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Home My WebLink About3261 TURLOCK DR - Building Permitsf (714)754-5273 • Fax(714)754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT JobAddress: 3261 TURLOCKDR Suite: Vicinity: HOUSE & ATTACHED GARAGE Parcel Number: 41206219 Applicant: DAVILA, ELIAS Address: 19651 EDUCATION LN. CA HUNTINGTON BEACH Owner: DE SALVO, NICHOLAS G Address 3261 TURLOCK DR COSTA MESA, CA Contractor: E D ROOFING SYSTEMS CO Address: 19651 EDUCATION LN. CA HUNTINGTON BEACH Zip: 92fi46 � Arch : Address: Zip: Phone: License: Zoning: R1 R1 Phone: (714)968-6135 Zip: 92646 Phone: Zip: 92626 Phone: (714)968-6135 License: 672009 Eng: Address: 77 FAIR DRNE, COSTA MESA, CA 92626 Status: ISSUED Applied: 10/15/1999 Issued: 10/15/1999 ISSUED BY: �`— Phone: License: SCOPE OF PERMIT REROOF EXISTING SINGLE FAMILY RESIDENCE & ATTACHED GARAGE (24 SQ). REMOVE EXISTING SHAKE ROOFING & RESHEATH WITH 1/2" OSB. INSTALL i-LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH 25 YEAR "ELK PRESTIQUE" COMPOSITION SHINGLES. Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 sa,s�o.00 sa,s�o.00 NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related � regulations. (Ord. No. 92-28, § 1, 12-27-92) . EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. . � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectione antl final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARA710N: . I hereby aHirm unaer penalty oi perjury one of t�e following declarations: ❑ I have ana will maintain a certificate of consent to self-Insure for workers' compensation, as pmvided for by section 3700 ot the Labor Code, tor ihe peAormance of the work for which ihis permit is issued. � I have and will maintain workers' compensation insurance, as required by sedion 3700 of the Labor Cotla, for the peAortnance of Iha work for which this pertnit is issued. My workers' c�o pensation Insuranca cartier and policy number are: I �� Carrier: �S( �T� ��(J /�-�� -� Poliry Number. (TM1is section need nat be comp/eted it the permit Is ve ed at one hundred dollars ($f 00) or /ess.J � I certity that in the pertormance ol the work lor which this permit is issued, I shall not employ any person in any manner so as to become su6ject to the workers' compensation laws of C ifornia, and agree tha� if I should becoq�@ subject to the workere' compensation provisions of Section 3700 o the Labor otle, I shall forthwith complywiththe� pr �sio� � , <` �� 1 � T F� � J Fs-� � Applicant Signature: i � � J"��C.�-�C Date: � � WARNING: FAILURE TO $ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRE� iMOU5AN0 OOLLAPE (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CADE, IMEREST, ANO ATTOqNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm iha! I am liw setl�un,�d$r provisions�Qf Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business antl Pmfessions Code, antl my license is in (ull lorce and effect Lic. N � 1 L- �� `7 _ _ Class a � Contractors SignaWre: �Y7 .�i�9—L.� .� Date: r� Z q G� CONSTRUC710N LENDING AGENCY: � ❑ I hereby aHirtn that there is a coretruction lending agency for t�e pertortnance of ihe work tor which this permit is issued. (Sec. 3097, Civil Code). �i Lenders Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm that untler penalry of perjury Ihat I am EXEMPT FROM TME CON7RAC70R5 LICENSE LAW for Iha following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to conswct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to tile a signed siatement that he or sha is licensed pureuant to tha provisions of the Contractors Licanse Law (Chapter 9(commencing wlih Seciion 7000) ot Division 3 ot the Business end Professions Cotle) or that �e or she is exempt iherefrom antl the Dasis for the alle9ed e:emption. Any violation ot Section 7031.5 by any applicent lor a pertnit sub�ects the applicant to e civll penalry ot noi more than five huntlretl tlollars (9500).): ❑ I, as owner oi ihe property, or my employees with wages as iheir sole compensation, WILL DO TME WORK, antl Ihe siructure is not intenaetl or oHered for sale (Sac. 7044, Business end Professions Code: The Contractors Licensa Law does not apply to en owner of property who builtls or improves Ihereon, antl who tloes such work himself or herself or �hrough his or her own employeas, pmvided ihat such improvements are not intentled or offered for sale. If, however, ihe building or imprevement is soltl within one year oi completion, ihe owneo-builder will have the burden of proving that ha or she ditl not builtl or improve tor purpose of saleJ. ❑ I, as owner of the property, am E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business entl Protessions Coda: The coniractors License Law tices not apply to an owner of propeny who builds or improves ihereon, antl who coniracis for such project with a coniractor(s) license pursuani to the Contractors License Laws.). ❑ I am exempt under sec. SignaWre: Owner ID venfietl Dy tlriveYs license. ❑ Yes ❑ No Business and Professions Cotle for t�is reason: Venfiw�ion ot Ownership by (rype ot document, i.e. - properry taa bill or daed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICA710N: Dnver's License No. Date: Expires: ❑ I hereby certify that no excavation five (5) or more teei in depth into which a person is required to descend, will be matle in connection with work authonzed by this permit, and ihat no building sWdure, scattoltling, falsework, or tlemolition or dismaniling �hereot, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title B, California Adminisirative Code). ❑ As owner-builtler, I will no� employ anyone to tlo work which woultl require a permit imm the Division of Industrial Safety, as notetl above, unless such person has a permit to tlo such work trom the division. SignaWre: Date: Division of Industnal Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I certify under penalty ot perjury that I hava reatl this application and state Ihat ihe informa�ion given is correcL I agree to comply with all state laws and ciry ortlinances relating to building construction, and authorize representatives of �he Ciry of Costa Mesa to emer upon the abova-tlescribed property for inspection puryoses. I agree no� to occupy or allow occupancy ot any builtling authonzetl by this permit until final inspection. ��• Signa_�tur'eYO, Legal (s) Da�e ,_.,` a-.�-----�-�' '� �' � S � `l `� An Or Authorized Applicant Date 0 t INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 FInaI BIocWRetaining Wall 202 203 204 2448d6 Final Feciory Fire Place Final Sign Final Demolition P� INiIiIALS 6 22� R � cooer iNsvecnoxrrvE 206 Final Mechanical 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Builtling/Occupanc �E �NTRIALS � , ,�r�._ _ TEMTEX PROOUCTS OF CP.LIFORNIq, INC. P.O. 80X t148 • 23560 OLEANOER qVENIJE PERRIS, CALIFORNIA 92370 TELEPHONE Ot41 657-7311 A SUBSIDIAFV OF 7EM7E% INOUSTqIES. INC. May 26, 1978 Mr. Jerry Flores 3261 Turlock Costa Mesa, CA 92626 Subject: Temco Fireplaces - Models TBF 28 2PS, TBF 36 2PS TBF 36 2RS & TBF 42 2RS Dear Mr. Flores: All fireplace units manufactured by Temtex Products, Inc, are listed by Underwriters Laboratories, Inc. File Nos. MH 101OSA - MH 10105B as zero clearance. The International Conference of Building Officials Reports Nos. 3011-3195 also states that our fireplaces are zero clearance models. Temco fireplaces are solid fuel and wood burning built-in fireplaces designed for installation at zero clearance.to combustibles. kl a . � /� % -__ �.dt"obert Powell Quality Control � �:. C c: �. :, Interna��ona! �c��fer�n�e �f B��d��; ��i�4�. R�3��i�3i41 MODF.L I�OS. 1'BF28-1, 1'B`r36-i ANll TBF42-1 � FIREPLACGS TEMCO INCORPORATEll �- . 4101 CfIARL01'TE.AVEVUE � NASHVILLE, TENNESSEE 37202 - . I. SubjecL• Model Nos. TBF'28-1, TBF'38-1 and Tffi�42-1 Fire- places. II. llescription: Model Nos. TBF28-1, TBF3&1 and TBF42-1 are solid fuel buming built-in fireplaces designed for installatlon a[ zero cleainnce to combus4bles. The fireplaces are essentially of the same sryln bu[ are made in three sizes, 28, 38 and 42 inches. Dimensions for the various Ereplaces aze given in Figure No. 1. The basic uni[ consists of a base sec[ion, a center section, a hood sec[ion and a stack� and chimney section. The base section consists of a hearth pan fabricatr.d From No. 22 gauoe Type 1 xluminized steel and supported on a bottom pan of No. 28 gauge aluminized steel. A heat shield of No. 28 gauge aluminized steel is installed between the hearth nan and the bnttnm pen. 1'he henrth p2n is lined with a 2-inch thick layer of 57-pound per cubic foot density Cem HP870 refractory Uricks manuFuctured by the Gem Refrao- tories, Inc.�The firebricks form [he hearth of�the fireplaces. The centei section consists of refractory brick (same as described above) insulated side and rear walls and an inner radiation shield. The side and rear walls emsist of No. 28 gauge galvanize� steel outec section with a No. 28 gauge aluminized steel in[ermediate secHon and a No. 26 gauge aluminized s[eel inner radiation shiPid (No. 22 gauge for the 28-inch unit). The &replaces are designed for use �vith a minimum 9-inch internal diameter triple walled listed low heat appliance chimney. A minimum� 2-inch cleazance is required between the outer chimney pipe and combus[ible materials. The Report No. 3195 Februar�,1976 onits are provided with a factory installed steel d�nip�r. A metal smoen is :dso pmvided wiUi cach u:�it. 'Phe fuctory suppliud heartli ' c�tension consists of a minimum 1-inch thiek lxyer of 16-pound per cubic foot density ref:actory-material covered with a No. 2�1 gauge 'Cypc 1,. alwnimun coated steel sheet Dimensions of lhe I�ea�th estension are shown in Table No. I of the report. 'fhe unit must he installed in accurdance with the manufacturer's installxtion insWctions and this report, - . � IdentiEcatiou: The fireplace units aze identiGe�l as follows: 1. The fire chamber bears a me[al listing label which is ei[her " rivc[ed or welded to the assembly at a locatlon visible after the fireplace is installed. The lisdng label contains the Under- '� � writers Labomtories, Inc. name, the manufacturei s name, . address, the model number und the words "zero cleazance ; builbin fireglace:' - � 2. Each s[arter section, chimney secHon, &e stop spacer, rnin � eap, housing, and hearth extension carries the Underwritr.rs l.uborntorios label identifying the.part numbeq the model number oE the (ireplace and the minimum clearanee lo . cor.:bvstiSle. . � .. III. Evidence Submitted: A report of fects conduclod�in accor- dance �vi[h the 1971 Edition o£ UL Sandatcl ')o: '127, inslallalion"' brochure, and shop drawings �have been submitted. ' � � Recommendation IV. Recommendntion: Thn[ the Temco, lnc., Dfodcl TBF28•1, TBF38-I and TBF42-1 are factory built fireP�aces provided they are fabricated and installed in accordance with this repod and. the mnnuFncturer's-instructions. � � This recommendation is subject to annual ro-ezamination.� TABLE N0. I—SIZE Of HEARTH El(TENSION IINCHESI MOOEL N0. OEPiX LEN6TN TBF2S-1 16 - 44 TBF38-1 18 52 TSF42-1 18 58 FICURE NO. 1 ffihfENSIONS AND CL�ARANCES Corrected Septembcr, 19ifi Page 1 of 2 1 Page 2 of 2 —.— e FIGtJRE N0. I DIi�1FT+SIO�S i1rID C1.EARA:�CES 25• �� 13�— 92 �r��t � 24 Z �--{—IS �i I I _____f . �-�1�0 �2. �4 �-�3g� �33�� 92' + _ � i� � - zs r-.f— is" 242 �,~ - -� z j� 5S 24� � � i• �� !04 `.-� S••� 3b � � -TBF -3fo TBF-28 Report No. 3195 � �� 2G" , � 39 � �02 � i_ 2l "---�-{ 252 _ oz ' � ,. - - �i za` � � ,.. 4 5 � 4Z .� 52 •3�TYP TB�'-42 0 C � ( �.. y.,. qppiicant to �iu in au spaces within heavy bortler lines antl sign all ap0�o0riate Eeela�ations. I � ,".. CITY-OF COSTA MESA . �� PeaMir no. �.., TRACT NO. -LOT NO.. BLDG. NO. �� -""" "' % IS�I'- - GI I OIBL��- � -7�00� TIj, � CONSTRUCTION PERMIT �p � ' ' " • • - � • - Project Addryss f' TVPE OF CONSTRUCTION r- - -� ^" '-�+� �'� � � G/ urLccfl aa-- :�d'�• owner L - �d,..p�. ' phon 3�: yy O�NEW .. O AOD - ❑ �ALTERATION - �� , - � - � _ ' ' . -' , nadress • j-' '�oo , �r t . y �/ .K/V C � REPA�R�� CONVERSION ❑DEMOLISH - � p ZONING REGULATIONS Ar`Ch/Eng." - .. . ." ' LicenSe NO.- ❑ OTHER � . � A.P. � �..{ . ' �y DESCRIPTION OF WORK Addr¢55 _ ._ ` .. . . .�" . ' � ' ' ` ZONE ' ' �. PLNG. IiEF. � � : �' ' Contractor ��e� "' � Phone_ •-' : TV,PE�OF PERMIT � - - � -' D rv --- TpeU ICDiNG' -� - , ' SETBACK C LST. PROPERTV LINE '� Address - " � � ' - ' - �"� _ � , O GRADING i� ❑ FOUNDATION"'� STRUCTURAL "' SIDE VARD _ � - �. CICENSEO -CONTRACTOR'OECLARATION - - � - • ^ � � - - ❑ TENANT' O ELECTRICAL OVLVMBING' OMECHANICA �5EF • „I hereby.affirm thit I am IlcenseE untler provisions of Charter9 (com- - ' R�IGHTA ' � mencing with section ]000) of-'Division' 3 of'the Business'antl ��'OTHER' P�of¢55ion5 Cotle, antl my Iicense is In full force antl' ¢ff¢ct: ' ' ' ' REAR VARD (TO P/L) � '' -PHOJECT DESCRIPTION��=, : ' . ' '__.' ' _ ' _ '• •-.. ._ � Litense Class ' ' License No. . ' PKG. SPACE REQ. PROV IDED Date " " "'�' ' . SQ.�FT. -_. ' �_ . . L " ' _ " ' ." ' . _ ' Si9nature i �v - STREET WIDTH - PARK FEE S �WORKEFS`COMPENSATIOMDECLARATION -- '� ' OCCUPANCV_CONST,RUCTION.TVPE - - I hereby affirm tnat 1 have a certifiw[e ot consent to self-inswe or. a VALUATION' '�ZONE ZONING APPROVED BV, � DATE [ertificate of'Wprker5" Compen5ation Insurance, or a'Certlfletl ropy tM1ereof (Section 3800, l�b. CJ. � ' GRADING CU. VDS. ' � ACRES � SPECIAC CONDITIONS: . � �PolicY No. - ..- ComPanY .. �•r- - .• . _ . _. •,.• . _ . -. � . _ .. ❑'Certlfietl copy iz h¢r¢by furnishetl: � -' � - ' REMARKS: ' - - - . . ❑ Certifietl COpY is tiletl with the city Builtling Division. _ . • � � EXEMPTIOry FROM WORKERS' COMPENSATION DECLARATION � � - � (This settion neetl not b¢�mmpletetl it tha�permit�is for one.huntl�etl . . _ _ . _ _. _ _ _ ,. . . � . � - � (�i�� OI 1255), • � if{� _ . n' . :! -I�cCrtity that In the pe�Po�mance.of4he work tor. which��this permit is - i55uetl, 1 Shall no[ employ any person in any manner so,as to become PLUMBING �'1 ' a PLAN CHECK � ELECTRICAL PLAN CHECK � �subject to�the Worker5' Compensation l.aw5 of California. �- BATHTUBS SHOWERS Date � 5lgnature '� NOTICE: If after�making [his tleclaration, you snoultl become su0ject TOIlETS' '„ URINALS � - - GENERATOR 0-1 KW_ 1d0 KW � to the Workers' Compensation Orovisions ot Ihe Labor Code, you must ._ __ _ TRANSFORMER . - � forthwith comply,with such provisions or tnis permit shall be tleemetl LAVATORIES DOUBLE �AVS ' � APPLIANCE 30-50 KW"_50 + KW' revoketl:' '" '...... _. r ._.._ _ .. . . _ ..._. .. ' . . CONSTRUCTION LENDING AGENCV KIT. SINKS DISHWASHER$ � � � - � MOTORS ' - 0-1 HP_I-30 HP - , I hereby aftirm that ther¢ is a constructlon lentling agencyforthe0er` SERVICESINKS •�. SUMPS� ' � ' UNC.SOL-AR) 10-50 HP 50'+HP. ' � formance of the work for_ which this.permit is,issuetl (Seciion 3097 � ~ �'� � Civ. C.). � • _. ' � ' `"� ' FLOOR SINKS •� FLOOR DRAINS FIXTURES - � �OUTLETS SWITCHES Lentler'S'Name' Lentle�/s Atltlr¢ss� �DRINKING FOUNTAINS ' �GAS TUBE $IGNS � � � � � - OWNER,BUILDER OECLARATION - ` � � � � INTERCEPTORS CL'ARIFIERS POLE LIG'FiTS � � � � � I hereby affirm that I am exemp[ from the�Con[ractor's License Law for --� - . . �" ' .� � the following reason (Section•�031.5'Business antl Professlons COGe: SWIMMING POOL PTRAP �" '- '" " Any_�'city�Ov county.•which'.requires�.a+,p¢rmit;to �con5truct, alter, �� POLE$ METERED SUB�� improve, demolish or repair any structure, prbr fo its`issuance, also re- yyqTER SERV ICE ALTERATION ��PANELS � MAIN SIIB . �� ,quires the apFli<ant for'�such�permit to file.a siynetl statement lhat he 't - is licensedpursuantto the provisious of the ConVa<tor'S Liceose law' GAS,SERV9CE OUTLETS - ' SERVICE ' ��- - �- AMP� ; _�- (Chdpter 9 (cOmmencing with..'Section,7000).of.Division 3'of'[he• Business antl.P/Messions'Cotle) o� thaYhe is exertlpCttieretromantl the yyq7.ER HEA7ER5 .. BTV OUTPVT � �- � � � � � - basisfor,•the. alleged;'ezemption..Any vialation �ot:5ection-�031.5 by - any applicant for a permil subjects the appli[ant to'a' civil p¢nalty. � SEWER CONNECTIONS � � - �� f ot more than tive nuntlretl tlollars.(b500)._. �'.��-j' ,4C: � ' ' I, as ownEr of IM1e proper[y, or my employees with wage5 as their SOLAR'TANK � �'-0OLLECTORS � �! compensdtion,�will�tlo the work, antl-the structure is not intentletl � _ or offeretl for 5ale. (Section 7044, Business antl Professions Cotle: The SOLAR PIPING $V5. �' ISSUE FEE � � �, . � ' �Contractor's �License Law tloes-not appty to an owne� of a property- � - ' - APPIICATION APPROVED BY " `'' DATE ,- who builtls o� improves thereon, antl who does such work'himself or ISSUE FEE - th�ough his own employees. Provitletl tha0.such improvements are not intentletl or of�eretl tor sa1e. If, however, the builtlin9 or improvement MECHANICAL PLAN CHECK SUMMARV OF FEES. - -is sold within one year-of wmpletion,.the owner will.have the bu�tlen, . _ �� of proving he tlitl not builtl or improve for the purpoSE of sale). - , � BVILDING� � , ' '' HEATING SVSTEM 0_300,000 BTU PERMIT $ ' SMIP. • � . 'S� - '�' '0'I'-as'"owner'bf tne property, am exclusively mntracting'with qNDDUCTING � ��-' ' ' - -'"' licensetl contractors [o construct the project (Section 7044, Business 100,000+BTU � PLAN CHECK y 'PERMIT:`. � 'antl"Professions Cotle:'The Con[ractor's License Law tloes not apply to- - ' ' ' ' - - - - -' - ' ---' :, ISSUANCE 'S -" an owner of property who builtls or improves thereon, antl who <on- REFRIGERATION Od00,000 BTU PLUMBING E ' ' . N 'tracts'�rom such projects'with a'mntrattor(s) licesnetl pursuant to' SVSTEM- -- --' -- ` -'-' - -� ^-�" � . ' ' GRADING�E -- the Contractor's �icense L.aw). 100,000+BTV • PLAN CHECK Jy � i � ,- ❑ I am exemG� untler Section � ��B. 8 P. C for this BOILERS g7V � ELECTRICAL y E 'reason� - - ' - "-- ' - PIANCHECK $"_.. .. . ' MICROFILM.S. '�' SVSTEMREPAIR,ALTEPATION � ' � t'. 'Ddte- � '- Owner--�-� ^ • -^- � � - � � � -- � � TOTALFEE$ MECHANICAL $ .I.hereby.certify that.l.have reatl this application antl state that the above EXHAVST SVSTEM MULTIPLE �� '�"� .� .� ^ information is correct. I a9ree to. comply with all city antl wunty - PLAN�CHECK'- $-- '"""" -CE55 AD- __ __ _. -ortlinancesantl5tatelawsrelatin9toconstruction,antl.hereby.autM1orize. ,. � � �,� . VANCEPC,$_ representative{ of this city to enter upon the above mentionetl .property..for /W/'�spe�ct�io/n� 8urpo .. _ _. _ . _ .. . . ^ ' • Slgnature � `P"�"^�Y' � Date �� '�� t . . - - . •� .- FINAL FEE $ � " ISSVE'FEE_"" ' ' ' ' -_ _" . _ __ ._ .. . _._. __ .. .. .._ 1 Drivers' L��ens¢ or 55 >F � � � CMF 0865-46 White-Builtlinq; Canary-Applicanh, Pink-Accoun[ing; Goltlenrotl-Assessor � ADDlicant to fill in all soaces exeeDt thase wit�in heavY bortler Bnes antl sian all aovrooriata Eeclarations. Ci7Y OF COSTa MESA CONSTRUCTION PERMIT PERMIT NO. O TRAC��T4. LOT N9. UNIT NO. A P# _ C] a- oc� a Zo�a � . ProjectAE�ress 3Z-6'� 7"uvyv�� +z,,,� BE 35 �� 0 S � S Main Building: Accessory Building: Applicanl'S Mailing Address 5�">��'V TVPE OF CONSTRUCTION NEW �`AOD ALTERATION REPAIR _ t �J� .ti, W�^�.�Z(,+y , i' `�-y�s - ❑ CONVERSION ❑ �EMOLISH ❑ OTHER Z , T Front � p Ownef.r�lame �� Phon DESC IPTONOFWORK/USEOFBLDG.�%A�� /-�-�� `�/��`O+ IB Rear 1 N Address� �/y� lJ-✓it�fh ��, �Sf'H�1fi24e...� � —_�"�'T q � o b %�r^� � Arch/Eng. U�'-D�� ti<<6-j"v LiCenSeNo. TVPEOFPERMIT' GRADING FOUNDATION STRUCTURAL � K Right� G Addre55 � �'""� ❑ TENANT 'JELECT0.ICAL ❑ PLUMBING ❑ MECHANIGAL . g � Left 5 � . R +Convactor's Nam ' ' Phone �OTHER �4i�.., � , Ping. Ref. # Parking Req./Provided E PROJECT DESCRIPTION 5�. FT. ��J = OCCUPAN � plannin Notes: n i Address Imailing) g � N ' ' ry� CON STRUCTION TVPE"�2i\�-LaVALUATION $ � T � City LicenSe No. �� ZONE G OING CU. VDS. ACRES g LICENSED CONTRACTOR DECLARATION ' � I hereby atfirm that I am licensetl untler provisions of Charter 9(commencing Remarks: ' with section 7000) of Division 3 of the Business antl Protessions Cotle, antl my license is in (ull force antl effect. ELECTRICAL FEES License Class �icense No. PLUMBING FEES Automatic Washer Transformer ❑ 15�50 KW Oale Signatu�e WORKERS' COMPENSATION DECLARATION COnStrUCtiOn POI¢ Sub. � 5O+ KW i M1ereby affirm [M1at I have a certiticate ot consent to self-insure or a certlticate Bar Sink ShOwErs of Workers' Compensation InSurance, or a certitietl copy thereot (Sectlon COOkIfIJ UOit Meter ❑up [O 100 amps 3800, �ab, c.) Backflow Preventer Service Sink Policy No. Company . Backflow Irrigation Sewer Cap " Dishwasher Meter ❑over 100 amps, 8 Certifietl copy is hereby tumishetl. - � _ Dryers ❑Gas ❑Electric $ub Panel -' Certitietl copy Is filetl with the city Builtling Division. � . Bathtubs Sewer Connection Date Applicant '" - - • ^- Fan Motors00.1 HP�1�'h.:8 EXEMPTION FFOM WORKERS' COMPENSATION DECLARATION Clafifiefs SOlaf CollectOis' . -- (Thissection ne¢tl nol be com0letetl it the pe�mit is fo� one huntl�etl ($300 0� - Ina SOldf �9-15 HP.O16-75+ less). � . Dishwasher Solar Pipin9 . � ^ F.A,U. I certify that in the pe�fo�mance oi the work to� which tliis permit is Issuetl, I • Pixtutf5 shall not employ any person In any manner so as to become subject to the � Drinking Fountains Solar Tank �� 1j Microwave 'L Workers' Compensation LawS of Califomia. � � . oate Signature Floor Drains Swimming Pool w/Spa Device Boxes . Pole Light . � NOTICE: If, afte� making this deClara[iOn, y0u ShOultl become subject to the OUtIELS Workers' Compensation provizions ot the Labor Cotle, you must forthwith Floof Sinks Ufinal �,d Range comply witn such p�ovisiOns or tnis pe�mlt shall b¢ tleemetl r¢vOketl. $witch¢5 CONSTRUCTION LEN�ING AGENCV Ga5$efviCe Outlets WatefClOset Sign I he�eby affirm that there i5 a constructlon lentlinq d9¢nGy To� the pe�tormdnC¢ of the work tor wM1ich� thi5 permit is issuetl (Section 309] Civ. C.) InterceptOfS Water Heater Garbage DiSposal Standing Sections Lender's Name Generator 065 KW �5-15 KW Trash Compactor �entler's Atltlress Kitchen Sink Water Service OWNER BUILDER DECIARATION .,.., - I hereby aftirm lhat I am exempt from the Contractor's License Law tor the LdvatOries Auto-Wash following rea50n (Section ]031.5 Business antl Prof¢SSional Cotle: Any City or ��.1.� county which requirez a permit to const�uct, alt¢r, improve, tlemolish O� /epai� P—Tfap L fwu�u�y T�dys any structure, prior to its issuance, alio requires the ap0��ant (or Such pe�mit to file a signetl statement that he/sh¢ is licensetl pu�suant to the prOvi5ion5 oT Roof Drains � tne Contractor's License Law (Chap[er 9(commencin9 with Section 7000) of Division 3 of the Business antl Professions Cotle) o� that h¢/She is exempt RBin5p0ction FBe $15 Issue Fee �'3� [herefrom antl the basis for the allegetl exemption. Any violation of Sectlon ]031.5 by any applicant for a permit subjects the applicant to a civil • �etyatty oi not more than five hundretl tlollars ($500). , -- DEVEIOPMENT SERVICES REQUIREMENTS: ,�� (�,, 2 oQ L�'I, as owner of the property or my employees with wages as Iheir sole Reinspection Fee $15 Issue Fee $ 3 r � I�-�-A..ls-. Date _�v �C7u compensation, will tlo che work, antl the structure is not intentletl or-otteretl 2oninp Approved By for sale (Section 704a, Business antl Professional Cotle: The Contractor's MECHANICAL FEES_ � Building Approved By �Date License Law Ooes not apP�Y to an owner ot a property who builtls or impmves thereon, an� wno tloes such wo�k himself/herself o� Ihrough his or h¢� own gpil2f HOOd O� T 2 I ❑ ' APP��tion ISuOd By Ddt — em0loyees, O�ovitletl Ihat such ImOrov¢ments a�e not intentletl or offe�etl for YP - ` sale. It, however, the builtling or improvement is soltl within one year o1 com- Canopy Type I I ❑ SUMMA OF FEES 2 pletion, the owner will have the burtlan of proving he/she Citl not builtl or im- Duct- Under Ground .v $•��) prove tor the purpose of saie). . BUI LDING PERMIT $ � SMIP ❑ I, as owner ot the D�operty, am ex<Wsively contracting wich licensetl con- Duct-Structural Refrigeratfon System PLAN CHECK PERMIT ' tractorst0 tonstruct the Project (Section 7044, Business antl Prote55ion5 Cotle: � ' � $ �= The Contractor's License Law does not apply to an owner of prooerty who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU � PLUMBING $ �SSUANCE $ builtls or improves tnereon. antl who mntracts for such oroiects with a r.on- tractor s1 license ENERGV P.C. $ ( pursuanc to cne Contractor's License Law). 1 am aware tha� Exhaust System ❑ Multiple ❑ System Repair/Alteration PLAN CHECK 25% $� GRADING $ o�oot of tneir worker's Gomoensation insurance zhoWa be proviaetl to me. � ELECTRICAL $ ❑ I am exempt untler Section e. & P. C. for this reason Firepl/Fact.6lt. ICBO # Fire Dampers MICROFILM $_�� ' PLAN CHECK 50% $ ��'7 �� oace �� o nB • � r r Heating System & Ducting Registers .� MECHANICAL $ TOTAL FEE L��_ I hereby certi that 1 nave reatl this apPlication antl state that the above ❑0700,000 BTU �100,0008T .� , apL"AN CHECK 25% $ information is cOrtect. I agree to comply with all city antl county ordinance5 '�r= ' , $ antl state law relating to builtling con uction, and hereby authorize re0re- zentatives o his city to entgr up roe a ve-m ioneG pr er y foy - .. InSpection u o5e5. / � / (/ ! Si9natur - � -://� Date �% 1/ Drivers' License r 55 - � %� /� Reinspection Fee $15 Isue Fee $ 3 - (_ii iiJ�J??�7R'�l�i11:�7$1 I�C�1 i� :.��L.J� 0865-46, rev. 5/88 White - Bulltlinq; Canary - Appllcant; Pink - Accoun[ing; Goltlenrotl - Assessor 9e �C� +:E7JU/�S { I�It% 1J%31 ' . CONSTRUCTION AND PLANNING � � POOL & SP,A . - � � APPF�J)VALS�, Permit# Date Inspector AppROVALS Permit# - Date Inspector 1� Tempor�ry Electrical Service or Pole 52. Pool & Equipment Location- :;' � .c� •� - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement , '% �:� .' � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � :" ��' � 4�: Elect�ical Condui[-Undrgrnd. � 55. Electrical Bonding � � . . 5. Steel�R2inforcement . 56. Rough Plumbing & Pressure Test � ; ��, 6. Electrical.UFERGrnd. 57. APPROVALTOCOVER-GUNITE ��'� ��'�' l 7: Footings 'p � g� �- 58. Electrical Conduit-Undrgrnd. ^ - , ; � ��, r 8. Fouridation 59. Gas Pipe, O Undrgrnd., Test � �i i' � 9� Water Ripe�Undrgrnd. • 60. Backwash Lines, P-Trap, � Undrgrnd: ' �;� 10: Structural Floor System /v 31 D� 61. APPROVAL TO DECK .. `� ' 11�. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' i� 12: Sewer Cap . 63. Heater & Vent-Final i ." 13. Roof Drains 64. Plumbing System - Final � � � 14. Rough Plumbing • 65. Electrical-Final . ,� 15. Rongh Electrical-Conduit . Solar System-Final �- - 1,8. Rough Electric Wiring � `/�rJ Yj� 67. Fencing & Access Approval -- 17. Rough W�ring Sign . � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough l-leating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVAIS Permit# • r 21. Duc[s, in Structure ,� 70. Underground Hydro � 22. Ducts, Ventilati g ; 71. Product Piping � Gas ❑ Oil ,,. 23. Gas Pipe-Rough & TestZ � 72. Underground Flush �;-'� 24. Roof Framing �� -.i . 73. Undergrnd.StorageTank �Gas ❑Oil � . - • 25a Roof Sheathing ' 74. Overfiead��Hydro ' ,� �' ' 26. T-Bai Ceiling 1Structu'raf) & Monocoat 75. Dry Chemical , 27: Frame and Flashing • �,j .� �!� 76. Dry Standpipe . 28. Lathirjg & Siding (� D� � 77. FIXED SYSTEM FINAL 29. Insulation � ' Z� 78. FIRE PREV. FINAL �� 30. Drywa�ll Nailing z.�� 1(� HEALTH DEPT. REQUIREMENT 31. Plasteri8rownCoef�'�"' � . 79. FINAL�INSPECTIO � � 32. Electrical Power.M@ter-Final . �80. FOOD CE ICATE ISSUED 33. Final Electric , i�f Notes: - � rlZ� � F, 34. Final Heating & Air Conditioning '�t ',� t_Z �-gq 35. Final Gas Pipe-Test � ' 36. Hood or Canopy . � � • � . - 37. Fina� Factory Fireplace , ' • . 38. Final Pl�mbing ' - 39. Water Service-Final : � 40. Gas Service-Final , 41. Solar pomesticFir,al� � � . � 42. Backflow Preventer � � i� � !' , 1 , � 43. Backflow Irrigation � . � � �. , �'� ,' � 44. Landscape�lrrigation System ', � � . �, 45. Sound Aitenuation � � ' . � � 46. Handicap Regulations • ' 47. FINALSTRUCTURE&BUILDING n 48. Special Requirements Completed ' ' . , ' 49. Elearic Release to Edison _ � .' �'• �' . ::r: , 50. Gas Release to Southern California Gas Cn � 7 ' ,-, �- _ �� , 57.CERTIFICATEOFOCCUPANCY 7-'- t'� � , .�' �i No. Date � `' J - .� � / LAWRENCE-ALLISON � WESTERN 8 ASSOCIATES CONPONATION \1"�� DIYISlON �� Aojec[ Featura �tem Sheat .of Job No. File • Omigned Date Checkad Date � cy�+e.r : �_ �°:� S !�i'� r T � �i :r =a � .... �~}DD�E�S'. 3Z..b � % t.� vl�c.i.�' �3k'; �,,v � c '" .�'��' � �? �` 3 ri 7 ..". ^. ^ �i «� y ? ;.> �%I�iSUS-u�-b� �%oRsirc= ; S ,� wr � C6NT�.� �iT�d'i QGc1/.YirC,l�/.� ;`r 's. ?3 .�'�. � y'9��y.��i+.:E L/ �/ � � 1 � bi�f.%� ��VJ �. F � :�.J `1L", / �� fri. C.e � %il I�iG F k'111iE f sU C�. . �( (A,11.1,�. ; � .�O O Q � r - � � .. • _�--...� �..;; ,,: ��;_ ; - - — ,H �A �-�v LE��,1—c� CJPS�iL-r,�r��rv'. P t c�` : � � �� tttY oF ' euN�' i��E� to BY ot� �ot 6L� of %rwGf' LZ4.� o-Yt (M�.�P � e c-vrd e.i , z, 3aocc 304 o Nn.d�. KN-1o's t'�'� O�{K t o�. Cv �r►1� � �ec.o�ber �f Sa � d c'v U„ �Y , sfie�-tIQ � , `� 6 . � ,\ � � �.,�� 89 � , c� � L�JC ��{��,�, �7p 9�� a�CSF' OSC TA MESA PLANNING DEP7. tuu[cr ro.e��c. o�rt. ReO, ev �� -DAi ^F �� . ORBC70t M r1ANN11M < ��n z9, /�� E--` .S� =3 � ' �..� j � � l I '' 3 � G "ai� ��,a� r , � �: 'f B �� _ �6�a'� � � � ., r4-o C,�, 74.KloCk De 8Y .�! '�--_,____� ��i�E� 19�$ 'W�SE PJ.�4ti� MUST 6e (7Pi JGd AT A1l 71ME5 hSAY.F� hD CHANGeS W1TY,OUT PRiUR kPFROVAL OF DEPT.� t �i� �� C� �� i.`!L�lS::�JRNCE O� G�4NilNG OG A 9E2�+1i PR APPROVAL OF Pi.rP7: AN.` �A[:!�1CATIONi SH.�iLI NOT BE CO;�STRULD TO BE A p:u;p)? Upp, p,� F�I nVPg;}YA� GF, ANY b'IOLATIGM O` ANY Of i!-�E F�U'� S�ON"` Of ;� �i5 COOE. NG feRMi; FRESUMING 70 GIVE � AUM.^,SiIY ��C. VI:�LAT_ Oft CANCEI 1f',E'r:;OV1$�pN$ Of iH15 � C^vOP: SH�u1.0E i/AIiD, EACEP'f IN $O iAR AS iHc WORK OR USE � \`1H;:'H li f.UiiiUR12E5 6 LK�VFUL. �. THE 15u'ifACE CP A PBRMI? BASED UPCN PLANS AND �$PcC:i�1CATibF:S $!tC�IL I'd0T CBEVF.Ni THc EU�LOiNG OffIC1AL fBGnl Mk«l� � iER REqL;;>ING THC COP.REC7i0 "OP"1T"9-'�— $AIC ('.l.N:i -�(: :•Pc<'!fi�ki!�ti5 OR i8C'd P.c✓fPNilNci . EU'LD!NG C78:A71'JNS P.EI.�iG CF�BRiED ON ThE .EU�I�i �JyE�� ^!N VIOI?.T'ON OF THIS CODE OR CF FNY O7HEP. ONDINAN�E O x 84 6 8/o�/s r.�.// ' i � i 2 L__—____ � Y �� ' 7A NVESA DEPT. IIOG. DFAT. @p0. ' �DAi�.,,�,,,��.. IANNINO tG1�1 � 0.. � � i..� ��rr. � / - � � '�, -�..�. ,..-, ._ ....� ,-.._... ..�.._...._. 3 _ �' i I ta � ;p c. ft.. T � . y � V. ��`q �iAGSS pr C� ) (o � ( Sh4�-� � _` 5 Si1�r �!� %�yi1G' LA�FCtie P�,a � e%e-� /in� o � 6 -j^e-ncG � . �` � �.� EL-c Svc. � !/� S�NGCO - ry p . ,�i.j —I.,�... ..._ I LilO sou,}�i Ele�a f.o�n s!�„1/� r��F `7hi: f1� ,--_�� ^ Z �S/n°n'!1[. t bd-�e �' - � !, ; _; ' 3oa�d ! �rff' S1q 7yv. add,,�F,.,,. ��.�.. . -i� q�t-',�--�- � S � A Wes+ ��eva�in� Ga�aqc dmr � �� es� S1d � GO L�� JS� gF �PaS�`�\�R S O�S��S� P�GE GPi GN oR Pt �� E�c \ _.. P SQ�'a P? ° r1 _ ! � . , � . � j�, .P, I; I _ �_ -- -- � � - �a' � _i ' 6' ( `� , ; � �—A,��O_"i' �- � � Y — �7'---�ia'� 7'�}. � f S Cv�,'��« �� . . 3z-(o� Tu.rloc.l� �r;oe. Cos�� Y�es�,CA � �� 1 s �e �) � /99'� ^� 7 V\�Q LL�6�WJy;d 6OtYy�O � Zd .l7 j�60 W�� 62;Q�vZJ� E/¢y�`c 22'oJ�WW o?�,0�1 � _,:. . _ d i'pv�. u.:P W iY�. J 5 .4 ��1 � ;:---T 7�Gi� .. �;�_ �_.� Z 3� �4�i. �B 2�.:8;�-�-- 8-0 �� =� 3�—',1 n�n �{a ✓ , a� �1�� ry S'rc ql✓s �.. � � y„�/.6 �b� E wv �"-li/a`G�% 1 � + pf4,�'e✓ 1 — _ � rv �it -: d � � �ti po+}Y„`�� Y^(.L � ,��s �p�5 �x-� ga��, - G'�X i� -,�" � � '— - __ �r 1 .. . q �� Q`` �� r�5 L Il � i zx4� �b,• 2• �r�„e �X y �. , -- -*- �u,;�law-FU�-��IIi,. I��'��_I_ � µI I'� g — �r 3 ' ____ � � � !$ �h �,�rih e 2 8 ,- � r 8! r x¢ Z -- ., . � .�,, �� x-�4 -� � 4n � 3� S �y ��,�, ��S ,/ h,�P�,w � 3 zGi Tµ��-'�ne e� s 7y► !��* C' �► q�y� LAWRENCE-ALLISON � WESTERN 6 i4550CIAtES CORPORATION DIVISION Aojsct Faturo Item � �'�_ e��J��. Job No. _ D�igned Checked �4 y IG,, � O ....� w�/��r� 16 ` --�/0. e_ �. ,__�z �,�x �°�' p B Z�4 7 ,Tq� ,4 -A ��"'�, 0 Sheet • of File � �' C�Afy��I/7t�J� ("�iK�i I � G/!er/ S�iI�+ fo�yia'�c�n �� / / . ; 7— (<- , Sp F . _ J\. > ��.�t e , • P22VEt _ :v iHE . �S �O� ;v �p� Eoac ; , / L � �,� / �P-!y.�s* • .-. I� � �r{,wµ. 4�•J• Typ � �'cAxv�y 2;�6coi6'p�� — � r � � T�°c o s-Y = 7X� �s� � /�(t�.�.. , <4?ygd t-o i:�. . ��'- �X�s�i�q Sfal:s � �:�� p �'j<r !y• � . �wI Sf+i �I 4 r ,, , �x� ;, �e ;' ?-D dr ,, ; , � � ; . � � � b. �rw��..� �� `�.i�° h/ `�,z,,.�.k,,�� LY!! ��'Jb"�?,� , /}–A 1•no` I � II 11 ! ---__�.I II II II._..'II I� I �IKS i i I � �� fid � � � q�i'oc � j I�i t'a� �f"1 t� � .�... 9��,s sra�. !, �� I � ; G-f� ZF4 � (6� ot� S � b .` � LAWRENCE-AL'LISON � WESTEHN ■ 11550CI�TES CORPoRATMIN DIVI$ION '. Rojset Fpturo Item � ...- - :.. ��.��. �.L `_' _ �..: tA�. .�i`-'�"'-^-yy� f::.__._' � � - :�Atv i�T..._.- . ' - N.��.; - - - - = � �:"i3�:':.�;:.;s:T__--`� � A Job No. _ D�igned Chxked Sheet Of File Date .Cro.�� sc.le`a�� e.vs+e f e � - 6 ' � � . r�.%/ - il��°�. �.......-... 9 �eP, _� r �LL 71h1E5 - tpV AL OF ,It OF aPPR( ...._ . �pr�SiRUEC � �'LPTION OF ,T pGESUM�N� ._'. . __ . fROVIS�ON`• : F<THE WOF i�0 UPOi� PI iH£ BUIlD1N� ';BFECtlO!`� �'� � p� FRO�'A_ ' �.iD ON iHBRhW qr.;: OTHER ORI � , IAWRENCE-ALLISON � WESTERN � � 6 �SSOCIpTES CORiORATKIN DIVISION Aojset Fmturo Item �� Job No.. Designed Cheekad .��X 8� 17 xi5 = ZSs `� m fa , T��ht- fM.EA = zsSt►zv = 37S � C n4T6C �M _ _ f�a.� eltve-/iar� � I>ewr b� rb' �clsTiul� P �n�(to = \20� f�ad SkyL14�T scso �469 �Jrt�� tG � $hNt Ofi File Date R. i —' � nAKE I �%EPT. I � lAl OF ; � iOBEA 2� AN! OF � iOGIVE i OF iHIS � � GR USE � ' N$ AIJD � Of61CIAL rcHCRS IN =vEr�;nr:G -"-�'HEN NANCE OF l7 � S w 111�¢ � P a C 3261 'jv�l1� 7� Cosfq hlcs�c.,C,4 9zL� CI' 'Y F COSTA CALIFORNIA 92628-1200 MESA P. O. BOX 1200 Insulation Certif cate � j�,� jj�' �p � ��.�� ,; u�ia��_ �r,�� c�s u�� Numba and Street City �,,U-,�,a _ Trt._ � zµs— 6 9 co cy s�na;�� tAcx�� Description of Installation ROOF S.e e . /�-(TvFGt�77 — �d5 e 3i7 � �-e ✓•� �j ��ri� � 'Itiiclmess (inches) � (((�� `A�EXTERIOR WALL-�^ (/� �{ � ,}�" 1 ��Cllfl� [`� �Oct r �.'l4 �✓ �'� � 'Ihickness (inches) 'g�(>.' ' CEILING Ba[[ or Blanket Type 'Ihiclmess (inches) �� I.00se Fill Type Contractor's minimum installed weight/ft lb � - 1 I, � BrandName .�. v,-+— r 'Ihermal Resistance (R-Value) •-� BrandName J v(i1 �s - ��Git �i ��-C 7hermat Resistance (R-Value) � —!/ Brand Name ,�0� -n s�(� 7� U/ �! "� Thennal Resistance (R-Value) /Z —I �j Brand Name Minimum thiclmess inches Manufacturer's installed weight per square foot to acheive Thertnal Resistance (R-Value) RAISED FLOOR Material 'Iliickness (inches) SLAB FLOOR Matecial Thic}mess (inches) Width (inches) FOUNDATION WALL Material 'Ihicirness (inches) Brand Name 7hermal Resistance (R-Value) Btand Name Thermal Resistance (R-Value) Brand Name 7hermal Resistance (R-Value) Declaration I heieby certify that the above insulation was ie,stalled in the building at the above locadon in confortnance with the current Building Energy Efficiency Stae�dards for new residential buildings contained in Tifle 24 of the Califomia Administrafive Code. General Contractor (Builder) Signeture ud Title Sub-Contractor (Insule[ion Installer) License Number Da�e Licrnse Signanve ard Tide ' Da�e t1zcN—.U�L� ��uL�l�Gfit, ,�-G�Qwc,f �, G-G% .fC�� r 3 � / � ,� � CITY OF, COSTA MESA REQUEST FOR OCCUPANCY TRACT N0. G� C� ;— DATE � LOT N0. G� % ADDRESS aj �2 (,; f T.�vu-oz'�C �'/ � The developer of the above entitled tract desires to se11 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) ,�i-ct�� 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. R�CEIVED � � U i! F CDS7h f1F5A pl;p;;i�r;, :�,-Y.. /'I�iG ( 19/3 Ah9 PM 7�8i9iiUilliuil��i3�4i5�6 � eC�V' I BY/ /17 .QXI/�-c� �.��%"P'u� Purchaser —�— BY ./`L!'rrrvLf' ��-�.L � -' Developer d/or orized representative BY Lender A.M. IF POSSIBLE P.M. IF POSSIBLE INSPECTION REQUEST Building Use Date 19_ Time Address M T W Th F Permit No. f 1 Underground Soil . [ 1 Underground Gas [}' Foo{ing Trench & Forms [ ] Underground Water _ [ 1 Steel (] Overhead Water & Gas [ 1. Floor'System ' [] Rough Plumbing � I 1 Steel Reinforce - � [ ] Sprinklers—[ ] � Lawn � ] F ire . ' [ ] 'Sheathing � .. [ ] Property Sewer Line �- " [ ] Framing & Flashing [ ] House Sewer Connection [ ] Insulation [] Swim Pool Pre Gunite �[ 1 Dry Wall Nailing [] Swim Pool Final [ 1 Lathing . [ ] Ducts [ ] Plaster Brown Coat � [ ] Heating - Rough [ ] Mechanicai-Final [] Rough—[ 1 Refrig. (] Air Cond. [] Final Gas Test [ ] Temporary Pole [ ] Plumbing-Final +[ ]� UndergroundCircuit�[ 1 Edison [�] Wiring-Final o [ ] Branch [ ] Building-Final [] Rough Wiring � [ 1 Special Requirement Special Notes " i � : v �u � A� y W � O �'� � �TRUCTU � `� SEPARAT RJFa ARE R FOR FL R}t,'l, P` If"n ` 1 HEATING, 11ENT!ldTiPlG � � REFRIGERATIOhI WOf ��CIE3!$ # 7 �,/ d I HfS NUPJ�F?ER i:":r.4'i ACG � , ALL INSPtCilOt4 REQJ ON LY� '1UIRED'� : ;, . y. , �E ),: G�;��u.hGS'�rHc..� FE:S�]f�S 1REUJ _t�JF F Ef1iPi0YEU, l;r' 5.�4�ST TN, T THE + STNTE DF C,.LIFO.'i�{�1 DIVI51 N OF ;!ND'JST�!AL S,'FET{' BE COASULT D fOR i � ACDiTiOP:.',L REQUI?EMENTS. , . �_.. � — �� Z . a cWj Z ZQ � y d m J 7 J N 0] J • Q] J Q UN Z �W d W W Z J Q m z J � W W O= zF w� N � � � i- Z Q U J a a Q 0 � z 0 F U � � H H Z ,- �353 I 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA.CALIFORNIA 92626 PAIO 173.45 4UC ?0-72�r�s,��Q210y+�` **'` ' APPLICATION FOR BUILDING PERMIT ForApplicanttoFillinCompletely qECEIVEDBV DATERECEIVED BUILDING �// _ � ADATE ISSUED ADDFESS �� O � Z .PERMIT NO. OWNER Heltzer Enter rises-Costa Mesa A�P� NO. �� I� MA I L BUILDING ADORESS 740 N. La Brea Avenue ADDRESS � T � ..CITV I,os An eles CA 90038 No��937-2171 TRACT 6245 �or 69 e�ocK CONSTFUGTION United California Bank W A A P LENDER BRANCH 1`731i1 Office � � � OWNER . nooaess600 S. Spring St., Los Angeles VALUE ARCHITECT David Freedman NELOL.3– / $ OR ENGINEER FIRE ADDRESS 113 N. San Vicente, Beverl H�1�. ZONE TVPE � GROUP CONTRACTOR George J. Heltzer ByPR�VED DATE ADOFESS %�FO N. L8 BTEd AV2Rll2 ZONE NO.OF USE OF NEW //�J F/t'N� � TEL. ' p�„qryg � gUILDING�/��- arv Los Angeles, CA 90038 No. 937-2171 STATE CITV VAFlOSAPPROVED VARDSAPPROVE� uc. n,o. 3144 LIC NO. MAIN BUILDING ACCESSORV BUILDING S12E NO.OF BLIX'8. (FROM C/L STRgE�jl� OF lOT NOW ON LOT FRONT ��T�'� � FT. USE OF EXISTING BLDG. � T. FT. SI2E OF NO. OF NEW BIDG. ROOMS STORIES- � L SIDE S FT. ' PT. EXTERIOR WALL ROOF COVERING COVEfiING REAR nL� FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN & MAIN BLDGS. ACCESS. BLDGS. g• Plan 407 A Rev. c uRa # 4PGROVED � ,�Ra� �D'� ��z3 � L 1 hemby acknowletlge ffiat I have reatl-this appliwtion antl state - H�� F��.�j�, �jE.�UI r [hat [he above info�mation is correct antl agree to comply with all laws regulating builtlinB �onsvuc[ion, antl I shall noi employ TAX any person in violaiion of Me workman's compensation laws of tha State of Wlitomie. c�j�f�� SQ. FT.� � % o 1-hereby certify Mat I am properly licensatl as a conbactor untler � the State of California Busineu and Professions Code, Divisicn 3, . THE AMOUNT SHOWN UNDER VALUATION IS FOR m� Chapter 9, entl that such licensas are in full forca and effect, or 1 THE PUF3POSE OF ESTABLISHING A PEFMIT FEE ONLV: ¢I am exempt from the provisions of the State of Californie Business VALUATION entl Professions Code, Di ' ion 3, Cha ter 9. � m . P PERMIT FEE $ II �i SiBneture ot . �O �7 � m Permktee S��^�� — P�N CHECK $ S/ �' E i ��/ � u Authorizad ABent TOTAL FEE $ /�/ � OWNER �yT�R ENfEgpgISES DATE ADDRESS ERAL C01 AP No. ROUGH PlUM81NG PROP. SWR. LINE SPRINKLING SYST MISCELLANEOUS CON. ❑ITIONING UNOERGROUND U POWER u ROUGH WIRING TRENCHES � FORMS /�' STEEL REINF. BON� BEAM n STEEL REINFORCE SHEATHING � , FRAME ANO l ATNING — STRUCTURAL,FINAL HEATING, VENT., REFRIG. ANO /. PLUMBING, FINAI AN� GAS TEST wi vrrair ciuei F INAL Drive TRACT Fi�45 FIRE BUILDING PERMIT N0. SUBCONTRACTOR OWNER ROUGH HEITING ANO AIR CONOITIONING TEMPOR�RY SERVICE OR POLE UNOERGROUNU � POWER � � ROUGN WIRING TNENCHES FOHMS STEEL RE FLOOR SYSTEM BON� BE�M ❑ STEEL REINFORCE [ SHE�THING FR�ME ANO FLASMING LATMING - IN ❑ OIIT n PLASTER,BROWN COAT STRUCTURAL, FIN�L MEATING, VENT., REFRIG. ANO A.C., FI PLIIMBING, FIN�L ANO GAS TEST n DATE 4-6-. SU6CONTRACTOR � . ��;:� `7 71 COSTA MESA BUILDING•SAFETY DEPARTMENT P.a. HOX 7200 COSTA MESA. CALIFORNIA 92626 871� 4/06/78 5050 TL - W� . APPLICATION FOR STRUCI'URAL PERMIT For Appticant to Fill in Completely — Use Ink Only RECEI DATE RECEIVED DA E ISS E ' BUILDING ADDHESS �� GI 7"�rC�cl(. .� ��e. �• n �� ` ' PERMIT NO. OWNER �P %l� � _ �° ., O M'N i A.P. NO. — — MAIL ( BUIL�IN %�iC ADDflESS S�}�`�C A's A'�oOV � �+DDRESS JGa �/ LOGyCD F _ TEL. b TRACT6,2y,s` LOT BLOCK ciTv �, os �F M s� wo.�(79-ab � CONSTRUCfION ' � LENDER � (.ciNPX BflANCH OWNER G G " �L � ADDRESS �� VALUE ARCHITECT TEL. - § OR ENGINEER , FIRE ADDRESS � ' 20NE VPE 6fi0UP APPROVED CONTRACTOR ,(,(/�L'r o wN e✓ � er DATE ADDRESS " TEL. ZONE' � NO.O USE OF N PLAFS ' BUIIDING � CITV ' NO. G �' STATE ' CITV VARDSAPPROVED YAROSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING 512E - NO.OF BLOGS. (FqOM C�5=REETI� OF LOT ' NOW ON LOT CJ FT FT. USE OF �� G EXISTING BLOG. Se arate ermits are re uired for � p p �I L. S D � FT FT. etectric, plumbing and heating work. � REAR d FT. FT. USE OF BUIIDING AND WORK TO BE PERFORMED p�{qN� g�. BET. MAIN & MAIN BLOGS. A�. BLOC>S. VAH. �F pq7E ' F CLQ �IICC E L C� C.U.P. # APVqpVED . APPROVE �� 1 hereby aeknowledqe that I hmra read thi� ep0�kation en0 stnte ' - � Mat tM1e ebova Informotion �� eorrect entl apree to comply with � . m all lews requletinp Euiltlinp conrtructlon, en0 I thall not employ � any penon In vloletlon of 4ho wotkman't compenatlon laws of o Me Stam of. Californle. � , I horoby certify ffiat I am pfoParly Ileanca0 a� a eontraetor undar SQ. FT. ' q ihe Sute of Callfornia BuslM�u end Profauioro Cotla, Divblon 3, THE AMOUNT SMOWN UNDER VALUATION IS FOR m Chav<er 9, ontl that such Hcenses ere in full torca entl eHect, or 1 7NE PURP06E OF ESTABL6HINa A VEqMfT FEE ONLV: � em exampt from t�e O�ovifi0m o7 iha State of Californie Bualneu VALUATION PERMIT FEE S antl Professlons C de, DWido� 3, Chapter 9. , r � 0 x n DO pWNCHECK f � �( 0 'Slpnaturaof �d� ,`� � LL , Permittea � --5�.��'Q �� $ ��D TAX E � � f U Authorizad Ap�nT TOTAL PAID S , SO