HomeMy WebLinkAbout1063 TULARE DR - Building Permits , , I - • w `CITY OF COSTA MESA ril
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BUILDING DIVISION
> .f •• : ,11 a DEVELOPMENT SERVICES DEPARTMENT PERMIT N BER
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4. 11.114h • PERMIT
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(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
• Job Address: 1063 TULARE DR Status: ISSUED
Suite: Applied: 08/03/2004
Vicinity: BLOCK WALL ALONG SO COAST DR Issued: 08/03/2004
Parcel Number: 41212207 Zoning: R1 R1
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Applicant: CARRION, SERGIO _ ISSUED BY: Art 1063 TULARE DR , - - - - -- - -
_' Phone: 714-540-7911 "
COSTA MESAr CA-- Zip: 92626-2112 • -
Owner: CARRION, SERGIO
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Address „•-- 063-TULARE DR - - - ,-•,„,
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,,COSTA MESA,CA Zip: 92626-2112
Contractor OWNER-BUILDER
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AddressR
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Phone:
Zip: , „ , • Llcense:- 000000. ' - - '
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Arch - - ,Eng:"
Address: - Address: - •
Phone: / Phone: ' "
Zip: , - License: License: - "
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--:- ,- ,• -, SCOPEOFPERMIT-,I-- -,: " -
REPAIR DAMAGED BLOCK WALL AT THE.REAR OF AN EXISTING.SFD.WALL BUILT-PER CITY STANDARDS. , •
NO OTHER WORK AUTHORIZED WITH THIS PERMIT. - - - - ' - - - .
, FEESUMMARY- . .
Plan Check: $0.00 - — - `. - -- " - • - • Calc Valuation: ,r $500.00'
Permit: : $23.50 Claim Valuation: $590,00
;vSMIP Res: ` • $0.00 - - J
SMIP Com -$0.00 - ,
Other x,''`$0.00 �
Inspection:/ "`$0:00 :1-,-::' •,
<,,,,,,,,/
•,Total: • $23.50 " / ,'i%./ , v/
1 PLANNING -,3,ZONING - /* // 70/
SETBACKS*,• ', .,> ` ' \(\:1,1';')</ �/
MAIN STRUCTURE Front 0-0 ,.Rear —0--0...\-:---c- ''-:- Left .0 0 .. Right - 0-0' -(''''''2
ACCESSORY Front 0-0 Rear 0-0 , Left 07-0 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)754-5626
2446-46(6/00)
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
v74 certify that In the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California.and a ree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro ID s. ,. �/
Applicant Signature: Date: n IS J
WARNING:FAILURE TO CURE ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND t' I ARE 106.006). ADDrnON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
force and effect.Lic.q Class a
Contractors Signature: Date:
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: Lenders 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).):
tic 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 ss - Business and Professions Code for this reason:
Signature: ( Ji07/ Y �Z4---y" Date: gr ?i — 0 �--
Owner IfSerifi by driver's license. yU Yes 0 No Drivers License No. Expires: !•2^/O•O
Verification of Ownership by(type of docume t,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 B,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 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 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 a permit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes 0 No
(Section 65850.2 of the Califomia 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? 0 Yes 0 No
B (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 al .te laws and ci ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describ r perry for i• pectin pu••.s- .gree not to occupy or allow occupancy of any building authorized by this perm ynntil final inspection.
y 3
ignature Of Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE/ INSPECTION TYPE DM1 pfTITIAL$ CODEI INSPECTION TYPE DATE =ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200Final Re-Roof �j 210 Final Electrical _
01 Final BIocWReteiningaULall 9 h —0 41 W, 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
-o,- mss, CITY OF COSTA MESA J
v..�1j P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92626-1200
r.1 Z:
�J � a'' DEVELOPMENT SERVICES DEPARTMENT
:`aCa1
April 22, 2004
Mr. - •'• - •.n
063 Tulare Drive
• . u - - _ • !26.26
Re: Repair of damaged masonry wall
Dear Mr. Carrion:
I am contacting you to inform you of the latest information I have available to
assist you in your attempts to formulate an action plan, for the repair of your
portion of the tract wall along South Coast Drive between San Leandro Lane and
Carmel Drive. First, I must apologize to you for the delay in responding to your
previous written inquiries. I thank you for your patience.
The City has now officially added South Coast Drive from San Leandro Lane to
Fairview Road to the Streetscape and Median Development Standards approved
list of aesthetically deficient arterial wall locations. The inclusion of this segment
in the standards, will allow property owners adjacent to the wall to solicit City
Council consideration for City financial participation in the reconstruction of the
wall. Your previous request is still active, even though funding for this project has
not been approved as yet. The City's Public Services Department shall continue
to request funding during the preparation of the City's Capital Improvement
Projects budget.
The following information answers the question you asked in your July 23, 2002
letter, regarding the scope of repair work on your rear yard wall. The City
encourages you to move forward with repairs as soon as possible to your wall.
You are not being required to replace the complete wall at this time, merely to
effect repairs where vehicle damage has occurred. This will allow your
contractor to merge and match the new construction with the remaining portions
of the existing wall as best as possible, with like materials. Please have your
contractor obtain a repair permit from the City's Building Safety Division on the
second floor of City Hall before commencing construction.
Please be aware, other actions may also be taken to begin relieving pressure on
the existing leaning wall. Remove any non-approved extensions in the wall
height of additional masonry courses or plywood. Such extensions place .
additional structural loads on the wall that were not considered in its original
Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245
FAX(714)754-4856 • TDD(714)754-5244 • wvAv ci.cosla-mese.ca.us
0
April 22, 2004
Page Two
Mr. Carrion
design and construction. Weep holes may be created in the bottom masonry
course of the existing wall, by removing the mortar head joints every four feet.
This will relieve hydrostatic pressure from landscape watering. Trees and other
vegetation pushing against the wall may need to be cut back as well.
I trust that this information is sufficient to assist you in getting started with your
repair project. Soon, I will be providing additional information to all the affected
owners adjacent to the leaning tract wall between San Leandro Lane to Carmel
Drive.
Please feel free to contact me, Monday through Friday, between the hours of
7:00 A.M. to 5:00 P.M., to provide clarification on any information stated in this
letter or to answer any additional questions you may have. I may be reached by
telephone at 714.754.5615 and/or e-mail at bmorqci.costa-mesa.ca.us.
Sincerely,
BurtMorga 611r1-4-4-1
Chief Plans Examiner
cc: Don Lamm, Deputy City Mgr., Dev. Svs. Director
William Morris, Public Services Director
Perry Valantine, Asst. Dev. Svs. Director
Ernesto Munoz, City Engineer
Bart Mejia, Associate Engineer
Salem Abderrahman, Plan Check Engineer
Edward Petros, Chief of Inspections
Jim Ggffos, Chief of Code Enforcement
File V
PROJECTADDRESs: - 1063 TULARE DR UNIT: - ' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067402
OWNER'S NAME: LEE DIANA M -
ADDRrss: 1063 TULARE DR •
PERMIT NO; 13 067402 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: OTH
714 ) 557-1969
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHEATH & RE—ROOF W/COMP , SHINGLE SQ FT: 6,000
ADDRESS: UNIT:
CLAIM VALUE; 6, 000 . 00 CALC—VALUE: 6, 000 . 00 GROUP OCC: R-3 /
PERMITTEE: DIANA LEE ( 714 ) 557-1969
ADDRESS: 1063 TULARE DR COMMENTS : SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM & HALLWAY, 1991 UBC
C .M. CA 92626 *******aE- **K**********+F*********lc+P**** -yF******T6ra6+tTc -*aF-****+F* -aE***********aF*****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N ING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S
CITY LIC.: STATE LIC.: CLASS:
Date 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 Insurance,or a certified copy thereof(Section 3800.Lab.Cl. LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: • PARKING REQ- PROV: PARCEL : 41212207 ZNE: REF NO:
1•':'7 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES>
>•
•
Date: Applicant: ***************.****************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not he completed if the permit is for one hundred($1W)or less). D EV ELOP MENT S ER VIC ES REQUIREMEN TS
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 ..
s • t to the W vers'Cnensation Laws of California. - ZONING APPROVED BY DATE:
r /O (9 Signature: �A A� /J� BUILDING APPROVED BY
I NOTI II.after making this declaration.you should become subject to the Workers'Com p�nsatmn provisions of the Labor DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �j
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY p — DATE: T"
which this permit is issued(Section 3097,Civ.CI. ********)..************4- • - • . . - - • - - '************* r **
LENDER: *************.******************************************************************
ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 , 00 SMOKE DETECTOR . 60
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by /� 1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE REJiiA'._�/ RED
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLFIE 1. TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 81 . 60 0 , 0 0 0 . 0 0 8 1 , 6 0 81 . 60 .0 0
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. It,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 81 . 60 OVER/SHORT; .00
improvement
of sale). one year of completion,the owner will have the burden of proving he/she did not build or improve
forthepBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 0 0 6 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).lam aware **************************************************************************st.y**.*
T that proof of their Worker's Compensation insurance should be provided to me. IND IV IDUAL F E E BR EAKDOWN
E I am exempt under Section: B P 7044 B.8 P.C.
for thsreason: OWNER—BUILDERnn ^ TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
/ Date: '61/19 y Owner: A-�-►" k) A _a_e_. SFR 6000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 6 , 000 , 00
I 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 will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
• r mantes and stale laws relating to building construction and hereby authorize representatives of this cit to enter upon the above-mentioned
pr.perry for in pection purposes. � , � ^ ^
IP. y Signature: / J 01 00161435-00161436 TOT 81.60
DATE: 06/01/94 TIME: 08:56
leers License or Social Security a:
1641.46 While—Building:Green—Code Enforcement,Canary—Applicent:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING
POOL SPA
APPPOVALS Permit# Date Inspector APPROVALS Permit # Date Inspector '
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
^i
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement ._
3. Electrical Conduit Utility-Undrgrnd. ' • 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUM-1E
7. Footings 58. Electrical Conduit-Undrgrnd.
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 •-.
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing n 65. Electrical-Final
•
15. Rough Electrical-Conduit 66. Solar System-Final •
16. Rough Electric Wiring 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 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing "`Kb'
'4 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat iii 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat .79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FQdD CERTIFICATE ISSUED
-
33. Final Electric Notes:r^�
34. Final Heating & Air Conditioning i.:...
35. Final Gas Pipe-Test I
l
36. Hood or Canopy - L_` •��
37. Final Factory Fireplace '--• rc
38. Final Plumbing t .. ,••� FI'
39. Water Service-Final }--.
40. Gas Service-Final +'
41. Solar Domestic-Final .
42. Backflow Preventer
43. Backflow Irrigation •
44. Landscape Irrigation System
45. Sound Attenuation iat
46. Handicap Regulations /
47. FINAL STRUCTURE& BUILDING +37-fr/ l ,. 3 _h
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO.4<Z7? DATE 'Li
LOT NO. 37
ADDRESS /do' G2L�
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
•urchaser
RECEIVEDDevelo r and/or authorized
CITY OF COSTA MESA representative
PLANNING DEPT.
NODI 15 1972 BY
AM
PM Lender
71819110111112111213141516
A
_ _ _ _Applicant to fill in all spaces except those within heavY_border Tines and sign all appropriate declarations
CITY OF COSTA MESA .
,e PERMIT•NO. i I TRACT NO - i LOT NO.. . BLDfa NO . I ,s ti`I I t o ,
I CONSTRUCTION PERMIT tn> it—;--7,R; !7 �/ , i . , -.- 1 i ._ ,I ;, •�- I - :
Applicant's Mailing Address .00 W" 4 -• 4 '• - , TYPE OF CONST CTION 'Ur NEW U ADD •Li ALTERATION, U•REPAIR _ f i ) I _-; ' 1 i. I - i '
L r
Project Address• I 01,-3 ' TUL'4€E•' 'D-.%. t i - .r _ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - r { t " ' . — I _ ; •;:945,. -5746/63 ` C� fO it
Owner's Name - EQ L ' ! - - - ''phone-s'/ -x7$"7 :rDESCRIPTION:OF WORK I -' ' , •, _, , I - _ 'ZONING REGULATIONS ' - - '
' I > '4NC ° - - z- 1 , . - I • — > - _ _ 1 .
Address -' TYPE OF PERMIT ( UIGRADING.• FOUNDATION U.STRUCTURAL , A P.. ,•i : r 'ZONE' ' . I ' •-
Arth/Eng I ' t - License No - I O TENANT ❑•ELECTRICAL ❑r PLUMBING- ❑ MECHANICAL v % `-BUILDING: F41: ' I
C f[ - i I _ .I .PLNG. REF. '' ` + { i , • �r TB err Cri Sr 1 F
Address I - 1 _ _ ❑ BOTHER .TO BUILDING - Ic-
e'
c
t S ISA - .� 11 - - e r r PROPERTY. LINE I REAR YARD (TO P/L) . I i t' ,
Contractors Name�A LSLQ'rri;N' I 'Phone der , PROJECT DESCRIPTION' Sq FT,' `'- - OCCUPANCY ' _ - _ _
: / - - 1 ' . 'LEFT SIDE YARD - + RIGHT SIDE YARDS •
Address(mailing)7-67840- Y)an ,- illi - CONSTRUCTION TYPE • ' VALUATION$ I + " i ''r ^
C2 jA 4
I - , - ZONE " ' GRADING CU.YDS: ACRES ' • ' PKG.SPACE REIT: • 1 PROVIDED
License No: • I
- - „ r i
LICENSED CONTRACTOR DECLARATION Remarks: 1 r, I I i ! i I I i STREET WIDTH SPARK FEE;$ I t
v \I.hereby,affirm that I am licensed under provislons of Charter 9 (commencing •
with section 7000) of Division 3 of the Business and Professions Code,and j I • ! SPECIAL CONDITIONS: - I ,-, ,
My IlCense'is In full orce affect. I _ • -•
I
License Class' -- 0 _t _ ,cense No. " a 33• ! •t i PLUMBING •� _ I r r • I Y •! , ,. !
.te ' ' ' Signature> ✓y,['C� _ i Bar Sink i Sewer Cap - i • ELECTRICAL t
V IRKERS'COMPENSATION DEC • - -TION _ - - -• - • y - I_ •
_-
.ereby aiilrm that i-have-a cerfi flea • of-consent to.self-Insure ora certlflcate , BackfIo v Preventer Sewer Connection Automatic Washer .I__� .. !Meter Dover 100 amps
oT Workers' Compensation insurance,'or a certified coDY the eof (Section
it) 3800, Lab. i • - i 4 Construction Pole i ;Sub Panel. i^
Policy No, `9'0 3748/ 11 Company Air i:L!!/ •
Backflow Irrigation Solar Collectors •
B Certlfiedtepy I's hereby furnished. ' / / I Bathtubs I Solar Piping i qi
Cooking Unit Sub Pole I •
Cert fletl o y IW�Ilpd with the City,B •ig Division, - Dishwasher 'Motors ❑0-1 HP a1 X-8
Date 9 -.01, "43 7' Applicant r ./ -i;f.:.i / ' _ _ Clarifiers lar ank /' t Vci r
' EXEMPTION/FROM WORKERS'C• re NSA •N�• - ARATION j (1.w/5 ' Dryers ❑Gas- ❑Electric Inc( .Solar ❑9-,15 HP 016:15+ '
(This section need not be complete,: the per t is • one hundred ($100)or ' l Dishwasher wimnm ,o pa - -
less):. ! r / + 1 - Fan - • 'Microwave I ! {
I certify that in the performance of the work for which this permit is issued I • Drinking Fountains inal ; 1 i I - ' I I ' , i
shall,not employ any person In any manner so!as to become subject to the - - 1 F.A.U. ! , 'Pole Light ! ' • 1
Workers'Compensation'Laws of California.. : Floor Drains , I/ . Water Closet! :
' Date i Signature • : . I ' F - i I
•NOTICE:If;after'making this'declaratlon;you'should'become subject'to the -- ' ; Floor Sinks ' - - Fixtures ' • •Range
Workers' Compensation provisions,of the Labor Code,-you must forthwith, -" I Device Boxes -
comply with; such provisions.ior'thisr.permit {shall be'deemed revoked.• ' q ' Gas Service , `,Outlets: • -Water Service _ 'Sign. ; ;
CONSTRUCTION LENDING AGENCY ' i - - ' ' ' ' ' ' , { •
•
I hereby affirm that there Is a construction•lending ageocy,for.the'performance, : }I ! Interceptors' I • - Outlets i - Standing Sections
of the work for, which"this permit -Is issued (Section -30 7- Civ C) - -• _ ' - - - - P. - + -
i . r + .' Switches . Trash Com actor '
! Lender's. Name - - r Kitchen Sink �- ! - I ' P ' ,•
'Lender's 'Address j ' ' - • - , 1 I
OWNER/BUILDER DECLARATION `- i •v 1 - I ..• { Lavatoriestg ,., 1 1 r r Garbage Disposal r ' 4 •
I hereby/affirm that I am exempt from the,Contractor's.License Law for the I - - - _ _. Generator 00-5 KW 05-15 KW { F ,
following reason.(Section`7031,5 Business and Professional•Code: Any city or . , p ,Trap' ,1 I ' - , l I
county which requires a permit'to construct,alter,improve;demolish or repair 1 . + - Transformer ❑15.50 KW I l - i i
',fly structure, prior to its Issuance,,also requires the applicant for such permit ' r t Roof Drains' ' ' r . =-11" •` I - ' i•- I r` •: • 'I ' I I
file a signed statement-that he/she Is licensed pursuant to the provisions of - - ,
Contractor's License Law;(Chapter 9 (cowmencing•with Sectlon:7000) of ; ;y ' + + ; t + ' t ❑5U+KW' • ,Reinspection Fee $15�
Asian•3 of the/Business and Professions Code);or that'he/she:is exempt , i Showers 1 i t. ' ! - 1 4i i + Reinspection Fee; $15
erefrom-and the,basis for the alleged exemption:Any violation of Section , Meter ❑up to 100 amps + I 'Issue Feel 1 '$ 3 i
i 4031:5 by:any applicant for•:a•permitzsub)ects the applicant to a: civil I ' ` ! D a, ' i , _-
eenalty of not more than five hundred dollars($500)- , e` I ; • ; Service Sink -I ; I 1 ; : i Issue Fee c,. I t• . I - ' 3' Zoning Approved By _ I Date 1 I •
1
tJ I,'as towner of' the;property 'or m'y employees-with wages{az their sole I ; i 1 !
compensation' will;do the work,and the+structure-Is not intended or offered I •- "1 ' i : r MECHANICAL I - . ' I i Application Approved By ! I I nate• t
' for sale i(Secsion 7044, Business and Professional,Code:1 The i Contractor's ; , i _ I � / �� I
i License Law does not apply to an owner of a property'who builds or Improves ' I I Boiler, t 4r- ' 1 Refrigeration System , I d
thereon, and\who:does:such work.himself/herself or through his or her own ) : ( ' ��I1•• j Application Issued By - • ! _Date I
• employees, provided that such9mprovements are;not intended or offered for ' ) - '/ ❑4,100,000 BTUFP100,000 BTU I 7 •
• sale- If, however,the building or Improvement Is sold within one year/of com- I Duct-Under.Ground 1 i / ( y { - '' ! S MMARV OF FEES I { •
pletlon, the wnerlwlll have the burden of proving he/she ditlinot build or im- I - ) ' I 4
I arove for the purpose of sale). i i + ! • ; .I l , { Duct-Structural I ! System Repair/Alteration 1 BUILDING PERMIT $ l • i SMTP ! { $
I,as owner,of the property,am exclusively contractingiwlthllicensed con- 1 , - - - I I { ' i I I
^tractorsto.construct-the project.(Section 7044,Business,and-Professions Code: . - --.,. Duct:,Ventilating- ._.",_, j_,_,_I ,_ _+_ „-Iy_-, _ , (PLAN CHECK: $ i PERMIT
The Contractor's License Law does•not apply to an owner of property who , ) e } • ) 1 , 1 ! ISSUANCE ; I $ '
builds or Improves thereon,and who contracts for such projects with a con- • Exhaust System ❑ Multiple ❑ -i I • ;PLUMBING ( - $
tractor(s) license pursuant to the Contractor's License Law): , i - t I f , I : l I • I I I GRADING I ' $ ' i
❑ lam exempt under Section I ' i B,& P,C,for this reason 1 Firepl/Fact.Blt. ICBO�# 1 ) 1 i ! !PLAN CHECK, $ f i ,
I I i li I - $ ! r
Date I • owner: r I I I • t ; 1 Heating!System&Ducting j .i - i I ` ELECTRICAL. $, 50-0 I i •
1 __ - i i i i MICROFILM - $ - '
^I hereb certlf .that I-have'reac•thisp''a Brat ton-ty and
trie'ances ,' 1 - I - ^--f-- .` i ,� _ :PLAN CHECK' $ $ ! I '
y- Y' pp ' ' • i •r' 00-100,000eTu�ioo 000 BTV— - - --• D'
information is correct. I agree to comply with all city and county ordinances , I J 1 _ i I �/ TOTALFEE. i '
sentatives
ancr,state laws relatingt• buildingeateconst- ction,and herebyauthorize re re- - MECHANICAL e ',es .
p Hood or T e l ❑. I ,1 ! 1 i "
of It •city enter!up•n he above-mentioned property Tor. 1 yp Reinspection Fee) • $15 , I : 1 LESS I i
inspection nu ••les, I I I I 1 i Canopy -Type II ❑i - i r PLAN CHECK'. $,
Signature / i..1.. .... ' _ .
I I i Registers I I , Issue Fee i $ 3 I' ' I I 1 I .
Drlversr,554f - - . . 1 f i I t + + 1 . FINALIFEE; , $
CMF 03-5-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod•Assessor ,
OWNER HELTEER Enterprises Costa Mesa DATE 2-8-72
JOB ADDRESS 1063 Tulare Drive BUILDING PERMIT NO. 41 0 _
GENERAL CONTRACTOR Georte J. Heltzer DESCRIPTION of WORK Res.w att.::r. _
AP No. LOT 37 TRACT 66 • FIRE ZONE VALUE $2 000.00
INSPECTIONS i.��a re �Date aG•OUP TYPE ZONE —
SOIL rie/ / s SUBCONTRACTOR PERMITS ISSUED
GAS
Date Number Si•nature '
WATER Plum•' •
ROUGH PLUMBING '&ava7JL' 's,' 7faCer'� ►TC11E ctSPA2
PROP. SWR. LINE F HOUSE CON. PZ ' Llrr�� fkarA e;F i .� r/Aa4��W . �-
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING '- i - 0C
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0 .
ROUGH WIRING �?raw��y� Heatin• and�Vent/./i��
TRENCHES L FORMS ►r STEEL REINF. �aS.�. Aarrip /or / • diger i•//4'i� I 0
FLOOR SYSTEM `an" raleCr' AI A Wie I Ini ,
BOND BEAM • STEEL REINFORCE Ile
SHEATHING.-.
FRAME AND FLASHING �` r' • ,e _
LATHING - IN ` OUT ! _�_ r % _
PLASTER, BROWN COAT riw:���F!:�i -,
STRUCTURAL, FINAL /�� y •f. i r
HEATING, VENT., REF RI G. AND A.C., FINAL Yirsa=VAr7 '�, �'7 UPA� 1.
PLUMBING, FINAL AND GAS TEST r firnIV��
ELECTRIC, FINAL A%1/ / o-' _
RIIII nluf. PIMA! / / w /_
S1
_ 34150 Palo
. -CR —9-72a00 345* *** 141.00
COSTA MESA BUILDING-SAFETY DEPARTMENT .
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECEIVED DATE RECEIVED DATE ISSUED
BUILDING /Z—S- 7 �_y� '7�t
' ADDRESS 1063 Tulare Dr. Costa Mesa dd0 /� -
er PERMIT NO.
OWNER Heltzer Enterprises Costa Mesa A.P, NO.
MAIL - ADIDRE s 1063 Tulare Drive
ADDRESS 740 No. La Brea Avenue
W W TEL. (213)
0-U CITY Los Angeles NO. 937_2171 ' TRACT 4Iji 37 LOTS? BLOCK
ZQ CONSTRUCTION. NEW IjDD ALTER REPAIR ,MOVING f1EM01 ISH
— 1— LEDER United California Bank
a m
_10 BRANCH Main Office G:/!d•�'f--
< al OWNER- O'
m ADDRESS 600 So. Spring St. Los Angeles
VALUE
J CO ARCHITECT TEL (LI-3) USE . $
N OR ENGINEER David Freedman NO, 653-3852 `�OO
U ZIRE �f /�
w� ADDRESS 113 N.San Vicente,Beverley Hills ZONE TYPE GROUP/}TU/t/y
a. W
APPROVED •
J O CONTRACTOR -George J. Heltzer BY DATE
m Z ,
m ADDRESS
740 No. La Brea Avenue
WW TEL. (21 N
3) Z
ONE O.OF USE OF NEW res W/ t3L'.
Z H CITY Los Angeles - No. 937-2171 Rl IPLANs 2 BUILDING garage
to STATE • CITY , YARDS APPROVED YARDS APPROVED
ul CC LIC. NO. 3144 LIC. NO. 1900 MAIN BUILDING ACCESSORY BUILDING
(FROM C/LAST R((..EET)
SIZE I NO.OF BLDGS.
- -
OF LOT NOW ON LOT FRONT 5O,- T. FT.
USE OF • (/
EXISTING BLDG. R SIDE J FT. FT.
1— SIZE OF, NO.OF I
Z NEW BLDG. ROOMS' STORIES L.SIDE -fT,i FT.
Q EXTERIOR WALL ROOF �]
o COVERING Plaster COVERING REAR 23I T. FT,.
J USE OF BUILDING AND WORK TO BE PERFORMED ' DISTANCE BET. BET. MAIN&
• 1
a -
MAIN BLDGS. ACCESS. BLDGS.
DATE .
o Single Residence c U.P# APPROVED
~ Plan #410 APPROVED WLD
VJ —_ay WLD 12-2O-71
zAM/r'b
o —
p I hereby acknowledge that I have read this application and state HOFOR SPECIAL c _
D that the above information is correct and agree to comply with RE•Q[tr^Fx/_srTS
CC all laws regulating building construction, and I shall not employ - �1
any person in violation of the workman's compensation laws of
h the State of California. J kJ,
` /� r/ �t ce
w
ZI hereby certify that I am properly licensed as a contractor under / J1 SO. FT. h j o
the State of California Business and,Professions Code, Division 3, THE AMOUNT SHOWN UNDER VAL ATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: R
am exempt from the pro 'sions of the State of California Business VALUATION
and Professions Code, Di on 3,Chapter 9. r ro
n, PERMIT FEE $ 01
m
ignature of a % kr'' J m
Permittee ��LL / kr'',
GGG;=_ $ iii) le
PLAN CHECK $ .7/ - E
Authorized Agent e' v� LL
/ • / TOTAL FEE $ /-