <,• r, f
r
r., -, 111• . . s I* .1 m -1C Cr n 0
&42.4$ackf low Prevenfer* -' ,,; �' 1 I I; ,. if,q_g'y /��i1 �_ , „ 4. r,.-r /_ 1
43. Backflow Irratiem+ CCSS r * `r rE•�- / I
'i. Y _^ > < N - k.MQt' Ar.arT ` 46(.(.41.-
8 7 .z r . i.,'
tt-- P .J
7�4. Landscarz IEigatlo4 Systems-.,_ * p -,F . ,; p; n-, * ,; c:
t45. and Atteribationt- r,cC& + £ F- c-' fa -F .1 `-4 C" XC
.r r r•• . r r m a "" c, C r��- r• _ .r
-46.rliandicab FetjUlatioQs '• * ;, Cr.
47.±IN�.L STRUCTURE & BUFEDING (lQ_pql &-14 rues
46. 4N'AL PLANNING' -r U• -C _` I • . tU Ct n �•
r.
y49. le&frcI eleaseto Edison I E
1 --7:: `
.e
H t,
t . •. f
,'30.SGas<tielease to Southern CalorniAGas v -L-'+ ' ci h + F r, 0=
•r
51. CESTIFICATE OF pCCUPANCY i. c.
No. Date
OWNER UNITED SAVINGS d LOAN DATE 4-27-70
JOB ADDRESS 125 The Masters Circle BUILDING PERMIT NO. 31739
GENERAL CONTRACTOR Ryness 6. Smith DESCRIPTION of WORK Residence W/Attached Garage
AP No. - LOT 7 TRACT 6508 FIRE ZONE VALUE $ 32.1.33.00
INSPECTIONS Signature Date GROUP T A I TYPE 999 ZONE {t-f
SOIL nq C64---4-"W" I PERMITS ISSUED
GAS SUBCONTRACTOR
Date i Number Signature
WATER Q yM 5- ii-7d Plumbin•
ROUGH PLUMBING c/, - /.-- , tthu - • S. /1-'7'70 d�
PROP. SWR. LINE f HOUSE CON. rU • 54-7---70 din . . i` if-a �707 <..,
SPRINKLING SYSTEM,/TE �� /u
MI ..__A.g gnffi %i ✓
ROUGH HEATING AND AIR CONDITIO ING 7''/7 A^45 --7-/7 -7t
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER fl
ROUGH WIRING Af2 /7. 7�; Heating a�n�dyan q
TRENCHES E FORMS STEEL REINF. '-/-90 LHJANLf)i raw
� ! �
FLOOR SYSTEM 7-iy--i el iatl Cr•IILL.���tt���//II 6- O .4 4
BOND BEAM n STEEL REINFORCE n fb
y�/7/�L�
SHEATHING /7/'('V
FRAME AND FLASHING
LATHING - IN 4 OUT RI WA;
PLASTER, BROWN COAT •
STRUCTURAL. FINAL i�� Elqctricc��.. / - -
HEATING, VENT., REFRIG. AND A.C., FINAL SS>27.� Al t41(JC�C'e�(1'. •V-- -M .5i/74 ✓
PLUMBING. FINAL AND GAS TEST l l
IFS-J` -1 D
ELECTRIC, FINAL 4---s-- 21
BUILDING, FINAL A,4 `tc""-I1.-ys`
3 173
" APR 29-7G�,,�1—;001676' ***163.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RECEI ly DA ' RF a1=E OAT
�E ISSEUDD
BUILDING
125 TherMasters Circle //�/ �/�
ADDRESS / EI '7E
PER [y
MIT. O.
OWNER United Savings 8 Loan Assoc. A.P.NO. —' 'II -PRO
BUIMAIL ADDRESS 125 The Masters Circle
Z ADDRESS 9800 S. Sepulveda Blvd. Q�
0 Q CITY Los Angeles, Calif.Lullj TEL TRACT/0St6 LOT-7 BLOCK
I—Z
Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING nFrorn ISH
— I— ENDER Owner
o_ m
J r BRANCH '
d) owNERUnited Savings & Loan Assoc.
CO -I ADDRESS VALUE
-CO
ARCHITECT TEL. USE $
- Q OR ENGINEER R.J . Maryick NO. 839-3840
Z Q FIRE
Ill CC ADDRESS 1538 N. Century, Santa Ana, Cali ZONE TYPE GROUP
WZ APPROVED
J Z CONTRACTOR Ryness-Smith Co. BY DATE
CO
mfr ADDRESS 140 E. Industry Ave. sinal fam resw/
lL w TEL. ZONE NO.OF USE OF NEW
zF CITY La Habra. Calif. NO. 879-3111 RI PLANS 2 BUILDINGatt. P car q_rage
STATE CITY YARDS APPROVED YARDS APPROVED
VVI T LIC. NO. 167538 LIC. NO. 1964 MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/LLSTSEET)
SIZE NO.OF BL
OF LOT 46 X 90 NOW ON LOS FRONT '7J FT. FT.
USE OF
EXISTING BLDG. R.SIDE 6 FT, FT.
I— SIZE OF NO.OF /
Z NEW BLDG. 2165 ROOMS 7 STORIES 2 L.SIDE (O FT. FT. _
EXTERIOR WALL ROOF /)
U COVERING Stucco COVERING Cfav Tile REAR / FT. FT.
—J USE OF BUILDING ANO WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& \
n-
a MAIN BLOCS. ACCESS.BLOCS.
Q VAR.41-7„ / S-6 DATE 3-1 7—
Single family dwel I ing 8 two car c.u.P.4yL q /_/� APPROVEDYQ — _��
H APPROVED
attached garage �Y W.L. D. DATE 4-24-70
2 Lot 7 Plan 4-C cu^9/if
o
UI hereby acknowledge that I have read this application and state
that the above Information is correct and agree to comply with
er all laws regulating building construction, and I shall not employ
F- any person in violation of the workman's compensation laws of
(q the State of California, 7y'/Z b
I hereby certify that 1 am properly licensed as a contractor under
0//‘ SQ.FT.�/ 0
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ii
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a:
am exempt from the provisions of the State of California Business VALUATION Ob
Pi and Professions C Division 3,Chapter 9. 0'O PERMIT FEE $ / 9 D
Signature of 1� '�s'�v!` � �r� /33 //SO E
Perm lttoe 27,472.4--'2•741-
,.d $ / PLAN CHECK $ .� 7 E
o :::-
Authorized AgentTOTAL FEE $ /63