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HomeMy WebLinkAbout262 15TH ST - Building Permits PROJECT ADDRESS: 262 E 15TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 04970S OWNER'S NAME: ST JAMES LYNDA ADDRESS: 536 WESTMINSTER PERMIT NO: B 049709 PLAN CHECK NO: N GOVT: N SUPP: N NEWPORT BEACH,CA 92663 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD t 646-3565 . ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ' : REROOF 1200SF W/COMPOSITION SHINGLES SQ FT: 3,000 ADDRESS:. UNIT: CLAIM VALUE: 3, 000 . 00 CALC—VALUE: 3, 000. 00 GROUP OCC: R-3 / E PERMITTEE: LYNDA TAYLOR ST JAMES ( 714 )646-3565 ADDRESS: 262 E 15TH ST COMMENTS: X C.M. CA 92626 ********+E;Eye*;t+Est**************:E:r*******;Ear*St******;E+t**x*+E****nwmPx +t-mP • Tj � LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions 01 Chapter 9(commencing with Section Z ONING R E Q U I R E M E N T S e�6VB'U V ' v R 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS O-� CURED CITY LIC,: STATE LIC.: CLASS: Il4 Date: Signature, MAIN BUILDING ACCESSORY BUIIJ+D^ N WORKERS'COMPENSATION DECLARATION: Ihereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT ' IN _Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CI. LEFT: FT IN RGHT: FT IN LEFT: r_ FT IN RGHT: k FT IN • OLICY NO.: EXP.DATE: r COMPANY: PARKING REQ: PROV: PARCEL: 42516103 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> . .• .. i'i > Date: Applicant: ******************************************************************************iE EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E'"M E N T S . _ I certify that in the performance of the work to which this permi slued.I shall not rynploy any person in any mner so as to become subject to the Workers'Compensation Laws of California. // ,/ // /� ( �^ ZONING APPROVED BY DATE Date:Ora-so j/`to_ Signature: ^/�///GL�C1d/"/L/ aM— �A/ice/-./•'E'�,.,,,.•x' NOTICE:If.after making this declaration,you should beci lne subject to the Workers'Compensation pro ons of the Labor BUILDING APPROVED BY : • DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• l/ �ra/Ix�` DATE: I{O---30-1 which this permit is issued(Section 3097.Civ.C). ****************************************ie *1F1! * ******************�¢*** ******"* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N ' F E E S U M MAR Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 , 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 70315 by PLAN any applicant for a permit subjects the applicant to a civil penalty al not more than five hundred dollars(5501). ISSUE FEE . I, as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 7 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS----> 54 . 50 0, 00 0, 00 54 . 50 54 , 50 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through • + his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00 torptheepurrpose of sold one year of completion.Ih¢owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 , 50 FA and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law).l am aware ******************************************************************************* that drool of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 C. for thisreason: [� L / TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: def SO /9/L� Ownec /2 1� TYPE 3000 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 3, 000 . 00 I do hereby certify mat I am aware of and understand the requirements of California Health and Safety Code Se Ions 255 5533.and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a � permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ,ex__•y ,/r these provisions. �•_— . r • Date: A 'Coat I r I hereticithat haveread this appbngh and state that the above information is correct. agree to comply with all city and county > OCT 3 0 1990 ordinancess and state laws relating to building nstruction and he . y uthorize represe olives of this city to ente u ¢above-mentionetl • property forinspectioninspection purposes. G'/� —___._......`6,Y Date.fir"L L/_& ignaturu. L. Zia • ' k, JZ! 0 ( CRY OF COSTA MESA ,. A Driver's License or Social Security a: Old IV th �/ 1641.46 Wilde—Building:Green—Code EnlorcomenC Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONS.TFRUCTIISN AND PLANNING I c & 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 _ 31..E1ectrical Condu t.Utility-Undrgrnd. 54. Forms • • - '4:•Electrical Condult-Undrgrnd. • - 55. Electrical Bonding ' ' S.,.Sieel Reinforcement 56. Rough Plumbing & Pressure Test - *• :116.:EectricalUFER'Grnd. 57. APPROVAL TO COVER-GUNITE � ''4.:i-Footings 58. Electrical Conduit-Undrgrnd. $,;Foundation Pr,i 59. Gas Pipe, 0 Undrgrnd., Test ', -� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural FloottSystem 61. APPROVAL TO DECK - , 11. Property Sewer Line'& House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap CI) 63. Heater & Vent-Final - 13. Roof Drains c 64. Plumbing System - Final - . 14. Rough Plumbigg" it 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 Electrica"I-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT ' -- _ _ • _ L .. •_ 7 7' •.,` -wit-, ,i.: -, t-. CO 20:'Rough Factory FSreplace I X!r, 'C-i :+; 0 0 t7. . .• :'APPROVALS)rCPermit # rt 5- t" "r Y.a� y: .r t"'z -i. :1 X "ti:-i•-+ > 7 C lx 21:�DuCt's, in-Structu '� .,••t; 7'S :. V1 -3'- ._ '" S '7S tqq a- `1 - • rRs • ,-IS C ••-,1 ?. -:/0. l dergrotsd_Hypro , 22. Ducts, Ventilating;' � < Y _ •r S E ?' ':71. Prod uctZtii ng O•QJs OOOil -- 23.-Gas Pipe=Rough&•-fest Wx ` ' R' I ' ,.s i; w r _ _ _ 72. Underground Flusj. , 4'O • 24:.,Roof Framing i F I-• ••• 'n a ^> C � -i �7S.b-Undergrn& e�T Stora. a k::Gas�0Gil - •" 25. Roof Sheathing : ,..7. y ;a/iY 0 pt `'74=Overhead lliydro- A 26.7T-gr Ceiling (Structural) &•Monocoat W a C'y -s 75:try Chemical •''i x C • 27'--Frame and Flashing' we A. W --,Aq 76F.- Staniri'e CF i' S •r1 x W - - c.W x Cr >4 wA v' y J?.P .••r C 28. Lathing;& Siding tr: ';1.4 IX i % •• ei-••ss 77IaFIXEDSYSTEM!F:INAL2v ^i.i ?V• 29. Insulation n - S 1 I. x- 78--&FIRE PREY. FINAL F ac: r n30. Drywall-Nailing x y I I I* w HEALTH,DEPT.t-REQUIREMENT -:31. Plaster Brown Coat „. (fly . ) iz z, X79,"FINAL INSPECTION 4 C "" t�. x ` 32. ';80{rFOOD CERTIFICATE ISSUED ,Electr• t Power Meter;F•nal I t•E, r: ,V Lr tJ 33`FinelElectric i, I J' A. L� I I ' '` ti ' ' t? •=i $.- 'T7 i -* to < .: I :r , N0s: •- '1M - '7 C 0771 ,n :�. �. ,_H .1. r. r` r. T r'l. . 4. 1-1.3. t 34.,-Final Heating& A•i.Condit•on•r+g� n r ! I `. 11' tr4 S ;r;ti S1--c, oi '7 I (' v C n MS s. Cr SC to 35.-Final Ga's Pipe-Testy ;'k lea .••O CI- r. I-Ir 36.�Hood or`Cano `` > I r: nolrl • ' ' f °' LI' • 37'Final Factory Fireplace 1 t° N ,n I Ii • ir i S tri.. . ,; 5 , _ r9: # C z it r "38. Final Plumbing . .- • .. t " , IC 239. Water Service-'Final'. . 4 :f l x • vM O -40. Gas Service-Final •' I ••• .).1 `" .n - ! P' •f,tr'tr• S a i0 I I b' + C4. 41(03 ir -r 541. Solar Domestic-Finals •• > %U I f< * r:,'•' '7' r -. ,1. .. }. T .y - '42:-Backflow Preventer - 03 - '` -t **._'•-•-•� ' , 43. Backflow Irrigation `•S:: > x • F i C ••+ Lc a i r. 44. Landscape Irri,ation S stem-.- - • s ,}� - " Li `3 r P Q Y r` L;' A ,n - ..tet _ .r, _ N _ CC:: ' • G >45'_Sound Attenuation •'r•-' :r :' is tag .'Y t. a; I ~ - • ..-.. v ',I i•• Y-13 . C . ...0 :46.•Handicap Regulations Cc J • 47. FINAL STRUCTURE & BUILDING ( I i:.7- t 48.' FINAL PLANNING `r i 1 t-I X49)-49) to Edison i -, . r+ i:; i - j '50.,Gas Release to Southern Califoipia Gas Co ...44,,.; I I l` : , 7 _ • ot.31'o J • 51. CERTIFICA•TEOF:OCCUPANCY ';•o C, No. Date PROJECT ADDRESS: 262 E 15TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 048860 OWNER'S RIME: TAYLOR/ST . JAMES ADDRESS: SAME PERMIT NO: B 048860 PLAN CHECK NO: 04057-90 L GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD 646-3565 .- ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD TO SFD SQ FT: 1 , 280 ADDRESS: UNIT: • CI;AIM VALUE: 66, 606 . 00 CALC—VALUE: 66, 606 . 00 GROUP OCC : R-3 /M-1 PERMITTEE: TAYLOR— ST JAMES ( 714 ) 646-3565 ADDRESS: 262 E 15TH ST COMMENTS: CM CA 92627 ** ************;'ESE*************-*-*************TE*3****3e********3***amu******3ETE***%*sc UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect. SETBACK S Cm UC.: STATE UC.: CUSS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING FRNT : 23 FT IN REAR: 10 FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that)have a certificate of consent to self-insure or a certificate of Workers' LEFT : .5 T IN RGHT: 5 FT IN LEFT: FT IN RGHT : FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). qv MAY EXP.DATE: CertifiedPARKING REQ: 2 PROV: 2 PARCEL : 42516103 ZNE: R2 REF NO: DR9013 copy hereby furnished. ❑ Certified copy is with me dry Building DivHid,. .PLANNING NOTES> 860 SF ADDITION OF LIVING SPACE PLUS GARAGE TO AN EXISTING > SFR, CONCRETE DRIVE TO BE REMOVED, Date: Applicant: ******************************************************************************* EXEMPRON FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed K the permit is for one hundred(S100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permi ued,I shall t employ any person• an anner so as to become subject to a Workers'Compensation Laws of California. �J ZONING APPROVED BY DATE: O 9 0 9�D _, Date: `%'�' /n Signature:/ /2L2 .L�nt f •� La— BUILDING APPROVED BYDATE: NOTICE:It,after making this declaration,you should become subject to the W rkers'Corhpensatlon ns of the Labor :— Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. - _�� CA CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance o1 the work for APPLICATION ISSUED _� - — �� DATE : oC/ O 4e Q which this permit is issued(Section 3097,Civ.C). **********************'ic*3e x*3F—!a x***********************************'** LENDER: *******************************ale ***** :************************************** ADDRESS: LEGALIZATION:N F E E SJMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 491 . 00 4 66 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 319 . 15 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ISSUE FEE any applicant far a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 495 . 66 0 . 00 319 . 15 814 . 81 814 . 81 . 00 IIIstructure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS——> COLLECTED • 495 . 66 OVER/SHORT: 0 0 improvement sdvnthlnone year ofcompletion,the owner will have the burden olproving he/she did not build orimprove BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose ofof sale). 491 . 00 4 . 66 xv I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business Cy and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ******************************************************************************* and who contracts for such projects<sth a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensztion insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN ❑ I am exempt under Section: B.S P.C. for this reason: J, /n, TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: `7 ''J— qt.! Dwner:/�� 11 �(1a 172h SFR 860 DWE—TYPE V—WOOD FRAME —GOOD 69 . 00 59, 340 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 2 05,25533,and SFR 420 RES—GARAGES TYPE V 17 . 30 7, 266 . 00 25534 and that I or any future building occupant wiMvill not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. • Date: Applicant: • I hereby certify that I have read this application and state that tit: .bove information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and h•eby authorize reps sentatives of this city I . : upon the above-mentioned 'properly nfor inspection/` purposes.rp Date: / / 7 D • Signature: Sr : ! /��- .��' ���di Drivers License or Social Security x: I D 1 00068902-0006 8903 TOT r Cr.-CG DATE: 09/04/90 TINE 12:25 1641.46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING PSPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 2. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 7. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O 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 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 aid Flashing 76. Dry Standpipe 28. Lathing`& Siding lr 77. FIXED SYSTEM FINAL 29. Insulation .' - !• 78. FIRE PREY. FINAL 30. Drywall Nailing iI HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! •i• 79. FINAL INSPECTION 32. Electrical Power Meter-Final • r 80. FOOD CERTIFICATE ISSUED 33. Final Electric �- .r i Notes: 34. Final Heating & Air Conditioning r • ! 35. Final Gas Pipe-Test P /rrfi�lI A9 I Al 36. Hood or Canopy //�. �• !J-�IG t / "I oh 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 & BUILDING131gl 48. FINAL PLANNING 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date I • PROJECT ADDRESS: 262 E 15TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 049033 OWNER'S NAME: ST JAMES, LYNDA ADOfESs: 536 WESTMINSTER PERMIT NO: B 049033 PLAN CHECK NO: 05768-90 S GOVT: N SUPP : N NEWPORT BEACH,CA 92663 CONSTRUCTION TYPE : PERMIT TYPE: STR PURPOSE: ADD 646-3565 ARCH/ENGINEER: RUING.: JOB DESCRIPTION : ADD 51SF TO WORKSHOP _ AREA SQ FT: 51 ADDRESS: UNIT: CLAIM VALUE: 3, 519 . 00 CALC-VALUE: 3, 519 . 00 GROUP OCC : R-3 / PERMITTEE: LYNDA TAYLOR ST JAMES (714 ) 646-3565 ADDRESS: 262 E 15TH ST CA 92626 #**#****##• R*iFF*3Rd#iTt*##*****#*#i*t0#**34*34i*tB*II8**##34###34#34#########34######34#3434######3434 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMEN TS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: • Date: signature: MAIN BUILDING ACCESSORY BUILDING FRNT : 20 FT IN REAR: 6 FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' LEFT: 5 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). \ jou?No.: EXP.DATE: PARKING REQ: PROV: PARCEL: 42516103 ZNE: R2 REF NO: ';CeaNY: PLANNING NOTES> ADDING (REMODELING) CURRENT CONSTRUCTION WITH A TOTAL OF /Cenitied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. > 51 SF TO BE ADDED. ###################34###3434##34##34343434#343434#######3434##34343434##3434#cit###34343434######34#####34 Date Appgcant DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This On need not be completed if die permit is for e hundred($100)or less). I certify that in the performance of the work for sy4yy'hich this permit'. sued,I shall not ymploy any person in a so as to become ZONING APPROVED B Y SCC DATE: 4D subject to the Workers'Compensation Laws Catlture' ,� (/ S 4017 ,/ —1 Date: R-I 7 — 9D Signature' y/mow►/d7/ BUILDING APPROVED BY NOTICE:If,after making this declaration,you should bec e subject to the Worke 'Compens ion provi s of the Labor �j� I DATE Code,you must forthGh comply with such provisionsmthat or this permita shad deemed revoked. APPLICATION ISSUED B Y : -6 S 1 / DATE: —I 1 1 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for !!! i•-- whichthisDermilisissuedlSectlon3o97,Civ.C). #3434#34##3434##34#34#34##########################i. #3E xiCit#####34#343434##3434###3F3r rn-F###, # LENDER: ###################34####343434####3434343434343434####3434#3434#34##cit###3434#3434#3434##34343434#3434#34#### ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 63 . 00 50 repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 40 . 95 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant toacivil penalty of not more than five hundred dollars(SM. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, win do the wort, and the TOTALS----> 63 . 50 0 . 00 40 . 95 104 . 45 104 . 45 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 104 .45 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK for the purpose of soler 63 . 00 . 50 40 . 95 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Protesslons Code: The Cartractors'State License Law Oces not apDN to an owner of Dmperrywhobuddsorimproves thereon ***** F#########34########################################################3434#3434## and who contracts for such projects with a contractor(s)8cense pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN ❑ I am exempt under Section: 8.8 P.C. for this reason: / ' TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: / —/2 — 90 • / �... ... 4/4 4 43 i .;rx. 51 DWE-TYPE V-WOOD FRAME -GOOD 69 . 00 3, 519 . 00 I do hereby certify that I am aware of and understand the requirements of Cali ornia Health and Safety Code Sections 25505, i14 ,and END OF FEES 25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the require ,nts for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from } these provisions. r ..�„ ..t.-. /-� Data: Applicant: SEP 17 6 r, CI I hereby certify that I have read this application d state that the hove information is correct.I agree to comply with all city and county 1 990 I ordinances and state laws relating to building c simction and h authorize mores datives of this city to ant up eabove-mentioned , /� property f r inspection`tipurposes. 1 ` T Date: [ -Qfl signature: CITY OF COSTA MESA / Driver's License or Social Security A: �/ 1641-46 White—Building;Green—Code Enforcement;Canery—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING - / PO, .v SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ID Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK -.moi • 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 7 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 El Gas ❑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 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 33. Final Electric Notes: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test 0.61:11 N. 36. Hood or Canopy • . "�u+S[1t` L) q�' T-1 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 """ ��J 47. FINAL STRUCTURE & BUILDING t P/�V�/ re 48. U4 48. FINAL PLANNING 49. Electric Release to Edison • 50, Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date 6.1 F'TY OF COSTA MESA CALIFORNIA 92628.1200 P.O.BOX 120'.. Insulation Certificate • oV,a to a Number and Street City . 1 he, Subdivision Lot Number Description of Installation ROOF Material Brand Name Thickness(inches) Thermal Resistance(R-Value) EXTERIOR WALL Material Brand Name 'IAN Vi//L£ Thickness(inches) '3 YZ Thermal Resistance(R-Value) Z j I CEILING Batt or Blanket Type Brand Name M RN vi Thickness(inches) 6 key/ Thermal Resistance(R-Value) '—/ Loose Fill Type BrandName Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) FOUNDATION WALL Material • Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I herebycertify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. Z)CA-1A- 9 A-. I-15i 5� l • " -• frac uil License Number Amillit—serrt -or ignature and Title Date Sub-Contractor(Insulation Installer) License Number Signature and Title - Date r - • CER IFICATE OF OC[Y}[° CONFORMANCE HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the products identified below and on attached sheets Nos. are marked with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) and were manufactured in conformance with applicable provisions of American National Standard ANSI/AITC A190.1-1983, Structural Glued Laminated Timber, and that such manufacture has been at our plant in Drain, OR , which plant has a quality control system approved by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected periodically by such Bureau. The manufacture of these members complies with the manufacturing and fabricating provisions of Chapter 25 of the Uniform Building Code, All Coast Forest Products for Stock JOB NAME' Chino, CA JOB LOCATION PO#1261 6-15-90 7742-D CUSTOMER'S 0ORO FR NO -3U6S I 5tiODATE ,r i CALORDERII /]NO • -_ - 24F-V4, WP-Glue, -Ind App, -Indv Wrap, Arch App, `Indy.Wrap . - -t= _= _ SIGNATURE A.+l/ COMPANY - Larn TITLE Quality Control ADDRESS FOB 297, Drain, OR DATE 07-06-90 AITC HEREBY CERTIFIES that the said company at its said plant is licensed by the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect of products which comply with applicable provisions of said Standard, that the adequacy of the quality control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of AITC, said company is capable of complying with applicable manufacturing and testing provisions of said Standard in respect of products manufactured at said plant. Conformance with the Standard in respect of any specific or particular product is the sole responsibility of the manufacturer; AITC's guarantee hereunder being that the said company is qualified to produce a product meeting the said Standard and that its plant is periodically inspected and verified by the AITC Inspection Bureau. OF: TiBf. AITC Certificate Na 67187 A 111,1C� AMERICAN INSTITUTE OF TIMBER CONSTRUCTION • S A ( A.� CC ,� . 19/�JZtif7 0 1983 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION AITC FORM IBCA Vitt t- S6/18/90 MA NUMBERt 7742 D Pape I CUSTOMER t ALL COAST - INO snob C net ee WWW eer.CneCn a �"JOB NAME! Stock COST PO N t 1261 INSP t PITC C�,OCATIONS Chino CA COST JOBN : NOTE t CCC.-.CCCCCCCCCCCtCCCCeCCCCCCCCCC CCCCC CCCCC ••CCCCCCCCCCCCCCCLCCCCCCCCCCCCCCCCCCCCCCCC I - Radius r ice' -- - ---- 1 W ;\a - --- - --I Era Notes I Mark Oty Camber Dimensions Comb. I App. Wrap Sea I I I SB 1 6 0 3/4 5 1/8 x 12 x 30 - 0 24F-V4 I IND INDV EN / / I SB 2 6 1 3/8 5 1/8 x 12 x 40 - 0 24F-V4 I IND JNDV EN / / I SB 3 10 1 3/8 5 1/8 x 13 1/2' x 40 - 0 24F-V4 I IND INDV EN / / I SB 4 6 0 3/4 5 1/8 x 16 1/2 x 30 - 0 24F-V4 I IND INDV EN / SB 5 6 1 3/8 5 1/8 x 16 1/2 x 40 - 0 24F-V4 I IND INDV EN / / I SB 6 6 3 3 1/8 x 9 x 60 - 0 24F-V4 I ARCH INDV EN / / I SB 7 2 1 5/8 5 1/8 x 24 x 44 - 0 24F-V4 I ARCH INDV EN / / 4-- I SB 8 6 3 6 3/4 x 13 1/2 x 60 - 0 24F-V4 I ARCH INDV EN; r / / - - = I S8 9i 2 3 6 3/4-x -24 x 60 - 0 24F-V4 I ARCH INDV - =-ENI / / _ I SB10 2 2 3/8 6 3/4 x 27 x 54 - 0 24F-V4 I ARCH INDV ENI / / I SB11 2 3 8 3/4 x 9 x 60 - 0 24F-V4 I ARCH INDV ENI / / I SB12 4 3 8 3/4 x 12 x 60 - 0 24F-V4 I ARCH INDV ENI / / c F.p. . � ,, •�� �. k4 : eta ! � * APPROVAL 4 i This signifies our acceptance of these drawings as being applicable + * to all contract documents and released for manufacturing. 1 * CUSTOMER : DATE : + * + CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT Developer/Applicant : LyNDA r '1tOR -S � Es T 1 Address : 262 �.• 16T14 (51-; �79] Telephone Number : 01140 646- 8565 Tract/Parcel and Lot Number(s) : Location of Project : PJL3'1E • 5114 C-777 Number of Square Feet of 6, 0 Residential Space x $1 . 50 Total j a� 0 O, Number of Square Feet of Commercial and Industrial Space x $0 . 25 Total Commercial/Industrial Project is : (Check One) Mini-storage Motel Preschool Movie Theater Bank Auto Repair Racquet/Health Neighborhood Shops - Hospital Warehouses R & D Large Office Heavy Industrial Hntel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park - Fast Food The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be made payable to Newport-Mesa Unified School District . Business Manager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/ Applicant agrees that if it is later determined that such representa- tions are not true then this certificate shall automatically terminate and the appropriate City/County shal be notified . Date : �j 4 I v--no inn ,eak' D veloper App cant PROJECT ADDRESS: 262 E 15TH ST UNfT: CITY OF COSTA MESA - BUILDING PERMIT 'PERM NO: EMP 048862 OWNER'S'•^gME: TAYLOR/ST. JAMES ADDRESS: SAME PERMIT NO: EMP 048862 PLAN CHECK NO: N GOVT: N SUPP : N CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC PLU PURPOSE: ADD 646-3565 ,(ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : ADD TO SFD SQ FT: ADDRESS: UNIT: CLAIM VALUE: • CALL-VALUE: GROUP OCC : R-3 /M-1 PERMmEE: TAYLOR- ST JAMES (714 ) 646-3565 ADDRESS: 262 E 15TH ST COMMENTS: REF 848860 CM CA 92627 ##*#########*****N-#*#r#**-x#*#**##N-####Bt#Bt BE######**#-##*####Bt#####->f######**aE#*#### LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY UC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING Date: WORKERS'COMPENSATION DECLARATION: Iheature:reby affirm that)have acertifiwie of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or acerifiedcopy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN CY • DMPANYPANY:: EXPO .DATE: PARKING REQ: PROV: PARCEL : 42516103 ZNE: REF NO: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > . Date: Applicant: *****************#*********************aE'Sk-*******jE***************************ir;�t-* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed d the permt is for one hundred($100)or less). DEV EL OPMENT S E R •V I • C E S R E Q U I R E M E N T S I certify that in the performance of the work for which this perm issued,I shall n employ any person in wanner so as to become , subject too the Workers'Compensation Laws of California. p ZONING APPROVED BY - DATE: Date: "7 -7` 7O Signature: %7L'.LC/( 4,/ (�/1- ✓Y/2.C� BUILDING APPROVED BY ��J� DATE: NOTICE:If,after making this declaration,you shou be came subject to the Wo ers'Compensation visions of the Labor - Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ., JE+O�� CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for f•!�a LAN ISSUEDalio'. - DATE:0`•� which this permit is issued(Section 3097,Civ.C). WR*34*##YE ***********fi:*iF,r7Fic r, ,Ter *******+' ' ...c***********************3F******F*TGIF** LENDER: **4444)Fat*44#*#****44 : 4*4 04,44******> c*************************************** ADDRESS: LEGALIZATION:N F E E FUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTF IC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,after,improve,demolish,or PERMIT 10 ,00 4 1 25 9 . 00 repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25% 5 0% 2 51 SMIP/NON-RES • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis tar the alleged exemption.My violation of Section 7031.5 by ISSUE FEE3 . 00 1 S . 0 0 15 . 0 0 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, win do the work, and the TOTALS----> 60 . 25 33 . 00 0 . 00 93 . 25 93 . 25 . 00 7 structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/hersell or through his or her own employees,provided that such improvements are not intended or offered for sale.if,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 93 . 25 OVER/SHORT • , 00 Improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK for the purpose of sale). 13 . 00 56 . 25 24 . 00 12 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owneroi property who builds or improves thereon *********#******#*******************************4444**#**********************#* and who contracts for such projects qth a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN ❑ I am exempt under Section: B.A P.C. for t}his reason: / / ,.--.. rt TYPE QTY DESCRIPTIO N' UNIT COST TOTAL COST .-- Date: 4-/ _y tin Owner . 1 .L_ L.. G.-if ' Al di 1E 20 FIXTURES, LIGHTING 1 ST 20 EA, . 75 15 , 00 Ido hereby certify that)am aware of and understand the requirements of California Health and Safety ..-Sections 2 15533,and ELE 3 FIXTURES, LIGHTING ADDITIONAL EA. . 45 1 . 35 25n14 and that)or any future building occupantwilw))I not(cirde one)need to compfywith said state codes and the requirements for a ELE 20 RECEPT/OUTLET 1 ST 20 EA. . 75 15 . 00 permit for construction or modification from theAirAir Duality Management District.Residential construction applications are exempt from ELE 2 RECEP T/OUTLET ADDITIONAL EA. . 45 . 90 these Provisions. ELE 12 RECEPT/SWITCH 1 ST 20 EA. . 75 9 . 00 Date: Applicant: MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 9 . 00 9 . 00 I hereby certify that I have read this application and state that a a ove Information..correct.I agree to coop ly with an city and county PLU 1 BATHTUB 2 . 00 2 , 00 ordinances and state laws relating to building construction and ere authorize repre-• tatives of this city to eirr 0 the above-mentioned PLU 1 WASH BASIN (SET) 2 . 00 2 . 00 properly1 ins7 purposes. / PLU 1 WATER CLOSET (TOILET) 2 . 00 2 . 00 h-- . Date: ff) Slgnatur . / ��4.A ''Lit, •1111 • AVM/ PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 . 00 2 . 00 Driver's License or Social Security It: 01 00068904-00068906 TOT 9S.2. 1841-40 White-Building;Green-Code Enforcement;Canary-Applicant:Pink-Revenue;Goldenrod-Assessor DATE: 09/04/90 T1F(E: 12:26 GDNSTROCTION AND PLANNING f - - & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 11. Temporary Electrical Service or Pole / . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. gte.0/�Q ..61) 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 UF 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 1 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 Frafning 73. Undergrnd.Storage Tank 0 Gas 0 Oil '25. Roof Sheathing '. 74. Overhead Hydro u . 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 PREV. FINAL 30. Drywall Mailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ( 79. FINAL INSPECTION 32. Electrical Power Meter-Final ''� 80. FOOD CERTIFICATE ISSUED I. 33. Final Electric j 1 Notes: 34. Final Heating & Air Conditioning Week 6 0 �r 35. Final Gas Pipe-Test 7.ju4( 1Grro•• 36. Hood or Canopy ' t i,, 37. Final Factory Fireplace 38. Final Plumbing Want C4fl) 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final ph42. Backf low Preventer 43. Backflow Irrigation + 44. Landscape Irrigation System 45. Sound Attenuation -46. Handicap Regulations r : 47. FINAL STRUCTURE & BUILDING '.' '48. FINAL PLANNING 49. Electric Release to Edison -50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY i No. Date PROJECT ADDRESS: UNIT: - OWNER'S ONE: ADDRESS: PERMIT NO; EMP 048862 PLAN CHECK NO: 05591-90 N PAGE: 2 ********************************************************rte-******** 'L ***i4***a .A- EARCWENGINEER: REO.NO.: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ADDRESS: UNIT: PERMITTEE. END OF FEES ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 al the Business and Professions Code.and my license is in full force and effect. CITY UC.: STATE LIC.: CUSS: - Date: Signature: WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance,ar a certified copy thereof(Section 3800,Lab.C). CY NO.: EXP.DATE: OMPANY: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EKEMP110N FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)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. Date: Signature: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor ' Code,you must forthwith comply with such provisions or this permit shag be deemed revoked. 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(Section 3097,Civ.C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason • (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/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(5500). I, as owner of the property or my employees with wapes as their sole compensation, wig do the work, and the efrstructure is not intended or offered for sale(Section 7044,Bustness and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale,If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or Improve for the purpose of sale). I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or Improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.8 P.C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and 25534 and that I or any future building occupant wil0will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air uality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for-inspection purposes. Date: Signature: Driver's License or Social Security it: 1841-48 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CpNSTH'UCTION AND PLANNIN� L & SPA APPROVALS Permit# - Date Inspector APPROVALS Permit _ Date Inspector 11 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. 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 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 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 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 OWNER MICHAEL SANTA CRUZ• DATE 8/12/59 JOB ADDRESS 262 E. 15th St. BUILDING PERMIT NO. 10162 GENERAL CONTRACTOR Patrick 0. Roy VALUE S 5,283.00 _ No. 117-181-4 LOT TRACT FIRE ZONE DESCRIPTION OF WORK apt, over gai a_tt. II.,.PECTIONS ff-/4 49 DATE GROUP TYPE ZOfilei res. Rh Underground Soil .1443 U.G. Water — SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gag f//yS 9-2-1-ey Rough Heating _._ 4 4,. ' ' 9'-J8*-57 n.2)0 d9 F( Rough Plumbing Alf/5 9-2.7-6y om ,-,,,,,)cf--'1 ,fes if -is--S- 7 cz o '12 g Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System _/ � ri Heating, Final t(q/A, , /-41 9- Plumbing Fixtures 0. - , _ Final Gas Test ,�> /.,, t d 9_ - 'iIttl Construction Pole Underground Power Rough Wiring Fier- 0- a-c t . -.,.ire-n.. O -/7-c't /4E02/-/i Trenches Forms Steel '• - _ Floor System Steel Reinforce Chimney Re-Rod P ' Beam t. ,hing 4'/9--W r-�2-1 • Frame and Flashings G - $ �-,j Lathing, In Out 1.f /6 +/9— Plaster, brown coat /0 a f-1" Plumbing Fixtures, Final /9---0-47 _ Electric,Fixtures, Final ) Building;:Final - _2/- l OCCUPANCY /i/ Form 210-3M-4.5? 10162 I 10162 •I"� +. �\�Y.-• .. . CbSTA MESA BUILDING-SAFETY DEPARTMENT 3_ i�� - `5�,1 P.O.BOX 317 COSTA MESA.CALIFORNIA I' ; PT.: DEPT. • FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUIL 262 E. 1161th. St. COSTA MESA. CALIFORNIA FOR OFFICEpr USE ONLY OWNER Michael Santa Cruz RECEIPT NO._ 0PERMIT NNO. 1 1±19. MAIL RECEIVED BY / D TE RECEI�VS° DATE ISSUED - ADDRESS 262 Mesa 16th, St. v- I ��/Z / I+2�J CITY Costa Mesa . TEL 85057 ADDRESS ARCHITECT LIC. COSTA MESA. CALIFORNIA � OR ENGINEER Robert Holford NO. /y� � /�/ ��(( ADDRESS 17th - Costa Mesa FIRE ZONE TYPE ( GROUPY' STATE [ 1. APPROVED ,�.Aµ{A./_ R./1/2 ...���111 CONTRACTOR Patrick O. Roy LIC.NO. 155074 BY V� DATE '% / J ADDRESS 511 Irvine - Newport Beach ZONING . /f LEGAL LOT p .0. Harr ONE NO.OF UBE OF N"' / (�� DESCRIPTION I NO._ 8 I BLOCK I TRACT$1111 r'� PLANS /BU LLDMc A.P.NO. 117 ••• 181 - 4 BYPZY _ CO, /�J DATE SIZE NO.OF SLOGS. YARDS �jE4E5 OF LOT 56 x 125 I NOW ON LOT 2 REQUIRED ALLOWED OronoCC��Y (CENTER LINE ST.) EXISTING BLDG. residence tgarage FRONT 1_57. --r. IN. SETBACK LINE FROM 8'1 a CENTER OF STREET O) REAR YARD 8LIR.SIDE FT. IN. SIDE YARD I LEFT 5 a I RIGHT 2911 L.SIDE (((///S FT. IN. DESCRIPTION OF WORK - a-}t tT r /.1#C4 & REAR (.�/Lf! "'!v �'�' NEW IX II ALTERATION I II ADDITION I REPAIR I I MOVING I ((DEMOLISH I BUILDING NO.OF 11� SIZE 23'x 24I ROOMS U STORIES 2 A EXTERIOR WAS �" ROOF � � ,�JJJ��1 I / Y COVERING SLUCC0 (COVERING cedar shingle: �(�(/"'✓ i��7� ___ Y Of BUILDING AND WORK TO BE PERFORMED V\- „[apartment . .e ] 'apt, As" iiiteseety _Si . c - -re' I HEREBY ACKNOWLEDGE THAT I HAVE RE THI w P ATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGR 0 COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND ST E LAWS RE ATING BUILDING CONSTR .N. VALUATION I SIGNATURE OF// / / / /( d 3 '� PERMIT FEE $ `0. e-O PERMITTEE /�'�� ��/ �' �4� /- I/ $ / / ' PLAN CHECK $ �. / 19-0 //re 0-8 AUTHORIZED AGENT !� �� ��� TOTAL FEE $ ( 'J t " 1 9884 , CA- et Lt//I& Le IS 2 2 1958 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA, CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT /+�/ TYPE( (OR PRINT Sines r BUILDING ADD EISS aS !!� 'e-A •� Sinej / COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY �( e / n [j •� I RECEIPT NO. FAMJ� / OWNER Afich/1'I Gi Sh AtrA c Q [/SII//�� /T/ MAIL / �` ST�PFsT R EIVED BY I DA=E —3 / DATE ISSUED ADDRESS 20 /Gy/ .l t �/ r I/f7 I (CI- c r1 CITY Cosi? / 1,5,9 TNOJ/DUOS? AD ESS ARCHITECT LIC. COSTA MESA, CALIFORNIA • OR ENGINEER Robert Holford NO. ADDRESS 17th. - Costa Mesa FIRE ZONE A l #O< CONTRACTOR Patrick 0. Roy LS . G IC TAT APPROVED // ae T.NOE155074 BY DATE(o// .+[ a/ ADDRESS511 Irvine Avenue-Nevroort Beach ZONING LEGAL LOT {] •0. Har]IZONE NO.OF USE OF NEW() DESCRIPTION I NO. I BLOCK TRACT sub RU I PLANS ../.. I BUILDING el OTR114F A.P.NO. // ' '. 19 / - y APPROVED ' BY DATE SIZE56 NO. SLOGS. YARDS EVES SFFLOT x l2S NOWW ON LOT 2 YARD RED ALLOWED \ USE OF (CENTER LINE STA.�I EXISTING BLDG. residence & garage p FRONT 'CO FT. IN. CENTER LINE FROM 501 REAR YARD 84I R. •SIDE •� FT. IN. CENTER OF 6E FRO 7 \` SIDE YARD I LEFT 51 1 RIGHT 29 L.SIDE tS FT. IN. DESCRIPTION OF WORK - qq RE/,A�Rzl�eP-A.� �� FT. IN.�J �Y NEW I X II ALTERATION I II ADDITION I f % cge-< , c� 6-I.>t / REPAIR I II MOVING I II DEMOLISH I /Z� "•�, / BUILDING NO.OF SIZE ROOMS STORIES _ EXTERIOR WALL ROOF `�- „ , COVERING (COVERING C�Co�I („to r0 ) J USE OF BUILDING AND WORK TO BE PERFORMED l 1 garage - 2 car e^o, / fin 2 cric,cy F-a-" APO lc- 1-o .4-e Cenil(2.ie to 2.rrn.Ll( I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE el C/ PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. A. { BUILDING CONSTRUCTION. / VALUATION S I rluc•e• SIGNATURE OF'*GA.cf� ` ,.� PERMIT FEE $ _ j PERMITTEE /// , / ^���ttt111 ���� _ //�I►► /� rt ' / / . )/r?� $ /c09T PLAN CHECK $ ... \ AUTHORIZED AGENT l/ \_f/Y J/� (/ TOTAL FEE $ )a, 1 OWNER SANTA CRUZ, Michael V DATE 5-19-54 JOB ADDRESS 262 17th St• BUILDING PERMIT NO. 251 GENERAL CONTRACTOR Owner-Builder VALUE $ 5,600.00 LOT AP# 117-181-4 BLOCK TRACT Dwelling •` , // , GROUP I TYPE V ZONE R41 FIRE DISTRICT #260 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench 555 4 9 -j4 Foundation Forms and Grade to Garage / Rough Framing 7/ti / Z7 JY Plumbing,Rough to Slab Gb6-75- /O-C,0 rrpD � � (c - Plumbing, Rough Complete -1--f-e--0.-� n— /C un/ G -9 -5lie t \� / Temporary Pole iI"" V Wiring, Rough 7/v� ..7//2-7, - . "liJr$ -e C MU g7 v Au Heating,Rough 2cc1- D 7�p a JY - ,AA / Heating, Final -2.GG/ny /y nN 1.11 Sewer --'-tf`n P n Bi 6 SepticaiTank orCesspool1._ cz 6 _ b ' \ \\h � / Lathing i�U p-«t G G///�O \ g / Plastering / �l/ ,Y \ti Plumbing,Final,Fixtures Complete70'_ -/y 7/3J4-- Plumbing,Final Gas Test 4z'.- 'N7 .A I Wiring,Final _, 24-6-45--4 i1G �l,,Ci re j ..n -o , fi Occupancy -L'ae�� SP-a-V(5 i / Form 210 GH 1M 12-63 • Costa Mesa Building Department 6INAPPLttFOR PERMIT 20 111 EAST 20th STREET _ _ B U I L D. � N.G _ _ . 'f COSTA MESA, CALIFORNIA Pr FOR OFFICE USE ONLY 1 FO/R� APPLICANT TO FILL IN t I Recei No. / Permit No. Building .0 �Z 1t /t 1in'!�Y/ !'— Address //�I - �J' / Costa Mesa, California Received by I Date ec'd. Date !sailed ..f---/T--4-7.6 Nearest Cross St. DrQ,4,v AR Building I Address Owner Ml c iliA 6L i14 n/Tr4 C Rif Z_ Costa Mesa, California Mail 2 fir Address 21„ Nearest • • Tel. Cross St. ' City CO3T,9. AIE,S,a No..(/ FSOS'7 Zone2 I No.of I Type v' I Groupie's— Architect roup r Architect or Lia /� Plans + {� / 1 ,�(� Engineer glee,rHa .n , T No. Approved ' by Date • ' Address /35. r / 7 t* Cen-in' /9E.,5/1 CORRECTIONS City Lie. • Contractor ertir-L1-,e No. • ,• a ' Address ' LegalLot Description I No. I Block I Tract _y (Attach Metes and Bounds) ,g,p, /17 —/y/— y . No.of Bldgs. , • O Size of Lot r( X /2 s Now on Lot Use of I No.of I No.of a - Existing Bldg. Families Rooms . L) Setback Line from Rear Yard „el '- - - � E `1 F� z Center of Street Side Yard ,S b ' ) " l D DESCRIPTION OF WORK c ` ` r t New I I Alteration I I Addition I/, Repair MovingDemolish I I I I I ' .1 BuildingNo.of • 1 ' Size '//X /7 Rooms , le. Stories Exterior Wall Roof -PITV nr nne i ft p(1 CD Covering I Covering fes/a<,r ' "'APPItOVAI:S'° `r"r" Use of New e�- to ^/� Foundation-Location . Inspector Date Building 1 -- �� Forms,Materials, .- 1 Under-Pinning Frame: Fire Stops, Bracing,Bolts - ' : , Lath. Int. I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building constructionPlaster, Int. Signature ofWait. PermitteePlaster,Ext. Authorized Agt. ' Masonry Reinforced Valuation Permit Fee $/�, C,ea gond Beam ?� Plan Check $ 3 r_ $ So a 0� Total S Fee E /11 6 6 FINAL c J c J �l O ' L Cly ,. _ • - 0 ' ' 6 • • • Street PLOT PLAN Show location and distances from property line and between buildings. Do you carry Workman's Compensation Insurance?, Yes © No El am aware of Provision 3700 of the State Labor Code which requires every employer to be insured against liability for workman's compensation. Signed is l t; OWNER . SANTA CRUZ, M. DATE 4-17-74 '' `- JOR ADDRESS 262 E. 15th St. BUILDING PERMIT NO. 38293 G RAL CONTRACTOR Pat Roy Bldrs. DESCRIPTION of WORK Fire Damage Repair to Res. AP No. u7-181-04 LOT TRACT FIRE ZONE VALUE $4,400.00 INSPECTIONS Signature Date TYPE V GROUP I ZONE kCd SOIL PERMITS ISS ED GAS SUBCONTRACTOR. Date I Number 1 Signature WATERi////.,Plumbing /-Jq" ��/ /, ROUGH PLUMBING � eY (� !/ � eT J':/611/� PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ^ Pi ROUGH HEATING AND AIR CONDITIONING /^r( / —36-7f TEMPORARY SERVICE OR POLE 1 UNDERGROUND fl POWER ❑ ' • ROUGH WIRING /) /` j'Z29Feat and Vent. TRENCHES 0 FORMS 0 STEEL REINF. 0 , f(, . (tar iyit.p. 7_p 1_y9 / U j7 FLOOR SYSTEM • �� "'� BOND BEAM n STEEL REINFORCE n /Alt f3htrf / n FRAME ANO.FLASHING /St Q. cr-er?Of LA' s — IN n OUT n PL. "R, BROWN COAT STRUCTURAL. FINAL Elef/tsiC HEATING, VENT., REFRIG. AND A 44 ç ,- 2.. --7q ta,e , 5-/- 79 3739/----- PLUMBING, FINAL AND( T ELECTRIC, FINAL Cj' •)L' T BUILDING, FINAL ; -"'r•AZ" 7SG 1 X8293 '.PU 17-71 —'BOO 663' ***:•44 CO • PAIL) COSTA MESA BUILDING-SAFETY DEPARTMENT . P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely P LIFATION FOR BUILDING PERMIT BUILDING -9/ RE I ELI BV DA,!/RE=EIVD DA E ISSUED ADDRESS�,�_�C.,/of - E• /y T`/• ST. gtN/' /nt7/ 7�t71•` /7-7� OWNER — 7 az. ., /7—//1 �" (/� PERMIT 3 Q 2?/ ��—"'TTTTT '— �• S//aTA �R A.P.A. .NO. C Sr7 MAIL / BUILDING 62 E I,J S 2ADDRESS #2l LZ E• /Sr~• ST• ADDRESS X A. a "met rs u,ui-Z CITY Cos rig //'fE5 H NO:T/FPJ OS7 TRACT ,S// LOT7 BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH ON LENDER 0 c n/t4'/(' o- m M �"'n rr•�1 /� 2 _ID BRANCH OWNER • 1✓ r7/�/V•rA C/C az -- J In a w ADDRESS CO-I y�7 �t ,s' 1 VALUE /,///�/ J Q ARCHITECT TEL. USE E4/,e F/[.t:J/n/N E$/•1+Y•OO OR ENGINEER NO, U a FIRE T Z W ADDRESS -rte �+ ZONE /YPE� GROUP Jam' (,/�/ CONTRACTOR PA T /� O 9 !/4---z A S APPROVED DAT J Lu Z _ Wf 17-7 JO mZ JCC ADDRESS ,J''// /R ✓/N e• 4 vz 1L w TEL ZONE NO.OF n USE OF NE, Z F cc /\ PLANS 02 BUILDING f(p/y,_1tr CITY N. a. NO�fce'IO/�3 /"�b W o STATE CITY YARDS APPROVED YARDS APPROVED D O LIC. NO. /J 5 /p 7 4 LIC.NO. / +49" MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF SLOGS. (FROM C/L STREET) OF LOT $6 �( / �S NOW ON LOT FRONT FT. ) F USE OF ap EXISTING BLDG. r)E 5 / .b E Al 6 ca gipg a t _ F SIZE OF /, NO.OF , I j �� Z NEW BLDG./SCO 4Z,F r ROOMS 6 STORIES / L.SIDE CC tF0 EXTERIOR WALL ROOF C 1 _V COVERINGaSTG./GCo (COVERING SN/ N(pLC$ REAR FT. FT. J USE OF BUILDING ANO WORK TO BE PERFORMED BET.MAIN& CL -RIES , 'bCNCF y MAIN DISTANCE BET. ACCESS. BLDCS. Q `J)-...'. VAR.* DATE 0 -�E PR t R / / RP Dy,4946 E C.U.P.# y/✓t APPROVELD/ N flY ROV64 I/ n DATE _7-17-7y Z �/(f [! O slicrE VI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ cep I- any person in violation 0f the workman's compensation laws of V) the State of California. $D2Y• m Z to I hereby certify that I ant properly licensed as a contractor under SO. FT. 6 the State of California Business and Professions Code, Divisicn 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: o am exempt from tie provisions of the State of California Business VALUATION and Professions Crete,Davis' n 3n eater 9. m /' t -t PERMIT FEE S °•' Signature of ; J r �D\ x� /! / ////Sv m Perm lttee ""//� $ �Y/'� PLAN CHECK $ E (((��� i. o Authorized Agent -_,-COLL TOTAL FEE $ 41,' OWNER SANTA CRUZ, MICHAEL DATE 6-13-60 JOB ADDRESS 262 E. 15th Street BUILDING PERMIT NO. 12219 GENERAL CONTRACTOR Patrick 0. Roy VALUE $ 7,000.00 - : AD No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK res.add.& alt. I ECTIONS L(,f/ DATE f GROUP Z TYPE V ZONE R4 Uuuerground Soil)4 U.G. Water K/ lit-C-6-0 PERMITS ISSUED Underground Gas 7-5 ., .GA SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating kith t/f1.2^ s -.---then i, 1-/d- Co a 6-a & 3 " Rough Plumbing al T-ZS--(i G, reelt.K2V gl g,,, t7_/-/nn a J 78 S-"� Miscellaneous /� 0 Prop. Swr. Line House Con. St. Svn /f Qf« Sprinkling System Heating, FinalS ///rca Plumbing Fixtures i�D W /1..P.64 • Final Gas Test /A-Y. //.r✓ J;t./,n Construction Pole - Underground Power Rough Wiring ,YK ,4?-•<rryo-/.` aeri. .P- 9-ca iii K7 d Trenches .-Forms ..---Steel v,.t.1,yy/c 7 -/] -Ego Floor System Steel Reinforce Chimney Re-Rod Bond Beam c 'hag its" t .- So I .e and Flashing R - - :D Lathing, In Out 1 2 -/6l6n Plaster, brown coat Plumbing Fixtures, Final //- 3./0 Electric Fixtures, Final f% e—/�-'e r Building, Final //-/Ss&a \t OCCUPANCY Form 210-5M-11-59 S-B P 12239 I . • 12239 . FEE RECEIVED C€STA MESA BUILDING-SAFETY DEPARTMENT G, //3/ o V1-`, • R 0.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. fOR APPLICANT TO flit IN COMPLETELY APPaRi1GaR! RMIT n[[n TYPE[OR PRINT BUILDING .,, BUILDING'' ADDRESS 2y2 E. 15th. St• COSTA MESA. CALIFORNIA fOR OFFICE USE ONLY RECEIPT NO. PERM NO. OWNER Michael Santa Cruz I I ���3//� MAIL aha E 1 th St RECEIVE• BY I DAT' AEC•VEOD I �O/EjeeLI FSO el ADDRESS e (p 3J(O CITYMxr�� TNOL1B. O ADDRES. . . ne. / 7 Costa BPSa ADDRESS OG/q .-e.-- . ARCHITECTLIC. •- COSTA MESA. CALIFORNIA OR ENGINEER R. Holford NO. 7. FIRE p ADDRESS 4 • - ZONE TYPE GROUP . CONTRACTOR Patrick 0. ., , APPROVED ` BY 111/'',s I •ATE/ S ill' - ADDRESS 511 Irvine Avenue — -• f NTNG I BLOCK I TRACT : ZO AJ // INO.OF P ANS � I BUILDING USE OF E„rillAi.1/// ay I A.P.NO.DESCRIPTION 117•- 181 - O APPROVEDA / , DAT V`Vaµ'rLJ3-p�C SIZE 56 x 125 I NO.OF BLOCS. .Z �;1 YARDS REQUIRED 1 'ALLOWED OF LOT JNOW ON LOT ' USE OF - (CENTER LINE ST.) r EXISTING BLDG. residence FRONT J 0 FT. IN. SETBACK LINE FROM CENTER OF STREET 801 REAR YARD 25 I y,�//B/ ,('' R.SIDE J•'- �/ FT. IN. /:i .. SIDE YARD I LEFT •• 1 f1 I RIGHT I L.SIDE '-Z=�% FT. IN. • DESCRIPTION OF WORK - t).3-I „ IN. P, REAR NEW I II ALTERATION I II ADDITION IX ' REPAIR I II MOVING I II DEMOLISH I • • BUILDING IIl�,, pp NO.OF SIZE •i•L X 1J ROOMS 1+ STORIES 1 • EXTERIOR WALL IROOF cedar shingles ' COVERING Gt11e .0 COVERING - USE OF BUILDING AND WORK TO BE PERFORMED • residence addition R a7+Pr .. ' I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REG ATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. ` BUILDING CONSTRUCTION. VALUATION )// Q ' PERMIT FEE $ /DY � SIGNATURE OF // PERMITTEE _/ -� .��1 /�/ $7000 �� PLAN CHECK $ 5• A10 AUTHORIZED AGENT / N • TOTAL FEE RY ��