HomeMy WebLinkAbout1022 VALENCIA ST - Building Permits City of Costa Mesa 1957
Building Safety Department CERTIFICATE OF OCCUPANCY NOC
P. O. Box 317
Costa Mesa, California
The Building located at Vtlnn'1a kThnortts TIM IT, A, A� fl, roil TI
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group IT P. J Occupancy.
Use of Building Lbu' lex residence with atteirAled ®xvvze
Legal Description Leg 39, Tract P
(See reverse side for Metes and Bounds)
Building Permit No. 19007 Electrical Permit No. 19556 Plumbing Permit No.
42949
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments— 4. and/or guest rooms
ISSUED TO: Building Official
•
Dillman-Brlmmell f rterpriaes byAC-
Date April 2% 1964
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bu3e-1M-11-e3—s-B r
4`psg Mf 9 CITY OF COSTA MESA
BUILDING DIVISION
> • ' 1, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
1,2
t>. irkili • PERMIT
q,� P05-00135
'Oanasm6o a�'
(714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING.PERMIT
Job Address: 1022 VALENCIA ST Status: ISSUED
Suite No Applied: 02/14/2005
Issued: 02/14/20
Vicinity: LAUNDRY ROOM
ISSUED BY:
Parcel Nunmber: 14166411
Applicant: JOSE ALVARADO
Address: 6558 WEST BOULEVARD
Phone: (213)753-2541
LOS ANGELES,CA Zip: 90043
Owner: MOSHAM, MICHAEL TR
Address 19471 WATERBURY LN
Phone:
HUNTINGTON BEACH,CA Zip: 92646
Contractor: GENERAL INSTALLATION CO
Address: 6558 WEST BOULEVARD
Phone: (213)753-2541
LOS ANGELES,CA Zip: 90043
License: 151839
SCOPE OF PERMIT
CHANGE OUT WATER HEATER LOCATED IN THE LAUNDRY ROOM.
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
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $35.80
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754.5626 .
2446-46(6/00)
DECLARATIONS
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
rk 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 worker ccomppensatlQn Insurance carrier and policy.number are' 1�. /��� �/
Cedric Cvi-ce•ai(. t1/2)0_,‘„ONO \ , , Polity Number:` Pt-03 -1'-cOZS4S 7
velpts.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 permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisio�SC/��r�� P L��S
plicem'Signeture)." "-' YEfR%Z r.Date:_
WWA� Nlal&FAIL RU E TO SECURE WORKERS'COMP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER,TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
TFOISAND DOLLARE(S100,003),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisionssi�jj�� of hapter 9(commencing with Section 7000)of Division 3 of the Business and:�fPro/efgssions Code,and my license is in full
force ndeffecf_L G.U. N" C' '
ass p LX
'b ✓ -G`a`a(ia(( rSignetura:"T�— nate., -nS
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 em 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).):
O I,as owner of the property,or my employeea 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,end who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I am exempt under sec. Business and Professions Code for this reason: _
Signature: Date:
Owner ID verified by driver's license. ❑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:
O I hereby certify that no excavation five(5)or more feel 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 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 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 ap_ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes LJ 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? ❑Yes 0 No
(it'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 final inspection.
ur Of Legal Owner(s)
ail
2-(Li-OS
Q
•.i: u8 .; ;_.
5orized Applicant .•_ �..Are, - —
CODE r INSPECTION TYPE ON INTRIALE CODEE INSPFCTION TYPE PATE INTIDALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical 2'
1266 Pool Spa Final 208 Final Plumbing J i 4-06- gi-
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
ky\vrvavr.L, U1Vl'1'LU ORV.LVU7 RAD WAR Lns.la .ac Sv vl
JOB ADDRESS 1022 Valencia Street BUILDING PERMIT NO. 25011 GENERAL CONTRACTOR R. C. Donatelly DESCRIPTION OF WORK Community Block Wall
AP No. 141-664-11 LOT TRACT FIRE ZONE VALUES225.00 _
INSPECTIONS Signature Date GROUP J TYPE III ZONE R-4
il PERMITS ISSUED
So
Gas Date Number Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.ID SUBCONTRACTOR I
Sprinkling System
Miscellaneous
ugh Heating and Air Conditioning
4 Temporary Service or Pole
Underground 0 Power D
Rough Wiring_...---- ',! c 6 S Heating and Vent.
Trenches 1Forms ID Steel Reinf. 0 , t . /—/-71r
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing —In 0 Out!0
Plaster, Brown Coat _
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final n // /�
Building, Final Ali?u /212—3/6, - _
. 1 25011
..,
COSTA MESA BUILDING-SAFETY DEPARTMENT CITY OF COSTA MESA
F.0. BOX 1200 COSTA MESA, CALIFORNIA 02020 - CI Cr M A
For Applicant to Fill In ComplatalyII`C�T�I�RQR PERMIT
TYPE OR PRINT // ED
ForOffice Uso On*
BUILDING ADDRESS /0 L 2---- //A /eaCr A P Ail.* (T�I�
COSTA MESA. CALIFORNIA ---- 2511 1 1
y RECEI ED SY DA/T/1 'CIII / //pR-T/i ISSI
OWNER (JO/.t-, _at,. y- / CAI` ! N.S / "� �V! s
MAIL 77T BUILDING
ADDRESS w��!r t )cfl& ADDRESS f
FIRE / rCITY NOZONE TYP(< / GROUPAPPROVED /
OR
ARCHITECT
ITS T TEL. BY' DATE
O.
ZONING
ADDRESS
Z I NO. S I ,USE OFNEW
l) /, ! 1_( I PLANS �.-. BUNDINO
CONTRw�TQR ((.1�/L - ,f1 w z.---7-i,,/ /� , c` y` .J-�- �j .�,p l�/
ADDRESS /G//(�7 �4/fo-A 4 LEGAL
EGCIrTION t Q 1 c 1 �\ J / 12�
CITY / . 71"-1 A.P.NO. ../E4:101,21 /1_____..
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE z p TEL /"'1LG G C SO'TO SIDE B REAR
LIC.NO. JJ 7p NO. .� ( O ` 4 l�
VES
SIZE OF LOT ^ 9 NO.OF BLOCS.
ALLOWED (U-B-C-REQUIREMENT)
NOW ON LOT
USE OP YARDS APPROVE YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
—r (FROM C/L STREET
SETBACK LING FROM FRONT FT,
CENTS- OF STREETIREAR YARD
��F
SIDE YARD] LEFT RIGHT R.SIDE FT. `` .
7_�.
DESCRIPTION OF WORK L.SIDEPT. 4 a{/FTtt
NEW ALTERATION ADDITION REAR PT' yYt "—TIC--
DISTANCE BET. (` BET.MAIN S
REPAIR MOVING DEMOLIUN MAIN BLOCS. ACCESS.SLOGS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES C.V.P.# APPROVED
EXTERIOR WALL I ROOF APPROVED ( Q ,f A//,1J /
COVERING COVERING SY WI/1// �7 TE I -({�r 6 J
USE or BUILDING AND WORK TO BE PERFORMED 1/w a
N
20 r X 3f pc-co we 4- L
fr. X S/ 4 0- Gc)N cc__ SQ-FT. 1
I HERESY ACKNOWLEDGE THAT.I HAVE READ TITS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE.IS CORRECT AND AGREE TO COM. PURPOSE Or ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND RATE LAWS REGULATINS VALUATION
BUILDING CONBTRU
PERMIT FEB s N
SIGNATURE OF F
PERMITTER /� �N / /
� r Ws LL- .��.
PLAN CHECK S
AUTHORIZED AGENT 2
same TOTAL FEE 5
*"v,UnrvLR MATCHAM, MICHAEL URIC 11-4-69
JOB ADDRESS 1022 Valencia Street BUILDING PERMIT NO. 31065
GENERAL CONTRACTOR owner-Builder DESCRIPTION of WORK COMM. Block Wall
AP N0.141-664-11 LOT 39 TRACT 3922 FIRE ZONE VALUE $ 50.00
INSPECTIONS Signature Date GROUP If TYPE TTT ZONE R-4
tio1/4s01L SUBCONTRACTOR PERMITS ISSUED
GAS _ Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. U _
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES 91 FORMS ❑ STEEL REINF. Q .� f1-s-(�'
FLOOR SYSTEM /
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT n
PLASTER, BROWN COAT -
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C„ FINAL
PLUMBING, FINAL AND GAS TEST/[i
ELECTRIC, FINAL
BUILDING, FINAL ��Z^�
Tq I flR am —4-69--SAGO 092 it*****5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For App(icraanA to ill in Completely
�JJ((%% c,� RECE D DAT/E fl EC V D [WE ISSUE Q ,.,
BUILDING a/S9 _. . S{4 , //-- �j 7 -47- /
ADDRESS _ /C�
A HE PERMIT NO.
OWNER .II. es .a . _ r ,,�L�-..1__.a A.P.NO. l.'�{(- (I, 'f/ (�c
MAIL c BUILDING I ' // 0 s 06
ADDRESS (-)42.4.1.. n ADDRESS (d)� lir �t�LC�L�J t
W . TEL. 9662 _ 3 7.1LOT 3q BLOCK
W W '/ TRACT /
o- U CITY a, I� / NO.
Z , NEW ADD ALTER REPAIR MOVING DEMO)ISH
Z < CONSTRUCTION RCT10N I�st' n
ON LENDER �'�`-4
o_ co
J D BRANCH
JCO n
OWNER ^ [/
CO -I ADDRESS '� � /���VALUE
J CO ARCHITECT TEL. USE $ /390
Q OR ENGINEER ,� NO
U Q FIRE
WCC ADDRESS r_ ZONE TYPE GROUP
0_ 41 /j)_ - APPROVED
JZ CONTRACTOR (S[.e(rJ[eA� — BY DATE
on
J cc ADDRESS
W WTEL
Z NO.OF USE OF NE
Ziage
F CITY NO. - !PLANS BUILDING
W 0 STATE CITY YARDS APPROVED YARDS APPROVED
U¢ LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
IgA /' NO.OF BLOCS. (FROM C/L STREET) CIO
/
OF LOT}F�F7{72tX 9 I NOW ON LOT / FRONT FT. CYO FT.( /[_/
USE OF
fff
EXISTING BLDG. _R SIDE FT. fT.
I- SIZE OF NO. OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. 0 FT.
a.1 EXTERIOR WALL ROOF
L
_ COVERING COVERING REAR FT. '��
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1
a MAIN BLOCS. ACCESS.BLDGS.
Q VAR.# DATE
O // / ,��/( C.U.P.# APPROVED // //_ Q
Ci)a (.f:'` `/ �Wt®L.l-W APPROVED l I /I .,t TE //r Y - CJ /
O
F- I hereby acknowledge that I have read this application and state
o
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
fA the State of California. m
Z I hereby certify that I am properly licensed as a contractor under SO. FT. „.co
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
am exempt from the provisions of the State of California Business
and Professions Code, Division 3,Chapter 9. VALUATION co
PERMIT FEE $ N
Signature of /J-(
Permittee �/Da' t• C $ /v ✓ PLAN CHECK $ E
�Ea-L. . 10-cwt
Authorized Agent ,` -- u.
u - TOTAL FEE $ ')
OWNER DflLMAN-BRUMNIELL ENTERPRISES DATE MAR 1 = 1453
JOB ADDRESS 1022 Vlaencia St. A thru D BUILDING PERMIT NO. 19007
GENERAL CONTRACTOR llmnn-Buell Enterprises VALUE $ 45,610.00
AP No. LOT 39 TRACT 3922 FIRE ZONE DESCRIPTION OF woRKb-plea Watt•ga
INSPECTIONS Signature DATE GROUP H&J TYPE V ZONE R-4
P H&S114
-V- PERMITS ISSUE.
Gas ?-a_ 1 SUBCONTRACTOR DATE NUMBER
Water ' " jr- ::
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating7-S-f,7 Y�,.,i _ __ r-.':! '� i"—
Rough Plumbing _ - •_ �.�ii'Sar ��K•,. / fid/ Cr,� ��
Miscellaneous /
Prop.Swr.Line 0 House Con. 0 St.Swr. ❑ dj.,/ 4 -f-C 3 /,../-y -.e OCT 8 19E3 401,61
Sprinkling System U
Construction Pole
Underground II. Power ❑ ( -1/tv_ _ _
Rough Wiri �' 7 -/_67 r424, �312Tf/63 r 93-5Z't-
'1`renches 0 Forms 0 Steel Remf. ❑ c IJ
Floor System }.27m .„%—...5--
S-�3
Bond Beam 0 Steel Reinforce 0 _ - //_—_ p
Sheathing _ r, �, G=r O ' 0C3 ---4Li7
Frame and Flashin ' �L 7 -73 " , 3 _ I.Y
Lathing — In Out �j�,�pjc�- �17 �-AG 3 `1�
Plaster, brown coat Av/'r a" 5-- 9� (� ----
Refrig. 0 Air Cond. ❑ Final
Heating, Final \ (� ��/3�;y
Plumbing Fixtures, Final . !3-�n��'T 11, pT , -421.--)2_101:4—_
Final Gas Test/5' at. p -%f� — — —
Electric Fixtures, Final 674 •Build (�
OCCUPANCY
CCi P Final � ���
OCCUPANCY
FORM BU4-5M - 7-61 1 QOM
I. 9007 F RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 8 1963
P.O.BOX 917 COSTA MESA.CALIFORNIA �, FINANCE DEPT.
For Applicant to Fill In Completely APPLIgI4.TIQ* TR1 Rai1IfA
TYPE OR PRINT BUILDING
.Udrvalencia bt. For Office Use Only
BUILDING ,/
ADDRESS .of TL a�.a 3922—,' C" ..C..
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA 1 On7
RECEIVED Y TER IV D DA (�
OWNER Dillman-Brummell Enterprises e"1 3 2
+ ^I^ 36r
MAIL
BUILDING
ADDRESS ]2081 Buaro ADDRESS
TEL
/
FIRE //
CITY Garden Grove NO.530-1160 ZONE TYPE GROUP
ARCHITECT TEL APPROVED DATE
OR ENGINEER Walters & Son Na.oR 3-6701
BY
ZONING
ADDRESS 436 Heliotrope, Corona del Mar
Z 'ti. NO.O UBE OFNSW/ ^ - '
CONTRACTOR Self / I PUNK I SUILOId OI P 4�(''/r.L.-
DEGAL 4B)- 39 t, 392-Z.
ADDRESS DESCRIPTION
A.P.NO.
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL TELSO•TO SIDE @ REAR P.L
LIC.NO. NO. �-
EAVES
SIZE72 1 x93 DG1 I NO.OF BLS. 0 ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/LSSTREET)
SETBACK LINE FROM 1 01511 5' FRONT 0FT. FT.
CENTER OF STREET V V REAR YARD
SIDE YARD I LEFT 10' RIGHT 51 R.SIDE 51T. FT.
DESCRIPTION OF WORK L.SIDE J 0 FT. Fr.
NEW X ALTERATION ADDITION REAR i�FT. + / �. FT.
DISTANCE BET. BET.MAIN @
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGS.
BUILDING VAR.* DATE
SIZE 441x57.51 ROOMS 28 STORIES 2 C.U.P.* APPROVED pp
EXTERIOR WALL ROOF APPROVi �g11y� , -,, '-Q� A �6
COVERING Stile CO I COVERING Shake BY fT'N"�'_` DATE J U
USE OF BUILDING AND WORK TO BE PERFORMED
11 ))nit f14•P11in GP}•!i_th att. GR-P 9N it
, 9-2,/ &Lin. A(/5/6 s% Cl
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE i
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. G
PLY WITH ALL CITY ORDINA.CES • 'ATE LAWS REGULATING VALUATION q
BUILDING CONSTRUCTIO N
PERMIT FEE 5�.34i Sb
AUTHOSIGNATRIZED
IZE AGENT �" �� D
m
PERMITTEE i 3/_/Q� - ..-' .. a5 O
S [!
AUTHORIZED TOTAL FEE a/S' S
S