HomeMy WebLinkAbout428 16TH ST - Building Permitsi
:
(714)754-5273 • Fex(714)754-4856
Job Address:
Suite:
Vicinity:
428 E 16TH ST
HOUSE AND GARAGE
Parcel Number: 42514106
�-�
CITY OF COSTA MESA � __; %
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
App�icant: JEFF VAN BOERUM
Address:
BUILDING PERMIT
Zoning:
0
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 09/7 311 9 9 9
Issued: 0911311999
Phone:� (774)846-8675
- , � , Zip: • .
/ "�
Owner. GERONDACE,.JOSEPH L
Address 426 E 16TH ST � �
. . . , Phone: ' � � � �
COSTA MESA; CA' - - - _ Zip: 92627 - - � �
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Contrector TOP NOTCH.ROOF CO , _ �
Address: 5011 ARGOSY,�AV� � , �
' �� -c��
H.B., CA���� Phone: 714-846-8625 � � �� � �, �' � '
SUITE6�� � , �
Zip: 92640%.' License:' 696973 � ' � -
i'
Arch : � : . . . : . . E�9, . . . . . _ : ; .
Address: � . � � Address: � ��.
� - ' - �Phone: � �� ..' Phone: �
. , . : . � , - . , _ . , �
.
Zip: " � , �, � � ` License: -. " ," License: � �
SCOPE OF PERMIT
REROOF - T/0, INSTALL 7l16" OSB BOARD, 1 LAYER OF 30# FELT WITH 40 YEAR COMP SHINGLESOVER PITCHED �
AND FOUR PLY HOT MOP OVER FLAT AREA. � •
Plan Check: $0.00
Permit , $139.25
SMIP Res: $0.00
SMIP Com: $1.31
Other. $0.00 -
Inspection: $0.00
Total:
SETBACKS
$'140:56
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FEESUMMARY
. . , . �, :�/�,
MAINSTRUCTURE Front, 0-0 � � Rear '
ACCESSORY ' Front �0-0 � � Rear
\ � - /�-
PARKING Existi p:�, 0 �, ,Reauiied:
NOTES:
PLANNING & 20NING
o- o �en a o
0- 0 Left 0- 0
. 0 Pr000setl: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0-0
, � $6,230.00
$6,230.00
�
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NO710E: The work authorized by ihis permit shall comply with all applicsble handicep access requirements undar Califomia stetutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This pertnit shall avtamatically expire and become void it work is nat commenced within 180 days, or if work Is suspended or ebandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permlt ta be considered legal, euch work must comply with all epplicable codes, and all
requlred Inepeetlone end tinal approval must be obteined. Failure to obtain Inspections and finel approvel will result in the axplration of this permlt.
FOR INSPECTIONS CALI: (714) 754-5626
WORKERS'COMPENSAnON DECLARAnON: �
I hereby ettirm under penalry of perjury one of Iha following tleGaretlons: � � �. ,�, ,
❑ I have and wlll maintain a certificate ol mnsent to selt-Insure tor workers' compensalion, es provitletl tor by sedion 3700 of the Lebor Cotle, for tha performance of the
,.., �work for which ihis pertnit is issuetl. ,
�y i have and will maintain workers' compensetion insurance, as repuiretl by sec[ion 3700 oi Ihe Lebor Code, for �he pedortnance of tha work tor which Ihis pertnit is issued.
My workers' compensetion Insurence wrtier end policy number ere:
Carder: Policy Number.
(Tbls section need nof be completed i! the permit is velue af one huntlretl dollers ($f 00) or less.)
❑ 1 certify thet in the pertortnance oi the wark ich this pe 'uued, I shall not employ any person In eny menner so es to become sub�ect to the workers'
compensatlon laws of Calilomla, nd rae� at should ject to the workers' compensatlon provislons of Section 3700 Ihe Labor Code, I shall fonhwith
comply with these provisio .
Applicent Signewre: Deta: 4 �.g
WARNINO: FAILURE TO SECUR ORKER ENSATION COVERAGE IS WFUL M1D SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENAL ES Ay CIVIL FINES UP TO ONE HUNDFEO
TFIOUSANDDOLLARE(5100. ,INAD T � ECOSTOFCOMPENSATION,DAMAGESASPROVIDEDWRINSEGTION31060FTHEL4BORC OE,IN/EREST,ANDAiTORNEV'S'rEES.
LICENSEDCONTRACTORS
I hereby aflirm ihat I am licen
forca entl eHecL Lic. q_
Comrectors Signature:._
with Saction 7000) of Division 3 of the Business and Professions Code, end my licansa is in full
�— Class # —� �
oaie: `3 r 5 'R �i
CONSTRUCTION LENDING AGENCVJ. v
0 I hereby ettirm that there is e construction lentling agency for the pedormence oi the work for which this permit Is issued. (Sec. 3097, Civil Cade).
Lender's Neme: Lendels Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aXirtn ihet under penelry of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5. Business antl Professions
Cotle: Any ciry or counry which requires e pertnit to construct, elter, impmve, demolish, or repeir any structure, pnor to its issuence, also requires ihe applicant for such pertnit
to file e signetl stetement that ha or she Is licersed pursuant to the provisions of the Contractors License Lew (Chaptar 9(commencing with Section 7000) of Division 3 af the
Business and Professions Code) or ihat he or she is exempi Iherefrom and ihe besis lor ihe alleged e:emptlon. Any violation of Section 7031.5 by eny applicant tor a pertnit
sublects the applicant to a civll penalry of not mora than five huntlred tlollars (5500).):
❑ I, as owner of the properry. or my emD�oYaes with wages as their sole compensetion, WILL DO THE WORK, entl ihe structure is not Intended or offered for sale (Sec.
7044, Business entl Prolessions Cotla: The Coniractors License Law does not apply to en owner of property who buiids or improves ihereon, and who dces such work
himself or herselt or Ihmugh his or her own employees, providetl that such improvements are not intended or oHered for sale. It, howevar, the building or improvement is
sold within one year of completion, the ownerbuilder will have the burden of proving that he or she did not build or improve for puryose of saleJ.
❑ 1, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: 7he conirectors License Law tloes not apply to an owner of property who builds or improves fhereon, and who conirecis for such project with a comractor(s)
license pursuant to Ihe Coniractors License Lews.).
❑ I am e:empt under sec.
SignaNre:
Owner ID verifietl by tlnver's licensa. ❑ Yes ❑ No
Business and Professions Code for this reason:
Verilicatian ot Ownership by (rype ot daument, i.e. - praperty fes bill or deed):
Driver's Licensa No.
Date:
E�ires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity thet no excevation tive (5) or more faet In tlepth into whlch a person Is requlred to descenQ will be matle in connectlon with work auihonzetl by this
permit, end Ihet no bullding sWCWre, scaHolding, falsework, or demolition or dismflntling thereot, will be more than thirty�six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec,
341, Title e, Calilarnia Adminisiretiva Code).
❑ As owner-builtler, I will not employ anyone to do work which woultl require a pertnit trom the Division ot Intlusirial Sefery, as noted ebove, unless such person has a
permit ta do such work irom the tlivision.
Signaiure: Date:
Division of Industnal Sefery Pertnit Number:
CERTIPICATE OF COMPLIANCE AND AUTHORVATION OF ENTRV: 1 certity under penalry of parjury that I have read �his application and state ihat ihe information given is
wrrecL I agrae to comply with all state laws end ciry ortlinances relating to builtling construdion, antl euthorize representatives of �he Ciry of Costa Mesa to enter upon the
ebove-described property tor inspection puryoses,.l egrye not to occupy or allow occupency of any bullding authorized by ihis permit until ilnal inspectlon.
CODE 11. INSPECTIONTYPE v
1616 Fizetl System Finel Fir /
1266 Pool Spa Finel �
200 Final Re-Roof
201 Finel BIocWReleining Wall
202 Finel Factory Fire Place
203 Flnel Sign
204 . Final Damolition
2a18-a8
�. � .1111:
i
or,� � �i
CODE� INSPECTIONTYPE
206' Finel Mechanicel
20B Finel Plumbing
210 Finel Electrical
212 Finel Flre Prevention
220 Finel Planning Approval
222 Finel Site
250 Final BuildingiOccupency
Q� ItII�11i
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�ooxsss or euiowa: Q z 8 E 16 TH S"C
arxexs�uxeiviwwm: GERONDALE, JOSEPH L
�ooxess: GERONDALE, LAVEANE D
426 E 16TH ST
'OSTA MESA,CA 92627631-2024
AYP�.MAIUNO IOONE59:
u�cxrt[cr on �rax�n:
1RCX.ON EN6'S 1UDPE55:
uc.xo:
VM:
uxr:
coNm�crarswxe: BEST' ROOFING ( 714 ) 650-1366
CUNiPACTOR5NY11N0 236 VICTORIA ST
�ooness COSTA MESA CA ueno, 603323
92626 uNr:
IJCENSED COMHRCfOFS DECLAPATION: I MraDy elf�m uMm pe�Wy G pm�ury tM1m I em licanwd uds pvrieione d Cheqar Y
(oommer�arq wiih Seclian 1000) d D'rvuun 9 al Ne Busmeaa uM Pmlma"nu Code. eM va b in IW Mn enE aflari.
cmuc.no.:051718 uc.cuss:C-39 uc.No.: 6 3 EXP: 09/97
De1et I�' I Z��Y Canleeaae
OWNEF BUI�OEF UECIANATION: I �e�aby alfirm uMx paiWy d perjxy IMI I ezemq han �he WMraqon Lianss lew la IM
Idlaxin9 ressm (Seaian 1091.5 Buniwa ad Hdaviaro Cotle: MY uY n mu wfiitli nqu"vaa e O�Y to matrucY. Mr. im0�me.
'�mdsh. a rpei eny evuaure, p'v m b uavare. ebo rpiaae the eppl'raN a wch pami to fib e opmd qetemmp Nm M a eM
Ibemed W�� lo iM prwmwu al Ihe CaNreCwa Limue lew �Ghaqm 9(mmmeevup vAh Setlion ]000) d Di.�eion � d iM
eueines+ eM Prdmsiov Cadel n ihm M w ahe a uemW thereivn eM tM bem la Ne albped sseiMun. My vbWbn d Saann
]031.5 by e�ry eppliraM b� a pa�mil cuEjeC51M appli[aN �o e Pnl peiully d nol more �hen (He hwE�eE AoOen �SSO011.
❑ �.mox�n.d�neworenv«mr�GbMa•winxapma,uie:.decamw�+��.wioeou»wak.d,em..Wct�nunamteneee
a aflered M sele lSeUvn ]014. Buvma ud Pmlenawn Cade: The C«qretlon lirome lew0on rot eVWY�oen ow�r d pWsM
who W Ws a'vnPewes Ihuaon. ud who EoeS such �k Ivmxll ot Mne� n WouOh hu n Mr own emPb'Ms. D�'�� IIW we�
im0�amenls are rot iniaMed «aHued lar eab. tl.lawewr.IM Witliiq ar inpimnmeM ie soM wn�in ma Y� d camDlnion. Ne
owrer-builder will hew tM EUNen W pwi�q M a ehe d'd m� buld a impo.e la iM qirywe d seM).
� 1. m ovmse d �ha MWaM. am eadmveN mNratlM wN 6eenaeE eml�eetoee m mWrW Ne M9� (Setlion )W1. Bus'u�ms eM
Pmieaeima coda�. Tha Canvedwe licenee Law Eom ml Mo�Y a en owner a qopMY v.1w Wilde «imD�+m �M�em eM who
conuecro m. eud, wd«n wnn e mareanrt.l rcemee wn�u m �n. cam�.aa, limn.e lew�.
� I em eeamq uMer Setlion: B. 8 P.C., lor Pio eeuon:
ome: ow�«:
I do MrebV �M Mtl I em eware d W wideiat+M the ma��aun tl Gliamis flsetlh eM SNaY Coda Seaiau u5o5. ?Sit]. end
25,S�a, md tlw I a erry Mun Mik'vq omReN xill / wil ewi (aeb me) neeE b oomyy wIh uid ptle aotlaa end Ihs �pu'vamonb br
e V�� laconevuciion n�roEi&s�ianhom ihelv�anepement Dimnd. Ra�idefaol mm�un W0�'mioro»examq Imn thaea
,���.
Dela: �DW���
WOFIlEP'8 COYPENSATION DECLAFATION: I lwab/ Nhm uMw pmeQy W prpry ans M Ne la0or.»p Gatle�etnm:
❑ �nb.ene.umeim,n.<.naw.amie.nio.w;�mo.�«.af�a:mmp.eno�...awu.ewMswo,a�aoam.�.mr
Code, la tM pelmrorce d Ihs wak In wNrJi Nb pwmE e mueA.
❑ inm,.d,ew��m�..o�a.•como.�����.�.�a���Mseema�ooam.i.no.coa..nrm.w�a�dm.
wwk la wliiM ihn permn u muad. My warken' companWian inwrenc� mnier aM pdiry numbm ara:
c�..:
Policy Number:
�mr, s«.�� �,,.e �m ee �,amee r m. ro�. � w, o,b n�„e,.e edw rsioo� d w...�
❑ I canh � in IM palame� s G iM wak br which Ihu pemii u hewE. 1�h II pby ury penon in enY meruw m n b
becoma wbjea to iM waken' compaiea�ion lewe d CeWartia. antl e d ehouk bcarc eub�w �o iM wMa�'
/ n�t �(� m swbn alao a ilw leeor coa.. � �onnwi uw. wwisim.. ,
ome: /'/ AppfceN:
W�minp: Fillun ro ucun �ro�ksn' cortpru�tlon rov�rt� li �iW I sibJct m rryleyr ro aln/nl puWtlp mtl
w
u.a m,.. � ro w�. n�,e�.e �ro�,.w ewr.. lr�aqooaA m.mao� ro m. � or �o�.,,..uon wma�.... po.�w.e ro� �n
9�ctlon �)O6 al Ms L�6or Cods, Int�ru( �n0 �flomryi Iw�.
coxsrnucnoN �Exarw naeNcr: i na.M ee� �m« wrenv a w�wr � ina. 4. w�n�,eo� i.�dma � ro� m.
pB110R�IBMG Cl �M v.olk kI xfilCh IAC W�Y If 6PME ($MiYI'l09i. CM. C�.
LENDEfi'S NAME:
LQlOEP'S PDDFE44:
I cMih �fat I heva IaeC �hu Wd'ration aM etms the� Ne Wwe vtlametion b carted.l e0�ee �ocamdY rNh ell aY enE aouMy advwnw
erd ��e 4we ralei^G to WJEnO conaVudion ud Maa'eWiarzs npmmetivas d Iho �Y b mux upon the ebore�memioned piapsy
�°`��fpBd1q1pUfp0'°'JIM GOULD
n
Date:/I ���� • �+'
(5151-iB.WP) WtNe-Buddvq85eleyG�eerFb:Gvary-Appiwa:Pink-Rmenue:Oddenmd-Asswmr
CITY OF COSTA MESA — BUILDING PERMI'f �'pERM NO: B 080391
PERMIT NO: H 060397 FLAN CHECK NO: N GOVT: N SOPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; OTH
JOB DESCRIPTION : T/O 6 REROOF W/BUILT—UP SQ FT: 1,137
CLAIM VALUE: 1,137.00 CALC—VALUE: 1,137.00 GROUP OCC: R-3 /U-1
COMMENTS: REROOF 600SF PART OF THE RESIDENCE
*�*******�r��*******�r�ru�***�*�e�e**�e****�r+�*�t��r�r�t�t*+t******�+�+t+��r�r�tx*+�*�*x�r�rx*��******
Z O N Z N G R E Q U I R E M E N T S
S E T B A C K 5
---- ------- MAIN BUSLDING ---------- -------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT' IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 42514106 7.NE; REF NO:
PLANNING Nf5TE5> -
i
iE iE iE iE'IE iE it 1E 1E if if if iE iE ik 1E # iE 1E 1E if 1f if iF if iE if 1E iE'II' iE 1E if iE iE iE iE iE if'IF iI' iE if if iE')C-ih #�f if iE 3f iE 1E iE iE iE if iE iE iE iE iE if 1E'If if'lE')f')i-iE 1i' iE if iE if 1f iE 3l'
D E V E L O P M E N T S E R V I C E S R E Q 0 I R E M E N�T S
ZONING APPROVED BY . DATE: �
HUILDING APPROVED BY : �+p�� DATE:
APPLICATION ISSUED HY: �`i" DATE: 11^�2—�y
aE iE 1E 7E iE'lE iE iE iE iE if if iE iE * if iE �E ik IE �E if ?���i�ik if 1k iElf iF 1E �k fE if�iF���1k k
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTR�IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 40.25 50
PLAN SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOT PAID DUF.
TOTALS----> 40.75 0.00 0.00 . 5 40.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 40,75 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
40.25 .50
iElE if iF 1E 1f if'lE'lE if if iE IE 1f �E iE 1E fE IE 1E fE �)k 1f it� 1f iE iE iE iE 1E fE fE'lE if k 1f fE;7Elf iE �h fE fk iE IE iF 1F �f Ik 1E 1k if IF iE it 1E 1k 1f')E �! ik 1E 1F ft i! 1E'X-'lElF'IE 1k if 1k 1! 1FlE # iElE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 113'1 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,137.00
. END OF FEES
0! a023E933—OQ21E924 Tt7tT �0.75
DATE: i1i12/95 TS%E= 03=55
CONSTRUCTION AND PLANNING
APNROVALS Permit #
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgmd.
4. Electricai Co�duit�Undrgmd.
5. Steei Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Founda[ion
9. Water Pipe�Undr9md.
10. Structural Floor System �
11. Property Sewer Line & HouseConPection
12. Sewer Cap
13. Roof Dreins �
14. Rough Piumbing
15. Aough ElectricabCondui[
76. RoughElectricWiring
17. RoUgh Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rou9h Heating & Air Conditionin9
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Dutts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Ceiling (Structural} & Monocoat
27. Frame and Flashing
28. �athing & Siding
29. Insulation
30. Drywali Nailinq
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Finat Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestioFinai
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation Sysiem
45„S\ound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Souther� California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
Date
POO SPA
Inspector � APPROVALS Permit #
52. Pool & Equipment Locat�on
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical ConduioUndrgmd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final ;
63. Heater & Vent�Final -
64. Plumbing System � Final
65. Electrical�Final
66. Solar System�Final
67. Fencinc� & Access Approval
68. APPROVED FOR P�ASTEFiING
69. POOLlSPASYSTEPASFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping C�Gas OOiI
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
� � 74. Overhead FlYdro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
I
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINA�L INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes: ,�li��y6 ����c�u,,��F
� �-�-�'� / 1 Y -C¢GC /l✓
J
l�
Date
Inspector �
1
H. V. LAWMASTER 8 CO INC.
7940 MAIN STREET — STANTON, CALIFORNIA 70fhi5-403P.f1.-002
828-8040
xxx
Field Data on Test Specimens Core Concrete Gunite. Grout/Mortar_
Project ,}, Uerondale Pool Permit No. 31782
Projecr - -- ---- - '-
Location __428--East-l-SthS#.y_Lnstu_NiesH�_Calif..
Conrracror Anthony Fools Architect
Locafion in Sirudure Engineer
Date Mouldecl 5/28/70 No of Specimens 6
Slump Specimens Marked
Sp�ified Strength at_2'1�—_days zp�� P.S.I. Mix Designafion � 4: to 1
Age �o be tested _7—days_��—days days days
READY MIX PLANT AGGREGATE $OURCE
Weafher Condiiion 1 Yd. �_Yd. Baich
-------Cleai— ----- —
Cement Monolith Type I�II Cement, Ibs. 140 el<s
Admix Sand 35 tone
Specimens made by n4
Dnta by �3
Delivered by ,"r2
Date Delivered Y � � � ��� �
— —�u fns-sa�v uEar.--
REMARKS:Q�.�„����-�+�-�a Water, Gals.
JIJN—`'r19�0---
+ 7 day braae eree corrected for chipped out portiono due to rebound..�A f M
,E,9,L1,ll,12,1i2�3�41516
Lab. No.
Date of lest
Specimen Dimensions
Area
U�timate Load
Lbs. per sq. in.
Hj D Correcied
e o a,v, r., o�>
FOR LABORATORY 1
7�972 �70973 _
Day Test I 7 Dav Test
t x 12.1
12
z,92e
RCE�6207
6.29 X t2,125
■29.57
98,000
3,a�a
7097d 70975
7 Day Test
6/4
6.29 X 12
31.0T No
90,OD0
2,896
T0976 7�977
Tesr
testa required
OWNER �
JOB ADDRESS
GENERAL C01
AP "�. 117-
I��sm�
GA$
DATE 5-1-
BUILDING PERM
SUBCONTRACTOR
ROUGH PLUM6ING 1 I ��. �6e�iX✓ � IS�/�
PROP. SWR. LINE I—I HOUSE CON. I—I � l��iQic�%P/Or- .w LM-�/L
ROUGH HEATING AN� AIR CONOITIONING
POWER
ROUGH WIRING�
TRENCHES � FORMS � STEEL REINF,
FLOOR SYSTEM
��:Ii�:IYU:U11
SHEATNING
FRAME ANO
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COSTA MESA BUILOING-SAFETY DEPARTMENT
P.O. eOX 1200 COSTA MESA, CALIFORNIA 92626
PFIC
!;1Y-1-70c�sn�� 012,: t.�t�:t28.:�
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVEO BY DATE RECEIVED D0.TE IS UEO�
AOIDRESS 2+28 E. Tfith Stx'eet J~- -70 5" lS'!�'
OWNER
Joseph Gerondale AP Np 7�3/3�OG PERMITNO.
MAIL same no�oa�Ess �i-28 E. 16th Street,
ADORESS [�
TEL. TRACTz��/ LOT'� BLOCK
CITY NO.
CONSTRUCTION W A � A P
LENDER Cash
XX
BRANCH
owNeRJoseph Gerondale
ADDFESS (]
AFCHITECT TEL s swim pool VALU$ 1�/OO• O
OR ENGINEER C• Adams N 5�1�221U
FIRE.�
ADORE55 ZONE � TVPE GROUP
CONTRACTOR Anthony Pools ByPROVED DATE�/ /�,O
ADORESS $ 1 Firestone Blvd.
ZONE NO.OF USE OF NEW
cirv SoUth Gate nTio�Sp32210 Q—/ P�^� � BUILDING
LTC No. 19p1`79 LICVNO. vMAIDN B ILDOING ACCE SORV BUILDING
SIZE � O y G.j ./G NO.OF BLDGS. (FROM GL STREET)
OF LOT /` � T NOW ON LOT ROM FT. FT. ��'r
USEOF residence & gara�e
EXISfINGeLDG. FT. SFT
512E OF �80 � ' NO. OF
NEW BLDG. ROOMS STORIES L SIDE FT. FT.
EMERIOR WALL ' ROOF
COVERING COVERING REAR FT. FT. �
VSE O BU�LDING A.ND WORK T P O DISfANCE BET. BET. MAIN &
�rivate st•nm pSo� `3`� ��'r MAINBLDGS. ACCES^u.BLOG$.
of sin le famil d�aellin "AR.* DATE
Y g C.U.P.�W .qPPROVEO
APPROVED I�j
v ��
I heraby acknowledBe that I heva reatl this application antl state
that the ebove infarmation is correct antl agree to comply with
all laws ragulatine Puittlinp constrvttion, antl I shall not amploy
any pe�son in violation of tha workman's compensatiOn 1¢ws ot
[he Stete of Celifor�le. a�
I hereby certify that I am properly licensetl as e conttector untler SQ. FT. '
the State of Celifornia Business antl Protessions Cotle, Divisicn 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR �
Chepter 9, antl that such licenses are in full force antl effeci, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLY: a
am azempt from the provisions ot che State of Celitornia Business �
VALUATION
entl Professions Code, ivision 3, Chapter 9. �
PERMIT FEE $ I � OO
5,a�e,�,a o, i, 900. oo a
Permlttee S PLAN CHECK S E
`C
LL
Avthorizatl ABent TOTAL FEE 5 �
/
1 � 2923I �
COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BOX 1200 - COSTA MESA, CALIFORNIA YT040
For Appl(canf fo Ffl! In Completdy
TYPE OR PRINT
a����Na q, ,-u
AODRE6H
COSTA ME3A, GLIFORNIA
owNeR Newport Balboa Sav'gs & Loan
uport Beach No 673313
B'�om�er�er �FAIANo 540883
501 Birch St.. Newnort Beai
� 4501 Birch St.
Newport Beach
146423 No•540 8833
83' x 60' no.o..tco.. __
I NOW ON {AT
9 onewcK un� �nor
DESCRIPTION Of WORK
X II �1 Tt��TIf�M I •�l�l
OCi 16-68PA��OO 673� *** 124.5C
CH_A
APPLICATION FOR PERMR
BUILDINfi
ior Offlce Um Only
ZONINf3
>N[ MO.oI UY[
R_1 �ux� 2 eui�
YAROH MPROVHD
MAIN BUILDINO
1984s ft"o.o" 7 1-1/2 �'�.� v-4o-6a
n' ROOMB Qf0111[Y C. U. P. SC
WALL ROOP MPROV[D � -
� stucco covew�Ho shakes er .u-K
urs uK uu�L�mYAnD WORRTO �6 PRR�ORM[D
Family dwelling with attached garage.
Plan 3A / po/ _ S '��
1 HEPCGY ACKHOWi.dD06 TNAT 1 NAV[ IIGO THI{ A�PLICA �ON
ANO BTATB TMAT TH6 ApOV[ IY CORR6R�AN0 I�ORBi TO COY.
� AUTHORIZ[O AGQNT
anw��ee�aeerHwN
YARDS MPROV HD
ACGEL80PYBUILDINO
r�4 � p.
DATB
v u,
07
�
� e '�
�a a4. �. - i�s �
iH[ AMOVM OM N UNDBR VALU�TON 18 IOR TH6 j
■UHPOB[ OP �BTABLIBNINO A P6NMIT PB8 ONLY. 3
VALUATION 0.a �
PERMIT FEB p
11 � o
8�� �a� � �
� S�
TOTALFEE