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Home My WebLink About1084 TULARE DR - Building Permits • / IMP CITY OF COSTA MESA y' .4 BUILDING DIVISION PERMIT NUMBER F i " •-i' ' DEVELOPMENT SERVICES DEPARTMENT. sk PERMIT ya P00-00205 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1084 TULARE DR Status: ISSUED Suite No Applied: 05/01/2000 ' Issued: 05/01/2000 Vicinity: Parcel Nunmber: 41211106 ISSUED BY: Applicant: NOCK ,RON VVV Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 Owner: FLYNN, EDWARD A Address , 1084 TULARE DR • Phone: COSTA MESA, CA Zip: 92626 • 'Contractor: NOCK PLUMBING Y� �7 p. �� 5 , Address: 11612 KNOTT ST .�C� Phone: (714)895-1246 �A.yY GARDEN GROVE,CA Zip: 92841 • License: 707775 Arch/Eng: • ' Address: - , Phone: Zip: License: SCOPE OF PERMIT • WATER HEATER. • FEE SUMMARY ' • AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation: $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub • $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 ' 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) ,$0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00, 0 Wash Basin $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 Waste and 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 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 notcommenced 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 DECLARATIONS T� r f WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: . O 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. - 4) 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. r My workers'compensation Insurance carrier and policy number are: Carrier: &Cc-DC'TJ rA-62),C Policy Number: kJ (A )C-'-{ 7 9 3 LIv'F (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 Calif. . .d agree that if I should become subject to the workers'compensation provisions of Section 3700 the or Code, I s all forthwith comply with these provision <---/ / Applicant Signature:) -Vat.____...../ - - ate: WARNING:FAILURE TO SECURE WORK RS'COMPENSATION RAGE IS UNLAWFUL A -SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C'VIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE rnST OF COMPENSATION,DAMAGES A • 'ED 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 ChpWc.9.(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full fort enact.. ..—• 202 77 5 ------r- , sConlractors Signature: Date: S [ 2_0-TY 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). 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 withinrdne'yearof completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). .•f vl rrut-N.1 ❑ I, as owner of thhe'property„am.EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors:LrcensdiLaw;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.). O I am exempt under sec. "'a PIS Business and Professions Code for this reason: Signature: v Date: Owner ID verified by driver's license.-a.•O;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 and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia 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 end 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? ❑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 agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes D No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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? ❑Yes ❑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? 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 fi I inspe ion. ure Legal Owners ate J And! r AuthNorizeBApplice� t_ to CODE I INSPECTION nil ' DATE JNTRIALS CODER JNSPFCTIONTYPE PATE INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing S-'j- c L7 tliLaLlz 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 2446-46 4`peal Ms 9 - CITY OF COSTA MESA , BUILDING DIVISION > �-• ,I DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER PERMIT -"pi•awrrto602-00124 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 1084 TULARE DR Status: ISSUED Suite: Applied: 01/28/2002 Vicinity: Issued: 01/28/2002 Parcel Number: 41211106 Zoning: R1 R1 Applicant: DUFF, DICK ISSUED BY: Address: W 1132 W BARKLEY Phone: 714-744-5996 ORANGE,CA ' ' Zip: 92868 Owner FLYNN,EDWARD A Address 1084 TULARE DR - - , Phone: - COSTA MESA,CA'- Zip: 92626 . % Contractor: 'SOUTH COAST ROOFING INC \ �� Address: 1132 W BARKLEY AVE ' ' Phone: (714)744-5996 , • ORANGE,CA N Zip: . 92868-1213 License: 365271 - - , Arch _ Eng: , . , Address:' Address: - ' - Phone: - - Phone: Zip: - License: License: __ SCOPE OF PERMIT / TEAR OFF WOOD SHINGLES, INSTALL NEW PLYWOOD AND CLASS A COMP SHINGLES:INCLUDES ATTACHED GARAGE. FEE SUMMARY - ' ' Plan Check: $0.00 • -_ Calc Valuation: $7,540.00 Permit: $153.25 Claim Valuation: ; $7,540:00 SMIP Res: $0.75 SMIP Corn: $0.00 Other $0.00 , ' Inspection: $0.00 Total: $154.00 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 Califomia 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 2446-45(WOO) DECLARATIONS (l fl 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. ve 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: r Camer: — Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) O I certify that in the performance of the work for which this ermit is issyyked,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia and a• .e th f I shoct to the workers'compensation provisions of Sec ion 3700 o the Labor Code,I shall forthwith uld bac slth'p comply with the : . . . .. - 4.4: . 1.-- _`Sv^ ' I ^ c " Applicant Signature. �AC \ Date: NNN'AAACCC/ L V WARNING:FAILURE TO SECU- -- R5�' COMPENSATI I. COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100.000).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 DECLARA N: -404 I hereby affirm that I am lic:nsep under provisl s , Cha•.er 9(c yy1IL •with Section 7000)of Division 3 of the Bysiand P fessions Code,and my license is In full force and effect.Lic.N a' \ \►�\• Class#‘---. / Contractors Signature: SI `� T �_~T Date: i �Z / 0 CONSTRUCTION LENDING AGENCY: I ❑ 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.). O 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: I 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? 0 Yes 0 No (Section 25505 of the Califomia 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 Califomia 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 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? l Yes U No (Section 65850.2 of the California Govemment 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 Califomia 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 stat - - d ci ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described p ..:rty fo spection purpose .I yee not to occupy or allow occupancy of any building authorized by this permit until final inspection. ----..----- -- ----1 Leg. ec ns(s) 11.2_ v c Date And/Or Authorized A.r ie. t ( Date POPE! INSPECTIONTYPE OATS 1NTITIALS CODE! INSPECTION TYPE BATE IdIIIIALH 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing 200 Final Re-Roof 2—6-ca. i] 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 . CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. /4:34.Y DATE /yr-- LOT ATE // p/'72LOT NO. �r / s �`�,�`R m. ADDRESS /401771 felO s .. The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. BY , �cG�e Purchaser RE C E IV ED Develop and/or authorized WY OF COSTA MESA representative OCT 30 1972 BY AM Lender 71819111101j1112 3 i4�5PM i � i6 OWNER HELTZER Enterprises Costa Mesa DATE 2-8-72 . JOB ADDRESS 1084 Tulare Drive BUILDING PERMIT NO. 34128 •GENERAL CONTRACTOR George .7. Heltzer DESCRIPTION of WORK Rep.w/att.gar. _ 'AP No. LOT 15 TRACT 6639 FIRE ZONE VALUE $23,600.00 _ INSPECTIONS Si.n.ture Dote GROUP T&,T TYPE \ ZONE R-1 SOIL _../ 7----2 � PERMITS ISSUED GAS SUBCONTRACTOR Date Number Signature WATER PIU .Ing ROUGH PLUMBING �I 6- / �� / . -/6- lot9.�7 PROP. SWR. LINE HOUSE CON. [� 17,,s- QT/77-ar 0n/ w L.9�,/4& 1,/� SPRINKLING SYSTEM R MISCELLANEOUS � f ROUGH HEATING AND AIR CONDITIONING 4,0 ,p�:Zli-s72 TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 //`` / ��y,,, ROUGH WIRING ul r (p�? iFleating a Ve _ p TRENCHES FORMS [� STEEL RE INF. �'' -1 /, • a-3-72 Oy$(Q�� FLOOR SYSTEM^ n L ,• _ __ 1' z6��Jg 7� " BOND BEAM `J STEEL REINFORCE n / / �/ / SHEATHING9.-- ^9�,� FRAME AND FLASHING (14-1 .... 1 1�LATHING - IN �` OUT �' �� PLASTER, BROWN COAT ¢ 9'7..if--- STRUCTURAL, A/ STRUCTURAL, FINAL t // {3 HEATING, VENT., REFRI G. AND A.C., FINAL /E,4 �0-1.3-7Z.(C. fit& jrael./�j[el, it 777/5I PLUMBING, FINAL AND GAS TEST n Mc a/7'7y / ELECTRIC, FINAL rd. /0'k.3-72 , /5 34128— PA, COSTA MESA BUILDING-SAFETY DEPARTMENT '' Q ' C,Isr00' 322* ***129.00 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI ED@.�� JZDATE RECEIVED DATE ISSUED ADDRESS 1084 Tulare Dr. Costa Mesa cBUILDING 99 ,6t - 3- 2/ 901J —f 20,7• PERMIT NO. OWNER Heltzer Enterprises-Costa Mesa A.P. NO. ---- 1 MAIL BUILDING ADDRESS 740 N. La Brea Avenue ADDRESS 1084// Tulare Drive Z Angeles, CA 90038 TRACT) 37 LOT/S BLOCK F-ci CITY Los Na� 937-2171 Fz Z I- CONSTRUCTION NEW ADD ALTER-REPAIR MOVING f)FMf11 LSH O N LENDER United California Bank (// am J D BRANCH Main Office 600 S. Spring St. J CO OWNER gir ADDRESS Los Angeles; California 90054 m J VALUE ._9•2 3 / G J co ARCHITECT David Freedman TEL.OL• 3- USE $ > ov� OR ENGINEER NO. 3852 O Q FIRE ^�1/ aW ADDRESS 113. N. San Vicente, Suite 306 ZONE TYPE {r l GROUP-1 Beverly Hills, CA APPROVED y J Z CONTRACTOR George J. Heltfer BY DATE OD J Er ADDRESS 740 N. La Brea Avenue al w ZONE NO.OF USE OF NEW res/ w/ti .t 0= TEL. RI PLANS 2 BUILDING Z I— CITY Los Angeles, CA 90038 NO. 937-2171 garage 0 STATE CITY YARDS APPROVED YARDS APPROVED rwn CC LIC. NO. 3144 LIC.NO. 1900 • MAIN BUILDING ACCESSORY BUILDING D O (FROM CIL STREETk' SIZE NO.OF BLDGS. rr,� OF LOT NOW ON LOT FRONT is/ F4". FT. USE OF EXISTING BLDG. R SIDE 5 FT. FT. I- SIZE OF NO.OF • Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. UEXTERIOR WALL I ROOF _ COVERING COVERING REAR .2-410FT. • FT. i J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 0- MAIN BLOCS. ACCESS. BLOCS. 0 Residence with attached garage _ VAR.* U.P# _APPROVED CO Plan #411 APPROVED W n DATE 12-20-71 z X61 Af4/r b o . UI hereby acknowledge that I have read this application and state HOLD FOR S•ECTAL --- r that the above information is correct and agree to comply with RLO�f -''- CC all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of cn the State of California. /J/n /� �J/ l/ °a Z / �2D SO.FT. / �v/ o 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 VALLMTION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e CC am exempt from the pro 'sions of the State of California Business and Professions Code, Di iIs'•n 3,Chapter t. VALUATION 42 ro PERMIT FEE $ n Signature of [. /�pI < 4/3, �� m Permittee - l� e I /.Y.fY teis.- ..t� et PLAN CHECK $ �jE Authorized Agent ! 6 OD, TOTAL FEE $ /01-9 9 u