HomeMy WebLinkAbout743 20TH ST - Building PermitsApplicant to fi�l in all spaces except t�ose within heavy Cortler lines antl sign all apOroOriate tleclaretions.
CITY OF COSTA MESA CONS �R UCTION YCERMII P RMI TflACT NO. LOT NO. UNIT NO.
�Project Address � � � w L� N >T , �. M . _
Applicant's Mailing Address �� �1t� � '
Owner's Name �� «CR L�'�'� Phone �a���'LJ
Address "�iK i. Lt3 2 D� ST �M '
Arch/Eng. ���% �License No.
Address
Contractor's Nam Phone
Address (mailing)
Ciry License No.
IICENSED CONTRACTOR DECLARATION
I hereby at�irm that 1 am licensetl untle� provizlon5 of Charte�.9 (commencin9
with section ]000) oi Division 3 of the Business antl Professions Cotle, antl
my license is in tuil force antl ef(ect.
License Class License No.
Date Si9nature
. `"'O,RKERS' COMPENSATION DECLARATION �
reby affirm that I have a ce�tificate of consent to self-insu�e o� a ce�U(Icat¢
Norkers' Compenzation Insurance, or a certifietl copy thereof (Sectlon
�tl00, Lab. C.)
Policy No. Company
eCertifietl caOY is hereby tumi5hetl.
Certifietl copy is filea with the city Builtling Division.
Dafe APPlicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be com0�etetl if the permit i5 /or one huntl�etl ($100) or
less).
1 tertify tha[ in [M1e Oerto�mance ot the wo�l for which t� e�m�t is ISSu¢tl I
shall not employ any person in any mann so as o e subjec[ to t{�e
Workers'� m nsation Laws ot Calitorni .
Date � �gnature
NOTIC If, fte� making this tlecla�ation, yoi 1 oultl bewme subj¢ct to the
Workers' Compensation provisions o( the Labor Cotle, you must forthwith
comply with such provisions or thiz permlt sha11 be tleemetl revoketl.
CONSTRUCTION �ENDING AGENCV
I hereby affirm Mat there is a construction lentlin9 aqency for the performance
of tne work for which this permit is issuetl (Section 3097 pv. CJ
LPntler'S Name
Lentler's Atltlress
OWNERBUILDER DECLARATION
I hereby affi�m ihat I am exempt from the Contrdcto�'s License Law fo� the
following reason (Section 7031.5 Business antl Protessional Cotle: Any cily or
county whiGh requires a permit to construGt, alter, improve, tlemolish or repair
any struc[ure, prior to its issuance, also requlres the applicant for such permit
to (ile a signetl statem¢nt that he/she i5 licensetl pursuant to the p�ovisions of
-= Contractor's License I..aw (Chapter 9(commencing with Section 7000) ot
'ision 3 of t�e Business antl Professions Cotle) or that he/she is exempt
�efrom antl the basis tor the alle9etl exemption. Any violation ot Section
_..31.5 by any applicanl for a permit subjects the applicant to a civil
�enalty of not mor¢ than tive huntlretl tlollars ($500j.
I, as owner of the O�operty o� my employees with wages as their sole
compensa[ion, will tlo the wotk, antl the st�ucture i5 not intentletl O��otferetl
for sale ($ec[ion ]044, Business anC Professional Cotle: The Contractor's
License Law tloes not aoPb to an owner of a property who builtls or improves'
tnereon, antl who tloe5 Such wo�k himself/ne�self or thtough his or he� own
employees, p�ovidetl Ihat such improvements are nOt intentle0 0� ofte�etl tor
sale. If, howev¢r, the Euiltling or irt�Provement I5 zoltl within one year of COm-
pletion, the owner will nave the burtlen of provin9 he/she tliC not buila or Im-
pr vG to� tbe purpose of sale).
�I, as owner ot Ihe property, am exclu5lvely contracting with licensetl con-
tractorsto construct the project (Section 7044, Businessantl Profe55ions Cotle:
The Contractor's License law does ml apply to an owner of property who
Duiltls o� imOroves the�eon. antl who contracts to� sucM1 oroiects with a con-
tractor(sllicense pursuan[ to me ConVactor�s License Law). I am aware that
proof of their Worker'S Compen5ation Insurance SM1oultl be provitletl to me.
❑ I,irn exempl untler Section B. & P. Q tor this reason
n t 1 �/ �'
I he�eb�tity�bave reatl tnis aOPliCatiO C ztate that the above
information is mrrect. I agree to complY with all city antl county ortlinances
antl s:ate laws relatinq o builtlin ' n, antl hereby authorize re0re-
Sentatives of t city to enter u n he bove-mentianetl p�op¢rty fOr
'inSDeCtian pu ose
$i9ndture Date,_t �Z/�
Drivers' License or 55 YF —r
(���S�92
T.YPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSIO,N ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OFPERMIT�'y LJ GRADING �yLJ FOUNDATION IJ STRUCTURAL
❑ TENANT �J ELECTRICAL ICJ PIUMBING ❑ MECHANICAL
� OTHER
PRQIECT DESCRIPTION 5�. FT. OCCUPANCv—
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGGU.VDS. ACRES—
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
iking Fountains
rc DrainS
rc Sinks
Service Outlets
Kitchen Sink
Lavarories
Roof Drains
ShOWers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
FEES
IMSf�fl a �flC{n+�04ls U
Reinspection Fee $15 Isue Fee $ 3
� MECHANICAL FEES
Boiler
Duct-UnderGround
Duct-Structural -�
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact.8lt. iC80 #
Heatin9 System & Ducting
❑ ai oo,000 sTu O i oo,000 sr�
Hoodor Typel ❑
Canopy TYPe I I ❑
Fefrigeretion System
❑aioo,000a�� ❑�oo,000
System Repair/ Iteration
Fire Dampers
Registers
Reinspection Fee � $15 � � Issue
h"`-_`65-46, rev. 5/88 Wnite - Builtling; Canary - ApplicanC Pink - Accounting; Goltlenrotl - Assessor
$ 3
A.P. #
ST
E
T Front
B Rear
A
C Ri9ht
K
g . Left
Ping. Ref. #
Automatic Washer
Construction Pole S
Cooking Unit
Dishwasher
Dryers �Gas ❑E
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
$WitChES
Garbage Dispoul
GeneratOr O65 K
120 L�..E
Fee
lectric
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transtormer ❑ 15-50 KW
❑ 50 + KW
Meter �up to 700 amps
Meter ❑over100amps
Sub Panel
re Motors�0.1HP�1'F.-8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
W LJ5-15 KW
�Ci(otp�
DEVELOPMENTSERVICES
Zoning Approved By
Buildin9 APProved BY _
Application Issued By_
Standing Sections
,� Trash Compactor
1
Issue Fee
IREMENTS:
FEES
N
I
N
G
R
E
�
M
T
S.
SUMMAflV OF FEES
BUILDING PEfiM1T $ SMIP $
PLAN C ECK $ PERMIT
PLUMeI G $ � ISSUANCE $
PLAN CHECK� 25% $ �/T ^�' ENERGV P.C. $
ELECTRICAL $ �a�" GRAOING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PCAN CHECK 25% $
61 Q0018Y7b-0]018477 TG�T 'SS.O�J
DATE: llf�2!8S TIflE� i1=57
CONSTRUCTION AND PLANNING
APPROVALS Permit # �
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgmd.
3. Electr�ical��Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd.
5:"Steel Reinfbrcemenl
GFER Grnd.
7. Footings .;
S^ Foundation
9. Waterl Pipe-Undrgrntl.
10.,Structu"r_al Floor System
71�,Property Sewer Line & HouseConnection
12.�Sewer Cap
13.. Roof Drains
14. Rough Plumbing
15. Rough Electrical-Conduit
'`1.6, Rough Eleciric Wiring
� 17. Rough Wiring Sign
�.78. Rough Eiectrical-T Qar Ceiling
i
� 19. �Rough Heating & Air Conditioning
.
�.20. Rough Factory Fireplace
�2,1. Ducts, in Structure �
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing �
26. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat
32. Electriral Power Meter-Final
33. Final Electric
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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. �Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electrie Release to �dison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Vo. Date
. PO iSPA
Date Inspector p�ppROVALS Permit#
:�' 52. Pool & Equipment Location
,. 53. Steel Reinforcement
54. Forms
r 55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
�� 58. Electrical Conduit-Undrgrnd.
-` ! 59. Gas Pipe, � Undrgrnd., Test
.�
� 60. Backwash Lines, P-Trap, O Undrgrnd.
.�
� ' 61. APPROVAL TO DECK
: �i
• i 62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Final
j 65. Electrical-Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR"PLASTERING
69. POOL/SPA SYSTEMS FINAL
FIRE DEPT.#tEQUIREMENT
- APPROVALS Permit#
.+ :
� 70. Underground Hjrclro
71. ProductPiping'O�Gas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe ,
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
n 80. FOO�D CERTIFICATE ISSUED '
�! Notes:� - '
y
Date Inspector
t .
.y .
L
.
. � _ I i
0
��� ADGlicant to till in all spaces exceo� tnose witnin neavy bortler lines ana sl9n all aoo�ao��ate aeclarations.
CITY DF COSTA MESA CONSTRUCTION PERMIT P RMIT NrO�. TRACT NO. LOT NO. UNIT NO. A P# Zona
Project Address ��� t.l� LO~ti S7' �� "� O
AppliCant'S Meiling Address �. p Q� TYPE OF CONSTflUCTION . NEW ADD ALTERATION REPAIR S Main BUilding: /�Cce55ory Building:
� E Z
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Flont 0
Owner's Name Phone��'���'a% DESCRIPTION OF WORK/USE OF BLDG. A Rear N
Address % Y^y w 7 a*y ('�Ar c� /4
Arch/Eng. '�;� ���+ �� � �r%,License No. TVPE OF PEflM1T GRADING FOUNDATIOrv STf2UCTURAI I K Right G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL �$' �eft R
Contrector's Name Phone ❑�oTHER Ping. Ref. # Parking Feq./Provided E
- PROJECT DESCRIPTION 5�. FT. oCCUVANGv n
Address (mailing) Planning Notes: M
CONSTRUCTION TVPE VALUATION $ T
City License No. ZONE GRADING CU. VDS. ACRES - $,
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am li[ensetl untler p�ovislons of Charte� 9(commencing Remarks: E '� 2
with section ]000) of Division 3 of the Bu5ine55 antl Profe55ion5 Cotle, antl
my license is in tuu torce antl effect. ELECTRICAL FEES .
License Class License No. PLUMBING FEES P.utomatic Washer Transformer ❑ 15-50 KW
Date Signature ' ❑ 50+KW
WORKERS' COMPENSATION DECLARATION Baf Sink Showel5 Constfuction POIe SUb.
� I hereby affirm that I have a certiticate of consent to self-insure or a certiticate -
of Workers' Compensation Insurance, or a certitietl wDY thereof (Section gackflow Preventer Service Sink Cooking Unit Meter Dup to 100 amps
'1 3800, Lab. CJ Dishwasher Me[er ❑over100amps
Policy No. Compan Backflow Irrigation Sewer Cap �
BCertifietl copy Is hereby furMshetl. Dryers ❑Gas ❑Electric Su6 Panel
Certifiecl ropy 's filetl with lhe city Bui tl' Divisio � Bathtubs Sewer Connection
� Date��P9 Applicant Fan Motors �0-1 HP �1 %- 8
EXEMPTI N FdOM WORKERS' CO A DECLARATION Clarifiers $olar Coll2ctOf5
�� (Thiszection neetl not be completetl it rne permi s for one hunaretl (g100) or F.A.U. InaSolar �9-15 HP 016-15+
Iess). Dishwdsher Solar Piping
1 cerlify that in the performance of th¢ work (or wM1ich this perm�t is ISsuetl, I FixLurCS
shall not employ any pe�son In any manner So as to become subject to th¢ D�Inkiny FOU�L21n5 5010� Tenk MiC�OWavB
workers' Compensation Laws o( California. Device Boxes Pole Li ht
Date Si9nature Floor Drains Swimming Pool w/Spa 9
NOTICE: If, after making this declaration, you shoultl become subject to [he Outlets Ran C
Worker5' Compensdtion provisions oi the LabOr Cotle, you must (orthwith FIOOI SinkS U�iOdl 9
comply with such provisions or tnis permif shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV SWitChes Si n
Gas Service Outlets � Water Closet 9
' I hereby a�firm that there is a construction lentling a9ency tor the performance '
of the work for which this permit is 155uetl (Section 309] Civ. C.) Intefceptofs Water Heatef Garbage DiSposal Standing SeCtions
Lentler's N,qme
Lentler's Atltlress Kitchen Sink Water Service Generator 065 KW �5-15 KW Trash Compactor -
OWNER BU?LDER DECLARATION
I hereby aifiim that I am exempt from ihe Contractor'S License Law tor the Lavato�ies Auto-Wash '
lollowing rea<on (Sectlon 7031.5 Business antl Professional Cotle: Any clty or , ,,
county whicd requires a permit to constru<t, alter, improve, tlemolish or repair P—T�ap Laundry Treys � �
any struGture, p�lo� to it5 is5uance, dlso require5 the applicant to� such perrtiit
to file a signetl slatement that he/She is licensetl pufsuant to the prOvlsiOns oi ROOi DIdi05
the Contractor'S LicenSe Law (Chapter 9(commencin9 with $ection 7000) of
Division 3 of the Business antl Professions Cotle) or that he/she is exempt Reinspection Fee $15 ISsue Fee
ther¢/rom antl Ihe ba5i5 (o� Me alleged exemption. Any violation o( $ection
]031.5 by any applicant tor a permit subjects the applicant to a civil
enalty of not more than tive huntlretl tloilars ($500). 3 DEVELOPMENT SERVICES REQUIREMENTS: �
� I, as owner of the oroperty or my employees with wages as their sole Reinspaction Fea $15 Issue Fea $ Zoning Approved By Date
compensation, will tlo the wOrk, antl the s[ructu�e is not Intentletl o� ofte�etl
tor sale (Section �044, Business antl Pro(essional Cotle: The Contractor•s MECHANICAL FEES Building Approved By Dat
License Law tlaes not aOP�Y to an owner of a properry who builtls or improves �
[herenn, antl who tloes Such wotk nimself/herselt or th�ough hi5 0� ner own goiler HOOd o� T APPIiCdti00 ISSUBd By � Det
em0loyees, provitletl that such improvements are not intentlea or ottared for Ype I ❑ �
sale. If, howeveq the builtling or improvement is soltl witnin one year ot com- Canopy Type II ❑ SUMMARV OF FEES
pletion, the owner will have the burtlen Of proving he/she tlItl not builtl Or im- DIICt - Und¢f Groufld
� �r.,9�e for the purpose of saie). BUI LDING PERMIT $ SMIP $
p.Q I, as owner oi the property, am exclusively contracting with IicenseA con- Duct-Structural Refrige ti0n System 'I:LAN CHECK PERMIT
trat[ors lo con5truc[ the projett Section 7044, Busin¢ss antl Protession5 Cotle: 9 $
The Contractor's Licenze Law �oes not apply co an owner at property who Duct- Ventilating ❑0-10 000 BTU ❑100,000 BTU �BLUMBING $ ISSUANCE � �$
Cuiltls o� improves the�eon. antl who mnt�acts to� Suth oroiects wl[h a mn-
tractor(sl Lcense pursuanx ro�ne Contractors �icense Law). I am aware tha[ Exhaust System ❑ Mul[iple ❑ System Repair/Alteratio[_L i( P � E U PLAN CHECK 25% $ ENERGY P.C. $
prooi of their WorkeYs Compensation insurance shoultl be provitletl io me. ELECTRICAL $ � GRADING $
❑ I am exempt untler Section e. & P. C. for this reason Firepl/Fact. BIL ICBO # Fire Dampers �Y1C0111Fi�@?? ! ispecti f1S MICROFILM $
PLAN CHECK 50% $
Oate Z Owner � � Heating System & Ducting Registers MECHANICAL $ TOTAL FEE $��
I hereby c rtiry tnat I have reatl this application antl state that the aDove ❑0.100,000 BTU �100,0008T Q
information is wrrect. I a9ree to com I wifh au tlty antl county ortlinances — PLAN CHECK 25% $
antl 5[ate laws relatin to builtli tlon, antl hereby authorize repre-
sentdtives of this ci to ent up0 th �bove-mentionetl property or '
inspectlon 1. /
Signature Date /\
ortvers• � e or 5�t. Reinspection Fee $75 laue Fee $ 3 /��� 01 DD027Q45-04027045 �[ij' ?.j'j
I narF: mi�sino rTnc� ,�.;�
uaoo�ro, rev. o�oo vvmie - nuuamg; canary - qppucanr, Nmk -/accounung; uoiaenroa - Hssessoi
:
� CONSTRUCTION AND PLANNING POOL & SPA
t
- APPROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. - 53. Steel Reinfarcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Rginforcement 56. Rough Plumbing & Pressure Test �
i�
6. Elect�ical 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, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property�Sewer Line & House Connection 62. Backwash & Receptor-Final "
12. Sewe}; Cap i 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 Condiiioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Structure �� 70. Underground Hydro
22. Ducts, Ventilating .. 77. Product Piping � Gas ❑Oil
23. Gas Pipe-Rough & Test ' ^ 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemiral
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 pomestic-Final
42. Backflow Preventer ;:,�' � "
43. Backflow Irrigation �s �, l '
44. Landscape Irrigation System X P I��� .
45. Sound Attenuation .�p� {pplB B Ir�c�%w� �"
46. Handicap Regulations ' �
�. St _..---__''
47. FINAL STRUCTURE & BUILDING . -
i•
� 48. Special Requirements Completed � ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co i -
51. CERTIFICATEOFOCCUPANCY �_ __'� r
No. Date � � - � _
Applicant ta tlll In all spaces except tnose witnin neavy bortler Ilnes and sign a11 approprtate aeclarations,
CITY OF COSTA MESA CONSTR UCTION PERMIT PFRMIT NO. TRACT NO. LOT NO. I InuT nin
�Proit Address �� 3 W Z� w�� �/h _
ApplicanYsMailingAddress --S��E t�
Owner'sName ��,��,��2�U� �LclV6 phone ������
Address �� 3 �`-' �" � ,]�'� � �'N
Arch/Eng. �V.%VL2-9[11I�Ic[ LicenseNo.
Address
Contractor's Nam Phone
Address (mailingl
City License No.
LICENSED CONTRACTOR OECLARATION
I hereby affirm Ihat 1 am licensetl untle� p�ovi5ions Of Chart¢t 9(CommanCin9
with section 7000) of OivisiOn 3 0/ the Bu5ine55 antl Profe55ions Code, antl
my license is in /WI torre antl effecf.
License Class License No.
Date Si9nature
WORKERS'COMPENSATION DECLARATION
`ereby aftirm thal I �ave a certiticate o( con5ent to self-insure or a certificate
, Workers' Compensation Inzurance, or a certifietl copy thareof (Saction
a800, Lab. C.)
Policy No. Company
Bcertitietl copy Is nereby lurnishetl.
Certitietl mpy i5 filetl with th¢ City Builtling Division.
Date Applicant
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl if tne permit is tor one huntlretl (5300) or
Iess).
I certity tha[ in the perfo�mance of the wOrk f r whith thi �t is i55uetl I
shall not em0loy any pe�son i� dny Tann,� a5 t0 5 bjeGt [o t�e
Worker s lion Laws af Ca ie. r
Date �-Si9nature
NOTICE: It, a te� making thi5 tle<IaratiOn, y0u 5 U d be Te subject to t�e
workers' Compensation provisions ot the Labor Gotle, you must forNwlth
comply wi[h such provisions or this permit s�all be tleemetl revoketl.
CONSTRUCTION IENOING AGENCV
I hereby ai/irm that there is a mnstruction lenain9 a9ency for the oerformance
of the work tor which this permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atldress
OWNER BUIIDER DECLARATION
I hereby atfirm Lhat I am exempt (rom lhe Contractor's License l_aw for the
lollowin9 reason (Section 7031.5 Business ana Professlonal Cotle: Any clty or
county wnich requires a permil to construct, alter, imOrove, demolish or repair
any sl�ucture, prio� to its issuance, also requires the applicant fo� such pe�mit
to file a 5igne0 statement tha[ he/she is Iicensetl pursuant [o the prOvislons o(
•he Con[ractor's License Law (G�aD�er 9(commencing with Section 7000) of
vision 3 of the Busine55 antl P�otes5ion5 Cotl¢) O� that he/sh< is exempt
etetrom antl the ba5i5 tor the allegetl axemptiOn. AnY violatiOn ot $ection
. J31.5 by any applicant fo� a permit subjects Ihe applicant to a<ivil
�enalty of not more Ihan tive nuntlretl tlollars (E500).
I, as owner of Ih¢ p�operty or my emo�oyees with wages a5 their sole
compensation, will tl0 the work, dntl [he strut[u/e Is not Intentletl o� offeretl
fOr sale (SectiOn 7044, Bu5ine55 antl PrOtessional Cotle: The ContraCtOr'S
License Law tloes not apply ro an owner ot a property who bulltls or improves
lhereOn, ana who tloes sucn work hims¢If/herself or through hi5 Or h!/ own
employee5, provitletl that such imp�ovements are not inlCrltl¢tl o� otte�etl for
sdle. If, nowever, tne bullding or improvament is soltl within one year of com-
, pl¢tioq the owner will nav¢ [he bu�tlen ot proving he/sne Gi0 not builtl Or Im-
prOve for the putpose o1 sale). ,
� I, as owner of tne property, am extlusively contractin9 wlth Iicensetl con-
t�acto�s t0 Const�uct the project ($ection 7044, Bu5ine55 antl PrOfes51on5 Cotle:
The Contractor'S License Law does not apply to an owner o( property who
builtls or improves thereon. and who tOnt�acts fo� such oroiec[5 wit� a ron-
tractor(sj hcense pursuane to me Contractor•s License Law). 1 am aware lhat
proot o{ IM1eir Wo�ker's Compensation insuranca shOultl be Provltletl to me.
❑ I am exempt untler Section B. & P. C. ior this reason
Date Owner ���aneu 1±
1 hereoy certity that I have reatl this aOP��cation antl state that the above
information rs correci. I agree to comply wit� all dty antl county ortlinances
antl State laws rel ting to builtl�'A OnSlruGtlon, dntl her¢by authorize repre-
5¢ntdtives Of lhi City to e Cer the abOve-mentionetl Property for
in5pection p .
5iqnature Date 6
Driver5' License or 5� �
� 3��3� I I I
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. �R04�1�4- 14GU MiO�lt/D
TVPEOFPERMIT LJGRADING LIFOUNDATION L75TRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑/ �PLUMBING ❑ MECHANICAL
❑ OTHER ��SL� h • 'F�
PROJECT DESCRIPTION 5�. FT. oCCUaArvCV_(��
CONSTRVCTIONTVPE� VALUATION$ ��C% �
ZONE GRADING CU. VDS. ACRES
Remarks: �J•�G
,- 1
C�SL.��
Bar Sink
Backflow Preventer
Backflow Irrigation
Drinking Fountains
Floor Drains �
Floor Sinks
Gas Service Outle[s
Interceptors
Kitchen Sink
Lavatories
Roof Drains
$hOW¢!3
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank '
Swimming Pool w/Spe
Urinal
Water Closet
Water Heater
Water Servica
Auto-Wash
Laundry Tra'ys
Reinspection Fee � $15 I � laue Fea � $ 3
Boiler
Duct � Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact BIL �CBO �k �
Heating System & Ducting •
❑0.100,000 BTU � 100,000 BT
Hood or Typel ❑
CanOpy Type II ❑
Refrigeration Sys[em
❑aioo,000sru ❑ioo,000
System Repair/Atteration
Fire Dampers
Registers
Reinspection Fee � $15 � � laua Fee � $ 3
0865-46, rev. 5/BB Wnite - Builtling; Canary - Applitant: Pink - Accountin9: GOltlenroU - Assessor
.. �. ,� ,
S Main Buildi
E
T Front
B Rear
A
C Right
K
S Left �
Ping. Ref. #
Planning Notes:
Autamatic Washer
Construction Pole Sub.
COOking Unit
Dishwasher
Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outl¢tS
Switches
Garbage Disposal
Generator �0.5 KW
Reinspection Fee
oEVELOPMENTSERVI
Zoning Approvad By�
Buildin0 APProved By ,
ti
�
Req./Provided
2one
ELECTRICAI "
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑overi00amps
Sub Panel
Motors �61 HP � 1 X- 8
Inc.Soiar �9-75 HP �16�15+
Microwave
Pole Light
Sign
Standing Sec[ions
Trash Compactor •
laue Fee
N
I
N
G
R
E
�
M
�� T
S.
FEES
$ 3
SUMMARV OF FEE� - ' S�
BUILDING PERMIT $ ___(Z� SMIP $
PLAN CHECK . $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENEfiGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �J�
PLAN CHECK 25% $
Ol 0001?i4�-0�01:196 TOT 31.85
DATE: 08/ib/88 7IISE: 1J':3i
.
CONSTRUCTION AND PLANNING PO� t SPA ,
Date Inspector Date Inspector
IAPPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
i
2. Soil Pipe-Undrgrnd: "�� 53. Steel Reinforcement � � �
3. Electcical Conduit Utility-Undrgrnd. 54. Forms � :
4.'Electpical Condui ;Undrgrnd. � 55. Electrical Bonding �
5. Steel ReinfQrcemgnt 56. Rough Plumbing & Pressure Test ' I�
i -
6. EYectfical IjFER Gmd. - 57. APPftOVALTO COVER�GUNITE � '� �
i
7. Footirgs '� � 58. Electrical Conduit-Undr9rnd. 'I •
8. Founiiation ,_ � 59. Gas Pipe, O Undrgrnd., Test �
9. Water� Pipe-Undrgrnd. �_ 60. Backwash Lines, P-Trap, O Undrgrnd.
10. �Structural Floor SYstem • � 67. APPROVAL TO DECK '
11. Property Sewer Line & House Connection �� ; 62. Backwash & Receptor-Final �i
72. Sewer' Cap � � 63. Heaier & Vent�Final .
13. Roof Drains 64. Plumbing System - Final .
14. Rou9h Plumbing 65. Electrical-Final -
15. Rough Electrlcal-Conduit - 66. Solar System-Final
�76: Rough Electric Wiring 67. Fencing & Access Approval
•'
]�7�. Rough Wiring Sign 68. APPROVED FOR PLASTERING
ti
18: Rough Electrical-T Bar Ceiling T 69. POOL/SPA SYSTEMS FINAL
19: Rough Heating & Air Conditipoing FIRE DEPT. REQUIREMENT
20, Rough Factory,F.ireplace . APPROVALS Permit #
27. Ducts, in�Structure , ��• �'. 70. Underground Hydro
22. Ducts, Ventilating 1� _:� �71. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough'& Test 72. Underground Flush /�
�
24. Roof Framing ;� � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing �� . 74. Overhead Hydro
26. T-Bar Ceiling (Structural) &7Monocoat 75. Dry Chemical
27. Frame'and Flashing � 76. Dry Standpipe
2S. Lathin,g:&�Siding � r 77. FIXED SYSTEM FINAL
29. �Insulation ' 78. FIRE PREV. FINAL
30. Drywa�l Nailing � j n �HEALTH DEPT. REQUIREMENT
31. PlasterBrown Coat•`' � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric �, Notes: g' ��� � r'-�j�
34. Final Heating & Air Conditioning ,BJ7 L� �� Q.Y' ,,�Q p- V-Q.•`„
35. Final Gas Pipe-Test . ; � �
36. Hood or Canopy -
37. Fina� Factciry.;Fireplac� ,-
38. Final Plumbiag �
.r •
�39. Water Service-Final .
40. Gas Service-Final ", " -- �1 '. �
_ �
�47. Solar pomestic-Final � � �' " / ' 7'.� ' '•
- ..
42. BackflOwPreventer:' �� � ' �
- r . I ��
�43. Backflow Irrigation�,,, " � �' , ���
44. Landscape Irrigation_System • �
45. Sound Attenuatior- ' •. �
� ..
46. Handicap Regulations �� �+ _
, '
47. FINALSTRUCTURE&�BUILDING q � � �
48. Special Requirement Complered
49. Electric Release to Edison •: +' � �
. ^ • i
;50. Gas Release to South�rn;California Gas Co �. �;.;'.,, ' ".
�
51. CERTIFICATEOFOCCUPANCY '. ,,.�:' "
No. � Date � � �
r�oTE
ADDITIONS, DELETIONS, OR COftRECTIONS SHALL
BE APPROVED BY THE PLANNING DEPARTMENT
�
_ STREET � _
.g.�
�
OYy
J `
41��
a
A
0
a
n
a
a
�
m
0
�
A
a
A �M
O —
�^ J
a
� �.
A
�, �APPROyE]
�
�,��',n`,=. OF CO q M S�A
: ; °. PLANNING DB�.
;r;;,�
:i.;,. ww�r ro eio�, oe,r. �
. . s. y y
C�%KCi___
�:, �� '� R ;,;', '� � ,+�,
1!
City of Cos*a M�sa 3uiiding Dapt.
gY�_����.� ( DA7E�6 �q �fS
THESE PLANS i'?�UST BE ^vi\ JOR nT iiLl TIME� !AP.K,E
NO CriANG�E'�7S W�ISHOUT PR40R APPROVAL OF DEPT.
THE�1SSl1AN EC OR GRA�ING O�RMIT CN APPROVht OF
PlANS AND SPECIF!CATIONS SHAIt NOT BE CONSTRUED TO BE A
PER7d1T FOR, OR FN FPPROVAL OF, ANV VIOIATION OP AN'( OF
THE PROVISIONS CP THIS CODE. NO PEP,MIi PFESUMI�G TC GIVE
AUTHORiTY Tv' V;O,ktr OR CAIJCFI TME PROVISIGNS OF'HIS
COOE SHALL 8E VAllU, 'cXCE?' !N 50 FAR A$ THE WORK OR USE
WHICH 1T AUTHOR:ZES G tA.N!FUL.
Tfic liil�?t�CE G' .i 'E4�1iT RASED UI'Crtd FI.PNS ANC
$Pef.lflC>>P,`_ r??li f<- -::A'�"J '({'. qUi,JIiQG QT: ��IHL
FROfA 1RcgLAFT:ft vr;sl_'Ft .����' � CG£G���::i�':-^d i.—:I F.ShC�.i:i �;J
$0.1U PiA:Jv i;?•:u -'4n:4:�U:�n 'vd i�'n'Oht ° :'e:ti1�N'�
OUIL'J!i:G O!'E'ATCi,+ .- i:.4i:hliiL� GN THCREUKDER'+/tiEN
IN VIOLqi�CN OF TYIS�P::C£ ;;i i;` AN•V DTHEP. OFDINANCe OF
1HF C17Y.
TYPICAL
Cement Coping Optional —�
Channel Block With 1-3/8�
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8" � at �4' -0" O.C.
For Fences Higher Than 5'
Ven.Ban 3/8"Q at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-1539
A.S.T.M.
AllSteelto be Lapped
24" or to Code .
NATURAL.GRADE
TWO 3/B"$ BARS �-1
CONTINUOUSTOP I
& BO7TOM ' ��_�
NORIZSTEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
s
0
a =
LL H
�
; Y w
¢ _
a
>Z
�
ca �D '
F�-�— W 1 DT H
p SEE CH1
v BELOW
D' I 'Q.
6�� CONCRETE BLOCK FENCE
FOOTING REQUIREMENTS CHART
GENERAL-`NOTES
"MORTAR; p�'e Pa►f Plastic Cement, and
' Three Parts Sand
GROUT; One Port Cement Three and
One Half Parts S�and
COPING: One Part Cement, Three
i Parts Sand
CONCRETE: Weil Mixed 1:2-1/2:3-I/2
Max. of 7- I/2 Gollons ot
.. -Wdter Per Sack of Cement
GROUT MAV 8E POURED FROM 7HE 70P
OF 7HE FENCE IN CELLS WHERE STEEL
OCCURS. �
CELLSAND AREASOF HOR120NTA� REIN�
FORCEMENT SHALL'BE CLEAR, CLEAN &
FREE OF AlL MORTAR DEBRIS, ETC.
i
� ..
'H OP EARTHTCOTH
�/3 THE HEIGTH OF FENCE
�OW �BOTTOM OF FOGTING.
SCALE: I/2�� = i'
WIDT,H . . _ 14" . . _ . . . . . . . . 14'� . . . . . . . . . . i. 12��. 12" '�
__._....._,. .: :
THI,CKNESS . . . . . . 10'�. .� . . . . . . . . .10�� . . . . . : . . . 8". . . . . . .`. . . . 8,;
� � DEPTH OF EARTHTOOTH . . . 24�� . . . . . 20�� . . . . 16�� . . . . . 12��
SPACING OF EARTHTOOTH, . 12' 14' . . . . . 16'. . . . . . . . . . . I6�
UWYERS NAME: S� r r�C� O CC � � L. / N�'_ _
City of Costa Mesa California JOB AooREss z��_�_ Q r� _ S_�= _�
1 F[RMIT NUMBER:_
. �. Building Department SIGNATURE � � _ _ _ _ _ _ _
,. ., , . . _. , _ � _ . 2ev�sEa r-wv. az
ADpllcant to fill in a1l sDaces except lhose within heavY eoraer Ilnas antl sign all aDoropriate aeclarations.
A MESA CONSTR UCTI�. N PERMIT PE MIT NO. // TRACT NO. LOT NO. UNIT NO. A P�y
%y � w a� S%, � � r W� S Main Buildi
s
. s Mailing Addre55 M C � CL TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E
ame /� � t, if.i /�,��� � CONVERSION ❑ DEMOLISH ❑ OTHER ' 7 Front
_ lg 4�.! PhonesP�'�7 g
�� g W rL C�� ��- DESCRIPTION OP WORK/USE OF BLDG. A Rear
ess
Arch/En . O 3 �7�M�V //d t� � C Right
9 ��— GCenSeNo. TVPEOFPERMIT '- _G��RALDING FOUNDATION STRUCTVRAL , K
Addr¢55 ❑ TENANT ❑ Ee�a.AL ❑ PLUMBI G❑ MECHANICAL g L2ft
CAntraCtof'S Nam O Pho�e ❑�OTHER ( TT FL'��E (.l� �I�MS }LK Pln Ref. #
9
PRQIECT DESCRIPTI N SQ. F7. nrri innr,iry Plannin N
Address (mailing) _ A '� g otes:
- CONSTRUCTIONTVPE VALVATION$�(.d�
CityLicenSeNo. . ZONE�_ GRADINGCV.YDS. ACRES
LICENSED CONTRACTOR DECLARATIOPI
I bereby affirm�that I am licensetl untler provislons of Chartor 9(commencing Remarks: r� i/� � �d � j,p ,,. .}� f,) 7,[ ("3�
wi[h Section 7000) of DiviSion 3 of [h0 Bu5ine55 antl ProfeS5ion5 COtle, antl
my license is in tull torce antl etfect.
Li<en5e Class Li<en5e No.
Dd�e Signatu�e
WORKERS' COMPENSATION DECLARATION
' ti¢reby a(firm that I have a certi/iGdt¢ Of ConSent to selNnsUre or a CGrtlfitdte
Workers' Compensation Insurance, or a certlfietl <Opy thereof (Section
J0, Lab. CJ
Policy No. Company
eCertifietl copy is hereby furnishetl.
Certifietl copy is tiletl with the city Builtling Dlvision.
Date Applicant
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissec[iOn neetl nat be comple[eA if the permlt is for One hundretl (5300) or
less).
I certify [hat in lhe performance of the work k whiG h15 �t iSlssuetl I
shall nOt employ any pe�son in any manne� as t b m s' ject to t�e
Workers' mpe at'on Laws ot C �
Date Si9natur
NOTICE. If, a r makin9 this tleUara lon, you s la b e zubject to the
Workers' Com ensacion provisions oi [he I�bor otle, you mu5t torthwith
comply with such provi5ion5 or IhiS pe�mit shall be tleemetl �evoketl.
CONSTRUCTION LENDING HGENCV
I hereby aftirm that there is a con5truction lentling agency for [he performance
af tne work tor which [his permit is issuetl (Section 3097 Civ. C.)
�entler's Name
Lentl¢r's Atltlress
OWNER BUILDER DECLARATION
I h¢�¢by dtfirm Lhat I dm ezempt (rom the Cont�acto�'s License Law for the
(ollowin9 reason (Section 7031.5 Business and Professlonal Cotle: Any city or
county whicb �equires a p¢�mit (O Construct, al[e�, improve, tl¢mOlish o� �epai�
any structure, prior to ils issuance, also requires lhe applicant for sucn oermit
to fil¢ a signetl zta[ement that he/she f5 IicenS¢tl pur5uant to Ihe provi5ion5 of
the Gontractor•s License Law (Chapter 9(mmmencing wlth Section ]000) of
'"`ii5ion 3 of the Business antl Prole55iOn5 COtl<) Or [hal he/she i5 e%empt
e/rom antl tne basis for the allegetl exemption. Any violation of Section
1.5 by any ap0licant for d plrmit subjecls Iha apPlitant to a�civil
�ynalry of not more than five huntlretl tlollars ($500).
LN I, as ownet of the prOperty o� my employ¢¢5 wI[h wd9es as thei� Sole
compensation, will tlo Ihe work, antl lhe structure is not intentletl or ofteretl
tor wle (Sec[ion ]044, Business antl Grofessional Cotle: The Contractor'S
License Law tloes mf apply [o an owner o( a properry wbo builtls or improv¢5
thereOn, antl who Ooes such work hlmself/h¢�SGIf Or [hrOugh his o� he� own
¢mplOyees, O�ovitletl tbal such ImOrovement5 ar¢ nOt Intentletl or off¢retl tor
sale. If, nowever, the builtlin9 or improvement Is soltl within one year of com-
pietlon, the owner will have the burtlen o1 proving he/she tlitl not builtl or Im-
prove for [he purpose ot sale).
❑ I, as owner ot the property, am exclusively contracting with Ilcensetl con-
trattors to construct tne orojecc (SecHon 7044, Business anE Professions Cotle:
Tne Coniractor's License law doe5 not aOPly t0 an Owner Of Property who
builtls or improves theteon. antl who confracts fot such orolecl5 with d ton-
tractor(5) license pursuane to ene ConVactor's Licensa Ldw). I am aware thac
proof o( their Wo�ker's Compensatlon insuranca Shoultl bo ptovltletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
.
naen Y O lC A/
I nereby certily that 1 have reatl this application an state tnat the above
Intormation is correct. I agree lo comply with all cliy and county ortlinances
antl slate laws relating t builtlin9 Wn tion, antl hereby autho�Ize r¢pre-
Sentative5 Of (his cit ente! bove-m¢ntlOnetl prOp¢rty tOl
I^Spe[tlon purpo^ cc � � �,���rt�
Signature Date_�� t/� s
08fi5-46, rev. 5/88
3ar Sink
3ackflow Preventer
3ackflow Irrigation
3athtubs
Clarifiers
Dishwasher
Drinking fountains
Floor Drains
Floor Sinks
Gas Service �UtICtS
I nrerceptors
Kitchen Sink
Lavarories
P—Trap
Roof Drains
Reinspec[ion Fee $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFact. Blt. iCBO #
Heating System & Ducting
❑6700,000 BTU 0700,000BT
Reinspec[ion Fee � $15
White - Bulltling; Canary - qpplican[; Pink - ACGounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal -
Water Closet
Water Heater
Water Service
Aum�Wash
Lsundry Tra'ys
Isue Fea
Hood or Typel ❑
Canopy Type II ❑
Refrigeration System
❑6700,OOOBTU ❑100,0008T
Syscem Repair/Alteration
Fire Dampers
Fegisters
Issue Fee
$ 3
FEES
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Fan
F.A.U.
Fixtures
Device Boxes
Outlet5
Switches
Garbage Disposal
Generetor �0.5 KW
� Reinspection Fee
—
DEVELOPMENTSER
Zoning Approved By_
Building Approved By
Aooliration Issued Bv_
Zone
ELECTRICAL
� Transformer � 15�50 KW
❑ 50+KW
Meter Uup to 100 emps
Meter ❑over100amps.
Suh Panel �
Motors �0.1 HP �lYh-B
InaSolar �9�15 HP �16�75+
Microwave �
Pole Light
Range
Standing Sections
15 KW Trash Compactor
$15 luue Fee
SUMMARY OF FEES �
BUILDING PERMIT 5 /,� SMIP $
PLAN CHECK $ �_�� PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GfiADING $
PLANCHECK 50% S MICROFILM $
MECHANICAL S TOTAL FEE $
PLAN CHECK 25% $ ___ __
01 00027i,5-DA027117 Tr_�r
OATE: �2127/S? 7IIiE: 11:07
FEES
$ 3
N
I
N
G
R
E
Q
M
T
5.
��TION AND PLANNING POO' SPA
LS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
mporary Electrical Service or Pole �,� � 52. Pool & Equipment Location
. Sail Pipe-Undrgrnd. �''� 53. Steel Reinforcement ' ,
3. Electrical Conduit Utility�Undrgrnd. � 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
i
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Grnd. (' 57. APPROVAL TO COVER-GUNITE .
�
7. Footings ', � 58. Electrical Conduit-Undrgmd. � �
�$: Foundation �� 59. Gas Pipe, O Undrgrnd., Test . ,
� �
'�9. Wate� Pipe-Undrgrnd. � �� 6p. 8ackwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection �.�� 62. Backwash & ReceptorFinal
.
12. Sewer Cap =�� 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing Sys[em - Final i �
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 OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd. Storage 7ank O Gas ❑ Oil
25. Roof Sheathing � � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monoco3t "` 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation , 78. FIRE PREV. FINA�
4/
30. Orywall Nailing HEALTH pEPT. REQUIREMENT
31. Plaster Brown Coat�� 79. FINAL INSPECTION
32. Electrical Power Meter-Final' 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �✓ ,� Ga �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Fac[ory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final .1 , .,
41.Solarpomestic-Final .� ^
� � .
42. Backflow Preventer � � �i '
43. Backflow Irrigation ti .
44. Landscape Irrigation System � � � '
45. Sound Attenuation " '
46. Handicap Regulations
.�
47.FINALSTRUCTURE&BUILDING 'Cdp v� ��
[
48. Special Requirements Completed
49. Electric Release to Edison ' '
50. Gas Release to Southem California Gas Co ��• „• , ; � '
51. C RTIFICATE OF OCCUPANCY ; f
No. Date � � ' �
6�ti��
`"�,��, �^���^� �
� � � a.�, 'P lQs�-�T/��
� '4Ci
PRII �n�,�`""•�
C �� COSTq Mf�L
�a� T N� D� A
�.
1�'w+H�,w; ����7"
�P��6���� �J
Cify of Costa Mesa Building Dept.
gy ��___ DATE� 19�
THESE P1AN5 MUST BE ON JO'S AT All TIN,cS MAK.`:
NO CHAhGES WITHOUT PRIOR APPROVAL OF OcP?.
THE�ISSUANCE OR GR0.NTING OF A PERMIT OR <,PPRO`J4t OF
PLANS AND SFECIFICATIONS SHALI NOT BE CONSTRUED TO BE A
PERMIT fOR, OR AN APPCOVAL Of, ANY VIOtATION OF ANY OF
TME PRO`/ISIONS CF TFIIS CODE. NO PERMIT PRESUMING TOGIVE
AUTHORItt TO VIOIaTE OR CANCEL 7HE PROVI510N5 OF THIS
CODE SHALL BE VALID, E%CEPT IN 50 FAR AS THE WORN OR USE
WHICH IT �UTHORIZES IS LAWFUI.
THE ISSUANCE OF h PERMIT BASED UPON PLANS AND
SPECGICATIONS SHAII NOf PREVENT TNE BUIIDING OFHCIAt
PP.Oi.1 THER'eFFTER RlOUIRING THE CORRECTION OF ERRORS IN
SAID P!ANS AfJD SPECIFICATIONS OR�FROM PREV�NTING
EUILOING OPERAilONS dEIMG CARRIED ON iHEREUNDEB WHEN
IN VIOIATION OF THIS CODE OR OF ANY OTHEft ORDINANCE OF
THE CITY.
Permit # �
THIS NUMBER MUST ACCOMPANY
ALL INSPECTION REQUE�S7__S �
�
9 133a1s -
Ceme�t Coping Optionel �
Chan�el Block With 1-3/8�
Horizontal Top of all
fenees
Fo� Fences 5' or Less
Vert. Ban 3/6"� at 4' -0" O.C.
Fo� Fenees Higher Than 5'
Vert. Ban 3/8"� at 32" O.C. "
Fill Celh Solid With Grout
Where Steel Otcurs
Reintoreing Stcel Shall
Contorm to See.A-15-39
A.S.T.M.
All Steel to be Lapped
24" Or t0 CodB
NATURALGRADE
TWO 3/8"¢ BARS �
CONTINUOUSTOP
& BOTTOM .
ilppliSTEEL MUST BE TIED IN
VLACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 6�� CONCRETE BLOCK FENCE
x
ti
u
w
x
z
o e =l—j
D �1
F�—WIDTH
p SEE CMI
t BEIOW
�.� .
NG REQUIREMENTS CHART
.y
GENER�aL— NOTES �
MORTAR: p�e Part Plostic Cemenf, and
GROUT; Three Parfs Sand
One Port Cement TMee ond
One Hulf Parts S�and
COPING: One Pert Cement, Three
Parts Sand
CONCRETE: Weil Mixed 1:2-I/2:3-I/2
MaY. ot 7-I/2 Gollons ot
Wafar Per Sack of Ceme�t
GROUT MAY BE POUREO FROM TNE TOP
OF THE FENCE IN CELLS WMERE STEEL
UCCURS.
CELIS AND AREASOF HORIZONTAL REIN�
F'OACEMEN7 SHALL 8F CLEAR, CLEAN &
FREE OF ALl MONTAq DEBRIS. ETC.
N OF EARTHTCOTH
�/3 THE HQiGTH OF FENCE
BECOW BOTTOM OF FOGTiNG.
SCALE: I/2" = 1'
WIOTH . . . . . . . . .14" . . .14�� . . . . . . . . . . I...12�...:.. : .. 12�� =
THICKNESS . . . . . . �0°. . 10" . . . . . . . .'. . . 8u. . ... . . . . . . 8'�
DEPTH OF EARTHTOOTH . 24" . 20" . , . . . . . . . . . 16° . . . . . . 12"
SPACING OF EARTHTOOTH. . 12' . . 14� . . . . . . . . . . . 16�. . . 16�
OWNERS N4ME: ��� G G OZ � C_( .(�rJ _�
City of Costa Mesa alifo�nia ��B ADDRESS � c.�, �. _�_ �� � s,_,���_
1 PERMIT NUMBER:_
Buiiding Deportment S��NAT�RE: ��'�-�-r �� - -- - -. _
„
'FflOM TRE OF�ICE OFTN6 � � �`�
G+�v P. p. BOX 319
BUILDING OFFICIAL
J(�GyS �. 6/' �,i-.i
GII`�� Og C�0���1 ���� �� 6 6��
CALIFORNIA ,� �
TO WHOM IT MAY CONCERN:
September 6� 1955 n p o
rf'
G. y. TriPP
743 E. 20th St.
Costa Mesa� California
Report on structure built without permit using the assumption
that the building is to be considered on the basis of occupancy as
requested in the or3ginal application submitted under the name of
B, J, Bergeron of the same address� stating that the building is to
be used as a two car garage (private) and considered as being a
20' x 2!�' or 1t80 square feet accessory building of Group J occupancy,
The Uniform Huilding Code, 1952 Edition� as adopted under Or-
dinance if31 of the City of Costa Mesa, California� Chapter 15, Sec-
tion 1501 Division 1� Private ag rages� sheds and agricultural build-
ings When not over one thousand sqvare feet in area. This building
is 2tlt' x 2l�� a total o£ 105b square feet precluding the possib3lity
of it being considered in Group J occupancg.
The abone building inspected on August 31� 1955 by A, J, Volz�
Building Official� as £ollows: /
ation - Nill /
-'�iestionable_.(not exposed),
tion over ad'acent £inished rade - Nill
�exterior wa31s - i� � 3°- 110” - 60" and at various
ntervals non-complying)
(i.nterior walls) - Not exposed £or inspection
c� rlabng � P+XjJVSCQ� V.11•
a�t Pter joiste 2 x 4- 2!�" OC. ll�6'! span (overspan)
1 x 8 T& G Sheathing i.n walls - Ex (No water proof under)
✓1 x 8 T& G�Roofing - 0. K.
Separation - West� Bathroom-shoorer, lavatory� toilet (cannot
determine compliance� all rough in plumbing concealed,)
�ast� Bathroom - all rough in plumbing concealed)
Hot water heater located in bathroom illegal.
Electric wiring in entire bui.lding concealed.
Respectflally sub�tted�
� ��
A. J. VOLZ
BUILDING OFFICIAL
AJv:ljb
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TNFORMATION TO SE FORNISi�D TN.F CITY AT°TORNEY FOR k'TLTNG COMPLA.T,NTS
1, Na�oe and adctre3s of person :iho commi.tted the affense:
(Skx�s� an address awificien�C to enable 2he �ra�n to be served)
�� �
�,..., � g-1i
2, Date oS�ense aas comed.t4edt o� - /S�- �,S
.......�.....e.
3o Time (hcru.r) o.£fen�e Vras commfi:t'ted: ��� v�/�; p e
4m Place of£engo i��:+ corawitted:
.�_...��.,� ���-�..�._.p? o �: �� �._..._
5, densra7. description oY o�fo:...e cor�uni.�tec�s (deseribe what the person dtd)
/C,dc.., r U
`-�1 6 j� �M CC c,�
r
6, Tha sect�.on o4 eode tha� was violated: �
�- L`
��5 �� �k .'�va,n, �..o � � / �`�� 3�: ,—.
7e N� and addreas of pea�cctti mak�� �he
5 . . i �% /i �/% , i
�.
es<�
b��o
�
8z Namee and addresses oY persons (ta.t.ttteases) wYx� ac2vally saa 4�he
oPfenae Comrnitted:
��Gi�,� f� �e�c�'� ;2"fiS� —C.U�a:C��� —Lf
�l-G��.. � , . , < < <,.- �
ivr R �%..4'....�4'�G.......L_.�.e�.�� __�/ /�.:o. � /� � -- �.��Mo 2.�c��
�
May 17, 2013
To:
,J
CITY OF COSTA MESA
P.O. BOX 1200 . 77 FAIR DRIVE • CALIFORNIA 92628-1200
AT&T
Building Safety Division
Code Enforcement
Communications
County Clerk
County Planning and Dev. Services
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
ESRI
Fire Admin. — Capt. Jason Pyle (Station 4)
Fire Prevention
Irvine Ranch Water District
Mesa Consolidated Water District
Newport-Mesa Unified Schooi. Dist.
Police Dept. - Planning & Research
Sanitary District Engineer
Sanitation Division Office,
So California Edison Company
Southern California Gas
State Board of Equalization
Time Warner
Cox Communication
U. S. Post Office - AIS
U. S. Post Office - Adams
File
The City of Costa Mesa would like to inform you of the following new addresses to be added to an
existing parcel.
Existinq Address
743 W.� S�
New Addresses
743 W 20�treet
1988 Wallace Ave.
1992 Wallace Ave.
1996 Wallace Ave.
Please refer to the site plan and attached list.
Assessor Parcel Nos.
42226204
Your cooperation in this matter is appreciated.
Sincerely,
MINOO ASHABI, AIA
Principal Planner
Attachment: Site Map
cc: Jim Liu, �T
Matt Hamilton
2147 Iris Place
Costa Mesa CA 92627
Le�-r� »'. i'r�����C , ~. `�__ _
\\,%�qSY' �I 1e �. ME BUIIDNC OFF1qALw anui n�i nc x�vu. �
� �'� — �� � 4. �ppAOVpBIE EFi0510N PROIECT�E �ENCES SIN
�` 8 a �e eP NG OAY NHEH THE SDAY RAIN PR03A6rt1TY 1
' f' _ _ — _ _ — _ _ �—'_ _" _ _ _ � _ — _ _ � ' .�='aest_^ e 5. MER A RNNSrIXtM. ML 9lT AND A�RIS 91ML
_...._ ___—_' ""'__'_"-'"_..."_ '_-
' fip ____ 6i--_-_._ _�____ BQtMSNID9ASiNS
I_— _-----___— .__— —__—__
'-- h
� I �' , r�. ,��5 ' �' y 6. CRADm AREAS OF THE PERMITIEO MEA PERIMEIEI
� � e. �'� . rh . 6 � ' •q5g' DE9LPNC�F� p TES OF EAq1 N'OHpNG �AY. DRNP
9561 1 '. �' �,y6� ' t�`, .. a 'i S
� �� � _ _ __ _ _ _ _ _ ]. TIE PERMIIIEE AND CONiRACTOR SHP11 BE RESPO
o°o°o°o°o° ° PftECAU110N5 10 PRE�IIIT PUBIJC TRESPASS ONTO
� /. �' o 000�°o GREATES A HAZARDOUS CONDITION.
I I : �O�Oo°o �O. A o
000�000000 =958� B. TIE PQtMiTiF£ MID CONIRACTOR SHUL INSPECT l
; � I, P. ���� o oow4p � INAJRE 1HAT iHE VqRK IS IN ACCOROPNCE M11H T
�„�i�n' ; ��������i 733 W
sszt ni, ;: / 000°o . s. Qtos�au allo s[oiMar cot�ma - SmiMET+is m�
gs 1e " s+nu ee aEraNm a� s� usNc nn �cn� �
U :�✓ zOt �'I .' o°o°o car�mas ro me Mnwuurn ex�rvr aancncne�.
��e I II � e� L�l o°coo 6 Z OtGI PROPfRLY CONTNNm TO MINIMIZE SEDIMENT TRAN:
� �RNNAGE FAqIJTIES OR AOJFCFNT PROPERTES NA
lfi � �� � I �D�D 44b
f � s o 0 10. WR51E RND MR7ERIAfS MPNACE]AENT CONiROL — P
'�.l -e' o°000 RELAiFD MATEPoRLS, WASlES, SPILLS OR RE9W6
i!�I; 0 � � D oo°oo ON 91E TO MININIZE 1RPN�IXiT FRON hiE 91E P
� I� Y � s • e C °oeo ��NINC PRWERN BY VAND OR RUNOiF.
I I 5 s��� � � o
. k;� I I: J'� o00o sssr
� �� I 000ao
��, ---�----- -p- �°�°�
! � • --
� I li � ag0000 LOT 2 O O �
W�\ °��
19 � �� o� �
Q �� „I � o 00o i`1`ib 1�/al � I
� oo �e
\ 95 9�
� M1• / i
l959A IL 965�
`\ fxliNl . �P . P �. 'sB
�� : _ ; _ — _ _ _ _ �� �—�._
� � �D°�
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v r 'I• � I P
� � o00 000 �5q0
o� � O OODO� Q / 9 I
i..a ' � o�S° �a LOT 3
a,\ o 00000000 .
� �' ie� . �°o oo�oo � �
\
3 � `,, �,� ,a ; 4 a0000000 � G9 Z ► re�c e ��� `d
, � �. ��,
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�9fiJ5 ' _
� � � � � v96�6
I � � �
� .: �o�o�°°o � o �1 �
I1 I I. " o 0 000a o LOT 4 I �
��-' ' ooGOo��Dp�o�� P95 ��,/Yy� v9 01 (�' / ,
i i95�E R�il . pp"p00 �� l�\ � I I�1 le I
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I96�61C1�� 6y� � 9`9
1 (�912)
�"�i
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� ". I I �.'� I �� . � � �. •
EROSION CONTROL CONSTRUCTIC
,s uasruL sr,�enrzEn consim,cnon arnx+cE/o
i6 INSfM1 2—ROW GRMEl BAC BERM (SE-6)
1] NOT USm
1B IN51pi1 GfU�EL 84C CHECK DAM. SPAGNC AS i
19 11LS�ALL pWN 11NK iENCE WiIN SCR@I FOR 0
PROJIDE GTES AT PLCESS POIN15.
10 5 0 10 EO 10
�..�....-,-.�
COUNTY OF OR.4NGE
BUII.DING DEPT.
636 No. Broadway
Santa .4na� CaGfornia
� Phone: KI 2•6211
1. OWNER'S
MAILING
�� Application for Building Permit
AND FOR A
Certificate of Use and Occupancy
�o . n n h'�-,-.��.f�
Permit No�-3-.�-��..'S•----
�" Date- - ---- ----------------- ------....----------- �----..
Name....-'--.,�.! . ...------- ..............-'----'--...--
��}i[ect or gineer)
Address .-- --- - - -.�.I..s1.A.e...�
� � � --- . .. .. ...............
City .-_..�.�fl� r�...g4..-� -'--- - ........' -- - "-
State
Lic No. -�-- -- - --- �---. Phone...... ......._.. -
--�------.. PHONE:----/-.....-----�------------..
CITY_.�Q�-.44r --(.1�.!!^:A..-----------
Name --"I.✓.-L�lJ.`.i.�-Q..�, •--- �------- - ................---' -- ..
,` (ContraQc[or)
Address `� TF-%�'£----�n--...�.�.,^,ncf -'F'�`�"'- ---'�...--'----'----- --
City..-c=f�Q,..,r.L E�-�--l�L.rr[► �-- ---- ......_........ - - ----- --
State i n '
PROPOSED USE:---... � � � d�- � � - - -.......-� ---- -- � - --
2. JOBLOCATION----- .....- - 7?��3 -- --- ----------- - --- �
(House o. � ( ame of Street)
NAME OF AND DIR$CTION FROM NEAREST CROSS STREET
(Town or School
3. LEGAL DESCRIPTION: Lot -- -- ..... ^- -----�---- ....----Block ---...1 ..... --- -........-`-- - .... Tract - -Lr-�-�- -- - .._...----
(Metes and Bounds Description se verse side of form � �r
4. CORNER LOT (�) INTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT (�`r)
i. SIZE OF BLDG.:--y:-�-:-�C.%.�......AREA:.�v.�%..0------...SIZE OF LOT:...�0..1I..1_a2..Q......AREA:.....�I�-OD---------.--
i ' p/
6. HEIGHT OF BLDG.:_..J...�.----_-----._-....._---_--CEILING HEIGHT:---_-Q-----------------------_-NO. OF STORIES-------_.I--_.----_-------..
7. NO. FAMILIES .............�................._.___._.Size of Smallest Bedroom:.�.i�J_X-I-i-..(�.................. Size of Kitchen�.�0_3.,�..�..P....4........
8. EXTERIOR WALL CONSTRUCTION:-�1�i["a�t`�•------...._..INTERIOR WALL COVERING-----�La-.,�-�o-/-�.--
(Frame, Stuccq Etc.) „ (Plaster-D a11, Em.)
. . ..
ROOFING�COVERING..._�K..tw'i� ...... ......._..._._. _
�.a.�,,�.��-�,,...� - �..o - ..
9. STATE HOW MANY I�UILDINGS NOW ON LOT AND GIVE USE OF EACH....��,r ...............................
! i
10. SETBACKS: Front Yard From Center Line of Street...._..r__�..........._......._ ..................._.__..,.............__...._........_.....
�/ / �
Nearest Side Yard....._..i! ..............Rear Yard...�.Q ......_._..Distance in Feet Be[ween Bldgs. on Same Lot....��.__.._._.....____..__............
(Property Line) (Proper[y Line)
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
/ / �
12. (a) Footing: Width-------�-�c---------------------Depth m Ground---1-'�"------------._Width of Wall....--/.iat..---...---...__.
(b) Size of Studs:___..i�.f�-y--.--_--Spacing.._.�..ii ..............._"CC Materis( of Flaor.._..._�,.�_.........
(c) Size of Floor Joists:--'-`------------...--------"-----Spaeing...---'-------------------�-'-------��CC
d Size of Rafeers:..... ..............................S acin ' "
i) r`�*�-� p g---- �-�- - a---116{I'- .. �C
13. VALUATION OF PROPOSED WORK: Induding all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $-----,�.J�'-�-Q"--------'.......--- .
14. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF C,QLLFO$NIA f+f�� THERETO.
llzi 1
--------------. Jignea:.
Plans Filed:..... �.. ��,f..l..�, _ �� . .
/ By:.
- l cS � P� �'1 li
FEES:
Bldg. Permit
Ptan Check
Total • -
Receipt No.
Paid to -
Date ............
FOR DEPARTMENTAL USE ONLY
i L� GROUP---�-`�'�.'�_L...--
� -- TYPE..----�-- -----.....
- --- - ------ Q
DIST.
�� IvIAp-----�—`- �../_------
- /f�
e L � ' SHEET NO..... � .....--- -�
DATE --ZI.��I-�� -�
----"-""
Soov--�-sz
(Owner)
- - ------ �� - ------- ------�-----
(Authorized Agent)
�ri��NU BY '
APPLICATION. _ _�..... �HEALTH ............................
%� FIRE
ZONING.--.---..---.---
--
PLANS AND � HAL----.----------.------
SPEC'S - --- -- - -........ STATE .. .. ............ .... .......'
CORRECTIONS ENGINEER
` e� c
INSPECTOR
PUTY
March 30, 1981
CITY OF COSTA MESA
CALIFORNIA 92628 P.O. BOX 1200
FROM THE OFFICE OF TME DEV ELOPMENT SERV ICES OEVARTMENT/
BUILDING SAFETV DIVISION
Ms. M. Anderson
Whelan Realty
735 Baker Street
Costa Mesa, CA 92626
CERTIFIED
Re: 743 West 20th Street
Costa Mesa, CA 92626
Ms. Anderson:
At the request of Edison Company, I made a safety inspection of a meter
installation at the above address. As a result of this inspection the
following violations were noted (Uniform Building & t�ationaT Electrical
Codes):
1. Meter box installed without obtaining permit.
2. Wires spliced behind meter box are not accessable.
3. Ground wire to service cannot be spliced.
4. Ufer ground required.
5. Ground to water line shall be exposed for inspection.
6. Circuits shall be identified.
7. Subpanel in illegal location in kitchen.
Q
0
Illegal wiring at patio, garage and in kitchen.
Illegal patio cover.
Upon receipt of this letter you have five (5) days in which to obtain the
necessary petmits to correct the above code violations. Double permit fees
shall apply. Upon issuance of permits you have ten (10) days in which to
comply with all code violations and obtain all necesszry i�spectio�s.
If I can be of assistance to you in this matter, you may contact me at the
Building Division, second floor of City Hall, 77 Fair Orive, or by phone
754-5231 between 7:30 & 8:30a.m, or 3:30 & 4:00 p.r�.
Respectfully,
�Cil...� U'r�
l �-��„`��
Chuch Conner
Deputy Building Official�� FAiR �RivE (71417545273 '
March 30, 1981
CITY OF CUSTA MESA
CALIFORNIA 92628 P.O. BOX 1200
FROM TME OFFICE OF THE DEVELOPMENT SERVICES DEVARTMENT/
BUILDING SAFETV DIVISION
John F. Whelan
Whelan Realty
735 Baker Street
Costa Mesa, CA 92626
Re: 743 West 20th Street
Costa Mesa, CA 92626
CERTIFIED
Mr. lJhelan:
At the request of Edison Company, I made a safety inspection of a meter
installation at the above address. As a result of this inspection the
following violations were hoted (Uniform Bui7ding & ��ational Electrical
Codes):
l. Meter box installed without obtaining permit.
2. Wires spliced behind meter box are not accessable.
3. Ground wire to service cannot be spliced.
4. Ufer ground required.
5. Ground to water line shall be exposed for inspection.
6. Circuits shall be identified.
7. Subpanel in illegal location in kitchen.
8. Illegal wiring at patio, garage and in kitchen.
9. Illegal patio cover.
Upon receipt of this letter you have five (5) days in which to obtain the
necessary permits to correct the above code violations. Double permit fees
shall apply. Upon issuance of permits you have ten (10) days in which to
comply with all code violations and obtain all necessary i�spectio��s.
If I can be of assistance to you in this matter, you may contact me at the
Building Division, second floor of City Hall, 77 Fair Drive, or by phone
754-5231 between 7:30 & 8:30a.m. or 3:30 & 4:00 p.m.
Respectfully,
c➢�.��� c��-,..�,
Chuck Conner
Deputy Building Official» FAiR oRivE (714)7545273
- '1
OWNER BERGERON B. J. V DATE q_�q_S�, `�
JOBADDRE88 %43 t+`�• �t.�'1 Street BUILDINGPERMITNO. �'l�j
GENERALCONTRACTOR Owner-Builder VALUE$ 960 00
�"'T #1 Qu% �2 BLOCK F'' TRACT 612 `j'WO i�,H2` Garaae
GROUP J TYPE V ZONE t(Lj. FIRE DISTRICT j�J(7
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR I DATE I NUMBER
Foofing TrenCh
Foundation Forms and Grade to Garage
Rough Framing
Plumbing, Rough Complete � � � � �
•7emoorerv Pole � ��� l�.. 9
0
Sewer ,
Septic Tank or Cesspool
Lathing
P ring
Plumbinp, Final, Fixtures Complete
Wirinp. Final
I+orm T10 G-H 1M 12-63
Costa Mesa Building Department .- APPLICATION FOR I ERNIIT
" � 171 EAST 20th STREET �g�,g,�-�q�g U 1 L D�� N���-'
� COSTA MESA, CALIFORNIA
vv
FOR OFFICE USE ONLY
d+'OR APPT�ICANT TO FILL IN , Reeeipt No. Permft No.
���d��g o oz.�,z 6 5' lo
idrew
Costa Mesa, CiiL�1fOP111}L Reeeived by Date Rec'd. Date Issued
- - s-
Cross St.
Owner
Mail
nronrcec2or
Engineer
Addrew
■ Addrew
Description � No. �
(Attach Metes and B
Size of Lot 0 �
Use of
Existing 81dg.
Setback Line from r
8
No.
/JS =3st s - -3�
��
Demolish
y -x9- �r
Building
Address
Costa Mesa, California
Nearest
Cross St.
Zone ,n �/ � No.ot � Type,rf � Group ,r
Date
CORRECTIONS
,.��.y
Size Q � Rooms Stories
ExteriogWall� / I Roor 9 • s0.. APPROVALS
Coverin ��d� Cover n
Use of New
Building �j �g� �� p���y� Foundation Lxation Inspecto�
� GT Forms, Materials,
Under•Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Applicatlon Lath. Int.
and state that the above is crorrect and agree to comply Lath. Ext.
with all City Ordinances and State Iaws regulating
building const tio
Signatureof � 'J,` � Plaster.lnt.
Permittee
Authorized Agt.
Valuation � Permit Fee
Plan Check
$ �� O �Total
� Fee
FORM 2O4 G-H 2M 9-54
M
.v�' I FINAL
O
A
�
2
D
r
Show locatloriliand•`di"starices .from {�j'1
r�-s.l� • t'.::�. ��.
property line and between buildinga
r '
-i. .
, .
� ,.
r� �
0
�'
OWNER TRIPP� GERALD L, / DATE io-5-55 �
JOBqDDRES$ 'jt� W Z(}tj1 BUILDINGPERMITNO. j9�y9
GENERALCONTRACTOR 0�.7�'�@T VALUE $
_ nr 1i5-31�3-6 s�ocK TRACT Demolish illegal structure
INSPECTIONS
Footing Trench
Fountlation Forms and Grade to
Rough Framing
Plumbing, Rough to Slab
P7umbing, Rough Complete
Temporary Pole
Wirino, Rouqh
Sewer, House Sewer, St.
SeptiC Tank or Cesspool
L�•'�ing, In Out
� :ring
Plumbing, Final, Fixtures Complel
Plumbing, Final GasTest
W iri�g, Final
Occupancy
TVPE V ZONE
DATE I SUBCONTRACTOR
0
PERMITSISSUED
� NUMBI
Costa Mesa Bnilding Department
� 111 EAST 20th BTREET
. " COSTA MESA� CALIFORNIA
FOR APPLICANT TO FII.L IN
lding -
iress y 3 �✓ 2Q ,
Costa Mes�, California,
5 sL � v ,�
Owner
Mall
Address
■ Contractor
i.r•ai
i e�. L1
No.
Lfc.
No.
i r nv. or
Size of Lot Q Now[
Useof �` �,,.,7 No.of
Existing Idg - amli
Setback Lfne from � Rea�
CenterofStrcet "�'� Sida
DESCRIPTION OF R
New I I Alteration I
Repair I I-Moving I
Building .i iNo.of
Size �%jL ,YyGs( Rooms
Exterior Wall I Roof '
of New
Demolish I �
Stories
�APPLICATION FOR PERM ''
►7'i BUILDiNG �
FOR OFFICE USE ONLY
Receipt No. Permit .No
� ,
Receiv by Date ReCd. Date Issue�
� -3cr S 1o,5=J.�
Building � d �Y �l
Address ��� _ �J.J — �J� �
Cos a Mesa, California
Nearest
Cross St. Cr t^/ ''° "p�
Zone I No. of I T�` GroUp
Plans �
Approved '
hv Date
�d_/.' u�. _
i
I hereby acknowledge that I have read this Applicatlon
and state that the above is rnrrect and agree to comply Lath. Int
with all CYty Ordinances and State Laws regulating
building construction. ���ppp � Lath. Ext. {
Signatureof /� �/� �
Permittee ✓�1A n lln�iJll I?laster, Int. .
Authorized Agt. / Plaster, Ext�
Valuation Permit Fee $. �, � � Masonry Reinforced
i.r. Plan Check $ eond Beam
$ Total o O
Fee $ p� • FINAL '
FORM 204 S-HP 2bf B-55
a Z2c
�
,-
ocT -,-sspp`�ST" sca � 2.rc
V�ESA f,;}t.::�y
19'7� -
, • ".
Show. Iooatlbn and distances from �
�property line antl betWeen buildings.
, Do you carry•�'orkman's Co�pensation ; -. : -• .
""'" :neurance? �e� � I�o ❑
��.
: am u�are of Provis=en 3'Cfl'o� the Statb .., __.
:abor Cocis �zhi»'_: r�caa� as et•erg e�nloYer
�+_�i:st iiab�iity for
.o bo ir';z;�ed a;;-.
�� �,mr�e:_s�tion.�/
:orlcm�n � -` //Ly�/,
ii �ned :
� �rir�� � '� '
c
OWNER LUCREZI, DI
JOB ADDRE55 743 W.
:G'"9RAL CONTRACTOR
A. .o. 115-346-45 LOT
iNSPECTI0N5
SOIL
GAS
W ATER
ROUGH PLUMBING
PROP. SWR. LINE � NOUSE CON. �
SPRINNLING SVSTEM
UNDERGROUNO � POWER
ROUGH WIRING
ORCE
SHEATHING
FRAME ANO FLAS I' 1
LAT4ING IN (
P ER, BROWN COAT
SInaCTURAL FINAL
HEATING, VENT., REFRIG. AND A.
PLUMBING, FINAL AN� GAS TEST
ELECTRIC, FINAL
aiiu niur. ciuei
F INAL
DATE
TRACT FIREZONE VALUE
$ignoture Date GROUP i TYPE
�i $vSCvF7nA�TvR
� • �- 32312
COSTA MESA BUILDING-SAFETY DEPARTMENT
p.0. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
nr.r -s-�oPA1000 �os� ��**27.00
Lq5!!
APPLICATIOPI FOR BUILDING PERMIT
�I D B DATE RECEIVED DATE ISSU
� �D - S- %�i �/J- •�-
OWNEp � � A.P. NO. (� �
MA I L BUILDING
2 .
AODFESS RBO�I ADDRESS '
NQL'�y1 TRACT
a U CI7v Cf �j' _
H Z
Z Q CONSYFlUCTION W
O�F LENDER
am
J � BRANCH •
J N OWNER
m J ADDFESS ///�/,y
m ARCHITECT TEI. S �uLW ��
J� OR ENGINEER O W NE
V Q FIRE
W � ADDRESS 20NE — T
p_ W
W Z APPROVED
J O CONTRACTOR C.�J BY
m Z
J � ADDRESS
w W TEL. ZON NO.OF
Z� CITV NO. ' P�'p'�'
W� STATE CIT�' �'ARDSAPPROVED
(/� CL LIC. NO. LIC. NO. MAIN BUILDING
� O (FROM C/L STREET)
SIZE �D ' � NO.OF BLDGS. '
OF I.OT NOW ON LOT ROfYT FT.
USE OF
EXISTING 9LDG. 5�
F 512E OF NO. Of �(�.�
Z NEW BL�. ROOMS STOR�ES I �. SID FT.
a EXTERIOR WALL ROOF
�% COVERING WOO COVERING G�OM Q REAF FT.
J VSE OF BUILDING AND WORK TO BE P RFORMED DISTANCE BET.
a � O O MAIN BLDGS.
a
Q � VAR.�W
O C.U.P.q�
~ APPROV
h
z
�
VI heretfY acknowletlBe that I have reatl Ihis application antl s[ata
� that the above information is correct antl agree to comply wlth
� nll laws reB�latinB builtling conscructlon, and 1 shall not employ
F any person in vlolntion of the workman'e compansetion lews of
cha State ot Calilomia. �
zI herebY carNfy Nat I em pro0arly Ileensetl es a conttector �ntler � � SQ. FT. �
tha State of Cnlifornie Business antl Profeczlons Code, Dlvisicn 3, THE AMOUNT SHOI
Chepte• 9, and thet such licenses ere in full forca entl eftact, or I THE PURPOSE OF E5
nm exempt from [he prOviSiOns of t a Stata o( Celltornla Businosa yALUATION
ontl PrPfBsslons C Divisi 3, C ter 9.
\ / ��
SlBnaiUre of � / / �j �
Pormlitee .i § � 0 /
Au[hor��atl Apant ' `
DA7E
BLOCK
� /�
VSE OF N— r�
BUILDING
f
VARD$ APPROVED
ACCESSORV BUILDING
� FT
BET. MAIN &
ACCFSS. BlDGS.
DATE
APPROVED
m
0
VALUATION IS FOR �
A 7ERMIT FEE ONIV: a
E S �OiO'O n
J
y. � m
K5 E
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S �7 � �