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HomeMy WebLinkAbout230 16TH PL - Building Permits Y 0" 9 CITY OF COSTA MESA 4 BUILDING DIVISION . • �,- .4r DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER V PERMIT 602-00141 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 230 16TH PL Status: ISSUED Suite: Applied: 01/29/2002 Vicinity: GARAGE ONLY Issued: 01/29/2002 Parcel Number: 42520213 Zoning: Applicant: FONSECA, EDUARDO ISSUED BY: ,504LY Address: Phone: 949-548-5569 ' Zip: Owner: WALDRON, JOHN B Address 4704-B NEPTUNE AVE Phone: NEWPORT BEACH,CA Zip: 92663 . Contractor -CRANK BROS'ROOFING CO INC Address:. 126 COMMERCIAL WAY . Phone: (949)548-5569 ' , COSTA MESA,CA Zip: 92627 Licenser 794724 Arch : _ Eng: Address: - - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT GARAGE ROOF:TEAR OFF,'INSTALL 30#FELT, INSTALL 20 YR SHINGLES;CRICKETT&WALL: INSTALL OE LAYER 28#BASE SHEET, INSTALL 72#CAPSHEET; 5 SQUARES FEE SUMMARY Plan Check: $0.00 -- Calc Valuation: $1,300.00 Permit: $47.90 Claim Valuation: $1,300.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $48.40 . i: _, . . PLANNING&ZONING SETBACKS . . MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 - . Rear 0-0 Left 0-0 Right 0-0 , PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work isnot commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754.5626 264646(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'c-)-1-A-7-corn eation C FG( /carriaand policy number are: _ Carrier: ill l 0 Policy Number: I /I I l0 % -0 (This section nee-a not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agr that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pprr9'Ylsioois / Applicant Signature: G-,C/.wG. /.- �/hrff/G- Date: ! — c.2_??- 0 2 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed unc{gT gripgs of rapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# 6.c,+f—�i�]9`-1 -1 t d _ _ Class# C l ,�`1 Contractor's Signature: .. a -r L— Date: /— c2 f'0 a CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: _ Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SC/Lar,-.4S> azure Of Legal Owner(s) Date re/2.1%ele-- /-oZp— OoZ And/Or Authorized Applicant Date CODE I INSPECTION TYPE Mg INIIUALS CODE r INSPECTION TYPE DALE HMIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical _ 1266 Pool Spa Final y � nz 208 Final Plumbing .. // 200 Final Re-Roof l —)/ i-7 Z `WV' 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval . 203 Final Sign 222 Final Site 204 Final Demolition , 250 Final Building/Occupancy. 1111111111111.1.-7 / Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . -.1111111111111 b`r' P R IT NO. CT N LOT NO. UNIT NO. +t��.�' OF COSTA MESA CONSTRUCTION PERMIT Al _ Project Address 2 30 A /��pi ,fie G05f`rl YN6S �" _70997 /41" 2145 2/11/87 30050 TI Applicant's Mailing Address '3O3•2 HFRr.CORA !(.bO itRjJc:.c '1 Z4 i TYPE OF CONSTRUCTION ❑ NEW ADD ALTERATION H REPAIR T r Phone72 Ira ti• I I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ` I A p # ¢2g— 2 0/J r /3 I Zone Owner's Na a LSO M.FiTZSi%AEJf SI 7 G.✓Gi 30 2-H9P-1`/� / 04-C/A) / G/ T60 DESCR PTION OF WORK/SSE OF BLDG. Address tt(. !•�! .-.a.r% a •.1 s t ccµ - eoct S Main Building: Accessory Building: Arch/Eng. Ol•J fa tom? License No. TYPE OF PERMIT . GRADI G OU DATION A STRUCTURi•Lt ..t Front ZO Address ❑ TENANT ❑ ELECTRICAL PLUMBING E MECHANICAL B Rear N Contractor's Namp 040/002. Phone ❑ OTHER A _ I PROJECT DESCRIPTION SQ. FT. OCCUPANCY R-3 C Right • N Address(mailing) CONSTRUCTION TYPE Je / VALUATION$ SSU .°� S Left G City License No. • ZONE GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 2 .yc PlanningNotes: ws %4) p��� L with section 7000) of Division 3 of the Business and Professions Code,and Etc St / C /r/Q','p-,s^'y/��'' Y(f -ALIS/S7(I / \/M my license is in full force and effect. • Z /O/1C ai - ' • l.. /f( jL(J�/I,Q,/L[.4I S License Class License No. _ /�IC..I f / • Sena. / Date_r Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION 'Bar Sink Showers ELECTRICAL FEES I I 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 Backflow Preventer Service Sink 3800, Vb. C.) Automatic Washer Transformer 0 15-50 KW Dailey • No. Company Backflow Irrigation • Sewer CaCI50+KW 8 Certified copy is hereby furnished. P • Construction Pole Sub. • Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps / Date Applicant , I/// EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors l DishwasherMeter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - - less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the , k/�,�( hich this permit is issued, I - shall not ernploy any person in any - pr s to become-subject to the Drinking Fountains Solar Tank Fan Worker Co tion Laws of Cali . is Motors❑0-1 HP ❑1' -8 Date Signatur. _ — ' Floor Drains - Swimming Pool w/Spa NOTICE:11,aft r making this decl.- , you sh F'�:l•ecome subject to the F.A.U. Inc.Solar ❑9-1 P 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures •comply with such provisions or this permit shall be deemed revoked. Micfpwa CONSTRUCTION LENDING AGENCY - Gas Service • ,3 Outlets • Water Closet .. �� . D¢V iC¢BOx¢s I hereby affirm that there is a construction lending agency for the performance / 2.• _ • P. fight of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - .. - Range Lender's Address Kitchen Sink . Water Service Switches Sign OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash 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 PI -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).bt r . • .. Division 3 of th Business and Professions Code) or that he/she is exempt - therefrom e basis for the alleged exemption. Any violation of Section 7031.5 any applicant for a permit subjects the applicant to a civil m of not more than five hundred dollars ($500). . I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 umpensation, will do the work,and the structure is not intended or offered • - •einspection Fee I $15 Issue Fee $ 3 for 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 Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- - -- - - Canopy Type II ❑ Zoning Approved By �w 'Date pletion;the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By < / Date __ //-- prove f the purpose of sale). Zar ��� as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By •t.%t .. .• Date _—//' eters 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 ❑0-100,000 BTU•❑100,000 BTU SUMMARY OF FEE S builds or improves thereon,and who contracts for such projects with a can- - y tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 10'00 SM IP $ f 519C9 proof of their Worker's Compensation ' urance '.• d be provided to me. PLAN CHECK $ G• S� PERMIT ❑ I am exe pt under Section & P.C.for this reason i Firepl/Fact.Blt. ICBG 43icr- Fire Dampers ,w ISSUANCE $ c���- PLUMBING $ 3 c Date A!/a • Own: Err �_ ' - Heating System&Ducting Registers P.C. $ PLAN CHECK 25% $ •SO I hereb car ify t.. hav:/-ad this application Mir that the above ❑o-100,000 BTU ❑100,000 BTU GRADING $ information is to omply with all city and county ordinances ELECTRICAL $ and state la relay•. �rrssss..rs'rrr g construction,and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ - sentatives • chi upon the above-mentioned property .r inspectio pur•• p.-7 • MECHANICAL $ 7` 00 5� Signatur. 7 Date // J / CO TOTAL FEE $ •�! Drivers' License or SS 4 - _ • Reinspection Fee $15 Issue.Fee PLAN CHECK 25% $ /• 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-Uridrgrnd. 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 ,/zq/f7 %f° APPROVALS Permit# _ 21. Ducts, in Structure C 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 3/.211/4 /L�$ (7 2 /'--1 76. Dry Standpipe • 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 3/j%, Gfl/ 78. FIRE PREV. FINAL • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT • 31. Plaster Brown Coat *3./.247 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final ! < 80. FOOD CERTIFICATE ISSUED 'r 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test L/_/0i7 t- 36. Hood or Canopy • 37. Final Factory Fireplace *(.i°lll ac/AW 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 11 47. FINAL STRUCTURE & BUILDING tikA �-- • 48.,Special.Requirements Completed I� - 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co - ' • 51. CERTIFICATE OF OCCUPANCY No. - Date City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division. C L7�719 MLS 0/7r?r.D6-1z: Number and Street City County Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material votE&1CK f'c, FN13Eti2C-i4a45 Brand Name Ok)bU5 CoRh11NG- F)e,t4W14]SS Thickness (inches) 6 Thermal Resistance (R Value) / EXTERIOR WALL Material' CD.1, 1 �t31_QG—L c Brand Name CtaiL'L)t CoR1IuC r I� I' Thickness (inches) `-` L Thermal Resistance (R Value) �- �� CEI LING Batt or Blanket Type t3' ' Brand Name Thickness (inches) Thermal Resistance (R Value) Loose Fill Type _ Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft2) Thermal Resistance (R Value) FLOOR, ELEVATED Material N• Brand Name Thickness (inches) Thermal Resistance (R Value) FLOOR,SLAB Material <J`S\ ' - Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material t-i - 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 regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). Z Ev _ General'eontractor(Builder) License Number Signatu e and Title Date •A - Sub Contractor(Insulation Applicator) License Number Signature and Title Date CMF 1106-46 LEO A. FITZSIMON ASSOCIATES, INC. CIVIL ENGINEERING,LAND PLANNING,CONSTRUCTION / 3032 HARTFORD RD. 714-538-6511 ORANGE, CA 92669 October 21, 1987 The City of Costa Mesa Building Dept. City Hall Costa Mesa, Califs Statement of Compliance, Grading and Drainage :230 .16th Place, .Costa .Mesa Gentlemen: I hereby certify that the grading and drainage on the above property as as completed conforms to the approved grading plan with all run off exiting the property to the City alley at the rear (north) property line. Very - ts, r• A. Fitz 'mon R.C.E. 17976 From the Desk o( . . . • GEORGE EDMISTON at 30 /G 7/ n /FP fi-s7 9si /'47.-W zo, S Hoe /1/ Q.Act o ( j4-#2T<,, .Viyr G3/ / 73/ C- Applicant to fill in all spaces except those within heavy border lines and si• gn all appropriate declarations. -. ` is5 TRACT NO. LOT NO. UNIT NO. ' 491 7 '10/10/96 r CIT�7GF COSTA MESA CONSTRUCTION PERMIT PERS". 23:00= It Project Address 230 • /GQGr¢cc cl�ic�3y9 (oiS/ • • Applicant's Mailing Address 3o t <'l/7i2rFoRO no o/Zp/,1G,tr.9 TYPE OF CONSTRUCTIO Li NEW LI ADD U ALTERATION El REPAIR f a ❑ CONVERSIONall EMOLISH ❑ OTHER ' Owner's Nate¢ . F_)ra-_12 Phonon&ora i A.P. • # Zone D RIPTIONJOF WORK/U E OF BLDG. Address' 3C>at rippl-Fog.° C.O.ogbdo.r:6 to • 41-661rA{ L t ;it ilik a_., — J S Main Building: Accessory Building: Arch/Eng. Let 4 Ft7'LS)N.iO n/ License No.eCt x7176 TYPE OF PERMITGRADINGGRADING FOUNDATION N STRUCTURAL T Front ZO Address '�03t ear *O g 2m' orz,�l.dat Cvi• gL66 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name llf-]to Y ❑ ,OTHER ,, A 1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right • N Address(mailin 1CONSTRUCTION TYPE VALUATION$ 000 0 s Left R ' City License No. ZONE - GRADING CU.YDS. ACRES Ping. Ref. Parking Req./Provided E LICENSED CONTRACTOR DECLARATION O I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and - my license is In full force and effect. T - S License Class License No. - Date Signature PLUMBING 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. Com• /— Backflow Irrigation Sewer Ca 0 50+ KW P Construction Pole Sub. Certified copy is hereby furnished. A Certifie \t-.) oty=sjiled with the city s_! �• 1 . Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 1C 0 �6 Applicant •� f" _ Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps EXEMPTIO F OM WORKERS'COMPENS•TION DE �A • • p (This section need not be completed If the permit is for On dred($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. DataSignature Floor Drains Swimming Pool w/Spa F.A.U. olar 0015 HP ❑16-15+ NOTICE:If,after making this declaration,you should become subject to the Inc.. Workers' Compensation provisions Of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures ' comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes I hereby affirm that there 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 Lender's Name • Outlets Range 9 Lender's Address Kitchen Sink Water Service Switches - OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW ❑5.15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for.such permit SEW ..�np to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains Sr-W 1-'2 SCI 2 ••00 - 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 ' therefrom and the basis for the alleged exemption. Any violation of Section . '031.5 by any applicant for a permit subjects the applicant to a civil ' * re Ity of not more than five hundred dollars($500). 3 I, as owner of the property • - - --- -^^-- -- Reinspection Fee $15 Issue Fee $ 14/ will do the work,and the structure is not intended or offered Fee $15 for 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 REQUIREMENTSIssu:e Fee $ 3 employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ , sale. If, however, the building or improvement Is sold within one year of com- — Canopy Type II ❑ Zoning Approved By Date p - g,ove , the owner se have the burden of proving he/she did not build or Im- Duct- Under Ground - Building Approved By Date rove for thwe purpose the pf ope). _ U I, s owner construct thet the property,act Se exclusively contracting with licensedionode- Duct-Structural Refrigeration System Application Issued By Date tractors to actorsu project (Section 7044,BoSan ss and Professions t Cotle: The Contractor's License Law does notoraapply to owner jofe property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU - , ' builds or improves thereon,and who contracts for such projects with a con- SUMMARY7OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware that • Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $ /7 Sb SMIP $ Os SZ • proof of their Worker's Compensation ante sh• id be provided to me. PLAN CHECK $ �•-+ PERMIT 0 I am exempt under Section `, •' C.PodThis maw Firepl/Fact.BIt. ICBG# Fire Dampers I�--� PLUMBING $ STIO ISSUANCE $ Date Owner I w ////� —Heating System& Ducting Registers ENERGY P.C. $ �- ❑6100,000 BTU ❑100,000 BTI, PLAN CHECK 25% $ I hereby ce ity that eve tea. is application a d St e that the above . GRADING $ Information Is corre . I ..pee t• :•m•ly with all cit .r• ounty ordinances ELECTRICAL $ and state laws rel ng • b yc• struction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of th • ci to a the above-mentioned prop¢ y r inspection pur•.se � Signature 4/4,� L Date MECHANICAL $ TOTAL FEE $ Drivers' Licen - •r 55* � 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 • 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 j 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 I" . 38. Final Plumbing �p Iq(. D - 39. Water Service-Final Pik���l • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation . !,44. Landscape Irrigation System 45. Sound Attenuation . - - - 46. Handicap Regulations 4 St 47. FINAL STRUCTURE & BUILDING p/ 48. Special Requirements Completed 49. Electric Release to Edison - • 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date _ rte _'� Applicant to fill in all spaces except those within\heavy border lines and sign all appropriate declarations. • Cit OF COSTA MESA __CONSTRUCCC 'iON PERMIT3a' 8 -G PERMIT NO. • T ACT N7 LOT NO. UNIT NO. I. pt Address'230 lea!�!r3CE CcJV19 I yG�i9 • Q 1S� �O �� 6� 101 REPAIR C — 5540 10/20/66 439.77 TI Afhe5nt Mailing Address 03t /Y n.i '1 2O �n 0211.-<.fi TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R Owner's Name G� ��- tTYSl7Hcn Phone v ❑ CONVERSION ❑ DEMOLISH ❑ OTH.E rj DESC•IPTION OF WORK/ SE OF BLDG. /v�L✓ t~(J 'EK Q AP ;W 4�j � 1, �Z"' - f Zone �3 Address 3c31 NA1ZTfYCD Q p'Orz1 Gs4_C/'L-E61C/ • - •O_, + 4 - '�•a 4'-"- ,S Main Building: ) is Q' Q. C. . Acce s Arch/Eng. OL A/et License No. TYPE OF PERMIT M GRADING jr 'DATION e�STRUCTURAL E Front �+ / 7 " fry unAt A ,,e r�o•/ 0 Address ❑ TENANT ❑ ELECTRICAL LfA PLUMBING ❑ MECHANICAL B Rear CVC/ L, ,ysn i1 Li/� I. N Contractor's Name Os 11J1�f� ❑ OTHER C 71J'"�--J-�' Phone DU C Right 5/ '6' N PROJECT DESCRIPTION SSG-.,___ S OCCUPANCY—(i,3 _ Address(mailing) �l-W-•. VALUATION 57A�g00 'w S Left 'I D, 2.2_,/- " • G CONSTRUCTION TVPF fU R City License No. ZONE GRADING CU.YDS. ACRESDR.,— 86 p�� E LICENSED CONTRACTOR DECLARATION �) -}�. A Ping. Ref.# 1/K� �31 Parking Req./Provided '2 pp,(M' / 0 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: rC•(J_ ii' -] __415! S Foe r-- 1f '�`5'. 25 449 Planning Notes: t {(�/.P-ld.I. M with section 7000) of Division 3 of the Business and Professions Code, and' Ll (J 7 �P a•�t'T • T • my license is in full force and effect. - License Class _ _ License No. S Date Signature _.- PLUMBING FEES W�� FOR SY�I;lAL RCrlulKLME)�TS WORKERS'COMPENSATION DECLARATION Bar Sink Showers- ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate ' 4 Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. - Company Backflow Irrigation Sewer Cap • Construction Pole Sub. 050+KW 8 Certified copy is hereby furnished. iTrot Certified copy Is filed with the city Building Division. 2 Bathtubsdill - 1 Sewer Connection Cooking Unit Meter ❑up 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) of less). Dishwasher Solar Piping 4/00 Dryers ❑Gas ❑Electric. Sub Panel I certify that in the performance of the work • •hi id is •ermit is issued, I shall not employ any person In any man•- -. ask sv sub' ct to the Drinking Fountains Solar Tank Fan Workers' Compens t' Laws of Califor• �ll..aa77 Motors❑0-1 HP 1 h-B Date caL�r-1-O KO Signature �. — Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar -15 HP ❑1fr15+ NOTICE:If,afterMaking this declaratio you shag e subject to the • I - Workers' Compensation provisions of the Labor Co• u must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall •e deemed revoked. - Micr ve CONSTRUCTION LENDING AGENCY 2_ Gas Service- - Outlets 4 Water Closet /o _ 04 Device Boxes le Li ht I hereby affirm that there is a construction lending agency for the performance _ g of the work for which this permit Is Issued (Section 3097- Civ.'C.) lnteroepto s Water Heater 9 Outlets Lender's Name - q OG • Range Lender's Address - L Kitchen Sink - Z .Water Service g OG Switches - Sign OWNER BUILDER DECLARATION I hereby affirm that.l am exempt from the Contractor's License Law for the 4.... Lavatories • - ,. Auto-Wash ' .0 Garbage Disposal following reason'(Section 7031.5 Business and Professional Code: Any city or ,Standing Sections county which requires a-permit to construct,alter,Improve,demolish or repair P-Trap / ' any structure, prio1 to its issuance, also requires the applicant for such permit - - Laundry Trays Generator 00-5 ■5-15 KW Trash Compactor ' to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drain;- d • the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ZW A54 tr. nlGYLKQ SE'T'YP _I 0 • • - Division 3 of the Business and Professions Code) or that he/she is exempt • ',erefrom and the basis for the alleged exemption. Any violation of Section 131.5 by any applicant for a permit subjects the applicant to a civil 4 - of not more than five hundred dollars ($500). as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 pm ensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 ' for 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 SERVICE REOU, EMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ ,/IJ7� v O_7.r, sale. If, however, the building or improvement Is sold within ono year of com- Canopy Type II ❑ Zoning Approved By ,fJ' - ` a Date / .tenon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Com• prove for the purpose of sale). - Building Approved By Date LAI ^•2_ —3G+ i • ttvv O I,'as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Sy Application Issued By Date /U •- 2,V.- Oe 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 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that —Exhaust System ❑ Multiple ❑ stem Repair/Alteration. BUILDING PERMIT $ Z 70'00 SMTP $ S proof of their Worker's Compensation insuran should be provided to me. _ (,,�f�UIL AN CHECK $ PERMIT ❑ 1 am exempt under Section .& P.C.for this reason Heating /Fact.BIt. ICBG# Fire Dampers • �W'l PLUMBING $ %cal 00 ISSUANCE $ Date 10/4.12/14X___ Ow, r HeatiSystem&D ng Registers PLAN CHECK 25% $ / a' as-ENERGY P.C. $ I hereby, certit I ha ea is applica io an state that the above ❑0-100,000 B 100,000 BTL— GRADING $ information Is r . I .• :�tmo omply with all cl and county ordinances ELECTRICAL $ - i and state la r in• -: /—•�I•'�.11' - -•r Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 9p I 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. 1g//41 O£' 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement ' 'J/J 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. /O/�"//( on- 57. APPROVAL TO COVER-GUNITE 7. Footings ! 4rbbj// /% e Q 4 58. Electrical Conduit-Undrgrnd. 8. Foundation /4/,t it ej ' 59. Gas Pipe, 0 Undrgrnd.,Test .. 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System IOA $6 A pd 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection I it, tag 62. Backwash & Receptor-Final - • 12. Sewer Cap V 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 71.20.D 477 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 ❑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 37.a* 76. Dry Standpipe 28. Lathing & Siding sI/0 7 Qi(. 77. FIXED SYSTEM FINAL 29. Insulation / ja' 78. FIRE PREV. FINAL • 30. Drywall Nailing 410/97 pa- HEALTH DEPT. REQUIREMENT f 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final Al/4347 �• 80. FOOD CERTIFICATE ISSUED 33. Final Electric /OS �• , Notes: /o /i//FC N vfroJjein7, . 34. Final Heating & Air Conditioning vSi,t�.alf'�4 ' J201 net- 35. Final Gas Pipe-Test #OI*V7 x.19 ' / ,! �p�r{.ce � .�Yt'��eil IDG. ! ��Ti 36. Hood or Canopy /V1.7 L oft af4.t/ ar • 4 X37. Final Factory Fireplace p 0/Q /�j �li� tit-it- it n4-a.irvaMeiC� ;4,, wel, fy/I 9 38:Final Plumbing ro{q� 4Q> ' / 4 .. . .2-/7-�,Y'7 Ul c,�a�,v� tG�tauX' n ��u+..i�[ 39. Water Service-Final /0 47 44) It b-li,.Y no N t- Lea GI,...,71,1!)iso. 7/ 40. Gas Service-Final /191 17 41. Solar Domestic-Final - 1 42. •Backflow Preventer 43. Backflow Irrigation • , '44. 'Landscape Irrigation System . 45. Sound Attenuation i• 146. Handicap Regulations 47. FINAL STRUCTURE & BUI LDING 4c� �2�n Oft es • k • 48. Special•Requirements Completed /2�7�//%/ i '�m/Y) • 49:,Electric'Release to Edison r ;+ ►. 50. Gas Release to Southern California Gas Co - /- 51. CERTIFICATE OF OCCUPANCY, No. Date _ _ � ► - • CITY OF COSTA MESA PARK FEES Fee Payment Receipt 001048 5539 10/20/86 1146.36 TL - Project Address 230 / ' Place, R, B, e A.P. Number yes — aoa — /3 Building Permit Number 8P a Sas 0 Owner's Name_ 1. O A. PITZSiMOnJ Mailing Address 3j 3A /- 0.4,1-fbr-e0 IPd . Cran.e, CA 92669 FEE: Single Family * Number of Units 2-Bedrooms or Less @ $ 861.76 = 3-Bedrooms @ 1,205.67 = . 4-Bedrooms @ 1,545.62 = 5-Bedrooms+ @ 1,810.50 = Multiple Family ** •Bachelor or Studio @ 474.37 = 1-Bedroom r @ 573.18 = /1410,06 2-Bedroom @ 881.51 = 3-Bedrooms+ @ 1,229.38 = � Total Fee "' i Nes 34' Planning Departmen p val • L'-•y g6 By ae t c..*n .� f Applicant's Signatu e 7 . City Ordinance 72-44 *• City Ordinance •••City Resolution 78-116 0 � CMF 0174-30,rev,7/85 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant '',LL • LEO A. FITZSIMON ASSOCIATES, INC. CIVIL ENGINEERING,LAND PLANNING,CONSTRUCTION 3032 HARTFORD RD. 714-538-6511 ORANGE, CA 92869 October 21, 1987 • The City of Costa Mesa Building Dept. City Hall Costa Mesa, Calif. Statement of Compliance, Grading and Drainage : :230 .16th Place,;.Costa:Mesa;. . Gentlemen: i hereby certify that the grading and drainage an the above property as completed conforms to the approved grading plan with all run off exiting the property to the City alley at the rear (north) property line. Very .e , !6. A. Fitz "*non R.C.E. 17976 9 City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division L :>o ��✓ 7-7L-Flet: 0-1.C) cfoS/ /r M134 Orens-7G-t Number and Street • // City County Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material O1l-eft'CLK F\B0?C-L.r3Ss Brand Name OWe*)SCoRh lNIG "FlE•t(?G-14155 Thickness (inches) 6 r Thermal Resistance (R Value) I EXTERIOR WALL Materiall-S U-tt IC`3LQt'1'1S Brand Name O.JL'US CORO)t-t� I/Li. Thickness (inches) Thermal Resistance (R Value) CEILING Batt or Blanket Type la'A ' Brand Name Thickness (inches) Thermal Resistance (R Value) Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft2) Thermal Resistance (R Value) FLOOR, ELEVATED Material N• I\ ' Brand Name Thickness (inches) Thermal Resistance (R Value) FLOOR,SLAB Material !J'P • Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material t-i'(a 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 regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). G EZ, T5si•�,or1 � Generar ntractor(Builder) License Number �ey r) - l ' c t O(Jues-c Prower4�t)>h"� 281 S'7 ‘, Signatu a and Title �a✓te N •A - Sub Contractor (Insulation Applicator) License Number • Signature and Title Date CMF 1106-46 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. 0053 x /12/3/ IQfp ufi 1 • CITY OF COSTA MESA CC/ONSTRUCTION PERMIT a �� Project Address 2-30 /O r- PL/9CE eosin /11t t13 t Applic.++!t's Mailing Address 3O Z Hgi&y14 D Ili ORAr Ara al,/ TYPE OF CONSTRUCTION U NEW H ADD U ALTERATION U REPAIR • �3�V�// El CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name Leo A.Err 2sImon Phon DESCRIPTION OF WORK/USE OF BLDG. Address SOIL HARTFD/10 ay) nQA E L.ti• ei 3/667 S Main Building: Accessory Building: Arch/Eng. 11....z)..)2(2 License No. TYPE OF PERMIT • El GRADING LI FOUNDATION ❑ STRUCTURAL E Front Q Address ❑ TENANT g ELECTRICAL ❑ PLUMBING WMECHANICAL B RearI N //�� Contractor's Name QL•1 n/L^n iJV f�-�� 111 'OTHER A Phone C Right - N PROJECT DESCRIPTION SQ. FT..Z•t 152:, JS b 0 SPOCCUPANCY K G Address(mailing) CONSTRUCTION TYPE VALUATIONS S Left - R City License No. ZONE GRADI NG CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION ^ Ping. Ref.# Parking Req,/Provided 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: `'.4� Q Planning Notes: 0 NI with section 7000) of Division 3 of the Business and Professions Code,and ))) � L7 g` . my license is in full force and effect. T License Class License No. S Date Signature I PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES 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 Backflow Preventer Service Sink utomatiWasherTransformer be c ransormer ❑ 15.50 KW /1 1800, Lab. C.) A0 50+ KW +oli rvo. Company Backflow Irrigation Sewer Caprl- Construction Pole Sub. Certified copy is hereby furnished. ' _ Certified copy is filed with the city Building Division. Bathtuhs Sewer Connection Cooking Unit .2 Meter up to 100 amps 1.0. 00 Date Applicant e. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors 2 Dishwasher Meter Dover 100 amps , OC (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher . Solar Piping . 2. Dryers ❑Gas Electric i _ Sub Panel / a, 00 , 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 te Drinking Fountains Solar TankFan Motors 00-1 HP 011/2-8 Workers' Compensation Laws of California. Date Signature Floor Drains 'Swimming Pool w/Spa • 2F.A.U. Inc.Solar ❑9-15 HP ❑1615+ NOTICE: If,after making this declaration, you should become subject to the _— Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 19 Fixtures Z be comply with such provisions or this permit shall be deemed revoked. Microwave Z . CONSTRUCTION LENDING AGENCY Gas Service Outlets Water ClosetDevice Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Intereptors Water Heater S6 Outlets 2_ 'Range a-- / `2 Lender's Name — Lender's Address _ _ Kitchen Sink' Water Service . - lbSwitches Sign 3 . ao OWNER BUILDER DECLARATION ,�P I hereby affirm that I am exempt from the Contractor's License Law for the lavatories"- Auto-Wash `M1 OC following reason (Section 7031.5 Business and Professional Code: Any city or e 2. Garbage Disposal Standing Sections Oc county which requires a permit to construct,alter,improve,demolish or repair t'—Trap Laundry Trays ' Generator 00-5 KW ❑5-15 KW Trash Compactor 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 , 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 . • - . 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 Icy of not more than five hundred dollars($500). I 1 as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 ' , pensation, will do the work, and the structure is not intended or offered ' Reinspection Fee I $15 Issue Fee $ 3 for-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 Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered forZoningApproved sale- if, however, the building or Improvement is sold within one year of com- Canopy Type 11 0 pP By Date .pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under GroundBuilding APProved By Date prove for the purpose of sale). • 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By E LAJ^ - Date i iZi g7 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 0100,000 BTU • - SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- ' tractor(s) license pursuant to the Contractor's License Law). I am aware that • Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ • SMIP $ • proof of their Worker's Compensation Insurance.should be provided to me. C • PLAN CHECK $ PERMIT 0 lam exempt under Section - ' B.& P.C.for this reason- 2 Firepl/Fact.BIt. ICBO#3 f 9J Fire Dampers g. � PLUMBING $ ISSUANCE $ Date Owner w� - He ting System& Ducting • Registers PLAN CHECK 25% $ ENERGY P.C. $ ' I hereby certify that I ha ad is applicatlo state that the above 0100,000 BTU 0100,000E17U— (`3� GRADING $ information is correct. • e oply with all city and county ordinances % - � ELECTRICAL $ �7.- 47 V . and state laws'relati•• to II. • traction, and hereby authorize repre- PLAN CHECK 50% S �7' MICROFILM $ sentatives of this It a pen he above-mentioned property for inspection purpo ; / 7 MECHANICAL S TOTAL FEE $ 1 01 • GO Signature / ) Date Drivers' License o SS _ / Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $_-U. 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. )-1327 fJ/ 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding t` 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 I , 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 3/(8/87 rp , 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/'/y7 , ,# r FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace WPM _% cT APPROVALS Permit# _ 21. Ducts, in Structure / 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O 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 e 32. Electrical Power Meter-Final (rj-)3t1 Q( k 80. FOOD CERTIFICATE ISSUED 33. Final Electric "? Notes: �- 10-i)3 � D>� � .2i-�-pr tont �j1C Tom:. 77 rt,a4,1;74, 34. Final/Heating & Air Conditioning �yrj �//,y�y / ,.�er 35. Final Gas Pipe-Test /OM 'T��' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final • 40. Gas Service-Final Al. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • '45. Sound Attenuation '46. Handicap Regulations • • 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - 1 No. Date _ _ ` OWNER VUORI, TAISTO DATE 8-29-61 JOB ADDRESS 230-A East 16th Place BUILDING PERMIT NO. 15160 GENERAL CONTRACTOR Owner VALUE $ 8,500.00 A^ No. 117-152-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res.watt.cpt. I 'ECTIONS Signature DATE GROUP I Pt JTYPE V ZONE R-2 Soil _Lo t?1 ri PERMITS ISSUED Gas p SUBCONTRACTOR DATE NUMBER Water A u/ QH 47 Rough Corn. Refrig. ❑ Air Cond. 0 Rough Heating L(/ I-1.46. syr ,F~L �?uo�vZti. Cb:0ar- 1 Q"1-Z4 1 3 a-bsi s- Rough Plumbing a.' ��4/ Prop.Swr.Line e<iouse Con. [tl St.Swr. 0 7W--- L../9 62 (ta,"H-.yam — q_L,2_i, L_3 f 4S Sprinkling System Constructioole Underground 0 Power 0 /� Rough Wiring '7 /t k-Ci retit j EQn ' it, 1,.r ,11-i-Ci JL7.0 IA Trenches 0 Forms ❑ Steel Reinf. 0 C. Floor System PI'S Bond Beam 0 Steel Reinforce 0 Sheathing i _�p=�J�/_ �� Frame and Flashing me- //— - C, ( • - C,.c-e - . Q-. / /, . _ _ Lathing — In 0 Out �` 1, _4 ( ,� i „r, brown coat Mo__ / 2 — i — 61 P 6, � pHeai n ❑ Air Co ❑ Final llHeating, Final /-0?/ (1)V7 Plumbing Fixtures, Finale /•/ J-''/` lGas Test n!j �„ f" / Electric Fixtures, Final "/"/�� , 2 Building, Final !*+ /f- -Si' r ^ A OCCUPANCY 4/1 FORM aU4-5M — 7.61 RT1lT T1 PflR CPFCTAT. Rr(1T TTRRMENTS 15160 ri• [ 15160 FEE RECEIVED 1, AUGlb1961: COSTA MESA BUILDING-SAFETY DEPARTMENT J P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE: DEPT: For Applicant to Fill In Completely CITY OF COMA PP P Y APPLICATION FORR PERMIT PE OR PRINT BUILDING ;23 C /cm R) BUILDING ADDRESS COSTA MESA. CALIFORNIA For Office Use Only C' %9• -S÷9 RECEIPT NO. / IT jl J OWNER ie. // 111-.. / JY/ feb O MAIL O / I� `t, RECEI 4• BY I D;�' 'ECEI • I DATE 1--UED ADDRESSSS� �L C�•Q�/ I�'yn p • D /� ,/o �' �p CITY � ,U • (1 NOI •g_t 4G. ADORES CQ 1-[/ �J ""' 4 / %// ARCHITECT //7 TEL. / COSTA MESA. CALIFORNIA OR ENGINEER l/iu^'L�-s NO. y YC Y T1'/1-A 1v FIRE • 7 Y DJ ADDRESS ' ^ ZONE / TYPE GROU �c• APPRO �D / LL, CONTRACTOR .4 �'-�•F/l BY .- DATE fi �1Ce 5. ADDRESS ZONING 1 Lo • ZpI�'./ NO.OF USE OFINEW V� I iA I aI CITY l < r) I PLANS I BUI LD IN .I /IF` VVVV"'' V` / 1I WW 0.41 I LIC.STATNO. TNO. LEGAL `DESCRIPTI ON{�(,' �/ c�� /27 L U SIZE I NO. OF SLOGS. 9"-/:)- �/I / "rte - !'�JJJ/q� W OF LOT NOW ON LOT A p NO I / / = T/ V & 0. USE OF YARDS ( EVES EXISTING BLDG APPROVED ALLOWED O SETBACKLINEPROM (CENTER LINE ST.) u. CENTER OF STREST REAR YARD FRONT FT. IN. Q ., SIDE YARD I LEFT RIGHT R.SIDE 17/ FT. _6 IN. Q DESCRIPTION OF WORK L.SIDE /O FT. �.{�y'' ,(/� IN. NEW I Is II ALTERATION 1 ADDITION I REAR l3 FT.�L ` Ih IN. REPAIR APPROVED LI /I //I �`TE !!!! 7/.6 / BUILDING / BY /!VI// SIZE .4 USE OF BUILDING AND WORK TO BE PERFORMED nirakter AND STATE THAT THEI HEREBY ABOVE IS CORRECT A THIS OREM TO COM- HE.AMO_U OF E_`SCIS I T) RP UA I.HN ISFOR /' OHL PLY WITH ALL CITY ORDINANCES AN BT T LAW GULATING A BUILDING CONSTRU VAL ON vp_40 'ti} •� %.' iCC 11,E SIGNATURE OFI PERMITTEE "`^'/ -� • (J,�n" o AUTHORIZED AGENT $.41 ��� 0 4 J • • 1 4 • 1I -,ti JSpecial Requirements: (1) Dedication to the City of Costa Mesa of 2.5' ' along-the-Tear of the property for alley widening Y (2) Two for one off-street parking under the direction of Director of Planning (3) Installation of residential sidewalks along 16th Pl. . by the applicant at his expense, under the direction . of the City Engineer. OWNER VUORI, TAISTO DATE 8-31-60 JOB ADDRESS 230 E. 16th Pl. BUILDING PE'MIT NO. 12(66 GENERAL CONTRACTOR NaCl 1C um. Orifi . C. VALUE $ • 1•0 AT 1.111-152-U8 LOT ' TRACT FIRE ZONE DESCRIPTION OF WORK Hesld2 Res. - IN, _CTIONS DATE I GROUP TYPE ZONE Underground Soil U.G. Water PERMITS ISSUED Underground Gas --- SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam ping -Finale and Flashing Lathing, In Out Plaster, brown coat Plumbing Fixtures, Final Electric Fixtures, Final `/ Building, Final yi r is 4- 3-y- 60 OCCUPANCY -1 Form 210-5M-11-59 5-B P 12766 l �A 12766 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT TINA E DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA Applicant to Fill In Completely CITY OCOSTA MESA For P Y APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS �%0 a -PMfi COSTA MESA. CALIFORNIA For Office Use Only ,� RECEIPT NO. PERMIT NO. OWNER 1 i, (�I O U (1�) I I /9 & MAILl y.. RECE VED BY DAM IVSD r8 §=7C ADDRESS d�'3..A0 Al , I (,7-1-1 r/ 7, Ln '`/ ��/' �I `-r-1/-4 f� I ///JU CITY COS //y- Al ESA- TNO.4(O'�` L ADDRESS 07 slU C /6 e7-52- ARCH TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS FIRE aLJ ,! ZONE TYPE CON7�ACTOR /.�.0;h1C- A,((4k' (Vic-- /SVG. APPROVED DATE ADDRESS f Ss 16/L/ / C/i ZONING 4�G - ('c ZO NO. US8 OF NEW CITY) DS 'V C�'j-'.S "'T� I PLANS 1......1-BBILDING /'� / (1 ( //ry/�I ! LEGAL I !) IQ�j/�- LIC.NO.Ja ���J NO. ll^S�7S �/'� ea IT Le, -e 2 }` /`! yY DESCRIPTION JJJ SIZE .. NO. OP BLOCS. / /� OF LOT S 'JC II �. 0 NOW ON LOT A.P.NO. 1/ i/ -/ T)_- a QJ USE OF .. YARDS EVES EXISTING BLDG. '/hVnL.//Yc APPROVED ( ALLOWED SETBACK LINE FROM (CENTER LINE ST.) CENTER OF STREET REAR YARD FRONT tL-...1( FT. IN. SIDE YARD I LEFT I RIGHT R.SIDE J/IL FT. IN. DESCRIPTION OF WORK • L.SIDE i/✓ FT. IN. NEW I II ALTERATIONI II ADDITION I REAR (A/FT. I . MOVING I DEMOLISH APPROVED (/ A 160 DATE /3/0, REPAIR A. M f L. SIZEDING) c-2,‘ r, NO. OF ROOMS STORIES / cf EXTERIOR WALL L— ROOF COVERING COVERING SE OF BUILDING AND WORK TO BE PERFORMED 4&H-Ail l/Vu &1 wlib/'NcT 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- PLY WITH ALL CITY ORDINANCES AND (NATE LAWS REGULATING BUILDING CONSTRUCTIO/N%�f_.//�/ [/�, VALUATION G� SIGNATURE OF L'�i� '_ ""'„��_"'g /j�D PERMIT FEE $ �i PERMITTEF ^�5[, N $ PLAN CHECK` �F AUTHORIZED AGENT 0 TOTAL FEE R'f OWNER W0 " TAISTO DATE 6-16-60 JOB ADDRESS 230 E-166thfl• BUILDING PERMIT NO. 12357 GENERAL CONTRACTOR Oumer—Bldr• _ VALUE $ 1,100,00 F No11.1-152-01 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt. Garage Ih_.,ECTIONS DATE_I GROUP D TYPE ` ZONE R4 Underground Soil U.G. Water PERMITS ISSUED Underground Gas — SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing _ Miscellaneous Prop. Swr. Line House Con. St. Swr. _ Sprinkling System _ Heating, Final Plumbing Fixtures Final Gas Test Construction Pole _ Underground Power Rough Wiring Trenches — Forms "----Steel T,, _ C 7 G — ( Floor System r —I a-cn Steel Reinforce Chimney lte-Roul B- ' Beam hing — — —Z 3 —G Frame and Flashing $ — J —q4 Lathing, In Out Plaster, brown coat _ Plumbing Fixtures, Final Electric Fixtures, Final Building, Final y� i�l' y OCCUPANCY I Form 210-3M-4.59 12357 .:s 12357 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT 6;— 76 - C> O \)(4 P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant fo Fill. In Completely AaRflaW MIT //II TYPE OR PRINT BUILDING ADDRESS BUILDING,, 5 G' /4 COSTA MESA. C IFORNIA For Office Use Only �1 1 (vtb C` I RECEIPT NO. P RMIT NO. OWNER / .,.vr`'�-. - // �� Sj MAIL V e is r+ RECErvsp�B� I yrs Il RED fr,¢O I 7,(72,7±, ADDRESS PG is `(1 VV1 /) J f'// / iii-''TEL. CITY r /6�Ho NO. ADDRESS O'<✓O g /(J ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. Iv FIRE ADDRESS ZONE TYPE GROWA/ A //i. ,- A -, APPROVED CONTRACTORA = TF/ '6 CONTRACTOR (=dam (/ ADDRESS ZONING IC I _NLOA.N ✓, I BUI LDOPNCITY _ '•� ry/L� STATE TEL. LEGAL b)(/ r, LIC.NO. //�� NO. ( DESCRIPTIO {� ///� T .�`T.3 I/••-0-(.�fy UE l;� V j t.� I NO, OF NOW ON LOTS 1 A.P.NO. // 1 —/5 �— —O IU OF LOT 47 !Y L J USE OF ff/�..,�� YARDS EVES EXISTING BLDG, y -,t APPROVED ALLOW�JD�Jy/. SETBACK LINE PROM (CENTER LINE ST.) /3 FT. ]X// IN. CENTER or STREET REAR YARD FRONT ^ (� F SIDE YARD I LEFT I RIGHT R.SIDE �{-3y+r. 14 IN. DESCRIPTION OF WORK VT. IN. L.SIDE NEW I (/ II ALTERATION I II ADDITION I REAR 2 FT. IN.` REPAIR I II MOVING I II DEMOLISH I APPROVED I(/ / I) DATE 6- /.{T /fin BUILDING I h 1 NO. OF ROOMS STORIES �v ��/� SIZE f J EXTERIOR WALL ROOF LL COVERING I COVERING _// / USE OP UILDING AND WORK TO BE PERFORMED / X ra.n 5 &S //! 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 AGR TO COM• PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCES AN ATE LAW RE TING BUILDING CONSTRUCT VALUATION 8 O D �/ ' L PERMIT FEE S SIGNATURE OF ���I� PERMITTER "C!� �""V A" /J D U a __ $ I /t PLAN CHECK $ " ! 1 " DRIZED AGENT qq o TOTAL FEE $JoS• y AUG 1 U '" OWNER vuoar, TAISTO DATE 9-21-60 JOB ADDRESS 230 E. 16th P1. BUILDING PERMIT NO.12891 GENERAL CONTRACTOR Owner-B1dr. VALUE $ 75.00 P^ No. 117-152-08 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK ReroOf REB. I ECTIONS DATE I GROUP V TYPE I ZONE Rh Underground Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam ` thing ae and Flashing g,' ' /,'- 7- &e ). Lathing, In Out Plaster, brown coat Plumbing Fixtures, Final Electric Fixtures, Final • Building, Final OCCUPANCY p77 //- 7-' d Form 210-5M-11-59 5-B P 12891 � • 12891 COSTA MESA BUILDING-SAFETY'DEPARTMENT (� ( C P. O. BOX 917 COSTA MESA. CALIFORNIA c i {{E I .C tUay t u For Applicant to Fill In Completely APPLIC T N6FORR111tMIT TYPE OR PRIN,.(T,/(/�//� f// B Wit"? ABUILDING DDRESS /�?O /�/ /`. GITY'LOE1F1 C TA MESA �OSTA MESA. ALIFORNIA For Office Use Only jjj C I T RECEIPT NO. ¢�.( 9 OWNER 1 /CfL// g I�NC3 $ MAIL J L /' //�/') RECEIVED BY ATE RECEIVED ATE ISSUED ADDRESS /?iD 4- //�f/�6� 11 ��yt'C (toff/ EOI CI.o�/-GO CITY r0.- : /'-�L -0 N •2--eliY ADDRESS �� ' ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS FIRE N `// ZONE TYP /GROUP . mac/ APPROVED �J. DATE PO/2P- C CONTRACTOR ©LL✓1-C N B\• � / ADDRESS . ✓ ZONING ZONE N .OF /� USE OF NEW CITY 1 I PLOANE / ` BUILDING STATE TEL. LEGAL ,I'� !/ / LIC.NO. NO. DESCRIPTION 47 0'1. ...Z.-14- CO 31 �/ , SIZE ie j., I/ N. NO. OF SLOGS. / J (((/// OF LOT _r �JI� `C� f Now ON LOT A.P.NO fJ 1 ._ t.s oZ - O g USE OF ��/ �/� D YARDS EVES EXISTING BLDG. Z v /A '�'J�'. APPROVED ALLOWED SETBACK LINZ PROM..„6r)/J (((///--` ./ �I (CENTER LINE ST.) p ��// CENTER OP STREET . 'REAR YARD r FRONT �� FT. IN. SIDE YARD I LEFT '� I RIGHT • • R.SIDE ��FT. IN. DESCRIPTION OF WORK L.SIDE FT. IN. NEW I I ALTERATION I II ADDITION I REAR T. 1% REPAIR ILII MOVING II DEMOLISH I APPROVED (,�� .. DATE /`�' I C BUILDING-- NO. OF ,( /•' _(, SIZE - ROOMS STORIES EXTERIOR WALLROOF ' ,k J ( COVERING I COVERING Co/J, : `i C._.. U6 F BUAND WORK TO BE PERFORMED 7nILDI� .4. 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. BUY WITH COLW CITY ORDINANCES AND STAT REGULATING A �� BUILDING CON VALUATION 47; SIGNATURE OF 1 '4 sL'0 PERMIT FEE S PERMITTEE '�/J m S / �� PLAN CHECK 5 4- AUTHORIZED AGENT Lam` re N TOTAL FEE 5