HomeMy WebLinkAbout250 15TH ST - Building Permits CITY OF COSTA MESA
togiltits q BUILDING DIVISION
f4 ,1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER: P10-00076
PERMIT TYPE PLUM STATUS: ISSUED
APN: 42516122 DATE ISSUED: 06/15/2010
ISSUED BY: BJZ
JOB ADDRESS: 250 E 15TH ST CM Suite/Unit:
Vicinity:
SCOPE OF WORK: REPLACE EXISTING WATER HEATER WITH ATAtVESS WATER HEATER.
OWNER: ZANDER, MARY LOUISE Address: 250 E 15TH STREET
PHONE: 949-650-0788 City/State/Zip: COSTA MESA,CA
APPLICANT: ZANDER,MARY LOUISE Address: 250 E 15TH STREET :
PHONE: 949-650-0788 City/State/zZip: COSTA MESA,CA
CONTRACTOR: OWNER-BUILDER License No. 000000
Address: PHONE:
City/State: ZipCode: CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CODE R. INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing (AI-lb b, /)(!ir9
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations:
Driver's License No. Expires: 'A
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry
(This section need not be completed thepermt is valued al one hundred dollars($100)or less.)
2,Art 2,Sec.341,Title 8,Califomia Administrative Code).
Policy Number:
...J ❑ As owner-builder, I will not employ anyone to do work which would
Lry.. I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California. and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
the.Laber�Code I sJ 'forthwith comply with these provisions. /
62//T/ � ' Industrial/ r.
Division of Safety Permit Number:
77
a�!pp r is SignaturenaOJafee HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# Class# (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
Contractor's Signature Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish. or repair any structure. prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
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 8. (If"'es", attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
��`,,,...CCC city ordinances regarding Hazardous Materials and Emissions.
yC1 I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
/LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professbns Code: The contractors License Law does not apply to an owner of Signature Dale
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors license Laws.). certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
insptcp urp es. I agree not to occupy or allow occupancy of any building
D authorize by it foal in ection. //1 /n
�--��
67.11 ,5/)*()
/ )Q /Signator I gal Owneds) Date
gn lure
3057-06(3/01) And/or Authorized Appbcant Date
r/ t
CITY OF COSTA MESA
> B'UILD'ING DIVISION
Ft`' �,,:Nl� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
. FOR INSPECTIONS CALL: (714)754-5626
%boom*^4. �
PERMIT NUMBER.• E07-00698
PERMIT TYPE ELEC STATUS: ISSUED
DATE ISSUED: 07/26/2007
- ISSUED BY: RMD
w H
JOB ADDRESS: 250E 15TH STCMry , S uite /Unit ,
Vicinity: REAR OF HOUSE
SCOPE OF WORK: UPGRADE SERVICE PANEL-TO 200A FOR SFD, SAME LOCATION(REAR OF HOUSE),
1 :
OWNER: ZANDER, MARY LOUISE r 'Address: P O BOX 2182 Unit: '
PHONE: 949-650-0788, {_ • ..City/State/Zip: CASPER,WY
APPLICANT: ZANDER, MARY LOUISE.' ' Address: . PO BOX 2182 Unit
PHONE: 949-650-0788 City/State/zZip: CASPER,WY •
CONTRACTOR: OWNER-BUILDER ' - - License No. 000000
Address: Unit: - PHONE: ; „_ - - .
City/State: . ZipCode: - CELL: -
ELECTRICAL PERMIT FEES - •
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00
Reinspection Fee $0;00 -
TOTAL FEES $54.00 •
.
•
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 andfinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. INSPECTION TYPE DAT INTITIA4 CODE( INSPECTION TYPE DATE INTITULS
1616 Fixed System Final Fire Prevention 206 Final Mechanical '
1266 Pool Spa Final 208 Final Plumbing _
200 Final Re-Roof - ' 210 Final Electrical f/4. slit 107
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
4
WORKERS'COMPENSATION DECLARATION: Owner ID verifieddbbydrriiv, nse. es 0 No \•
I hereby affirm under penalty of perjury one of the fonowing declarations: Driver s:License4 . / Expires: 4®/�8
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownersrshiprby(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed if the permits valued al one hundred dollars($100)Orion)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
c 3 l=certlfy=that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of Califomia, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date
the de I s II forthwith comply with these provis'ons.
/is �J/q/� •7 Division of Industrial Safety Permit Number:
pp Signalwe ' rlCo�18'l. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No
($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# Class# (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
Contractor's Signature Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work far which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the Califomia Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes',the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
O I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8 (If yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for •
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). inforrnation given above is correct. I agree to comply with all state laws and
r-- city ordinances regarding Hazardous Materials and Emissions.
_I,-as.ovmer: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 Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
)guy
u +• I agree not to occupy or allow occupancy of any building
autho y -.
until fi al inspection.
( %// a4 746/2,-7 _Signa •-or legal Ownens)-------.4... .c. le'^ _
r—Signa.re_-:i -.h ( Date_—. -
a05]<fi(3ro]) And/or Authonzed Applicant Date
JUL-SJ-2.008 12: 16P FROM:BRG LL 949 650 0788 TO:17147544956 ,P. 1
0
CITY OSTA MESA, BUILDING SAFETY L_ ..ISION
POST IN CONSPICUOUS PLACE ON THE JOB
NOTICE
Schedule inspection one workday in advance. To schedule inspections, call (714) 754-5626. Provide the following information:
1) Permit number, 2) Job address, 3) Inspection
item number.
io
Building Address: �5O `! . /CD al. 3t� • /p Owner:
Building Permit e: Electrical Permit LeQ� 9L2)OContractor:
Mechanical Permit a: Plumbing Perna e: Job Description �/ In )�
NEW ADD ALTS REPAIR MOVING DEMOLISH IaS7 olrTEc 07 g�C��L(x-(..rte- Yy��� IJ A-.
PERMITS EXPIRE 980 DAYS (6 MONTHS) FROM ISSUANCE OR LAST INSPECTION
CONSTRUCTION APPROVALS
Item i STRUCTURAL Date Inspector Items POOL&SPA Date Inspector
3 Job Site Consult 94 Pool&Equipment Location
4 Footings I Ufer Ground 96 T Steel Reinforcement
6 Slab 100 Electrical Bonding
B Structural Floor 102 Rough Plumb&Pressure Test
I1 Pre-Inspect Roof 104 Approval to Cover-Gunite
12 Roof Sheathing I Building Height 106 Elec Conduit-Underground
14 7-Bar Ceiling-Structural 108 Gas Pipe 1 Underground Test
16 Shear Panel 110 Backwash Lines, P-Trap,
18 Frame&Flashing Underground
20 Lathing&Siding 112 Approval to Deck
22 Insulation 116 Pool Plumbing System-Final
24 Drywall Nailing 118 Pool Electrical-Final
26 Plaster Brown Coat 122 Fencing/Access I Alarms Approval
30 Pre-Grout 124 Approval for Plastering
31 NPDES/BMP 126 Pool I Spa Systems-Final
33 Disabled Access
FIRE DEPARTMENT APPROVAL
1610 Overhd Hydro/Overhd Rough
1612 Dry Chemical
ELECTRICAL 1614 Dry Standpipe
36 Ufer Ground 1616 Final-Fixed System
38 Elec Conduit-Underground
44 Rough Elec-Wiring FINAL INSPECTIONS
46 Rough Elec.Conduit (Must be completed prior to requesting occupancy.)
48 Elec T-Bar Ceiling Call(714)754-5626 for the following: Data Inspector
$0 Elec Power Final/Meter Release 200 Final Re-Roof
SI Temp Power Final 201 Final Block/Retaining Wall
203 Final Sign
204 Final Demolition
206 Final Mechanical
PLUMBING&MECHANICAL 208 Final Plumbing r�
52 Soil Pipe-Underground 210 Final Electrical )_u_67 -
53 Shower Pan Call(714).327-7400 for the following:. Date Inspector
54 Water Pipe-Underground 212 I Final Fire Prevention
55 Underground Gas Call(714)754-5671 two(2)working days
62 Rough Plumbing prior to final. Date Engineer
63 Prewrap 216 I Final Public Svs. Dept.Approval
64 Rough Mechanical Call(714)754-5245 for the following: Date inspector
66 Rough-Factory Fireplace 220 I Final Planning Approval
68 Sewer System Call(714)7545626 for the following: Date Inspector
72 Gas Pipe-Rough 222 Final Site
90 Gas Pipe Test-Final 250 Final Building/Occupancy
92 Water Service-Final
NOTES: SEE REVERSE
0550-46 (rev.3/06)
•
ASIDRES30FBMLOIG: 250 E 15TH ST UMT: CITY OF COSTA MESA — BUILDING PERMIT
10FRLRS MAME IF I010AMN: ZANDER, MARY LOUISE PERM NO: B 076863
ADORES= P 0 BOX 2182
CASPER,WY 82602 PERMIT NO: B 076863 PLAN CHECK NO: N GOVT: N SUPP : N
AP PL.MAILING ADDRESS: CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO: JOB DESCRIPTION : T/OFF ROCK ROOF & REROOF W/SAME SQ FT: 2, 600
ARCH.OR ENG:5 ADDRESS: UHT:
CLAIM VALUE: 2, 600 . 00 CALC—VALUE: 2, 600 .00 GROUP OCC: R-3 /U-1
CONTRACTOR'S NAME: J.P. CONTRACTORS, INC. (714 ) 921-2370
OM
CRACTORSM/JUNG 2484 N. GLASSELL COMMENTS: X
ADDRESS: ORANGE CA uCNO.: 594913 *********AF+t**SE*** ****RF****** sFREsk+E****x*****RE****sic+ESF***rE*RESF*RF** *sE*x*sE*SE*+ESE****
92665 UMT: Z ONING REQUIREMENTS
UCENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code,.••.my license is in full force end affect.
C714-6C.NO.: LC.CLASS: C-39 LIG.NO.:e- :PC91 XP : MAIN BUILDING ACCESSORY BUILDING
Dlae: / 1i�r e 9C Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
NER BUILDER DECLARATION:I hereby affirm under penalty afCrN ' I am exempt from the Contractors License Law for the
following reason(Section 7031.5 Business and Professions Code' ny ch •. county which requires a permit to construct.alter,improve, PARKING REQ: P RO V: PARCEL: 42516122 Z N E: REF NO:
vnofeh,or repair any structure.poor to its issuance.abo ...res the applicant for such permit to file a signed statement that he or she PLANNING NOTES>
licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the
dusiness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section .>
7031.5 by any applicant for a permit subjects the applicant to a del penalty of not more than fee hundred dollarsf550o]). ***************r*r****************************************************************
❑ I.as owner o the property or my employees with wages as their sole compensation,will do the work,and the sinuture is not intended D E V E .Ta OPMENT SERVICES REQUIREMENTS
or offered for sale(Section 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 tense or herself or thrash he or her own employees,provided that such
improvements are not intended or offered for safe.If,however,the building or improvement is sold within one years completion,the ZONING .APPROVED BY •
. DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). a
❑ Las owner of the properly,am exclusively contradktg with licensed contractors to construct the project(Section 7044.Business end BUILDING APPROVED BY
Professions Coda:The Contractors License Law dies not es apply to an owner of propend who builds or improves thereon and who DATE:
contracts for such projects with a mntrador(s)licensed pursuant to the Contractors License Law). e •
❑ lemexempt under Section: B.APc.,for this reason: APPLICATION ISSUED BY: DATE:
********************************** * **************************** • **
Date: Owner LEGALIZATION:'N F E E SUMMARY STRUCTURAL SEGMENT:Y
1 do hereby certify that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534,end that la any future building occupant will/will nol(circle one)need lo complywith said nate codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
permit for construction or modification from the A' ueWananagement District Rmidenne construction appicalbm are exempt from these
provisons. PERMIT 54 . 00 . 50
Date: Applicant: PLAN SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE
o Ihave and wilmaintain acen nsleoconsent tosell-insure for workers'compensation,as provided for bySection 3700of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code. md
pmaegewakf«wghthspembssaed. TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00
I have end wit maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work fa whit,this permit is issued.My woken compensation insurance carrier endicy number are
Career CA COMP INS COAEXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: .00
Policy Number: NWC.31854 /—U1 07/22/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
,This section need nor be completed r the permf is for one hundred dollars f4100)Of leas.) 54 . 00 . 50
• fy that in the performance of the work for which this permit is issued. - I not empl any person in any manner so as to
• one subject to the warners' oft. lawsofCalifornia, become mhjea mIca *******************************************************************************
• /ppeenmlFlnn provisionsofSection 3700 the Labor Code,I shall •'h corn provisions. I N D I V I D U A L F E E BREAKDOWN
•:: )—�/-`�y Applicant:
Warning:Failure to secure workers'compensation rover• a . la 4,,ands Il subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Mall fines up to one hundred thousand dollars($100.“•, add?,•n to the cost of compensation damages as provided ler In
Sectlon3706oimeL.aborCods,rmerest,andatrorgey a. SFR 2600 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 600 . 00
• CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which the permit is issued(Section 3097.Civ.C).
LENDER'S NAME: PROVIDE SMOKE DETECTORS
LENDER'S ADDRESS r:q'n7
I certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county ordinances ' _ - -- -
.f
and state laws relating to Wilde°wnmudion and hereby authorize representatives dlhb dlyto enter upon the above-mentioned property { > �`J �- F. -. - rr, r
for inspection purposes. I M P ROY ( � 1 v� t:,7 F . r'...• ,~
DATE
1:ii
Pant Name ��
i / i Date, /—
V Signature of OvmerrAgentrAPpican
(5151:1 .WP) Whim-Building&Safely:Green--e:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POG SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
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 i
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
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 • 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final �((
16. Rough Electric Wiring 67. Fencing & Access Approval 11
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 9 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 ❑Oil
25. Roof Sheathing 4191/ 74, Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing&Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL p
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION •
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
{
34. Final Heating & Air Conditioning - 1
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
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
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -
48. FINAL PLANNING •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
•
ADDRESS Of MALCOM 226 E 15TH ST Inn CITY OF COSTA MESA — BUILDING PERMIT
0%n1ERSNAMEIFKIa,IW YAO, GEORGE PERM NO: B 079169
ADMIEs9: 1906 TURPENTINE RD
15 WHITE CAP DR PERMIT NO: B 079169 PLAN CHECK NO: N GOVT: N SUPP : N
TITUSVILLE, FLA 32750 407-383-0706
APPL.MAIADIO ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH
ARCHITECT ORENmlEER: LK.NO.: JOB DESCRIPTION : T/ OFF SHAKES INSTALL CLAYLITE TILE SQ FT: 2, 723
ARtlI.OR EWA ADDRESS: WET:
CLAIM VALUE: 2, 723 . 00 CALC—VALUE: 2,723 .00 GROUP OCC: R-3 /
CONTRACTOR'SNAIF:
CONTRACTORS MUMS COMMENTS : ICBG REPORT # 3523 LIGHT WEIGHT TILE5 . 95 LB /SQ FT
ADDRESS Lit.NO.: SE IE iE iE 3E iE IE 3E ff-0(-�E 3E fE dE*1E iE 1E 1E lE 1E lE K-iF irk iF 1E fit lit if iE IE IE*lE 1E 3E 1k lE*fE i(-1f iE 3E)E IE iE if dL-1E*fE iE*3F lF fb iE iE 3E 7E ff fE iF if iE 3f�E aE if iE if*3f dE 3E lk dE
MT: ZONING R EQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACK S
(commencing wlh Section 7000)of Division 3 d the Business and Professions Code,end my licensee is in full force and effect.
CITY LIC.NO.: LIC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dale: Contractor. LEFT : FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
'WNER BUILDER DECLARATION:I hereby affirm under penaly of perjury that I am exempt from the Contractors License Law for the
liming reason(Section 7031.5 Business and Professions Code:Any airy or county which requires a permit to construct,aver,improve, PARKING REQ: P RO V: PARCEL : 42533106 Z N E: REF NO:
.amdbh,or repair any structure,prim to its issuance.also requires the applicant for such permit to file a signed statement Nal he«she PLANNING NOTES>
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Sadiron 7000)of Derision 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permit subjects the applicant to a coil penalty of not more than live hundred dollars 185001). ***3+********IE#******IE*IE3****1f**lf*3*3*3E3*1E***********IEIE**********14116*iE******iE***
❑ I.as owner of the properly or my employees with wages as their sole compensation,will do the work.end the structure is not intended D EV EL OPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply loan ownerd properly
who beide or improves thereon,and who does such work himself or hersel«through his Cl her own employees.provided that such
improvements are not intended or offered for sale.O,however,the building or improvement b sold within one year of completion,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale),
[] I,as owner d the properly,amexclusively contracting with licensed contractors to constant the projed(Sedi«t 7044.Business end BUILDING APPROVED BY : DATE:
Professions Code:The Contractors License Law does rat apply to an owner of properly who builds or improves thereon and who
contracts for suds projects with a c rdraao.(s)licensed purs the Cont ors License Law). AM
7�
O Iam amp(under Section: B.BP.C..' `� (�L� APPLICATION ISSUED BY: DATE: —2.6- 9�jj
(�\J ***************************************%*3+*****9+3+36 ' *************** ******* -***
Omit: ac� ilfoo ow. LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: Y
I do hereby un' I ant aware d and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534.and that l or anyhsure building occupantwill/wit not one)need to comply wihsaid Mae codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a prank for commotion or codification boon the Al says vsp«mn marid.Residential contortion appfrtlions are exempt from these
PERMIT 74 . 75 . 50
provisions. •
SMIP/NON—RES
Date: Mpt's"` PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty el perjury one or Me following declemons: ISSUE FEE
❑ I have end W./maintain a certificate of consent to self-inme for workers'compereatko,as provided for by Section 3700 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for"°°°"«m'"°dN°"°"for which this°«m°"issued. TOTALS----> 75 . 25 0 . 00 0 . 00 75. 25 75 . 25 . 00
❑ I have and wit maintain workers'woke 'compensation es required by Section 3700 of the Labor Code,for the performance of the
work for which this permit b
rmissued.Myw« n
le 'c«npalstlbn insurance mhed
rreplu
ploy number we: REVENUE DIVISION TOTALS--> COLLECTED: 75 . 25 OVER/SHORT: . 00
Carrier
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
}u
(This section need not be completcompletedI de penny a for«1e hundred dollars Manor Ns.) 7 4 . 7 5 . 50
I certify that in the performance of the work for which this permit is Sued.I shall not employ any person in any manner so as to
become subject to the workers'compensation laws of and agree tha il I should become=hied to the workers' *****************************************************************36363+*******3+*36*
compensation provisions d Section 3700 of the Labor Code.I•... ,Mit. "•n.. , Nose proclaims. INDIVIDUAL F E E BREAKDOWN
aC Dam: (�.4 az 1 i t to ApWnanl: to a r e
Warning:FsllukJ to secure workers'rompensadoncoverage Isunlawful,and shall subject anemployertoahrlyWpenalNuand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($104000).In addition to the eon of compensation dames as provided for In
Section3706 of the Labor Cade,lnterest,and artomsys less. SFR 2723 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 723 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the wok for which this peri is issued(Section 3097.Civ,C).
LENDER'S NAME EX
LENDER'S ADDRESS: {„ Y ID 11 t.1J
�
I certify that I haveand read this application slate that the above information is correct.I agree to comply with all city end county ordinances
and stale laws relating to building°easeuaian and hereby authorize representatives of this city to enter upon the above-mentioned property
1--' i' ('�.
for inspection purposes. BRIAN HARMON DATE �-If '
JPrint Name C I
Signature -O Agent/Appkra VContraa«
DDate: �V'Q )4:1 `�
M
(5151da.WP) White-Suildig 8 Safely Green-Rb:Carry-Appicant:Pink-Revenue;Goldenrod-As LS
Pr
CONSTRUCTION AND PLANNING P .& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location :
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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE •
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. f , 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System . ! 61. APPROVAL TO DECK '' '
11. Property Sewer Line & House Connection -62. Backwash & Receptor•Firtal 1
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 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 74, Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL r •
A
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED d
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
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
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
ADDRESS OF BSLaNG: 250 E 15TH ST Ude: - CITY OF COSTA MESA — BUILDING PERMIT
amlEnsfaMEIPalaw ZANDER, MARY LOUISE PERM NO: B 07686_2
ADDRESS: P 0 BOX 2182
CASPER,WY 82602 PERMIT NO: 8 076863 PLAN CHECK NO: N GOVT: N SUPP: N
•
APPL.MuuNO ADDRESS: CONSTRUCTION TYPE: 5—N PERMIT TYPE: SIR PURPOSE: OTH
ARCHITECT ORENONEER: UC ND.: JOB DESCRIPTION : T/OFF ROCK ROOF & REROOF W/SAME SQ FT: 2, 600
ARCH.OR ENG.'S ADDRESS: UNIT:
CLAIM VALUE: 2, 600 .00 CALC—VALUE: 2, 600.00 GROUP OCC: R-3 /U-1
CONTRACTORS KANE: J.P. CONTRACTORS INC. ( 714 )921-2370
COIRRACTORSMMUNG 2484 N. GLASS ELL COMMENTS: X
ADORES& ORANGE CA uc.No.: 5'94913 ** ***#*********###**#**#*#*#************#*#***##*#**#**#***#**#*#**##**#**#*#*
92665 DMT, ZONING R E. Q U I R E M E N T S
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury thi'I m licensed under provisions of Chapter 9 Jr' E T B A C K p!3'
(ca endrtg with Section 7000)of Division 3 of the Business and Professions Coda and,my license is in II force and efled. •
C .NO.: uc.cuss: C-39 uC.NO.: 5 ' . 91 XP: MAIN BUILDING ACCESSORY BUILDING
y ` FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
. oats: / Contractor: / LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty o1,6enjury1hal lI em exempt from the Contractors License Law for the
lowing reason(Section 7031.5 Business and Professions Cmg.Any clay a county which requires a permit to construct,alter,improve, PARKING REQ: PROV: PARCEL: 42516122 Z NE: REF NO:
molsh,or repair any structure,prior to its issuance.ebo geniires the applicant for such genii file a signed statement that he or she PLANNING NOTES>
.licensed pursuant to the provisions of.the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the '
Business end Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section > '
w 7031.5 by any applicant for a permit subjects the applicant to aavil penalty 145
of not more then lee hundred dollars 0011. #######################*#RE*********#***#******#*#***{6************#********#**#*
o I,as owner of the property or my employees with wages as then sole compensation.will do the work,and the sticture a not intended D EVELOPMENT SERVICES REQUIREMENTS
• or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of properly
who bolds or improves thereon,and wino does such work himself or herself or through his or her own employees,provided that such
improvements are not intendeda offered for sate.5.however.iM building aimprovement sedtl within one year of completion,the •ZONING APPROVED BY .•
DATE:
owmrbuider writ have the burden of proving he or she did not build or improve for the purpose of sale).
0 I.as owner of the property,em esMsivey contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE:
Professions Code:The Contractors License Law does not apply to an owner ol property who builds or improves thereon and who
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law) ^M -
•
********************************** **************************** • '
❑ lamexempt under Section: B.AP.C.,for this reseal: APPLICATION ISSUED BY: � DATE:
**
Dat` eft LEGALIZATION:N FEE SUMMARY M M A R Y STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware of end understand the requirements of California Health end Safety Code Sepias 25505 25533,end
25534.and duet la any future building oxopant will/veil nor(circle one)needto complywih said state codes and the requirements ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modification horn the Ai s l6 anagement District.Residential M
cwtuction appiwliaeic sexempt from Nese
provisions. PERMIT 54 . 00 . 50
Dale: Applicant: PLAN :MIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of penury one of the following dedastions: ISSUE FEE
❑ I have ind wil maintain a cartificide 01 consent to self-insure for workers'compensation.as provided for by Section 3700ofteLabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the performance d
orencelne work for which this permit is issued. TOTALS----> 54 . 50 0 .00 0 .00 . 54 . 50 54 . 50 . 00
rQ I have and soil maintain woken'compensation insurance,as required by Section 3700 of the Labor Code,lor the performance of the
work la wnkN this
remits issued.My wales' umber we:
l caner: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: .00
1 PorcyNumber: NWl_iitf4 (—V1 07/22/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need nor be completed 1 rhe permits ler one hundred dollars 1$10010I less) 54 .00 . 50 "`—
❑l• niy that in 9u performance ot the work for which this pemtt is iseuedvl I not am person in any manner so Its 10 •
wblect to vithe workers'Scompensation 3oofaC CeManla,endp NmJ�� *****#**####****iE##*****###****#*##*#*iF#***######*##1r#*####**#***#**#####*#*###
penestin provisions of Section 3700 d the Labor Code,I shill loon whim provisions. INDIVIDUAL F E E BREAKDOWN
ate: 1—a,/—1>C Z-
Applioant:_
Warning:Fegure a secure workers'compwusdon covfragi Ildln/a I,and. subject an employer to criminal penalties and TYPE QTY D E S C R I P. T I O N UNIT COST TOTAL COST
civil Anes up to one hundred thousand dollars(S100,0W)addl n to the cost of compensation,danuges as provided ler In
' Secdon3706ofMeLaborCod,Intxutandatmm'.ea. --, SFR 2600 ' REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 600 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for whit's this permit is issued(Section 3097.Civ.C).
LENDER'S NAME:PROVIDE SMOKE DETECTORS
LENDER'S ADDRESS:p- - '
I certify that I have read this application and male that the above information is correct.I agree to comply with all sty and county ordinances 01 00202898-00202899
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the abae-memionsd property TOT 54.50
for inspectionpurposes. - M P ROY DATES 03/21/95 TIRE: 14:05
Print Name
Date:? 7 C
/ Signature of OwserlAgenVAPWicanVContredyi
(5151-46.WP) Whne-Buildup K Safety:GreenCCan�ary-APPEcant:Pink-Revenue:Goldenrod-Assessor s.
OWNER MCKINLAY, WILLIAM DATE 12-8-58
JOB ADDRESS 250 Oast 15th St. BUILDING PERMIT NO. 8133
GENERAL CONTRACTOR Owner-Builder VALUE $ 150.00
AP. No.117-18 * TRACT FIRE ZONE DESCRIPTION OF WORK Enclose carport for gar.
GROUP I TYPE .V ZONE Rif PLAN NO. 81331
INSPECTIONS DATE PERMITS ISSUED
< SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel by( r
Floor System / r
Steel Reinforce Chimney Re-Rod
Bond Beam '� ///// .
Frame and Flashing 1 0.51/ l/ /-�$j-Ty
Lathing, In Out U y�rf._11. - I /-//G/-it
Plaster, brown coat '/ > aa%L. //2(e/.r9f
Underground soil WIG Pipe Test •
Top Out
Furnace
Gas Vents
Rough Plumbing _
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final •
Plumbing Fixtures, Final •
-
Final Gas Test
Construction Pole -_"
Underground Power
Rough Wiring ,
O Final ,1- t
OCCUPANCY
Form 210.-5M-1-57 / / / h133
8 33 APPRC` ED
CITY OF COSTA MESA .
COSTA MESA BUILDING,•QDEPARTMENTI E PLANNING DEPT.
P.O.BOX 31 p �` ., iii6 V >, SUBJECT TO BLDG. DEPT. REG.
COSTA MESA. CALIFORNIA (9 -S-DcO` •iW� n pIp _
9 'S
7
FOR APPLICANT TO Ff UK. '- , I ONDuo#2E$M1-
ADDREIN 2.5o . E. /5< Stein Of COSTA C.E a PLAN MOLD I .
/�� COSTA MESA. CALIFORNIA, FOR OFFICE USE ONLY
SVV 14— I—I AN M L' F`� I N RECEIPT NO. �P13 j
OWNER I, I N .-� L (� VV
G� RECEIVED BY DATE RECEIVED )2 DATE ISSUEDED
MAIL
ADDRESS a.5 0 r E, is/( Si.. r7(/L /.2- f -SF/ _2-Ca-
CITY
a-
CITY (JOSr/A rel CSIN . TNEO:Ll-8-Saab? ADDRESS '
ARCHITECT t\1 N E. LIC.
NO.
OR ENGINEER �F COSTA MESA, CALIFORNIA
FIRE
ADDRESS ZONE
CITY LIC. ZONE �/ PLANS TYPE / GROUP /
CONTRACTOR OWNER NO. / (((- -rr/,/
25Th • E. I J JI-• TEL. /.7 ?tag APPROVED// ( J
ADDRESS NO. BV K�� / DATE/7i �/�
LEGAL LOT CORRECTIONS
DESCRIPTION NO. BLOCK TRACT ,�// I
J
A.P.NO. l( 7_ / l s..1 - LTG JL-CL-t . / .'
•
•
SIZE 3S n, I2:.� NO.OF BLOCS. / ��- ��/ ��/ /
OF LOT , NOW ON LOT I&_ .� 2
USEOF 0v4r_ c_ L /
EXISTING BLDG. I � `YG , i / � B � _ - ��
SETBACK LINE FROM /`� I
CENTER OF STREET EJ/ REAR YARD / A' /- i '
F �
SIDE YARD RIGHT S'" LEFT F �v/6 / / / ea I
DESCRIPTION OF
///WI��/ORK /
y / _ /' • r
NEW ALTERATION I ADDITION ' ''�. �_ / � -.coL
REPAIR MOVING I DEMOLISH , 1 �J/� /��I
SIZELDING/�K� ROOMS / STORIES / �^--�` 7�/L/�' /A
EXTERIOR WAL Rf� y�L, ,�,R1jOOF /1 C��`A
COVERING /Of/ OVERING GOn/lei, /��Y
BUELDINGEW'. / / �l�C��-G'SF `.."y
Fjr/S• LAIC CA I 70 C./ T /•••>AO r#/C> / /
.....--`,
< </S c S TGCs The mount shown under valuation is for the
I HER BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL purpose of establishing a permit fee only.
CITY ORDINANCES AND STATE LAW REGULATING BUILDIN CONSTRUC•
TION. VALUATION _
SIGNATURE OF 04,02 a ///9� c 6.—____"'" PERMIT FEE $ L 0
PERMITTEE -v�•E�+�u^� LLL `-c"�_ /5 TT
(• PLAN CHECK $ .IZcTL' .
AUTHORIZED AGENT . TOTAL FEE 5010 ` /