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267 16TH ST - Building Permits
J ADDRESS OPBNL001D: 267 E 16TH ST • wet CITY OF COSTA MESA - BUILDING PERMIT OWNERS Num IEKNOYvwG IBBS, FLAVE B TR . PERM NO: P 077215 ADDRESS:2128 MIRAMAR DR BALBOA,CA 92661 PERMIT NO: P 077215 PLAN CHECK NO: N GOVT: N SUPP: N APPL.NOUNS ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: REP ARCHITECT ORENGNEER: tit NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR AS PER REPORT SQ FT: ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / cmnciarsNAME:OTIS L R PLUMBING ( 714 ) 548-4227 CONTRACTORS MMUNG 820 IRVINE AV COMMENTS: FIRE DAMAGE REPAIR, RE:#B77157 ADDRES&NEWPORT BEACH •CA uC.NO.: 272694 *********iEat****'+E'iE#****+e+E+t*aERE** •tE4aa*iE'+toE•+teEitREr*et***aE'***REat+t**:t+tiaaERt*it•#+E+E+(SEREtE•N+a****** 92663 DIT, T108 ZONING REQUIREMENTS • LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter e S E T B A C K S (commencing with Section 7000)of Division 3 c the Business and Professions Code,and my license is In full force and effect. . CITY LIC.NO.006944 LIC.CLASS:C 36 LIC.NO.: 272694 EXP: 09/96 MAIN BUILDING ACCESSORY BUILDING � FT IN FRNT: FT IN REAR: FT IN Date: 14. r t, Is to Gomred«: ECC fl S Pl L& s RI 1 rug LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt from the Conlradon License Law for the ' following reason(Section 7031.5 eesiees m and Professions Code:Any city or county which requires a permit to nsvud,alter.improve, PARKING REQ: PROV: PARCEL: 4 24516 419 Z NE: REF NO: ' mdeh,or repel any structure,prior to its issuance.also squires the applicant for such permit to fib a signed statement that he or she PLANNING NOTES> Idcensed.pursuent to the provisions d the Contractors License Law)Chapter 9(commencing with Section 7000)d DNSon 3 of the > . airiness and Professions Code]or that he or she is exempt therehom and the basis for the alleged exemption.Any violation of Section 7031.5 by any appbcard for a permit subjects the applicant to a civil wetly of not more than five hundred dollars(15003). ****************************************************W************************** ❑ I.as owner 0 the propeny or my empoyees with wages as their sole compensation,will do the work and the structures not intended DEVELOPMENT SERVICE' S REQUIREMENTS or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an ownerd property who bads opr inoves thereon,and who does such work himself or hersef or through his or her own emplorwe.provided that such improvements are not intended or offered for sale.I.however,the building or improvement is sold within one year of completion.the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as owner of the ProPertY.am exdushelY eoureclin9 with liCensed wonders le CCflitrUCI Ihe Prefed(Seethe 7°44.Elusirwes end BUILDING APPROVED BY : DATE: Prows.Code The Contractors not License Law does napply to an owner of property who builds or Improves thereon and who • contracts for suds projects with a oontradorN)licensed pursuant to the Contractors License Law), /] A o I am exempt under Section: B.a P.C.,for this reason: ' APPLICATION ISSUED BY: DATE: GiEIF- I Lc Data: owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that lam aware el end understand the requirements of Caloenle Health and Safety Code Sections 23505,PcsA3,and 25534,andthm l orenyhsure building occupant will/wB not le one)need to comply wah saidatme codes and therequ'vements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e permit formnstructon or modification from the ArtCTfrranagement District.Residential construction applications ere exempt from these PERMIT 76.00 provisions. Date: Applicant: 25% SMIP/NON-RES PLAN • WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d pe.jtay one of the fo0ow4ng dedsratora: ISSUE FEE 20 ,00 ❑ !have and wilmaintaitacenAmeoconsent loself-insure for workers'e«npnWwadded for bySedion37Doofthe tabor BUILDING-DIV--> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE dom Code,for the peanceofthe work for which this permit hissued. TOTALS----> 76 .00 20. 00 • 0. 00 96 .00 96 . 00 .00 ar :t ❑ I have andwmai taworre ks 'cdnperemInsurancee, ldn Insurance es required by Section 3700 dan the Labor Code,for the performance of the . work tN'permitlseh" sd.My`rerkancompensation insurance m rN'r end policy number we: REVENUE DIVISION TOTALS--> COLLECTED: 96 ,00 OVER/SHORT: . 00 Carder: . Pricy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I the perm]is for one hundred dollars MOO)or Ass./ 96. 00 _ o beco thmdettpthev hcedlhework lor whichtes of this prune aIshall hat employ soylnpp,"npsedtomw swab io e' **********************W******************************************************** bcandy at in the the mance theososaton wive of Cslrmit'a and ons that Y I should beer n In son In any to the so as n' . compensation [[s�alons d Section 3700 d the Labor Code,I shag ffaofl wwsh cdnpyywithhtthose provisions. INDIVIDUAL F E E BREAKDOWN .9p Date: y' n C O Applicant: I++[ -tit'/ Warning:papule to secure workers'compensation coverage 1s unlawful,and shall subject anemployer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($1040001 In addition to the cost of compensation,damages as provided for In section 37O6of the Labor Code,Intones,adaftomey's lwa. PLU 1 BATHTUB 7 .00 7 . 00 • CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjurythere that is a construction lending agency for the PLU 1 DISHWASHER • 7 . 00 7. 00 « penmanceotheworkfowhichthipennilsisued(Section3097,Ch.C). PLU 1 LAUNDRY TUB OR WASHER 7 . 00 7 . 00 LENDER'S NAME: PLU 1 SHOWER 7 . 00 7 . 00 LENDER'S ADDRESS: PLU 1 SINK, KITCHEN 7 . 00 7 . 00 I certify that l hoe reed this application and statetha theabbove information is correct.l agree to comply with alldty and countyodinanoes PLU 2 WASH BASIN 7 . 00 14 . 00 • end state laws relating toheildog construction and hereby autlorizerepresental&ee of this city to enter upon the above-mentionedpropeny PLU 2 WATER CLOSET (TOILET) 7 . 00 14 . 00 for inspection purposes.LEE OTIS PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5 .00 AL Pnn1 Name PLU 1 GAS PIPING SYS 5+ OUTL-PER OUTLET 1 .00 1 . 00 Qat yl(-7 'ckco END OF FEES -91 Signature of owrodAp.nvAppEgeM/Cwnuador 01 00204603-00204603 TOT 96.00 (5151-46.WP) White-Building&Safety:Green-Fie:Canary-App1cent:Pink-Revenue:Goldenrod-Assessor DATE: 04/17/95 TIME: 14:41 4 -6-'wl AaoRESsocsts c: "267 E 16TH ST wit CITY OF COSTA MESA - BUILDING PERMIT O'ANERSNAM wmoi :GIBBS, FLAVE B TR PERM NO: B 077157 AooREss:2128 MIRAMAR DR BALBOA,CA 92661 PERMIT NO: B 077157 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MIBNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP ARCHITECT OR ENGNEER: UC.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR AS PER REPORT SQ FT: 50, 000 ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: 50, 000 . 00 CALC-VALUE: 50, 000 . 00 GROUP OCC: R-3 / CONTRACTOR'S NAME: ' cams CTORSMMLOM COMMENTS: FIRE DAMAGE REPAIR ADDRESS: us(.No.: ZONING REQUIREMENTS WIT: SETBACKS UCENSED CONTRACTORS DECLARATION:I hereby affirm under penally of penury that I am licensed under provisions of Chapter 9 (ownmendng with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. CITY LIC.NO.: UC.CLASS: LIC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUIreaonERDEn7031. Business by affirm and penally perjuryor hat counymacemgfms aCaatodonLiroroe Law for the PARKING REQ• PROV: PARCEL: 42516419 ZNE: REF NO: OWNER realm(RBDEC DECLARATION: 5 N:I her end Pndeusms a all Any ery a county a axehich requiresIrvin the permit to connect Uce elfer,improve,the ty molish,or repai any structure:prior to is issuance.also requires the applicant for such peat to Mea signed statement thin he or she PLANNING N TES> licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 1000)of Dbiin 3 of the . dusness and Professions Codel or that he or she is exempt therefrom and the bay for the alleged exemption.My violation of Sacral > 7031.5 by any applicant for a permit subpdsthe spoken,to actvil penalty of not more than fere hundred da0ass(S50OD. ##################************1f####******####!E************#########iE#********** }II3 I.as owner of the properly or my employees with wages es the:sole oompunsatcn,will do the work,and the etmcture IS nor intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does nor applytoan owner of property who buids or improves thereon.and who does such wok fimsal or herself or through his or her own employees.provided thee such improvements ere not'weaned or offend for sale.II.however,the bugling orimprovement le sold within one year of completed the ZONING APPROVED BY DATE: ownerbwi der will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as ormerof the property.ant asdusively contraclng with licensed contractors tocoratruct theproed(Section 7044 Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Lew does not apply to an owner of queerly who builds or improves thereon end who contracts for such proted,with a mnradot(s)licensed pursuant to the Contractors License Law). SUt ❑ lam ex under Hon: B.AP.C..for A APPLICATION ISSUED BY: DATE: (g ` 9L Dme•</ 4— 96 ower: v i4.0e4eri LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Heath and Safety Code Sections 25505,25533,and 25534,and that l or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modificatinbamtheAi Quality Management District Resident's/construction applications are exempt from these provisions. PERMIT 574 . 75 5 . 00 Date: Applicant: PLAN SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:l hereby affirm under penalty of perjury one of the following dedartiwm: ISSUE FEE ' o I have and will maintain a certificate ol consent to selfiinsure for workers'compensation.as provided for by Section 3703 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the performance olds wad y«wftcn this permit is rued. TOTALS----> 579 . 75 0 . 00 0 . 00 579 .75 579 . 75 .00 ❑ I have and wit maintain waken' mpenen insurance.as required by Section 3700 d maintainmatio Labor Code.ler the pedormanoe of the work for which the peee.Myworkaeoompuneelminsuranmnsder and peywmxate: Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 579 .75 OVER/SHORT: .00 Pity Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK �s eedmn need not be competed I the peons(is for one hundred dollars Rawl or less.) 574 . 75 5 .00 ❑ beton that subect1e po workere dtheworkforwaseh this wmga issued,ale thanll employ ldanycome in any metheraalp ******************************************************************************* compensation subjw m the mane e'c 3700 of.i e lows Of deelinn)'a end th co Nal i should become subject to the worker' oomporoelem prddeiom a swan 3100 a m.Lebon cane,I mag fmnwitn pomp/with moue provisions. _ INDIVIDUAL F E E BREAKDOWN • Date: Apnlicenb Warning:Callum to secure workers'compensation coverage Is unlawful,and shall aot$ect an employer to criminal penalties andTYPE QTY D E S C R I P T I Q N UNIT COST TOTAL COST civil lines rot to one hundred thousand dollars(5100,000),In addition to The cost of compensation,damages as provided for In Secdon 3706 of the Labor Code,Interest,andatiomaya fes. SFR 50000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 .00 50, 000 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of Perjury that there ill e construction fending agency for Ma END OF FEES pedamance of the work for which this pend is issued(Swim 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: . I certify the I have read this application and state that the above information is correct.I agree to campy with all city and countyordinances and stare laws relating to building construction and hereby authorize representatives of this city to enter upon the ebove'mentioned property for inspection purposes. FLAVE GIBBS 01 00204375-00204376 TOT 579.75 „a....-4452.‘ Neste GATE: '04/15/95 TIME: 10:34 ,� �- Date: 4//97956 Signature of 0vnerlAgeaOApplicant/Contrador (5151 J6.WP) White-Buikvq&Safety:Green-Rle;Canary-Appicant:Pink-Revenue:Goldenrod-Assessor CITY OF COSTA MESA, CALL} NIA . OCTOBER 30, 1969 MRS. EVELYN N. KIRCHBERG 267 EAST 16TH STREET COSTA MESA, CALIFORNIA DEAR MRS. KIRCHBERG: A ROUTINE INSPECTION WAS CONDUCTED AT THE PROPERTY OWNED BY YOU AT THE ABOVE ADDRESS BY MR. DEAN DORRIS OF THE BUILDING DEPARTMENT AND MYSELF. THIS INSPECTION REVEALED THE PRESENCE OF AN UNOPERABLE MOTOR VEHICLE IN THE DRIVEWAY OVERHANGING A PORTION OF THE SIDEWALK. THIS IS IN VIOLATION OF THE COSTA MESA MUNICIPAL CODE, SECTION 9298.17, STORING OF DISMANTLED VEHICLES. "No PERSON SHALL STORE OR ALLOW TO BE STORED UPON HIS PROPERTY ANY AUTOMOBILE, TRUCK OR OTHER VEHICLE WHICH IS EITHER DISMANTLED OR DISASSEMBLED, EITHER IN WHOLE OR IN PART, OR DOES NOT QUALIFY TO BE OPERATED UPON THE HIGHWAYS UNDER THE VEHICLE CODE OF THE STATE OF CALIFORNIA WITHOUT FIRST OBTAINING A PERMIT FROM THE CITY COUNCIL." A REINSPECTION WILL BE CONDUCTED ON NOVEMBER 10, 1969 AT WHICH TIME WE HOPE TO FIND THE VEHICLE UP TO MOTOR VEHICLE REQUIREMENTS OR REMOVED FROM THE PREMISES. YOUR COOPERATION IN THIS MATTER WILL BE GREATLY APPRECIATED. IF I CAN BE OF ANY ASSISTANCE TO YOU, I MAY BE REACHED AT 834-5k26. VERY TRULY YOURS, JOHN MARSHALL FIRE CHIEF BY JAMES W. RICHEY INSPECTOR JWR: CL CC: DEAN DORRIS, BUILDING DEPARTMENT ROY JUNE, CITY ATTORNEY ENC.: RN 2576 . p. POOJECTADORESS: . 267 E 16TH ST UNIT: 0 CITY OF COSTA MESA -- BUILDING PERMIT PERM NO:' M 046348 'OWNER'S NAME: FLAVE GIBBS ADDRESS: SAME AS ABOVE • PERMIT NO: M 046348 PLAN CHECK NO: N• GOVT: N SUPP• : N • CONSTRUCTION TYPE: PERMIT TYPE: MEC. • PURPOSE: 0TH 714 /631-9156 ARCH/ENGINEER: • REG.NO.: •JOB DESCRIPTION - : REPLACE HEATING SYSTEM SQ FT: •• ADDRESS: UNIT: PEnrnmEE; CLAIM VALUE: CALC—VALUE: GROUP OCC: / ADDRESS:- ABC HEATING 6 A/C ( 714 ) 540-0972 2951 GRACE LN COMMENTS : C.M. CA 92626 • *+rsesrsrsr**+riE�E*+r****�e*ye*+ex�E�rye********�E�r******keys***************ar*�r->Etr**it+t*****arc**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(Commencing with Section . Z 0 N I N 'G R E Q U I•. R E M E N T S - 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS an uc.: 0 6 0 1 STATE LIC.:0 CLASS: .20 ' . ' Date: co Signature: , este._ . _ ...0ii4....d/ -- MAIN BUILDING --- ACCESSORY BUILDING ---------- WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRN T: FT IN REAR: FT IN FR N T: FT IN REAR: FT IN Compensation Insurance.ora certified copy thereof(Section 3800,Lab.C). LEFT: FT .IN RGHT: FT IN LEFT: FT IN RGHT: FT - IN POLICYND.: WCG10330D MUTE: 01 /01 /91 ' COMPANYSUPERIOR NAT. PARKING REQ: PROV: PARCEL : 42516419 ZNE: REF NO: • 7 Certified copy is hereby furnished. (M Certified copy th the city Building Division. PLANNING NOTES> Re) > Date) 34,4e/ Applicant: C"Itei A ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($10o)or less). DEVEL OPMENT S E H'.V I C E S R E Q U I R E M E N T S I certify that in the performance of the work for which this 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 B Y • 'DATE Date: Signature: ——-- — --- NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : •DATE: Code,you must forthwith comply with such provisions or this.permit shall be deemed revoked. —'-- ,l CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ' ////i DATE: U winch this permit is issued(Section 3097,Civ.C). ********************** (. -*. �y +p.*************************77 ** UNDER: ******************************************************************************* ADDRESS:' -' • LEGALIZATION: N F 'E E SUMMARY STRUCTURAL SEGMENTiN • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG' PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT - 9 . 0 0 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed , pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business - 25% SMIP/NUN—RES •- and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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(3500). - ISSUE FEE 15 . 00 I, as owner of the property or my employees with wages as their sate compensation, will do the work, and the BUILDING—DIV—> . PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 1 ❑ tructure is not intended or offered for sale(Section 7044,Business and Professional Code: TheContractors'State License Law TOTALS-----> 9 . 00 15 . 00 0 . 00 24 . 00 - 24 . 00 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> • COLLECTED : 24 .00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business . 224 . 00 . ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ****************************************************.**..************************* that proof of their Worker's Compensation insurance should be provided to me: INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY • D E S C R I P T I O, N UNIT COST TOTAL COST Date: Owner. MEC 1 INSTALL FORC/AIR FURN <= 100 K BTU/H 9 . 00 9 . 00 I do hereby certify that I am aware of and understand the requirements of Califomia 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 Quality Management District.Residential construction applications are exempt from these provisions. ' Date: Applicant: I hereby certify that I have read this application and state this e information is correct.I agree to comply with all city and county ordinances and state laws relating to budding construction.-i •)nze representatives ojthis citytttyyy���Ater upon the above-mentioned • , propertyfor inspection purposes. ,r • /1 / 1`v Datate:: 341711b Signature: L��,w•.e"`/„i// I/lam Driver's License or Social Security x: ' 01 00055356-00055356 TOT ' 24.00 DATE: 03/05/90 TIHE: 09:43 164146 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • t • t• CONSTRUCTION AND PLANNING POO SPA - APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service`or Pole.c: - 52. Pool & Equipment Location k2. Soil Pipe-Undrgrnd , • _ '.,` ; ,/ 53. Steel Reinforcement _ 3.<Electrieal Conduit-Utility-Undrgrnd ', 54. Forms V. - 4'.-Electrical Conduit-Undrgrnd. _ LT55. Electrical Bonding 5. Steel Reinforcement �•=: 56. Rough Plumbing & Pressure Test _.r C'' 6`"=Electiical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -- 7.;Footings -7 58. Electrical Conduit-Undrgrnd. - r 8. Foundation /- 59. Gas Pipe, 0 Undrgrnd., Test •.J 9. Water Pipe-Undrgrnd. J - � 60. Backwash Lines, P-Trap, 0 Undrgrnd. - 10. Structural Floor System ,' _ .1' 61. APPROVAL TO DECK _;- 11. Property Sewer Line_.& Ho`use•Connection - - 62. Backwash & Receptor-Final 12. Sewer Cap - -- 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final -� 14. Rough Plumbing _ it , - 65. Electrical-Final • f 15. Rough Electrical-Conduit ; p 66. Solar System-Final 16. Rough Electric Wiring ^ 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING -.' 1 • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19..Rough Heating &,Air Conditioning - x FIRE DEPT. REQUIREMENT 20:-Roiigh Factory Fireplace - V.:. _. . ,. APPROVALSti�,, Permit# - 21.-Ducts, in Structure t. " ' _ - _ } r• 70. Underground?Hydro 22.-Ducts, Ventilating) , _ •- _ -71, Product Piping O_'Gas 0Oil 23. Gas-Pipe-Rough & Test (Ti-" "' ¢ _ ..72. Underground Fltish- 24.''Roof Fr-Timing - _,t .73.-:Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - "' •. _K 74: 'Overhead Hydro_ _ s 26.-T-Bar Ceiling (Structural) & Monocoat _' - • 75�_Dry Chemical -- _ 27.c-Frame and Flashing' y�_ Y - '• t 76. Dry Standpi Pe -' - :28. Lathing & Siding .' 1;.� - r 77. FIXED SYSTEM FINAL. _- -- 29. Insulation " _ r •' r 78?FIRE PREV. FINAL l - • 30. Drywall Nailing ` , _ HEALTH DEPT. REQUIREMENT : 31. Plaster Brown Coat'• S 79. FINAL INSPECTION - -:32.•Electrical Power MeterFinal " r. ;, 80 FOOD CERTIFICATE ISSUED_ 533.'Final Electric ;• hi '• + Notes: 2y7 ' -' -66" •_34._Final Heating& Air,,Coriditioning (o 0 L£D i r r 35.-Final Gas Pipe-Test: ,- '' -:. 0 r - •. - `36_Hood or Canopy ! - = r _ ` ; - _ •_ , -�37.-rFinal Factory Fireplace• • i-. - _ - ,- - 38. Final Plumbing t - `4 " F--,- T - 5 ^i 39. Water Service-Final•` r c ^= - _ '40. Gas Service-Final t _ ':.Ir t" ' 11 x A. _71 c r v v - -.. i. z `41. Solar Domestic-Final "' . rp, ^= - 42. Backflow Preventerr J. • ." .; i. c;• I -1,-1 . . ,r t'.1- , •- 43. Backflow Irrigation* ;; _- e t t • • r t rl• nt _ -44. Landscape fRigation System ` ' ' , .� c>, ; _ - _ - , . r _ - -45:Sound Attenuation - -46. Handicap Regulations 47.-FINAL STRUCTURE & BUILDING C •- -- - -i 48.TFINALPLANNING- r'`-' • ..1-7�* = - _ in 9, ,4Electric Release to Edison t ' * ; r. ' _ r 50.=Gas-Release to Southern California Gas Co - '-i 1' •. -. 7 - -51. CERTIFICATE OFOCCUPANCY ` '• - ' - No. Date I AODRESSOFBMLCING: 267 E 16TH ST • LINT: CITY OF COSTA MESA — BUILDING PERMIT MINERS NAME IFIO4ONN:GIBBS, FLAVE B TR /-PERM NO: B 077157 ADDRESS:2128 MIRAMAR DR 4 BALBOA,CA 92661 PERMIT NO: B 077157 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MMUNGADORES& CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP ARCHITECT OR ENGINEER: uc.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR AS PER REPORT SQ FT: 50, 000 ARCH.OR END'S ADDRESS: INT: CLAIM VALUE: 50, 000 . 00 CALC—VALUE: 50, 000 . 00 GROUP OCC: R-3 / CONmNAVE: SsuCOMMENTS: FIRE DAMAGE REPAIR CONTRACTOR'S MAILING ******************************************************************************* AOORE53: UC.NO.: ZONING REQUIREMENTS UMT: S LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACK (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. Cm LIC.NO.: UC.CLASS: LIC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I ern exempt from the Contractors License Law for the following reason(Section 7031.5 Buseexs and Professions Code:Any city«county which requires a penin to mnetmn,cher,improve, PARKING REQ: _ P ROV; _ PARCEL: 42516419 Z N E: REF NO: demolish,or repel any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES> r•_ licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7030)of Division 3 of the • .usiness and Professions Code]or that he or she is exempt therefrom and the bazar for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subled the applicant to a civil penally of not more than five hundred dollars 1$50O1). ******************************************************************************* XO 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 D E V E .L O P M E N "T S E R V I C E S REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of propend who builds or improves thereon.and who does such work himself or herself or through his or her own employees.provided the such BY ' : - • improvements are not intended or offered for sale.If.however,the building or bnpovement is sold within one year of completion, ZONING APPROVED . r DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ' ❑ 1,asowwrero the property.amexdussly contractile with licensedcontractors to«mwna the prded(Section 7044.Business and BUILDING APPROVED BY • DATE: Professions Code:The Contractors License Law does not apply to an owner d properly who builds Or improves thereon and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). i- '7 ', ❑ lames under lion: B.AP.c.,f« APPLICATION ISSjJED BY: S DATE; lye.d ti C y y�se� p� ************************ *******************4 ******************** * ******** °a // /y v��i� LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of end understand the requirements of California Health end Safety Code Sections 25505,Px51.1,and 25534,and that l«anyhaure building occupant will/will nd(dmle one)need tocom*with saidatste codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e pane for construction or modification horn the Ar OuakryMarnagement District.Residemel construction appimionsareexempt from these provisions. PERMIT 574 . 75 5 . 00 Date: Applicant: _ PLAN SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE ❑ I have and will maintain a certificate of consent to sel-insura for workers'compensation.as provided for by Section 370of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the pengmegedthe work for which thiepemaetssued. TOTALS----> 579 . 75 0 . 00 0 . 00 579 . 75 579 . 75 . 00 ❑ I have and will maintain workers'compensation insurancees required by Sedan 3700 of the Labor Code,for the performance of the- workwhich faissued.this permit nam carder Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 579 . 75 OVER/SHORT: .00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK his section need not be completed d rhe permit is for one hundred dollars/S:00)or less) 574 . 75 5 . 00 o I comfy that in the performance of the work for which this permit is issued,I shell not employ any person in any manner aro as to become subject to the workers compensation laws o California and agree that ill should become subject to the workers' ******************************************************************************* compensation provisions d Section 3730 of the Labor Code.I shall fonhwith crampy with those provisions. INDIVIDUAL F E E BREAKDOWN Dee: Applicant: Warning:Failure to secure workers'compensation coverage Is unlawful,end shell subject en employer toadminai penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000),In addition to list cost of compensation,damages as provided for In Section 37O6oftheLborCode,Interest,and alomey'sfees SFR 50000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 50, 000 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a ronemdon lending agency for We END OF FEES performance of the work for which this permit is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application end Stele that the above information is CoMP.I agree to comply with all city end county ordinances end state laws relating to building consoudion and hereby authorize representatives of this thy to enter upon the above-mentioned property for inspection /purposes.�� LAVE /�GIBBS/J-�n�/ �j • Dee c. l,l<. .i:_ . —i' ll Signature d Owner/AgenvAppbcant/Contrador (5151-46 WP) White-Building d Safety:Green-Fie:Canary-Applicant:Pink-revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL iPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. i . 53. Steel Reinforcement . • 3. Electrical Conduit Utility'Undrgrnd. 54. Forms -,4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding . -5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings 58. Electrical Conduit-Unclrgrnd. 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 .. = i - i - FIRE'DEPT. REQUIREMENT 20. Rough Factory Fireplace '; ; • APPROVALS Permit # 21. Ducts, in Structure > -- - 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping OGes ❑Oil J 23. Gas Pipe-Rough & Test . . - •- 72. Underground Flush • 24. Roof Framing .. . - 73.. Undergrnd.StoragtTank EiGas 0 Oil 25. Roof Sheathing - '' .C..---‘ S (,4 1.- _74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Mono-coat - 75.-Dry Chemical ,- - _ - ! 27. Frame and Flashing: = 6--(1<cle 6 - 76. Dry Standpipe 28. Lathing& Siding s - - : 6ycLf Ce 6 7: FIXED SYSTEM FINAL- 29. Insulation - • - _ _ [-f?-`ISP' g4(/ 78'. FIRE PREV. FINAL 30. Drywall Nailing {!/ 6 /�ii/ .-- , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 0 I �,.1 - t 79. FINAL INSPECTION - - 32. Electrical Power Meter-Final f -_ 80. FOOD CERTIFICATE ISSUED i. 33. Final.Electric . . - - Notes: 34. Final Heating& Air Conditioning 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 . 1 , 'r..- 41, Solar Domestic•Final 1 42. Backflow Preventer . r 43. Back.flow Irrigation 44. Landscape Irrigation System= r - -a _ 45. Sound Attenuation- :' r 46. Handicap'Regulations - a. 47. FINAL STRUCTURE & BUILDING b'_l- /�/_W.1J . 48. FINAL PLANNING P 'C� T. • _. 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co • . - 51. CERTIFICATE OF OCCUPANCY No. Date • City of Costa Mesa" . California 92628-1200 P.O.Box 1200 - • Insulation Certificate t Permit Number 3 7 7 /S'7 Number and Street City • County Subdivision Lot Number Description of Installation ROOFr Material �T� Brand Name �O RNf u ` Thickness (inches) 6 f u _Thermal Resistance (R-Value) f EXTERIOR WALL Material 1 FSA- • Brand Name C 0 C N f Li Cs Thickness (inches) 4 �� Thermal Resistance (R-Value)—I 3 CEILING Batt or Blanket Type ' Brand Name Thickness (inches) Thermal Resistance (R-Value) Loose Fill Type Brand Name Contractor's minimum installed weight/ft2 lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR • Material Brand Name Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Width (inches) • FOUNDATION WALL • Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Declaration • I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adminstr ive Code. /�W )Gene tractor(Builder) OALi n Number Signature and Title Date . Sub-Contractor(Insulation Installer) License Number Signature and Title Date 1907-46 A00gESS OF MALOWO: 267 E 16TH ST WIT: CITY OF COSTA MESA — BUILDING PERMIT OW WEIFIooani GIBBS, FLAVE 9 TR. • // PERM NO: M 078100 ADURES5: 2128 MIRAMAR DR BALBOA,CA 92661 PERMIT NO: M 078100 PLAN CHECK NO: N GOVT: N SUPP : N • APFL.SWUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: REP ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR AS PER REPORT SQ FT: ARCH.OR EMI'S ADDRESS: LINT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / CONTRACTOR'SNAME CONTRACTOR'SMMUND COMMENTS : FIRE DAMAGE REPAIR, RE: #B77157 1DORES9: UG NO.: **************3E*************3E*1E*1E*****31**313E*3E 311E*3E*111E**311E***1E******3 *******3131** DIT: ZONING REQUIREMENTS UCENS ED CONTRACTORS DECLARATION:I hereby shim under penalty of perjury that I am licensed under provisions of Chapter 0 SETBACKS (commencing with Section 7000)of Maim Sof the Business and Professions Code,and my Ilan is In hall force end effect. CITY LIC.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dal.: Convector: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt hen the Contractors Ibex.Law for the following reason(Section 70315 Sunless end Professions Code:Arydyne cams which require a permit to construe,after,improve, PARKING RE](�• PROV: PARCEL: 42516419 ZNE: REF NO: demolish. s h.or repany structure.prior its St or to an:.also requires the applicant la such permit to file a signed statement that he a she PLANNING NV TES> s licensed pursuant to the prodaia°of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the ,k. F Business and Professions Coder or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section y > ' 7031.5 by wry salient la a permit subjects the applicant to a civil penalty of root mere than fns hundred dollars[S5001). dE********1E****3E*********1E************E'111E******1E311E***3E1E1E***1631****111E****1E********* ❑ I.al miner c4 the re01995Y Tv ITT OntiOnntie with wages as thei sole compensation.will do the work.and the stnecture is not intended 1; DEVELOPMENT S E R V I C E S REQUIREMENTS or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an Owner of property who drill or inproves thereon.and who does such work himself or honer or Sough he or her own employees,provided that such ./t improvements are not intended or offered for sale.5,however,the building a wsyear inproemt sold within one of acnpWbn,the •ZONING APPROVED BY '' DATE: Inowner-builder will have the burden of proving he or dna did not build or improve la the purpose of sale). I,a owners the property,am exclusively contracting with licensed contractors to muvud the project(Section 7044,Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not appy to en owner of property who builds a Improves thereon end who contracts la such projects with a=undone)licensed pursuant to the Cawadors Lienee La • I) •.g A ❑ lern exemptu B.APC..for n: l ' ,APPLICATION ISSUED BY: DATE: CT- kt - "II ��°° .111E3E1E1E313E3111311f313E3E111E3E3E113E****111E1E313E313E1E****#iE#ii31##3E 3EfE311E31#313Ei1****1E3E3f3E3E31311111******* ** Date: l0�// 96 Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N I do hereby certify that I am aware of and understand the requirements of California Health and Solely Code Sections 25505,25533,end 2S534.and Mei belling occupant will i/wnor on need campy with said state codes end requirements for BLDG PMT PLUMBING ELECTRIC L, MECHANIC FIRE SMIP/RES GRADING a permit for costmeionormodircaton from the ArTgaRranagement District Redental caAnxtbn appiwias are wimp'Iran these PERMIT ' 26 . 50 provisions. Date: Applicant' PLAN 1 y 25% SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one dale lofbwing dedantbns: ISSUE FEE i.--. 1...:322 . 00 ❑ Ihave and will maintain acandies oconsent oseR.ieunfor workers'compensation,asprovidedfor bySeaion3700of the Labor BUILDING—DIV—> PERMIT ISSUE PLANcCH•ECK TOTAL PAID DUE Cods.for the pedwu onnceoftheworkforwhichthispennhisisued. TOTALS----> 26 . 50 22 . 00 " 0!00 48 . 50 48 . 50 • 00 ❑ I have and will maiman workers'compensation insurance,as required by Sedan 3700 of the Labor Code,for the performance of the work for which this permh is issued.My wakere'cempensoau tion inrarnce carrierere:end policy number REVENUE DIVISION TOTALS--> COLLECTED : 48 . 50 OVER/SHORT : 00 Carrier: Number: BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN—CHECK ,This section need not be completed a the permit is for one hundred dollars 0100/or lest.) 4.8 ..50 ❑ I certify that in the performance of the work for which this permh is issued,I shall not employ any meson in any manner so as to Y / banana subject to the workers'compenswnn lava d cSdonia,and rose that H I Mould became subject to the workers' unlawful, 13 * E1E* 11E** E* E** E1E* 1E*************1 *1E***** *** E* 11E* 11 ***# 1E31 11E* E* E* E* E* E* E* /XIcompensation provisions d Section 3700 d the Labor Code,I shall forthwith campy with those provisions. IND IV IDUAL5FEE: BREAKDOWN Date: Applicant: • / :n TYPE QTY DESCRZPTIIdN �- UNIT COST TOTAL COST Failure nun workers'co radon Coverage b and shall subject employer to criminal penalties arch chill fines rpt to one hundred thousand dollars($104000),In addition to the cost of compensation,damage as prov/ded for In Section 3706 of the Labor Code,Interest,and eUornmeefea. NEC 1 INST FORC—AIR/GRAV FURN <=�00 K BTU 13 . 25 13 . 25 CONSTRUCTION LENDING AGENCY: I hereby affirm under peaky d perjury that there is a mrutwdion lending agency for the NEC 1 REFRIGERATION SYSTEM <=/'1 0 /K BTU/H 13 . 25 13 . 25 performance of the work for which the perms isissued(Sedan 3097,Cs.C). END/OF� EES LENDER'S NAME: 7 LENDER'S ADDRESS: -. n t o /474n , I certify that I have read this application end date that the above information s coned.I agree to comply with all city end countyordinances l c and state Ise Mang to building construction end hereby authorize representatives of this ay th to enter upon e above-mentioned propery ' for rapeara purposes. FLAVE GIBBS - - //�y�p{�,t Rani/ 6:i / Jr� /�Ya...��(�-�" Date: l0///////9 1 � Ment/ApOEan✓C°mr°cta - I _ .. _ (5151'46 W P) White-euildng A Safety;Green-Ne;Canty-Appicanl:Punk-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POO. WA qii3PROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector i. 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. A FounWater Pipe-on ■ 59. Gas Pipe, 0 Undrgrnd.,Test .� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 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 CZ < 11��JJ�i__ 19. Rough Heating& Air Conditioning 02/2L /[f,/�` 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE// ISSUED _�-1_ - 33. Final Electric Notes: 6 -/2 -gC e a C'TX�U1D- 34. Final Heating& Air Conditioning 7 3/ f6 f 1_t-eX___49422- 6h 35. Final Gas Pipe-Test 36. Hood or Canopy • rj_ /-7-x -4, 4 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final • • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADogESS OF BUILDING: 267 E 16TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT ONI MEw,@nm:GIBBS, FLAVE -B TR' /-PERM NO: P 077215 ADDRESS 2128 MIRAMAR DR ( BALBOA,CA 92661 PERMIT NO: P 077215 PLAN CHECK NO: N GOVT: N SUPP : N APDL.MMUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: REP ARCHEECT ORENDNEER: UC.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR AS PER REPORT SQ FT: ARCH.OR ENG.'S ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 / coNmAcTOIrsKAME:OTIS, L R PLUMBING ( 714 ) 548-4227 caNmAcrolrAIMMODRE$& 820 IRVINEBEAV **********x****D***lGElEE*********i***l#HB***s5E-********************sH***x-*+E+t-*i(-**x**+t�E*** ADOREss:NEWPORT BEACH CA uc.No.: 272694 92663 um,: T108 Z ONI NG REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby spun under peraky of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. cn'yuc.No.006944 uc.cuss:C 36 uc.No.: 272694 EXP: 09/96 MAIN BUILDING ACCESSORY BUILDING �rLS �llfl FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: P nlq(, contrado t vYI 1 uq LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contactors License Law for the following reason(Section 7031.5 Busi ass and Professions Code:Any city or county which requires a permit to construct,atter.improve, PARKING REQ: P ROV: PARCEL: 42516419 Z NE: REF NO: moth.or repai any structure,prior to its issuance.also requires the applicant la such permit to file a signed statement that he or she PLANNING NOTES> 'sensed pursuant to the provisions of the Contractors License Lew[Chapter 9(commencing with Section 7000)of Division 3 of the r siren and Professions Coder a that he or she is exempt therefrom and the bans for the alleged exemPhion.My violation of Section > 7031.5 by any applicant ler a permitsubEeds the applicant to a civil penalty o not more than five hundred dolarslS5001). ******************************************************************************* ❑ I.as owner of the proPenyor my employees with wagons their tole oompens°liun,will do the work,and the structure b at intended DEVELOPMENT S ERV IC E S -, R E Q U I R EMENT S or offered for sob(Section 7044.Business and Professions Code:The Contrednot os License Law does appy to an owners property it,. who bolds or inpren. such ves thereat and who does work himself or herset or thrarigh his or her own employees,provided that such improvements are not intended or offered for sale.H,however,the building or improvement a sold within one year of completion,the ZONING APPROVED BY ^. DATE: ownerbe Will havethe burden of proving he or sdid not build he ld or improve for the,purpose of sale). o I.asowner of the property.am exclusively contracting with licensed contad ctors to anew*the project(Seon 7044,Business anBUILDING APPROVED BY : tdA DATE: Professions Code;.Ths Contractors license Law does not appy to en owner of*barb who builds or improves thereon end who contracts kr wci'pgeds with a contrador(s)licensed pursuant to the Contractors License Law). ,'7-I_ s Ji o IamexemptunderrSecton: B.SP.C..fortireason: f L� l�• APPLICATION ISSUED BY: DATE: 4411rI t�ko ********************************************* ******************** ********** Date: Owner: LEGALIZATION:N F E E S U� [/ 1CM M A R Y STRUCTURAL SEGMENT:N I do hereby candy Bat I am aware of and understand the requirements of Cellomkt Heath and Safety Code Saslow 25505,24433,and .1 .- 25534,and that I or any future building occupant will/wit not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modification hen the Ak Quality Management District.Residential construction appicatio sareexempt from these provisions. PERMIT 76 .00 Pc `s. Date. APplcenL PLAN 25% �' J, �, SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the follovring declarations: ISSUE FEE 20 .00 L/' ' . '' °� ❑ Hum and MI maintain a cerfdicate of consent to self-insure for workers'compensation.as provided for byScotian 37Doathe Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the performance athe work for which this permit is issued. TOTALS----> 76 . 00 20 . 00 0 00 96 . 00 96 . 00 . 00 ❑ I have and willmaintan workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the r� wolfs » dNeparmevi®se.Myw« dcompensation lairoacarrier gare: REVENUE DIVISION TOTALS--> COLLECTED: Carder: ' 96 . 00 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC- (' FIRE SMIP/TOT GRADING PLAN-CHECK .a section need nor be completed r the penitis for one hundred dollars(31001 or less.) 96 . 00 `ire ,`- .J''' ❑ 1 ands that in the performance of the work for which this permit S issued,I shall not employ any person in any manner so as to F / biome subject to the workers'compensation laws of California.and agree that H I dauld become euNed to the workers' ***********************************144*4.-4**************************************** compensation!visions s of Section 3703 of the Labor Code,I shall�foskw,wfh comply with those provision. -� ' `p. Date: L1' 1'� \ti,(p Applicant: 7y,�,[� ' I N D I V I D U A L 'F E EtLl J • B R E A K D O W N T Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal pena/gu and TYPE QTY D E $ C R I P T I O ~N.A UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(S104000),In addition to the cost of compensation,damages as Provided for In .l Section 3706 of the Labor Code,Interest,and attorney's fees. PLU 1 BATHTUB 7 ,�. v x � 7 . 00 7 . O0 • �f CONSTRUCTION LENDING AGENCY: I hereby aHiim under penally of perjury that there is a construction lending agency for the PLU 1 DISHWASHER ,/ ' �l �_1' 7 . 00 7 . 00 cabman:*of work for which this permit is issued(Section 3097,CW.C). PLU 1 LAUNDRY TUB OR WASHER „ 7 . 00 7 . 00 LENDER'S NAME: PLU 1 SHOWER V A': 7 . 00 7 . 00 r' LENDER'S ADDRESS: PLU 1 SINK, KITCHEN F I; 7 . 00 7 . 00 I certify that I have read this application and state that the above information is correct.I agree to comply with all city end county ordinances P L U 2 WASH BASIN tee 7 . 00 14 . 0 0 i 1 and slate laws relating to building construction and hereby authorize representatives of this chyle enter upon the above-mentioned property PLU 2 WATER CLOSET (TOILET)! 7 . 00 14 . 00 `, for inspection purposes. i - LEE OTIS PLU 1 WATER HEATER AND/OR'{VENT 7 . 00 7 . 00 Q�� Print Name PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5 . 00 ; Date; gin 16Z PLU 1 GAS PIPING SYS 5+ENDTL-PER FEE$OUTLET 1 .00 1 . 00 , y` -ALL --y Signature of Owner/Agent/Applicant/Contrador 1 (SI SI.46 WP) White-Building&Safety;Gran-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor 4 INSTRUCTION AND PLANNING POO WA 'PROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - a �� 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgtnd. 54. Forms 4. Electrical Conduit-Undrgrnd. I 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UFERGrnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. _I- 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connectio4_27,94. fp 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System -Final 14. Rough Plumbing 12 LL IP 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring • 67. Fencing & Access Approval , 17. Rough Wiring Sign _ 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ,, , - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • . APPROVALS Permit # 21. Ducts,in.$tructure . - - . .- 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test - 72. Underground Flush 24. Roof Framing I 73. Undergrnd.Storage Tank D Gas D Oil - 25. Roof Sheathing ' - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Manocoat - 75. Dry Chemical -_ 27. Frame and Flashing _ 76. Dry Standpipe - 28. Lathing&Siding - 7T. FIXEDSYSTEMFINAL - 29. Insulation' - 78. FIRE PREV. FINAL 30. Drywall Nailing ' - 1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . _ 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. FinalElectric - Notes•11 Z-5 :-- 34. Final Heating& Air Conditioning r ' p_1.� 56 ,I er e`vi 35. Final Gas Pipe-Test . . •' _ U a c-CLt� n/ 7_1 _1‘-1�-fin_- /�- 1/ '_ 36. Hood or Canopy • �- h e -s P,- -/�.Z__ - _ I 37. Final Factory Fireplace ( // Crr- -44-1-4,e 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - - , 43. Backflow Irrigation - - 44. Landscape Irrigation System . ,- 45. Sound Attenuation • 46. Handicap'Regulations 47.• FINAL STRUCTURE & BUILDING 48. FINAL PLANNING. . 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY a No Date AassoFaMtm+D 267 E 16TH ST UHT: CITY OF COSTA MESA — BUILDING PERMIT I WDOF.tEga,M1EIFKNOW GIBBS, FLAVE B TR SPERM NO: E 078022 ADDRESS: 2128 MIRAMAR DR / . ' BALBOA, CA 92661 PERMIT NO: E 078022 PLAN CHECK NO; N GOVT: N SUPP: N APPL.MAIUROADDRESS: a CONSTRUCTION TY1Ee„f'-'" PERMIT TYPE: ELE PURPOSE: REP ARCHITECT OR ENGINEER: uc NO.: JOB DESCRIPTION ; FIRE DAMAGE REPAIR AS PER REPORT SQ FT : ARCH.OR MIS ADDRESS: WIT: CLAIM VALUE: CALC-VALUE; GROUP OCC: R-3 / cctnucTowsMAia JAMES STEWART ELECTRICAL (714 ) 548-4349 cONTRACTdi'AMMLIND 263 E 16TH *******+St+t�E**REE-HED*****SE******4*******a7(-***HESE*EEEEx EE�r*x***AE�r Ht�t Etx HEHHaE,E*aEit-+E**x*x�r�t*�r�EHt�t ADDREaS: COSTA MESA CA =No, 407976 92627 DMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions d Chapter P SETBACKS (commencing with Section 7000)of Division 3 of the Business end Professions Code,end my license is In full force and effect. CITY UC.NO.: LIC.CLASS: C 10 u NO.: 407976Xlr` : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: -�o 5t Convacto / LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby arm under pe perjury that I am oxen horn the Contractors License Law for the ?awing reason(Section 7031.5 Business and Professions Code.Any city or county which requires a permit to conswa,aur,improve, PARKING REQ: PROV: PARCEL: 42516419 Z N E: REF NO: - demolish,or repel any structure,prior'0 its issuance.also requires the applicant for such permit to fib a signed statement that he or she PLANNING NOTES> 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 > r.,,..-j" 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($5001). **********************************I********************************************* ElI,as owner of the property or my employees with wages as the'sole compensation,will do the work end the structure is not intended DEVELOPMENT S 'E -R V I C E S REQUIREMENTS or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an Owner of property who builds or improves thereon,and who does such work fimseff or herself or through his or her own employees,provided that such ri7 improvements ere rot intended or and for sale.5,however,the building or mpwement is sold within one year of completion,the ZONING APPROVED BY DATE; owner-builderv veil have the burden of proving he or she did not build or improve ford the purpose sale). ' ❑ Las owner of the property.am exclusively contracting wnh licensed contractors to construct the papa(Section 7044,Business and .. Professions Code:The Contractors License Law does rot appy to an owner ci prapeny who builds or improves thereon and also BUILDING APPROVED B Y DATE: contracts for etch projects with a contractor(s)licensed pursuant to the Contractors License Law). . ' ,v' ❑ lamexemptunderSection: B.AP.C.,fix this reaaon: APPLICATION ISSUED BY: /nDATE: 000 • q *********************************************i *******************�** )E **** Date: Owner LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that l ern aware of end understand the requirements of California Health and Safety Code Sections 25505,25533,and 25534,and that l or any haunt building occupant will/will not(circle one)need to comply with said stale codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING apermit forconstruction or modification from the Ar u itty.anagement District.Residential construction appications are exempt from these provisions. PERMIT 56 70 Dale: Applicant: 50% SMIP/NON-RES • PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE 22 . 00 ❑ I have and will maintain a certificate of consent to self-insure for isorkent'compensationas ptovided for by Section 3700 crl the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the performance duwork missued. TOTALS----> 56 . 70 22 , 00 0 . 00 78 , 70 78 . 70 . 00 o I have and tel minuet workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this perrti is issued,My workeW compensation insurance carrier and policy number are: REVENUE DIVISION TOTALS--> COLLECTED: 78 . 70 OVER/SHORT: , 00 Cerner: Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed if the permit is for one hundred dollars/$1001 or less.) 78 . 70 ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner an as to become subject to the workers'compensation laws of California,and agree that R I should become subject to the workers' ******************************************************************************* compensation provisions of Section 3700 of the Labor Code.I forthwith comply with those p s. INDIVIDUAL F E E BR EAKDOWN — y Date: Z. -6-- (4p AApo.: 'i'KUi (�th / Wanting:Failure to smuts workers'compensation coverage lawful,end shall subject employer to criminal',ensign and TYPE Q --' DESCRIPTIO N UNIT COST TOTAL COST civil fines W to one hundred thousand dollars(S100,000), p00),In addition to the cost of compensation,damages as provided for in 1 Secron37osoftheLaborCode,interestandattomeyty»s. ELE 12 FIXTURES LIGHTING 1 ST 20 EA. 1 . 00 12 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the ELE 20 REC EPT/OOTL ET 1 ST 20 EA. 1 . 00 20 . 00 performanceof the work for which this pennmisissued(Section 3097.Civ.C). ELE 18 RECEPT/OUTLET ADDITIONAL EA. . 65 11 . 70 LENDER'S NAME: ELE 13 RECEPT/SWITCH 1 ST 20 EA. 1 . 00 13 . 00 LENDER'S ADDRESS: END OF FEES I candy that I have read this application end stale that the above information is cored.I agree to comply with all city and county ordinances and state laws relating to building construction end hereby authorize representatives of this city to enter upon the above•mentioned propend • for inspection purposes. JAMES STEWART 15:Zj-ca"-/C— is Date: G— C— /Y .-signature ofAgentlAppli anconad« (5151 i6.WP) White-Building A Safety:Green-File;Canary-Applicant;Pink-Revenue:Goldenrod-Assessor • I . CONSTRUCTION AND PLANNING POOL es SPA i A'PROVALS Permit# Date Inspector APPROVALS Permit 41, 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 Uridrgrnd. • 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. Root Drains ' 64. Plumbing System - Final • v2 14. Rough Plumbing 65. Electrical-Final 15. Rough Electricat•Co6duit •' ;'r u 66. Solar System-Final 16. Rough Electricl!iring' G,.- 67. Fencing & Access Approval 17. Rough Wiring Sign / " 68. APPROVED FOR PLASTERING 18. Rough ElectricaY-'T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air,Conditioning - FIRE DEPT..REQUIREMENT 20. {lough FaptoryFireplace c:_, r- : - APPROVALa_C Pdhnit# 21. ducts,in Strdcaure.- = - - 70._Underground Hydro 22. Ducts, Venula-ling. :'. ::- -- - ` �: 4 71. ProductP' in f�1J. 1p 9uGas ❑Oil -r i 23. Gas Pipe-Rough & Test - - ".:1:-!2 :: 72. Under rbund Ftush 24. Roof Framing- ' _ 'r" • - _ ._,:?.- " 7 Undergrrid.Stor§ge Tank ❑Gas ❑Oil 25. Ro f&heathing i' V:: tit: ' 74•, Overhead Hydr& 26. T-Bar 1-oiling (StrvCt6ral) & P7✓d dOoat - `� _'.`. 7�', Dry CheOiical - 27. Fran` Flashing•:: ,�- >1 '^*: 76. Dry Star iPe`', 111111 -c. 28. athg & Siding G i .-. - STEKFINAL 29. Insulation. '• ' 73: FIRE PREY. FINAL - 30. Drywall Nailing - •1iEALTH DEPT. REQUIREMENT _ 1 -- 31, Plaster BepwrYCoat S. rt.-,^n . 79. FINAL INSPECTION 32. ElectricaePovykr Meterfinall/j;/ SIL FOOD CERTIFICATE ISSUED 33. Finalflegric; _r:, r ��! a Notes: '-1' 34. FinarHeating`& Air Gonaftioning tis c,,-' _ -.` 35. F1na1 Gas.Pip2-Test� ` r't` ,. - l ,C_ - - 36. Hood-or Canopy P ' " - :lir 7 `.1 .... - 37. Final:Factory Fireplace „ _ . •- ,. 4 p,+ - 38. FinarPlutnbing 39. Water Se `ce-Final : - ' `-' ' ` " • i - is 40. Gas Service-Final .: >t tr' S . l ¢c- 'J • 0;. 41. Solar Domestic-Final. '' ``. J• . - - 42. Backflow Preventer 43. Backflow Irrigation ' '1-' • - 44. LandscapalrriggationSystem c - � - 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 .i 267 /6. 14 ` S / Z fr/ F Cou,wtc•c- ZG 0 _ A C go 3 9 /4( 1- Co r,.vv 4- c-r- 20 /-1✓-70 - 6 - s 4 _ 1-2.1c-5 - 2v /1 0 C Rc zo gv-p 0 - _7 OYye_'r Z-0 /h .p - g / l c-eo 4)G-tic 2.0 O— ? Sr- o4c Oce._ Is A2 2 ro Io PIA 55 L,v ¢ ecorea41.3 2_0 /a"--p 01 !! IFALA Z0 Aw.p 0 /2 Pl4f5 /4,51c, de.lcw, 8,4445 20 A?r^f 0 /3 C b 45p 2 77i ty 01 b5 _ O at it a zo A�-p 0 - /S Dis ti Wash zo /aw.p 9 % Lts 6c.c.h PoccA - 80.4s /.s g"vh Ct /7 Ceti,, F0.MS pW, U /c g, ICI cr t fro," + OO Cc_ IS /'gyp © pq { L4s G0.-sic-4 i! LC/1rt 20 _G� rad � _DOOI- 20 A."9 -- _ • l _ ADDRESS OR BulLOP10: 267 E 16TH ST WET: CITY OF COSTA MESA — BUILDING PERMIT ONNERSmimw IDKIYIN: GIBBS, FLAVE B TR /PERM NO: B 076790 ADDRESS 2128 MIRAMAR DR BALBOA,CA 92661 PERMIT NO: B 076790 PLAN CHECK NO: N GOVT : N SUPP: N t WPL.AIMING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: DEM ARCHITECT ORExaIEER: uc.NO_ JOB DESCRIPTION : DEMOLITION IN PREP FOR FIRE DAMAGE REPAI SQ FT: ARCH.OR ENG.'S ADDRESS: MIT: CLAIM VALUE: 1 , 000 .00 CALC—VALUE: 1, 000 . 00 GROUP OCC: R-3 / CONTRACTORS NAME: carimAcrowsMMuNG COMMENTS: DEMOLITION FOR FIRE DAMAGE REPAIR ADDRESS: LC.NO, **********************************************************AH*AE**********AE******* WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby elfin under panty of perjury that I em licensed under provisions of Chapter9 SETBACKS (cadencing with Section 7000)of Oirisun 3 of the Business and Professions Code,and my license is in lul force and effect. CITY LIC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: Contractor: LEFT: . FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty el perjury that I em exempt from the Contractors License Law for the followitg reason(Sedion 7031.5 Baden and%leads Code:My aly a cavity Mich duds a permit to constms,after,improve, PARKING REQ: PROV: PARCEL : 42516419 ZNE: REF NO: , demolish,or repel any structure.prior to as issuance,also require*the applicant for such permit to file a signed statement 0m he or she PLANNING NOTES> S licensed pursuant to the proveiam of the Contractors License Law(Clwyd 9(commence with Section 7000)of Division 3 d the Business and Professions Code]or that he or she S exams therefrom and the basis for the alleged esemplion.Any violation of Section > 7031.5 by any applicant fore Man t subjects the applicant to a chit penally of rice more than five hundred dollars i550Oi). ******************************************************************************* 0 I,as owner of the p open or my employed with wages as the/sole compensation,will do the worn.and the structure is nor intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Lew does not apply to an owner of propend who binds or improves thereon.and who does such work Nmaed or heves or through he or her own employees,provided that such •improvements are not intended«olwedl«we.E,howe.er,the building«improvement issold wiaof within one ZONING APPROVED BY • DATE: _ ownerbuilder will have the burden of proving he or she did not build or improve for the purpose of de). ❑ I,as owner d the property.erne add*eaeracting with lineetsed contractors to uwndud to prated(Section MAL 9uaiers and BUILDING APPROVED BY : DATE: - Professions C...:The Contractors License Law does not apply to an doer of property do builds or imgoves thereon and wit contracts for projects with a•• fadpris)licensed pursuant to the Contractors License Law). ❑ a B.aP.c_f«w.re.w APPLICATION ISSUED BY: DATE: 3 lc He r/ / //,CJ/ **********************************************+i******************************** Id ' e Owner. ''/ as7 �4 LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby germy . Ian aware d ate understand the requirements d California N.�n a,e sssGGGety Code Sections 25935,25533,and • 255534,andam l or any Mum building omrpanwdl/wR nd(drolew)need to coeyly with said de codes and the requirementabr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a add for construction or modirvationh«n the Arty Management Dig rid.Residential construction eppicmvu are exempt turn these proviSiOna. PERMIT 25 . 00 Date: Applicant: SMIP/NON—RES PLAN r. . 50 WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedersiore: ISSUE FEE ❑ Ihaveandwiimeinteinacandketedcnsenttosef4nsunbrdicers'compens0tion,esprovidedforbyRedd3700oftheLabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE code,I«the performance of Id work for which this m permit is TOTALS----> 25 . 50 0 . 00 0 . 00 25 . 50 ' , 25 . 50 . 00 ❑ I have and will maintain workers'cangene.Iin insurance,es named by Section 3700 of the Labor Code,kr the performance of the forw°kwnlethis emworkers' a n .p .a.My «p«daenirianened. insurance cad numberare: capler: REVENUE DIVISION TOTALS--> COLLECTED: 25 . 50 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK This&w/on need not be completed/me perm/is for one hundred dollar 151001 or less) 25 . 00 C50 ❑ I Cally that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so es to • become subject to the workw'compensation laws o aOW if CaMomie. d agree I should become subject to the workers' ********************************************************1E********************** compensation provisions of Sedian 3700 of the Labor Code,I shall fonhwhh comply with those provisions. INDIVIDUAL F E E BREAKDO W N Date: Applicant Warning:Failureto secure workers'compensation coverage Is abjectunlawful,and shall abject an employer to criminal Donald's end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST chaff fins W to one hundred thousand dollars 0104000A In addition to the cost of conpensaflor,damages as provided for In Secuon37ggofthe Labor Cods foremost,and artomey'slees. NO FEES WERE SELECTED FOR THIS PERMIT CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the r ' performance of the work for which the permit is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is coned.I agree to comply with all coy and county ordinances and state laws relelleg to building congbudian and hereby authorize representatives of this city to enter upon the able-mentioned propend Ion imapecti°n purpuses. FLAVE GIBBS Are r / At" ' .w:�,4�'� Dale: fit.i 1_' _ 1 net Name Signatur.of OwnerlAgentlAPpkcant/Conlrador (515148 WP) White-Bulking a Safely:Green-Fle:Cenay-Applicant:Pink-Revenue:Goldenrod-Assessor / CONSTRUCTION AND PLANNING POOL JPA 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 ' FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑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 I 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes: 1 34. Final Heating.& Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final _ 41. Solar Domestic-Final -42. Backflow Preventer 43: Backflow Irrigation 19 reined- Y' 44. Landscape Irrigation System • - - 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING ` /_ (icor - 48. FINAL PLANNING Gly ' 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co - - 51. CERTIFICATE OF OCCUPANCY • No. Date OWNER FATES, ('YRIIS R. & E. MERLE DATE 2/20/56 JOB ADDRESS 267 16th St. BUILDING PERMIT NO, 2398 GENERAL CONTRACTOR Dike & Colegrove VALUE ;" 8,000.00 L. . 18 BLOCK TRACT 293)4 Residence & garage GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 2)419 PERMITS ISSUED ' INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER r Footing Trench t /p•S / -Th Foundation Formsyd Grade to Garage Rough Framing ' `:- ,,� LS - 1 Plumbing, Rough t la et. lL(p�i i, ` Plumbing, Rough Complete C cr�ir — IS. 4- C-grt to_ L-c. 34 7-Ar-c SI VO _? --- ‘--.. Temporary Pole Wiring,Rough 7U_c e , ( -a—9 MAY-2 .wbD ,. 3 -..c Heating, Rough ,�„ /p •'4,,y,{'6/, .,,�.+ r�_,i i-f s 1 Heating, Final - �% , .#, e.- '.5'7 [� `-e./4,0 3 ' Sewer, House 2),e,, Sewer,SL 01i el; SNS r,, - � q d — _ 7 �„��R n � �i� y Gc69 d> Sr-•'c Tank or Cesspool _ L .t g, In Out l ^�) Plastering 14',4-C--6 Plumbing,Final,Fixtures Completer(P.Lt./ 7.//-30 Plumbing, Final Gas Test/S .21. ci ).//-sem /lam/zeif/ .,Avt/ /q'-CG i•2-t-y.c., Wiring,Final 4-L6 7-4-• IC (s(,Ze-c" 'fGr'J 7^/n?-.0_ -----4-4A--_,-.0 Occupancy & t/54n 7//:S6 ' / / FORM 210 3M 10-^5'5 costa Mesa Building Department APPLICATION FOR PERMIT • 111 EAST 20th STREET 2419 BUILDING 1 �. Ar COSTA MESA, CALIFORNIA ' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY _ -- Receipt No. I Permit No. Building I .� 3 97 Address 267 Sixteenth Street Costa Mesa, California Rec ' ed by. D e Rec' Da Issued Nearest • ler S� '2��6 Cross St. Santa Ana Avenue Bug Address Owner Cyrus H. & E. Merle Gates Costa Mesa, California Mail Address 306 Ramona Place Nearest Tel. Cross St. City Costa Mesa No.Lj $7976 Zone No.of Type I ,CiToup Architect or Lic. /�L� I Plans I `� `�-5t Engineer Carl son & Mi d,il Phrnrllic'• Approved by Date idress Garden Grove City Lic. CORRECTIONS _ ntractorDike & Colegrove No. 2707 Address 419 E. 17th St., Costa Mesa Legl Lot De cription I No. 18 I Block I Tract 2934 (Attach Metes and Bounds) No.of Bldgs. Size of Lot 531 X 137.51 i Now on Lot none o Use of No.of No.of Xi Existing Bldg. none Families Rooms 5 ', Center of Street 50t Side Yard SetbackRear Yard 60.5t 2 51 a DESCRIPTION OF WORK _ -- . r New I i I Alteration I I Addition I , Repair I I Moving I I Demolish I • Building No.of size 1017 so. ft.Rooms 5t Stories 1 I 'erior Wall Roof +e ring Fr.Stucco I Covering Comp. APPROVALS Use of New Building Single Family VResidence & Garage Foundation Location Inspectorector Date Forms,Materials, Under-Pinning Plan # Z518 Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath.Ext. with all City Ordinances and State Laws regulating building construction. Signature of Plaster, Int. Permittee C, Plaster, Ext. Authorized A•t. Masonry Reinforced Valuation Permit Fee $ o O — Plan Check $ / O — Bond Beam $ 8,000.00 - Total Fee $ 3O - FINAL rnRM 206 c-M 2M 5-54 C O a ' • a I- • 4 O,' "„ n • Street - • . — • PLOT PLAN Show location and distances from • t property line and between buildings. .p.,, ir • -- _ - - OWNER KLING,'A. C. pw // - CI DATE 8-28-56 JOB ADDRESS 267 E. 16th St. _1)., ii .- 3-7 BUILDING PERMIT NO. 3554 GENERAL CONTRACTOR Owner-Builder S- 1.4 -5 7 VALUE $ 4,000.00 AP. No. LOT 18 TRACT 2934 FIRE ZONE DESCRIPTION OF WORK Add. to DweltlinP C--IUP I TYPE ZONE z i PLAN NO. IhoPECTIONS . . PERMITS ISSUED DATE NUMBER Jamas. 'os Steel — Floor Syste„ nS - (Sly - - 6 Steel Reinforce Chimney Re-Rod —� t. Bond Beam _— / Frame and Flashing 6 ' - N-66 •f /11Lathing, In Out — / TIIIM— _AN Plaster, brown coat tEe-/ ') • i ,� 1. -sb - Underground soil W/G Pipe Test ., ` . / .l / Top Out ..Furnace a ' _ Gas Vents Mai Rough Plumbing MMIngligahalltiliNier l/ _ Cesspool Septic Tank I Mr -I _ ell rl Prop. Swr. Line House Con. St. Swr. t V /I /1, I Sprinkling System .4&,ev f Heating Final (/ - l /a x I I P1 'ng Fixtures, Final I /p IG I F. as Test Construction Pole 9— •/-5d Underground Power •V G ✓ Rough Wiring d 7-g-1-6 r�-t.��.-vt- - t3Zceq 8- 3 L- a 6 Sod 9 Pe-- 30 ,39W...- Fixtures, Final 1/ C jg i_7/- 5-7 0 -OCCUPANCY 1 Form 210—sm—t-SI 3554 Costa Mesa.Building Department • " APPLICATION FOR PERMIT P. O. 317 COSTA MESA, CALIFORNIA'O 25'77 BUILDING „milkFOR OFFICE USE ONLY FOR APPLICANT TO FILL INReceipt No. I Permit No. Address LC? L_ l 6 *,.t S Y II SS-6—S4 Costa Mesa, California Received by (�Date Recc''dt._/ Date TIssuued r/ Nearest �j / / �+ - J1 U `� ( �t ` —�+ v Cross St. 40/2./+^/�...a s r Building Address Owner /9 , , (4.- �C Costa Mesa, California Mall Address '2.6. "7 11 / t- T!! s.j Nearest ' Tel. Cross St. City Coc FA; in LsS/q B No. v" Z._ S.-' Zon� ,/ I No.of I Type �/ Group 9 Architect or tic. C.f/1 Plans (/ �f/ Engineer J t.t:NC/. No. Approve by Bete •'dress /D. p.e Ct� �. (�_.ltracter S 1�r-t) Nloty tic. l A . e d F� iJ Address S/a/�)� CITY OF COSTA MLSA Legal Lot J pIANhIM., DEPT. Description I No. / 5' I Block I T��/ uBiLCT T3 CLOG DEPT RFG. (Attach Metes and Bounds) Ji m 2931/ 'n �((*,_ r� y No.of Bldgs. BY / •J--a DATi_ 2L Size of Lot Sl X / i ] I Now on Lot ul ;.m 7 Cly 4se of No.oi No.of '.7 33 Existing Bldg. V i.v L Cr I Families I I Rooms / S Setback Line from LL X, Rear Yard 17 /r> 2 Center of Street Side Yard S .=r. y DESCRIPTION OF WORK • r New I i/I Alteration I I Addition I Repair I I Moving I I Demolish I Building No.of ' Size Rooms is Stories rior Wall 1 Roof c_euI id e.a .eying sir cCC.C- Covering )tcCK APPROVALS Use of New Building V Lc a i:_,N Cr- 2... B B . R Foundation Location Inspector Date Forms,Materials, : n- r9 P/7 / O^J L Under-Pinning Frame: Fire Stops, Bracing,Bolts tin I hereby acknowledge that I have read this Application o and state that the above is correct and agree to comply Lath. Int ^ 'o� iall City Ordinances and State Laws regulating l/�1 1 mIo building construction. Lath. Ext 1 13 (((�JJ"""" ��1 � "i Signature of �//// y I^ - Permittee -���K- Plaster, Int d ' , SII/ v� Authorized Agt Plaster, Ext. re ' NR la-/ 7 Valuation Permit Fee $ /et_ Masonry Reinforced /t L7/• O 0 Q �•' Plan Check$ 6 I /'' ( Bond Beam $ / Total /�,� Fee $ /• FINAL Th FORM 204 10.55 D.P.15 5. ° O C . \ 11 k a J o 0. a ° . a. _ _ Ii \••%. ( .: • • • • Street - ' .. - PLOT PLAN Show location and distances from •• Property line and between buildings. �' .t' •_ i /a 5 • 267 E rG ��` s -c-crr - _ 1. raft - . . + id GFI GFI / /°) *V 1/ 1 r /• ¢ a y y /L . `,y Hyl 6 FY IS. WaSLtl _ / I �j 4I 1' t Pio Orb + 1 rb !O tuA ig A 7 !TR 1 131-1+" )„,‹ F G1/4,-. -Cr,- l7, r m,51, r iv ✓\ F,A'�+ 10 I?( -el to r0 . iii 510 I io Nii�ro WwUt Ti�„-....,-�..,..� i 11.1 a 2. Mtn-rex 0 'II: lG IGFL G RSC :11 _. F� v1 d. Floc Fe-% 17 .G, LIS". /8 Cil (> J . E:jj s 1./ o • t2 IS S (35...is V r�bYX Far I /6'9- q a4w tgr I11J_..)0.c,i c-t, 1g Disk Garb 0—SI 1 1 n u p et, II I CI S ke toc-c" 1 �2 -Me WkSk Oist