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HomeMy WebLinkAbout201 16TH ST - Building Permits ADDRESS OF BUILDING: 201 E 16TH ST WIT: CITY OF COSTA MESA - BUILDING PERMIT OWNERS NAME IF MOWN: SEVERNS MARK MICHAEL PERM NO: P 075515 ADDR'u: 201 E 16TH ST COSTA MESA,CA 92627 PERMIT NO: P 075515 PLAN CHECK NO: N GOVT: N SUPP: N APDL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : REPLACE HOSE BIBB SQ FT: ARMOR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-1 / cONTHACTOWSNAME: GOLDEN STAMP CONSTRUCTION ( 213 ) 587-6414 CpPNACTORSMMLR1G 3312 GRAND AV COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: HUNTINGTON PARK CA L1c.N0.: 672969 *#♦EaE♦E** ♦E1F*iFiE1E♦EiE*♦EiE*feie+t*iE*itiEftlE+fiEiFitiFatiEatiEititaE♦E♦EiE*atififif♦EiF*iEi ******itiE#Atit*lEie*it******** 90225 DMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally 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. CITY Lt.NO.: y [LJC.CLASS: B LIG.NO.: 672969 EXP: MAIN BUILDING ACCESSORY BUILDING Date: 15.— O T> 9 7 contra.: e. wit, a lira el."'Jr •••4_/%/ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 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 horn the Contractors License Law for the lollowig reason(Sodion 7031.5 Business and Professions Code:Any sly or county which requires a permit to construct.after,improve. PARKING REQ: PROV: PARCEL: 42533404 Z NE: REF NO: demolish,or repel any structure.prior to is issuance,also requires the applicant(or such permit to file a signed statement that he or she o licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 d the PLANNING NOTES> isiness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 331.5 by any applicant for epermit subjects the applicant loo evil penaJty of not more than law hundred dollars jS50011. ******************************************************************************* ' ❑ I,as ovmer of ihe property or my employees wkh wages as thek 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 R E M yY U I R- E M E N T S / or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply propertyto an owner property who bolds or improves thereon,and who does such wade himself or herself or through he or her own employees.provided that such improvements are not intended a offered for sale.n,however,the building or improvement a sold within one year of completion.the ZONING APPROVED BY DATE: ' ` owner-builder will have the burden of proving he or she did net build or improve for the putpose of sale). to ❑ stdemod�ely adeapirtdh � �ou'044.Professions Code:The property. licenseLaw not apply to en Ownerof protywio buil «improvesves thereon Businessd wwbo BUILDING APPROVED BY : DATE: contracts for such projects with a contractors)licensed pursuant to the Contractors license Law). ❑ laexempt under Section. B.& 2 P.C.,for this reason: APPLICATION ISSUED BY: DATE: '- , J %'I mely Date: caner: *********************************************** * ***************************** 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 Safety Code Sections 25505,25533,and 25534,and that I or any future building occupant will/will not(circa one)need to empty wih said state coda and the requirements for a permit for constmctlon or modification the Air Iua aargement District.ResidentWcmdmctre ionappicatiare am from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADIN provisions' PERMIT 5 .0 0 Date: Applicant 25% SMIP/NON-RES ' .` WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the(dowing declarations: PLAN o I have and will maintain a certificate of consent togaff-insure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE FEE 20 . 00 Code,for the perfownceofthe work for which this permiisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE o Ihave and veil mantai,workers'compensation insurance.as required bySecticn3TWCode, TOTALS----> 5 . 00 20 . 00 0 . 00 25. 00 25 . 00 • .00 work for which this permit is issued.My workers'compensation insurance carder end policy number are: Carder. REVENUE DIVISION TOTALS--> COLLECTED : 25.00 OVER/SHORT: - ' 00 ' Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK its radion need net be completed if rhe permk is for one hundred dollars($1001 or lest.) 25 . 00 j I ceniy(hal 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 abject to the workers'compensation laws of Cdibmia,and agree that H I should become abject to the wwkan' **********************************************************************fF******** • . compensation provisions of Section 3700 of the Labor Code,I shall forthwith*amply with those provi!sioions. I N D I V I D U A L F E E B R E A K D O W N ,9 Date: /� C }3' 9 S Applicant: C a. '�/o S I e cLd Y% �'c ' , '. `+} 7 Warning:Failure rosecure workers'compensation coverage Isunlawful,and shall subject an employer tocriminal penalties and TYPE QTY DESCRIPTIO N UNIT COST `TOTAL COST civil Ants up to one hundred thousand dollars 0104000),in addition to the cwt of compensation,damages as provided for/n Section 3706 of Me LMorooM,Interest,and adorneY'a lees. PLU 1 VACUUM BRKR/BACKFLOW PROT. 1 TO 4 5 .00 . 5 :00‘...H, CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES r. •`' performance of the work for which this permit is issued(Section 3097.Civ.C). _ LENDER'S NAME: LENDER'S ADDRESS: r(} • -- - I fifty that I have read this application and slate that the above information is coned.I agree to comply with all day and county ordinances '9 �T 'SI - .,end state laws relating to building condrudion and hereby authorize representatives of this city to enter upon the above-mentioned properly 1 I I,h for inspection purposes. CARLOS MEDRANO DAT ' / <7 Print Name r 2 -"jos l-[ CLel Y 2 lv C7 Ds.: R 02( L.. n1 .!F ^x•` - 4; Signature of Owner/Agent/Applicant/Contractor C ri t (515146.WP) White-Building&Safety:Gran-File:Canary-Appfcan:Pink-Revenue:Goldenrod-Assessor ��'-'- 4 CONSTRUCTION AND PLANNING - POOL 'A 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 -a. r$•-electrical Conduitlittiity-Undrgrnd. 54. Forms '",r.fl .E,!ectrical Conduit g drgrnd. 55. Electrical Bonding - 1 5.-Steel Reinforcemertxi 56. Rough Plumbing & Pressure Test ` 1_..8,�Vectrical UFE%carp,. 57. APPROVAL TO COVER-GUNITE • 1 .:.,Footings `� „ `� 58. Electrical Conduit-Undrgrnd. _ (4,... -8. Foundation ^>`- _;� 59. Gas Pipe, 0 Undrgrnd.,Test • M i-9. Water Pipe-Undigr- nd. ce 60. Backwash Lines, P-Trap, ❑ Undrgrnd. • t). Structural Floorystem 2 : 61. APPROVAL TO DECK 11. Pl,operty Sewer Line,& Houstconnection 62. Backwash & Receptor-Final 12. Sewer Cap C ro • 63. Heater & Vent-Final 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing-, 71 65. Electrical-Final r v 15. Rough Electrical-Cohduit u' . 66. Solar System-Final 16. Rough Electric}Siring 67. Fencing & Access Approval ' • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricaki Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning e.. FIRE B1F?T.tREQUIREMENT ,J, 20. ?nugh Fr 'toliFic'�ePlace ���'. _ * ,,,t; , lAPPR,�OVQ;C f�-,E Permit # t _ ._ . . s -',-v r k r 21. Duct in tru urtr1-5 .. .. •` x S C7 nr-n i r r- -71 c * _ * r ,� n* 70. FlJndergr0uytl H:r+dro f. 22. QuctS, V�rjtild3:ng;;x •u p_ c a j r i. 71. Produ&Ylping td Gas O Oil 23. Ges Pipe-Rough& Test T 'I * C1 Q' r OY 72• Undergro JQd F19s-1-1 24, Roof Fra 'in -• O? b''.." r 7 C--,...: C' 1.4- .. ? �- ! 9 r �; �-.x 73� Undergrnd.StorageTank ❑Gas 0-Oil 25. RootSheihing t-Ct w 'V t r :> v,i" 74T . Overhead Hydro '• ir 26. r2Bar,Ceiling (Stri ral) & Monosoat c y el* 7 Dry Chemical r-.- i_ :Z 27. Fume and: iding«[71, -ni y ��it 7T Dry StDrS 7.-..•T %rr r• T r r. o .. 28. Lathing Siding * SMF, C, 7TH FIXED575T@M. .InlAk r 29. InsulatioF <1.* S Y ( f 7 F1REVREV. F$NAL K > o'• c` - 30. Drywall Mailing ' ti y r, Ft 5c2; p.,k[tALTH.DEPt..REIS'UIREMENT D 31. Plaster Br wn'CoetCC* = 1 c-nri Mai 79. FINAL ImSPECTIDN e a; _ ;132. ®ectrical ow? iAr`F tal * c� tI rt: ` 1 8Qy FOOD CERTIFICATE I$SI lE0. r E 33. Eina Elear ic> * m i M * „ i t+' ' ' NG'tes: -I_ "" 0 rO " 34. Eina Oleating Aire ndTionin'gS 1 a " - " ` 35. EnatGas Pipe.7es * 6'". • - ( r 'c Clic* + :..r*' ' 1I1 f7.. r n I * . t c.c.. . .r. 36. I'tn OC�Or Canon* -•i ''.l I'1 s rt '. .) t an �s1 i rt -37. Ftnal•Factory Firep)ace i =;-, w * I' w * (U ~� H _ 38. FinagIumbing L' ° r -It r 1 i m = - 0 ii .39. Water Service-Final''- g t c F ^� • :40. Gas Service-Final di ` '" 7 * On) `.c., % r .:HF. Irl Y k i- • 0T r •? • 41. Solar Domestic-Final `" •• x - _ i i.- 42. Backflow Preventer * :d * ^ I sY. S ^' t a c AI 0-4 ti t. r1 . • F' • 43. Backflow Irrigation j>1 * 171 * 1 --* •- • - Y_ x 0. - c 4'4. handscapklIrr atiorrt5ystem {:; ?� ;c ' s `* `1 R' `=;, t _. I; r +: r'-• r' k r r a N 45: St and A,ttentlation- - . .. i m rt m c. e; • F' 46. Handicap Reguiationt '; '7.1 F it •• cc S e P. 9NlgL STRIJ-CTURt & BUILDING x i-+ ; .* _ It 1 48. E1NA-PL PLANNING* . E-H 4 !'3 'tt� an •: 49. ktectrric Release to Ellison x▪, .�" t j • , x rY Y . 50. Gas Release to Southern Caiiforgjajias th ill it , r c • _ 1' c 51. CERTIFICATE OF OCCUPANCY "' - No Date ADDRESS OF BUILDING: 201 E 16TH ST DMT' CITY OF COSTA MESA — BUILDING PERMIT a ERSNMIEIFIOKIWN: SEVERNS, MARK MICHAEL PERM NO: E 075514 ADDRESS: 201 E 16TH ST COSTA MESA,CA 92627 PERMIT NO: E 075514 PLAN CHECK NO: N GOVT: N SUPP : N APPL.'UUNGADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCHITECT ORENGNEER: LIC.NO.: JOB DESCRIPTION : REPLACE OUTLET SQ FT: ARCH.OR ENG.'S ADDRESS: UNIT: CLAIM VALUE: CALC—VALU • GROUP OCC: R-1 / cax'RAGTGR'SIuuE, GOLDEN STAMP CONSTRUCTION ( 213 ) 587-6414 CONTRACTORS MAILING 3312 GRAND AV COMMENTS: NO OTHER WORK AUTHORI • B BY THIS PERMIT ADDRESS: HUNTINGTON PARK CA UC.NO.: 672969 ***************************** • ********************* ************************** 90225 UNIT: Z 0 N N G REQUIREME T S LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty d perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 1000)of Division 3 of the Business and Professions Coda,and my license is in full force and effect. CITY LIG.NO.: LIC.CLASS: B LIC.NO.: 672969 EXP: MAIN BUILB NG ACCES.ORY BUILDING __. Dae: n_ 0 5 q; Contractor: ! 2.-e-l0 j`t 4,A2r 1 Iv FRNT: FT IN REAR: FT IN F FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LE FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penaly of perjury that I em exempt from the Contractors License Law for de following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,after,improve, PARKING REQ: /PROV: PARCEL: 4 Z NE: REF NO: demolish.or repair any shutters,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she filicensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of Dirlsion 3 of the PLANNING NOTES> .udness and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > + I 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fire hundred dollars[55001). ******************************4e****** * *.*********** ************************ ❑ I,as owner ofthe property or my employees with wages as their sole compensation,will do the work,end the structure end intended D E V E/L O P M E N T S E E $ R E y U I R E M E N T $ or offered far sale(Section 7044.Business and Professions Code:The Contractors License License Law does not apply to an Ownerproperty who builds or improves thereon,and who does such work himself or herself or through his or her own employees.provided that such imw prgments are ltd intended«stared i«sale.n,however,the buiding«hnprovemaMbsod within one year of completion,the ZONING APPROVED BY . DATE: owner-builder will have the burden d proving he or she did not build or improve for the purpose d sale). / ` ❑ I,as owner of the properh,am exclusively contracting with licensed contractors to consruct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY _ vs DATE: contracts for suds profess with a contractor(s)licensed pursuant to the Contractors this License Law). / , �� ❑ I am exempt under Section: B.&PC..for reason: APPLICATION /ISSUED BY: DATE: VZ g ** Dale: Owner: ********************** ************** **** I do hereby certify that I ant aware d and understand the requirements of California Health and Safety Code Sections 25505,25533.and LEGALIZATION:N E E SUMMR Y STRUCTURAL SEGMENT:N 25534,end that I or any future building occupant will/will not(circle one)need to comply with said stale codes end the requirements for ) a permit for mnaructionor modification from the As Orality Management District.Residential construction applications aexem etions ept from these BLDG PMT PLUMBI ELECTRIC ME 'ANIC FIRE SMIP/RES GRADING provisions. PERMIT 175 Data: Applicant: 5 Cot SM I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of a perjury one the following declarations: PLAN ❑ Ihave end wilmainaiacertificate dconsent toeetif;nsure for worker;compensation.as provided to by Section 3700of the Lab« ISSUE FEE I1 15 . 0 Code,for the pedormanceof the werkfor wchthispermiisissued. BUILDING—DIV—> PERMIT ISSUE PLA HECK TOTAL PAID DUE o Ihave and WMmaintain workers'compensation insuranice,as required by Section 3700of the Labor Code.for the performance athe TOTALS----> ` 0 . 75 15 .00 0 .00 15 . 75 15 .75 . 00 work for witidh this permit is issued.My workers'compensation insurance carver and policy number ere: Carder REVENUE DIVISION TOTALS--> - 0LLECTED: 15 . 75 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK his section need not be completed a the pend is for one hundad dollars 151001 of less) N. 1.5'. 75 ❑ I codify that in the performance el the work for which this permit is issued,I shall not employ any person in any manner so as to / become subject to the workers'compensation laws of California.and agree that B I should become subject to the workers' ******************************************************************************* compensation provisions d Section 3700 d the Labor Code,t shall forthwith comply with those prmn INDIVIDUAL FEE BREAKDOWN Date: / L 0R q C Applicant: C. 5 •K. An c.. M tt_ctst a Art) Warning:Failure to secure workers'compensation coverage is unlawful,and shell subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fins 1p to one hundred thousand dollars/SfOg000A In add/tion to the cost of compensation,damages as provided ler in Section 3706 of the Labor cods,mfesn,and etmmey's fees. ELE 1 RECEPT/OUTLET 1 ST 20 EA. /� . 75 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES { \c \ performance of the work for which the permit is issued(Section 3097,Civ.C). `\y..\__ v 7 LENDER'S NAME: LENDER'S ADDRESS: Ind slate taws s havereadthis application state that Iliaabove information rmatleeito«rectf agree totcomply ponall aryend county eddirerly and nspe taws urp se to building construction and hereby authorise representatives of this drytosmart upon the above-mentioned properly for inspection purposes. CARLOS MEDRANO A\ O Print Name cur/os Mex_el_> aivO Date l), —®S' 9s Signature of Owner/Agent/Applicant/Contractor ;1 _n1:,41. 1 3- `n'Ti L HI 7- _ '-' ' (5151-46.WP) White-Building&Safety:Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - ;30E'lectrical ConduitU City-Undrgrnd. 54. Forms c. _ ra. Etpctrical Conduifaridrgrnd. 55. Electrical Bonding �1mme -• .n., .;,:._Steel Reinforcemeeay1- ' 56. Rough Plumbing & Pressure Test 6'.-Electrical UFER,Grnj. 57. APPROVAL TO COVER-GUNITE i • -- . ,T`r`7.L,F.potings a - 58. Electrical Conduit-Undrgrnd. '--8. Foundation _:•x..a• 59. Gas Pipe, 0 Undrgrnd.,Test ^ J 79. Water Pipe-Undr and. 1 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floortystem 61. APPROVAL TO DECK • Ti. Ftbperty Sewer [ine & Houset5onnection 62. Backwash & Receptor-Final 12. Sewer CaP - ^ 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final - 14. Rough Plumbing-, m 65. Electrical-Final ' 15. Rough Electrical-Conduit =• 66. Solar System-Final 16. Rough Electric firing', 67. Fencing & Access Approval 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING 4. 18. Rough Electricals Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air ConditioningFIRE gEPT. REOUIREMEf T ,�- - n* r n' 1•f••• :/ W '2 A' t7' r+ r :'i 20. (pug'? Faretor";Fira ace ' X1'1 "T'^ )iO P ET,Te G 1PPF V OPePtit# x >4 ' •- 21. tutu;in Structura-:♦ •• •• '•+S. -* 5 C ^* 70. Rnder§Tg4r H} 1ro a rr n cr 'Cel t CJ 22. faCt VcfI{tila',-(ng':�. mcV N.. syn 4 m 44 if, E.-,* •171. Produgitpjng UEias C}Oil 23. �as x •,. + w, t- r•I . C� G I 'pe-liough & Teat rn r i' io t a 0 ' x•-•72. Underground FLusfr t `' `. 1 j..,. ,' ) r. rn 'V a v * >' 24. Rbof=FraMing- A ' `F"' •'ri .A g 'T. ri; 7AUndergrn .StorregjanktGas OOiI 25. floof`Sheffihing '....--i< c• � * a i%t .S 74'2 Overhead Hydrni- * 0 - * - -1 r rn ' c T * Y co r7 tot 7' '7 * r 17 X 26. F;BaiTCeiting (Stru Zral) & two�t 'oat x O y m* for Dry Cheitical ;,D * 67 .. K . 1 ... ,R 1-' - ' x - -, 27. Eiame ang.,Flashing;• . x c x- r > cc* 76. Dry Stan�e FCC a- to .n-, _ >,t c" * ;7 n, ,-., 7,,28. Lathing Si-Siding c",- t `' 4F G S •' "•* 77 FIXED TEM;F.INACY r. n �,, at .w G 29. Insulation .. . S •• * -* 7fg FIRE PREY. FINAL t > X t=- 30. Drywall Nailingw r, * . I*a 4-4 l ALTI Q,EPC.REOY/IRAMENT 31. Plaster Brown Goetr.ic- PT.r * * 79.E FINAL IGt6AECTION• t r a T f', -r- i - -1 32. Electrical Povre3 Mgr-Pie X ''' t x 80�FOOD CERTIFIS'ATE IISUED_, • to ; r to „• 5..33. ,3nal,':ilectric'2. rr: C K t* Ndnes: •-1-1 In t.M 7 ti "'34. FMaI-Heating Si Aii'1Conditionin§.S r * X •ru •S e * 5 r -, n r tr. r * ! 61 .-ty-o o f F * .ter r J *'"7 - * ,LOU1iU�r .Jr,_it•1.. v 3 Final Gas Pipe es(yK C ., _r I o a.; * Mor ________>. r. . . 1. S A c36. Hood'or Canopy n'* =' t^^ < r !, E ,-,c t t- a_ T Vf. H , NT L MT; , .iV _37. Rine Factory Fireplace z E.t. , Jr. I - xto '7138. Final Plumbing 2�:‘ rice i a * it _ '- * T Y, It f'39. Water Service-Fina{"'* j `" * It •�`•' i m r40. Gas Service-Final * T. S ' M I O1- crus P1 * R t _. K C T41. Solar Domestic-Final' f ••• 7. '' F n ^ -; x 1 7u CP -k ^ D 42. backflow Preventer `.: * i !i. Cr: --t-' * a ""1 r. -' f-,--, t ,.., M r0 * . 43. Backf low Irrigation - j;SS * X * , it * `� ; n; : r 44. Landscape'Irrtpation$ystem 3r'1�• ` T { is a Om1< 74 * * .rr- r7 * - C. 'G:* :E - - 37: r S t+ 45. SQund Attenuation .",1 , .. * -,. x Mt C' r < • Fa t ,16. Pa"ndicap Regulations- * * X S Cru S * 43. NNAtt STRUZTURFr& BUILDING 'K K S .f t w r ti. 'M r 48. EtNK1.PLANNING 1 T n •K ' "71 C 4 t" r ~ 'r I u S K '-. 49. Electric Release to E4ison ' r D. Gas Release to Southern California-Gas Co * - - - " - Si. CERTIFICATE OF OCCUPANCY ` * • m� s r' " No. Date r4., N. - . ADDRESS OF BUILDING:I 201 E 16TH ST D"' CITY OF COSTA MESA BUILDING PERMIT aWNER1NfNEIFOON1I: SEVERNS MARK MICHAEL PERM NO: E 075514 4 ADDRESS: 201 E 16TH ST , COSTA MESA,CA 92627• PERMIT NO: 075514 PLAN CHECK NO: N GOVT: N SUPP: N • APPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH •ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : REPLACE OUTLET SQ FT: ARCH.OR ENG.'S ADDRESS: DHT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / CONTACTOR'SNAME: GOLDEN STAMP CONSTRUCTION ( 213 ) 587-6414 • CaNTRACTOR'SMMUNGG 3312 GRAND AV COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: HUNTINGTON PARK CA uC.NO.: 672969 ** * ***itRERExiE#REj *****RE**atac******xRETE*RPRPRFx* **+E**+tRtitRE*****aERE*RE****RERE*Rr**at******et* 90225 0MT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty 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 lull force and effect. • Cm LIC.NO.: LIC.CLASS: B LIC.NO.: 672969 EXP: • MAIN BUILDING ACCESSORY BUILDING Date: ) t 0 1 Q S Contractor: G 2^r /m N a aw> 1'>1J47 FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I ern exempt from the Contractors License Law for the following reason(Sedion 7031.5 Busses and Professions Code:Any dy or county which requires a permit to construct,aher,improve, PARKING REQ:. PROV: PARCEL: 42533404 Z NE: . REF NO: demolish,or repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she ' 's licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)d DNsion 3 of the PLANNING NOTES> 3usiness and Professions Code]or that he or she is exempt therefrom end the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the applicant to a dvil penalty of not morethan We hundred dollars PS500]I. . ******************************************************************************iE ❑ I,as°mar of the properly or my empkyees with wages de their sole compensation,will do the veurk;and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not appy to an owner of property . who builds or improves thereon.end who does such work himself or herself or through he or her own employees,provided that such improvements are rot intended or offered for sale.5,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). O Professions CodeI,es owner of the r he ty.an eas License laactingea not licensed with contractors of construct the project(Section 7544.Business end . appproperty who builds orimproves thereon and who BUILDING APPROVED BY : DATE: contracts for such prams with a mntrador(s)licensed pursuant to the Contractors License Law). 7 ❑ Iamexempt under Section: B.&PC..for this reason: APPLICATION ISSUED BY: DATE: V2' S. 4f)lee Date: owns;: **********************'3E******************** * *********************** ** **** • LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am aware of and understand the requirements d California Health and Safety Code Sections 25505.25533.and f 25534,and that I or any future building occupant will/wit not(circle one)need to comply wEh said state codes and the requirements for a permit for omemction or modikatan from the Aiouua11iyyl�anegemenl Distric.Revdenlud construction applications we exampltrom these PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING provisions. Data:• Applicant: . 50% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby aunder penalty of perjury one d the following decln aratio : ISSN affirm ❑ Ihave and wmaintanacentrioleoconsenttoselfib -insure dthe ISSUE FEE 15 ,-0 J Code,Iertheperformarceofthewaitforwhchthispermitisissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ maintainIhave and vetworkers'compensation insurance. byS370Odperformance of the TOTALS -- > 0 , 75 15 , 00 0, 00 15 . 75 15. 75 00 nrequiredmm, work for which the permit is issued.My workers'compensation insurance rapier end policy number we: Carder: REVENUE DIVISION TOTALS--> . COLLECTED: 15e75 OVER/SHORT: . 00 ' Policy Number; BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK • This section need not be competed y the permit is for one hundred dollars(slml or less.) 15. 75 o I certify that in the pedomonce of the work for which this pemmh is issued.I shall not employ any parson in any manner re as to / become subject to the workers compensation laws o Cahoma.and agree that it I should become subject to the workers' ******************************************************************************* compensation provisions of Section 3700 of the Labor Code.I shall forthwith co mmpy74t h those provisions. Date: / -D-- r-0'8 4.G Applicant: no .a -ic Jo S a/''© INDIVIDUAL F E E BREAKDOWN Warning:Failure to secure workers'compensation coverage is unlawful,and shall sublacf en employer to criminal penalties and TYPE . QTY DESCRIPTIO N UNIT COST TOTAL COST civil tines up to one hundred thousand dollars($100,000),In addition to the cost of compensation,damages as provided for In Section 3706 of the Labor Code,Interesf,and alforneyi less ELE 1 RECEPT/OUTLET ' 1 ST 20 EA. . 75 . 75 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency fdr the END OF FEES 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 correct.I agree to comply with all city end county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. , CARLOS MEDRANO • • Print Name CI a-Yhoc A4 4L_r.a ' t Date: l>-.)—®CS' 9S Signature of Ow erlAgenUAppfi anOcpntrmpr • 01 00196098-00196098 TOT 15.75 • DATE: 12/08/95 TIME: 10:45 . (5151-46.WP) White-Building&Safety:Green-file:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor ADDRESsa BOLDING: 201 E 16TH ST WIT: CITY OF COSTA MESA - BUILDING PERMIT OWNER 'S NAME IF KNOWN: SEVERNS MARK MICHAEL 'i PERM NO: P 075515 ADDRESS 201 E 16TH ST COSTA MESA,CA 92627 PERMIT NO: P 075515 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAIUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU - PURPOSE: OTH ARCHITECT ORENGNEER: LIC.NO.: JOB DESCRIPTION : REPLACE HOSE BIBB SQ FT: ARCH.OR ENG.'S ADDRESS: WIT: • • CLAIM VALUE: ' CALC-VALUE: GROUP OCC: R-1 / coNTRACTORSNAIa: GOLDEN STAMP CONSTRUCTION ( 213 ) 587-6414 CpRRACTOWSMAIUNG 3312 GRAND AV COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: HUNTINGTON PARK CA UC.NO.: 672969 ############################################################################### 90225 INT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affbm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)d Division 3 d the Business and Professions Code.and my license is in full force end effect. . CITY LIC.NO.: �y }UC.CLASS: B LIC.NO.: 672969 EXP: MAIN BUILDING ACCESSORY BUILDING Date: /5- 0 L` ' 9 +7 Gontraaor r= a'7(lo j Nie d it'a_"14" FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,aper,improve, PARKING REQ: P ROV: PARCEL: 4 2 5 3 3 4 0 4 Z NE: REF NO: iemolish,or repair any structure,prior to Rs issuance,So requires the applicant for such permit to file a signed statement that he or she ' licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the • PLANNING NOTES> usiness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant fore permit subjects the applicant to a civil penalty Wrest more than IS hundred dollars[S5001). ###.##.IEiF#.]f##{(..K.*{f.lE•lit#.N•#.If.#.N.•N..1E###################################################### ❑ I.as owner ofthe property or my employees with wages as their sole compensation,will do the work,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work himself or herself or through hS or her own employees,provided that such improvements are nol intended or offered for sale.If, the building or improvement is sold within one year d 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 propend,em exclusively contracting with licensed contractors to construct the project(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 BUILDING APPROVED BY DATE: contracts for such projects with a contrador(e)licensed pursuant to the Contractors License Law): \' - 1^ ❑ I am exempt under Section: B.8 P.C.,for this reason: APPLICATION ISSUED BY: ,�-C�f{ };E DATE: L lidel Date: 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 25534,and that I or any future building occupant will I will not(circle one)need to comply with said state codes and the requirements for . a permit for constructionor modification from the Ak anagement District Residential construpnappimtbro are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING provisions. PERMIT 5. 00 Date: _ Applicant 25% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ' ISSUESSN 00 - oI haw)and wil maintain a certificate of consent to self-insure for workers'compensation.as provided for by Soman 3700 of the Labe FEE 20 .SS Code.for the performanceoftMworkforwlKhthSpermkisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL. PAID DUE ❑ Ihave and v. compensation d 1maintainworkers'compenninsurance,esrequiredbySection3700meLaborCode.fortheped«manceoft» TOTALS-- > 5. 00 20.00 0. 00 25.00 25.00 . 00 work for which this permit is issued.My workers'compensation insurance carrier and policy number are: • Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 25 . 00 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK his section need net be complered y rhe pent is for one hundred dollars/SIOsj or less.) • 25.00 0 I tend'Thal in the performance of the work for which this permit is issued,I shall not employ any person in any manner 03 as lo ' become subject to the workers compensation Taws of California, and agree that it I should become subject to IM workers' ############################################################################### compensation provisions of Section or 3700 of the labCode,I shall forthwith comply with those provisions i - INDIVIDUAL F E E BREAKDOWN Date: /a- o'Sr Q 'S Applicant G 7. 't/CO C, /-4 CL d'r a /VC) Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and TYPE QTY D E S C R I P T . I 0 N UNIT COST TOTAL COST civil fines n ro one hundred thousand dollars($100,000),In addition to the cost of compensation,damages as provided for in • Section 3rosplha LaborCods,Interest,and attorney's fees. PLU 1 VACUUM BRKR/BACKFLOW PROT. 1 TO 4 5. 00 5 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES ' performance of the work for which the pend is issued(Section 3097.CH.C). LENDER'S NAME: , • LENDER'S ADDRESS: I certify that I have mad this application end stale that the above information is correct.I agree to comply with all dry and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the abovementoned property _ for inspection purposes. Cl CARLOS MEDRANO Print Name ,5 7 ; ' r 2 �'/o S H �' Jv Dae: /� O 01 .00196099-00196099 TOT . 25.( Signature of OwnerAgnt/Applipwcntrsdor DATE: 12/08/95 TIME: 10:45 ' (51et-45 WP) White-Building 8 Safely;Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor r -M. ADDRESS atMLmc: 201 E 16TH ST UMT' CITY OF COSTA MESA - BUILDING PERMIT oWNERSNMIEIFIwa"N' SEVERNS MARK MICHAEL PERM NO: B 075513 "DDm49i 201 E 1eTH ST 4 COSTA MESA,CA 92627 PERMIT NO: B 075513 PLAN CHECK NO: N GOVT: N SUPP: N �liAPDL.MUIIIIO ADDRESS: t. CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ARCHITECT ORENGINEER: LK NO: JOB DESCRIPTION : T/OFF 6 REROOF W/BUILT-UP SQ FT: 5, 000 ARCH.OR Nal ADDRESS: Wit CLAIM VALUE: 5, 000 . 00 CALC-VALUE: 5,000 . 00 GROUP OCC: R-1 / CONIRACTM?MWE GOLDEN STAMP CONSTRUCTION ( 213 ) 587-6414 CONTRACTORS MMLDC 3312 GRAND AV COMMENTS: REROOF 3000SF FOURPLEX SMOKE DETECTORS REQUIRED PER 91UBC =mu: HUNTINGTON PARK CA mml: 672969 txtEss * tStSEEStt**w+ *+ *********lr*****ASx*+ * Ex *BE*is* E7C v V VR 90225 11117: Z ONING REQUIREMENT LICENSED CONTRACTORS DECLARATION:I hereby Ulim under pmWy d pemvy that I am licensed under provision cl Chapter 9 S E T B A C K ° � I I RED D LICENSED wth Section 7So0)d Division 3 d the Octans and Professions Code.and my tense b in lay force and.lea. �✓ CITYLIC.NO.: UC,CLASS: B uC.No.: 6729/69 EXP: MAIN BUILDING ACCESSORY B Data: I � S co„,„.. �' 1-l(/p KA 1-5-lied FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 9 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 horn the Contractor,License Law to the following reason(Section Toots Buebeu and Praia/tan Coda:Any city o county whidr requires a permit to aoneruct,alter,improve, PARKING REQ: PROV: PARCEL: 42533404 Z NE: REF NO: she demolish, f ekes,ed pursue n�the pr tore.prior thesCoMtiacm Liscens requires [Chapter S(commsuch s to file 77000ned 0) Diement vision he or the PLANNING NOTES5. sines,and Professions Code]or that he or she is exempt therefrom and the barb for the alleged exempton.My violation of Section > .131.5 by any applicant for a permit tubtede the applicant to adh penalty of not more then the hundred dollars 1550011. **************it**************************************************************** ❑ I,es owner of the property or my employees with wan as the sole compensation.will do the work.and the thillCIUM is not intended D E V E .L OP MEN T SERVICES R E Q U I R E M E N T-. S or offered for sale(Section 701a,Business and Professions Code:The Contractors License Law does not apply to an owner of pronely who bolds or improves thereon.end who dos,such work himself or herself or through his or W her own employees.provided Usuch ' - improvements are not intended or offered or Bale,t,however,the buikling or improvement is sold within one year of completion,the ZONING APPROVED -.BY DATE: • owner builder wit have the burden d proving he or she did not bold or improve for the Purpose Of saa). - - ❑ I,as ower of the property.em excluaveN oouradbg with licensed contractors to construct the mad(Seabn 7044,Business and Professions Code:The Comradoe Liwne Lew does rid apply to an ower d property sero bolds a improves thereon and who BUILDING APPROVED BY : DATE: contracts to such projects with a amrsdorls)lama Pursuant to the Contractors License Law). p� ❑ Iamexempt under Secton: S.AP.C..tor this reason: APPLICATION ISSUED BY: DATE: aa Date: Owner ********************************************** ********************* ***** ** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby candy au 1 am aware or and understand the requirements of CaManis Health and Selly Code Sections 25505,25533,and any2553c.endcatlaMusdilkgompemv.AOlwO nd(droboD)nsed to comply Whsec dtlepodaeendthe npdramWabr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2 Permit and laawdi Mu,.S�mliinhamiMAr�t Ai-We/augment District to Residential wit ad ate core s codes are exempt from Nae provides. PERMIT 72 .00 . 50 Date: Appt'ran: °MIP/NON-RES. WORKER'S COMPENSATION DECLARATION:I hereby drum under peraiy of od perjury at the following dedualbro: PLAN ❑ Ihave end will macen/ldab d consent to self-insure a nsure workers'compensation.asproMed for by Section ion 3700the Lebo ISSUE FEE mantaCode,torthepetoncedmeworktowlWthispermtiebeued. BUILDING-DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE nns ❑ Ihave and w;Emantailworke� pm , antbnbarnance.as moulted bySecion37D3dw mmd tie TOTALS - > 72 . 50 0 .00 0 .00 72 . 50 72 . 50 . 00 work for which this peat is issued.My woken'compensation insurance oder end poky number me: Carder: REVENUE DIVISION TOTALS--> COLLECTED: 72 . 50 OVER/SHORT: .00 Play Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK is section need not be completed IVat pent is b one hundred dollen(SIOO)or Mss) 72 . 00 . 50 -J I cenly that in the pMonance of the work by which this pent Is issued,I shat riot employ any person In any manner so es to become abject to the widen'compensation laws d C.Mode.and agree that it I should become subject to the anon ******************************************************************************* Seanprovisions d Sen 3700 d the Labor Code,I.hall lorthwth comply with prose provisions. IND IVIDUAL F E E BREAKDOWN Date: 11. O 5( 4 S Applicant: C A .71 S Net Q "r1. 7%/a Warning:Failure to secure workers comanssdon coverage Is unlawful,and shall.rt ect an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Ones or to one hundred thousand dollars($104000A M addldon to the cost of compensstMR damppr s as provided tor in Section 370the ro Interest,end SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this perm Is issued(Section 3097,CN.CI. LENDER'S NAME: LENDER'S ADDRESS: I candy that I have read this ealicaticn and dee that the above information is coned.I agree to comply with aft My end county ordinances and state laws relating to building consvuction and hereby authorize npraaentatives of this city to enter upon the abate-mentioned properly for inspection purpoua. C x CARLOS MEDRANO Print Name O� L 1Y )OC / & - ne0--) Date: I � VS pts Jl .i:1- r i• �. Signature d Owner/AgerwAppace tTatrador r A nc I I (5151Je.WP) Whir-Building&Soley;Green-Rb:Canary-Applicant Pink-Revenue:Goldenod-Aesxeor - CONSTRUCTION AND PLANNING POOL - A 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 I,8.Electrical Condutt:Uulity-Undrgrnd. 54. Forms yx4.,pectrical Conduit-1Jiscirgrnd. 55. Electrical Bonding • ;,:5_.5jeel Reinforcemen r 56. Rough Plumbing & Pressure Test ".:-.Ti _. 6 gjectrical UFER:,G,610. 57. APPROVAL TO COVE R-GUNITE m :yp� -- .,-t Footings ,T 58. Electrical Conduit-Undrgrnd. c ,•r C .• 8. Foundation - �1 59. Gas Pipe, 0 Undrgrnd., Test ~n9. Water Pipe•Undrglnd. , 60. Backwash Lines, P-Trap, 0 Undrgrnd. Y0. Structural Floor'System 61. APPROVAL TO DECK r rt. Woperty Sewer pine & House„- onnection 62. Backwash & Receptor•Final 12. Ewer Cap - 63. Heater & Vent-Final 13. Roof Drains .- 64. Plumbing System - Final . 14. Rough Plumbing- -tt 65. Electrical-Final - 15. Rough Electrical-Conduit C•' 66. Solar System-Final ' R G . 16. Rough Electric Viri4 • 67, Fencing & Access Approval . 17. Rough Wiring Stir 68. APPROVED FOR PLASTERING 18. Rough Electrica(y'1' Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heatint& Air Conditioning • • Fjj,1E RPT.tfiEOUI( EMENZ 20. �' ut F tor, Fii:e( ace 14 e- ; S ti ;,y (IAPPROV4Wr;'.- Permit# C - z_ _ . a -->` is n 21. Bina`in i91rttElurin &tX •' " ,�S * -6 , :7-1.4,. ..,* 70. 93nder57tjpd H15dro , 22. Du V�1,til tin " ')l. x r co, t.t t"� '' �1. uy @.• gp;,r * r, E.y: 1 71. Product'fpmg U6as OOil rr 23. G`es wpe-Rough & Test -� :-t._. i :n '7,.... T C 3.- ' 72 .. Underground FZLsh 0 24. oof<Fragjing'" '' r rr s a r- r S• 741 Undergrnd.StoEagg Tank.O Gas 0Bil 25. Roo Sheithing ?1 ` 74;anverhead Hydra 26. I Bar!Ceiling (Structural) & Ikih at K G it-`� bw 7cc. ,pry Cheltitical E+; k U 't:' 27. Frame and Flashing.* _ + .,•� 0^ .. -. r: •77. _ ng.* "c:^ * T n tom* 76. Dry Starlpipe E_rr. i. ... is 2 >-28. Lathing$?Si f1 ni c'' pa''-- tX �' E "�r n• d76�',. "*' t9 x Ca;F• C !* i ' x 7X1 FIXEDS�'ST4Vr171NA6. .-i r � .. .. .2 .o-> t m 29. Insulation • !^r; J S •• k I I ;r 7f FIRE PREY. FJJJ L " ,, a 30. Drywall Nailincj # r, s _ .1 ALTH DEP7.`f4Et5UIREMENT 531. Plaster BrawnCoaw* S r Pi, * t Kr' 79. FINAL IWSPECTiQN >' Ir ^32. pjectricaPrpowe M rFinal % tv k "8t FOOD CERTI%ATE ISSb1ED, er =33. gnah=leric -G- m d . N6tes: M 4 •'. •• yc - r- � MC 0•134. FinaHe4[jng A 'fondtionirt t x : - - CE m r n n 35. �Inal Gas•Fipe.7es2 x o •• k i-I - !4k• D �:� -ill * t r.11 -: c=am. r rr . ..r rt +-f -136. Hood`br canopy r:t D 1 D"= 4: `' I 11 -• n' • z.r 7-37. Finaf.Faciory Fireplace_x - - :, *• _. X38. FinaFr 'lumbing, ;* r " I ti m K ''39. Water Service•-5�indl . . cc • t •r S 1* c-, - • - tr. rn "-40. Gas Service-Final r.:, `a ='r r S x m lit: t Qt. Y • ifir. n:-1-• M r !t: E1 . _ ,_ ' Q X41. Solar Domest&Fi(C4 - W. c •y- i. r 42. Backflow Prevents.' Ba '.1 ay: CrI iHti .* i--I x rr. Cr. . ., z7._' x x .. 43. Backflow Irrir�atloe-t . >, • G -k ,�; . - . • 44. Landscap"e•Ir? atio System cm() x R rn r' =' s c: 'o r � . ! - .,c' a n 711+: r 4. Q Cr <k : S ' C ' . . i 45. $pund At3enuatioa.i - . .. t < 41 ;CI ;: r -: : c.N VdJ• E- 46. Handicap Rego latiTn . •c t- Cr `" E. FN �L STRLITURF & 811LDING t r I rr 48. FNAL PLANNING` - ` r> .• r1 CC C I I- N 49. Electric Release to Etiigon .~ + i ` _�; .,- ' 50. Gas Release to Southern California -Gas Co * f :-.I • r'; C• 51. CERTIFICATE OF OCCUPANCY ' t`' i-' No Date KGKENNETH G. OSBORNE &ASSOCIATES January 23 , 1973 Mr. Keith Hosfiel 435 Redlands Avenue Newport Beach , California 92660 Reference: Soils Testing 201 16th Street Costa Mesa Dear Mr. Hosfiel : As requested, this firm has performed expansion and direct shear tests on soil samples obtained from the property located at 201 16th Street in the City of Costa Mesa, ,California. The samples were taken at a depth of 3 feet below existing grade. The expansion test was performed in accordance with the Orange Empire Chapter of ICBG Soil Expansion Test. The result is as follows : • % Relative % Expansion Test - Compaction 60#/ft 1 90 0. 8 This is generally considered nonexpansive. The results of the direct .shear tests are presented on the attached Direct Shear Summary. These results in- dicate an apparent cohesion of zero and a shear angle of 33 degrees. Based on these parameters and a soil density of 110#/ft3, the following allowable bearing values were calculated for samples remolded to 90 percent of maximum density : 1. q = 1650#/ft2 for 12" deep footing 2. q = 2200#/ft2 for 18" deep foor. ��DING SAFETY DEPT. FEBI 1873 Job No. 73-767-1 - - Page l FOUNDATION ENGINEERING • 1810 E. BALL ROAD • ANAHEIM. CALIF. 92805 • ( 714 ) 635-6220 • 0 KENN! Ili G.OSROR. ..i & ASSOCIATE s Mr. Keith Hosfiel January 23 , 1973 The maximum density was determined in the laboratory in accordance with A.S .T.M. Test Method D-1557-70T modified to use three layers in lieu of five . The direct shear tests were performed on saturated soil samples . The results are based on laboratory testing only and do not represent the result of an extensive subsurface exploration. The opportunity to be of service is truly appreciated. Your questions regarding this matter are always welcome. Respectfully submitted, KENNETH G. OSBORNE & ASSOCIATES Osbjorn Bratene OB:dhd R.C.E. 21873 • Job No. 73-767-1 Page 2 f DIRECT SHEAR SUMMARY 2000 1600 N �O a 7 0 1200 z n a x 800 /6,7 ,o 400 0 0 400 800 1200 1600 2000 NORMAL LOAD, P.S.F. JOB NUMBER 7)- 7674 BORING NUMBER DEPTH MOISTURE SaTU?ATep UNDISTURBED - --• REMOLDED —o—(a 90% MAXIMUM DENSITY Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA SA CONSTRUCTION PERMIT s jI PER NO. TRACT NO. LOT NO. UNIT NO. ectAddress n I E ) l1'h nST /t� 3010/�7 r t • , 2119 3/31 /86 F¢C- TL ' TYPE OF CONSTRUCTION U NEW L I ADD U ALTERATION H REPAIR Applicant's Mailing Address �Q I�>✓ t` _� WWII') Phone ❑ CONVERSION ❑ DEMOLISH ❑ IEnR• A,P-# Zone Owner's Name //�,� \\�7f�� /l/rye a1ESCRIPTION 0 WO 1K/ SE OF BLDG. Q ) n /Ak1 Address QC)I 1 T11 ST V % ..�,� `I.t IIx • S Main Building: Accessory Building: Arch/Eng. License No. TYPE'•F PERMIT NI GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front O Address • /1`� ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam-a S 01 L r , / I 1 Phone s.7 1.��_1:1� ❑ OTHER C Right N o * ' 1 c n�1 / 1 PROJECT DESCRIPTION SQ. FT. - - OCCUPANCY K G Address(mailing) os r% p . Y7esp-PPIQ ) 10f CONST RUCTION TYPE VALUATION$ S Left R City License No. I 'l I ZONE GRADING CU.YDS. ACREST E LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided • I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: f M with section 7000) of Division 3 of the Business and Professions Code,and RECEIVED MAR 2 7 1986 my license is In II f and effect. 4L 33(0 3 T License Class klcen o. $ L O Date /I Afr 7 vIniz.c. PLUMBING FEES 3��yFfU' Signature ( WORK RS'COMPENSATION DEC RATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate `f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink ' X800, Lab. Automatic Washer Transformer 0 15-50 KW P c1>nj,as 4 ZeIn1Th revs' Policy No. Company Backflow Irrigation Sewer Ca - 0 50+KW P 1 Construction Pole Sub. BCertified copy is hereby th the — Ce i ie is filed with the city - 11-i.• Di Bathtubs Sewer Connection Cooking Unit 1 Meter Dug to 100 amps Date .��I j$�1 Applicant �. #11. / --.1/!.a EXEM ION FROM WORKERS'COM f NSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if t'e permit is for one hundred($100) or less). Dishwasher Solar Piping . Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank FanMotors❑0-1 HP 01%.8 Workers' Compensation Laws of California. - - Date Signature Floor Drains Swimming Pool w/Spa F.A.U. 'NOTICE: If,after making this declaration, you should become subject to the Inc-Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors Water Haatar Outlets Lender's Name t� Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories : • Auto-Wash Garbage Disposal ;Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt ctperefrom and the basis for the alleged exemption. Any violation of Section `:5140315 by any applicant for a permit subjects the applicant to a civil ' '1tenalty of not more than five hundred dollars($500). ' --❑ I, as owner of the property or my employees with wages as their sole Reinspection Feb I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - Reinspection Fee 1 $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pletion,the owner will have the burden of proving he/she did not build or Ire- Duct- Under Ground Building Approved By Date' /�//� prove for the purpose of sale). !/ 40 0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the protect (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System D Multiple 0 System Repair/Alteration BUILDING PERMIT $ $MIP $ proof oftheir Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers PLUMBING $ J r.th ISSUANCE $ Date • Owner Heating System& Ducting Registers ' PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that'I have read this application and state that the above 00.100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ , information is correct. I agree to comply with all city and county ordinances and state laws relating to bulldin• construction,and hereby authorize repro PLAN CHECK 50% $ MICROFILM $ 'sentatives o this city to ent upon the above-mentioned property for inspection , e . / - �j/a(jLY MECHANICAL $ _ • TOTAL FEE . $. Signature �. ///t i✓/ - _ • - • ` ._ - CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL PA Date Inspector Date Inspector PPROVALS Permit# APPROVALS Permit# 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduit-Undrgrnd. , 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test -9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ 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 O Gas ❑Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank O Gas C Oil • 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final I i 42. Backflow Preventer •43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date f""rr Ill/Or In: , tle1LR "^ L c cv I.) JOB ADDRESS 201 E. 16th St. BUILDING PERMIT NO. 36322 GENERAL CONTRACTOR Owner Bldr. DESCRIPTION of WORK Demo BPa AP No117=144-20 LOT TRACT FIRE ZONE . VALUE $ 500.00 INSPECTIONS Si•nature Date GROUP TYPE ZONE Flea? PERMITS ISSUED ; SUBCONTRACTOR G, Dote Number Signature WATER Plumbing nA///����' ' ROUGH PLUMBING ez,,,,.. � 0A3 tvh9.c.- PROP. SWR. LINE 0 HOUSE CON. Etr � SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 . ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. 0 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT n ' PLASTER, BROWN COAT . STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PI NG, FINAL AND GAS TEST I-1 ELL_.RIC, FINAL BUILDING, FINAL /� C'7.���-J SPECIAL REQUIREMENTS in-C7--19-717 1 36122 'PR ?6-73-- OO 939 *****5.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely P� ATION FOR BUILDING PERMIT /� `'� `— -- RE EI E BY DA=E4iEC^IV *D DATE _- ISSUED ADDR ESS/��C/J l j UI. • � J !L] (�!1//)1G z* 2 Y i 3 OWNER ( 1 ,e Itk Hosp .,- e- I— A.P.NO. /1/ '��T -� PERMi�� I !'� MAIL \, ADDRESS BUILDING . of E.I �-•-- Z ADDRESS Fr., -. 0 } yL.11n`� I TEL./ (/ [' 1 Q 0 CITY Al tto PrAT "-'e et ck NO. b 7�F J TRACT LOT BLOCK Z C CONSTRUCTION NEW ADD ALTER REPAIR MOVING I- FI 0LENDER o- CO d J 7 BRANCH �c+ ' Y",!/ ` _ _I Cl) OWNS Lz JU0 &FIEL�. Q W ADDRESS.03 ARCHITECT `` .}. ( ATE may/ ,( ['.s, L0NISH tern CO C OR ENGINEER kkJ S 1 e l F�v Pz4.� BP CRNOI. (4)!524IMS LL (TYPE7r1"- VALU$ ,�/s=FIRE W ADDRESS 1 k c aCL 41 I./ ea C/ (4.V V ZONE GROUPW 2 CONTRACTOR 0e,722 )i j97 2/• BYPROVECDATF�^JJ2 -'72 J O Z f/. / CO 2 J gc ADDRESS WW ZONE NO.OF USE OF NEW • ZF CITY NNO.TEL. R_3 PLANS 0 BUILDING W O STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC. NO. LIC. NO. MAIN BUI ING ACCESSORY BUILDING D 0 SIZE 9o(/�X l/�.3o NO.OF BLDGS. (FROM C/LST ET) OF LOT / (� NOW ON LOT FRONT FT. FT. USE OF •�11 EXISTING BLDG. Q S r T e h Ce- GAN C', 4 a-- R.SIDE F . FT, I- SIZE OF !, NO.OF Z NEW BLDG. d 5 b ROOMS STORIES L.SIDE F FT. Q EXTERIOR WALL .y ROOFXj� / Q C-) COVERING S/HCO !COVERING IJ[trLT k r REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 13. d ilp Cinl F) . MAIN BLOCS. ACCESS. BLDGS. Q .{r� � }^, VAR.As DATE O / 4 IA C/ 4:9 C 1 % - C >�- C.U.P.its APPROVED I— / J APPROVED t� f n /r A^' r RY DATF 4.4 UI hereby acknowledge that I have read this application and state g D that the above information is correct and agree to comply with ! tr all laws regulating building construction, and I shall not employ J any person in violation of the workman's compensation laws of _ -` N the State of California. •(W W ZI hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; a CC am exempt from the provisions of the State of California Business , i-s and Professions Code,Division 3,Chapter 9. VALUATION .............PERMIT ��to ,� C/ ERMIT FEE $ Signature of /f/ m Permittee ✓-/� $ 5� PLAN CHECK $ E Authorized Agent TOTAL FEE $��LL `41.1 OWNER HOSFZEL, Keith DATE ..5-18-71 'JOB ADDRESS 201 East 16th Street BUILDING PERMIT NO. 36674 1) GENERAL CONTRACTOR same DESCRIPTION of WORK Block and stucco wall OOP No. 117-144-20 LOT Por 42TRACT Npt. HtstIRE ZONE VALUE E 500.00 IP CTIONS Signature Date GROUP ,T TYPETT ZONE R2 so._ PER MITS ISS ED SUBCONTRACTOR GAS r Date I Numbers Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ I ROUGH WIRING Heating and Vent. TRENCHES El FORMS C] STEEL REINF. o-7/ayn -i'_3_, ,.791 FLOOR SYSTEM BONO BEAM in STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT PLASTER, BROWN COAT STP"CTURAL, FINAL Electric HE 3, VENT., REFRIG. AND A.C., FINAL PLU,.,OING, FINAL AND GAS TEST n ELECTRIC, FINAL auu nluc PIMA! /SIA `r✓i..70 -'73 36674 if-7"�'-"'0211Orr, t, t::.;:5.50 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely r .�t� RECEyD�� DA�FER^C$I DAT�r}6S J BUILDING ✓ / E // '� X_' �/J!!// fj !(/X� ADDRESS p r�j OWNER • . i cc ` A.P. NO. ' I7—,y�— PERMIT Ni�C, MAIL P' C7/ BUILDING �1/�+/ ib'�'4 ADDRESS 6 t'�.y VV n /, f ADDRESS /��L/1 z� 0 Lli W CITY `%�n �Ii0-ctc/V NEOL'� //d J TRACT /COT �3 BLOCK HZ " JA7 Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH O-N LENDER `a. co /X/\' J /��� BRANCH / tb J y OWNER t - m J ADDRESS VALUE ARCHITECT TEL. USE $ J QOR ENGINEER NO 0 U FIRE WQ Q ADDRESS ZONE TYPROUP IL W APPROVED W Z CONTRACTOR APPROVED BY DATE J Cp CO Z J p• _ ADDRESS .r LO LLI W TEL. ZONE NO.OF USE OF NEW C([ Z Hr CITY NO. BWALL PLANS BUILDING Z Cl STATE CITY YARDS APPROVED YARDS APPROVED LU co CC LIC. NO. LIC.NO. MAIN BUILDING ACCESS() Y BUILDING / NO.OF BLOGS. (FROM C/L STREET) '�1f O OFSIZE LOT �Y X 7/ tp NOW ON LOT FRONT FT. /) I/, Ejli USE OF /�� ///� EXISTING BLDG. R SIDE 0 FT. killFT. H SIZE OF ` / �1,.''�N O.OF V /� Z NEW BLDG. Iry V 6�A�`ROOMS STORIES.� L.SIDE ��� �/" FT. U EXTERIOR /LLgT I ROOF T e • COVERING �1�tawi`—o ,COVERING f+uh_\ REAR FT. FT. USE OF BUILDIIsJ A v FOR ED DISTANCE BET. BET.MAIN& d 6. eV t MAIN BLDG—Sr . ' ACCESS. BLOCS. (] 61-0CM ti-)Ps-GC4D CU.P# �%�7J'4 ' APPROVED I— 7L' APPROVED j �/� L Z 5( !-f C CO RY W LJ DATE S-(r'Y-7 3 O V I hereby acknowledge that I have read this application and state ` 6-6 D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ H any person in violation of the workman's compensation laws of the State of California. ea H z b SOFTI hereby certify that I am properly licensed as a contractor under . . 0 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: rc am exempt from d e provisions of the State of California Business _q/ and Professions Coue Division 3,Chap er 9. VALUATION // PERMIT FEE $ ��_ N �/ N Signature of / / j 0 Permittee �TIJ-`�"�t`"•/\` , $ D PLAN CHECK $ E — `o Authorized Agent u TOTAL FEE $ I. P 3571 - AID 169.50 -71 7_- 00 91:0 .** COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 P C ION FOR BUILDING PERMIT For Applicant to Fill in Completely RE D DATE RECEIVED DA E I UEDr BUILDING t1 - ADDRESS 4 �� �� Pert / / A.P.NO. OWNER r'... /77./ 14.°.57 BUILDING 2 n I 454 �"� MAIL ADDRESS //v J r Z ADDRESS W W TEL G. TRACT I LOT BLOCK ( Z CITY NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVINf OFMDI ISH OI— LENDER Ci. CO cn • • J O BRANCH I'[=11 1 44s .J N OWNER mJ ADDRESS JJ ,ty/ r.Ie VALUE J CO ARCHITECT TEL. USE A. ?Lel. 4r-G S < OR ENGINEER NO. �/y Z Q ZONEFIRE TYPE rls� GROUP T w W ADDRESSQ{ 3M V APPROVE m z1� � /J 2 /1_13 W Z CONTRACTOR BY �/V DATEZ. Lb JO m Z J¢ ADDRESS W W TEL. ZONE NO.OF USE OF NEW o t CITY NO.EPLANS BUILDING Z l— WO STATE CITY YARDS APPROVED YARDS APPROVED (/)CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING J O (FROM CAL STREET) SIZE I NO.OF BLOCS. OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDF FT. FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. • ✓ EXTERIOR WALL ROOF COVERING I COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 MAIN BLOCS. ACCESS.BLDGS. 0 / i" c.Ex UU r-rr-4 c -Afe. e LkUNOKY VAR.* DATE APPROVED I— APPROVED U) --BY DATE Z \ _ ) /� O � /il/FJ UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with cr all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of M the State of California. ,�[,/'�^��. �y�-I� m I hereby certify that I am properly licensed as a contractor under �� "L./"O• FT. (►`L PIS�� � O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FO s Chapter 9. end that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business 2 end Professions Code,Division 3,Chapter 9. VALUATION j F ' m PERMIT FEE $ 1 14 D Signature ofm Permittee __ _ $ --_ PLAN CHECK $ C E 7j O Authorized Agent %� n TOTAL FEE $ fig 11=1 . IIIIIIM i Costa Mesa Building Department APPLICATION FOR PERMIT P. 327G / BUILDING ,-- i '� COSTA MESAESA,, CALIFORNIACI FOR APPLICANT TO FILL IN / FOR OFFICE USE ONLY Receipt No. I Permit No. Building dP [/ r Address?Ad/- P. — i&r r s lift �� Tit Costa Mesa, California Received by Date Reed. Date Issued Nearest �� D V/` ars--S+',f4 �o��/ C G Cross St. el PeV �y.. 0•40-1,_ t Building e (� fel Address Owner 4.{ ,��y� l �.+1 Mail pp �����,�� 2,4% Costa Mesa, California Address/ etb--S --*.rowel Nearest '; 00 Tel. a Cross St. Archil 3S�� Q No./t,�WTr1r Zone No.of Type Group Architect or Lic. /•C� I Plans Engineer No. Approved by Date Address (�, (�ffff/t'-!!!!��(QQQp����j�•�$$$$g'�� TT�NNN7 Contractor Q O&M City Lic. [ >•• a t � No. illi Vp/ Address 0 I ir9 / - CITY OF COSTA MESA DescriptionLeI No. 421 I /B�lo�ck I meetAO 'l PI ANNINC DEPT. (Attach Metes and Bounds)d/s/// - 7'j 17 • 8 V r r � / No.of Size of Lot . q$, l04��b Now on Lot D Exi of ^ �o.p(�1� I No.cfFamil / I Ro.m / -_� ,• 1 el e a Existing Bld 0/t Families Room ^-^^�^/� r'V Setback Line m2 / Rear Yard �O�7L 2 Center of Street � Side Yard 3 hY 3�f r+ 't,a\` 01_,,,,, D DESCRIPTION OF WORK _, r New I I Alteration I I Addition I Repair I I Moving I y{• I Demolish I _ Building >>ct No.of Size 1 U )a-'b Rooms Stories • TT Exterior Wa Roof — �'�/ '� nP �"_ Covering ,�jD Qltpl, I Covering , • APPROVALS 'C Use of New a ' ���'' "� Building ,J -721,7,4._(.....• Foundation Location Inspector Date ,l Forms,Materials, �jl //.IJA w e >; ia_./scat ander-Pinning A/"' -" - —"'•�'� Frame: Fire Stops, ..� Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Int. with all City Ordinances and State Laws regulating building const ction. Lath.Ext. Permitteeo -7 / Permittee �(�rl/1 /P 7$274...LG,n Plaster, Int • Authorized gt Plaster,Ext valuation Permit Fee $ a -- • Masonry Reinforced J O Plan Check$ Bond Beam $ O' O Total / Fee $ 4 FINAL FORM 204 10.55 0.P.6 5. 0 u J c . ' J 6 a a. a • ,,,, p t 1 75-SSI f�cosES:as 735 s"'i•'^Z PQ t • • • • Street PLOT PLAN Show location and distances from property line and between buildings. R. I. PAID,,,, C r y 3578.5 rC 111-79x:,. > ic UO 461* ** 9..02 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • PP IC TION FOR BUILDING PERMIT For Applicant to Fill in Completely BUILDING '�(/EX/ /� RE El E V DAT•-• -17 DATEISSUED4- ADDRESS 6 I/� 14/' MC//J �'f]' Sl � I '�7 v / PERM NO/ OWNER j a CJI slII,,-�+�{� /,// A.P.NO. I I7-�J I I /4/J,-a-C2[�.�r MAIL / c /I .tiEtr _ Q /�CF It [`r S (�'I U 2- ADIDRESS !W/�/!!/ v/ ADDRESS sC^rL� W W �/y���� SLI TEL. // .y TRACTI � eel- L. i{�j BLOCK 0 U CITY A10 ._ :: I0n.cl f_1L2L(�s I NO. 6 /fes r2/Sr Z Z Q CONSTRUCTION l -y EW ADD, ALTER REPAIR MOVING DEMOI ISH ][\/1 O cn LENDER a CO 4 Cy J D BRANCH �j[� C/ J co - - _ OWN �R E{roS-FI^•^ ADDRESS 1{'I� -,-t- (�iCt �` m< ARCHITECT W S� go. 7 �S -94 USE "� w/A' 1 eAR-i l LUN$ `� ODS N OR ENGINEER/8 J P Y I_�Iti CI /IC '�On. /n(9L?lFi( -7— LAIZ Q ,,r� 5 r // thy,4' ZONE TY•E�/ GROUP Z 2 ADDRESS -�l PP "ter V 0- wAPPROVED W Z CONTRACTOR , . •� 4G/` BY / DATE, -' J o — CDZ J ce ADDRESS LU lL ZONE seal NO.OF USE OF PLANS a. BUILDING NEW, Pc.s. = TEL. CITY NO. Z F - 'APPRVE Get Gam"' W O STATE CITY YARDS VED YARDS APPROVED D to� LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILD( G D O (FROM C/L STREET) SIZELOT gA./,r o I NO.NOW OFON BLLOT DGS. OF FROM 50 FT. FT. USE OF —2 EXISTING BLDG. yjttp��,� /� R.SIDE FT. F. . F SIZE OF NO. 2 NEW BLDG. OMS STORIES L.SIDE iO FT. F /(�/6 Q EXTERIOR WALL.rr ROOF •'}J U COVERING .ILKi.-C-o COVERING//'/p �y f'e REAR JNJ FT. FT. - J USE OF B ILDING/A/ND WORK TO BE P.ERFO FORME DISTANCE DISTANCE BET. BET AIN& a y P. '1 ,,,rr,•.�.4 �q // rprMAIN BLOCS. ' Aw E . BLDGS. ( ,// VAR.# a D•TE �,�t'-'! '� O /I ^ ` C.U.P.# eF��/-y,17 A•TREovED It1Y 'a `—v� APPROVED . !✓ �IZ- F AA 0 ! /. - Z 4111:yealK U/U//Y Y ��1.1 DAT /L~.1I hereby acknowledge that I have reis application and st ��D that the above information is correcd agree to comply with CC all laws regulating building construction, and I shall not employ F„ any person in violation of the workman's compensation laws of N the State of California. // � b zI hereby certify that I am properly licensed as a contractor under T SQ.FT. o the State of California Business and Professions Code, Division 3, ,THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: d CC am exempt from the provisions of the State of California Business and Professions Code, ivision 3,Chant 9. VALUATION m �e PERMIT FEE $ j Signature o �v C/ij, �//fie 7 m Permittee /-W� $‘ / 7" PLAN CHECK $ 1 r E ` o a u. Authorized Agent or'TOTAL FEE $