HomeMy WebLinkAbout478 16TH ST - Building Permits�r
E
�F�BOJFE+. p�ppE55: 4%$ E 16 TH ST
owni.aseame: RLEIN, LARRY J
'' nooRess: 97S E 16TH ST
COSTA 11ESA,CA 92627
UNIT:
695-5854
RBCHIENCINEEH: HRION 5 JEANNETTE eec.xo.: C8012
nooness: 470 N NEWPORT BL UNIT:
N.H. CA 92663
� PEPMITTEE: TRACEY KLEIN f 714 ) 6.45-2088
AOOHESS: 9%£f E 1 6 TH ST
C,M. CA 92626
❑CENSEU CONTpACTOP OECIANpTION: I �ereCy alfirm Ihat I am licensetl under provisions ol C�ap�¢r 9(commencing with $ectian
7000� of Oivision 3 oi Ihe Business antl Pm�essions Code. ann my license i5 in full fa¢e antl ellect.
cirr uc.: sTare uc.: cuss: EXP :
�ate'. Signa�ure:
WOflI(Efl5' COMPENSATION OECLAflRTION: I �ere�y aifirm tha� I �ave a certilicate ol cons¢n� to sel4in5ure or a certifi[at¢ ol Workers'
Compensation Inmrance. or a cenitietl copy thereot �5¢ction 3800. La�. C�.
POLICY NO.: EXP. DFTE:
COMPpNY:
�� Certiliea copy is hereby Wmished. ❑ Ceni�iea CODY i5 IileO with (he city Buildinp Oivisi0n.
Oate: Apphcant:
E%EMPTIONFHOMWOPKEBS'COMPENSPTIONDECUflRTION: �ThiS clion eeUna�becompletetlift�epermitisforone�unAreA�5100)arless�.
I cetli�y t�ai in Ihe Detlormance ol Ihe work lor which Ui ermii iss tl. I s�all not e loy any pers�i in any manner so as to become
5� lec to I�e Workers' Compensalion Laws ol Califor ia.
aie: � Signature: �
N� E: II, af�er making �nis declara�ion, you s�ould become suble�� he Warkers' Compensation pmvi5ions ol IAe La6or
e, you mustiotl�with comply with such provisions orlhis permit all be OeemeO revoketl.
CONS7HUC710N LENUING AGENCY: I hereby atfirm Nat iAere is a consimction lentling aAency lor t�e De�ormance oi the work Por
which this permi� is issuetl (Seclion 3097. Civ. C�.
LENOEN:
FDOflE55:
OWNEH BUILOEfl OECIAflRTION: I �ere�y a��irm thal I am exempl trom the ConVacmrs' S�ale License law for the followinp reason
�Sec�ion 7031.5 Business ana Pmlessional CaOe: Any ciry of counry wAicA repuires a permi� m constmci, alter, impmve, Oemolis�, or
repair any slmdure, Wior lo its issuance, also requires Ihe apo�icant for such permil ro file a sipne0 statement ihat h¢/sAe is Iicense0
pursuam m the pmvisions o� the Comraclo�s' State License Law (Chapter 9(commencing with Seclion 7000) of Oivision 3 ot ihe Busine5s
and Pmiessfons CoOe� or Ihat he/s�e is exemD� ��ereimm antl ��e OaSis tor Ihe allepe0 exemption. Fny vialation ot Sec�ion 7031.5 by
any apPl¢ant for a permi� sublecis the apDlican� �o a civil penalry oi no[ more than �ive huntlretl tlollar5 ($500).
1. as owner o� ��e pmpeny or my emyloyees with wages as iheir wle compensatian, wiil do the work, antl I�e
� slmcture is not intended or oflereU for sale (Sec�ion 7044, Business anA Pmiessional CoOe: The Contraciors' Sia�e �icense Law
aaes nol apply �o an owner ot a pmp¢riy wlq 6uilas or impwves t�¢reon, and w�o dou SucA work himself/�er5¢It or IAmuph
his or he� own em0loyees, pmvitled Iha� such improvemenls are not intended or oflereA for sale. It, however t�e CuilEing or
imDmvement is soltl within one y¢ar ol completion. Ihe owner will have ��e burtlen oi pmving he/she tliA not Ouiltl or impmve
, for ihe purpose of salel.
I, as owner o� ihe pmperiy, am erclusively contracting wilh licensetl con�mctors to cons�mc� �he pmleci (Seclion 704d, Business
❑ an0 Pm�e55ion5 COEe: iAe COnlratlOrs' S�ate Lic¢nse Law Eces no� aDPN �o an ovmer of prOperry wlw GuilAs or impmvu thereon
and w�o coniracts lor suc� pmjects wil� a conirador�s) license pursuan� lo ontracbrs' $tate Lic¢nse Law). I am awa�e
Ihal pmof of I�eir Worker's Compensa�ion insurance shaultl be pmvided 1 e.
� I am exempi unAer Setlion: B. 6 P. C.
lo�r finis /reason:
Date: (�/S � 7 � Ownec
� o �ereby ceNiy I�at I am aware of an0 untlerstan0 the requiremen�s ol Cali�ornia Health Satery COUe Sec�ions 25505, 25533, anA
25534 antl �Aat I or any fuNre builaing accupanl wilVwill nol (circle one) neeU �o comDly wii ai0 sta�e codes ana Ihe requiremen�s for a
permi� br cons�mc�wn or motlilica�ion Imm ��e Air Oualiiy Management DiSiricl NevAenlial conSVuc�ion appliwtians are exempi fmm
Ihese pmvisions.
Date: � Ap0licanl:
1 �ereby ce�iity Ilut I �ave read I�is application antl s,3N
orainances and s�atelawsrelatingio Ovilding construct/�n
pmoeny lor inspection purpases. l
o� Social Sewriry <:
i5 correcL I agree �o comDly with all city antl counry
n��es af iNs dry � enter upon ihe a�ave-men6oneE
� ��
t646a6 Wnite—Bviltling; Green—Coae Enlorcemenp Canary—Applicam; Pink—Revenue; GolOenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERbi NO: b 067640
PERMIT NO; H 067640 PLAN CHECK NO: 09707-93 L�/ GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ADU
JOH DESCRIPTION : 608SF 15T £L, 527SF 2ND FL AUDITION SQ FT: �,135
CLAIM VALUE: 90,000.00 CALC—VALUE: 83,990.00 GROUP OCC; R—"
COMMENTS: EXPAND FAMILY ROOM F ADD A MASTER BEDROOM
ib}i%#`"IE'H'iPiEiM1lEifiEi�"1F3Pif'){'iEif'X"1Fi4ihi4i%if'iEiEif'iEifiE'ipif"x'y")%ihlFiEiFiFi%'If'i4iE'%fiFii'iRiFifiElF')hlfjFjE'N"If'H'K'iFihif#'k' 'Y -'K'K"K"N'i!'if'�if
Z O N I r� GS ERTEH�AUCIKRSE M E N T S A� ,
------------ MAIN BUILDING ---------- --------- ACCESSORY �iIi�YlP1G ---------
FRNT: 20 FT IN REAR: 10 FT IN FRNT: FT IN P..l�r FT IN
LEFT; 5 FT IN RGHT: 5 FT IN LEFT: FT IN �`�P/ FT �^�
/
PLANNINGRNOTES> TWO STORY ADDITIONaR607.54SQ15FT5 i5T�FLQO^/y�526.8rSQpAFT3-53
> 2ND FLOOR, TOTAL 1134.2 S{� FT. REAR SETiRO�iC 10'
iEifkiEik#iEiFifjflfiFiEiM1ikiEiElFfEiEiE'iiEiEiFiFlf�tiFlEifiF##il�lEif!!i.'!F'If lElfifiEir.ififlEiF3F?i1fl�-if� .FiEiEiEkiclfif-Y1flElFif�7EatiFi'.:�1EiEiE
D E V E L O P M E N T 1S E R V C E S R E�� I R E M E N T_S
ZONING APPAOVED HY : 1{� �_ /,,'a0� DATE: 6 �
_.' _ �
B U I L D I N G A P P R O V E D B Y : ' ��L S, DATE: �,_ CD
APPLICATION IS$UED &Y: ' (_yF%� DATE
iE if� if �1F if iE i4 iF iF?F 9f �E if +F 9F fF?E �}6 iE if # 1E �lE iE �!F if �Y fh iE iF # fE iE 1F if iE iF if ik iElf iE # iE 1F 1FlE # iF 1F 1F k 3E �F iE �)f # iE iE �IE # M if i� �1F if� 3E �E %�- if 11� il�/t # iP M jF
LEGALIZATION:N F E E 5 U M M A A Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC.'�MECHANIC FIRE SMIF/RES GRADTNG
PERMIT 567,50 � . 8.40
PLAN 368,88 � SMIP/NON—RES"i "
ISSUE FEE �
BUILDINC—DIU—> PERMIT ISSUE PLAN—CHECK TOTAL P.AID �' DUE
TOTALS----> 575,90 0,00 368:8 �_ 4;78 944.78 .00
'AEVENUE L12VISION TOTALS--> COLL�CTED; 575,90 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC M£CHANIC 'RE SMIF/TOT GRAAING PLAN—CHECK
567.50 • g,q4 �
# iE if if it iF iE 1E iE if # iE if ih if i4 k�)f fE 1E 1f iE i(-ih 9E iE if� ff iE iE iF # iF if-if-jf �lf ic if iF aE M ff� # if iE 1f * iF if iF iE iF7! iE if iF if fh if 1E ah �f !f iE if 1ElF if if ff?t iE if� if� if 9i� iE iE
I N D I V Z D U A L £ E"� H R E A K D O W N
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
SFR 1135 DWE—TYPE V—WOOLI FRAME —GOOD 79.00 � 83,990,00
END OF FEES
l� r� � _ . ~ � .. ._ .. .
`Ne y`e: "�'
�e f �e �� va/c�i' o �.
�ti3 pe��t;'�" �145 9een Q.Cf¢nc%�
%lJ%o��6j F.e.bruary 21� l 996.
/� • ' % •
�
Oi OOi62403-00162fQ4 T f_1T 575,9p
oar�: oaiisi�c TIpE: 16:22
�
�CONSTRUCTION AND PLANNING � � POOL PA �
i� APPROVALS Permit # Date inspector AppROVALS Permit � Date Inspectot
•` t. Temporary Electrical Service or Pole 52. Pool & Equipment Locacion _ �.
2 Soil Pipe�Undrgmd. 53. Steel Reinforcement '
3. Electrical CQnduit Ut:lity-Undrgrnd. - 54. Forms ��
4. Electricai Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steel Reinfarcement �. �� (,� 56. Rough Plumbing & Pressure Test �
6� Eiectncal Ur'ER Grnd. 57. APPftOVAL TO COVER�GUNITE
7. Fooungs 2.�.p-�� jpG'„� 58. Electrical Conduit-Undrgrnd. '
B. Foundation s��/ � Z.T1.g-qd,� ��p(.(,� 59. Gas Pipe, O Undrgrnd., Test
�v
9. Wa?er Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, � Und�grr.d.
10. Structural Floor System 67. APPROVAL TO DECK '
1 t. Property Sewer Line & House Connection 62. Backwash & Recepior-Fina4 �
12. Sewer Cap � 63. Heater & Vent�Fina� �
73. Roof Drains 64. Plumb�ng System - Final
14. Rough Plurt�bing 65. Electrical-Finai ''
15. Rough Electrirai-Conduit 66. Solar System-Final �
76. Rou9h Elec:ricN�iring 67. Fencing & Access ApP�oval
17. Rough Wirin9 Sign 68. APPROVED FOR PLqSTEflWG
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEA7S FINAL
19. Rough Heatin9 & Air Conditioning FIRE DEPT. REQUIREMENT I
20. Rough Factory'rireptace APPROVALS Permit # �
21. Ducts, in St�ucture 70. Underground Hydro
22. Oucts, Venx�latir.g 77. Product Piping � Gas Cl Oil �
23. Gas Pipe�Rough & Test 72 Underground Flush
24. Roof Fram9ng 73. Undergmd.StorageTank �Gas ❑Oil . -•
�' -�/
25. Rooi Sheathin9 ��,Cj {� S�� 1/ %�i � 74. Overhead Ffydro ,'
w�
26. 7�8ar Ce�ling lStructural� & Monocoat 75. Dry Chemicat . �
27. Frame and Flashing 76. Dry Standpipe � .�
28. Lathing & S�ding �/B�G �t.L[r 77. FIXED SYSTEM FINAL ,
29. Insulation (y-�-��b �<,�jv 78. FIRE PREV. FINAL ' ' .
30. �al! Nai�ing Fp �/p-`�p �(,�� HEALTN DEPT. REQUIREMEtVT �• . ��
31. Pl;ster Brown Coat 'J-'� q� �G(/�%r 79. FINAL INSPECTION '
_ �.
32. Electncal Power Meter-Finai ��, 80. FOOD CERTIFICATE ISSUED •,
33. Final E{ectr�c Notes: ,c � �
�Q/� ��C �v' ��.5-p B.Y'�ti �
34. Final Heating & Air Condition�ng -• G��_ / / I I
i� G¢ N£;�.Qj G225G9L)
35. Final Gas PiPe�Test _ , �-�, 2�_(�61 ''D_ �/
-p
36. Hood or Canopy '
Ss_� lsY�ers m�_F.�i��.�
37, Final Factory Fireplace '
38. Firal Plumbin9 Z'/2- q6 - C� �,,��- �S_ ''�'
39. Water Servicz�Final ��.
40. Gas Sarvice•�inal �
41. Solar pomestic-Final ��` � �� � �
42. Backflow Preventer • - �1�� �� `�/ � - �� �,�
Ip .
43. 8ackflow Irrigation - �� �
� ' .
44. LandscaPe Irripation SYstem .' ,���` ���k �'(�� �L�,.��' /_�_ l �y�
-��
45. Sound Atienuation '�k',• �/�` ��- ��_ .!� _
46. Handirap Regulations:�.-'��`� . C ��f
Y-z ``l<!- .�'K Su l. k.� �`t/c_V'�!t ���
47. FINALSTRUCTkiREi BUILDING `/,�8 �� �6���' o� `��� I
i p "�/�
48. FINALPL4�t�11�f ~ , �Zq` G�- •�--. S'(� � (y� ��
49. Electric Rete�� to Edison �� „'� 7_�-C�p- �,e� ��
50. Gas Release to Southern Califomia Gas Co 7�-3.Fj�i - 5'/?,pyyy� p� �'�f�
51. CERTIPICATE OF OCCUPANCY _ � �
No. Date . ,_ "
TO:
Applicant:
Address:
NEWPORT-MESA UNIFIED SCHOOL DIcTRICT
CER'IIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
( � - City of Costa Mesa
( ) City of Newport Beach
( ) County of Orange
"= ' . .�T[� � LG-
Telephone Number: ��'X�� — � ���
T�faCUP ��-'� I nt NiimhalEF�•
��
Location of Project:
Number of Square Feet of
Residential Space
Residential 1
Sr. Citizen Space
Commercial and
Industrial Space
R & D Space
Warehouse Space
_ �
��:��. 02.
�_ x $1.65
Commercial / Industrial Project is: (Check One)
Warehouses
R&D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
x $ .27
x $ .27
x $ .2652
x $ .2253
Motel
Bank
Neighborhood Shops
Racquet / Health
Hotel
Medical Office
Office Park
1245
' �.,
4 '
District Receipt No. -- f�
Plan Check No. �7� L— /� L
.
� � = _ ���
. ` ==�� �'.
Total
Total
Total
Total
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government
Code Sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now
be issued by yourjurisdiction.
Checks are to be made payable to Newport-Mesa Unified School District.
1
sY: ]
Aul zed RepreSen � rve
The above representation as to square footage is t ue. Applican c
representations are not true then this certificate shall automatically rmi
notified. %- �
/L �
Date:
►�
i
�
that�.if it is later determined that such
and the appropriate City/County shall be
KL e/iv
--J` City of Costa Mesd " "
California 92628-1200 P.O.Box 1200 '
Insulation Certificate
Permit Number ✓ � � � ` �
� � � �. � � �� s�, �o �d � ��� �
Number antl Slreel City
� r�n ��.
uniy Subtlivision
Description of Installation
ROOF
Material
Thickness (inches)
EXTERIOR W
Material �1 �� �S S
Thickness (inches) _� � 7
Brand Name
Thermal Resistance (R-Value)
Lot NumDer
Brand Name Ce'f q r n L��
Thermal Resistance (R-Value) ��
CEILING ,
Batt or Blanket Type ��� Brand Name CGr��^� h�
Thickness (inches) % � � Thermal Resistance (R-Value) Ta-�
Loose Fill Type Brand Name
Contractor's minimum installed weight/ft2— Ib. Minimum thickness inches
• Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR
Material
Thickness (inches)
Brand Name
Thermai Resistance (R-Value)
SLAB FLOO� O� � S T ed n G rG�t
Material 1- Brand Name
Thickness (inches) q- �� Thermal Resistance (R-Value)
Width (inches)
FOUNDATION WALL'
Material
Thickness (inches)
Brand Name
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 Adminstrative Code. /'
�rec+��-� �d,l�' � ��crn l7 � � �,��
General ���raCior (Builder) I � ^'� � Licens�Numb r
_ �+ � (
SignaWre and Titla � Date
�,11,2�1 -7c�vq s)
S b-ConUa1qor r(Insulalion Ins�aller) Licensa Number
Sc L � e, r hi 7-, � c„ -}� d�--, .
Signature antl Title Da[e
190]-46
.:' _ "
ALLfED iNSULATfON, INC.
2814 159th STREET
REDONDO BEACH, CA 90278
�
OIA fORM (AB6
INSULATION CERTIfICATION
lic. #496841'
ANpMn�
�a�o� a��•v�ae
(7N) 960-1lH
F�i (ft3) 77Q-fY30
71ds ic fo r.rtrtify fl�nf. in conforrtianrvf with tho currr.nt mrnrgy rogulnlinns (Cnlifotni� AdminisUalivr. CodC,
T{Un 7.5, Slata ol Ce1HonJa') q�id npprovr.d plm�s, f��sulallon hns been Installr.d in tlir, building located nt:'
COSTA MESA
- -.. ....._._..._- ----------------
cnr
478 E. 16th ST.
[I�nwl iln.11l qv�l��bin�—� •_----_— 9Vw.�—.
nunrs
TVD� oi Metr�iel
F.XiFfiIOR WAt.L.S
�yn�olMnrd.l FIBERGLASS
ORANGE
� i:oc� �,;n—.a,,.
UESCRIPTION OF INSi/1LlAlION
Mmnlect�na�
hlanular,i�ira� CERTAINTEED
lo. ,..d. N.,...-1 '--
CEIIINc:S
nntte:
lrnenlM��r�i.1 FIBERGLASS _ ta,ou�,cm�n CERTAINTEED
'- -' --- — - io. � �.n. r�.�.,—� —
Sn. h. Cov.�ed ALL
$ub CnnUeNm Ilnrol�liop AnplicUm) ALLIED INSULATION INC.
ffmul�llnn. M��nnrv. F,�e.l "--�Cu�� "SAi.1F" II �� r���� t\nner�l t:nnir�cinr�--
M C.. SILVA _.... _. _—.- -.--- tiue MANAGER
1•r�ItlmN. Ad��l�d�pnlb• r�,l•. F.nn,av 1^.�dU�nn Sm.,.In.�N. d!r.l,i.t:
•.Cnrnull�n��. Upnn rnrn�d.lipn nl Ib� IMtMiNipn Of Inryiinflpn. � eprA
r,•�111V.n0 Ihq Il.w 4��ul�li�n hm lyrn Intlell;d In ConlO�mnr n w1U� ILn
•mdr n�.nq nl tl�n.• vqiM1la�l�n� �Iq11 IK npl.led enil .. n1•rl 1
�L� 4��u1nti0�� �I�N4a�n. d hv p�w, Imihl .r�IhA Intidmi0�� V.rn dl�n�r
.,�rrl �hnU h� pn11nr1 �b � r.m�.pir��n��l loc�llnn wilbin Ih� rlw•'IInO;'�
�••11 Vnlw N U�e r�nam�� nl Ibq n1it�+nr,1 0l � rnal��lnl p� F�dl�llnq
it.��� m.�.��1 �o �hn nanepf ol h.i�. 16� r.dnanc! rl��. Ilt) ni rnn�elypr
bnn�Ninn1 �Mp11 nol Indnd. eny v�liq I�r oll�tliv� Im:lna I
lhicknei� 11 Ve�ne"
lhicknnn 3i�� 0 Vnlue•' R-13
11�icknen ��� fl Value" R-22 `
LicenteNumber '196891
tlele NNE 4, 1996
E%C611PT Irpm Sre. 19078 0l the Ile�hh end $drry Cade ol 1he Sb4
O/ C����Ornl�: • �
..No cn�tlllco�e nl nroinnncv or dmibr ce�lllicn�lon �h�t � newly com
IUacIqA botel. mnl�l. �puU���nl Im��te. Iwmn m plher �nid.nlinl
dwrllinq 11 hnhllelrlR dqll Me IaV..A hY futh e building den�rbnrM
unle�� U�n fbvcinit �� teml tnthflet Iii.. m(nlmum mlrpy Inwln�fon
IundN d� qleblid�id Pm W nnl 10 Ihl1 Chnp V,l.
��
OFBNLqNG: q 7 8 E 1 6 TH S'C
""" ;c"""E"a'OMN KLEIN, LARRY J
:DHE54: 47S E 16TH ST
�P�4¢� COSTA MESA,CA
�,�oq� 645-5854
APCXRECTOPFNtlNEEN: BRION S JEANNETTE
�1qCN.ORENO.'9 ADDRE54: 4'� O N N EWPORT H L
CONfRACTqI'9N111E N . B .
CONfPACTOR5YY11N0
wo�as:
UNf:
92627
uc.xo.: C�012
V i:
CA 92663
uc no.:
urrt:
LICENSEO COMFACTOR9 DECL1fl�TI0N: I Mroby Mkm urdsr psiWy W pa''ryry Nq I em IleanpE uMx provi�lorn of CMqm Y
�eommencnp wllh 8sc�ion 1000) ol Orviaion J d Ns Bwinep uW Pmfaebrn Cads, erd my Ilosnes is In lull brca end e%M.
cmuc.do.: uc.cuss: uc.No.: EXP:
De1a: Canvetlar.
OWNEH BUILOEP OECIAfl�TION: I hmeby tlfiim vMer penely d Po�N�Y �� ����A �m �M Conlretlon Liwnee law la ihe
lollowmp reevon (�ion Nt1.5 Buai�ee� entl Hdee�ona Cads: Mry ciy a oounry xfiitli isyui�se a pmnil to mMrucl. Mer. imprws.
demd'sh, a�apei eny aVudure, pe'v b'ts iauence, ebo repu've� �M eppl'reN ta orA panrtit to Rb e aiyned pmsment �hu M w eM
� liceneed Wnuw m the Y��+ d IM CaLLrodas Lioeme Lew ICheqa 9(mmmero�9 wuh Seeion )000) d DiJsion 3 d ihe
,uaimav end Prdmsbm CoEel a tIW he a Me "u aKamq thse4wn vM �M bmn lor Me NbpeE exemqun. MY videtion d Satlion
]0�1.5 by eny epplirant lor e perm� eubjem iM eyplicaM lo e tivi pe�y d rwl more Ihen fve huMred dolbre jf500j).
❑ I.avovmerd�MproparryamY�VM��w�?�theiedemnpame(ion.wJlEOlhexork,eMihaeWcturoendinteMeE
j� o,arce,edror.ele(s«ian�oea.euvne�.naaiaessvncom:rnecom.ma.L�va�..doaz�wwW�e.�e•„amwooam
w�o buiEa a'vn0� �hmean, uM xfw daea �utli w�k IimeeX a MnM a IMaqh he a her own employee�, proviEeE Ihet euch
impovementa are ml inieMeE aWered lor vala. tl. howwx. tha Gnl�inp a vnqwaneM ie sdd wilhm ona Y� d compbtion. iM
�a�a« w�n n� me a� a wodro ne « mb e�a �w d,�a «�wa* ra me wmo,. d�).
� I. ea ox�wr d tM MWeM. am eFdia�MY mnireaiq wAh Awmad canYRawa ro cwbruq iln 0�q� (Sedion )Osa. Businme eM
a�ae�. com: me cmv.aa. � �e� aoe. �a wcN w d; om:� a nwenr �.no wm. >�wo+o inm.o� .�a ..no
convens In arh W9�� wnh e mtlMv(e) IcmaaC W� vu to Nr Oaqradae licem Lewl.
❑ I em eaemq uMer Sectbn: B. 8 P.C., far N' r afm:
o�,: �� —/ � — 9G; �,,: � �' G ��
i ao nore�r �an�ry m.i i� e.�. a�d ��e in, �,w��,am a c�eom� aNh eM Sde�Y Coda Sadiwu 25505, Y55�.i, enC
P5551, eM ihel 1 a anY M1�ure buikiiq ompem rrill / wil � I�b «n) ��o wmpry w,h aaitl peb wEee anE iM reQuirtmenro br
e Prmn IammVuctionu moddr tionhanlM A'r'�ueG'y�Ti—�ev�� Obtria. Reridemel aormiueion WO�iaeare ersmq Imn ihe�e
a�s�,,.
n�a: �avr�:
WOPKER'S COMiEN5�T10N OECL�II�TON: I Mraby eM udr pmutly W perjury ons M ths Iqbwirp Aetlueliom:
� I heve erd xil meintein e cenRicele M cwueni to nMiwn b xMen' mmpenmton. m pwkeA la by &eeun �J00 d tM LeEa
Code. la iM Oa�ormeMa W IM xvrk Iv which Nw V� u'vsuetl.
� I M1ew ud xiE meimen wohen' oxnpemelion imurerce, m m��inE by Seaian 3]IID d iAe Lebar Cada, la ihe perlormenca d iha
wak la nhich Ihb penM u ivued. My waYen' oomperoetion imuearics uerix eW pdiry numbee ue:
Carmr.
Poliry Number:
�is aMion noeC not hs tanpbteC l rM permt'w Iw me hvnOmC ddlers �fIP01 a b.v.)
� I cMA' � in IM perlamance d iln wark far xfiFh ihu pwme a ieeued. 1 Mell nol emqvy vry paean N ury menn« o av lo
bacoma vubl� to tM v.arFars canpenwbn kxs d CelJorrve. eid a�jrea Ihm C I ehouk become wEjae to tha xvMn'
componutim pmvnuna d Seaion �)00 d Ihe labar COAe. I ehdl lonhv.n� mmpy xnh Itoe powsioeu.
Weminp: F�llun ro��cvn woh�ri compewtlon covx�p� l� unl�wlu( �ntl �lull rlJc� �n �nployx ro crlMnl pen�tt/u nb
clvll Aro� yi ro on� h,ardreJ fMuuM aolYn lS�OO,OOOA M�OOltlon b M� cwf o/ ro�vMu�fbrt Eemep� ei qoNESC br In
SxNmJ]OSOItMWorCoes.InM1nsS��ettom�Yilw. '
CONSipUCT10N LENDINO AGENCY: I Mreby � uMm pmaXy d per'µy ttat tAra u e m�ruaion Wdi�p epercy la iM
paAormaMe d I�e v.oM la wt�iM Ihe pemi� u earoE (Sed'an �09]. CM. CI.
LENDEH'S N�1IE:
LENDEF'S ADDflE55:
ae thm iha ebwa inlormmion ia cmae. I eprae lo wmply vm� all ery enE munry oMirences
eM naraby eutlwrse eepmenlmrvea W �hu dry �o emer upan �he ebwa�manlionetl P�PeM
KLEIN
L �.
Deta ��
Whne�Buildvq 8 Sefery: GreamFk: Ceneiy-Rpplranl: Rnk-Revenue: GdEenroE-Asxsea
CITY OF COSTA MGSA — BUILDING PERMI'C
PERMIT NO: E 076410 PLAN CFIECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE
JOB DESCRIPTION : 608SF 1ST FL, 527SF 2ND FL ADDITION
PERM NO: E 076410
GOVT: N SUPP: N
PURPOSE: ADD
SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /
*�*************D*x**x****����*x��D���t*****R*BEDROO*��*�**B****�***x*�***;�******
Z O N I N G R E Q Q I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- 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: 42515105 ZNE: REF NO:
PLANNING NOTES>
i
1E fE 1E �)E!E �F iE iE 1k 3ElE 3E iElE iE iE iE iE �E iE IE iE iE tE iE �E jF if if ik 1E fE 3ElElE 3ElE iF �E fElF iF �)E iF jE iE �Elf if if 1E if tE 9E fE ff !E iE iE iE 3Elf 3E �1E iE iE iF 1E if if 1f fE �E �E iE �E �E 3E iE
D E V E L O P M E N T S�E-R V I C E S R E Q U I R E M E N T S
ZONING APPEiOVED BY DATE:
BUILDING APPHOVED BY :
APPLICATION ISSUED BY:
**�*������,�������,�*�**
LEGALIZATION:N
BLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
BUILDZNG—DI��—>
TOTALS---->
Y
F E E S U M M A R Y
p63M65 15500
ELECTRIC MECHANIC
63.65
508
15.��
PLAN—CHECK
0.00
DATE:
DATE: �3 ��1�
�i�*�*u-�-*****�iFf�+�7F�F **
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
78.65 78.65 .00
REVENUE DIVISION TOTALS--> COLLECTED: 78.65 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
78.65
iE iE 1E iE k iE iE fE iE iE iE ik fE 1E iE 1E 1f 1E 1F iE iE if if 1E 1E 1E 1E 1E iE iE 1E iElk if 1klf !k!k 1E fE 3E dE iE fE 1E fE �f �E �f 1f ik iE IE iE iE iE 1E iE 1f iE iE iE 16 ik iP 1E iE iE 1E 1E iF iE iE if iE i! f(� iElf
I N D I V I D U A L F E E 8 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
ELE 20 FIXTORES, LIGHTING 1 ST 20 EA. .75 ].5.00
ELE 1 FIXTURES, LIGHTING ADDITIONAL EA, .45 .45
ELE 19 RECEPT/OUTLET 7. ST 20 EA. .75 14.25
ELE 20 RECEPT/SWITCH 1 ST 20 EA. .75 15.00
ELE 1 SERVICES BELOW 600 V 6 HELOW 201 AMP 18.50 18.50
ELE 1 RECEPT/SWITCH ADDITIONAL EA. .45 .45
END OF FEES
CONSTRUCTION ANDPLANNING (
AP�.�VALS Permit # Date
1. �G�,ipora�Y Electrical Service or Pole
2. Soii Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgmd.
4. Electrical Conduit-Undrqmd.
5. Steel Reinforcement
6. Electr�cal UFER Grnd.
7. Footings
8�. Foundation
9. Water Pipe�Undrgrnd.
10. Structurol Floor Svsrem
11 . Property Sewer Line & House Conneccion
72. Sewer CaP
13. Roof Dra�ns
14. Rough Plumbin9
15. Aough E�ectricabConduit
76. Rough E�eciric4Vi�ing
V. Rough Wiring Sign
18. Rough ElectricabT Bar Ceilin9
19. Rovgh Heat(ng & Air Condtioning
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Oucts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framinq
25. Roof Sheathing
26. T�Bar Ce�fng (Structurall & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation �
30. Orywall Nailing
31'.�Plaster Brown Coat
_ _.
32. Elec.trical POwer Mecer•Finai
33. Finai Electric
34. Final HeEting & Air Conditioning .
35. �Fina� Gas piPe�Test
36. Hood or Canopy
37. Finai FaCtory Fireplace
38. Final Plumbing
39. Water Se�vice�Pinal
40. Gas Service•Final
41. Soiar pomesticFinal
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 Fielease to Southern Cali(ornia Gas
Date
w�
Inspector
�
' POOL �A
i
APPfiOVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit�Undrgmd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Recepior-Final
63. Heater & Vent-Final
64. Plumbinc� System � Final
65. Etectrica6Finaf
66. Solar SYstem-Final
67. Fencing & Access AnProval
66. APPROVED FOR PLASTERING
69. POOI(SPASYSTEMSFINAI
FIRE OEPT. REQUIREMENT
APPROVALS . Permit #
70. Underground HYdro
77. Produci Piping O Gas ❑ Oil
72. Underground Flush
73. Undergmd.StorageTank OGas ❑Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
Date �Inspector
78. FIRE PREV. FINAL �
� HEALTH DEPT. REQUIqEMENT
FINAL INSPECTION
B0. FOOD CERTIFICATE ISSUED
Notes:
A�PqR50FBU1LOP10: 4'�$ E 16TH ST
°""E"s"'"'E"'°'°�'": KLEIN, LARRY J
A°0fl� 478 E 16TH ST
, i�'�,' COSTA MESA,CA
`•' 645-5854
�vr�.ruiuxo �oonEss:
A1ICNRECTORFNtlNFEN: BRION S JEANNETTE
,1RCX.ONFNO.'SADDPESS: q'�O N NEWPORT HL
N.H.
COf1iNACTqYS N�ME:
CONiPACTOWS YYIIN�
11WNESS
�
� UNT;
'•�
92627
�'V
11GN0.. CgQlZ
UNT:
CA 92663
uc. ra:
UNT:
UCENSED CONTflRCTON4 OECLAFATION: I Mreby eflim uMm peroly d ps�ury Na I em IbmM uMm pariabne d Chaqer B
�wmmmci�p wilh Seclian )000) d Dimion � d me Buviiroas eM Pmhae'vn Code, ud my limme b in IuA Iwca enE eifed.
cm uc. No.: uc. euss: uc. No.: E XP :
Deb: Gwnraar.
OWNEN BUILUEX �ECIAPRTION: I hareby dfirm wder qndy d perjury Ihel I em wtemq hom �ha Conueqpe licenaa Law lor IM
lolbwip reeaan 1�� »1.5 &n'rio� enE Rdasiona COCa: �iry Ny a cvuMy xfiid� nqu'vu e pertnil lo oonehucY. Ner. improw.
Eemd'eh, a repei ury eleu[lu�e, pna b Ef eauenca, a6o ndu'um IM eppl'vaN /p auch pmmG lo fib e aqned MlameM Nel M a eM
� r���a w�i m ms ao�w�. a m. com�ne«. u�,e �w �Cheqx B(cammenanp xilh Sedion )000) ol DHeion 3 d Ihe
Jueinea erd RWeaixa Codel m �tW Ir a aM ia exomq Ih>ehan eM �M Mve lor Na sApeE w`amqion. My violmun d Sqion
]W 1.5 by anY WO��� in e psrmil wEpG� tM epplium to a cN penehy d np maa Ihm f a huMeed EoOs'� �SSOOjI.
�I.mmxwrdlMpopenyamyempbyemwthwepeamNeiMeoompenWon.w9Eothswk,arqlMtl'uctunwml'urtended
a Mared br eele I��� )O<d. Buumu ud PrdpabneCods: iM1e CoNreape liowa LewEwa ndeoolvto en ownerot waoeM
wlw WdEe a inqwea t�eiem. vM who Goes �utli xark Hmsell a hensl a Mraph
impwemeMe ue nd'weMed a c/1se01a eeb. tl. hw�ewr. iM buik"uq n inpow
owixrWiNx Mill hava tM burdan tl poYvp M or eM d'W �w bWld a impovs tor t�
❑ I. v mawr d ihe ww+M. am uduervdr mmreqYro xilh li.w�ead cgnV^ecmre a cpe
Proleeaione Code: The Con�reaan licmw lew daee M appF� lo M owiisr at pop
wntrern br wN propea r.'nh e mmMa(e) lian»E WA� �o IM CCMraqore U
� 1�'}/, aumq uMx Sxli/on`: B. 8 P.0 �tar N)u //
Dele:.J'�—��) ��CV Ownx��/ � �.'G
I eo henM �+��h Net 1 em .wu. tl enE urdenlW IM nauinmWa d cellam�
P5St6, end Mei I or eny Mun WiWirq oavpem will / wil �(rircb ma) nsotl W qy v
� (5saon ]ou. Bua4�wa vd
a imqwn iharaon end who
end
� br
Dete: ApqFaep:
WONKEP'9 COMPENSATION OECIAFATION: I Mraby etfirm urdu pnelly W prjury one d ihe /Wbwi�q EVWeliwu:
� I hev� ud wll meinteii � wrUliul� d awu�nt io �W�nwn be xakwi compwuvbn. n pwiEeE In by Swbn 3)00 0l lhs lebor
Cods, lor �M partormu�cs W �M xcA In Mich ihie qrmn b bsued.
❑ I hevs eM wil meimen walw�' compemelion im�ruiu, n �p�inE by Saqim J�0 d iM lebor Coda, br �M psilwmerws d Ih�
wM lar whlM Mh MrtM's ivued. MY waFan' mm0+�ion iim�uic� mmx uk V�/ numbv v�:
c�w
ad�cr rmmw.:
,hia udbn nwd mf b mnpHfW IlM prmt u br arw �undnd ddlen �Si00) w Nu.)
� I cenA' � In iM pMmnenca d tM wak lar whkh iM prtna b NsuM. I 4W nd ampb� erry penm In enY menrw o n to
becwm subl� to ihs xwkers' aanpemelbn 4w d Califwn4, aM apros Na H I should beroma wb«f to tM woMen'
mmpenee�ion povuion� d Sepion 3]00 N iM laEa COCs. I tlull lonhwilh wmpy xilh iMn qwisons.
Dwo: �pplcaM:
W�m/np: F�Nun ro��cw wortwi roI11pN1Ytl0Il COYIIIp/ h YI14WN( IIIAN�II III��ItI N MIp/Oyll f0 C/IMIW pNNNM IIM
c/vll 11iwa up ro on� �wMrM tMuuM Eol/an (SIOq000i. In �OE/tlon ro IM ros( ol mmp�rwt/ony tl�m�ps u prov/aM br In
S�ctlm ]10B ol M� LMor COW, Ilrtwl, �nd ettomy'� /w�.
CONSTPUCTION LENDINO ROENCY: I Mnby elfiim �Mer paneAy d perN�Y �� Ihma o a awatrudion bMinp eperwy br t�e
pe�lormeze d IM v.ork br xfiiM Ihe psmi o ewed (Sepion 3�B), GM. C�.
LENDEP'S NRME:
LENOEF'S �DOFE59:
I ceniy ihet I Ma reeE ih'p epplicatim eM pets Ihet iM ebo.s inipmetbn ie cmw. I epma to compty wilh M rmy arW counry oMinenme
vM slete levA releiip to buYdvq canm�cnon ud hereEy eWw¢a mpaseruetiwn d Ihu cayto smer upon tM ebow-menlianad qvpeM
TRACEY KLEIN
Ome� „L ���-7 �i:
(5151A6.WP) Whaa-Buddiq85alery;G�ee'rFde;Cebry-�ppicant;Rnk-Fevenue:Galdenm�Asxaa
CITY OF COSTA MESA - BOII�DING PERMIT
/ PERM NO: M 07641.7
PERMIT NO: M 076411 PLAN CHECK N0: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: ADD
JOB DESCRIPTION : 608SF iST FL, 527SF 2ND FL ADDITION SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMEN'LS: EXPAND FAMILY ROOM 6 ADD A MASTER HEDAOOM RE:JkH6"7640
�x���*x*******x*��x��*�*�***�x*+�*�*�****�x�******��*�������*��*�*�*�r�***��**�+�***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- 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: PROC�: PARCEL: 42515105 ZNE: REF NO:
�PLANNING NOTES> _
i
�1E iE 3E jf 1k IE iE jE �f 1E iE 1f IElE 16 # 1E 1t iE 1E 1E if �E 1E 1E iE 1E �E 3f 3ElE if iE fE f(� iE jE�iE fE �E iE iE iE �E fE �E �E 1E IE iE 1E fElf ik jE 9E jf 1E iE iE iE dE �E iE fE fE �E jF jE �E 1E 1E jE 1E �F dE if iE iE
' D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
c; ��%-
:��f�P��t�?is� ��1�1�'.f���rd LjP . � DATE:
ILL?INr, APPA�7VED BY :
IV : IV
- DATE:
'` DATE; 2� (���(
�iE�����' 4�*�riErrrxi�%ify"i��EO�`�'�'J�i���`���"�1��1�'#�l
BLDG PMT PLUMHING ELECTRI �MECHANIC PIRE SMIP/RES GRADING
PERMIT '� ,� 29,50
• �' ' 252 SMIP/NON-RES
PLAN '"' !�� -
ISSUE FEE - � �/ '' 15.00
BUILDING-DIV-> PERMIT ISSOE PLAN-CH'ECK• TOTAL PAID DUE
TOTALS----> 29.50 15.00 O.OQ' 44.50 44,50 .00
rr. . "
REVENUE UIVISION TOTALS--> COLliEGTED: 44.50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHRNIf �- "FIRE SMIP/TOT GRADING PLAN-CHECK
44.90 :
fElE 1E �f !f %ik iE 3E iE iE if 1P K iE fE iE iE iE iE Ik ik 1F IE 1E 1E 1E ik 161E 1ElE iE ik iE 1E 3f iE 1E iF 3E fk �f fE iFlE 1E iE 1E 1E 1f iE if if 1E if iE iE if 1E IF iE 1f iE 1E 1ElF fE iE 1E �E ff if 1E if dF 9klf if
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 NJ,' ;, UNIT COST TOTAL COST
��H ^ �
MEC 1 INST FORC—AIR/GRAV'FURN';<= 300 K BTU 9.00 9.00
MEC 1 GAS PIPING SYS 1— 4 OUTLETS 3.00 3.00
MEC 1 FACTORY FIREPLACE ' ' 6.50 6.50
MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4.50 4.50
MEC 1 INST/REL NON—PORTABLE EV�P COOLER 6.50 6.50
END OF�, FEES
1 _
; n, .�
,l . , ' "
i �
CO%lSTRUCTION AND PLANNING POOI .PA
APP;!OVALS Permit# � Date Inspector AppROVALS Permit# Date �nspeqtor
t. �mposary Etectrical Service or Pole 52. Poo1 & Equipment Location
i
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utilitv-Undrgrnd. 54. Forms
4. ElectriGal Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrntl.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water 7ipe�Undrgmd. 60, Backwash Lines, P�Trap, � Undrgrnd.
�i0�. Struttural Floor System 67. APPROVAL TO DECK
`1. ProperTv Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Gap 63. Heater & Ven[-Final
73. Roof Orains 64. P�umbing SYs[em - Pinal
74. Rough Plumbing 65. Electrical-Final
75. i;ough Electriwl-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. POOLlSPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning �15, �y� PIRE DEPT. REQUIREMENT
-! ��
20. Rough Factory Pireplace . . APPROVALS, Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating 77. Product Piping O Gas ❑ Oii
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead HYdro-
26. T-Bar Ceiling IS[ructural) & Monocoat 75. Dry Chemicai
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulat�on 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH pEPT. REQUIREMENT
31. Plaster 8rown Coat 79. FINAL INSPECTION
32. ElectriGal Power Meter-Final ' 80. FDOD CERTIFICATE ISSUED
33. Final Electric Notes:L�_j �_�'� '� U ����)
34. Final Heating & Air Conditioning �Oa. 6 g� / ,�-�L5 � _7`�f�� _
IY
35. Final Gas Pipe-Test
.�=�5--�� G_�z�s� Dk- -
36. Hood o� Canopy ' -
�I_��`�L���-'-C O ���,
37. Final Factory Fireplace �o .�o ,Ej �-1-��A�� (2 m/
oc_t.�-t- ! �J'u
38. Final Plumbing � _
39. 4Vater 5ervice�Finai � -
4�. Gas Service-Final ' �
41. Solar pomestic•Final
42. BackfloW P�eventer
43. Backfbk' 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
,�onessarea�m�c: 478 E 16TH ST
°nv"E"s"WEi`�av": KLEIN, LAFtQ-Y 3+
���°�E�' 478 E 16TH ST
+ COSTA MESA,CA
nvvi. �uur+c �noness: 6 4 5- 5 8 5 4
,wcxrrecton�+r+�nn: HRION S JEANNETTE
/,ncx.onExc.�swoxes: 470 N NEWPORT HL
CONi11ACTOP'S NANE: N � B �
cartnacroaswuiwo
1
92627
u"' CITY OF COSTA MESA - BUILDING PERMIT
�PERM NO: P 076412
PERMIT NO: P 076412 PLAN CHECK NO: N/ GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ADD
uc. ra.: ��T012
CA 92663
.�non[ss: uc.xo.:
UNT:
LICENSED COMHACTONS OEC�APATION: I hareby eflim uMer paneXy d perjury ihel I em Iceroed uMer povisbns d Chep9er 9
(mmmmafp wilh SxYion )000) d Division � d IM Busiiress aM Prdesebna CaEe. erd my licema ia in tull brce ard eXed.
cmu¢No.: uccuss: uc.No.: r, EXP:
Deie: Comredor:
V
OWNEP BUILUEP UECIAPATION: I hemby �em ueMer pare�y d perpry Ihe� I em eeemq /mm ihe ConVatlon Lieenae Lew la Ihe
Idbwig resmn (�� i031.5 &rsiwsa eM Prdeasbns Cade: �nY cry a counlY �� �Vuime e pertnn to mmhuct. eM1a.'vnyova.
damden, �,av� eny s��un�re. o�a m aa asueMe. atro revuvres me wWimm i« sucn w�nm m �b e sia�a s�aiemeoi ine� ne «:ne
. r,�d w��,� p,�ne wo��s d�n� cooum«s u�� �w Icnew� s l�m�re ..an smo� �000) a oHe� a a�na
Business aM Prdeaons Cade� w �hei M a sM ia evemq thxehan antl ihe basc la Na ellapaC saemqion. My violeiion M Seqion
]o]t.5 Ey any applirem Iw e permil subpea �M epdK�� �a e avil paneny d nd mwe then frve huMrad ddlara �5500��.
�I,eso�merMihapropetlyormyempbyeeawnhwegeaestheireobmmpanaeiian,vnlldoihexnrk,endtheawcwreendimandeE
or oflerad for sele (Seclion J006, Businesa end PrWesaiona COCe: TM Coniraclors Licenae Lew tloea � epply�o en ownerd pmpairy
who WiIEa or'vnproves thereon, vd who Eoea such work MmseM a henep w throu0h hb or her own QmdoY�s� O��ded thet wch
imo����s �a nrn in�eMeE a oHered lar ub. tt, lwwever. ihe EuilEirp a inpovemeni ie edd wi�hin orre yeer d mmpblian, Ihe
owrwr-0uiker wiil heve iM Wrden d proviiq M w ahe d'M rw� WiN w impove fa IM W�a d eab):
� I. ea oxmr d the yroperry. em eaduawly oonlredip wiN Ibemed convactas ro cawruu IM poptl (�� )�. �irims end
Prde�iwis COCe: Tha Contradon l'serue Lew Aow iwl xpqy b en owiror d popeny w}a WiNa or impovea Ihereon enE who
wnvacis iw wdi,G'q�s wiN e mMredmlc) licansed pursuent to tM Canveppn Licenea Lewl. '� <. r
� I em eRampt uM9r Senion: B. d P.C., br Ihie reeaon: � ���
1
�� oeia: ow�a,�
� I Eo Mreby ceniry Ilal 1 em eware d eM uMentanC the requiremenU d CgNomu Heellh eM SefMy Cotle Sedione 25505, 25533, aM
25530, erd tlw I a ury INure buiMiip ampani xill / wil nm �arcb�are) neeE ty'canply w�h eek ie oodes ard tM rpuirtmenla br
epermnfamerel�uclionwmod'ifimlionhwnlM�r�y arupe�eni0iaiia. Lidentielwmrvei eppiutiwqenuemqirantheae
0�,5 .�—l3 — 9lv .,���� `� .� �� f� c,�—
WOHKEH'S COMVENSATION DECLAF�TION: I hereby eifirm under panelly d perju' e W ihe Iollovrine dedumuna:
� I heve end wil manlei� e cenitkale d mnxnt io aellinsure la waken' compenee�ion, m D��� �or by Seqion 3]00 d ihe lebor
riC1�0.�Of��1B �Bl�Of111011C9 Oi�11B Md%�O! W�YChl�119 p81Tll 191f911B�.
❑ i nere �a me �ao�en �xe�s• canro�sme� ��w,�..s �ea�v,ae M sea�on a�ao a me �eno. coa. r« me o�,�m d mo
work la xfiiN i�n pertnn "s sued. MY warken' comPo�seibn inwrerce'ariier erd pdiry numbm era:
c��:
Policy Number:
, mis sett;ar need no� be cwnPb�eC a tM G�e i: br one nundred dollers BtoJl o, bss.)
❑ I carlM �het in Ihe pe�lwmence W the woA I« whch Ihis parmit ia i»uad. I shell na employ eny person in eny menner eo as lo
becana aubl� io Iha workers' cwnpeme�ion lews d Calilanie, end egrea the� il I ehouk becane wbjea �o �M xnikers
compensmim piovisons d Setlbn ��00 W ihe Lebor Cade, I ehdl lonhwn� mmpy vrilh Iliwa pmviaiona.
oe�e: nod�c
Wem/np: Rllun ro��cun woNen'rompxiutlon roveny� h unbwN( �ntl �hell �u6/K� en �mp/oyx ro etlMrol pm�Mu mtl
c/vlI flroa up ro on� hunOrM fMuvrr.l doll�n (5100,0001. In eW/Hon ro fM cwt ol comp.nsatlon, tlem�p� �� povlGotl br In
Sectlon 3]p6 oI tlre LeCor COJe, Inronaq end ettorneyl lea.
CONSTRUCTION LENOINO AOENCY: I hareby �rm unEer penelry ol perlury thm there is e mnrmd'wn biMinp e0eriry Iw Ne
�IBI�OlTeMB OiIhB Wpi(�OfW}IId1�11B ppl111� U 6911Bd�$BC�1Jfl 309�/.�iM.C�.
LENOEF'S NiVIE:
/L`�ENOEN'S ADUHESS:
1c.nih���BiaeElnisepWicef eM9de�M1etNeebaveiniormelbnismrtea.IaareatowmWwilnalldlYaMcounryorCinezes
slele kxs rale�inp io W iltliig wnmwion eM hereby eu�horize repeeemetivea W �Ns ply to enter upon ihe ebwa�memionad propaity
lorinsp¢nion Dutposes.
� � TRACEY KLEIN
� �
(5151�C6WP)
�.
o�e ,�—/. � -%�v
Whiie-Buildinp 8 Sefery; Greer�-Fle; Cenery-Rppliranp Pink-Revenue; Ooldenrad-Asseaor
JOB DESCRIPTION ; 608SF 1ST FL, 527SF 2ND FL ADDITION
CLAIM VALUE: CALC—VALUE:
SQ FT:
GROUP OCC: R-3 /
COMMENTS: EXPAND FAMILY ROOM & ADD A MASTER HEDROOM, RE:#B67640
iE iE iE iE iE if iE 9E if 1E iE 1E iE aE iE iE iE iE iE iE iE iE iE iF 3E if iElf if 1E iF iE iE it iE iE iE 1E iE �E 3E 9t it �f iE iE jE IE iE 9E IE aE 1E k iElE iF iF iE iE ik iE 9E �E iE �E iE jE iE 3E iE iE 1E 1E 3E iE iE if iE
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- 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; 42515105 ZNE: REF NO:
PLANNING NOTES>
>
1E ik iE iE 1E iE iElE �ElE iElE 9E IE fE iE 1E 1E iE iE iE iF IFlE �E 1F 1E 1E iE fE 1E fE iE iE if 1E iE 4�F jE iE 3E iE iE fE iE�lE 1E,IE iE iE 1E iE 1f iE if 1f df �ElElE 1ElE �ElE 1E jE iE jE 1k 1E fE if iE dF �E �)E jE fE
D E V E L O P M E N T S E R V I C E S' R E Q U I R E M E N T S
ZONING APPROVED BY � DATE:
BUILDING APPROVED BY : �� DATE:
APPLICATION ISSUED BY: �—�- DATE: Z��j ��
9EIEiEiEiElElEiEjE3E�EIE�ElEfEklEiEiEiElEiE�iF����F�F3F�3FiF3F3f3Fi�3F�fTf3F�F3F3F3F3F3F 1F�F�F3F3F�F3F�iE16iE1klflf3EafjEiE �iF�f 1EiE
LEGALIZATION:N F E E �S [3 M-M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRICf MECHANIC FIRE SMIP/RES GRADING
PERMIT 28.00 ' .� . ••
253 (/ ,,: SMIP/NON—RES
PLAN �� �;i ',�. .—
ISSUE FEE 20.00 � .-�
HUILDING—DIV—> PERMIT ISSUE PL'AN—CHECK TOTAL PAID DUE
TOTALS----> 28.00 20,00 ��. 0.00 48.00 48.00 ,00
� �,
REVENUE DIVISION TOTALS--> COLL'•ECTED',: ,;` 48.00 OVER/SAORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC ..- -FIRE SMIP/TOT GRADING PLAN—CHECK
4 8. � � .� (� �J "_ �.
" r.
1E aE 1E iE fE 3E 3E fE 1E iE iE 1E iE iE iE jE iE 1E 1f �E fE IE IE fE fE 3E fE �E 1ElE 1E 1E dE aE �E�E iE �E3ElE4l� fE 3E iE �E fE �E �E #�E �f iE iE aE iE ff iE if dF IE �E If aE 3E �E jE if if if ik jE * if iF jE �f iE if !E
I N D I V I D U A L ,-F =E E,�� B R E A K D O W N
o '
TYPE QTY D E S C R I P T I O' N'� ,:^� �- , UNIT COST TOTAL COST
/
PLU 1 BATHTUB 'I����� 7,00 7,00
J !"'
PLU 1 SHOWER �-,; -„ .-- 7.00 7.00
PLU 1 WASH BASIN (SET) ./' `= 7.00 7,00
PLU ]. WATER CLOSET (TOILET) 7.00 7,00
END OF FEES
_ i� . r: , . - _.
+./
CpNSTRUCTION AND PLANNING POOI ,PA
t�IOVALS Permit # Date Inspector APpROVALS Permit # Date Inspector
1. 4Tamporary Electrical Service or Pote 52. Pool & Equipment Location
2. �Soii Pipe-Undrgrnd. Z�E�G 53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgmd. 54. Forms
4. Electrica� Conduit-Undrgmd. 55. Electrical Bondiny
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
�,� Footings 58. Electrical Conduit�Undrgmd.
8. foundation 59. Gas PYpe, O Undrgrnd., Test
�
9. Water Pipe-Undrgrnd. 60. 8ackwash Lines, P�Trap, � Undrgrnd.
�0. Struttural Floor System 61. APPROVAL TO DECK
� 7. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
i
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains .��, p� � 64. Plumbing System � Final
�iv'1
14. Rough Plumbing _zr g 65. Electrical-Final
15. Rough Electrical�Conduit 66.'Solar System�Final
16. Rough Electric Wi�ing 67. Fencing & Access App�ovat
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling � 69. POOL/SPA S1'STEMS 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 OGas UQi1
23. Gas Pipe�Rough & Test 72. Underground Flush �
24. Roof Framing 73. Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat � 75. Dry Chemiral �
27. F�ame and Flashing 76. Dry Standpipe
28. Lathing & Siding .� 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. DrWvall Nailing HEALTH DEP7. REQUIREMENT
31. Plaster Brown Coat � � 79. FINAL INSPECTION
32. Electrical Power Meeer�Ffnal 80. FDOD CERTIFICATE ISSUED
33. Final E�earic - Notes: �_��_ _� _
l 4n28-i/.�� _.
34. Final Hea[ing & Air Conditioning_'
�' / $� �L_�25%�LS_I%L_C_
35. Finat Gas Pipe-Test '
=2L-�6 �,'��- - -
36. HoodorCanopV ' �. �O�o��i'QG C.ORR��CY�Oy n����Ch �
37. Final Factory Fireplace �O`^q=Q / � I�R� Q (2 .. /_
af_I 1 `O �v I�[_
38. Final Plumbing ��
_aY 9 6 � �.
39. Water Service•Final -
40.•G8s Service-Final 1
41. Solar pomestioFinal �
42. Backflow Preventer�
43.'Backflow Irrigation ,
44. landscape Irrioation System -
45. Sound Attenuation ,
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�I
�.\
e !
PflOJECT FO�flE55: 4 7� �E I��•� 5•r
OWNEfl'S NAME: KLF.IN, LARRY J
ADDPESS:��$ E 16TH .`'iT
COSPA ,HESA, Cl�
ANCNIENGINEEfl:
ADDNESS:
UNIT:
9262%
HEG.NO.:
UNIT:
PEeMInEE:1RACX KLE1N (714)64S-2OSH
noonEss: q•�g E 16TH ST
C.M. CA 92626
LICENSED CONTBRCTON DECNBATIQN: I hereby af�irm Ihai I am licensetl wder pmvisions of ChaO�er 9(commencing wil� $ection
700�I oi �ivision 3 0l Ihe Business and Pro�essions Cotle, and my license is in WII force an0 eflect.
CITY LIC.: STATE LIC.: ClA$S:
Date: Signature:
WOBeEPS' COMPENSATION DECIAXRTION: I hereby afiirm ��at I have a ceNiicate af consent to self-insure or a certiticate oi Workers'
Gompensation Insurance. or a certifiea copy roereof (Section 3B00. Lab. C).
POLICY NO.: E%P. DRTE:
COMPRNY:
� Certi�ied copy is Aereby fumished. ❑ CertilieE copY �5 IileO with ihe ciry Building OiNsion.
.a�e; Applicani: '
EXEMP710NFBOMWONRENS'COMPENSPTIONOECLAPATION: QhisS li inee0iwl�ecomple�eOiilhepermitisb�onehunGre0�81W�orless�.
I ceriity ihal in Ne pedormance o� �he work for w�ich this pe ii i is ed, I shall no employ any p¢rson in any manner so as to became
sublect la Ihe Workers' Compensaiion �aws ol Calitamia. '
Oa�e: � 93 Signa�ure: ' �� r'��'
N ICE: II, ai�er making �his Aedara�ion, you should become su�lec� Ihe Workers' Compensation pmvisions o� �he Labar
Code, you must forihwi�h comply with such pmvisions or �his permi� hall be deemea revoked.
CONSTPUCTION LENDING AGENCY: I hereby a��irm Iha� �here is a consimc�ion lentling agency tor the pedormance al ��e waB �or
which Ihis permil is issuetl (Sec�ion 3097. Civ. C�.
LENOEfl:
RDONE55:
OWNEfl BUILOEH OECLABRTION: I here0y a��irm t�ai I am eaempl irom ��e Conlraciors' State License Law for I�e follovnng reason
�Seclion 7031.5 Business ane Pmlessional Code: Nny city ol county whic� requires a permit to cons�mc�, al�er. impmve, tlemoli5h. or
repai� any slmc�ure, prior �o i�s issuance, also requires ��e applitant �or 5uch permillo lile a 5igneE stalemenl lhal he/she i5licenseC
pursuanito Ne pmvisions oilhe Coniractors'Stale License Law(Cha0�e�9l�ommencing wifh Sec�ion 7000�o�0ivision 3 oilhe Business
and Piolessions Code) or thai Ae/s�e is evempl there�mm and ��e basis for Ihe allegetl exemption. Any viola�ion of Section 7031.5 by
any applicani for a permi� su�leds Ihe applicani �o a civil penally ol nol more �han �ive Aun4reA Jollafs (5500).
I, as owner al ihe pmpeny or my employees with wages as iheir sole campensation, will tlo Ne work, antl Ihe
;Q slmciure is not imenaed or oHered for sale (Section 70a4. Business anU Professional Code'. The Conimcbrs' Stale License Law
does no� a001y to an owner o� a pmperty who builtls or impmves �hereon, antl wha tlaes such wod himseli/hersel� ar �hmugh
his or �er own employees, pmvitled �hai such improvemen�s are not inteneed or o��ered for sale. Ii, however ��e builtling or
improvemenl is soltl wilhin one year o� camplelion. Ihe owner will have Ihe burden af pmving helshe Oi0 not build or impmve
for the purpose oi SaleJ-
I.as ownerotihe proOeMy.am exclusvety con�mc�ing wil�licensetl conVaciors�o con5tmc��Ae prolec��Section 7044, Business
❑ an0 Pro�essions Code: The Conlractors' Slale LRense Law Uoes not apply Io an owner ol prop¢rty who �uilds or improves �hereon
and who wmracls for such pmjects with a canVacmr(5) license pursuant m the ContractoK S�ale License Law�.l am aware
IM1aI pmol ol IAeir Workefs Gampensation insurance Slmuld �e pmvitletl to me.
� I am exemD� untler Seclion: 9. 8 P. C.
lor' In/fs reason: ,
Oate: ^/ � _ 7 � Ownec � ��/
I do h¢reby cetli�y ��al I am aware o� anA un0ers�antl Ihe reQuiremenis o� Cali�omia Heal�h Safery Cotle Sections 25505, 25533, ana
2553A an01Aa1 I or any fuiure buileing accupan� will/will nol (circle one� neetl to comply wit SaiA s�ate codes antl �he repuiremenls for a
� permil loi conslmqion ar moddica�ion tmm �he Fir Oualily Management �iStncL Besitlential con5tmciion apDlicalions are exemD� �mm
I Ih¢5¢ pfOviSians.
�atc: NpPlicanP.
I hereby cer�ily I�ai I have reatl �his appbcatlon and slate Iha� Ihe t�e Inlormalion is carrecL I agree ta comply wilh all cl�y antl coun�y
orUmances an0 statelawsrelaling�o butltling canstmclion and �ere b��orizerepresentatives oilhi,ciiyto enteruponlhe above�meniioned
pm0etly la inspec�ian purpo5e5. �� C )�� O�J
�if�
Dale' ` � � � Signature: � �
�rivefs License o� Social Secunry o:
I6aL46 Wnite—Buileing: Green—Coae Enbrcemem: Canary—Applicanq Pink—Revenue: GolOenroa—Assessor
CITY OF COSTA MESA — BUZLUTNG PERMi'f
PERMIT NO; B 061632 PLAN CHECK NO: 01134-93 5
CUNSTRUCTION TYPE; PERMIT TYPE: STR
JOB DESCRIPTION ; BRICF{ PILASTERS W/SiOLb' W.I, FENCE
CLAIM VALUE: 1,100.00 CA1,C—VALUE: 1,100,00
P�RN. NO; 3 06163L
GOVT: N SJPP; N
PURPOS�'; O'.'d
S� F'L; 110
GRO(JP OCC: R-3 /
COMME:N7'S : X
iF # 7t #�IE Y- fk if� IE!f 3f �%# # N� 3E iE it j(� # iE if 3E # 16 # if iE �lh 1E 1h iE * k iE �f # iE if iF i4 i(� iF # iE #�k # iE X� jl- #�)f # jF it ##:�!( lf if-# �% X• ih iE 3f- #� ie ##� 3(� 3F # 1@ JE iE 3F �3�i
2 O N I N G R E Q tJ I R E M fi n T s"
S E T B X1 C K S
----------- MAIN BUILDZNG ---------- -------- ACCESSORY BUILDING --------
FRNT: FT IN kEAk; FT IN FRNT; FT IN REAR: FT' IN
LBFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IIv
PARKING RE • PROV; PARCEL• 42515105 2NE; R1 REF NO:
PLAI4NING N�'PES> BRICK PILASTER AND WROUGHT IRON FENCE NOT TO EXCEED 6 FEET I
> N HEIGHT AND LOCA'PED 1 FT INSIDE Ot THE FRONT PROPER?'Y LINE
�� iEiEiFiElE1F#3kikik3FlE±fi(-iE3h7(�%�iP#ihiE##iE�lEik�lFiFfFiFiF%�(�3E3EiEif�lEiF##�)Fi6if�3f�#iFifi(�k%iFiE#Eif%iE�%IFN�iEN�iPiFiE#%�#-li�iE3E#!(:Y?C�iFif?f
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPkOVED BY K--�pS DATE: L���1
BUILDING APPROVED HY ; � DATE: /
APPLICA'PION ISSUED HY: �P� DATE; �,� � ��� �,
ihiFiFiE�1Fi(��1E.Y�3k�IfiEiflhX�fEif?f1(�1Edf�ildt'3T'iF�tiritx��F�iFR�xx�rw�ir3F�irx�iF irnirvr.��Tie ir3rx�ftxiF-0Eif1EaE#�1Fii•ihii� nirxx 3EJF
1E iF 3E !E iF iF i4 # iE-K�iE if iE iE iF iE iF%# iC if ik K� ## iE �lF iE j6 # ff 3f if #'k 3F iE jF 36 iE i(� # iE�%� ib X-iF 3f� iE iF 4 if� !E iF it ## lF 1k i(� iE 9E if-!E �7i� i4 jF.X'iE iE # 7F 3(� IE �1F it� i4 �7f i!�
LEGALI7.ATION:N F E E S 0 M M A R Y STRUCTURAL SEGMEN'f:Y
,
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SN.IP/REs� GRP.DING
PERMIT 2'I.00 50
PLAN 17.55 ' SMZP/NON—RES
IS5UE FEE ' ��
BUILDING—DN—> PERi�IT ISSIJE Pt�APl—C�tECK TOI'AL PAID pLJE
TOTALS----> 27.50 0.00 � 1'/,55 4�,05 45.05 .00
�•
REVENUE DIVISION TUTALS--> COLL"ECTED; ' q5.U5 OVER/SHORT; ,00
BLDG PMT FLUMBING fi'LECTRIC MECHANIC F'IRF. SMIP/TO'f GRADING PLAN—CHECK
27.00 .50 1'7.55
�N� 14 iF # it Ik iE !E!E # iE if if� �1F 3f� iF iF fF?f� 1(� # 1E 1E iE # if %�?! �1f� # 14 3F �Ih X�'�f if ii'# iF# #�!F %iF it fE itlf iF iF-!f if iE 3E# ih if� %# ih ## iP iE iF # iF 3F 1t if if # 3E if if #!t 1f df
I N D I V I D U A L P£ 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 TOi`AL COST
�w `.�.
SFR 110 kES—PILASTEk WI1'H "^'_'D �,CC BET/ F7', 10.00 S,100,0U
$ND t5r- FEES
t .
. N
! 'J'
'
.� '7 � . �
' . a
`/ . �' /
,�
CONSTRUCTION ANDPIANN�NG
APPROVALS Permit#
7. TemporarY Electrical Service or Pole
2. Soii Plpe-Undrgmd.
3. Electrical Conduit Uttl��ty�Und�grnd. ��
4. Electricai Conduit�Undrgrnd. �
5. Steei Reinforcement
&. Electrical UFER Grnd
--�
7. Footings
8. Foundatio�
9. Water Pip2�Undrgmd.
70. Structural F�oor System
17. Property 5ewer Line & House Connection
12. Sewer Cap
73. Roof Orains
14. Rough Plumbing
75. Rough Electrical-Conduit
16. Rouc�h Electric LViring
77. Rough Wii ing Sign
18. Rough ElectricabT Bar Ceiling
79. flough Heating & Air Condiuon�ng
20. flough Factory Fireptace
21. Ducts, in 5tructure
22. Ducts, Ventilating
23. Gas Pipe��tough & Tesc
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structurai! & Monocoat
27. Frame and Flashing
28. Laihing & Siding
29. Ins�lation
30. Drywall Nailing
37. Plaster BrO�vn Coat
32. Electrical ?ower MaterFinal
33. Final Electric
34. Final HeaCing & Air CundYioning
35. Final Gas Pipe�Test v
36. Hood or GanoRY
37. F�nal Factory Firepiace
38. Final Plumbing
39. 4Vater Service-Final
40. Gas Service-Final
41. Solar pomesticFlnal
42. Backflow Prevenier
43. Backflow Irrigation
44. Landscape �rriqation System
A5. Sound Attenuation
46. Fiandicap Reguiations
47. FfNAL S7RUCiURE & BUI�DING �
48. FINAL P4ANNING �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
Qate
Z
POO L 'A
Inspector APpROVALS Permit,�
52. Pool & Equipment Locat�on
53. Steel Reinforcement
5A. Porms
55. Electrical Bondinq
56. Rough Plumh�ng & Pressure Test
57. APPROVALTOCOVER�GUNiTE
� 58. Electrical Cordu�t�Undrgrntl.
59. Gas Pipe, O Un�rgmd., Test
� 60. Backtvash Lines, P�Trap, C� Undr?rnd.
---.... _ _... �. .. _ _....
67. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heaier & VenhFinal
64. Plumbinc� SYsrem - Final
65. E�ectrical-Finai
66. Solar System�Finai
67. Fencinc� 8 Acccss Approval �
68. APPROVED FOR PLASTERING
69. POQL(SPASYSTEMSFINAI
FtRE DEPT. REQUIREMENT
APPROVALS Permit #
Date � InspectQr
70. Underground Nydro
77. Product Pfping O Gas ❑ Oil
72. Underground Fiush
73. Undergmd. Srora9e Tank O Gas ❑ Oil
74. Overhead HYdro
J5. Dry Chemical
�6. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FlRE PREV. FINA�
HEALTH DEPT. REQUIREMENT
79. PINAL INSPECTION
80. FOOD CERTIFICATE ISSUED J
Notes: �2irrD+-� Zli�. /`rn .I
� -r '� 9/
I
. . , � gi�,��
�
�
�
���.���
ClTlf OF GOSTA M°�^ '
FiAtJNI\G G'cPT. �
6U{IECT TO BIDG. DFPT. REO.
�...... DATE__.`i/5.��-�t�.
DOECfOI OI' PLANNIN6
r,���or
,
AD�i i u, . . r,:.-L : ,
sra; :;_.�_,,._._
,�, p�p��pVED
G iy of �osta F�7�sa Building �Qpt.
I �r �n I dATE �5�-19-1-
@�' _.. ^ ,` •,.�,....:, _�
THcS. p ��^ ;` ., i•.p�;:� :P
�-
i GH.;: � � 2
�0 , ... � �0 3--.
' p{n � . . . .. � - ,r .._.T—
�,:<. ^
'�.�'�.;�• i .. �
; �. . i1� ;
� J..� i
1'tiil:rb• .�� .• �
1 H�
SP@l9 .;r� ,., `.; �
FNGW iitr':.Ed''���
SP.tC�' LP ,': ; qV
QU����.1��L'.' f�f.'i:i
IkV�v..A'Ipl::f IH
; IIIEqfY.
" � �'a .
� , h;._.:- d
c ' . � .�
.• R[ND[MCE ;�
� =.l'.
,� �
� G .
�'' -
, , :�:<",:,
•� - �•JC
.� DEPT. 5•
�r VAL OF
i� TO BE A
a O P.N
:1!N 310 ,NE
:,F: GF �HIS
•.;n�xC. USE
? % �? ���C6 D[Mtf
_ =FSi� !l51N
r. vy� ;TING
,� �,;pq 9HEN
p;; ItiA 'F OF
II
STREET
�
,�CTIONS SHALL
; �E�:��rrn�dr
�{7� ��� /���,-�
`��- /.� � - 6 s
f_jrief�_ }7��C�S7�Y� Gt� GIIYbC(qi2`� 1`+'t��
�J/ /1�
��'t C� — Y/p7L f0 2XCO�lL� cO 7i' !r1
he���w �`[Qcs�Ys ls�"�( �( �0� �ee�OJ
/S" in �viol�GL Qnd Shall be �Pace�l
Q/'i2 ii9 iYr[UIn b f �� (��OQ'�,
tl�
11[lIDEMCE RElIOEMCL
f
W
�
N
insidn. Properh�
�inc� '
�
l6'� 5-�-�--
.�
�
�S-
Cement Coping Oot�onal —
Channel Block With 1�3/8�
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"¢ at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Co�form to Sec.A-15-39
A.S.T.M.
AllSteelto be Lapped
24" or to Code
NATURALGRADE
TWO 3/8"t5 8AR5
CONTINUOUS TOP
& BOTTOM
HOQ7ZSTEEL MUST BE TIED IN
PLACE A7 71ME OF TRENCH
INSPECTION.
TYPICAL 6�� CONCRETE BLOCK FENCE
a s
� �
�
>w
s =
a
> Z
>-
a
i�
W O
U F
Z
w in
�
yo -
d -p N
o A — —
D'
�wiorN
� SEE CHa
'+ BEIOW
D' I 'Q.
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR; p�e part Plasfic Cement, and
Three Parts Sond
GROUT: One Part Cemenf Three and
One Hali Parts S�and
COPING: One Part Cement, Three
Parts Sand
CONCRETE: Weii Mized 1:2-I/2:3-I/2
Max. of 7-I/2 Gallens ot
YVater Per Sack of Cement
GROUT MAV BE POURED FFOM 7HE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HOR120NTAL REIN-
FORCEMENT SHAIL BE CIEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H GF E4RTHTCOTH
V3 TNE HEIGTH OF FENCE
��OW BOTTOM OF FOGTiN6.
WIDTH . . . . 14'� . . . . . . . . .'. . 14" . . 12".., . . . .
THICKNESS . . . . . . IO��. . . . . . . . . . . .10�� 6��.
DEPTH OF EARTHTOOTN . . . 24° . . . . 20�� . . . . . . . . . . . 16��. . . .
SPACING OF EARTHTOOTH. . 12' . . . . . . . . . . .14' . . . . . 16'. .
City of Costa Mesa, California
Building Department
i��`: f'�ED NOV. 82
SCALE: I/2�� = I'
8„
12"
16�
� PFO'"�ADOflESS: q 7 8 E 1 6 TA JrT
I ' OW 'SNpME:KLEIDI, LARRY J
RDDPE55:q'78 E 16TH ST
COSTA ,viESA, CA
r
�
pflCHIENGINEEF:
AUDHESS:
UNIT:
92627
HEG.NO.:
I1NIT:
PEflMITTEE:TRACY KLEIN (714)645-2088
aooeess: q�g E 16TH ST
C.M. CA 92626
LILENSEO CONTNACTOB OECIANATION: I hereby a��irm Ihai I am licensetl untler Omvisions ol C�ap�er 9(commencing wi�h Sec�ion
7000) of Oiv�sion 3 0l I�e Business and Pmlessions Cotle, antl my license is in full lorce an0 e�fect.
CITY LIC.: STPTE LIC.: ClASS:
Date: Signalure:
WONREXS' COMPENSR710N OECLAflATION: I AereUy aifirm Ihat I �ave a ce�ilicate ol consent to selbinsure or a cenificate af Workers'
Compensaeon Insurance. or a certiliee copy inereoi (Seclion 3800. La�. C).
VOLICY NO.: E%P. OATE:
COMPRNY:
I 0 Gerlitietl copy is �ereby �umis�ed. ❑ Cehilie0 coOY is �ileU wii� �he city Builtling Division.
�a�e: ADDlicani:
ETEMPTION FPOM WOHREflS' COMPENSATIUN OECIAMTION: QAis on neeE not Ue comDleleO if Ue permil is �ar ane hunOreO (5100) or less�.
I certily ihat in Ne peAormance oi ��e wark lor whic� 1 mit 5� suea. I shall not mploy anyperson in any manner so as �o become
5ubject to �he NorkerY Compensation LawS ol Califo nia. �
Oa�e' � SignaWre: �"
NOTICE: It. aliei making ihis tleclaralian. you s�oWE Gecome suble o ��e Warkers' Compensation 0��'isions ot Ihe Labor
CoOe. you musi fonhwi@ comDly wilh such pmvisions or Ihis per shall he Aeemed revoketl.
CONSTflUCTION 1EN01NG RCENCV: 1 here0y allum Ihat I�ere is a conslruclion IenUing agency lor ��e Oerformance ol ihe work lor
which Ihis Oermit is i=sued �Seaion 3097. Civ. C�.
LENDEN: ,
AOOflESS:
OWNEH BUILOEfl DECIANATION: I hereby aifirm ihal I am exempt Imm Ihe Contraclors' $la�e License Law br �Ae lollowing reason
(Seqion 70315 6usiness ana Pmtessional CoCe: Any city ol county which repuire5 a De�mi� lo consimct, alter, impmve. demolish, or
repair any simclure. prior lo its issuance. also reQuires ine applicant for sucn permit ta lile a signeU statement inal he/she is IicenseU
Oursuanl to �he pmvisions ol Ihe Conirac�ors' Staie License Law (Chapier 9 �commencing with Section 7000) ol Division 3 0� Ihe Business
and Pmfessions Cotle) or I�a� �e/sne is exempl Ihere�mm and I�e basis br Ihe allegea exem0lion. Nny violation o� Seciion 7031,5 by
any applicanl for a permit suUlecls Ihe apPlicant Io a civil penalty ol nol more Ihan live Auntlretl tlollars (E500).
I. as awner al the pmDehY or my employees wiih wages as Iheir sole compensation, will Jo �he work, antl Ihe
:{� slmcWre is not imenae0 or ol�ereU br sale (Section 7044, Business and Pm�essional Cotle'. The Contraciors' S�a�e License Law
does not apply to an awner oi a propehy who builtls or improve5 ihereon, and who tloes such work himsel�/hersell or Ihrough
Ais or her own employees. pmviAetl Ihai SUch impmvemenls are noi iniendetl Or oflered fof Sale. II, howev¢r Ihe buil0ing of
impmvement is sold wi��in ane year of completion, Ihe awner will have ��e burden o� pmving he/s�e Oi0 no� bwltl or impmve
for ihe purpose ol sale�.
I, as owner ol the proper�y, am eKclusively coniracting wiih licensea conVac�ors �o consimct the pmlec� (Sec�ion 7044, Business
❑ antl Pmiessions COAe: T�e ConVactors' State LicenSe Law does no� apply Io an owner Of property who builds or imD�oves Uereon
and who coniracls lor such prolec�s wi�h a conirac�or(5)license pursuan�lo I�e ConVactors' S�a�e License Law). I am aware
�hat D�ool of Iheir Worker'S Campensation insurance shoultl �e pmvitled Io m.
� I am exempi under Semion: B. 8 P. C. ,
��for Iti reasan:
aa— 93 ow�e�, � �,
I tla hereby cenily Ihal I am aware o� an0 un0arslantl Ihe rtquiremenls ol Call�amia Healih Salery Code Sec�ions 25505, 25533, and
25534 and Ihai I or any fuiure buildmg occupan� will/will no� (circle one) neeU lo camply with saitl slale cotles and �he requiremer�s far a
permil for uons�mclion or motlliica�ion Irom ��e Au Oualiry Managemen� DisVic�. Resiaenllal conslmction applice�ions are exempt Imm
Ihese provisions
Date: Npplicanl'. _
I hereby cehAy ihal I havo reatl Ihis application and sta �hal ihe o Informa�ian is correcl. I agree lo comply wlth all ciry antl counry
oralnanwsantls�atelawsrela�inglobutldmgconsimcli antlhare Ihoriierapresanl�ivesolthiscirytoen�erupontheabove-men�ione0
pmpehY /��or 'mspeclmn purposes. •
"Ratr�� L�/' �� Signaiure: Q ��
oriver�s License or social Security a: �
�66i-46 Whpe—Butltlmg�, Green—Code Enbrcemenl', Canary—HppllcanC Pink—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — B�i�DING PERM.IT PERM NO; E 05?&93
PERMST NO: E 061893 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTZON TYPE; PERMIT TYPE; ELE PURPOSE; OTH
JOB DESCRSPTIQN ; 9 �XTERIOR LIGHTS ON FENCE R8�•Q �I�O�� SQ FT;
CLASM VALUE: CALC—VAi,UE: GROUP OCC: R-3 /
COMMENTS: Ei,EC. CONDUIT FOR POTENTIAL FliTURE LOW—VOL, GATE LOCKS. PER BOB C.
�if�Yx�cif��*if�fif�liEiE�r"iExiE��r'xiFi%�e�x�%ifu?f,�tx'�'iEat���r�fifx'iE*#izxiE�u'iEiFltiFiEx")fifi%u%iE)%ifY'�eSfiftt'i�..�iifxitiix'+��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BiJILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: ?T IV REAR: FT I13 FRNT: FT IN REAR; FT IN
LEFT; FT ZN RGHT: FT IN LEFi: FT IN RGHT; FT IN
PARKING REQ: PROV; PARCEL: 92515105 ZNE: REF NO:
FLANNZNG NUTES>
>
3F iE 3f # iE if if iE iE E-� iE iE �lE iE 3E-lf ##f iE #?E �1E iE # iE #iE iE iE?F :e?E �1F'�!6 #IF iE # iE # ie �lE iE iE ik iE ih if # N• iF #�# iF iF iE #iF# iF ### 3E it if ff iF i6 # iE ### if 1f it
D c V E L U P M E N T S.E R V I C E S R E Q U i R E M E N T S
ZONING APPROVED BY . DATE;
BUILDZNG APPROVED BY : —' UATE;
APPLICATION 'tSSUED BY: � DATE: ' I�F
#ifiF)fiElfiFafififaf�EiElElfiEiFiEaiiclEiF�'It*..! 1 Fit r'Ititx.�'C�n xhY %Rat��tt—x{r� t�f?'hla�ifififififlEif#;('*lt..YFittt #.itifat
ifififif�lf-iEiElfii�iE�lEiEjEiF�f-ikiFiE3f�iEiF�FiEiE#iEifiE�EiF9E�!Eie�E��FiEiFx ''##iEiEif##�f#iE#i'siF#iFN•iE#iF##if#�lEi(�#itiFiE'k##1E##iPiEiE
LEGALIZATION:N F E E S U M M A A Y STRUCTURAL SEGMENT:i�i
BLDG PM? PL'JHBItiG ELECTRIC MECHANIC FIRE SMIP/RES GkADING
PERMIT 2S.U0
508 SN,IP/NON—RES
PLAN
ISSUE FEE 15,00
BJILDING—DIV—> PERMST ISSUE PiAN—CAECR TOTAL PAID DUE
TUTALS----> 25.00 15.00 0.00 40.00 40,00 .00
REVENUE DZVISIO,� T03ALS--> COLLECTED: 90.00 OVER/SHORT; ,00
BLDG PMT PiUMBING ELECTRIC MECHANIC FZRE SMIP/TUT GRAPING PLAN—CHECK o
90.00
iE 3f #!E iF 3F iE IF iE iE 3f iF iE if iE 3F iE iF iE iE ie 3f 1f if iE iF iE if �7E iF �lE iE �1F if if iE iE �E ik �If if 1f if iE if #".E if �F :4 iE iE if if !E iE 1E if IE if iE iE # iE 3F if iE 3F if��1F �!E iElF If iE iE �E if �!
Z N U I V i D U A i F E E H R E A R D 0 W N
TYPE QTY P E 5 C R I P T 3 O N UNIT COST TOTAL COST
ELE 9 FIXTURES LIGHTIN� 1 ST 20 EA. .75 3.00
ELE 1 MYSC CON�llUCTOR NOT iISTED RE�i PERMIT 11,00 11.00
ELE i MISC CONDLiIT NOT i,ISTED REU PERMIT 11.00 11,00
END OF FEES
01 00137570-00137670 T�] T 4�p.p{1
DATE: 04/22/93 TIt1E: 15:ti7
CONSTRUCTION AND PLANNlNG
� APPROVAIS Permit �
t. Temporary Elec[rical Service or Pole
2. So�l Pipe-Undrgrnd.
3 Electrical Conduit Ut'�rtY�Undrgmd.
4. Electrical Condurt�Undrgrnd,
5, Steel Reinforcement
6� ElecCrcai UFER Grnd
7. Paotings
8. Foundation
9. LNater Pipe�Undrgrnd.
10. Structural Floor System
11. Properry Sev,rer Line & Ho�se Connection
12. Sewer Cap
73. Roof Dra:ns
14. Rough Plumb�ng
15. Rough Electrical-Condurt
76. RoughEledricWving
77. Rough 1V�rir.g Siyn
18. Rough Eiectrica6T Bzr C?i;�ng
79. Ro�oh Heai�ng & A.r Co�_dit�onmg
20. Ro�gh Facmry Pireu�ace
2t. Ducts, in Structure
22. Ducts, Venti�ating
23. Gas ?ipe�Ro�gh (y ?est _
24. Rouf Fammg
25. Roat Shcathlnq ___--
26. T�Bar Ce�hn9 ;Sv�ct��all & b�oaocoat
27. Frame and Flashing _
28. ( athing 3i S:d�nu
29. Insula0on
30. D�ye:all IVa�hng
31 . Plaster Bro�vn Coat
32. Electr�cal Power M,et¢�_F�nal -_
33. Pinai Electnc
3A. Final HeaLng & A�r Gonuitionin�
35. Final Gas Pipe�Test
36. Hoad or Canopy
37. F�nal Ftcto�y F�repiacc __
38. Final Piprhbing
39. 1Vate: Sctrv�Ce�Fina!
4D. Gas Serv;ce�Final
47. Solar pomestic-Fm;,!
��2. Bacrctlow Preven;cr
43. Back('ow IrriBaUo�
44. Landsc:.pe I�ngaunn S�;s[an
45. Sourtd Attenuat,or
46. Hacdlcap Reguia7�o^.�.
47. FINAL STRUCTURG R� oUILDING
48. FINAL PLAfVNING
49. Electric Release to Ed�son
50. Gas Release to Southern California Gas G
55. CER7IFICATE OF dCCUPANCY
No. Date
Date
Inspector
�
e
0
POOI & SPA
APPROVALS Permit #
52. Pooi & Equipment locat�on '
53. Steel Reinforcement
54. Formt
55. Electrical8onding
56. Rough Plumbing & Pressurc T�st
57. APPROVAL TO COVER�GUN'�T[ I
58. Electric�l Co^duit�Undiqrntl. �
59. Gas P�pe, f� U�tirgrnd., Test
60. Backwash Lines, P�Trap, L,' Undr�rnd,
67. APPROVAL TO DECK
62. BackwasYt & Recepro�-Finai . �
63. Heater & Vent-'rir,ai
64. Plumbina SVsiem - F��a! �
65. Eiectrical�F��nat! �
66. Solar Syst.:m-Finai .
67. Fencing & Access Appru,al
68. APPROVED FQR PLASTEAING
69. POOUSpASYSTE'�dSFtNAL ___`
FIRE DEPT. REQUIRElNEb:T ;
APPROVALS Pa:mu-m �
�
70. Undergrouni H�;.ro
71. Product P:ping ^ Gas _' 0�1
Date
72. Undergrounc Fl�sh I �
.- -___-. +- _, ____-.
73. UndergmC.Smra,.��T&r!c ^Gas ,. J.� ,�
?4. Overhac0 Hvu.o ____-_ -. _.I _-__ .I ___ .
--------�--._� _ .
75 Dry Chem�ca� I �
----- �- - - - . .
76. Dry $TanGi�.G:
� - -
77. FIXcD SYSTE�r� FINRL i '
i
78. FIRE PREV. FI�;AL _ �___ L___
HEALTH DEPT. REOUIREi�iEVT
_ __________.__.___I__ .___.
79. FI"JAL INS^FCTiON
80. FOOOCE�;IFiCATEi55UED '
-- - -' ----1 - - -
Notes:
-- �
-------- - �
�
--------- - --�
-- -- I
�
April l2, 1993
Dear Inspector,
I had the preparation crew stub out the electric conduit for the
potential, future installation of low-voltage gate locks. It is not
intended for a 1 IO curcuit.
Sincerely,
Larry J. Klein
' � f ���e�
J
�
. . .. . Sy
� �N . 1
p I
�
�
SOUTHWEST INSPECTION AND TESTIN6 INC.
10826 S. Norwalk #A
. Santa Fe Springs, CA 90670 '; �(yr[rG���
310-941-2990 714-526-8441 (1(�Y P1dX'�7'9'A�'4�G-0026
---------------------�_____________�___�----__---- ' �n�-�nnL
__'_'_'_'____________ __'_ ____�=c'vv===eca�6lS�c='=_=====c=
FIELD DATA ON TEST SPECIMENS
--- ASTM C31, C136, C143, C172, C173, C231,
CONCRETE: X GROUT: MORTAR: SHOTCRETE: CORES:
�C I 1 'Y 1996
C1064 ---
GUNITE:
ADDRESS: 478 E 16TH ST. COSTA MESA JOB #: DATE: 5/4/96
JOB NAME: KZEN RES. PERMIT #: 867640 ISSUED BY:
ARCHITECT: GNGINEER: ESI/FME
CONTRACTOR: OWNER BLDR9 SUB CONTRACTOR: CP & 8
----------------------------------------------------
LOCATION IN STRUCTURE:
----------------------------------------------------
CONCRETE SUPPLIER: PLANT:
TYPE OF CEMENT: ADMIXTURE:
SLUMP: WATER ADDED:
CONCRETE TEMP: MIXING TIME:
DATE CAST: 3/26/96
--------------------------------
SPECIMENS MADE BY: GARY RUTHERFORD
--------------------
FIELD IDENTIFICATION
-- -----------------
� A � B
------------ — ----------
MIX #:
TICKET #:
AIR TEMP:
TIME CAST:
RECEZVED F1T LAB: 4/29/96
SPECIFIED PSI: 3000
LAB IDENTIFICATION : 603998 : 603998 : 603998 .
----------------------�---------�---- ----�---------�—
AGE DAYS : 28 : 28 : HOLD .
DATE TESTED : 9/30 : 4/30 . .
SIZE—IN. : 6X12 : 6X12 . .
AREA—SQ.IN : 28.27 : 28.27 . .
CRUSH LOAD—LBS : 123500 : 124000 . .
COMP—STR.—PSI. : 4368 : 4386 . .
� H/D . . . .
CORR FACTOR . . . .
CORR. STR. —PSI . . . .
TIME TESTED . . . .
----- — ---------------------------------------------
� E � F
REMARKS:
------------------------------------------------------------------------------
ASTM C39, C174, C192, C470, C617, C42
COMPLIES: X DOES NOT COMPLY: �
BREAK TYPE A: X B: C: D: E:
--------------------------------------------------------------------------- — --
THIS REPORT SHALL NOT BE REPRODUCED, EXCEP FULL WITHOUT THE APROVAL OF SITI
RESP LL SUBMITTED
SO HWE9T SPECTION AND TESTING
SAMPLES CAST BY OTHERS: ,
OSCARi6. ANDRES
LAB� MANAGER
ASTM C39 BREAKS A= cone 6= cone and split C= cone D= shear E= columnar
�
�J
OWNER SPEICH. ANDREW J. DATE 3-9-66
JOB ADDRESS 478 E. 16th Street BUILDING PERMIT NO. 25370
GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Install Ylindows in Gar
P" `10.117-�El-OS LOT TfiACT FIRE ZONE VALUE $ 50.00
� I. , ECTIONS ISi uature Date GROUP J TYPE V ZONE R-1
SoIl I � I PEAMITS ISSUED
.� n.,.. 1—'—I� SUBCONTRACTOR n„�„ i rr.,.,,he. i c;a.,�r,,.o
or
/ � _—
* 25370
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BO% 7RW � GOSTA MESA, CALIFORNIA Y26tE
For Appllcanf to F711 ►n Complero/y
TYPE OR PRINT
ADOREi59 -/ ` ��.IO ��'
COSTA ME3A. CALIFORNIA
OWNER � � AL/+/' r � �= r,
MAIL /� / �(_ \
ADDR88Y / O � '
TEL J7
CITY � NO:� ��7G
R�CHITEGT �/' T!L
'NGINEHR NO.
:/
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CONTRAGTOR V `�" �`��' `.
e�rr 'L'_"
STATH "��
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CITY ��' C'.� � A MESA
MAR 9 1966
APPUCATION FOR PERMII
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D�sc��R�ON
A. P. NO. � Q
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N0T6: NO6AVBOV[RHANOSl7ALLB8L888THAN
DO' TO BIDi a RBAR P. L
8AVE8
10•ot�LDaa. ALLOWHD W.B.G..REOUIR8M6NT'.
lOW N
YARDD APPROV6D YARDSAPPROVED
MAIN BUILDINO ACCES60RY BUILDIN6
Y6TBACK LIXi r110M � � / S
CHNTHR OP YTRHIT' �� RR�R YARA L
DESCRIPTION OF WORK
� �
I XCR6BY ACKNOWL[D06 TNAT 1 MAVB RGO
ANp 8TAT8 T!{AT TH6 ABOV6 COPqBCT�AI
PLY WITX ALL CITY O N �TAT[
auitolNocoNeTRu o
SIGNATUREOP , � .�.
PERMITTE
AUTHORIZiD A66NT
oierwNcc err. I eer. �
MAIN BLD¢Y, ACCE
VAR..}� DATH
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il �
BQ. F�. �
0
LIWTION TM8 ANOUHT BMOWN UHDBH VALUATION IB ROR TH8 �
TO COM. PURP08B OP 69TABLIBHINO A PEflMIT FEB ONLY.
�uuTlHo VALUATION
?.�% 01
� D PERMIT FEE p
0
$ W
TOTA{.FEE �
'osta Mesa Building Department
� 111 EAST 20th STREET
' � � COSTA MESA, CALIFORNIA
FOR APPLICANT TO TILL IN
Buflding �� /��
Address •
Costa Mesa, California
Cross St.
Owner
Mail
Address
nroniLecc or
Engfneer
Addresa
Address
(Attaeh Metes a
Size of Lot �
..�� ��a �
Size
�xterior Vif:
:1I
�S-'Z� yi�+�. 1�7`_
IBlxk I Traet���y
t)
No. of Bldga�1�
'� Now on Lot / V �
� INo.oi No.of ♦
Famillesl Room�v
t RearYard � �
Alhretion
Moving
O No. of
Room:
R
- W Ci
, �_
I hereby acknowled
and state that the a
with all City Ordii
building constaxctin
Signatureof�
Permittee i
Authorized Agt.
Valwation
$ /y�700
FONM 204 o-H 2M 5-54
Addition
ihat I have read this /
ve is rnrrect and agree
ices and State Laws
'u3y � .I�/%L...��-'
�
�
PLICATION F�R PERMIT
� � BUILD.ING '
d+'OR OFFICE US� ONLY
._.RecelptNo. I PermitNo.
� 3 Sc /
Received by Date Redd. Date Issued
�.,"7�'' a7 -%_.S c> � d—S 6
Building
Address
Costa 1VYesa, California
Nearest
Cross St.
Zone No. of Type I Group
i (G I Plans y I?.1�'f�
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APPROVALS
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Materials,
�inning
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, Bolts
Int.
Ext
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