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(774)754-5273 • Fax(714)754-4856
CITY OF COSTA MESA ���
BI/ILDIN6 DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Job Address: 909 W 20TH ST
Suite:
Vicinity: RESIDENCE 8 ATTACHED GARAGE.
ParcelNunmber: 42249449
Applicant: HOBBS, JEAN
Address: 1218 E POMONA ST
SANTA ANA, CA
Owner: THOMAS, ROBERT B TR
Address 909 W 20TH ST
COSTA MESA, CA
Contractor: A 1 ALL AMERICAN ROOFING
Address: 1218 E POMONA ST
SANTA ANA, CA
Zip: 92705
Arch :
Address:
Zoning:
Phone: 714-543-5400
Zip: 92705
Phone:
Zip: 92627
Phone: 714-543-5400
License: 693307
Eng:
Address:
PERMIT NUMBER
✓ 899-00602
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: OS/03/1999
Issued: 05/03/1999
Phone: Phone:
Zip License: Zip: . License:
SCOPE OF PERMIT
REROOF: T/O 2 LAYERS; PLYWOOD ALREADY IN PLACE; APPLY 1 LAYER OF 3Q# FELT; REROOF WITH 30 YR ELK
SHINGLES. 23 SQUARES. � �
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
SETBACKS
ACCESSORY
PARKING
NOTES:
$0.00
$87.25
$0.50
$0.00
$0.00
$0.00
$87.75
Fronl 0- 0
Front 0- 0
Existinq: 0
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
u
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0. 0
Right 0-0
$3,865.00
$3,865.00
NOTICE: The work authorized by this permit shall comply with all epplicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not,commenced within 180 days, or if work is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlone end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnONDECLARAnON:
I�by eilirtn untler penelry af per�ury one ol tha tollowing aeclerations:
I heve entl will melnteln e certHiwte af consent to seH-Insure for workers' wmpensatlon, es provided tor by sectlan 3700 a� the Labor Cotle, for ihe performence oi Ihe
wOrk for which Ihis permlt 19 Issued.
Qf I have antl will meinlaln workers' compensation Insurance, es requiretl by sectlon 3700 0l ihe Lebor Cotle, tor the pertormance ot Ne work tor which this permll Is Issued.
My w ers' compensetlan Insurance cartier entl policy numDer are:
Cerrier. �CL/n"n/GE ��L PolicyNumber: N�� /-S��i�1-�V
(Th(s secNon need nat be comp/eted I/ the pe�mit is va/ued et one hundred dollars ($100) or /esS.J
❑ I cenily thet In the paAortnence oi the work for which this permit is issued, I shell not employ eny person in any menner so es to become subject ta Ihe workers'
compensation laws of Cellfornia, end egree ihet Ii I should becoma subjact to the workere' compensetion provisions of Section 3700 of ihe Labor Code, I shell fotlhwith
comDly with the rovislons. '� / '
Applicant Signeture: �!! ✓ � �.-/� -- Date: � 3 �%�'J
WMNING: FAILURE TO URE WORKERS' COMPENSAr10N COVERAGE I5 UNLAWFUL ANO SHALL SU6IECT AN EMPLOYER TO CRIMINFL PE T1ES ANO GVIL FINES UP TOONE Hl1NORED
THOUSAND DOLLARE (5100.000). IN ADDITIIXJ TO THE COST OF COMPENSATION, DAANGES AS PROVIDED FOR IN SECfION 3]OB OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby attirm that I em Ilcens¢tl untler U Wsions ot Chapter 9(commendng with Section 7000) of Dlvlsion 3 0l Ihe Busineca� � fessions Code, and my Iicense is In tull
fofCB enC eHeCI. LIC. M (0 3� qess #
Comractors Slgnature: .1 F Date: .5-- 3-�J 9
CONSTRUCTION LENDING AGENCY:
❑ I hereby eflirm thet thera Is e consiruction lentling egency for the peAormance of ihe work for whic� this permit Is Issued. (Sec. 3097, Civil Cade).
Lentlers Name: Lendefs Address:
SlgnaNre:
OWNER-BUILDER DECLARA710NS:
Date:
I hereby atfirm t�at under penalry of perjury thet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for ��e following reason (Sec. 7031.5, Buslness and Protessions
Code: Any ciry or counry which requires a permit to conslrucL alter, improve, demolish, or repair eny stmc�ure, prior �o its Issuance, elso requires the eppllcant for such permit
to ille a slgnetl statement Ihat he or she Is Ilcensed pursuant to t�e pmvislons of the Contractors License Lew (Chepter 9(commencing wlth Sectlon 7000) o� Dlvlsion 3 of Ihe
Business antl Professians Cotle) or thet he or she is exempt Ihereirom end the besis lor the elleged exemption. Any violetion of Section 7031.5 by eny epplicant lar e permit
sub�ects the epplicant to e civll penalry of not more then five hundred dollers ($500).):
❑ I, es owner oi the propeny, or my employees with wages es iheir sole compensetion, WILL DO THE WORK, end the structura Is not Intentletl or offered for sale (Sec.
7044, Buslness end Prolessions Cotle: The Contrectors License Law tloes not apply to en owner of praperty who bulltls or improves thereon, and who does such work
himself or hersalt or Ihrough his ar her own employees, providad ihet such Improvements ere not Intended or ottered lor sale. If, however, Ihe building ar improvement Is
sold withln one year oi completion, the owner-builder will have ihe burtlen oi proving that he or she ditl not bulltl or improve for purpose of sale.).
❑ 1, as owner of t�e properry, em E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to wnstruct t�e project (Sec. 7044, Business and Professlans
Code: TTe conirectors License Law does not epply ta an owner ol propeM who builOs or improves thereon, enA w�o contrects tor such proJect with e coNredor(s)
license pursuant ro the Coniracbrs License LewsJ.
❑ I em e:empt under sec. Business end Professlons Cotle for this reason:
Slgnature: Date:
Ownar ID verllied Dy ArlveYs licanse. ❑ Ves ❑ No Drivefs License No.
Verification ol Ownership by (rype of tlocument, i.e. - properry tvc bill or deed):
6cpires:
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICA710N:
❑ I hereby certly t�et no excevetion fNe (5) or mora feet In depth In�o which e person Is requlred ta descend, will be made in connection with work aut�orizetl by this
pertnit, end t�a� no 6uilding structure, scaHoltling, felsework, or tlemolition or tlismantling thereof, will be more Ihan thlrry-six (36) teet high. (Chap. 3.2, Gry 2, Art 2, Sec.
341, Tille 8, Celifomia Atlministrative Code).
❑ As owner-builtler, I will not employ enyone to do work which would require e pertnit tram the Divislon ot Industriel Safery, as noted above, unless suc� person has a
pertnit to do such wark trom the division.
SigneNre: Dete:
Division oi Intlustnel Sefery Pertnit Number.
CERTFICATE OF COMPLIANCE AND AUTHORVA710N OF ENfAY: I certity under penelty of per�ury ihat I have read �his epplication and stata Ihat Ihe Intormetlon given is
correct. I agree to comply with all state laws and ciry ordinances relatlng to bullding constructlon, entl euthonza representatives of the Ciry oi Coste Mesa m enter upon Ihe
aDove-tlescribed property tor insDecilon purposes. I eqree not to occuOY or ellow occupancy ol eny bulltling authorizetl 6y this pertnit until final InsDectlon.
COOE1, INSPECTIONTYPE
1616 Fixed System Finel Fire Prevention
1268 Pool Spa Finel
200 Final RaRool
201 FInaI BIocWReteining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Finel Demolitlon
zaae-as
oah IMiiIpLS
-S �-4q ��.�z
COUE I INSPECTION TYPE
206 Finel MBChenical
20B Finel PlumDing
210 Final ElecMcal
212 Flnal Fire Prevention
220 Flnel Plenning Approval
222 Flnal Site
250 Flnal Building/Occupancy
Date
S-3�r 9
Da e
PAIE lt{�Le4
H. J. LAWMASTER 8 CO._ INC
7940 MAIN STREET — STANTON, CALIFORNIA
828-8040
69CM5-403AT-002
Field Data on Tesi Specimens Core —Concrete Gunite Grout/Mortar_
Project Rtibert Thomas Fool Permii No.�yC�� •
Project
location 909 W. 2Dth St. Costa Mesa
Conirador Anthnny Pcols Architxt
on eam
Location in Sirucfure ➢eep end, �hallovr end Engineer
Date Moulded 5/28/69 No of Specimens 6
Slump 5" Specimens Marked
Specified Strength at 28 days 2000 P.S.I. Mix Designation
Age to be tested_?_days 26 days �ays days
READY MIX PLqN7 AGGREGA7E SOURCE
Weather Condition Overcast 1 Yd. —Yd. Batch
CemenT Type Cement, Ibs.
Admix Nore Sand
Specimens made by L. �.`:pragu2 #4
Data by �� �` 3
Delivered by #2
Date Delivered #
REMARKS:��r�i����/�y"�� Water, Gals.
��.
Lab. No,
Data of Test
Specimen Dimensions
Area
Ultimate Load
Lbs. per sq. in,
H/D Corrected
8450
�av Tes!
63,0��
2,141
RCE�{6207
�451
Test
—29.51
7,000
2,770
easa
66,500
2,313
c.uu:C�,.�_T G,�,,,,,,,�
8453
Test
AM
8454 9455
Dav Tesi
sa�v oevr.
re�
INSPECTOR'S NAM
LABORATORY NAME
ADDRESS
TELEPHONE
JOB ADDRESS
OWNER'S NAM
CITY OF COSTA MESA
BUILDING SAFETY DEPARTMENT
SPECIAL INSPECTOR
WORK PERFORMED - DATE tp"r}% �f �dQ � G�
BUILDING PERMIT N0. �o[.,
NOTE: All special inspectors are to be registered with inspector's
registrar at the office of the Building Safety Department.
Inspectors shall furnish proof of affiliation with an ap-
proved testing agency; or, a state-licensed architect or engineer;
or he shall be in the direct hire, under state and federal pay-
roll regulations, of the owner/developer of the proposed project.
This proof shall be in the form of a signed letter from any one of
the above three. i`^2��n -
��
REMARKS: L
U'TJ �
�� �%a� �
�
Robert B.
JO]
GE
A^
I.
� Soil
DATE y-zu-o3
BUILDING PERMIT NO.
VnLUE S 2.000.00
'LONE
SUI3CONT1tAl:TOli
1�1
`�- -�� 19579
CDSTA MESA BUILDING-SAFETY DEPARTMENT
p, p. BOX 9f7 COSTA MEBA. CALIFOiWiA
For Applicant io Fill In Complefely
TYPE OR PRINT
BUILDING b_ .-. . . �_ �r�
COSTA MESA CALIFORNIA
MAIL ��
ADDRESB
an '
ARruITEC'f
O� GINEER
TEL. ��
NO.
TEL. ��
STATE . TEL.
L74 NO. NO.
61ZE �z X�pO NO. OR BLDG9. z
OF LOT NOW ON lAi
I1SE OF
EXIBTING LOG Cu_FLti,uG
98TBACK LINB FROM �.� i REAR YARD�(c+/
CEllIEN OF BTRHHT
SIDE YARO LEFT ���, I RIGHT I�/y
DESCRIPTION OF WORK
BUILDING�y�p'�f NO^OF
nw� .y/.fi
L/idJ%'7� COVERING !�
LDING AN� WORK TO BE PERFORMED
I:PI
FIRE
�� �
L80AL
FEE RECEIVED
FINANCE sD��
ITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
COSTA MESA. CALIFORNIA
NO. OF U98 OP N6W Y/�� F�
PLANe: Z eui�ou+a��f4�%.A/Z
4��`Z`{% 71��7i�-
//� " -s-/Y — 'L g
YARDS EVES
APPROVED
I IC6NT[R L�NH 9T.1
�
1 NeRBBY ACNNOWL8Dp8 TNAT 1 NAV6 RBAD TH19 APPLIGTION {Hg �MOUM BHOWN UNDBH VALUATION IB PON TNR
AND 8T�T8 TMAT TX6 A80VE IB COFItBCT AND AOIiHC TO GOM- pURP088 OP EBTABLIBHIN6 • PBqMIT p¢@ ONLY.
PLY WITN �LL CITY OROINAN059 AHD HTAT[ U1W8 RCOULATINO
aWLDItta CON9TRUCiION. � � YALUqTIOON � PERMIT PEH S ��
61GNATUR& OF P� �
PERMITfE �.���/�� I!�p''�'�
S�r7"1 / "' PLAN CHECK $ ISD
AUTHORIZ6D AGENT C 2
TOTAL FEE /v � L
,
J
OWNER `j'[�OP1A5� ROHER.T B. �CT z 8 �9$p DATE 5_19-58 _
]OB ADDRESS 909 W 20th Street �R 2 �959 � BllILDING PERMIT NO. �O%7H
GGNERAL CONTRACTOR —B ' _ VALUE $ ].],2,QQ
. o. LOT Q�y% TRACT 1'j12 FIRE ZONE Df;SCRiPTtON OF WORK y�12b under 93T'pOT't iOT.
IIP TYPF. ZONE PLAN Nn�6��C��1�7A
INSPECTIONS I DATE I SUBCONTRACTOR I DATE
caat
I
Ninal
" � 6778
�
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COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31�
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING
ADDRE55
COSTA MESA. CALIFORNIA
c�siuii�
ARCHITECT
OR -"GINEER
A�LnE55
�E�.� ��oT a�Z
oesceirliov NO
A.P. NO. /� �'^ S
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SIZE^_ � � �� � ^M/
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CITY LIC.
NO.
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YESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
FECEIPT NO. PENMIT NOD.
V
R^ENEO BV p/.T%RE JEI�Ep'] OATE ISSl1EO�
S� V �
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ILDING
DRE55
COSTA MESA. CALIFORNIA
TEL. IAPPROVED
NO. " BV
�
NO.OF BLDG6.
NOW ON LOT
SETBRCK LINE FROM �
c[Nr[rx oF Srr+[[r REAR YARD
SIDE YARD __ RIGHT �J LEFT p�J
1�
DESCRIPTION OF WORK
NE`" ALTERATION � qDDITION
REPniR _ � � MOVING _ _ DEMOLISH
BUIL�ING / �� /NO.OF
SIZE � ���,5 ROOMS STORIES
E%TERIOR WALL ROOF �
COVERING COVERING
r
�Ct�",tt1c� il�-e�-, ) .v��o'�re.o.�e-�✓
I H EBV 1CKNOWLEOGE TMAT I sVE ELD THIS PPLICATIOrv 1NO
ST E TNAT TME .�BOVE IS <ORRECi �rv0 aGREE TO COMPLY WITN LLL
CITY OROINLNCE$ ANp ST1TE LAWS PEGULATING BIIILOING CONSTRUC�
TION.
SIGNATURE OF �� n
PERMiTTEE Y 1 w_�y
AUTHORIZED AGENT
5
CORRECTIONS
PLA?JN
V' ' �
VALUATION � Q,-0
PERMIT FEE $ - .
/��; � � PLAN CHECK 5
$
' �. TOTAL FEE $ �, «� v°"'r
OWNER
W
TYPE 0
�i3��t7
MAR 1�1958 �ATE
BUILDING PERMIT NO.
PLAN NO.
� �,
INSPECTIONS _ I DA7E I BUBCONTRACTOR I ___ PERMITSISSUED
caat
F �inp Fixtu
Fiml Gas Test
� , . .
�f � � so�s
COSTA MESA BUILDIN6 DEPARTMENT
P.O. BOX 31�
COSTA MESA. CALIFORNIA
BUILDING
ADDRE55
OWNER
MAIL
ADDRE55
CITY L�
ARCHITEC
OR � '^IN
ADDnc55
FOR APPLICANT TO FILL IN
� L�/ „LO t h V7
COSTA MESA. CALIFORNIA
1
�y TEI.
/ri,% �����i
IIC. _.
! . NO.
ADORE55 ��
LEGRL LOT (, /
DESCNIPTION NO. � 7 / I
A. P. N O. � I S`� S/v
OF LOT / X� � ��a,
USE OF
EXISTING BLOG. OH � '
SF.TOACH LINE FHOM i
c[rviEA oF SiAEEi �' /�(� REHR YARO '
j r I
SIDE YARO RIGHT LJ• LEFT �J�
DESCRIPTION OF WORK
NEW ALTERATION II ADDITION
REPA�n MOVING DEMOLISH
BUILDING R�X zG• NO.�F
SIZE / ROOMS � STORIES
EXTERIOR WA�� ROOF
COVERING af �✓ Ctl�VERING // ]�
USE OF NEW i. . �. J i
� �� � �ECEIVED
��- i�-,5'�
V �`
FINF,I�CE DEPT.
APPL��CyAT I��ST�O'F.f2SAPERM IT
BUILDING
FOR OFFICE USE ONLY
PECEIPT NO. PERMIT NO.
b S:
RECENEO BV pPTE NECEIVED DATE ISSUE
COSTA MESA. CALIFORNIA
FI
CITY LIC. � � J
NO. \
TEL _ APPROVED
NO BY
K TRlACT I/�/�. �
^ o�V
NO.OF BLOGS. /
�IOw ON LOT
l�i
OPYE
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1 NEPEBY ACI(NOWLEDGE SMP� 1 �NqYE Nt>D TMtS 1Ppl1C>T10N ONO f S
ST�TE iHaT THE �OOVE IS COPRECY AMD wGPEE TO COMPIY WITH nLL ' f�
CITY ORDIN<NCE$ �NO STATE L.�WS W GULSTING BVIL�ING CONSTFUC�
noN. VALUATION
SIGNATURE OF PERMIT FE� S
PERMITTEE
3 �` PLAN CHEGK S
s �
AUTHORIZED AGENI' TOTAL FEE eu
UWnCK THO.
JOB ADDRESS
WATER
SPRINKLING
MISCELLANI
CONOITIONING
UNOERGROUND U POWER U
ROUGM WIRING
TFENCHES FORMS � STEEL REINF.
FLOOR SYSTEM
FRAME AN� FLaSMING
LATHING — IN rJ
PLNSTER, BROWN COA
ST� 'URAL, FINAL
HE, :, VENT., REFF
PLUMBING, FINAL ANO
ELECTRIC. FINAL
BUILOING, FINAL
SPECIAL RE�l11REMEN
ma��.arQ.:�
7RACT FIRE ZONE VALUE b 2 800.00
Signar�ro Date GROUP T7T TYPE .7 ZONE R—
T�� 3iio�^vriT^nA�T^vR ��—�RMITS ISSUI
^ /COSTA MESA BUILDINGSAFE7Y DEPARTMENT
P.O. BOX 7200 COSTA MESA� CAL160RNIA 02E20
ior ApplicaM fo F(If In CompleNly
TYPE OR PRIM
e���oiNa c�Oc) 20th StTeet .
ADORfiDD
COS7A MESA, CALIFORNIA
e
Costa
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Fires.tone Blvd
i Gate. Calif
une�wor
DESCRIPTIOM OF WORK
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OWNER
JOB AD
Ih��ECTI
W ATER
ROUGH
MISCELLANEOUS �e Q
ROUGH HEATING F � AIR CONOITIONING
UN�ERGROUND L �O
ROUGH WIRING
TRENCHES �q/FORMS
BON� BEAM �(�" STEEL
SHEATHING
FRAME HNO FLASMING
1 ATHIN(: - IN n
Sl URAL, FINAL
HEAiiNG, VENT. �
PLUMBING, FINAL ANO GAS TEST
BUILDING, fINAI
re
DATE
BUILDING PERMIT N0.
SUBCONTRACTOR
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�' � 30279
COSTA MESA BUILDING-SAFETY DEPARTMENT
' P.O. BOX 7200 COSTA MESA. CAIIFORNIA 92626
Pato � o.r ,t��� �
°b1Y 13-b9cr�sr,�� a,,= 3-�.50
APPLICATION FOR BUILDING PERMIT
ForApplicant to Fi!! in Completely qECEI ED eV OATE RECEIVE DA E ISSUED
ADIDRESS 909 W 20th Stree�t ' 3"� �/3-
P RMI
OWNER RObeTt B. ThOID3S �+�P• NO. � S-�d �-M��.y,
MAIL BUILDING O W� GlJ 4t1 StSBet
AOORESS $a.I�e ADDRESS 9 9
TEL. TRAC�(ZZ� LOT Z4 BIOCK
CITV NO.
CON5TRUCTION ,�1-,,, W A � A
LENDER ULIILLIOWR
B:iANCH
OWNER
ADDRESS � ^ �j(�
ARCHITECT TEL S V U5 41 .^"'��'O
ORENGINEER C• A�IIIS NO.S �O
FIRE 'q�
ADORESS ZONE � TVPE GROUP
Anthon POOZS APPROVED q g
CONTRACTOR BV DATE V -�7
ADDRESS 5871 F3restone Boulevard
TEL. �f �ON� NO.OF USE OF NEW � ,
CITV �Q th Gate al���' S-, 2G10' � P��' BUILDING
LIC. NO. 1C)Ql� CITV �'AfiOS APPROVED VARDS APPFOVED
LIC. NO. MAIN BUILDING ACCESSOFV BUILDING
SI2E NO.OF BLDGS. (FROM C/L STREET) /� /
OF LOT NOW ON lOT FRONT FT. l• FT. ^"'��
USE OF
EXISTINGBLDG.TeS�C�eTiCe & garage S T. FT.
SIZE OF � �� NO.OF !-�
NEWBLOG. OO- ROOMS STORIES L.SIDE FT. 11"FT.
EXTERIOR WALL .. ROOF
COVERING COVERING REAR FT. FT.
USE OF BUILDING AND WOFK TO BE PEIiFORMED DIS7ANCE BET. 6Ef. MAIN &
xivate swimmin ool in the rear MAIN BLDGS. ACCESS. BLIX'aS.
f Siri 12 f8mi1 dwBlli.ri CURP.� AP ROVED
APPROVED I
/
I hereby acknowledge that I have reatl this application and state
ffiat ffie above information is correct antl agree to comply with
all laws regulating builtling construction, antl I shall not employ
any person in violation of the workmen's compensation laws of
the State of California.
I hereby certify that I am properly licansatl as a contracror untler SQ. FT.
the State ot Calitornia Business antl Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR
Chapter 9, antl that such licenses are in tull torce antl effect, or I THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLV:
am exempt trom the provisions of the Staie of California Business VALUATION
and Professions�de, Division 3, C� epter 9. �
�f L^^ PERMIT FEE $
SiB^atura of / ¢'� WV.�QQ% / � n
Permittee � p(�/ ��.0 � $ PLAN CHECK S v
Authorizetl Agent 3� 5 �
TOTAL FEE $