HomeMy WebLinkAbout280 15TH ST - Building Permits X64.. t ALLEY
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p6 ..p'MFs CITY OF COSTA MESA
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�a CALIFORNIA 92628-1200 P.O. BOX 1200
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:it I !a DEVELOPMENT SERVICES DEPARTMENT
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•
December 29, 1992
To: •
Building Safety Division Newport-Mesa Un. School Dst. (2)
Code Enforcement Pacific Bell
Communications Police Dept. - Ping. & Research
Copley-Colony of Costa Mesa Santa Ana Heights Water Company
County Administration Office Sanitary District Engineer
County Clerk/Bd. of Supervisors Southern California Edison Co.
County Registrar of Voters Southern California Gas Co.
County Tax Assessor State Board of Equalization
Engineering Division (2) Street Division
Fire Admin. -Training Officer U.S. Post Office - AIS
Fire Prevention U. S. Post Office, Adams Avenue
File (2) Mesa Consolidated Water Dist. .
The City of Costa Mesa wishes to advise you that the following
addresses have been changed or added:
OLD ADDRESS NEW ADDRESS A.P. NO.
280 East 15th Street 280 East 15th Street 425-161-07
280 East 15th Street
Unit "A"
Your cooperation in this matter is appreciated.
Sincerely,
•
STEVEN C. CLARKE
Assistant Planner
(280E15TH.ADD)C13 •
•
cc: Carlos and Donna Garcia
280 East 15th Street
Costa Mesa, CA 92627
77 FAIR DRIVE
Building Division(714)754-5626 Code Enforcement/Business License(714)754-5234 Planning Division(714)754.5245
FAX(714)556-7508
)
PROJECT ADDRESS: - _ IT: \I
C OWA�iNAME: 280 E 15TH.ST A CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 057863
ADDRESS: DONNA & CARLOS GARCIA
280 E 15TH ST - PERMIT NO: E 057863 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA
CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: NEW
ARCH/ENGINEER: ( 714 ) 646-9439 REG.NO:
ADDREss: PACIFIC BUILDING CONCEPTS NO1 JOB DESCRIPTION : NEW SFD W/ATT CARPORT, RE:#857862 SQ FT;
18102 SKY PARK SOUTH A-1
` PEflMInEE: IRVINE CA 92714 CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
.ADDRESS: BEACH CITIES BUILDERS (714 ) 965-1369
7; 1U T1 ASCOT EIR ********�F****�E**D ****+Tk*************************�F**�F+r*�F*****�6 �E+E**a�*****+Ex�6yF�F�F�F
HUNTINGTON BEACH CA 92646-4321
LICENSED000)of
CONTRACTOR DECLARATION:uneadI herafore that am licensedi under provisions f Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS
CITY LIC.: 054474 STATE LIC.: 551563 Aotconsenttosete.tnsureoracertiticateoewnrters'
/ Date: C-07 — i't2 Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I hs' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.ora certified copy thereof(Section 3800, LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
'OLICY No.: 1091250-92 EXP.DATE: 01 /01/93
COMPANY: STATE PARKING REQ: PROV; PARCEL: 42516107 ZNE: REF NO;
D Certified copy is hereby furnished. C)t Certified copy is filed with the city Building Division. PLANNING NOTES>
n >
Date: C—If ^ 9ZApplicant; *******************************************************************************
Y EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This lion need not be completed if the permit is for one hundred($100)or less). DE VEL OPMEN T S?E R V ICES REQUIREMENTS
1 cerlily 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. ZONING APPROVED BY 1 DATE
Date: Signature: '
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - . . DATE
Code,you must lodhwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: •
Q. # DATE• fell °
which this permit is issued(Section 3097.Civ.C). **********.******************************-**** ****.**************** * k41)(1***
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N
•
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 65 70
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed ,e
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ]0% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15. 00
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
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 65 . 70 15. 00 0. 00 80. 70 80 . 70 . 00
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 REVENUE DIVISION TOTALS--> COLLECTED; 80. 70 OVER/SHORT: . 00
for the purpose of sale). . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusivelycontracting with licensed contractors to construct the project(Section 7044,Business 80. 70
❑ 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). l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me.
o I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: Owner: ELE 1877 NEW RES BLDG FOR 1 OR 2 UNITS/ SQFT . 03 65. 70
1 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 will/wit)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 Duality 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 01 this city to enter upon the above-mentioned - - h —
property for inspection purposes. _..1 - '
Date: — r2 Signature: i .f_`• L_ r
Driver's License or Social Security 4: /
1641-46 white—Buildrna:Green—Code Enforcement:Canarv—Anolicant:Pink—Revenue:Goldenrod—Assessor
.
CONSTRUCTION AND PLANNING _ & SPA
Date Inspector Date Inspector
`APPROVALS Permit # - APPROVALS Permit #
1. Temporary Electrical Service er 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. .Footings, 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test'
11: Water Pipe-Undrgrnd. / 60. Backwash Lines, P-Trap, 0 Undrgrnd,
10. Structural Floor,System J.; -1;,I 61. APPROVAL TO DECK
11. Property Sewer Line & House--'L`onnection . ' 62, Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final '
•
13. Roof Drains • 64. Plumbing System - Final
;r14. Rough Plumbing 65. Electrical-Final
' 15. Rough Electrical-Conduit 66. Solar System-Final
-t 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 Fireplacei . - _ APPROVALS '"Permit#
21. Ducts,in Structure ; . 70. Underground Hydro
22. Ducts, Ventilating - r 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 t }+ HEALTH DEPT. REQUIREMENT
'31. Plaster Brown Coat I 1 1 79. FINAL INSRECTION-'
32. Electrical Power Meter-Final {/!!z 1 80. FOOD CERTIFICATE ISSUED
33. Final Electric • -, // 1 ,t Notes: -
34. Final Heating & Air Conditioning., i ..•
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 I ,
43. Backflow Irrigation
-44. Landscape Irrigation System, r ._ .. , .
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 - 1 `' • -- -
t 51. CERTIFICATE OF OCCUPANCY '
No. Date
•
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 280 E 15TH ST A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 057862
ADOR�ss: DONNA & CARLOS GARCIA
280 E 15TH ST PERMIT NO: B 057862 PLAN CHECK NO; 01631-92 A GOVT; N SUPP: N
�r; COSTA MESA
CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: NEW
N. (714 ) 646-9439
ARCHIENGINEER: REG.NO.:
PACIFIC BUILDING CONCEPTS NO JOB DESCRIPTION : NEW SFD W/ATT CARPORT SQ FT: 1' 4 , 158
18102 SKY PARK SOUTH lini: A-1
IRVINE CA 92714 CLAIM VALUE: CALC—VALUE: 141 , 570. 10 GROUP OCC: R-3 /M-1
PERMITTEE: ! /
ADDRESS: BEACH CITIES BUILDERS (714 ) 965-1369
. 10131 ASCOT CIR COMMENTS• NEW SFD W/ATT GARAGE( 2 STORY) t
HUNTINGTON BEACH CA 92646-4321 ********-i******************************************** **** *********�E**it*****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U I R E M E N�T —
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS "_
CITY LIC.: 054474 STATE LIC.'551563 CLASS: B
Date: C'—/9— 72 signature: MAIN BUILDING ACCESSORY BUILDING •
t'I WORKERS'COMPENSATION DECLARATION: I hereby affirm tha ace i late al consent to self-insure or a certificate 01 Workers' FRNT: 20 FT IN REAR: 10 FT IN FRNT: FT IN REAR; FT IN
^nmpensation Insurance.or a certified copy thereof(Section .Lab.C). LEFT: 12 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN
.ICY NO.: 1 0 9 1 2 5 0—9 2 EXP.DATE: 01 /01 /93
oMPANY: STATE PARKING REQ_; 5 PROV: 5 PARCEL• 42516107 ZNE: R2 REF NO• DR-92-04
ID Certified copy is hereby furnished. L Certified copy is filed with the cdy Building Division. PLANNING NOTES> ADDING A DETACHED UNIT (RENTAL) TO A LOT WITH ONE EX. UNIT
i. > TO REMAIN .., P F E REQ
Date: 6—/9-9Z _ Applicant: *************.***************4*4*4***diik********************************,4********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: ection need not be completed it the permit is for one hundred($1(0)or less). D E V E L O P M E N ,T SERVICES R E Q U I R E M E N :T S•
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. ZONING APPROVED BY - S r l DATE; -C.IT ck f r1 t
Date: _ Signature:
NOTICE:It.after making this declaration,you should tecome subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ' .' DATE: ..
Code, you must forthwith comply with such provisions orThis permit shall be deemed revoked. / I i i
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: r I 't [ DATE• f l j Cj r
wNch this permit is issued)Section 3097.Civ.C). *********************************** iE****+t** * ********************* iE•*Fr T**Fet**-**
LENDER: ****************************************************.***************************
ADDRESS:
LEGALIZATION;N F E E L- S •U M M- A R :Y =-- STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: Ihereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC .:.i',....— 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 786. 50 '• .'• .— 13 ,65
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed dl $MIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business / - .0
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 127. 811 . 06
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5001. 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
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS----> 801 . 21 0 . 00 1 2 7. 8,1 r% +' 919402 929 . 02 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through •
—
improvementssoldowdhnonevyearofcompetionotheownerwillhavetheburdenofprovinghe/shediU otboldoriimprove REVENUE DIVISION TOTALS--> COLLECTED: •' ' - 801 . 21 OVER/SHORT: 00
tor purpose of sale). 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 786 . 50 . %- _ ,'' • ., 14 . 71
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon •
and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).l am aware .x,*,*.x.*.**,*,.N,.K.*..**.*.**.*.yF**.**.**y(..N.**.*.**.*.**.*.*.******-*.**.*..)(..)[.****.{(.***.{e*.**.**.****.**.****.**.***.*i(.
that proof of their Worker's Compensation insurance should be provided to me.
o am exempt under Section: B.&P.C. I N D I V I D U A L F:E E " BREAKDOWN
�
for this reason: �'• •r
TYPE QTY D E S C R I P T I O N - UNIT COST TOTAL COST
•
Date: Owner: • '
I do herebycertifythatlam aware of and SFR 1877 DWE—TYPE V—WOOD FRAME ' ` —GOOD -_ 69 .00 129, 513 , 00
understand the requirements of California Health and Safety Code Sections 25505,25533,and a
25534 and that I or any future building occupant wiIMI'not(circle one)need to comply with said state codes and the requirements for a SFC 1877 ECU—RESIDENTIAL AIR CORD —AVER . 2 . 70 5, 067. 90
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from SFR 404 RES—GARAGES TYPE V - :T. ' 17, 30 6, 989 . 20
these provisions. END OF FEES -•
.
Date: _ Applicant: •�• ,y
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 4 t
ordinances and state laws relating to buildigg construction and hereby authorize representatives of this city to enter upon the above-mentioned r
property for inspection purposes.
Date: /9 — 9Z Signature: --
Driver's License or Social Security 4:
1641-46 Whim—Building;Green—Cole Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
1
1
Sit
}NSTRUCTION AND PLANNINL L & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service o{ Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. •
/ 54. Forms
4. Electrical Conduit-Undrgrnd. 7/� it od 55. Electrical Bonding
5. Steel Reinforcement ` /L= 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. / if 57. APPROVAL TO COVER-GUNITE
7. Footings . 58. Electrical Conduit-Undrgrnd.
8. Foundation 1 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash-Lines,PTap, 0 Undrgrnd.
_ i
10. Structural Floor System '' >13 :. y, 61. APPROVAL TO DECK
11. Property Sewer Line & House.Connection --'`'�'"�' 62. Backwash ece for-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 ❑Oil
23. Gas Pipe-Rough& Test - . 72. Undergrdund Flush ,
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing g(,(/9z_. ,j1-4L.. 74. Overhead Hydro - .
26. T-Bar Ceiling (Structural) & Monocoat / _•
,�,gy�pp•- 75. Dry Chemical • '
27. Frame and Flashing, , r -•`O/Ilj/c-Z 'VPS 76. Dry Standpipe ,
28. Lathing & Siding l 77. FIXED SYSTEM FINAL
29. Insulation ill f y061- 78. FIRE PREY. FINAL .
30. Drywall Nailing / 777a(f HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat _ w/�)Q' � 79. FINAL INSPECTION
32. Electrical Power Meter-Final r +. + 80. FOOD CE /TIFICATE ISSUED
33. Final Electric - Notes: 70(� ��
34. Final Heating & Air Conditioning - • 'f fc1p. `fe LA-704
35. Final Gas Pipe-Test • • 1-23_ /2 licca etr 1 - ler5
r.
36. Hood or Canopy '• ant .e /1
37. Final Factory Fireplace p -��� / t, C7 o
38. Final Plumbing (lepd// L ej L, ��O _
39. Water Service-Final - • • ! /I 4t- cID C.a 0le l 'ib I�ri
40. Gas Service-Final �'��- '
41. SolarDomestic-Final �� at 40 e,
42. Backflow Preventer i r -
43. Backflow Irrigation - - .
44. Landscape Irrigation System
45. Sound Attenuation . - - -
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING `/�tif
i /
, l .
48. FINAL _i1 - ri I. roc`s
49. Electric Rel ase to Edison
U t. - . ,
50. Gas Release to Southern California Gas Co I I .
51. CERTIFICATE OF OCCUPANCY .
1 No. Date
I;
.y
MENTIOICSCE OF FACILITYCF � ^
PAYMENT OF SCHOOL FACILITY FEES • � `(//,
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
Developer/Applicant : CarIOD , � ercr1
Address : ev c. t s }- S4- • Coc._ hi (.54_ CA- ct 20 1 "-
/
Telephone Number : Li-1 -t Co'i 4- c/`t 39
Tract/Parcel and Lot Number(s) :
Location of Project : SAnE rks A3o .t
Number of Square Feet of S 0
Residential Space ?77 x $1 . 50 Total ).\
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 Hotel 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 appropriAL_
te City/County shall be notified .
Date : 6 //` � G /� A
Developer/Applicant
� hdl C( S IrwutcG \ cccos- -7
13 N.
CERTIFICATE ATTACHMENT.
ASSIGNED TO
AITC CERTIFICATE NO. 8154 —91
Customer Name BUENA PARK LUMBER COMPANY Customer Address BUENA PARK
Job Name Job Location •
Customer P.O. # 64185 Date 07/23/92 Mtgrs Order# 52-2437
Line No. Quantity Description
1 INVOICE Il 13 5 361
2 1 5 1/8 X 15 23 IND. GLULAM
3 1 5 1/8 X 16 1/2 23 IND. GLULAM
4
5
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Special Notes or Instructions
ENGINEEREDWOOD SYSTEMS
Pill
Errs •
Certificate of Conformance
Certificate N? 8154 -91 •
THE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the structural wood products
identified below and marked with a collective mark of American Wood Systems (AWS) were man-
' ufactured in accordance with the specifications indicated below.
*. ANSI Standard A190.1-1983, for Structural Glued Laminated limber
•
0
0
Proof loaded end joints
JobNuno GEORGE M. HUFF
Jobloovlon SANTA FE SPRINGS, CA.
Cwlaner'o OrWr Na 4721 — Date 06-30-92 Mfgr'e Order Na 52-2437
signature t1. Title n r D i rp r to► ..
(� James E. Carson
tympany Bohemia Inc, Address OreaonDea 06-30-92
IT IS HEREBY CERTIFIED that the structural glued laminated timber production of the above-named
manufacturer which carries a collective mark of American Wood Systems(AWS)is subject to regular
audit by American Wood Systems, such audit consisting of the inspection with reasonable frequency
of the manufacturing process,with adequate sampling to verify the quality of glulam construction and
the adequacy of glue bond.
p•PruZ;e b/Ve6:7&//o
SEAL f Michael R. O'Halloran
. Executive Vice President
1YyIN ;GC‘14*
AMERICAN WOOD SYSTEMS-A RELATED CORPORATION OF AMERICAN PLYWOOD ASSOCIATION
CI1 _ OF COSTA MESA
CALIFORNIA 926281200 P.O.BOX 1200
Insulation Certificate
o,So E. /S- sAreil caste f1�s�
Number and Street City
/�ra9 e
Coy. Subdivision Lot Number
Description of Installation
ROOF ••
Material i✓/y4 Brand Name
Thickness(inches) Thermal Resistance(R-Value)
EXTERIOR WALL
Material Brand Name iferriv./lA
Thickness(inches) - 3/2 " Thermal Resistance(R-Value) e—// •
CEILING //,,
Baa or Blanket Type 4r9'/// /HJev,/l oy Brand Name /%Or/ryi/,4
Thickness(inches) 6"+ Thermal Resistance(R-Value) „e-/9
Loose Fill Type Brand Name
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 ////i� Brand Name
Thickness(inches) Thermal Resistance(R-Value)
SLAB FLOOR
Material N/<J Brand Name
Thickness(inches) Thermal Resistance(R-Value)
Width(inches)
FOUNDATION WALL
Material /Vast • Brand Name
Thickness(inches) Thermal Resistance(R-Value)
Declaration
I hereby certify 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.
&so•CCf 6-1+4v to/%43 SS/ S6a. 3
petal Contractor(Builder) License Number
�uwva 2— iv— 513
sig/n/ ature and Title
y
entractes(Insulation Installer) License Number
i - O as,,'•'
Signature and Tide Date
FINAL GRADING CERTIFICATION
•
Project Address: 280 E' /CT" £1.. Co sits .Mas*
• Lot Number: LOTS op ri-p 4. o 1/4adais
• Permit Number:
By Civil Engineer:
I certify to the satisfactory completion of grading in accordance with the approved plans, .
specifications, local and state codes. All drainage devices required by the grading permit,
grading plan and grading ordinance have been installed. Adequate provisions have been made
for drainage of surface water from each building site.
The minimums are:
2% Fall from structures within 5 feet from exterior walls.
1% Fall for asphalt surfaces and landscaped areas.
0.5% Fall for concrete surfaces to approved disposal areas.
The final monuments as shown on the recorded tract map were Set.rAll final grading eleva-
tions are within + 1;10 of the designed elevations�ot as regised •
Supen•ising Civil Engineer tOili LLtt Re_. No. C 317Z°
(Sip:alum)
Dale j/7/93
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PROJECT ADDRESS: •12AO E 15TH SC UNIT:
N1T A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05786`_
OWNER'S NAME: DONNA & CARLOS GARCIA
ADDRESS: 280 E 15TH ST PERMIT NO: P 057865 PLAN CHECK NO: N GOVT: N SUPP: N
4 COSTA MESA
CA 92627 CONSTRUCTION TYPE: 5—N • PERMIT TYPE: PLU PURPOSE: NEW
ARCH/ENGINEER: (714 ) 646-9439 flEG.NO: -.ADDRESS: PACIFIC BUILDING CONCEPTS Nom. JOB DESCRIPTION : NEW.. S:FD W/ATT CARPORT, RE: 4B57862 SQ FT:
18102 SKY PARK SOUTH A-1 1 •
PERMITTEE: IRVINE CA 92714 CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 /M-1
ADDRESS: BEACH CITIES BUILDERS (714 ) 965-1369
10131 ASCOT CIR COMMENTS• NEW SFD W/ATT GARAGE( 2 STORY)
HUNTINGTON BEACH CA 92646-4321 ********iE**************************************** **********+tTF*****************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
clTYuc.: 054474 STATE LIC.: 5515 6 3 Ays: B
Date: G—l9-9Z signature: _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm ave 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(Sectio .Lao.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
POLICYNO.: 1091250-92 EXP.DATE: 01 /01 /93
COMPANY: STATE PARKING REO: PROV: PARCEL: 42516107 ZNE: REF NO:
❑ Certified copy is hereby furnished. C Certified copy is filed with the city Building Division. PLANNING NOTES>
�p p >
Date: b -t -qz Applicant: *******************************iE***********************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: anis s ion need not be completed ilthe permit is for one hundred 131001 or less). DEVELOPMENT SERVICES REQUIREMENTS
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. ZONING APPROVED BY ,•
DATE;
•
Date: Signature:
NOTICE:It.after making this declaration,you should become subject to the Workers'Compensation provisions of me 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 B Y: c DATE: ��*
which this Permit i5 issued(Section 3097,Civ.CI ******************,*********************n" *, ********************** *
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason PERMIT BLDG PMT PLUMBINGBNG 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
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 2 5 t SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 3. 00
I. as owner of the properly or my employees with wages as their sole compensation, wilt do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 32, 00 3. 00 0 . 0 0 35. 00 35, 00 . 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
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 35, 00 OVER/SHORT• . 00
for the purpose of sale). 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 35. 00
❑ 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).l am aware ,**,*,*,*-,*******,**_*****-***.*_***,***,*,***,****_***.***-**.****.**_****.**********************se*
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
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 PLU 2 BATHTUB 2 . 00 4 00
25534 and that I or any future budding occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU 1 DISHWASHER 2 .00 2 , 00
permit for construction or modification from the Air Ouatity Management District.Residential construction applications are exempt from PLU -1 LAUNDRY TUB OR WASHER 2 ,00 2 , 00
these provisions. PLU 2 SHOWER 2 . 00 4 , 00
Date. Applicant PLU 1 SINK, KITCHEN 2 . 00 2 . 00
PLU 1 WASH BASIN 2 , 00 2 . 00
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 PLU 2 WASH BASIN (SET) 2. 00 4 00
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned PLU 3 WATER CLOSET (TOILET) 2 , 00 6 , 00
properly for inspection Purposes. PLU 1 WATER HEATER AND/OR VENT 2 , 00 2 , 00
S Date: 6—/.1 -7Pe Signature: PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 , 00 2 , 00
Driver's License or Social Security if: PLU 1 GAS SERVICE 2 , 00 2 . 00
1641-46 White—Burtdinq:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor • --
CONSTRUCTION AND PLANNING • .,3L & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. f/� y!^ _ J 53. Steel Reinforcement
i
I, 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,
4 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
-J I
9, Water Pipe-Undrgrnd. 71fq��'I�jX-!.y 60. Backwash Lines, P-Trap, 0 Undrgrnd.
a n�
10. Structural Floor..System ' ' (; 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection i • . 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 O'Gas 0 Oil
23. Gas Pipe-Rough 8/Test 72. Underground Flush .
24. Roof Framing - 73. Undergrnd.Storage Tank O Gas 0011
25. Roof Sheathing - , ; ; 74. -OOverhead 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. InsulationI 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ,. 79. FINAL INSPECTION .
32. Electrical Power Meter-Final I 180. FOOD CERTIFICATE ISSUED
33. Final Electric - i -Notes:
34. Final Heating & Air Conditioning ( .
35. Final Gas Pipe-Test _ I '
36. Hood or Canopy .
37. Final Factory Fireplace , • . .
38. Final Plumbing - •
39. Water Service-Final •
40. Gas Service-Final • ,
41. Solar Domestic-Final C - .
42. Backflow Preventer I I,
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 I
50. Gas Release to Southern California Gas Co I I I; ` - • '
51. CERTIFICATE OF OCCUPANCY '• , -
No. Date
_
PROJECT ADDRESS: I UNIT:
OWNER'S NAME:
ADDRESS: PERMIT NO: P 057865 PLAN CHECK NO: 02334-92 N PAGE: 2
. y
• *******x*+r********+t***************** ***************************** ************
AflLM/ENRESS: REG.NO.:
ADDRESS: UNIT: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
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 of the Business and Professions Code.and my license is in full force and effect.
CITY LIC.: STATE LIC.: CLASS:
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.or a certified copy thereof(Section 3800.Lab.C).
POLICY NO.: EXP.DATE:
COMPANY:
0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division.
Date: Applicant: y r'' ✓^
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(SI®)or less). •,
I certify that in the pellormance 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. --
cr
Date: Signature: i. ;,.1
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor ) r
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. if 1
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for r' :rr
which this permit is issued(Section 3097.Civ.C). '_r I '
UNDER:
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($500). •
I, as owner of the property ar my employees with wages as their sole compensation, will do the work. and the
❑ 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 himselflhersell 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'Slate License Law does not apply to an owner of properly 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 •I v
25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
l these provisions.
e. -
Date: Applicant: s - -
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county 1 -
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 if: it ,
164146 While—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CGUR CTION AND PLANNING _JL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ?� j� 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 COVERGUNITE
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 zni •L7!/fes- 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing PlumbingcebeinGe. J 65. Electrical-Final
15. Rough Electrical-Conduit 1 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. butt's, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas OOil
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 PREY. 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:/.44_92_.y17 _O `1C /. _ /
&
34. Final Heating Air Conditioning r �__ .t�f^r-e-LO�}C�'
35. Final Gas Pipe-Test 1212 WC( is
36. Hood or Canopy 7777
37. Final Factory Fireplace J)�j
38. Final Plumbing f itz 1 2'LtD
39. Water Service-Final
40. Gas Service-Final /,p///.0-_.
41. Solar Domestic-Final '�`lF
42. Backflow Preventer
43. Backflow Irrigation .
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUI LDING
48. SINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 280 E 15TH ST 0NIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: GRA 057866\,
OWNER'S NAME: DONNA & CARLOS GARCIA \
ADDRESS: 280 E 15TH ST PERMIT NO: GRA 057866 PLAN CHECK NO: 02335-92 L GOVT; N SUPP: N
COSTA MESA
CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE; GRA PURPOSE: NEW
(714 )646-9439
ARCH/ENGINEER: PACIFIC BUILDING CONCEPTS REG.ND.: NOW. JOB DESCRIPTION : NEW SFD W/ATT CARPORT, RE: #B 57862 SQ FT:
ADDRESS: 18102 SKY PARK SOUTH A-1
PERMITTEE: IRVINE CA 92714 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
ADDRESS: BEACH CITIES BUILDERS (714 ) 965-1369
10131 ASCOT CIR COMMENTS: GRADING FOR NEW SFD
HUNTINGTON BEACH CA 92646-4321 *+F+F+FEF***+F+F*+F***+FBF*+E*****SESr*********SFSE*EF***. *+F** ***SF***+t+t*+F***********+F+F*******
LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NG R EQU I R EMEN T S
7000)of Division 3 0l the Business and Professions Code.and my license is in full force and effect. S E T B A C K S
GITYLIc.: 054474 STATE LIC.:k51563 CLASS: B
Date: 6—/9— YL ("Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm th ave ac a e 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 00.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 1091250-92 EXP.DATE: 01 /01 /93
I COMPANY: STATE PARKING REQ• PROV: PARCEL: 42516107 ZNE: REF NO:
❑ Certified copy is hereby furnished. }� eluted copy is filed with the city Building Division. PLANNING NOTES>
6— l9— q2 >
Date: Applicent: i `. E•1FT4***************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: a, ,. ed not be completed it the pentit is fa one hundred(5100)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 for which this per ssued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: .
Date: Signature:
NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. , r/ -- I
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• V W DATE; ( *
which this permit is issued(Section 3097.Civ.Cl. ***************************************** * * *****************
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the fallowing 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 T
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 15,
pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES
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($500). ISSUE FEE 3 . 00
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended oroueredfor sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 15. 00 3 . 00 0. 00 18 , 00 18 . 00 • 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
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 18, 00 OVER/SHORT; . 00
lorthe purpose of sale). 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 18 , 00
❑ 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).l am aware *.*.**.*.**., ,**, *,*,***, ,*,*,**,***,***,***,N**,*,"*,*,*, *,*****,**N,*******************************
that proof of their Worker's Compensation insurance should be provided to me, I N D I V I D U A L F E E BREAKDOWN
o I am exempt under Section: B.&P.C.
for nis reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
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 NO FEES WERE SELECTED FOR THIS PERMIT
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 Duality Management District.Residential construction applications are exempt from
these provision.
Date: Applicant:
I hereby certify that I have read this application a state that the above information is correct.I agree to comply with afl a} and county _ . .
ordinances and state laws relating to building co guction and hereby authorize representatives of this city to enter upon ye-mentioned ' -
property for inspection purposes. _
Date' / — ,Z Signature:
Driver's License or Social Security e:
1641-46 While—Buildmo:Green—Code Enforcement:Canarv—AoolicanC Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING PVJL & SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service 6r Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. • . 53. Steel Reinforcement
•
3. Electrical Conddif-Utility-Undrgrnd. 54. Forms
4:. Electrical Conduit-Undrgrnd. • • 55. Electrical Bonding •
5. Steel Reinfgrcement - -. •, 56. Rough Plumbing & Pressure Test
6, Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7: Footings ' 58. Electrical Conduit-Undrgrnd.
r
8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test
9., Water Pipe-Undrgrnd. •
60. Backwash Lines,P-Trap, 0 Undrgrnd. • ,
10. Structural fjloor,System 61. APPROVAL TO DECK
•
11. Property Sewer Line-& House Connection ••-; 62. Backwash & Receptor•Final •
12. Sewer Cap _ i 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 FIuSh _ •
24. Roof Framing - - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - , -• 74. Overhead Hydro _
26. T-Bar Ceiling (Structural) & Monocoat • z 75. Dry Chemical •
27.-Frame and Flashidg` 76. Dry Standpipe
•
28. Lathing•& Siding 77. FIXED SYSTEM.FINAL -
29. Insulation s ' • •
� 78. ,FIRE PREY. FINAL
30. Drywall Nailing l I HEALTH DEPT:REQUIREMENT
31. Plaster Brown Coat I , ; 79. FINAL INSPECTION
32. Electrical Power Meter-Final ! 80. FOOD CERTIFICATE ISSUED
33. Final Electric. .
}� Notes:
34. -Final Heating& Air.Conditioning : I -
35. Final Gal Pipe-Test - I.
' - - -
36. Hood or Canopy - , -
37. Final Factory Fireplace r • •
38.-Final Plumbing ' ' - -
39. Water Service-Final .- •
40. Gas Service-Final ' - - ,
41. Solar Domestic-Final .
42. Backflow Preventer 1 -
43. Backflow Irrigation b - -. • -
44. Landscape Irrigation System - • • , - •
45. Sound Attenuation
46. Handicap Regulations - _ - .
47. FINAL STRUCTURE & BUILDING '�//� �y��
48. FINAL PLANNING /J' �o� ,
49. Electric Release to Edison •
•50. Gas Release to Southern California Gas Co - - -
51. CERTIFICATE OF OCCUPANCY _ -
No. Date
PRO.IECT ADDRESS: 280 E 15TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 057864
OWNER'S NAME: DONNA & CARLOS GARCIA
ADDRESS: 280 E 15TH ST PERMIT NO: M 057864 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA
CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE: NEW
ARCH/ENGINEER: (714 ) 646-9439 REG.NO.:
ADDRESS: 18102
BUILDING CONCEPTSNOI JOB DESCRIPTION : NEW SFD W/ATT CARPORT, RE: 41157862 SQ FT:
18102 SKY PARK SOUTH A-1
PERMITTEE: IRVINE CA 92714 CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /M-1
ADDRESS: BEACH CITIES BUILDERS ( 714 ) 965-1369
10131 ASCOT CIR COMMENTS: NEW SFD W/ATT GARAGE( 2 STORY)
HUNTINGTON BEACH CA 92646-4321 ***************************yEyr;,r*****yryE*********sryE*Tt*TeyF******sr*xiE*****yr****Tr****+e
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETH ACK S
CITY TAC.: 05447 4 STATE TAC.:5 515 6 3 CLAS B
Date: 6—/f -9Z Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I 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.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
°OLICY NO.: 1091250-92 EXP.DATE: 01 /01 /93
OMPANY: STATE PARKING RE • PROV: PARCEL: 42516107 ZNE: REF NO:
J Certified copy is hereby furnished. 51 Certified copy is filed with the city Building Division. PLANNING N TES>
>
Odle: B'/'/p - !p Z Appfcant: ************************************1_E.******4—**********************************
1- EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: need not be completed it the permit is to one hundred(5100)or less). D E V E L O P M E N T SERVICES REQUIREMENTS
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. ZONING APPROVED BY . ' DATE
Dale: Signature: 7
NOTICE:II.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor -BUILDING APPROVED BY : 1 ' . 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 B Y•* ,I ~ DATE-
. .
which this permit is issued(Section 3097,Civ.C). ************* ******1h*,*************i **** :********************** * * **
LENDER: ,
ADDRESS: LEGALIZATION:N F E E SUMMARY 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 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 31 , 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 }}
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 15 , 00
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
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 31 . 00 1 5 , 0 0 0 . 00 46. 00 4 6 , 00 •
, 00
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.Iheowner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 46,00 OVER/SHORT: 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK
I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 46, 00
❑ and Professions Code: The Contractors'Stale 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).l am aware .*,*.*,***.**,**,.x,*N,*,*,*,***,.***,****,*,**,*,***,*,*,*,**,**,*,***,**,**,*,*,***,***,**,*****,*,*,*,*******.*****
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: 8.&P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Daher: MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9, 00 9 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 2 FACTORY FIREPLACE 6. 50 1 3 , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a
permit for construction or modification from Ihe Air uality Management District.Residential construction applications are exempt from MEC 2 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 9 , 00
mese provisions. END OF FEES
Date: Applicant:
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county
ordinances and slate laws relating to building construction and hereby authorize representatives of this dry to enter upon the above-mentionedc r •
property for inspection purposes. c 1_ • _ - - -
Date: 41;q- to Signature:
Driver's License or Social Security K: (. L
164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING E & 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
s4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steet Reinfprcemeltt 56. Rough Plumbing& Pressure Test
6. ElectricatUFER Grrid. 57. APPROVAL TO COVER-GUNITE .-
7. Footings. 1 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 t%. 61. APPROVAL TO DECK
r-
11. Property Sewer Line & House bonnection 1 ' 62. Backwash & Receptor-Final
12. Sewer CapI 63. Heater & Vent-Final
e3. Roof Drains 64. Plumbing System - Final
N. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
{7. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning fb-.//n1�f7t' FIRE DEPT. REQUIREMENT
-
-CC
20. Rough Factory Fireplace 1'7lAPPROVALS • Permit #
21. Ducts, in Structure. :: . 70. Underground Hydro
22. Ducts, Ventilating - 21. Product Piping O Gas 0 Oil
23. Gas Pipe-Rough & Test ` - - 72. Underground Flush •
24. Roof.Framing J - - -73. Undergrnd:Storage Tank OGas OOil •
25. Roof Sheathing - , , 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - - _ 75. Dry Chemical
27. Frame and Flashing' ' 76L. . Dry Standpipe . '
28. Lathing& Siding • 77. FIXED SYSTEM FINAL •
29. Insulation . 78. FIRE PREV:FINAL -
30. Drywall Nailing i HEALTH DEPT. REQUIREMENT
31. Plaster Brawn Coat - 79.'FINAL INSPECTION -
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
I) 33. Final Electric Notes: ;
.34. Final Heating.i Air Conditioning - (�,/�/QL �[r • '
35. Final Gas Pipe-Test ' "G • •
36. Hood or Canopy - -
37. Final Factory Fireplace _ ,, /yry �� , ' r
I -
38. Final.Plumbing -
'
39. Water Service-Final - .
I 'r .
40. Gas Service-Final ,
Al. Solar Domestic-Final - -
.
42. Backflow Preventer -
43. Backflow Irrigation - -• - •
44. Landscape Irrigation System -
45. Sound Attenuation
46. Handicap Regulatioris - .
47. FINAL STRUCTURE & BUILDING - '
48. FINAL PLANNING . • - r
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co 1 1 - .
51. CERTIFICATE OF OCCUPANCY ,
No. Date
' i Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CI`'V OF COSTA%MESSA 'CONSTRUCTION'PERIWI-T= • _ PERMITERMI.- NO. ^ TRACT NO. LOT NO. UNIT NO.
Project Address a o E. /S 7' F S—T L4134L� ,
-e1 Applicant's Mailing Address 5 4/�E • - TYPE OF CONSTRUCTION U NEW LJ ADD I ALTERATION U REPAIR r b
y7,. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.p-# Zone
I Owner's Name i:34 VW) A ' 0-/EH Phone - ,
+� DESCRIPTION OF WORK/USE OF BLDG.
Address ?430 E ' /S Z-� ST: E / S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT GRADING LJ.FOUNDATION ED STRUCTURAL E Front • 83_9_8 6/27/86 1903E6 TL
Address /� r , ❑ TENANT ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N
f--/Gt�NEi2 '❑ OTHER A I
Contractor's Name PhoneC Right - - - - N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) CONSTRUCTION TYPE VALUATION$ •S Left ' R
City License No. ZONE GRADI NG CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ret.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks:' Planning Notes: i 0
with section 7000) of Division 3 of the Business and Professions Code, and . • __ --
•
my license is in full force and effect. . . T
License Class License No. _ . ` - S
•
Date - Signature PLUMBING I FEES - • -
- - WORKERS'COMPENSATION DECLARATION Bar Sink - Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section ,_, ' .
Backflow Preventer ' Service Sink .
3800, Lab. C.) _ Automatic Washer Transformer ❑ 15-50 KW
Policy No. Company Backflow Irrigation Sewer Cap0 50+ KW •
® Certified copy Construction Pole Sub.
is hereby thehetl. �/
•
Certified copy is filed with the city Building Division. / Bathtubs Sewer Connection TCO Cooking Unit Meter Duo to 100 amps
Date _Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - • Solar Collectors Dishwasher Meter Dover 100 amps '
(This section need not be completed if the permit is for one hundred ($100) or •-
iess). Dishwasher - Solar Piping - ' Dryers ❑Gas DElectric Sub Panel `
I certify that in the performance of the work for which this mit is issued, I - _ •
shall not employ any person in any manner o s to suttject to the . Drinking Fountains S• olar Tank - Fan • Z
WOrkers'yC FrWlt>{Isatipp Laws of California. fn - Motors ❑0-1 HP ❑1X-R G�
• Date {l Z ( G�Signature Floor Drains SwimmingPool w/Spa -
P F.A.U. Inc.Solar ❑9-15 HP 016-15+
NOTICE: If,after making this'declaration, u should become subject to the —
•
Workers' such
Compensation provisions of the Labor Code, you must forthwith . Floor Sinks Urinal FIXtUTQ$ Microwave •
comply with such provisions or this permit Shall be deemed revoked. - '
' CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that tnere is a construction lending agency for the performance Pole Light ,
• of the work for which this permit is issued (Section 3097 Civ. C.)
Interceptors • Water Heater Outlets Range • ,.•�
• Lender's Name 9 V ido
Lender's Address e "�� • Kitchen Sink • Water Service SwitchesSign • -
OWNER BUILDER DECLARATION
• I hereby affirm that I am exempt from the Contractor's License Law for the / Lavatories Auto-Wash . .4 00 ' GarbageDisposal
following reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap • Laundry Trays Generator ❑0-5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor •
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains '
the Contractor's License Law(Chapter 9(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt - - - - -
ther-from and the basis for the alleged exemption. Any violation of Section - .
70 45 by any applicant for a permit subjects the applicant to a civil ., •
r
P' ` ty of not more than five honored dollars($500).
• TI s owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
t f pensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee - - $ 3
••r sale (Section 7044, Business and.Professional Code: The Contractor's MECHANICAL FEES-
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 DEVELOPMENT SERVICES REQUIREMENTS: •••
employees, provided that such improvements are not intended or offered for Boiler i Hood or Type I D
sale. If, however, th6 building or Improvement is sold within one year of com- Canopy Type II ❑ 'Zoning Approved By ,,,QQQ Date
prove for the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By ( //) Date //j7.tr/'g
Prove the purpose of sale). \VVV'/ /f--_ (D G
0-1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code: . •
The Contractor's License 'Law does not apply to an owner of property who - Duct-Ventilating - 00-100,000 BTU ❑100,000 BTU '
builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES
tractor(s) license pursuant to'the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $
proof of their worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple❑ System Repair/Alteration
❑'I am exempt under Section PLAN CHECK $ PERMIT -
C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $
..•..\ - PLUMBING $ /•• -
• Date / Vfl*-' Owner f�Wraith Heating System& Ducting Registers PLAN CHECK 25% $ •.Qfj ENERGY P.C. $-
I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100,000 BT GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL •$
and state laws relating to buildi construction, and hereby authorize repre-
sentatives of this cit to-e te` porn the above-mentioned property for PLAN CHECK 50% $ • 2o
inspection purposes G / _r�q.Gb /�
Signature A-....1t'Ii[ - Date l� /-II MECHANICAL $ • TOTAL FEE $ /"7•W00
Reinspection Fee $15 Issue • $ 3 " PLAN CHECK 25%
. Drivers' License or S5# �
- a _ - .
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor •
CONSTRUCTION AND PLANNING POOL&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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE to
7. Footings 58. Electrical Conduit-Undrgrnd. .inm
8. Foundation -59. Gas Pipe, ❑ 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
1.3. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring g•_i -sr/ /' f4 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 ❑Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush ,
24. Roof Framing 73. Undergrnd.Storage Tank ❑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 C 80. FOOD CERTIFICATE ISSUED '
33. Final Electric s'(`-6fr en. Notes: £/7/Pi7
34. Final Heating & Air Conditioning
s c� ��
.Pi i2 A , �i�9/r
er:
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 ,
li. .
'47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison i .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER WARD, JACOB L. DATE 3-13-64
7 JOB ADDRESS 380 East 15th Street BUILDING PERMIT NO:n728. •
GENERAL CONTRACTOR Owner-builder VALUE $ tail.00
lo
AP No.117-264-63 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORT ddapt.aboveGar.
INSPECTIONS Signature DATE GROUP I TYPE V ZONE R 2
Soil PERMITS ISSUED
_,_: SUBCONTRACTORDATENUMBER
S.
j '
r It I Corn. Refrig. 0 Air Cond. 0 _ e .
Rough Heating fi4" -6 % C— — a., rd
�a
Rough Plumbing y-/6 -G/ • _ -�6 - `ri ea �,/
Miscellaneous _
Prop. Swr. Line.0 House Con.,0 St. Swr. 0 1 44-6" 1- R. _ Leu -V-ASf3-(o`l L4'3n O —
S tinkling System - _V P %°
Construction Pole
Underground .0 Power .0 /�e --/
Rough Wiring I'[/I/Yl -63'Cv rlg—F-T -merit= - Ara. -
Trenches 0 Forms 0 Steel Reinf. 0 41I116
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing CA: C/LJ/6('
Frame and Flashing
Lathing- In, Out:.[gam p. ` 4
Plaster, brown coat
c CA-.
Refrig. .0 Air Con. .0 Final _
Heating, Final I rye,'Zy'
E 4bing Fixtures, Final -c 4,- z--6y
Iv'-1 Gas Test . • ' /,.T
Electric Fixtures, Final C((
Building, Final his /= i/ -G C----
OCCUPANCY
Form BU4—SM-3-63—S-B P nimnia
- , : Hit ,
_ .. - I
;
L ` 65
COSTA MESA BUILG SAFETY DEPARTMENT 91 26r0022to > n•**3 00
P.O. BOX 1200 COSTA MESA, CALIFORNIA 02020
For Applicant to Fill In Completely APPLICATION FOR PERMIT •`
' TYPE OR PRINT BUILDING
ooILDINo lj Q ��_ '1/ PrP For Offke Use Only
ADDRESS L/ glop. ^'� _sr
Brown'NO. PERMIT NO.
COSTA MESA. CALIFORNIA -.
//�� /n' ////�j��� RECEIVED BY DATE RECEIVED DATE ISSUED
OWNER G4 .. (2.� nLJ&f to-2G-6y C—nni-60
MAIL 7gebc 2t:17 - ADDRESS
ADDRQp �1 �Y ADDRESS
//SS �JJ /1'� // TQL FIRE 'J
CITY ( /�4',yy Ale.52, A.0• NO. ZONE c3 ��>�. GROUP -// jI
ARCHITECT TEL
APPROVED
// /n'/�DATHGy2b��C!
OR ENGINEER NO.
ZONING
Ria.. .-C
•
ADDRESS ZONE A. �NO.OF USE OP NEW 410--.1-1_. ,
K ) PLANS I BUILDING �t�
CONTRACTOR nain✓Eei a 1 1 ;2._ ` 1 y ,
Q� £ LEGAL S.
ADDRESS . J�jgF DESCRIPTION 4. r J P �, - _. ( .
CITY A.P.NO. / ) / — ' u f- J J
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL 90'TO SIDE 8 REAR P.L
LIC.NO. NO.
91 EAVES
8s'" _ f / �'�/ email]NO.or email] .'a ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
• YARDS APPROVED YARDS APPROVED
USE OF (a MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG, y,
(FROM C/L STREET)
SETBACK LINE FROM FRONT FT,t FT.
CENTER OP STREET REAR YARD
0
SIDE YARD LEFT RIGHT R.SIDE PT. f/ FT.
DESCRIPTION OF WORK L.BID FT. FT.
S NEW _ ALTERATION_ ADDITION REAR PT' FT'
: '; DISTANCE BET. BET.MAIN a
REPAIR t MOVING DEMOLISH - MAIN!SLOGS. ACCESS.BLOCS.
: VAR.* DATE
£ BUILDING NO.OF
SIZE ROOMS STORIES C.V.P.* APPROVED
j EXTERIOR WALL 4 ROOF �. AFRRrV{p' n / P
COVERING I COVERING `.. S7W./J „ .4.' q DATE f0 —�6-, L
e. USE OF BUILDING AND WORK TO BE PERFORMED "2,-.1-----C-0,-.-0-e__.
7�� 1T� ,7/ /) y
ex—ri
/..c
�n
A/1!i.S / e.. /.. O - IO�;.� r I
CS.f/.//in/t £ VN_ SO.FT.
t I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE To COM. • PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. 1
PLY WITH ALL Erre ORDINANCES AND STATE LAWS REGULATING a
BUILDING CO - VALUATION �/ O ]
' ^ PERMIT FEE ; J `� N
r SIGNATURE OF
1 PERMITTEE \ tkAN 'Jt O n p n -�' E
\.. f /•2 0 PLAN CHECK $ W
AUTHORIZED AGENT g O 0
TOTAL FEE $
OWNER .y. DATE 6-26-68
JOB ADDRESS 28u— 15th St. BUILDING PERMIT NO. dBf65
GFNERAL CONTRACTOR DESCRIPTION of WORK Legalize Enc.of Por.of Car.
0.117-161-33 LOT TRACT FIRE ZONE VALUES 15U.UU fvl Sewing tam.
IN3PECTIONS Signature Date GROUP , TYPE V ZONE 1t2
SOIL
GAS SUBCONTRACTOR PERMITS ISS ED
Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. Li
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND Li POWER El
ROUGH WIRING ' Heating and Vent.
Li TRENCHES fl FORMS STEEL REINF.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
P, -ER, BROWN COAT
S_ NURAL, FINAL Electric
HEATING, VENT., REP-RIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL ...Y I3 z�z
BUILDING. FINAL J/
-,'w r-
,
20I °q FEE "cCEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JUL 2 3 1963
P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely CAFPLIkALIO3iFIQ(aLSWAR
TYPE OR PRINT BUILDING
i For Office Use Only
BUILDING �� "'/ I
ADDRESS `-'1 0
RECEIPT NO. 2O1 n
COSTA MESA, CALIFORNIA U 1�.J]
REC IV DHY DA ERECE ED DAT- ISSUE•
/ /^ / _
OWNER S. L. • iLa- _MAIL / „ 7 SF
' ' _ / ��/
ADDRESS( / FIRE'Q�j 'f � � / �1
CITY ( a5]� MERE a NO. S X1-'6 ZONE TYPE a0
ROUP •
APP Q�/9/_/.a PATE !
ARCHITECT .�-. TEL. BY VVVVVV___ (%
OR ENGINEER NO.
_______-------' ZONING
ADDRESS 1 /
�jOO��11I v I NO.OF a I USE OF NHW
I.I • PIANS BUILDING
CONTRACTOR '421/416111 � jvR\ /1 �In ---
��.(��(/�
-
DESSDICAL U
CRIPTION Loo c A-
ADDRESS
.------.--• A.P.NO. I 17 - / ry1 1 C I - 33
CITY
' NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
STATE TEL 30•TO SIDE 9 REAR P.L.
LIC.NO. j-^
�. EAVES
SIZE - IG K / '�/' I NO.M OF
LOTS ALLOWED (U.B.C.REQUIREMENT)
OF LOT `ry L� oc+7 - - --
YARDS APPROVED YARDS APPROVED
USE OFQ MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. IC . ijBmE
(FROM C/L STREET)
SETBACK LINE FROM FRONT Q FT.
CENTER OP STREIT REAR YARD
- R.SIDE FT. FT.
SIDE YARD LEFT I RIGHT DESCRIPTION OF WORK L.SIDE FT. FT.
i
/
/
NEW ALTERATION ✓ ADDITION REAR FT. FT.
DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLOGB. ACCESS.BLDGS.
BUILDING NO.OF -•1 � VAR.# DATE
SIZE ROOMS STORIES)O(/ C.U.P.#' APPROVED
EXTERIOR WALLtU� I COVERINGO �(�C/� ' APPROVED { l,{,0 e)-a? -6.3
COVERINGA vI
USE OF BUILDING AND WORK TO BE PERFORMED
=0.
I HEREBY ACKNOWLE S(1AT I HAVE READ THIS APPLICATION THE A •UNT SHOWN UNDER VALUATIO FOR THE £
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A FERMI FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTIO / / _//� N
SIGNATURE OF act / //�I� � PERMIT FEE $Q\ j
PERMITTEE I//j/'/'^' Lt/ I
$ PLAN CHECK $ �� o
AUTHORIZED AGENT 4
J / TOTAL FEE $ (77
•
OWNER CGIT, GLENN P. DATE 4-8-59
JOB ADDRESS 280 E. 15th St. • BUILDING PERMIT NO. 8833
GENERAL CONTRACTOR Owner - Builder VALUE $ 6,J�2),_no
APP _- "
LOT TRACT FIRE ZONE DESCRIPTION OF WORKAdd Bdrlfl.I,VMR.Ha11 upstairs
GROUP I TYPE V ZONE R4 PLAN NO. 8833
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
,/
DATE NUMBER
cheysikm (�Stcel /J_
Floor System (P ��p�-�r��� 1"'1/.1
Steel Reinforce!) ,'Chimney Re-Rod ://a /{'y
Bond Beam O /
Frame and Flashing
Lathing, In Out •
Plaster, brown coat
Underground soil W/G 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
(' -traction Pole
:grou '`
:ground Power \/I
Rough Wiring / y stmt.. g'tJ 7-31 96 r
Fixtures, Final ! 4 i
OCCUPANCY
Form 216-5M-1-57 8833
ti 3
'. MAR 12 1959w/
COSTA MESA BUILDING DEPARTMENT
P.O.BOX 317 Fr;'",r.'CE DEPT.
COSTA MESA, CALIFORNIA -(CTE PirS.
-
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
no RDEISS flOdtnrr jgru.17, ,ezcsi BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
CoCEIPT NO. 615 wrUMQa
OWNER GL4N� / •. ///•�(l 1 O
MAIL ��jj a') (� RECEI ED BY /DATE RECEIVED�y DATE ISSUED
9
ADDRESS 2/a ,e./A� 'd J/0G.6/G�r ,.T-, -S I 4-R.S/
TEL tr,.. BUILDING
CITY (G1.J7/�" J970..rA/s� NOm/G ZSA•. ADDRESS •
HITECT
ORCE NG I NEE�Cji/J,/9 Jy'',n'- i' 0,1.. .Ot/I COSTA MESA. CALIFORNIA
%% FIRE
ADDRESS ZONE
ZONE NO.of TYPE ROU —
J CITY LIC. ///� LANs
CONTRACTORf,�/rj!/j/` NO. /\ /J
TEL. APPROV ,//J.//,.^- I� O�/�
ADDRESS NO. BY • (/✓\ 4 OATS T o J
LEGAL LOT '" /�IGr /i/%/ti/I/1• CORRECTIONS
DESCRIPTION NO. , BLOCK TRACg�/JLir ,
rannoreasSIOSO
A.P.NO. // t -- /(P /.-- / ['.✓ll.V L!i r� ^n( 3.7 �yl-�q
SIZE i. ..l NO DE BLDGS. L-AA Y .k Va v ,A IL,
OF LOT ,7O //2y NOW ON LOT / C:. •
USE OF •� ��� \� ' A Mt'SA
EXISTING BLDG. A •-,r{ges«. PL.\Ni,i. ' 1)F?i.T
SETBACK LINE FROM L • SUOJLCT"T0.6,1❑G. O PT. REG,
CENTER OF FR T. SUAR YARD Z.". LJ ,
/ / . RY e �' •• __y
SIDE YARD RIGHT LEFT ,�`t,rtJ
DESCRIPTION OF WORK l PLAN'TLCH. -4'./ Y
NEW ALTERATIONX ADDITION X 4,//`/. 4 (rife! "3 -.3/ 1
REPAIR I MOVING DEMOLISH ? j 1r\? rR 17,f gV.r4T+ kdI•H;`
BUILDINGft // /l / NO.OF ? 1 i n �.' imp F i� tL ��
SIZE �//���/�/O�q ROOMS STORIES 2,
EXTERIOR WALI(/vOO ie ROOF /V /� }j'_1 I-:, I _ `.' 11 ',i' . �-.
COVERING ,fypj.db, COVERING C�®4T i r ; /im • X ::37 .
USE OF NEW [� �^ sus /"/‘�• , , '�/%�. ,J ,,.,. ,-(�7�
BUILDING ,Q,�/®F/.e� �l� o�oG/a�� }/ 6-i�•/'4 31yct .
vl bh J LU
4%U/Aire /200 .►/�i`yG% ._ --_ �// 1 �j
I\r gher"jylp l*vI,1 C gil. rc fnr-fhP. / -
I HEREBY ACKNOWLED THAT I HAVE READ THIS APPLICATION AND
j
STATE THAT THE AB• +
E IS 'R •ND AGREE TO COMPLY WITH ALL purpose Of ns:717!k-Het. - . fl.1.
CITY ORDINANCES A D S:1:0.;#'W REGULATIN B GING CONSTRUC.
TION. VALUATION
SIGNATURE OF �' •
PERMIT FEE $ /8... e-°
PERMITTEE s
$ // 'Sir
PLAN CHECK S 7,
�j T'L TOTAL FEE $a7, \g.-r
AUTHOR•Z-2D AGENT
OWNER YOUNGER, B. 6. DATE 7/23/63
JOB ADDRESS 280 E. 15th Street BUILDING PERMIT NO. - 20193 -
v GENERAL CONTRACTOR Owner-Bldr VALUE $ 100.00
\AP No117-181-33 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Remodel Res.
INSPECTIONS Signature DATE GROUP .I TYPE V ZONE R2
Soil PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
-
iv_ eh Corn. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous •
Prop. Swr. Line ❑ House Con. ❑ St. Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power 0 _
Rough Wiring
Trenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing— In 0 Out 0
Plaster, brown coat
Refrig. 0 Air Con. 0 Final
Heating, Final
I 1bing Fixtures, Final
1:),:r:Gas Test _
BFixtures, Final /.9/;it
Building, Final / ,(�
OCCUPANCY
Form BU4-5M-3-63--S-B P _n_ nL-. Mi no