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HomeMy WebLinkAbout287 16TH PL - Building Permits 0 . \ _ - - , CITY OF COSTA MESA :tt"4. BUILDING DIVISION PER IT NUMBER t' AlEVELOPMENT SERVICES DEPARTMENT ', • PERMIT 'gym 1 99-01640 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 287 16TH PL Status: ISSUED Suite: Applied: 10/11/1999 Vicinity: CARPORT Issued: 10/11/1999 Parcel Number: 42522108 Zoning: Applicant: BURKE, MIKE ISSUED BY: Address: 1653 SUPERIOR AV (/ CA , Phone:'(949)642-7222, . COSTA MESA -i.' ' - / Zip: 92627 - - , i.=, Owner: WIEDLUND; EUGENE ARDEN TR Address 287-16T14 PL#3,. - / - ��i i iii A _ COSTA MESA CA - 9 Zip: 92627 - - �� Contractor LEE ROOFING-OF-COSTA MESA ? Address: N.1653-SUPERIOR-AV • ''.•••-,"‘",, �,*;� i i CA-- � ' Phone: (949)642-7222 " Ay _ / y / !, COSTA MESA \�A '! . Zip:' 9262747 License`; 349686 'Arch : .• • • Eng: . Address: r ' .. Address: • : . ". r Phone: �, -�� ' _ - Phone: , - , / ,/' . _ - . Zip: I a,"" ' License: '.yLicense: • SCOPE OF PERMIT V - / REROOF,EXISTING CAR PORT(12 SO).TEAR OFF EXISTING ROOFING&INSTALL NEW HOT TAR BUILT-UP ROOF SYSTEM WITH/CAP SHEET. - FEE SUMMARY ' - . Plan Check: , . $0.00 - -- , :/- Calc Valuation: $2,700.00 Permit: . , $83.25 -__- „ -Claim Valuation: $2,700.00 '_ SMIP Res: . $0.50 — — - , / - SMIP Com: $0.00 ' `. ' Other: y $0.00 ,-- \ $0.00 -- , vTotal: $83.75 ', Vvv , v . , . .., `* •� ,,,),:. PLANNING'&ZONING / SETBACKS '' MAIN STRUCTURE Front- 0-0 - ' cRear 4 0-0 Left 0-0 : - Right 0-0 r / . ACCESSORY ' Front / 0-0 -Rear - 0-0' • Left ' 0-6 _ Right\ 0-0 i,: ',/ .. PARKING Existing:,-_ 0 i/Required: ' 0 .v . Proposed: 0• ' - „ NOTES: VA. . . . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLFIRAT/ONS • WORKERS'COMPENSATION DECLARATIONF- I hereby affirm under penalty of perjury one of the following declarations: 0 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 end will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which 1 permit is issued. My workers'cLompensajjW Inswance carrier and policy number are: ../ Carrier: 5%i}7e &n/cr Policy Number: /.30‘) / OV (This section need 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' compensationinw ,and agree that if I should become subject to the workers'compensation provisions of Section 370 of the Labor Code, I shall forthwith comply with ih e ^vi ons. /pq Applicant Signature: CWL'1/ — Date: /t//fit / / 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 OOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37080E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licgrved under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Busln and.F essions Code,and my license is in full force and effect.Uc.k ` : ozpearef Class S Contractors Signature: Date: 4 CONSTRUCTION LENDING AGENCY: J 0 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: Lenders 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers 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: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑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 California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). e WIII any pen .......facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly nsoection pu••ses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. .r SICr,-O4Le•al Owrnii)/, ALSA nd/Or Authoriz:•Applicant D. . CODE 0 INSPECTION TYPE - g9IF INTITIALS CODE( INSPECTIONTYPE PAIS 1NTRIAIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical _ 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof /O 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 2446.46 PROWECTADDRESS: 287 16TH PL nmCITY OF COSTA MESA BUILDING PERMIT PERM NO: B 061659 GOVT: N SUPP: N OWNERS NAME:WIEDLUND, JULIA L TR ADDREss: 287 16TH PL #3 / PERMIT NO: B 061659 PLAN CHECK NO: N ►� COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT ARLN/ENGINEER: ( 714 ) 631-4032 REG.NO.: L. ADDRESS: UNIT: JOB DESCRIPTION : REROOF WITH COMPO OVER BUILT—UP SQ FT: 8, 112 PERMITTEE: CLAIM VALUE: 8, 112 . 50 CALC—VALUE: 8, 112 . 00 GROUP OCC : R-1 / ADDRESS:PETRONELLA ROOFING ( 714 ) 548-1645 2626 NEWPORT COMMENTS : SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC —�c�`[OR �OSTA MESAb CA 426?h ****�E***4****�r� ****Sr******** **********RE****�r*** ****** x�r********I . x©E LICENSED CONTRACT R 3 CL i ATION: I here y affirm that I am licensed under provisions o fiapter 9(commencing with Section Z O N I N GS ERTEBQAUC I KRSE M E N T S C A fl° D 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. t71 v' 1 ` p CITY LIC.:0326 STATELIC.00460707 cLASS:C 39 �EQv1n Date: y/7�al3 Signature: 17 2� f' MAIN BUILDING ACCESSORY BUILD�N WORKERS'COMP NSATIDN DECLARATION: I heregrat f have a certificate o enc to self-insure or a certificate of Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN R EAR: FT IN Compensation Insurance.or a certified copy thereof -•ction 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:pWC115706 EXP.DATE: 12/01 /93 COMPANr:GOLDEN EAGLEPARKING RE • PROV: PARCEL : 42522108 ZNE: REF NO; ❑ Certified copy is hereby furnished. 141 Certified copy is filed with the city Building Division. PLANNING N TES> 'Date: Y 7/9J ADDIit. /�/ f `� ****it*i(iE**************lE**************!E*iE**1f#*ie*ie1(-***i4ie*ie************3&\1*****if*lh* EXEMPTION F OM WORKERS'COMPENSATION DECLA" t•. (This section need not be completed it the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E ,N x 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:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVtD BY : DATE: ' Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /y� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; (ti.� ( /" DATE Which this permit is issued(Section 3097,DIV,C). *******.**********.********t **k**** * :****** *"** f************'***** .R K.cl ' -A-It -** LENDER: ************************************************ f***********************9(*x.*** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish.or p ERM i T10 8 . 0 0 repairepair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 81 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/ ,81 r 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 I. as owner of the property or my employees with wages as their sole compensation, wit do the work• and the BUILD ING—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----> 108 , 81 0 , 00 . ' , 0 , 00 108 , 81 108 , 81 . 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 ; 108 . 81 OVER/SHORT: . 00 tar the purposeofsale). 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 108 . 00 . 81, ❑ and Professions Code: The Contractors'Stale License Law does not apply loan owner of property who builds or improves thereon a and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ************.x.**********la*************************************************'*1(-**** that proof of their Worker's Compensation insurance should be provided to me. o I am exempt under Section: D.&P.C. I ND I V I D U AL' 'F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTION/- UNIT COST TOTAL COST wner: II da hereby certify that am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 8 1 1 2 REROOF BY VALUE RESIDENTIAL NOZONE ,' 1 .00 8, 11 2 . 0 0 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 END. OF FEES '+ permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ' these provisions. V Date: Applicant. • 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 ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned y It property tor ins eclioor purposes. r _. Date: (f7/`�3 Si. : /� Driver's License LLL or Social Security': of 00136893-00136894 1641.46 wane—Dmltlln Green—Code Enforcement:Canary—Applicant;Pink— DATEa 04/08/93 TInE¢ 16:,,1 108.81 9Revenue:Goldenrod—Assessor 16•Qt CO NST'RZCTION AND PLANNING POOL PA APPROVALS Permitr Date Inspector APPROVALS Permit , Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. So:' Pipe•Undrgrnd. 53. Steel Reinforcement 3 Eectricai Conduit Ut.lity'Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUN'TE 7. Footings • 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Viater Pipe-Undrgrnd. 6D. Btcicciash Lines,P-Trap, Ur-el-yr-id. 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. Rost 7ra.rs 64. Plumbing System -Final ' 1 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 Hearing & Air Conditioning FIRE DEPT. REQUIREMENT 1, 20. -lough Factory Fireplace APPROVALS Permit t 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 CGut IT 0 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing Sr Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREraENT 31. Plaster Brown Coat 1 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED D -� 33 Final Electric Notes:elO// a_ 7(C /A 34. Final Heating& Air Conditioning I. , . r �r fer 35. Final Gas Pipe-Test 36. Hood or Canopy • i 37. Final Factory Fireplace ,.. 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final I 42. Backflow Preventer 43. Backflow Irrigation ./ 79 44. Landscape Irrigation System �"� 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING %A ) _ .( 48. FINAL PLANNING TT ' ! 49. Electric Release to Edison +� 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date t/?RUJECTADDRESS: 287 16TH PI. UNIT: 4 CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 046499 p OWNER'S NAME: WHIDLUND ' ADDRESS: SAME AS ABOVE ' PERMIT NO: P 046499 PLAN CHECK Nb: N GOVT: N SUPP: N • • CONSTRUCTION TYPE : PERMIT TYPE: PLU PURPOSE: OTH 714 /631-4032 ARCH/ENGINEER: REO.NO.: JOB DESCRIPTION : WATER HEATER REPLACEMENT SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALL-VALUE: GROUP OCC: / PERMITTEE: ALL AMERICAN HTG & A/C ( 714 ) 541-0917 ADDRESS: 3022 N. HESPERIAN WAY #101 ,COMMENTS: SANTA ANA CA 92706 ******************************+Eel*+Eel*****+tit**********+ebe*bEeE*****+rar**btyeer********Nan LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions al Chapter 9(commencing with Section Z ON ING R EQUIREMENTS 7000)of ONision 3 of the Business and Prof."' •pe,and my license is in tun force and effect. - CITY LIC.: ATE LIC.: -3, S E T B A C K S 0 9 9 1 9 ATO •4 4 3 1 CU.:: C6//( 2 ( MAIN BUILDING ----- -------- ACCESSORY BUILDING - Date: Signature* �i► ` FRNT: FT IN REAR: FT IN FRNT: ' FT IN REAR: FT IN WORKERS' MPENSATION DECIARATtDN: I he,• affirm that I have a cera,.• I to seU-insure or a certificate of Workers' Compensation Insurance,or a certified copy th: •A(Section WOO,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: WCO297893 En.DATE: O1 /O1 91 COMPANY: UNITED PAC PARKING REQ: PROV: PARCEL : 00000000 ZNE: REF NO: -1, Certified copy is hereby furnished. ® An.t`� ;• .• . • Division. PLANNING NOTES> • • irate: V/VFI ..., .nt: ********************************7f***iE**********k*****.N****IE*******sE*se********** EXEMPIMN FROM WORKERS'COMPENSA IN DECLARATION: (This sect (S10010( DE V F. L O P M E N T SER VICESREQUIREMENTS I certify that in the performance of the •• or which ' permit is issued,I shall •pldy any person i .1 manner so as to become subject tot4 Wo ers'CompensationCaws• ,i,,,� _.?>.r.x� ZONING APPROVED BY DATE: Date: l// ? Signature: .♦\�� _ ---- ---- NOTICE: aper making this declaration.you „ • become subjectTOM- orkeri Compe +i*• 7r. . of the Labor BUILDING APPROVED BY : DATE: M Code,you must forthwith comply wsuch p•. .• or this permit shall be • • ed revoke. --"—" __ CONSTRUCTION LENDING AGENCY: I hereby affirm • ••n is a construction lendim .perry for the performance of the work for APPLICATION ISSUED B Y: • DATE: // which thus permit is issued(Section 3097,Civ.C). ******************************** *****eE* ***W*******************S6 ( � SF ** LENDER: • ******************************************************************************* ADDRESS: . LEGALIZATION:N , F E E S U M M A: R Y 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 2,00 repair any structure,prior to its issuance,also requires the appfrcant for such permit to file a signed statement that he/she is licensed 25% SM I P/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the ateged exemption.My violation of Section 7031.5 by PLAN any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 3 . 00 I as owner oI the properly or my employees with wages as their sole comcensation, will do the won, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure s not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> • 2 . 00 3 . 00 0 . 00 5 . 00 5 . 00 . 00 does not apply man owner of a property whowork M builds or improves thereon,and who does such mseu/herseff or through • his or her own employees,one yeareedtofcompletion, ra notintendedburdenofretl she/siw however notbuild or improve or REVENUE DIVISION TOTALS--> COLLECTED: 5 . 00 OVER/SHORT : 00 improvement is sold within oneproving. 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 , ' 5 . 00 ❑ and Professions Code: The Contractors'State License Law aces not apply to an owner of properly who builds or improves thereon and who contracts for such projects with acontractor(s)ecense pursuant to the Contractors'State License Law).I am aware *****************************************.******.***************.*.7(..***********i***. that proof of then 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.S P.C. for this reason: • TYPE QTY DESCRIPTIO N ' UNIT COST TOTAL COST Date: Owner: PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES • 25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a 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 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection pia Date: //�- i/� Signature: 01,00055936 -00055963 TOT DATE: 14:05 5.00 Driver's License or Social Security N: Canary=Applicant;Pink-Revenue;Goldenrod-Assessor r CONSTRUCTION AND PLANNING _ POOP 'PA 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 drnd. 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 Plumbing65. 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 OOil 23.•Gas-Pipe-Rough& Test - ' - 72. Underground Flush 24. Roof Framing 73: Undergrnd.Storage Tank 0 Gas O Oil - 25. Roof Sheathing -- -- 74: Overhead Hydro 267T-Bar Ceiling (Structural) &-Monocoat - - - 75.Dry Chemical - 27. Frame and Flashing - 76. Dry Standpipe - r. 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 t 33...Final Electric - - • Notes: '34. Final Heating•& Air Conditioning _ 35. .Final Gas Pipe-Test - . - • - . - - 36. Hood or Canopy . 4 . - -37.- Final Factory Fireplace • r- • //// // _ 38. Final Plumbing '• , • .iL/ ✓� _ 39. Water Service-Final r l ,-Z - - - .40. Gas Service-Final - ' - - '241. Solar Domestic-Final - . - , • 42.-Backflow Preventer - ' 43. Backflow Irrigation, - . , . . '44. Landscape Irrigation System : , _. ' : - ' i '45. Sound Attenuation -. - : - _ 46.••Handicap Regulations - - - - 47.. FINAL STRUCTURE & BUILDING -. 48.-FINAL PLANNING -- • 49. Electric Release to Edison - .^ 50:Gas-Release to Southern California Gas Co - ' ' 51. CERTIFICATEOF-OCCUPANCY No. Date ECT ADDRESS: 287 16TH PL0NIT 3 CITY OF- COSTA MESA - BUILDING PGRMIT PERM NO: P 046141. • OWNER'S NAME: EUGENE Will EDL AND ADOREss: SAME AS ABOVE PERMIT NO: P 046141 PLAN CHECK NO: N GOVT: N SUPP : N . • . CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 714/631-4032 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPLACE WATER HEATER • SQ FT: ADDRESS: UNIT: • • CLAIM VALUE: CALL-VALUE: GROUP OCC; • / PERMITTEE ALL AMERICAN HT & PLM ( 714 ) 541 -9753 ADDRESS: 3022 N. HESPER1AN #101 COMMENTS : SANTA ANA CA 92706 **********4�************ir*****ifeFrt*ye** -** *****prat-**et*>E*,****rtaEa(-iE******** -ar*+Ciro***0 • 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 CITY uc.: 02/9919 surEuc.:443064r it' : JG // • Date, __/__ Signature: . - ., % r ../ — —`-- --"--"-- MAIN BUILDING --- --- -:-- ACCESSORY BUILDING ----------- WORKERS'COMPENSATION DECLARATION: Ihereby affirm that Ihave acertificateofconsent'os. eoracertiflcateofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: _ FT IN Compensation Insurance or a certified copy thereof(Section 3803.Lab.C). LEFT: FT .IN RGHT: FT IN LEFT: FT IN RGHT: FT IN nun,NO.: WC 019'7893' EAP.DATE: 01 /01 /91• • ' cDMPANY: UNITED PAC PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: Ti Certified copy is hereby furnished. ( Certified copy is ele/pJ with the del Division. i� PLANNING NOTES> Date: �� •'N Applicant: `-•^-•LST% 1� delafill • **************************IE*******************4******************if******N***-**ie EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if ••-nni for one hundred($103)or less). DEVELOPMENT SERV ICES .-- R E Q () I R E M E N TS • I certify that in the performance of the work for which this permit is issued,I shall not employ any peT36n in any manner so as to become ' subject to the Workers'Compensation Laws of California. ZONING APPROVED 'BY __ DATE: ' Date: Signature: BUILDING APPROVED BY _ • DATE: _ _ • NOTICE:IL after making EMS declaiation,you should become subject to the Workers'Compensation provisions o/the Labor Code,you must forthwith comply with such provisions or this permit sluff 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 : DATE: _-/_-�p _ which this permit is issued(Section 3097,Civ.C). *****************************1 X- ********** **********TLg, * -E** LENDER: ******************M*********?f***********************************4*****if********* ADDRESS: . LEGALIZATION:N . F E ' SUMMARYY STRUCTURAL SEGMENT: N • • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Stale 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,after,improve,demolish,or PERMIT - 2 ,00 repair any structure,prior to its issuance,also requires the applicant tar such permit to tile a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7300)of Division 3 of the Business 25% S M 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 penatty 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, 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 TOTAL S———- > 2 . 003 . 00 0 • 0 0 5 . 00 5 . 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 REVENUE DIVISION TOTALS--> COLLECTED• 5 . 00 OVER/SHORT: . 00 improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or improve for the purpose of sale). • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 • D • 0 ❑ and Professions Code: The Contractors'state License Law does not apply to an owner of property who builds or improves thereon . and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******'********ie**************************************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAK DOWN ❑ ' I am exempt under Section: ' B.8 P.C. for this reason: ' TYPE QTY D E S C R 'I P T I O N UNIT COST TOTAL COST Date: &toner PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533.and END OF FEES • 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a • permit for construction or modification from the Air 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 repres ntatNes of this city to ter updDjhe above-mentioned . properly for inspectiononpurposes. n' r Date: /16---",/, Signature bed - • Driver's License or Social Security N: 01 00054292-00054292 T Ej T 5.00 1641.46 White—Buildlnol Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor DATE: 02/16/90 TIM: 14:29 . J . CONSTRUCTION AND PLANNING POO WA APPROVALS Permit # Date Inspector APPROVALS Permit+ Date Inspector i - 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 OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation "- ! 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House:Connection .• 62. Backwash & Receptor-Final - 12. Sewer Cap63. Heater & Vent-Final .. 13. Roof Drains ' 64. Plumbing System - Final 14. Rough Plumbing ' - , 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure - 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Miter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test - 36. Hood or Canopy 1 -37. Final Factory Fireplace 38. Final Plumbing %/Atha/P/W' - 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer • - • 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation - • 46. Handicap Regulations - - 47.- FINAL STRUCTURE & BUILDING 48. FINAL PLANNING -- 49. Electric Release to Edison 50: Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY No. Date L1 r 'll A 'n all spaces within heavy border lines a1- f sign all appropriate declarations. ~ CITY OF COSTA MESA PERMIT NO. TRACT NO J LOT NO. BLDG.NO. - . - - CONSTRUCTION PERMIT - ssiy7 ,f 01'59 11 /03)62 7007 TL Project Address 287 f6th PLACE TYPE OF CONSTRUCTION _ • OwneMRS.WTFDLUND Phone 642 497 r rrr❑������nnn NEW ❑ ADD ❑ ALTERATIONcr ' Address287 16th -PLACE COSTA MESA •fr 3' SIREPAIR 0CONVERSION ❑DEMOLISH - 66ZONING REGULATIONS Arch/Eng. License No. • OTHER ys A P. Address - - - ..- _ DESCRIPTION OF WORK K-q/.%e-. Oi S - - \: ContractorA-AMES PLUMBING-HEATING-Phone 530 2441 - tag/pi" - • ZONE PLNG. REF. - TYPE OF PERMIT BUILDING TO BUILDING ' SETBACK C ST. PROPERTY LINE ' , Address 1 R4 K E4 GARDEN GROVE CA ❑ GRADING •❑ FOUNDATION ❑ STRUCTURAL SSIDE E YARD - - - - (V�' LICENSED. CONTRACTOR DECLARATION ❑ TENANT-D ELECTRICAL ❑PLUMBING -DMECHANICA SIDE-YARD- - • '1 hereby affirm that I am licensed under provisions of Charter 9(corn- . . RIGHT mencing with section 7000) of Division 3 of. the Business and 0 OTHER , - 'Professions Code, and my license is In full force and effect. • REAR YARD(TO P/L) - -- , .License Class— C-36 - License No. 250307 PROJECT DESCRIPTION- - - ; PKG.SPACE REQ. ` PROVIDED, ,- - Date 1110382- Signature A-AMES-PLUMBING-HTC ' SQ. FT, ��_ . STREET WIDTH . - PARK-FEE$ ' •,WORKERS'COMPENSATION DECLARATION -- OCCUPANCY CONSTRUCTION TYPE — I - ,I hereby affirm that I have a certificate of consent to self-insure or a VALUATION - _-- ZONE ZONING APPROVED'BY - -- I DATE - , :certificate of Workers' Compensation Insurance,.or a -certified copy _ _ _ - - - ' ' i thereof(Section 0, b.C.). ,GRADING CU.YDS. - ACRES SPECIAL CONDITIONS: - - - - ',:saucy NMF82076419 Company FREMONT- - - _ - - g Certified copy.is)hereby furnished. _ _ ". REMAR KS:'l 1 3 "" .. I AILJ Certified copy is filed with the city Building Division. ., - - -- - it t --w - --'-'-' - / _ ,' EXEMPTION FROM-WORKERS' COMPENSATION DECLARATION - -_ • - - - . 1 a _ _J el (This section need-not be completed if the permit is for one hundred Is �� ,'t -; t. s, or less). -($100) - -. _ - Certify that in the performance of the work for which this permit'is r issued, I shall not employ any-person in any manner so as to become {'PLUMBING - ,`PLAN'CHECK- -4^ ELECTRICAL -- - --PLAN CHECK- - - subject to the Workers Compensation Laws of California. • - ,Date 1 /U4/R7' Signature A-AMES PLUMBING-HTCBATHTUBS" SHOWERS - - - •UW tLLI N(... - GARAGE - _ - - "_ . e e NOTICE: If after making this declaration, you should become subject- TOILETS , 'URINALS - 'GENERATOR 0.1 KW_1-10'KW to the Workers' Compensation provisions of the Labor Code,you'must TRANSFORMER 'forthwith comply with such provisions or this permit shall be deemed LAVATORIES DO,�1BLE LAYS -APPLIANCE- 10.50 KW_50 +'KW revoked.. . 'KIT.'SINKS- - - DISHWASHERS - - ;MOTORS -0.1 HP 1-10 HP. 'CONSTRUCTION LENDING AGENCY - - ;I hereby affirm that there is a construction lending agency for_the per- SERVICE SINKS -a a - SUMPS - — - .1(1 NC.SOLAR) 10-50.HP50+ HP '' formanr ce of the,workl flair which,this permit Is issued^(Section 3097., - - - - - " LFLOOR SINKS - FLOOR DRAINS- ,FIXTURES OUTLETS -- SWITCHES tLender's,Name - - ' •Lender's Address ` - DRINKING FOUNTAINS -- ' - GAS TUBE-SIGNS -- - -. OWNER BUILDER DECLARATION - - - - - ` INTERCEPTORS - CLARIFIERS - POLE LIGHTS r !I hereby affirm that I am exempt from the+Contractor's License Law for '- - i the-following reason (Section 7031-3 Business and Professions Code: - SWIMMING POOL - -P TRAP - - LUNSI Hut-I IUN - - 'Any city or county which requires a permit`to construct, alter, - - • POLES "METERED - ' SUB- " - - I improve;demolish or•repair any structure, prior to its issuance;also-re-- WATER SERVICE -ALTERATION - PANELS --- MAIN -SUB-" quires the apFlleen-0 er such permit to file aSigned statement that-he - • - - iS licensed pursuant-to-the provisions of-the'Contractor's License Law + - .- .� ,SERVICE - - AMP '(Chapter 9 (commencing with Section 7000) of Division 3 of the GAS SERV ICE `. OUTLETSdie 11 - Business and-Professions Code) or that he-is-exempt-therefrom and the WATER HEATERS - 'BTU OUTPUT -- - -- -- - - -- - - i b;:,y;c for the alleged exemption. Any violation of Section 7031.5 by • lj„,`!'-'applicant far -a permit subjects the applicant to a civil penalty ' SEWER CONNECTIONS- I• " - - - ---- -- - -- -- o - - - -- $T �'bt more than five hundred dollars ($500). ;LI);i is owner of the property, or my employees with wages as their SOLAR TANK -- - COLLECTORS --- —- -- --- - - -- 4 Sole compensation, will do the work, and the structure is not intended or offered for sale-'(Section 7044, Busibes5 and'Prbfessions Code:'The SOLAR PIPING SYS. ISSUE FEE -- - - Contractor's License Law_does not apply to an owner of a property who builds or improvesm - - thereon, and who does such work hiself or ISSUE FEE • - • - - 11 'APPLICATION APPROVED BY/ f/ • -y .through his own employees,,provided that such improvements are not - - intended or offered for sale. If, however, the building or improvement M• ECHANICAL PLAN CHECK lis sold within one year of completion, the owner will have the burden of proving he did not' build or improve for the purpose 'of sale): - "- - - • - ❑ I,- as owner of the .property, am exclusively contracting with- HEATING SYSTEM 0-100,000 BTU AND DUCTING licensed contractors to construct the project (Section 7044, Business P i 100,000 + BTU and.Professions Code: The Contractor's License Law does not apply to _ 7•re an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU ,tracts-from such projects with-a contractor(s) licesned pursuant to- SYSTEM ,the Contractor's License Law). 100,000'+ BTU ❑ cam exempt under Section - " -- '" - B:& P.C.for this' BOILERS BTU reason - r i x MICROFILJIAi Date Owner SYSTEM REPAIR,ALTERATION • .� ill h"e- ertify that I have read this a•. ' -. and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ ' infor do corre comply' h al "and county ®' ordina es an. ' e,aws relati ConstruCti'- an. her.y authorize I represent ives sofp city ter.-upon I' she-abOv mentioned - ■, property y+ inspecti•n p-n. -�" FINAL FEE SI J Signature e=� - - Dafe' G •Drivers'License or 55 - � - ISSUE FEE - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS permit Date Inspector APPROVALS Permit D•ate ` ;, Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . 2. Soil Pipe-Undrgrn 44. Steel Reinforcement •' . 3. Electrical Conduit Utility-Undrgrn . 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding _ ., 5. Steel Reinforce • 47. Rough Plumbing & Pressure Test •- - - 6. Electrical UFER Grn • I 48. APPROVAL TO COVER-GUNITE - _ 7.. Footings I 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test . - 9. Water Pipe-Undrgrn - _ 51. Backwash Lines. P-Tran. •❑ Undrgrn i .. • - 10. Structural Floor System . 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final I 12. .Street Sewer Connection - - 54. Heater &Vent-Final . . . , 13. Rough.Plumbing - 55. Plumbing System -Final 14. Rough Electric-Conduit.. "C - - .56. Electrical-Final 15. Rough Electric-Wiring - - ' 57. Solar System-Final . 16. Rough Heating & Air Conditioning - 68. Fencing &Access Approval 17. Ducts, in Structure • - 59. APPROVED FOR PLASTERING _ 18. Ducts, Ventilating - - - 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing • 21. Roof Sheathingand NOTES: / �i �y( +1.0-71--....:t„/• •_ 22. Frame and Flashing - • �7�� ��l1��` ��/l` `1 P� r- `" encu 23. Insulation - - -2.42/ 4 2 ' ..rn rjicdi `,.i ftac..a.JL. ,a 24. Lathing & Siding „�&-ei7 _�`" /T ,/ 25. Drywall Nailing • - - ��-ii_GCli �� ll FAQ �. 26. Plaster Brown Coat - ,' 27. Electrical Power Meter-Final ip. 3 ��i ,//I- �ed '22iF4f 28. Final Electric - - ✓ /- 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing ' -32., Water Service-Final 33. ' Gas Service-Final • . 34. Solar Domestic-Final - 35. Landscape Sprinkling System • 36. Sound Attenuation • - 37. Handicap Regulations ' 38. FINAL STRUCTURE & BUILDING • 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. • 42. CERTIFICATE OF OCCUPANCY No Date • -- . OWNER SODERBLOM, H. F. DATE 643762 JOB ADDRESS 287 E. 16th Pl. BUILDING PERMIT NO. 17231 GENERAL CONTRACTOR Owner VALUE $ 125.00 AP No. 117-191-11 LOT TRACT FIRE ZONE DESCRIPTION OF WORK COIR.Blk Wall 1 'ECTIONS Signature DATE GROUP J TYPE II ZONE R-2 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power ❑ Rough Wiring Trenches 0 Forms 0 Steel Reinf. 0 _ Floor System Bond Beam 0 Steel Reinforce 0 - P� Sheathing Frame and Flashing Lathing — In 0 Out 0 T er, brown coat 1. .4g. 0 Air Cond. ❑ Final _ Heating, Final Plumbing Fixtures, Final _ Final Gas 'rest Electric Fixtures, Final _ Building, Final t,-""/5 S 11-••• ' OCCUPANCY FORM BU4.5M - 761 i7Lj1 17231 rEE RECEIVED +COSTA MESA BUILDING-SAFETY DEPARTMENT N+�/I JUN 8 1962 P. O. BOX 917 COSTA MESA. CALIFORNIA 7 FINANCE DEPT. For Applicant to Fill In Completely APPLICATION ESR PtrRMITSTA MESA TYPE OR PRINT BUILDING ADDI LEISS J 9 I C (GTlf c...f- C c...- COSTA COSTA MESA. CALIFORNIA' �y For Office Use Only / 7�3 f S O O E(A B L o M I RECEIPT NO. I PE O. OWNERFA- MAILy RECEIVED BY DATE RECEIVED DATE I ISSSUED ADDRESS (2 S CT H'CSL sl t]J -O Y I C9 `<"1 'G Y L e-- No.3a77 ADDRESS .� b'7 cry �r'L NCA7-1C /G `_`‘ op ARCHITECT 0 uJI l�(e TEL. COSTA MESA. CALIFORNIA OR ENGINEER f� NO. S 0+1%* (c FIRE ADDRESS �j ZONE TYPE GROUP CONTRACTOR O U.)1 /& `/` - DYPROVED � DATE 6 ��] ADDRESS -S/1I -e ZONING ZONE I NO. S '9 I USE OF NEV✓i///�� CITY PLANS BUILDING / ill LIC.NO.ATE NO. LEGAL / b) -1-02. !as-/ ��11 DESCRIPTION, OF LOT /�!!x /35 INONOWDON" ZOF A.P.NO. 1/ 7-- /9/- // USE OF �✓ YARDS EVES EXISTING BLDG APPROVED ALLOWED SETBACK LINE FRON ,_ / (CENTER LINK ST.I CENTER or STREET //•. REAR YARD FRONT FT. IN. SIDE YARD I LEFT v I RIGHT . R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE 71 S//FT SIN. NEW I t- II ALTERATION I II ADDITION I REAR — FT. IN./ ( (Ai REPAIR V MOVING I V DEMOLISH I BBYPROVED ! i. ,/ �I DATE 4 _f.-t� BUILDING -NO. OF SIZE ROOMS STORIES EXTERIOR WCI-ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED 9X pT Le C a- I�y k ‘1 4,60 5<e:ice Gum- c-- Co I HERESY 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 OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION VALUATION 3 QD SIGNATURE OF e(Cn��/ PERMIT FEE $ PERMITTEE 231gJ - o_ $ PLAN CHECK $ �' AUTHORIZED AGENT / 5e GG ¢ TOTAL FEE $ w OWNER SODERBLOM, H.F. DATE 2-16-62 JOB ADDRESS 287 16th Place BUILDING PERMIT NO.16267 GENERAL CONTRACTOR Owner–Bldr. VALUE $ 5,130.00 AP No117r191-11 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Det.Opts. I 'ECTIONS Signature DATE GROUP J TYPE III&V ZONE R2 so.. PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Ref rig. 0 Air Cond. 0 Rough Healing Rough Plumbing Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. 0 Sprinkling System Cons struction Pole Underground 0 Power Rough Wiring Trenches U Forms U Steel Rein'. u -- Floor System Bond Beam 0 Steel Reinforce 0 Sheathing _ - Frame and Flashing ,ffr,!ei 6- 72–d:% Lathing — In ❑ Out ❑ P' 'er, brown coat 1 A.. 0 Air Cond. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final ,,,, p ���e�1�- -e< !emi/,6a 'ado, Building, Final Ea.? / OCCUPANCY HOU) FOR SPFCIAL RFQJTRFMF1VIS FORM BU4.5M - 7.61 1 6267 : 1,.::16267 FEE RECEIVED 'COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 3 01962 V" P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. b For Applicant to Fill In Completely APPLICA'TfOI�FFOR'PERFiiIT' TYPE OR PRINT BUILDING _J p (� / _ BUILDING ADDRESS ` 'J 7 6 f 6`/�< I�L A'C c ''//COO-STA MESA. CALIFORNIA For Office Use Only •OWNER /i r so 0 c/ZB L o M I RECEIPT No. PERMIT 2N 1-7 MAIL Si �-y/'_ / RECEI BY l DATE EIVEY.�11` O ISRUEO/, ADDRESS 103 J" C / /T� L S� U—V�I� �(o'WY TEL./Teas /- �/ �/- BUILDING CITY ( T G /v �r7 L C=. No.:3.YS'7 7 ADDRESS ARCHITECT TEL. OR ENGINEER NO. COSTA MESA. CALIFORNIA / /� BJ FIRE ADDRESS /� p Q ZONE ��1T TYPE /i tit [OO UP/` / X CONTRACTOR /Y ryF SODER N APPROVED / '� �f DATE //JO i Ce ADDRESS /2 2 C / #t�i 5 7 VVV�ZONING A0-4- V a �'� µ�1 / ZONE NO.OF USE OF NEW a CITY ( - L�� a ' / AC. ? 2PLANO _USE OF N t t✓ 1 STATE / TEL. T2` S "toy Q LIG.NO. / OLEGAL L r}� (�/JL^ q�W�/ NO. 3S1 7 1 DESCRIPTION r(/�Q/,J /©yam �Y /4 V'�r (J OF LOT (00 ( ( 3 s SIZE I NOW ON LOTNO. OP S 1� / ( 1 /' / w A.P.NO. USE OF YARDS EVES EXISTING BLDG. APPROVED / ALLO D ///fff 8 \ SETBACK LINE FROM (CENTER LINE ST.) �✓ // V / (� CENTER OF STREET REAR YARD FRONT FT. 6 I tug. Q I r -1 SIDE YARD I LEFT I RIGHT R.SIDE 7 5 FT. IN. 0 DESCRIPTION OF WORK L.SIDE �/1:214/{�Ft jp IN. NEW I X II ALTERATION I II ADDITION I REAR !FTI. 11'""✓ IN. REPAIR I I MOVING I DEMOLISH I APPR 1 �V11.. DATE(BY1 I^ . 17 \ BUILDING NO OF q� r !SIZE 2 15 K ..S"V. ROOMS STORIES H 1J vV EXTERIOR WALL ROOF q �;' F .t s�'I `, - ,,\, COVERING I COVERING y d ti llb h� d' 1l` x '' `a V USE OF BUILDING AND WORK TO BE PERFORMEDTi) W in fi �p `Iqj t-0 'q P 11� e ,„,„ IJI I >.6csi G CH-� � �TS oN BA C ;�. O F L.to 7 7 y�B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ;tit it Jr\1 '' // _�l/ ^I. t I�� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOU XOWN UNDfiR-VALUATION IF FOR THE+ PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING 'IPV ��)-OK.,-EBLBLISHINOt'A EPERMIT'-FEE BUILDING CONSTRUCTION. VACDATTYSN.---"'- SIGNATURE OF_BSL. 4 -LJ L.A. _,. _ ` �1 PERMIT FEE $ /G// .14 ,\\� PERMITTEE `� V I $ ,5 /�Cl / PLAN CHECK 5 ,.f -` i AUTHORIZED AGENT . � TOTAL FEE - 01 ,0 (:)lfrir /titf� Gikt_ r 0 .,,p,„,;.„:„..,..:,),, ,..„-,(4.,,,,t...„,-„. 1-- , , !r /O&rz 9 /0 u1 - " ( HD P-A13/ 9-m-gwji , `) .‘-4-.. Y\ . 07" , 1 . . J I OWNER SODERBLOM, H.P. - • � DATE 2-16-62 . JOB ADDRESS 267 E. 16th Place , J/y,,,`� rI,_ 6 BUILDING PERMIT NO.16266 GENERAL CONTRACTOR Owner-B1dr. VALUE $ 79,174.00 AP No. 117-191-11 LOT TRACT FIRE ZONE DESCRIPTION OF WORK 8 unit Apt.Blc I 'ECTIONS Signature DATE GROUIH & J TYPE V ZONE R2 SouPEFMITS ISSUED Gus SUBCONTRACTOR DATE NUMBER Water/ -€224,1 Ails Li-e Piot.- _,rte -'y-/i%---- Rough Corn. Refrig. 0 Air Cond. 0 _ Rough Heating - —A---W cliZe'�� - . .. 9- 24/-4,1.- ?-0K-50-7,,,A .5-6771.-- Rough Plumbing / '94 ba , , r7� n"y ✓I�e./ - , �/ _ .'‘_62,T PJ�'r `" i'✓ Miscellaneous Prop.Swr.Line ❑ House Con. 0 St.Swr. [`� Sprinkling System r/Y- 7//yj9a.`4+../ �/7 //-7.4,z,. .../7o4.7 ti Iv lt Construction Pole �'�""' CC1S / Underground 0 Power E 7-7� _y/' / ,Rough Wiring p _L1 "Z1 2 :--, .'-'tC—a — 6-,Ro-GL /•71. -/✓ trenches U Norms U steel Heml. �, . ay -c °� /.. ," Si di—/'f'4i.} Floor System ` m0. 6J.-�0V —63! Braid Beam 0 Steel Reinforce 0 4 Sheathing m IBJ / — 6 y Frame and Flashin i ft s/ ' (�..,- .?- ,Z Lathing — In ., .! .t Out gr 2 / 6. 'r ,Si r j-n7=/ q=6_,— 1 .er, brown coat - gC • -P . . CIL i .g. 0 Air Cond. 0 Final Heating, Final )l-- i'-/744 Plumbing Fixtures, Final /l.. .Final Gas 'fest 45 )/.a j _Electric Fixtures, Final 44/4(.47. ..7/ O#t' /4/ !T- ,!9Building, Final ((�� `� OCCUPANCY e.."- HOLD FORM BU4•5M — 7 61 I IOLD TOR SPECIAL RCQUIREMENTS 16266 F it RECEIVED 7. JAN 3 O Woz 'COSTA MESA BUILDING-SAFETY DEPARTMENT / FINANCE DEPT. P. O. BOX 317 COSTA MESA. CALIFORNIA n /y CITY OF COSTA MESA o For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT �/ BUILDING BUILDING .-1 ADDRESS / 4 / C i&TH i7/_ ACC . `COSTA MESA. CALIFORNIA q� For Office Use Only OWNER �r ,f 6° (a/C f_ Z. 0 ) I RECEIPT NO. I }ERe.IIT No. MAIL p RECEI D BY DA CEIV O (/�/JTE IIRSUED ADDRESS .23 CrifEL Sy- I j' o-- .9--I r>%6 (r'�'," /cam/ /7n TEL.0/ -S BUILDING CITY �L C,•N/L/T TE L'NO.334W 7 1 ADDRESS ARCHITECT TEL. COSTAtMESA. CALIFORNIA OR ENGINEER NO. ADDRESS ZONE FIRE j, �J /' ,�^ ZONE TYPE GROUP CONTRACTOR (/, /� Sets F/r La M APPROVED ��1AT, Ye 7� /�T)� C c `� BY ( %' DATE V J v ADDRESS (231 G / /f 1. l- v ( `,/ TYPE) ,p�� , /� ZONE .� J+O.OP 2----=.7):OF Nyr+w CITY C_y�L/ 1e/:/�,�/g L� /s p '�{�-� f� ` PLArve E LIC.STATN O. %J tlR/ TNO.c.- /ne os .o.se LEGAL Q I I° ey 2 _5V DESCRIPTION 117-49/ -ii F%{'JC;i OF LOT /00 x / J I NO. OF NOW ONLOTC A.P.NO. USE OF pp,, YARDS EVES EXISTING BLDG. T�rl,/ APPROVED ALL WED • SETBACK LINE FROM y (CENTER LINE BTd [ /y'_ (/` CENTER OF STREET REAR YARD G/L FRONT �rj,) _FT. �l7� /-IN. SIDE YARD I LEFT 6-1 I RIGHT N. / f R.SIDE i5 FT. IN. DESCRIPTION OF WORK L.SIDE IN. NEW IX II ALTERATION I V ADDITION I REAR FT. St -141 I-N. '' REPAIR I LOVING I II DEMOLISH APF OVED`Iri, I`/ " V,�{.+ BY Njo I r �'p:' CIATEI S� __ i SIZE BUILDING�J 7 (� x NO. OF ROOMS STORIES2 r , ub s B'ti�a d� 4J :�..! 1 'k' • EXTERIOR WALL ,1 ROOF �,/ �j ^'1 B'I Ce COVERING slcj C(_U I COVERING Coil �- 'y� ID F,",' t° F 1�:. I USE OF BUILDING AND WORK TO BE PERFORMED 116` IL it \ 1 0' QgT I , Su° LL) B 'OM t KPT' t/ c CCI Azi f tfr C./ 1 < 411 .�s'`it.i�v - •- .�r GI Q-. I' VAOVED 't V I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION % IMOUrit�SH'WNAT53 1 ��- ILI THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT ANDAGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. \ PLY WITH ALL CITY ORDINANCES AND STATE a LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE OF 4 (e _ PERMIT FEE $ Ay 0 PERMITTEE ���/ VVVVIIII • I �'L 4 J�j/7Y ^7//// ��_ i LI- $ / f / 7 X. PLAN CHECK $ C AUTHORIZED AGENT / 0 =` TOTAL FEE $ /' I/ —E Plai:24-i' 47? ( //f 0 a ii 11 . 47 /� b) . _i f w A i . .......4.. , 4 ._13 4.• ftr , , Cfl • • \' - _ . OWNER SODEHBLOM, H. F. DATFLO-10-62 JOB ADDRESS 287 E. 16th P1. BUILDING PERMIT NO. 17979 GENERAL CONTRACTOR H. F• Soderblom VALUE $ 168.75 AP No. 117-191-1]. LOT TRACT FIRE ZONE DESCRIPTION OF WORK PVt.Blk.Wall 1 'ECTIONS Signature DATE GROUP j TYPE , ZONE 8-2 Son PERMITS ISSUED Cas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line ❑ House Con. ❑ St.Swr. ❑ Sprinkling System Construction Pole Underground ❑ Power C _ Rough Wiring Trenches ❑ Forms ❑ Steel Reinf. ❑ _ Floor System _ Bond Beam ❑ Steel Reinforce ❑ _ Sheathing Frame and Flashing _ Lathing — In ❑ Out ❑ P' 'or, brown coat i g. ❑ Air Cond. ❑ Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final PM CI — I, ro 2/ OCCUPANCY FORM 6U4.5M — 7.61 l O(]7[1 4, 17979 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT OCT 101962 P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEP1. o w'" For Applicant to Fill In Completely APPLICATION'TOR PERIMIIT TYPE OR PRINT _ BUILDING BUILDING 2 y-7 E/6 T f� PZ A- < L ADDRESS COSTA MESA. CALIFORNIA� �/nFor Office Use Only OWNER 70 L9/F-f-l.-tt't-✓ `c1'L4-!--i I RECEIPT NO. I PIR7979 MAIL +� �J en-y� _ RECEIVEDEC . BY DATE RECEIVED DATE ISSUED ADDRESS 42 6 ,/� ` / �! L per,/Q- (� / IQ^4Q-by CITY [�-G C.- N ✓At L" L TEL TBURECEIVOC Q 7 1• /4, CU,. ARCHITECT ,- ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. `J FIRE J}w ADDRESS }/-�� r p fa ZONE _ 'nq n TYPE„ GROUP // CONTRACTOR Hi I- 500 t-1 1J C 0 APPROVE"`,y�e.. , DATE /D...L7L7L7A///Q'(O ADDRESS ((2 3 l$ C r 1 f(If- I, S Y YYY///--I.��) IY 'NI NG //�CITY (�)' `� c ,c ` `. Z/ .- 2, I PLANS ZF I BUILDNG NO.OF USE OF eWAl� STATE q FC // �p LEGAL LIC.NO. % V L NO. C( VJ U 7 DESCRIPTION 2_0 [ / V/ IlL/P 2_s/ / SIZEOF LOT (QIC Jr NOW ON LOT A.P.NO.I NO. OF BLDOS. 1 t ( �F `f7I— 7/ USE OF ^ �T YARDS EVES EXISTING BLDG. ,Y-1( APPROVED ALLOWED SETBACK LINE FROM -- /( V (CENTER LINE ST.) CENTER OP STREET REAR YARD FRONTF`� T.1 IN. SIDE YARD I LEFT I RIGHT R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE .----Fr"" IN. NEW I II ALTERATION I II ADDITION I REAR 1 FT. 1 IN. ` ' REPAIR I I MOVING I DEMOLISH I APPROVED BY ��/�i b/ OATE16/ 'i 'rY BUILDING NO. OF / (R_ [) 1 /T' SIZE ROOMS STORIES I�\\// EXTERIOR WALL I ROOF COVERING COVERING USE'722F2' BUILDING ecT W2 if•S BEPERFORMEDoy Cx - Go AuyrL-L. H6LLeSc/1. C-'- /4 /G/'� 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 OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCT! / VALUATION SIGNATURE OF 7j/ /9�'ge...t �I,....-/ PERMIT FEE S' SC& PERMITTEF Pn / ,�n"`f"I` ell $ f e JV PLAN CHECK $ AUTHORIZED AGENT ^�f E .TOTAL FEE $ -co y