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Home My WebLink About764 20TH ST - Building Permits(714) 75a-5273 • Fex (714) 75a-485G • www.c�.costa-mesa.�.IdLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 764 W 20TH ST Suite: A Vicinity: ROOF Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Conslruction: V-N Parcel Number: 42228120 Zoning: nppliwnt: GUILLEN, CARLOS Address: 764 W 20TH ST UNIT A COSTA MESA, CA Owner: GUILLEN, CARLOS Address 764 W 20TH ST #A COSTA MESA, CA Comractoc OWNER-BUILDER Address: Zip: Arch : Address: Phone: Zip: License: Phone: 949-631-5826 Zip: 92627 Phone: Zip: 92627 Phone: License: 000000 Eng: Address: ISSUED BY: Status: ISSUED Applied: 0822I2005 Issued: 08/22/2005 Phone: License: aa.�r� vr rr.rtmi � TEAR OFF EXISTING ROOF. INSTAIL 1 LAYER OF 30# FELT, 30 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS NEEDED. 7,400 S.F. WIATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Permit: $97.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 PLANNING 8 ZONING SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o Rear 0-0 Rear 0- 0 Reauired: 0 Lefl 0- 0 LeR 0- 0 Pr000sed: �0 Calc Valuation: sn,000.00 Claim Valuation: 3a,000.00 R�gnt o- o Right 0-0 NOT�CE: The work authorized by this permit shall comply with all applicable handicap access requiremeMs under Califomia statutea and related regulatlons. (Ord. No. 92-28, § 1, 12-2/-92) EXPIHATION: This permlt sha�i automaticalty expire and become void if work Is not commenced wlthin 180 days, or if work is suspended or aDandoned for a perlod of 780 days. INSPECTIONS: In order for the vrork authorized under this permit to be considered legal, such xrork must compty with all applicable codes, and all requlred Inspectlona end final approval must be oblained. Failure to obtein Inspections and final approval will result in ihe expiratfon ot th(s pertn0. FOR INSPECTIONS CALL: (714) 7545628 zsaere la�Vol WORKERS'COMPENSATON �ECLARAnON: • I hereby eHirtn untler penalry of perfury one al the lollowing declaratlons: ❑ I have entl will melntain e c6rtlticate of consent to self-Insure for workers' compensetion, es O�ovided tor by sectlon 3700 of the Lebor Code, br ihe pertortnence of the work tor whlch this pertnit is �ssue0. ❑ I heve end wlll melntein worKero' compensetion Insurance, as requlrea by secllon 3700 0l Ne Lehor Cotle, for ihe pertormance ot ihe work for whlch this pertnit Is issuea. My workera' compensaNan Insurence carder end policy number are: Carder: Policy Number. (Th/s secf/on need no( be comp/efed 1! fhe permlf /s velued et one huntlred tlollero ($100) or Iess.J �--I�certlly thet in Ihe peAormenca of the work lar which Ihis permlt is issued, I shall not employ eny person in eny menner so es to become subject to the workers' �corrmpensetlon laws ol Cellftlmia, e grae thet it I shwld beco�le sub�ect to the workers' compensatlon proNsions o1 Section 3700 of the Labor Code, I shall foAhwlih wmply with these D�ovision9. t>��'(� f�pplkenPSlpnetu7e:, rDate: �'/Z L /� � WAfWWOeFAIWRETOSECUREWO RS'C06�PEN3RT10N RAOEISUMAWfULMlDSIULLSUBIECTANEMPtOVERTOCRIMINALPENA�TIESANDCMLFlNESUPTOONEHUNDRED h10USMlD WLLAHE (f100,000�, IN ADDITION TO THE WST OF COMPENSATION, UAMAOES AS PROVIDED WR IN SECTIpJ 31O80F THE IABOR CODE, IPREREST, M1D FTfORNE1"S FEES. LICENSED CONTRACTORS DECLAHATION: ' I hereby eHirm thet I em Iicensetl under proNslons af Chapter 9(wmmencing with Sectlon 7000) ol �Ivlslon 3 ot the Business entl Prolessions Cotle, end my Iicense Is in tull ' lorce entl eMecL Uc. a Cless x contrectors slgneWre: oete: CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirm that there Is a constructlon lentling egenty lor Ihe peAormance ot the work for which this parmit is issUetl. (Sec. 3097, Civil Cade). Lentlels Neme: Lentlets Address: SlgnaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby etlirtn thet under panelry ot pe�ury thet I em E%EMVT FROM THE CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Protesslons Cotle: Any clry or counry which requiras e permit m consWct, elter, improve, demolis�, ar repair any sWcture, pdor to its issuence, also raqulres Ne applicant tor such permlt to file e signetl statement ihet he or she Lv Iicensed pursuant to Ne provisions ol the Cantrectors Ucense Law (C�apter 8(cammendng with Section 7000) of D'Msion 3 of the Business end Prafesslans Code) or thet he w s�e Is exempt theretrom end t�e besls for t�e elleged ezemptlon. Any vldation of Sectlon 7031.5 by eny applicent for a pertnit sub�pcls the epplicant lo e Gvll pe�alry ol not more then iive hunAred dollers ($500).): � I; as.owner ol tha properry, 0� my employees wlih weges es Ihelr sole compensation, WILL DO THE WORK, antl ihe structure is not intendetl ar ottered tor sale (Sec. �7044, Business entl Profess�ons Code: The Contractors LJcense Law does not apply to an owner of pmperry who builds or improves Ihereon, end who does such work himsetl or hersetl or Ihrouph AIs or her own employees, provitletl that such Improvements are not Intendad or aHeretl �or sale. If, hov.•ever, the builtlinq or improvement is soltl within one year oi completion, ihe owner-builder will have ihe burtlan oi proNng that he ar s�e tlid not build or imD�ove far purpose ot sele.). • ❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTNG WRH LIGENSED CON7RACTOR3 to construct tha project (Sec. 7044, Business antl Protesslons e: The contrectors Ucense Lew does not eppty to en owner ol property who bullds or Improves thereon, antl who contracts far such project wit� a contractor(s) licanse pursuam to the Conttaaors Licanse Laws.). I em-exemot un�ec. _ Business and Prolessians COCe tor thls raeson: . , i _ OwnerlD verilled D�drivefs Ilcense. �] Ves ❑ No �D�rs llcerea No: vednwuon of rnvnersmp ty (rype o� dxumem, �.e. - properry tae bm or aee�: -' 'j DIVISION OF INDUSTRIAL SAFEn' PERMR CERTIFICATION: ❑ I hereby cenity that no excavatlon Me (5) or more teet in tlept� Imo whlth a pamon is reqWred to descend, will be meOe In connectlon with work auNodzed by thi5 pertnll, entl Ihat no buildinp Siructure, scettolding, telsework, or demdi�lon or tllsmentling thereol, wlll be mora lhan Ihirry-slx (36) feei hig�. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title 8, Calllamla AtlmlP�stralNe Cotle). ❑ As owner-Dulltler, I will not employ enyone to do work which would requlre e permit Imm Ihe Didslan oi Intlustdal Setety, es notetl ebove, unless such person hes e permil lo tlo such work Irom t�e dlWslon. Signeture: Date: DiNsion of Industdal Safery Pertnit Number. CERTIFlCA7E OF COMPLIANCE AND AUTHORRATON OF EMRY: I ceNfy untler penalty of perJury thel I heve reed this epplication antl state ttiet ihe infortnation given is correct I egree to comply wlih ell stete laws antl ciry orClnances releting to bulltling construciion, entl euthodze represenietives ol ihe Ciry of Caste Mesa to enter upon lhe ebove-descnbed property lo ction puryoses%.J� gree� f2��t to occupy or ellaw occupancy ot eny building emhonzed by �his permit until tinaly' 'spectlon. p,�v �� $� / Z Z�D S" -� �ign8�ure Ot Lepa ner(s)' ' - -- Date � J AnNOr Authodzed Applicant Dete COOE I. INSFECTIONTYPE 1618 Fized System Flnal Fire Preventlon 1268 Pool SOe Final 200 Final Ra-Roof 201 Flnel BIocWRetalninp We�� 202 Finel Fectory Firo Plece 203 Finel Sign 204 Finel DamoOtlon � It� • a_ _._ � ��l �� J� COOE I INSVECTION TYVE 208 Final Mechenicel 20B Final Plumbing 210 Finel Electdcel 212 Finel Flre Prevention 220 Finel Planning Appro�el 222 Flnal Site 250 Final Building/Occupancy ,� - Job Address: 764 W 20TH ST Suite: B Viciniry: ROOF, BLDG B Primary Occ: R3 Dwellings/ Cong Res <10 Parcel Number: 42228120 Applicant: MIKE ROGERS Address: 2626 NEWPOR7 BL COSTA MESA, CA Owner: GUILLEN, CARLOS Address 764 W 20TH ST #A COSTA MESA, CA Comractor: PETRONELLA ROOFING Address: 2626 NEWPORT BL COSTA MESA, CA Zip: 92627 Arch : Address: Zip: Phone: License: Type ot Construction: V-N Zoning: Phone: (949) 548-1645 Zip: 92627 Phone: Zip: 92627 Phone: (949)548-1645 License: 460707 Eng: Address: ISSUED BY: Status: ISSUED Applied: 08I16R005 Issued: 08I162005 Phone: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30# FELT, 30 YEAR COMPOSITION, AND REPAIRlREPLACE SHEATHING AS NEEDED FOR UNIT B. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $83.25 $0.50 50.00 $0.00 $0.00 $83.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o FEE SUMMARY PLANNING & ZONING Rear 0-0 Lefl 0-0 Rear 0- 0 Lefl 0. 0 Reauired: 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0• 0 Right 0-0 s2,iao.00 sz,�oo.00 NOTICE: The work authorized by this permit shall compy with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92Q8, § 1, 12-21-92) ' EXPIRATION: This pe�mit shall automatically expire and becoma void if work Is not commenced within 1 BO days, or If work Is suspendetl or abandoned for a pedod of 180 days. INSPECTIONS: In order tor tha work authorized under this permit to be eonsidered legal, such work must comply with all eppllcable eodes, and all required Inapeetlona and final approval must be oblained. Failure to obtain Inspectlons and tinal epproval will result In the ezpiretion ol this permit. FOR INSPECTIONS CALL: (714) 7545626 aaaae �aoo� WORKERS'COMPENSAnONDECLARAnON: r ` �! I hereby attirtn under penalry of pe�ury one ot the lollowing declaratians: ` ❑ I have antl will mainiain a certi(cata of consent to self�lnsure for workers' compensetion, es proWded for by section 3700 0l the Lebor Cotle, lor ihe pertortnance of Ihe work lor whiCh Ihis permit is issueO. �I have aM will maintein workers' compensatbn insurence. es raquired by section 3700 of the Le6or Code. for the peRortnence of the xroAc tor which thLs pefmit is L5we0. �My_worke campe sation In urence�e rtier end poliq number ere: A--y� t1 C er:, �fur� �✓v�.d �cyNumber,�__�Qa[J / �—d"1 �(Tiiis sectla'need not be completetl i/ ihe permit is veNed et one hundred dollars ($100) or less.) ❑ I certily t�at In t�e pertormance ol the work tor which this permit Is issued, I shell not emplq eny person in any manner so es to 6ecome subject to Ne workers' campensetion laws of Celifomia, end egree that It I shwld Decome sub�ect to the workers' compensatlan proWslons of Sectlon 3700 01 the LeDor Code, I shall tort�with compy wii� Nese p�roJW �'ons. /� �f �+ Appllcanf9gneture: -� -�./' �'�c rDa�e:-�----_b/�/ �e�01 WARWNO��FAILURE TO SEIXIRE WORKERS' COMPEN' IXJ COVERAGE IS UMAWFUL M'0 SNALlSU&IECf PN EMPLWER TO CRIMIILSL PENALTE$ PND CML FlNES UP TO ONE HUNDRED TIqUSMlD DOILARE (5100,000),IN ADDRION TO THE C OF UJMPENSAT�ON, DAIMGE5l5 PROVIDED FOR M SECfION 3]080F THE IABOR COOE, INTEREST, PNO FTTORNEV'S FEE9. LICENSED CONTAACTORS DECLARATION: I here6y aNirtn that.l em Iicensedy nder rovis ons ol C�epter 9(commendng with Sectlon 7000) of DlNsion 3 of.Ihe�Buelness and Professbns Cotle, entl my Ilcsnse Is In full force�entl`eHect. LJc_. x L%b`+ ��, �� —� � / Cless Y_�`. G' 3`1 O�ctofaSignetvrai �__.-/L✓ C/d '�C.-c � ete;. �// n1� CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirm �hat there is a construaion lending egency for ihe Oetlortnance of the work for whlch Ihis permit Is issuetl. (Sec. 3097, Civil Cotlej. Lentler's Name: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARAT10N5: 1 hereby aNirtn thet under penalry ol pehury that I em EJ(EMPT FFiOM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry whic� requires a permit to construct, alter, improve, tlemolish, or repair any sWCNre, prior to its issuance, elso requires the applicaN for such permil b file a signetl statemam thet he or she is Iicensed pursuant to the provisions ot t�e Cantrectors License Lew (Chapter 9(cammendng with Section 7000) 01 D'Msion 3 of ihe Business antl Pmlessions Code) or Uat he or she is exempt therefmm and the basls for the alleged exemptlon. Any Wdation of Sectlon 7031.5 �y any epplicent tor e pertnit sublects the applicant to e civil penelry of rwt mora ihen five hundretl tlollars (5500).): ❑ I, es owner ol the propeM1y. or my employees with wages es their sWe wmpenseLon, WILL DO THE WORK, and Ihe strucWre is not intentled or oMered for sala (Sec. 7044, Business an0 Professions Code: The ConiraIXors License Law tloes not appty to an owner oi property who builds or improves thereon, antl who does such work himself or herself or ihrough his or her own employees, provitled that such improvements are not Intentled or oRered for sale. It, however, the building or improvement is sold wiihin one year ot comple6on, t�e ownerbuildar will have Ihe burden ol proving that he or sha Aitl not builtl or Improve for purpose of saleJ. � ❑ I, as owner at Ihe property. am E%CLUSIVELV COMRACTING WITH LICENSED CONTRACTORS ro wnstrud the projeq (Sec. 704A, Businass and Profeuims Cotle: The contractors License Lew does not appty ro an owner oi property who bulltls or Improves thareon, and who comrams tor such pmject with a contracror(s) license pursuant to ihe Contractors License Laws.). ❑ I em ezempt under sac. Business and Professions Code tor this reason: Signature: Date: Owner ID verified by tlnvefs Iicensa. ❑ Yes ❑ No Drivers Licensa No. Vedlicatlan ai Ownership by (rype of OocumeN, i.e. - praperty taz bill or deed): Expires: DIVISION OF INDUSTRIAL SAFE7V PERMR CER7iFICATION: ❑ I hereby ceNiy that no excavation Me (S) or more teet In tlapth into w�ich e person is requlrad ta descend, will be made In connectlon wlth work euthorized by �his perml6 end Ihat no building shvcture, scaflolding, falsework, or demolltlon or tlismantling thereol, wlll be more Ihen thirly-sia (38) feel hlgh. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celitomia Atlminisiretive Code). ❑ As owner-builder, I wlll not employ anyone to do work which woultl require e permll Irom the DNislon ol Intlustrlel Sefety, es noted ebove, unless such person hes e pertnit to do such work trom the division. SigneWre: Dete: Oivision at Industdal Salery Permit Number. CERTIFlCATE OP COMPLJANCE AND AUTHORIZATON OF EMRY: I certity under penelty oi perjury �hai I have raad this eppllcation end stata t�at ihe Inlormation given is correct. I egree to comply with ell state lews entl ciy ordinances relating m building conslruc�ion, and euthorize representetives oi the Cicy of Caste Mese m eNer upon Iha ebove-descnhed property for inspection purposes. I agree noI to occupy or ellow occupancy ot eny building authonzetl by this pertnit until linal inspection. COOE t. INSPECTONTYFE 1618 Fl:etl System Final Fire Prevention 7266 200 201 Pool Spe Finel Finel Re-Raol Finel BIocWRetaining Well 202 Final Factory Fira Place 203 Final Sign 204 Final Demolition , �. 1 .1111. :�C +t : COOE 1 INSPECTION TYPE 206 Flnel Mec�enlcal 208 210 212 220 222 Finnl Plumbing Finel Electrical Finul Fire Preventlan Final Plenning Approvel Finel Slte 250 Final Builtling/Occupency Pdff ItIImELi JOb Address: 764 W 20TH $T Suite: C Vitinity: UNIT C, ROOF Primary Occ: R-3 Dwellings/ Cong Res <70 Type of Construction: V-N Parcel Number: 42228120 Zoning: Applicant: MIKE ROGERS Address: 2626 NEWPORT BL COSTA MESA, CA Owner: GUILLEN, CARLOS Address 764 W 20TH ST #A COSTA MESA, CA Contracror. PETRONELLA ROOFING Address: 2626 NEWPORT BL COSTA MESA, CA Zip: 92627 Arch : Address: Phone: Zip: License: Phone: (949)548-1645 Zip: 92627 Phone: Zip: 92627 Phone: (949)548-1645 License: 460707 Eng: Address: Sta�us: ISSUED Applied: 08I162005 Issued: 08I762005 / ISSUED BY: Phone: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30# FELT, 30 YEAR COMPOSITION, AND REPAIR/REPLACE SHEATHING AS NEEDED FOR UNIT C. 6 SQUARES. ' FEE SUMMARY Plan Check: $0.00 Permit: $41.80 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Calc Valuation: Si,�oo.00 Claim Valuation: 3i,�oo.00 Total: $42.30 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0- 0 Lefl 0- 0 Right 0• 0 ACCESSORY Froni 0- 0 Rear 0- 0 Left 0- 0 Right 0- 0 PARKING Existin : 0 Reauired: o Pr000setl: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permlt shall automatically expire and become void if work Is not commenced withln 1 BO tlays, ar if work Is euspended or ebandoned I for a pedod of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply wlth all eppiicable codea, anE all requlred inepeetlone end tinal epproval must be obtained. Failure to obtain Inspectlons and tinal approval will result In the explration of this pertnit. FOR INSPECTIONS CALL: (714) 7545826 zuaae �e�ao� WORKERS'COMPENSAnON OECLARATON: . . I hereby affirm untler Denalry ol per�ury one of ihe fWlowing tleclaretions: ❑ 1 heve end wlll malntain a cenllicete of consent to selt-Insure tor warkers' compensatlon, es prodded for by section 3700 of the Lebor Code, tor Iha peAormance o1 t�e work tor which this pertnit is Issued. ��hava end wlll malntain workers' compensetlon Inwrance. es requlre0 by sectlon 3700 of the Lebor Coda, for ihe pertortnanca ot ihe work lor whkh thls pertnit L5lssueC. My workers' comp1ensatlon rence rder entl policy number are: �/� / �,/� Cerrler.-% �f�/`� v� PWicyNumOer..._,,,(I'(J CS�—vY ❑ I certity t�et in Ihe peAortnence ot the work for which t�is pertnit is issuetl, I shell not employ eny person in eny menner so as to becomo subjoct to the workors' campensetlon lawa of Celtlomla, end egree thet it I s�oul0 become su6�ect to Ihe workers' compensation proNsions ol Sectlon 3700 0l Ihe Lebor Catle, I shell forthwith comply with these praNsions. / p AppllcanY5lgnature: y rDeta:� � O��//J� WFRNIN��FAILURE TO SECURE WIXL(E0.S' COMPENSATION COV � GE IS UNUW FlA AND SHML SUBIECT AN EMPIOYER-TO CRIMI PE T1E5 AND CML FlNES UP TO ONE HUNORED hKK15AND DOLLRRE (510p,000). IN AODRION TO TME CQST OF CO ENSAiION, DPA41GE5 AS PROVIDED FOR IN SECiION 3]OB OF THE UBOR CODE, IMERE5T, PND �TTORNEY'$ FEES. LICENSED CONTRAC70RS DECLARATION: I hereby eHirm Ihat I em torce entl eHect. Llc. p Contreclors Signewre� WNSTRUCTION LENDING AGENCV: ol Chepter 9(cammendng with Section 7000) of Divislon3.ol.the Business and Erolessions Cotle, end my Iicense Is in full r] ❑ I hereby eflirm that I�ore Is e wnsiruction lentling epency lor the peAormence of the work tor w�ich this permit Is issued. (Sec. 3097. CINI Coae). Lendefs Nemo: Lentlers Adtlress: Slgneture: Date: OWNER•BUILDER DECLARA710NS: I hereby eNirtn Ihet under penalry ol per�ury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7037.5, Business and Prafessions Cotle: Any ciry or counry w�ic� requires e pertnit to conslruG, etler, improve, demolis�, or repair any strucWro, pdor to its Issuance, elso requlres the epplicam tor such pertnit b tile e signetl stetement thet he or she Is Iicensed pursuent to the provisions ol tha Conirectors License Lew (Chapter B(commendng with Sectlon 7000) ot Divlsion 3 of the Business antl Pmleuions Code) or Ihet he or s�e Is exempt t�eretrom and t�e besls tor the alleged exemptlon. Any vlWation o1 Section 7031.5 by eny applicent far e permit subjacts Iha appllcant to a civil panelry ol not more then tive hundred dollars ($500).): ❑ I, as owner oi Ihe properry, or my employees wlth wages es ihelr sole compansation, WILL DO THE WORK, and ihe sWcture Is not IntendoC or oHeretl tor sele (Sec. 7044, Business and Professions Code: The Coniractars lJcensa Law does not eppy to an owner oi properry who builtls or improves thereon, entl w�o does such work �imsetl or herself or ihrough his or her own amployees, provided t�at such Impmvements ere not Intended or oflered for sele. If, however, the hulltling or imprwement is sold within one year ol completion, the owner-builder will heve ihe burden of proving that he or she did not Ouild or improve tor purpose of sale.). ' � I, es owner ol the properry, em EXCWSIVELY CONTRAC7ING WITFi LICENSED CONTRACTORS to construct the pro�acl (Sec. 7044, Business end Prolessions Code: The contractors License Lew does not appty to en owner of pmperry who builds or Improves Ihereon, end who contracts for suc� pro�ect wlih e comractoqs) license pursuant to ihe Contractors Licensa Lewa�. ❑ I em exempt untler sec. Business and Professions Code for this reeson: Signe�ure: Da�a: Owner ID v0Afi8C 6y Arivefs Iicense. ❑ Yes ❑ No Drivefs License No. Expires: Vedficetion ot Ownership hy (type oi document, I.e. - property tav DIII or Oeetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: ❑ I hereby cenity Ihat no excavation live (5) or more leet in tlepth inio whicti e person is raquireA to descend, wlll be mede Im m�nection wlth work euthonzeC Dy lhls permit, and that no bulltling structure, sraHalding, lalsework, or demolition or dismentling theraof, will ba more then t�lrty-sl: (38) teet high. (Chep. 32, Grp 2, Atl 2, Sec. 3a1, 71I1e 8, Celltomia Atlminisiretive Gotle). ❑ As ownar-builder, I wlll not employ enyone lo do work w�ich would require e permit trom the Dlvlsion of Industdal Sefery, es notetl ebove, unless such pemon hes e pertnit to tlo such work irom l�e division, Signeture: Date: Division of Intlustrial Safery Permit NumDer. CERTIFlCATE OF COMPLIANCE AND AUTHORVJITON OF EMRY: I ceNfy untler penalty of perjury thet I have reatl thls epplicatlon and state that the intortnetion given is wrrect. I egree to wmply with all atate lews entl Gry ortlinances relating to builtling wnstrudion, enA euthodze representetives ol the Ciry of Costa Mese lo enter upon t�e ebove-tlescn�ed pmperry br inspecuon purposes. I egree not to acupy or allow occupancy oi eny building authorized by this permil until fnal inspection. CODE I. �xsveenoNrrve 1618 Fl:etl System Final Flra Prevention 1288 Paol Spa Flnal 200 Finel Re�Roof 201 Final BIocWRetalning Well 202 203 Finel Fectary Fire Place Finel Sign 204 Finel Demolltlan .�-- Applirant - PdIF 1��4 8�— � Date �ar_ �Date CODE� INSPECTIONTYPE 206 Finel Mechanical 208 Finel Plumbinp 210 Final Elect�ical 212 Finel Fire Prevention 220 Flnel Planning Approval 222 Finel Site 250 Finel Building/OCCupenty PAg I�LS HtLLIARD & B John Hilliard ❑ June 27, 1978 �%/N m tf , 'N `'.. Zr sp-� �T� r Consulting Acoustical Engineers Mr. Randal Bryant Bryant Construction 29521 Ana Maria Laguna Niguel, California 92677 Subject: Plumbinq Inspection �] cQ �{ �1. 20 T `` Dear Mr. Bryant: � 78/538 ❑ Gordon Bricken We have examined the plumbing installation and find that the pipes in the party wall have been isolated from the frame of the wall so that the plumbing does not detract from the STC rating of the wall as required by the City of `''" - K. Hil��rd, D.Sc. 'ti�•� r l�• Uf CA��Y�,I Approved by: 4/�� Gordon L. Bricken Vice President 1971 East Fourth Street, Suite 18 ❑ Santa Ana. California 92705 ❑ (714) 835-3728 COUN'PY OF ORANGE BUILDING DEPT. 636 No. Broadway Sanca Ana� CaGfornia Phone: KI 2-6211 Permit No.....✓...`�'!/.....a . Application for Building Permit AND FOR A Certificate of Use and Occupancy Date---'----_K_.�! ....�� /-------'-'------'-- t . OWNER'S NAME ��/ �// _� �� - W � � �-t,- �� - - - -- - -- - - --_._... PHONE:IIIU- ��- �---�------ MAILINGADDRESS--1.-�-�%-�ii�?-S�-s�-� ��-- --- ---- - --- CITY.��'�--��--�=��e_�,�.---� Name - �O )J �� -'------------------•--------------------'-------'------- (Architect or E�gineer) Address--------------'----- --�-----------------'--_.--._.._------ City _. State Lic. N PROPOSED USE: �� C� � �-n [;r-- -- ' -`-(/`�� 2. JOB LOCATION----�lD--�------------'-i/tI � O T�2� (House No.) (Name of S[cee[) 3. LEGALDESCRIPTION: LotFI,V %5�1+1/v/Nn�______ (Metes and Bou�ds Description—Use reverse side of form) - Name ._..�.�._. V��..� e' � ---'-----..._.--------'-----'---"------�----"-------'-------------- n (Con^tract(or) Address J F�t ��'e..---�- ��--`�--1�-t:--!`-l'--� ��..�---------' -------'------------- � i-es,i t� City -'--'�----�-------------".--------------------------'-'-------------'------------ State `� Lic. No..��0-�----�'-�--`------`---.__... Phone_/��_'i9 -C..� -------------------- /G�.4s71 SChODJ Me SA �� e�_e_� ra �-:.�r------ ----- - - - ------ --- - 3 Lrf/i_(Town or School District) �pS �Q. /!h C.'SCt. i ��7 -------------------------- Track---l_�_Z...-----------�------ 4. CORNER LOT ( ) INTERIOR LOT (X ) THROUGH LOT ( ) SLOPE OF LOT (/°,�-),'��„ 5. SIZE OF BLDG.:,: f--�`---��--`�'--..._--.AREA:----�-'-�--.`._:----'�----5IZE OF LOT:_C:.��_,��IJ.--_/.._-AREA:.9�.�•� �!4i�j` E . ---� . . � - .' G. HEIGHT OF BLDG.:-_-_-.-_--------•--.-__._._.--__-CEILING HEIGHT:--_--=__--_------------------NO. OF STORIES_L..._....---.------------_- 7 8. . � _ . NO. FAMILIES...._....�- .__..._Size of Smallest Bedroom:. ��-... :_ .�r' . ............... Size of Kitchen._._.._�____..................._.... EXTERIOR WALL CONSTRUCTION:_.: �. �^. �L�`�C. ' ............._INTERIOR WALL COVERING._. n_✓ �_:-3C-�:, -- -. (Frame, Swcco, Etc.) � � � �(Plaster-Drywall, Etc.) SETBACKS: Front Yard From Center Line of Street-----=`1-�-_ "..�.---:----_ ---- ------------------_-.._.---------........---.----------------...._.. 'j •- - -�_i �� Nearest Side Yard._._.....s�T__.......Rear Yard...�. z.��_Distance in Feet Between Bldgs. on Same Lot ............................................ l0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width....-1`1-�-----------'-__------Depth in Ground��.-�"[.-'�----..Width of Wall--:''---�-_--_�-----_---- Accessory Bldgs. and �b) Size of Studs .�_ �-�-_.....-----Spacing--. �^_�::�-----.."CC Material of Floor. � D�/----__-'-----_-_-'•--.--' Similar r Structures: �" -,_,,.._._,.�. . (c) Size of Floor Joist�:------/--'�=�--------'—:-....Spacing....-"----....'------------------------��CC (d) Size of Rafters:-- 9---��---`-F------'--...._-'----------Spacing---9--�-I--n-:�'...._...._:'CC 12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $--- ---c-..._-:--------`--------`---- . , 3�'�n� 13. I HEREBY CERTIFY T AT 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 OP THE COUNTY OF ORANGE Ah`D THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed:_�_Gf.�.a�..�f�(h�.�a �t.l� �O'�e%�ts '---`----"`-----'---`-'----- `----'----'--'--`---------------------------------' / � CJ.�'� (Owner) Plans Filed:._'--'-- -- �`---- --'-----'---'----_........_....-'---....._._ . BY`-------------'-------_..----------._- "---__------------------'------'- (Authorized Agent) FOR DEPARTMENTAL USE ONLY Bldg. Permit Plan Check Total - - Receipt No. Paid to - Date ...._...... SM-2-51 FEES: � � � Q �-Q Gxour --- - - j%. _... ��-: " $- - �" ��-U, -- - TYPE -- - -----y....... - -- - - $.�..��.0-�.� DIST. /� " --�x-L�-�1' - - MAP- v - .�� .-�� - ' �- - - SHEET NO.--s�-� - - - DATE-- ��LY.' 4.� L - - - - Uri�:CK1N(; BY APPLICATION.��r-f--�' HEALTH--......_...._...-----.-- ZONING____.._....i._.... �t__.. FIRE PLANS AND MARSHAL . SPEC'S_ -- ---- - '! - STATE --------- -- -- - - CORRECTIONS ENGINEER __i %'JSPECTpR Project qddress //n � A.P. Number /�� — Building Permit Number 1 Owner's Name Mailing qddress_ FEE: Planning Department ApplicanYs Signature ' City Ortlinanca 72-44) CMF Ol)4-32 Rev. ]/77 CITY ( OSTA MESA PAFcK FEES Fee Payment Receipt /iJ �7��/ - �j,�Z Park Area Single Family' 2-Bedrooms or Less 3-Bedrooms 4-Bedrooms 5-Bedrooms + Multiple Family "» Bachelor or Studio 1-Bedroom 2-Bedroom � 3-Bedrooms + Date N° - 3'17 � @ $ 702.70 = @ 963.73 = @ 1,260.33 = @ 1,476.32 = @ 386.81 = @ 467.38 = @ 716.80 �� a @ 1,135.66 = / Total Fee "«"/L/ 7/ !Q V / Sce4Q�d5 "'" City 0.esolutlon 77-89 Canary—Plannlnq; Pink—Financa; Ooltlenrotl—Appllcant � ( `Co�SG� �iCSJ OWNER COI^IANa ELIZABETH DATE ].1-S-S5 JOBADDRESS ?(�I� W. Qnt}L St. BUILDINGPERMITNO. #ZO�1�-1 GENERALCONTRAC70R P. B. Andrews VALUE $ wS3OO.O0 � AP 115-31i9-8 BLOCK TRACT Dwellin� & 1 Car Garage GROUP I��T TYPE SJ ZONE Rjy FIRE DISTRICT 2055 PERMIT$ ISSUED INSPECTIONS DATE SUBCONTRACTOR } ._ _ _. � DATE I NUMBER \.1 Footing Trmch �1A..-� � ' !' Foundation Forms and Grade to Garage Rough Framing � Plumbing, Rough to Slab �i • • Plumbing, Rough Complet � Temporary Pole Wiring, Roug "'` �—�� ' Heating, Rough Heating, Final Sewer Sewer, St. � ' nker Cesspoold e � % - 1� La� �, In t Out � L Finai, Fixtures Compl ta7v��j � ��. �T � FinalGasTest /� , _ ,c,�,t�c \�— _ 2 ,.�%_� Final Occupancy F'm m 'l.t , Costa Mesa Bnilding Department APPI.ICATION FOR PERMIT . �� 117 EAST 20th STREET / n:�5 . g� f�, D i N G ' COSTA MESA, CALIFORNIA ✓ F� FOR O�'P'ICE USE ONLY �OR APPLICANT TO F'II.L IN Receipt No. Permit No. Building � Address \ 2�.— �-r Q � � Costa MeSa, California Received by Date Ree'd. � Dah Issued Nearest 7� �/' j- S 3 ��'��'� CrossSt. Buildina // Mail Address No. sl Contractor (Attach Metesand Bounds) i! / H ��;".3�"c3 Size of Lot � �� ,� / I NowonLot Useof No.of No.of Existing 81dg. Famllies Rooms Setback Line from � � Rear Vard 'y4, � Centeroistree2 Ridwvwrn e n1 �l' _ New Size L Costa 1Vlesa, California Nearest Crou St. Zone �:/ I No.of I Typc . i Unde •ame: CORRECTIONS APPROVAIoS rn Loeation I Inspector Materials, I hereby aclmowledge that I have read this Application and state that the above is correct and agree to comply Lath. Int with all City Ordinances and State Laws regulating building Co 'on. Lath. Ext Signature of Permittee _ , l Q� P�� Plaster, fnt Authorized Agt plaster, EM. Valu.atlon Permit Fee $ � G•!� �� Masonry Rei eo Pian Check $ �� U L Bond Beam s �3 c e � Total Fee $ � U �) FINAL iRM 204 S-HP 2h1 B-5a ► Street rr.oa ri,AN Show Iocation and distances from property Iina and between bufldinga 6 � • �. ., . ,• . S ' � ` COSTA MESA BUILDING-SAFETY OEPARTMENT P.O. HOX 7200 COSTA MESA_ CALIFORNIA 92626 �5: 5/ I-/7': I^I �' Tl. APP � C Tl FORSiRUCfURALPERMIT �` For Applicant to Fdl in Completely — Use I y REC IVE� OATE flECEIVED DATE ISSUED BVILDING � � ADORE55 � �' S / PEFMIT NO. OWNER � A.P. NO. MAIL BUILDING ADDRESS '� y � A AODRE55 TEI. 7RACT LOT BLOCK ��T� � p . ruo. y /-y93J COf�STR ON �" LENDEF X O� L�,.v L� BRANCN 1, � ' � � OWNER � AD�RESS �//u,K.� G i- % • VALUE ARCMITECT TEL%� / � P� S q NGINE �6 , ' � ) FIqE AODAESS � J � ST r/� N%I H/ ZONE TVPE ROUP CONTRACTOR � G J3 ♦. �A, T eV ROVED DATE ADORESS j. /v /S L ) /7 TEL. IONE NO.OF USE OF NEW CITV / r+o. p/•i937 PIAP6 eU1LdNG STATE CITV VARDSAPPqOVED VARDSAPPROVED IIC. NO. j�: (J fr�7s LIC. NO. MAIN BUILDING ACCESSORV BUILDING SI2E N0. OF BLDGS. (fROM UL STREET) OF LOT 7 S �` � s%/ NOYaONLOT � FT. FT. USE �F � EXIS'TING BLDG SeFarate pemtits aze required for � si T FT. electric, plumbing and heating work. REAR FT. iT. USE OF BUILDING AND WORK TO BE PERFONMED p6�{q� BET. BET. MAIN 8� � MAIN BLDGS. ACCESS BLOGS. VAR.ib DATE i �,..,� ,.�, C.U.P.�/ APPRpVED APPROVED 1 haraby aeknowlatlpe that I hm�a reatl tM1ia epplleetion antl steta �^ n Mnt t�e ebove Informetlon ia corract end eprea to comply with m ell la'%�� rapulatln9 bullElnp ConRructlon, antl 1 shell not amploy � ony person in vloleilon of Me workmen'� companfetion lawf of a tho Stete of Caiifornle. I �vaby canffy that I am proparly Iicanaetl es a eonbactor untler 54. FT. rv Me S�1e of California Budnau end Profeuiona Cotla, Dlvislon 3, TME AMOUNT SMOWN UNDER VALUATION IS FOR m Cheptar 9, entl t�et such Ileanaes ere in full force antl Nfeet, or I hIE PURPOSE OF ESTABL6HING A PERMR FEE ONLV: � em e%empt from the provision� of the Siete of CaIl7ornia euslnexi VAlUAT10N pERM1T iEE S enE Professiona Cotle, DHi�lon 3, C�eptor 9. � Sipneturs oi%��%� es �/ .Il i ��N CHECK S ^ 0 Permittee =y+�l� /7i. �� S TAX S LL i u Aut�OfizBtl Apent TOTAL PAID S __l :��45?'�'7 . �'�..__ COSTA MESA BUILDING-SAFETY DEPARTMENT ' P,O, BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Complerely — Use Ink Only R BUII.DING /_ �4 ADDRESS y/ OWNER r.� '� A J3 � / ,7/� � APP�CpTIQN FOR STRUCfURAL PERMIT � MAIL ^G BVILDING ADDRESS�L I�ZI I,% �q ADDRESS cirv I_r'1(oUl✓A IC1f(e/�G_ No.�$1-2437 TRACT BRANCH ARCHITE� OR ENGIN& ADDRESS OWNER (rp FIRE ZONE APPROVED TEL. CITV NO. F STATE CITV � IIC. NO. LIQ NO. W 512E � NO.OF BLDGS. 0. OF LOT Z2 NOW ON LOT a USE OF � EXISTING6LOG.SIN�.�� {�f.Ll�� y FSeparate permits are required for � electric, plumbing and heating work. (.W.i USE OF BUILDING AND WORK TO BE PERFOiiMED Q � -� (� vOL � a > r a x w QI hereby acknowletlpa that I hava reatl this applicatlon entl stnta � Mat the ebove information !s correct antl aprea to comply with a all �aws raguletinp bullding construction, and 1 shall noi employ Wany perwn in vlolation of Me workman's compensation laws of �. Me State of Celitornia. 3 1 hereby cenify thet 1 am propeHy Ilcensetl as a contractl r under the Stete of Callfornle Buainesa end Profesaiona Code, Dl�ialon 3, Chepier 9, antl Net such Iieenses are In full forca entl afioct, or I em exampx from tha orovisions of the Siate of Ceilforni �Businese entl Profass�ons Co e ivislon 3, Cnepter 9. SlBnature p'1! Parmlttae n�moreaa nee�c � J VALUE NO.OF USE C FlANS BUILO VAqDSA�PROVED VA MAIN BUIIDING ACC ROMC/V5�'RSET)� � DISfANCE BET. BET. MAIN & MAIN BLDGS. ACC6S BLD C URP ��K 7i'C— I� APPFOVfiD✓ �_ n � OLD FOR SPECI L RE U^ r tiF � m . FT. a`(� THE AMOVNTSHOWN UNDER VALVATION IS FOR m Vw THE GURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �\ VALUATION PERMIT FEE S p N � r� PLAN CHECK E "� /� o /� $� 7 1/J%I TAX E LL\.f\ �� `" ` � v TOTALPAID = Fc C a a y y "i F G W F Q O � � } a a w a O a a z 3 �6�10 _��O A COSTA MESA BUILDING-SAFETY DEPARTMENT •'P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 For Applicant ro Fill in Completely — Use Ink Only BUILDING �� ADDRE55 �O W. � � STiG� � OWNER (�%� MAIL i. ADDRESS CITV {,,.ti{�V � N�L. I CANSTRUCY�ON LENDER BRANCH ADDRESS ARCHITECT � � _ � TEL.. _ CONTRACTOR ('�LO�„/�L ADDRESS TEL. CITV NO. STATE CITV LI0. NO. UC. NO. SIZE � � NO.OP BLDGS. OF LOT �� X � 2 Z NOW ON LOT I USE OF � . � �. `. Segarate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFOFMED 2. C.A� Caa2.3� �. Lo�w�otz H �,�I EIIEI7? 5jo�n TI. �� FOR STRUCI'URAL PERMIT DATE RECEIVED D�A.+TE ISSUED t"'f '��7 A.P. NO BVILDING � M NO.OF / PLAfS vARDSAPPROVEO MAIN BUILDING iOM C/L STREET) VAR. qW G.V.P.9� I / ��- / �A VAWE � 2 s V GROUP � �DATE � � USE OF NE �/'�� — BUILDING VARDS APPROVED ACCESSOflV BUILDING FT. // F FT. / FT. I hereby acknowletl0e thet 1 have reatl this applieation antl stata '^ � thet tha ebova Informetion is corract enC agree to comply wit� m all Iaws rapulatinp building construction, and I shall not amploy �d� FOR SPEC L RE UIIC� any Oerson �� lolatlon of Ma workmen's compansatlon lawa of m the Stata ot Celifornie. �� — -\� 1 heraby cev��fy that I am properly Iicansetl as e eonttactor untlar � SQ. FT. a�� the Sute of Calitarnie Businass antl Profavions Cotle, Dlvialon 3, THE AMOUNT SHOWN UNOEF VALUATION IS FOR m � Chepter 9, entl that such Iicensas era in full force and effact, or I 7HE PURPO6E OF ESTABLISHING A PERMfT FEE ONLV: e em exempt from the provlsions of the Stete of Celifornie Busineas VALUATION PERMIT FEE § �"� a entl Protessiom Cotle, Divl on 3, Chopter 9. J� /y� SiB�eture �- '/ S // �j PLAN CHECK S � o/�J Permlttee �+ �� $ y ��%%% � �' / /� � TAX E � A�thorizatl AGant / u TOTALPAID S