HomeMy WebLinkAbout1028 VALENCIA ST - Building Permits CITY OF COSTA MESA
;r� ► BUILDING DIVISION _
FI DEVELOPMENY SERVICES DEPARTMENT -PERMIT NUMBER
t 1.1 411 PERMIT
Pam'* B04-00166
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1028 VALENCIA ST Status: ISSUED
Suite: Applied: 01/14/2004
Vicinity: Issued: 01/14/2004
Parcel Number: 14166412 Zoning:
Applicant: WALLY ZIGLAR ISSUED BY:
Address: 63 VIA PICO AV
STE 433 Phone: (949)366-6597
SAN CLEMENTE,CA Zip: 92672
Owner LE, DUC
Address 14 BUTLER ST
Phone:
IRVINE,CA Zip: 92612
Contractor: OZONE ROOFING
Address: 63 VIA PICO AV
STE 433 Phone: (949)366-6597
SAN CLEMENTE,kCA • r
Zip: 92672 t i License: 758431 t `
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXIST.SHAKE, INSTALL 7/16"OSB,30 LB FELT AND 30 YEAR COMP.SHINGLES. �
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $6,850.00
Permit: $139.25 Claim Valuation: $6,850.00
SMIP Res: $0.69
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.94
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under 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:
❑ I have and wih 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
�^'ork for which this permit is issued.
(have and will Intain workers'compensati insurance,as ired bysection 3700 of the Labor Code,for theperformance of the work for which this /
r� pe permit is Issued.
• My work ' p atlon trance cern d tic number re: 2
Carrier: r ]/� • Y Policy Number: / -7 J / 9/ -)"O 0 3
(This section need not be completed it th permit is valued at one hundred dollars($700)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califo ree that If I shguld become subject to the workers'compensation provisions of Section 37 of the L r Code,I shall forthwith
comply with theL ) nt / /4-- O
t/Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS' PEN ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed—��nd`'- ovi I s�/(CMpter 9(commencing with Section 7000)of Division 3 of the Business an rot io04�ode,and my license Is in full
force and effect.Lic.# l J J / Class#
J
Contractor's Signature: Date: / /)C 0 V
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil pehalty of not more than five hundred dollars(5500).):
❑ 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 properly 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,em 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 properly who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑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 S00 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❑Yes or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
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 ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑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.
/ , 3: ut::
atur Date
CODE f INSPECTION TYPE GAIE I :. cot*( INSPECTIONPATE INTmAta
1616 Fixed System Final Fire Prevention / 206 Final Mechanical
1266 Pool Spa Finalz� 208 Final Plumbing
200 Final Re-Roof !�/ /i 210 Final Electrical
201 Final Block/Retaining Wall V 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition - 250 Final Building/Occupancy
` CITY OF COSTA MESA -
4 W
@@ BUILDING DIVISION
f :r" r DEVELOPMENT SERVICES DEPARTMENT PERM NUMBER
Os Idarl in•
�� PERMIT
!'* ' ,s•' 01-01873
(714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1028 VALENCIA ST Status: ISSUED
Suite: Applied: 11/28/2001
Vicinity: Issued: 11/28/2001
Parcel Number: 14166412 Zoning: C
•
Applicant: PETER TAYLOR ISSUED BY: T
Address:
Phone: 714-883-5432
Zip:
Owner: LE, DUC
Address 14 BUTLER ST
Phone:
•
IRVINE,CA Zip: 92612
Contractor: PETER TAYLOR
Address: 2480 IRVINE BL#147
Phone: 714-883-5432
TUSTIN,CA
Zip: 92782 License: 643624
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REPAIR 8FT DAMGES BEDROOM WALL INCLUDING WINDOW,WINDOW TO COMPLY WITH ESCAPE REQUIREMENTS.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $2,200.00
Permit: $83.25 Claim Valuation: $2,200.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244616(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: ` Policy Number: 8
(This section need not be completed if the permit 1s valued at one hundred dollars($f 00)or less.)
I certify that in the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of 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 provisions. /p`� ✓
Applicant Signature: 4! I ��r� 'YVU Date: 7 ( I At
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERA IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RIVES UP TO ONE HUNDRED
THOUSAND DOLLARS(5100.000),IN ADDITION TO THE COST OF COUPE SATION,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 provisions of Chapter 9(commencing with Secti '7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.a 6149 g6 2Li Class# //{/C�
Contractor's Signature: o i— / = 1cr—r Date: 1l , /tel
I
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5.Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a perrr4'
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No 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:
El I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code),
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date: _
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
materiel? ❑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 end 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 Califomia 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 Quality Management District or from any other air pollution control district or agency? L1 Yes LI No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑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 slate 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.
Signature Of Legal Owner(s) / / Date
C ( 1r7$/P7
( And/Or Autho ed Applicant Date
CODE 6 INSPECTION TYPE DdIE INTRIALE CODER INSPECTIONrySjggjJlNTEE PATE ILLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
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 o
204 Final Demolition 250 Final Building/Occupancy Z / 0
City of Costa Mesa
Building Safety Department CERTIFICATE OF OCCUPANCY N? 1985 C
P. 0. Box 317
Costa Mesa, California
The Building located at 1028 9aletcia Street, A, B: C & D
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group ff Pn .T Occupancy.
Use of Building Yogrplex Residents atth Attached Garage
Legal Description Lot 19, Tract 1022
(See reverse side for Metes and Bounds)
Building Permit No. 19106 Electrical Permit No. 19555 _ Plumbing Permit No. 42948
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-Brwnell Enterprises by - gyiegyeL._/„.„
Date ittay 1� 199
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 (el U.B.C. Form sus+-1M-11-e3--$-B r
OWNER DILLIMN-BRU1MELL ENTERPRISES DATE MAR 1 2 1963
JOB ADDRESS 1028 Vplencia St.. A thru D BUILDING PERMIT NO. 1900& C'
GENERAL CONTRACTOR '_Dj l lmnn_J urmsval 1 Faterprise8 VALUE S 45,610,00
AP No. LOT 38 TRACT 3922 FIRE ZONE DESCRIPTION OF WORKy._p1ex Watt.ge:
INSPECTIONS Signature DATE GROUP H&J TYPE V ZONE R_4
Gas _S PERMITS ISSUED
Gas 7_$ L SUBCONTRACTORPERMITS
NUMBER
W'rkf/J Refrig. !_ /72
F i Corn. efrig. " Air Cond. ❑ i 2 n f
�.7/
Rough Heating y��1/z�N� v3-_ ee'w t. "13 .d.:,20
Rough Plumbing ii new n'illAre %' v. _ -- .e i
Miscellaneous
Prop.Swr.Line❑ House Con. 0 St.Swr. 0 p>Y /i_yam a_ tc/.r-a i..._ oCi-8_196 S
1017011
Sprinkling System
Construction Pole _ d
Undergrounds Power ❑ %/•. • '�/-6? I
Rough Wiring /T6 -1 -[ _±.. 4. i, _ _ __ - _ ` -J
Trenches ❑ 'orms ❑ Steel 'emf. ❑ S c - LCL _3
Floor System c -I-'I, a
Bond Beam 0 Steel Reinforce 0 _�_ - - - -/- X03 -- .4
Sheathing .- a- C. - iv - - 3 I�Ll
Frame and Flashin n� '- -, • , 1411-
Lathing - In Out /G . I
Plaster, brown coat )97 a -r9 C
Refrig. 0 Air Cond. 0 Final (�,,,
Heating, Final 3-/3- to
Plumbing Fixtures, Final J t f 1 S__ U ? - y' �B
Ir&i Gas Test j.5r {q br
L.:�;'.lI is Fixtures, Final '�i iiii .S
-Cy
Building, Final
OCCUPANCY
��
MRM 411111.5M - 7.61 1(lrinft
.. � �Q�� FEE PC.0 IIXFD
sOSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE
For Applicant to Fill In Completely APPLICA9ITON`FR'PERA1rr
TYPE OR PRINT • BUILDING
1323 Valeucia 3U LL.t For Office Use Only
BUILDING
ADDRESS , 't'.'- RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA ��((''''�f�f��((��RR//''����
RECEIVEDppV DATHREC IVSD DAfkSBUEPJ
OWNER Dillman-Brummell Enterprises /G- 3- 63 /Ann , . ,_
BUILDING "' IJO.�
ADDRESS 12081 Buaro MAIL
ADDRESS
EL. FIRE
T /�/
CITY Garden Grove TE 530-1160 ZONE TYPE ' GROUP
ARCHITECT Walters & Son TELOR 3-6700 B'PROVED DATE
OR ENGINEER NO.
ADDRESS 436 Heliotrope, Corona del Mar ZO /ZONING 1
N `/L N .PLANHO ,.,L OFCc�\� I USE OF NEW I/
CONTRACTOR Self
�-` I Bu1LDINa{il �
DEO�- (3.8 "r. 39 2 X-
ADDRESB �- D88CCRIALRION 2 )
CITY -- A.P.NO.
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE ,-- TEL. 90'TO SIDE @ REAR P.L.
LIC.NO. NO. ,_-- -
SIZE 721x931 I NO.OF SLOGS. 0 AL OWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED
USE OF ,-. MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROMC QqLSTJET)
CENTER
SETBACKOF LI HESTREET V FROM 1.01[lD REAR YARD I FRONTV(.S FT. FT.
51 101 R.SIDE 10
SIDE YARD LEFT RIGHT
DESCRIPTION OF WORK L.SIDE S....CT Fr.
NEW X ALTERATION ADDITION REAR {S FT FT.
DISTANCE BET. ET.MAIN Q
MAIN BLDGS. ACCESS.BLDGS.
REPAIR MOVING DEMOLISH
BUILDING Cq C NO.OF VAR.S 11 DATE
SIZE 441X// . )1 ROOMS 28 STORIES 2 _ C.U.P.# APPROVED
EXTERIOR WALL I ROOF APPROVE 1 ,, . , I 2
COVERING 5tnrrn COVERINGShake BY ICI\ j�/(A/�/� DATE S✓ �� j
USE OF BUILDING AND WORK TO BE PERFORMED 1 ��I���///��V��V���•��- ��`/
4 unit dwal1inE with att.. o�
fl
pP gay $Q.Fr. nisb
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _
AND STATE THAT THE ABOVE IS CORR - AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDI JJ) • - ATB LAWS REGULATING VALUATION q
BUILDING CONSTRUCTION/ //.
SIGNATURE OP �" ----.......---;;;.r-----.....-
✓� PERMIT FEE $ /��6-0 m
PERMITTE �' ///�/ ' �i(�I/0
D- / m
$ A� ✓� PLAN GNECK $ e ;,Q cC 0
AUTHORIZED AGENT \ TOTAL FEE S /13/.7J N
• COSTA MESA u5LDIINc SAFETY DEPARTMENT CITY OF CuS�n MESA
P.O. BOX 1209 COSTA MESA, CALIFORNIA 92620 nnEEC
16 1965
For Applicant to Fill In Completely APIRLTION FOR PERM
TYPE OR PRINT �,�
eulLDlna D /' L lc . *
ADDRBSS Zp v Q4j/c/q RECEIPT NO. Ap U MIT��
COSTA MESA. CALIFORNIA 0LLJ•
^ RERE= Y DATE RCMP DA"'n417
OWNER ().0T ice 1\r,,4,. 9(4nA4s ( /A {fa /Z/ (�O/To�
BUILDING
MAIL _/�co 0 5S
ADDRESS CJ FIRE '�(-�
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ARCHITECT T� BYPROVED 1 F/(/( DATE ( !G 6�
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CONTRACTOR / r .Tl A { �/ V� -1 r1
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CITY C_�m A ale n A.P.NO. I q ! - 6 V-
��,�..ATE yy (� �/p�f g/ NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
LIC.NO. 2i 7J NQ S(O Z /�P L 90'TO SIDE a REAR R.
EAVES
OF LOT CI '- - R ) I NO.OP LDLOT Oe.
NOW ON ALLOWED (U.B.C.REQUIREMENT/
USE OP YARDSAPPROVH YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET) .\
SETRACR LINE FRON FRONT PT {M/� rr.
CENTER OF STREET REAR YARD 1 ,I
ol
SIDS MARDI LETT RIGHT - R.SIDE FT, l,_FTT2
DESCRIPTION OF WORK L.SIDE PT. 6SS
NEW _ ALTERATION _ ADDITION REAR PT. `1 PT. __
DISTANCE BET. a BET.MAIN a
REPAIR . MOVING DEMOLISH MAIN BLOCS. \1 ACCESS.BLOCS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL I ROOF APPROVED / 6
( I�--i6 - `
COVERING COVERING SY 1 p rDATE O l
USE OF BUILDING AND WORK TO BE PERFORMED W- {y
et" 1 3e -Deer o L✓4 t C w
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SG.PT.
I HERESY ACKNOWLEDGE TNAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C
AND STATE THAT TIE ABOVE.IS CORRECT AND AGREE TO COS PURPOSE OP EZTASLISHINO A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AID STATE LAWS R[GYVNO VALUATION
BUILDING CONTI . PERMIT FEE SJ
SIGNATURE
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PHRMTTHF 5 ZOO PLAN CHECK f .
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AUTHORIZED AGENT TOTAL PEE S J
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vnvic,n U1tl11L1, 0AVJS1t AlIn LUAIY LAl'G 1.4—.1.0-02
JOB ADDRESS 1028 Valencia Street BUILDING PERMIT NO. 25012
kGENERAL CONTRACTOR R. C. Donatelly DESCRIPTION OF WORK Community Block Wall
N AP No. 11}1-664_12 LOT TRACT FIRE ZONE VALUE $ 200.00
NI
NI" `ECTIONS I Signature Date GROUP J TYPE III ZONE B-4
S PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
\, Water Plumbing
Jtough Plumbing
• Prop. Swr. Line ❑ House Con.0
tiSprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 ower
Rough Wil g Heating and Vent.
Trenches Forms 0 Steel Rein!. 0 e. /�Z 9/6 3
Floor System 7
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing—In ❑ Out O
Plaster, Brown Coat
SI—ictural, Final Electric
ng, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final tL k4f
3106-t
NOV —4-6 P9<Asa00 091 4*****5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
q D (� REC �/gV ��ER�CCEIV 4,11) VI
ADDRESSLDING
BUI / 0 2 5) VanC Qc.L a Jam'• ////�P[[ ////�J 66 /J// (7O/
PERI p
OWNER `i' tail _ 4 , A.P. NO. -. .i Ili•4
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BUILDING -
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ADDRESS ��L(•1..�-Q, ADDRESS f ural+$ bO
W W � RAJ[. �/ TEL. by TRACT S ^✓- LOT 3 3 BLOCK
I- U /te' l CITY "/N F�-� NO.ASN
Z Z Q CONSTRUCTION cn �7�Q
NEW ADD ALTER REPAIR (MOVING DEMOLISH
O LENDER
Ea_ co , /
J D BRANCH
J al JU ^ 4 [
a al OWNER N
ADDRESS
Ib J VALUE
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Q ARCHITECT TEL. USE (daze� $ /5e —
V) OR ENGINEER NO.
U Q FIRE
w 2 ADDRESS __ ZONE TYPEPGROUP �{///�
0- w q/��� APPROVED U
J Z CONTRACTOR .— & �/ • \_� L d,/ BY DATE
m Z
J cc ADDRESS t /
W fly
Z TEJ/ NO.OF USE OF NEW
Zr CITY __ NOL /lel' (PLANS .� /'BUILDING 'I /
W STATE CITY YARDS ED YARDS APPROVED
j O LIC. NO. .— LIC.NO. MAIN BUILDING _ ACCESSORY BUILDING
SIZE fl 3-
OF LOT t K '/31 NOW ON LOT I FRONT C/L STREET)
FT. 40 FT. ` L'
USE OF N !!
EXISTING BLDG. / - 'Yrs..,( R. /�SIDE FT. `SFT,
H' SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT.
U
ms
EXTERIOR WALL ROOF _
_ COVERING COVERING REAR FT. s.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
1
a MAIN BLOCS. ACCESS.BLDGS.
Q VAR.# DATE
A C.U.P.# ,s APPROVED
O 81 tt ' • tot t y waif RAPPROVED Lek DATE 'i/ e/{7
:41 .
VI heerre(b`yyy acknowledge that I have read this application and state v_/l/V ,
✓ that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
f" any person in violation of the workman's compensation laws of
tM the State of California. co
&
zI hereby certify that I am properly licensed as a contractor under SQ. FT. 6
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 PURPLE OF ESTABLISHING A PERMIT FEE ONLY:
Cr
am exempt from the provisions of the State of California Business
VALUATION ce
and Professions Code,Division 3,Chapter 9.
a° i N
PERMIT FEE $
D
Signature of //// �7/'/'//7 CO
Permittee /// aka? 9_ Steil
$ /�-/ `� PLAN CHECK $ E
S. o
u.
Authorized Agent TOTAL FEE $
''OWNER MOSELEY. D. E. DALE 11-4-69
JOB ADDRESS 1028 Valencia Street BUILDING PERMIT NO. 31064
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Com RIork Wal l
AP No. 1.41-664-12 LOT 38 TRACT 2992 FIRE ZONE VALUE $ 150_00
�II iCTIONS Signature Date GROUP J TYPE III ZONE R-4
SO,.- SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE❑ HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER O
ROUGH WIRING^ Heating and Vent.
TRENCHES Yum FORMS ❑ STEEL REINF. n , -L it-9(-t
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
Sr TURAL, FINAL • Electric
h IG, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL �t��
BUILDING, FINAL n-.21-ir