HomeMy WebLinkAbout2330 Ticonderoga Way - Building Permits •
CITY OF COSTA MESA
BUILDING DIVISION
F ,I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
!� PERMIT /
"e�^o-narc4� J 602-01513
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2330 TICONDEROGA WY Status: ISSUED
Suite: Applied: 09/18/2002
Vicinity: 2330 THROUGH 2344 TICONDEROGA Issued: 09/18/2002
Parcel Number: TPN98078 Zoning:
Applicant: BLANKS, JERRY ISSUED BY:
Address:
Phone: 714-573-0155
Zip:
Owner MONTICELLO COMMUNITY ASSOC.
Address 150 VALLEY FORGE
Phone:
COSTA MESA,CA Zip: 92626
Contractor PREMIER ROOFING AND BUILDING CO INC
Address: 17501 NORWOOD PARK PL
Phone: (714)573-0155
TUSTIN,CA
Zip: 92780 License: 634404
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF, APPLY BASE AND ROCK ROOF. INCLUDES 2330 THROUGH 2344
TICONDEROGA WAY.A
MULTI-UNIT CONDOMINIUM BUILDING.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $18,000.00
Permit: $293.25 Claim Valuation: $18,000.00
SMIP Res: $1.80
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $295.05
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
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)7545626
2446-46(Woo)
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 wit 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:
Cartier: ' Policy Number:
(This section need not be comp-ted if the permit is valued at one hundred dollars($100)or&hs.) •
❑ I certify that in the per1/2 ante of the work for whi this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of.alifomia,an gr that' should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pr•,rs•• . 9
Applicant Signature: ,} Date: /p/ °�
WARNING:FAILURE TO S 7 URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL.AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENAL /E/E/S AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE(S1•.,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS D CLARATION:
I hereby affirm that I am ken d under provisions of Cha• f 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lie.N .2 _ Class a
Contractors Signature: Date: 9,,/',c $/°1 ----
CONSTRUCTION LENDING 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).
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 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. ❑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:
❑ 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,end 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 and certify a Business Plan for emergency response to release or threatened release of a hazardous
materiel? 0 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 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 end Safety Code been fully complied with? [5 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 aggermit for such construction or modification
from the South Coast Alr Quality Management District or from any other air pollution control district or agency? L i 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 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 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 agr:e 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-des •ed property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
,r/ / ///
S` e Of Leal Owner(s) 9 / 'r/O to
And/Or Authorized Applicant j/ Date
INSPECTIONnag ZEE IyJOULS CODE INSPECTION TYPF PAM IITIDaka
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �.v.'t��� 208 Final Plumbing
200 Final Re-Roof P /—l7`— ( 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
• 'PRDJECTADDRESB: 2330 TICONDEROGA WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069467
OWNER'S NAME: LEMEN NINA J
RESS: 2330 TICONDEROGA WAY PERMIT NO: B 069467 PLAN CHECK NO: N GOVT; N SUPP ; N
~ ADD
-4. COSTA MESA,CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : T/O RESTH & REROOF W/COMP & HOT MOP SQ FT: 2, 508
ADDRESS: UNIT:
CLAIM VALUE; 2, 508 . 00 CALC—VALUE: 2, 508 ,00 GROUP OCC: R-1 /
PERMITTEE: STOUT ROOFING, INC. ( 310 ) 923-6775
ADDRESS: 9700 WASBURN RD COMMENTS : REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DET, REQUIRED
DOWNEY CA 90241 ****4*aEkLx**+Er*****r***********kPled**irar****year**************kr*************+r********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 059377 sTATELIC.: 402536 Cuss: C-39 EXP; 10/95
Date:3O/fl/q'4 signature:__ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
Compensation) uranje or a ceJ,llied copy thereof(Section 3800.Lab.a LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: D8 L2697 EXP.DATE: v 5/19/95
OMPANY: AIGcarviv PARKING REQ• PROV: PARCEL; 41916356 ZNE; REF NO;
i Certified copy is hereby furnished. EN Certified copy is filed with the city Building Division, PLANNING NOTES>
>
T ^( /
Date. `NO Obi Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'OOOCOMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U T A E M E N 'T S
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become ,
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE;
•
Date: Signature: BUILDING APPROVED BY
ode.NOTICE:N.afterstmaking this declaration,wwihu should becomeSubjects the Workers'Compensation provisions of the Labor DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for APPLICATION ISSUED BY: • • DATE: IO. (
which this permit is issued(Section 3097.Civ.C). ************************** ** ********4****************************.7f {6* **. ****
LENDER: *************4************ ***************************************** ***U******
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 fife a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SM I P/NON—RES
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 the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or altered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS—---> 54 . 50 0 . 00 0 . 00 54 , 50 54 . 50 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 , 50 OVER/SHORT; . 00
improvement is sold (. one year of completion,the owner will have the burden of proving he/she did not build or improve
or the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT GRADING PLAN—CHECK
for
I.as owner of the property,am exclusive) contracting with licensed contractors to construct the project(Section 7044,Business 540 0 $0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of propeM 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 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 ,00 2, 508 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant wilVwill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby cerhly that I have read this application and slate that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and he by authorize representatives of this city to enter upon the above-mentioned
property for inspectionppurposes.
Date' IO'2hL4 Signature: 01 00170485-00170486 T011- 54.50
Driver's License or Social Security a: DATE; 10/28/94 TIt!E: 12:20
1641-46 While—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
•
cc-- �' 1 PO i SPA
CONSTRUCTION AND PLANNING
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. „�� 53. Steel Reinforcement
•• 9. Electrical ConduiVUtility-Undrgrnd!:• 54. Forms
I,4.ilectrical Conduit-Undrgrnd. 55. Electrical Bonding
•• 5: Steel ReinforceMent 56. Rough Plumbing & Pressure Test
e• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7:footings58. Electrical Conduit-Undrgrnd.
ki 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
. . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor'System 61. APPROVAL TO DECK
11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap •• 63. Heater & Vent-Final
i
13. Roof Drains64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough ElectricWiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ,
19. Rough Heating & Air Conditioning I FIRE DEPT. REQUIREMENT
20.4flough Facto:Y Fireplace 'r ; - ' PPR41VAtS1,-.:Permit # -
21.-17p uekt, in,Strdcture ; ; , ; j. " - '' _:70. ; egrreuHro r
22. Ducts, Ventilating - • :271. ProducfRiping ILT%s O'Oil
23.:GatPipe!IRough Wiest . n, -;• '; ^72. Underg}oun 1 Flush , - -
24.,Rod Framing r7 - + • 773J1Undergrnd,Storage.Tank0Gas 0Oil
25. Roof Sheathing " 4p',::-l` J- . lie, 74,'Overhead Hydro
- '
26.•T-Bar Ceiling (Structural) &-Mongcoat a 75)-Dry Chemical 1 t -• •
27. Frame and Flashing• _
- • . > ; 76. Dry Stand'.pilie , : '• •.
8. Lathing-81 Siding.• i I: - r 77.7 FIXED SVSTEMIFINAL'
'29. Insulation ' - " " I` 78.-'FIRE PREY. FINAL ' - • • '
i'30. Drywall Nailing ,; • ; - -+ HEALTH DEPT. REQUIREMENT
'�
-31. Plaster Brown Coat' , j " :, - ; i•-•::,: .,79.7FINAL IN$PECTIb'N .
'1.32.,:Electrical:Povier Meter•FinaI, I 1. , .•80. 'FOOD CERTIFICATE ISSUED..
_33. -Final Eledtrid ' ' rz. T' I ;, ; "Notes: i.---ii, ; _
a.
'34. Final Heating.& Air_Conditionig- x . •i
35. Final Gas Pipe-Test' z• , - ! '
36. Hood or Canopy-. : - ' , .r I - _ ,�� • r
r^ _
' 37. Fina.Factory Fireplace - ' - I !" ? -
38. Final;Plurnbing . . j -
39. Water Service-Final- '. - -
40. GasService-Final j '
:41. Solar Domestic-Final _. •• • • I I ' • ...
„ y_
42. Backflow Preventer` , ,:r ' -, -,
43. Backflow Irrigation. r - . -
r •
•
;44. Landscape Irrigatyog System,.;;. _ - - _
_45.,. ound Attentiation, + r - 'ti -
•.'46.'Handicap,Regulations • . • "
•47.:FINAL STRUCTURE& BUILDING 6-(6'(s -�- ••
48. FINAL PLANNING" _ ; •
•49.`Electric Release to Edison i
50. Gas,Release to Southern Califlor-pja,Gas Co . .
51. CERTIFICATE OF OCCUPANCY .
No. Date
OWNER SAN VISTA Building Co. DATE 7-21-67
JOB ADDRESS 2340 Ticonderoga Way BUILDING PERMIT NO. 27315
GENERAL CONTRACTOR San Vista Bldg. Co. DESCRIPTION OF WORK Res.watt.gar.
AP No. 930-03 LOT 77 TRACT 5160 FIRE ZONE VALUE $13,240.00
INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-3
Sail W,
l' ik C"7 SUBCONTRACTOR I PERMITS ISSUED
Gas 0) % YY'1� 4Y/ 2 Date Number Signature
Water idq*V ( 4
t-41i Y� 72-C7 Pumbin_ / / � ����
Rough Plumbing / 9z
Z -c7,'_t. . ., 7..ii : .. 5345
Prop. Swr. Line 0 House Con.,al--- -s Sot--2.-6,7 /
Sprinkling System
Miscellaneous J
Rough Heating and Air Conditioning !4 _ ,r'_223-c7
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring — /'lam' 7-47/� eatin_ and Vent.
Trenches{1-Corms 0 Steel Reinf. L( Iet /F,7 Aa,-
,- _€./ir r, 7. //-17 �a7s�.
Floor System @ o /
Bond Beam 0 Steel Reinforce 0
Sheathing 6v#,//a- /
Frame and Flashing %Ars e XYZ 7
Lathing —In O/ Out l� . Q Yp 7 _
Plaster, Brown Coat - e— // —
Structural, Final / r Electri
Heating, Vent., Refrig. and A.C., Final /r(i /thigh d7-/-/v7 cipW4L
Plumbing, Final and Gas Test 0 /y fj2
Electric,ug Final W�� /.7v
_ 1/22
Building, Final / c ��
rer )te l�L
PAID
�F yY n JUL 25-67LIicn001670" t:,'•67.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 02626
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING ^ .I^ For Office Use Only
ADDRESS 2 3 a 0 1 {/Le{VId[e/A Q Sit It)Cal RECEIPT NO. AP 14.71T NSi.
COSTA MESA, CALIFORNIA 1 `may c.5����
Q. (1 v, i i1 net co BUILDING%� � -�j(�7 DA'7--2%t;
OWNER MAIL �1 u /��' � �1
ADDRESS 2 2.414 e W a'144-14/A, LLpp,1 LQ ADDRESS FIRE / _ ///�
CITY l 4.�PL_G4-d NO.D.3Z'.4 54i ZONE TYPE ✓/ GROUP f •t
ARCHITECT / TT� TE��pp gli*.'
APPROVED DATE
OR ENGINEER {/, L'�D.y_ NO. /23•-12 Zi
1azS!`y E -�Lewr be11 ZONING
ADDRESS
ZONE NO.OF .d UN[V/
/n� R� PLANS 2 BUILDING Sing Res.
CONTRACTOR lV Qw/-[.2
LEGAL " ' �
DESCRIPTION 7'7 1 i a
ADORES! Qnls/. •:r;n': 930-03-77
CITY n A.P.NO.
cL {.!✓_
NOTE: NO CAVE OVERHANG SHALL BE LESS THAN
STATE TEL EO•TO SIDE Si REAR P.L
LIC.NO. NO,
EAVES
SIZE ( X /+T 1 NO.OP SLOGS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 2a NOW ON LOT 'V
YARDS APPROVED YARDS APPROVED
USE OP MAIN BUILDING ACCESSORY BUILDING
EXISTINZ3BmO: __
(PROM C/L STREET)
SETBACK LINE-rfM FRONT 0 FT. FT.
CENTER OF STREET REAR YARD -
SIDE YARD-LIFT E RIGHT R.SIDE FT. Ff.
DESCRIPTIONIOF WORK L.SIDE 0
PT. Fr.
NEW I L ALTERATIDN ADDITI•N REAR RT. PC.
lllllllllflf ` DISTANCE SET. BET.MAIN Q
REPAIR MOVING DEMOLISH MAIN BLDQS, ACCESS.BLOCS.
BUILDING +2 Mrs VAR.OC DATE
SIZE Z-O X / 0 ROOMS q4 ST/DRIES I C.U.P.# /,� APPROVED
EXTERIOR WA{.L� . _ O I ROOF CPL-�✓,}•to• APPROVED Kat ii, X�Cl. 7-7-67
COVERING A COVERING 4GH� ' BY �'/ it DATE
USE OF BUILDING .ND WORK TO B- ' RFORME• - 0,
•
IP Bq.PT. /y- 7 7✓p /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHO UNDER VALUATION IS FOR THE
AND STATE THAT -E ABOVE IS CORRECT'AND AGREE TO CON. PURPOSE OF ESTABLISHING ,A PERMIT FEE ONLY.
PLY WITH ALL CITY •RDINANC[S AND STATE LAWS REGULATING VALUATION
BUILDING CONBTR -q ON. D7
SIGNATURE OF PERMIT FEE 5 �� F
PERMITTEE / --til /t A A /..---- GO
5 � Gy PLAN CHECK S
AUTHORIZED GE I 1 +e+j ?51° Oq}�_ /,
.. _ _ - _ _ • - �J T TOTAL FEE $ ¢37 42
Q A/
OWNER ARNOLD, BLANCHE DATE 1-29-68
NvJOB ADDRESS 2330 Ticonderoga Way BUILDING PERMIT NO. 28159
\....".4G-ENERAL CONTRACTOR R. M. Wilson DESCRIPTION of WORK Patio Cover
AP No. 141-701-03 LOT 77 TRACTp FIRE ZONE VALUE S 180.00
INSPECTIONS Signature Ir Date GROUP IV TYPE J ZONE R
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date i Number 1 Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE El HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND El POWER.
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 9 STEEL REINF. 9
FLOOR SYSTEM
BOND BEAM in STEEL REINFORCE ri
SHEATHING
FRAME AND FLASHINGr�
LATHING - IN u OUT n
PLASTER, BROWN COAT ,-
L
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C„ FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC,ILDINGFINAL E e AL t /S-
BUILDING. FINAL 144 /7 Q n
ar 28159
JAR.30-68POBi:105 0*****3.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 - COSTA MESA, CALIFORNIA 82628
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING ,{ / For Office Use Only
ADDRESS 23 SO -rico NAY`'YoJ e-
/ RECEIPT NO. Ca �Ry{j-NO.
COSTA MESA. CALIFORNIA ; E..�JL!'�
t� / �- RE Y2D (y oA/TER {�Vj[D ) TH MS o
OWNER , /Q(!/fr i(0l /�/ t0(%/� /'tt '/�ajl .�C( „ ,
MAIL ADDRESS .S. ei � J y2C�4'� ADDRESS ! �3O Q1
CITYoc `�4T`. NO. 2gJ 1+ ZONE �i TYPE GROUP
� APPROVED
_/[_l/
OR ENGINEER L/;P ba4-� TEL
er 1, DATE P'29 T'7a
,I �/jIA�. ZONING
ADDRESS i lV lo'v� ZOU NO.OP uH[01 rvEW PA no
01 In J I C 4-
PLANS I SUILOING �0 t2
CONTRACTOR / (y"el)
V 424'
.[JJ,�OA /�/ �/ l 1 TT T /� /
ADDRESS
10 U.�e_v Sv / /T.✓ / in- LEDCRITON ✓U I L7 / 1 �I.Q! �'7l IGn
CITY �'Lli 011/44L-
NOTE:./ A.P.NO. I4l- ZU l 3
STATE / SC+// / NE 1{ / ego
SOT TO SIDE 4 REAR PH OVERHANG SHALL BE LESS THAN
LIC.NO. .5^
!!// (i O:.J� V(%
SIZE I NO.OF SUES
M,. I ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT P
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. CiDO_AES
(FROM C/L STREET)
BETSACR LINK FROM FRONT EX FT. FT.
CENTER OF STREET REAR YARD
SIDE YARDI LEFT I RIGHT R.SID[ TEx FT. _ FT.
DESCRIPTION OF WORK ��// L.510[ Ie- FT.
NEW ALTERATION ADDITION X IREAR Ex FT.
/
DISTANCE BET. BET.MAIN S
MAIN BLDQS, ACCESS.BLOCS.
REPAIR MOVING DEMOLISH
BUILDING NO.OF VAR.# DATE
SIZE RROOMS STORIES C.U.P.# �}� APPROVED
EXTERIOR WALL I ROOF APPROV` LC7 Y 11� /
COVERING COVERING BY DATE
//�� DAT! -29 -68 a
USE O BU IN AND WORK TO BE PERFORMED y110
it
/71:771arelf: SO.Fr. 0
1 HEREBY THAT EDO I NAVE READ THISAPPLICATIONTO
C - PUR AMOUNT SHOWN UNDER VALUATIONMIF FOR THE j
AND STATE THAT THEIS COTTER AND AGREESIITO COM• PURPOSE OF ESTABLISHING A PERMIT IHS ONLY. 2a
PLY WITH ALL CITY C• AN• LA B R UTATING VALUATION
BUILDING COMBER . . /
SIGNATURE 0 /T//TT///�
� 'J/ PERMIT FEE $
PERMITTBS //
$ Io PLAN CHECK S
AUTHORIZED AGENT
. .. . ... .. .. ..:a .-r .. ..:...... .. TOTAL FEE $