HomeMy WebLinkAbout248 20TH ST - Building Permits PROJECT ADDRESS: 248 E 20TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 070556 \ 1
OWNER'S NAME: MILLER ROBERT L
ADDRESS: 1777 WHITTIER AVE PERMIT NO: P 070556 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
546-6985
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; C/O DISHWASHER SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: /
PERMITTEE: PACIFIC COAST APPL INSTAL ( 310 ) 324-8476
ADDRESS: 139 WEST VICTORIA ST COMMENTS; X
GARDENA CA 90248 ********4******************************************sr**********err***************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ON ING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY LI 060311 STATE LIC.:362642 c •:5:C EXP; 09/95
dl 6� / �� MAIN BUILDING ACCESSORY BUILDING
%7y signature: _ �� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
Err KERS'COMPENSATION DECLARATION: I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
ompensation gm tbc2 s 8oprtel 01 thereof(Section 3800.Lab,6)8/01 /95
POLICY NO EXP.DATE:
' COMPANY:
EAGLE PARKING REQ• PROV; PARCEL: 42620118 ZNE: REF NO;
,,yy PLANNING N TES>
t edified copy is hereby furnished. L1 Certified copy is fled with a city Building/Di r >
iiii
/ Date: a/ 9 Applicant: DEVELOPMENT SERV IC E Sr, REQUIREMENTS
E' MPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($110)or less).
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become ZONING APPROVED BY
subject to the Workers'Compensation Laws of California. , • DATE:
Date: Signature: BUILDING APPROVED BY
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 1 r-",
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; ' " DATE:
which this permit is issued(Section 3097,Civ.C). *************'*'*'********'******'****'*'**'**'******'**'***'************'***'*'******'*****'***'
*******************************************************************************
ADDDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7,00
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25% . SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ,
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 20 . 00
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 7. 00 20 , 00 •
0 . 00 27. 00 27 . 00 . 00
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State 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 employees,provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED; 27, 00 OVER/SHORT; , 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sale). 27. 00
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who buddy or improves thereon *******,**,***********.******.***,µ*********, **,*********,****,***,*,**,**,**,****,*,*******,**,
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL "F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C. i-
for this reason: TYPE QTY DESCRIPTION— UNIT COST TOTAL COST
Date: owner: PLU 1 DISHWASHER 7.00 7 .00
I do hereby certify that I am aware of and understand the requirements of California,Health and Safety Code Sections 25505,25533,and END)OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a \ ,
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from , \\.//
these provisions.
Date: Applicant' 01 00174202-00174202 TOT 27,010
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county •
GATE: t2/29/94 Tiff: 07:22
ordinances and state laws relating to building construction and hereby authorize reprentative . this ity to enter upon the above-mentioned i,
• 'for inspection purposes.p ;.��,J�
Date.
1•1�l9 Signature: 6 � / -
Driver's License or Social Security#: _ _ .
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING : POOL LPA
APPROVALS Permit# •� Date Inspector APPROVALS Permit# Date Inspect/or
1. Temporary Electrical Serene or Paler"1 52. Pool & Equipment Location
2. Soil Pipe•Undrjgrnd. - -.'' 53. Steel Reinforcement
Th
,i�32.-_g)ect ical Condluit;
PROJECT ADDRESS: UNIT: •"
OWNER'S NAME: 248 E 20TH ST CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B' 048441
ADDRESS:SNAMEMILLER
SAME PERMIT NO: B 048441 PLAN CHECK NO: N GOVT: N SUPP : N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; OTH
i 631-2931
ARCM. INFER: REG.NO.: JOB DESCRIPTION : REROOF 1600SF RESID W/CLASS A FIB . SHIN SQ FT: 1 , 900
ADDRESS: UNIT:
1* CLAIM VALUE: 1 , 900 . 00 CALC—VALUE: 1 , 900 .00 GROUP OCC: R-3 /
PERMITTEE: CUSTOM ROOFING ( 714 ) 981-2345 _
ADDRESS: 994 BUFFINGTON A COMMENTS: X c1'
UPLAND CA 91786 **********************************************************.a *trent#a 1'-i
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N 'G REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,an. my license is in full force and effect. SETBACKS REQUIRED
O
CITY UC.:05 1 7 STATE uc.:4 7 6 2 7 cuss: 3.�
Date: G f sionatu .e,sr clic / MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I her : irm that I have acertificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT : FT IN REAR: FT IN
Compensation Insurance,or a certified copy there. •• tion 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT : FT IN
POLICY NO.: EMP.DATE:
COMPANY: PARKING 7REQ: PROV: PARCEL: 42620118 ZNE: REF NO:
• Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES>
> . ,
uate: Applicant: *******************************************************************************
EMEMPRON FROM WORMERS'COMPENSATION DECLARATION: (This section need not be completed if The permit is for one hundred(51 W)or less). DEVEL OP MEN T SERVICES REQUIR EMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person' any manner so as to beer e
subject to the rke Compensation Laws of California. ZONING APPROVED BY ''�
�� DATE:
Gate: �0 /Signature: �.-s- /
NOTICE:I�maldng this dedaratiod,you s•: become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE:
Code,you must forthwith comply with such : ns or this permit shall be deemed revoked. _
CONSTRUCTION LENDING AGENCY: I hereby a m that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY. DATE: -[-�^1
which this permit is issued(Section 3097,Civ.C). ************************************************** ****************** ** ** :*
LENDER: ********************************************************W**********************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 43 . 00 5j 0
repair any structure,prior to its issuance,also requires the applicant for such permit to fife a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Businessie.__ SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE '
I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ tructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—--—> 43 . 50 0 . 0 0 ' 0 . 00 43 . 50 43 . 50 . 00
does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through
his or her own employees. provided that such improvements are not intended or offered for sale.If,however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 43 . 50 OVER/SHORT: .00
, forme purposeofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 43 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts far such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL, FEE B RE AK DOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY D E S C R I P T I O, N UNIT COST TOTAL COST
Date: • Owner: SFR 1900 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 1 , 900 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from /!
•
these provisions. P• i
Date: Applicant: •
1
d.
I hereby certifyand that I have Latin this ingtion and tion that the above auth zeinformationnsis ties of agree to complyterwith all cityv and county �.
ordinances and state laws relating to building construction and h .q,authodze representatives of this city to enter upon[heabove-mentioned 4
property for inspection purposes. /7 /I J'
Gate: i�'f'/�` `Sign. . :: / •`/ ' .moi!/ >—
01 00066907-00066908 TOT 43,50
Driver's License or Social Security A: DATE: 08/06/90 TINE: 08:50
1641-46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL •PA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
• 1. Tenldary 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 Reinforceinent 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings .- 58. Electrical Conduit-Undrgrnd. . •
' 8. Foundation - , . 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System I 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 Conditionings r * ti r. r .,FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace _•_L r.4.1 c , APPROVALS•i- .-Permit #
21. Ducts, in,Structure` * - 70. Undergr'ound`Hydro
22. Ducts, Ventilating •^ - _ .J i It -71. Product-Biping OGes 0 Oil
23. Gas Pipe.Rough & Test _ _ - * 'r ,j-' • 72. Underground Flush- a ',' '
24. Roof Framing - -! j „ 73.-Undergrnd.Storage`Tank 0 Gas 0 Oil
25. Roof Sheathing -, C C:o• t 74. Overhead Hydro
26.'T-Bas.Ceiling (Structural) & Monocoat .: . ie. 75.::Dry Chemical .`i
27. Frame and Flashing -T - . . : 76. Dry Standpipe T ,. ~~
28. Lathing & Siding , _;� • } 7 •• t• 77.-.FIXED SYSTEM F.INAL4
29. Insulation a -i a r i a 78.tFIRE PR EV. FINAL r. " ' -
30. Drywall Nailing , -a t HEALTH,,DEPT.;REQUIREMENT
31. Plaster Brown Coat _ - ^' 79. FINAL INSPECTION ' - -~
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
^
33. Final Electric- _ ' Notes: to 2,605,....-,,, j, e `el: a
34. Final'Heating & Air Conditioning ' - .y ' • _ -'
/,
•
35. Final Gas Pipe-Test ' .r
..
36. Hood or Canopy . - - ._
1 .5
37. Final Factory Fireplace - _ -
.. s Y � _. _
38. Final Plumbing ' - -
39. Water Service-Final
140. Gas Servide-Final
41. Solar Domestic-Final ,- - ^ - - '
42. Backf low Preventer - '
43. Backflow Irrigation • -,..• - ' _ -_ -
44. Landscape IrrigationSystem - - _ 1...- ,t . _ _
45. Sound Attenuation • •- -• - - •
�4t6.. Handicap Regulations - -
/4y FINAL STRUCTURE & BUILDING 8- d btcj�. . - .-
48. FINAL PLANNING
49. Electric Release to Edison - . , •
•
50. Gas Release,to Southern California Gas Co -�
51. CERTIFICATE OF OCCUPANCY
No. _ Date
PROJECT ADDRESS: 248 E 20TH ST UNIT: GARAG CITY OF COSTA MESA — BUILDING PERMITPERM NO; 'B, 048442
OWNER'S NAME: MILLER
ADDRESS: SAME PERMIT NO: B 048442 PLAN CHECK NO: NL
GOVT: SUPP: N
•
R CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
631-2931
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; REROOF 500SF GARAGE W/CLASS A FIB . SHIN SQ FT: 700
' AODRESS: UNIT:
CLAIM VALUE: 700 . 00 CALC—VALUE: 700 , 00 GROUP OCC : M-1 /
PERMITTEE: CUSTOM ROOFING ( 714 ) 981-2345
ADDRESS: 994 BUFFINGTON A COMMENTS : X
UPLAND CA 91786 **ar+karryr+H*******er r*er*******x***** yP******+e**************err*************ar*yr*er**et
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS
7000)of Division 3 at the Business and Professions Code,and my license is In full force and effect. SETBACKS
CITY uc.: 07.1?7 STATE 1.1T47627 CLASS: 9
•
Date: 8V Signator, %6' • +:" MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I her.y a,rm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance,or a certified copy there. ction 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• PROV: PARCEL ; 42620118 ZNE: REF NO:
'7 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES>
>
•
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(SI®)o less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become ,•
subject to the Workers'Compensation La of California. - ZONING APPROVED BY DATE:
Date: �ti O ( Signature: ..famr-t'� Iii—
NOTICE:If,atter making this declaration,you s ecome subject to the Workers'Compe :tion provisions of the Labor BUILDING APPROVED BY , DATE:
Code,you must forthwith comply with such pro s or this permit shall be deemed revoked.CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; DATE: y`Q'�
which this permit is issued(Section 3097,Civ.C). *.**************************.*******.N.**** *ii. ************.**ie*i(•ie*******ft**, *,IF* , ,*
UNDER: *******************************************************************.************
ADDRESS: LEGALIZATION;N F E. E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031,5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 19 . 00 5 0
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NONN—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 19 . 50 0 .00 0 . 00 19 . 50 19 . 50 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 19 . 50 OVER/SHORT: . 00
provement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
forthepurpose ofsale).
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 1 9 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon •
and who contracts for such projects ryth a contractors)license pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensthon insurance should be provided to me, INDIVIDUAL FEE BREAKDOWN
❑ I am exempt under Section: B.X P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 700 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 700 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,2%11,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a '
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. 01 00066910-00066910 TOT .50
Date: Applicant: , DATE: 08/06/90 TIIIE: 08:51
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and h by authorize representatives of this city to enter upon the above-mentioned 01 00066909-00066909 TGT 19.00
property for inspection purposes.
�e /Jg DATE: 08/06/90 TIME: 08:51
Date: �J/4af'gI� Signator
Driver's License or Social Security it:
1641-46 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL SPA
APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector
<'
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4: Electrical Conduit-Uhdrgrnd. 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, O 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 ElectricWiring 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 77 _ -FIRE DEPT. REQUIREMENT-
• r, •
20. Rough Factory Fireplace •-,• 4 - .APPROVALS- Permit#
21. Ducts, in Structure : •' - i 1 S . 70. Underground Hydro
•
22._Ducts, Ventilating - c71. Product_Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test - _ „ ,72. Undergrourid Flush '
24. 'Roof Framing - 73.' Undergrnd.Storage Tank O Gas 0 Oil
25. Roof Sheathing - , 74.. Overhead Hydro °
26.•T-Bar Ceiling (Structural) & Monocoat75. "Dry Chemical - _
27.-Frame and Flashing , •' ' r 76. Dry Standpipe -'
28. Lathing& Siding • _ - . 77. FIXED SYSTEMJFINAL^ '
29. Insulation - . -• ' '' 78. FIRE PREY. FINAL '
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
•31. Plaster Brown Coat - • - t .`79. FINAL INSPECTION
X
32. Electrical Power MeterFinal 4 - • 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 - - -'
42. Backflow Preventer - -
43. Backflow Irrigation
44. Landscape Irrigation System '
45. Sound Attenuation - - • - '
46 Handicap Regulations - ' •
Lg9lFINAL STRUCTURE & BUILDING &"moo l
48. FINAL PLANNING ,
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co • - . .. ..
'51. CERTIFICATE OF OCCUPANCY
No. Date
J! ___-- - - % Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
-CITY OF COSTA MESA ICONSTRUC�TIION PERMIT PERfy�T NO TRACT NO. LOT NO. UNIT NO.
Project Address 24 '/LH/
E• 40 4.5 • C ill
aCJ ( �n` I •
�.y
Applicant's Mailing Address L /le E. Ro l i ya Qre�{f_Ar LA TYPE OF CONSTRUCTION U NEW Li ADD a ALTERATION H REPAIR 1 - e .v 'r 4.
n^ � A� p�.,.v 3'J
El CONVERSION ❑ DEMOLISH
Owner's Name 1T moor /�Phone-F`�� 3434 OTHER A.P.# - �J�. I Zone
DESCRIPTION OF WORKLUSE OF LPG.
Address Da Aiva E.- e-ri ' 9a..toteg S Main Suildi . ` �Q(., Ac es ry Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ G APING UN ATION C STRUCTURAL T Front \il
iO O1 �,�` Zp
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B /s n N
Address A Rear C� I
Contractor's Name �•. ((77 O/. +^ Phone '',''/,/ ❑ OTHER 1.pr`�-! ' • L�ltrug /NC /� .-. NOW C Right �S1P1/4
� N
e Address(mailing) 'us ut_y-p� 2e �J _S1g' PROJECT DESCRIPTION 5Q. FT. OCCUPANCY K " Q`• Ca G
.rte _ <53LCV 3 CONSTRUCTION TYPE VALUATION$ _. $ Left `s1�
City License No. ZONE -_ GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: M
Q
7 with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. T
License Class!•
_ _�� 'Cense No -. ,
S.
O Date ' !S Signature�i/! 4(. - - t PLUMBING FEES k .
\ WORK RS COMPENSATION DECLARATION Bar Sink Showers •
I hereby affirm that I have a certificate of consent to self-1 re or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certifie co• thereof (Section
800, Lab. Backflow Preventer Service Sink
Automatic Washer Transformer 0 15.50 KW
,'olicy No Company �� �� - J� Backflow Irrigation Sewer CapConstructior Pole Sub. 0 50+KW
iiCertified copy is hereby furnished.
Certified copy is filed with the city BuildingI on/^/ D Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant [ 1 I�7 -
EXEMPTION FROM WORKERS'COMPENSATION DEC LAR ATI N Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the 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,1
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan - Motors 00-1 HP 011/2-8
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 018-15+
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 1 Gas Service -Outlets Water Closet 42- �O 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 Civ. C.)
Interceptors Water Heater Outlets Range
Name
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 -
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal 'Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap
any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW❑5.15 KW 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 -
therefrom and the basis for the alleged exemption. Any violation of Section • - •
031.5 by any applicant for a permit subjects the applicant to a civil
malty of not more than five hundred dollars($500). • -
J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not Intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Secion 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 ownDEVELOPMENT 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 corn- - Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground __ Building Approved By Date
prove for the purpose of sale). _ Leib(
U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By � ', Datp if 7
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their 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.Blt. ICBG# PLUMBING $ -00 ISSUANCE CE $
Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-1 00,000 BTU 0100,000 BTL ELECTRICAL $ GRADING S
information is correct. I agree to comply with all city and county ordinances -
and state laws relating to building construction, and reby authorize repre- PLAN CHECK 50% MICROFILM S
sentatives of this cit to enter up•n the above- •P. tioned property for $ i
Inspection pun..- / ✓ >� g MECHANICAL $ S •�0
Signature i ..�._ —�/ at ,'` Date3 -7- 7� - TOTAL FEE $
Drivers' Licenr 55 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
'
CMF 0865-46,rev.4/84 Whit- - -Accounting;Goldenrod -Assessor
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 _ -
3. Electrical Conduit Utility-Undrgrnd. 54. Forms . . . '
4. Electrical Conduit-Undrgrnd. 55: Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Jest
•
6. Electrical UFER Grrid: 57. APPROVAL TO COVER-GUNITE
7. Footings 58. 'Electrical Conduit-Undrgrnd.
8.,Foundation 59. Gas Pipe, 0 Undrgrnd.,Test -
9., Water Pipe-Undrgrnd' 60. Backwash Lines, P-Trap, 0 Undrgrnd. is
• 10.;Strudtural 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 po 71. Product Piping 0 Gas 0 Oil
•
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil -
-
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing _ � ' 76. Dry Standpipe
28. Lathing& Siding - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION •
32. Electrical Power 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 d1�7r
t�,l�a 3/8/�r -id
41. Solar Domestic-Final
42. Backflow Preveriter
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 .
OWNER MC MUR'PRY; H. E. DATE 10-2—'58 _
JOB ADDRESS 2Dti E. 20th Street BUILDING PERMIT NO. 7869 ...-
GENERAL
GENERAL CONTRACTOR Platt VALUE $ q,}.181 .00
lliA -12 LOT 213 TRACT FIRE ZONE DESCRIPTION OF WORK Family Fm.
GROUP I TYPE V ZONE fat PLAN NO.
PERMITS ISSUED
li .SECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Trenches Forms Steel 9.---,E.--b2 /O 4-2)-"s
Floor System
Steel Reinforce Chimney Re-Rod y �r
Bond Beam g/t //-S -,yD ,. -Ki7
Frame and Flashing F/// a //Sn
Lathing, In, OutS. ////n/n"
Plaster, browd coat id AI- /k ti,</,c-L
Underground soil W(6 Pipe Tee) W/(J•jft St
Top Out ,s0 . t ogsr. /6-2y-5"g /G Z9 / ,---
Furnace
Furnace Lu///—&-qc'$c, C0A3r" /0-27- Y /G Z 9 / "'-
Gas emerR .ti-k'. A-1-1' ( /E—+=-cam- G
Rough Plumbin "
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final -, 4 0' J 2,-(y,y1
Ply-:ping Fixtures, Final Ii// /cW f 9i/12't17
fTi `t�S (i' L.,dY' t � 011:
y� .-:Gas Test !
eatifrnction Pole
Underground Power
Rough Wiring /t0 5L'1 //„(,e./ .T,Oo - 0 - ‘d ;''r P 1/-S- re? 7-,__I Za 024--
Fixtures, Final .or}- t it'�y!(�', l
OCCUPANCY a .[SY'.13.h I
Form 210-5M-1-57
7Rhe
022 SE11)yES.0-338E Qatrtr24.00
7869 Olt
COSTA MESA BUILDING DEPARTMEN S•
P.O. BOX 3I7 11
COSTA MESA. CALIFORNIA filO _,vt
FOR APPLICANT TO FILL IN �•APP�LICATION FOR PERMIT
DREI552y8 �c 2 a marl. sr. BUILDING
AD
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
,y �� c'H URT `� RECEIPT NO. PEgyAIT6N7
OWNER•-/ aYfY/iS , _ ( OJ YY/
MAIL n T's.r n
RECEIVEDAS,pBY// DATE�RIECEIVE!D(� DaT/Ey�SSUFp�/
ADDRESS _24,gw b 2a ! !T J 7 �" !' y/ /O-O2j r6i `.'t ..),
CITY COSTA �LCS A TEL.NO. L/ br a 1//' ADDRESS fit
z 0 ��
ARCHITECT LIC.
OR ENC INEER/31-/-
wR',t�/J//YCC7 /N/O. COSTA MESA. CALIFORNIA
ADDn_.S /�%JJ� c/I /vL �L./Y ORT /J L UO FIRE ZONE
3
O/CONTRACTYI(O L P�^ G TYA NO. [�J�/p/� 20NE if PLOANS _/ '/TYPE GROUP,/
ADDRESS.2S/J S/L-"l/1,4 v/STA} NO. L// S.p>S BYPROVED�(Sll /SMI// 4ZATE (CS Z�
LEGA`• [ CORRECTIONS _ 'I
DESCRIPTION NO. i al100-1 ,
BLOCK -*,16.14 A
A.P. NO. /le__. �/ [/ -� �2- /!� M
SIZE l lUl l� /\� , 'VI ...F BLOGS./ I00...„• APP OV D
OF LOT ll( 00 IOw ON LOT
USE D F )12-0..c'..,
<, /j cry Y CI' S'I'A h9 tSF1
EXISTING BLDG. .vim'-..-c¢ _ it gill I`.y DEpT
CENTER r NST EROI" // � .5'I
']II''' SUBJECT TO LOG. DEPT. REG.
CENTEP OF STREET (�(�� / /pXRE/qR YARD /
SIDE YARD RIGHT /i'l� LEFT' // 7 ' / O _/\ I
DESCRIPTION OF WORK 9Y - DwTF 1 //-�J U .
PLAN The
NEW / ALTERATION ADDITION
REPA,.. MOVING DEMOLISH
BUILDING ^ / .1" l/ NO.OF
SIZE LZ Si x 1d 'ROOMS / STORIES /
EXTERIOR WALL , ROOF
COVERING 5/Lt e O COVERING C041P0.
USE OF NEW y // e ae .�_
BUILDING /k .jci4-..� 4_. cce ./`W..._.
/
,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. VALUATION //
SIGNATURE OF � " PERMIT FEE rD �N
PER MiTTEE " p 1
' (J 1J/ _ PLAN CHECK 3 O
S O O
AUTHORIZED AGENT / TOTAL FEE S a V- VOM!