HomeMy WebLinkAbout2991 GRACE LN - Building Permits CITY OF COSTA MESA
4 ; ► @ BUILDING DIVISION
>YY . �; $ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT B05-01590
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.(SUILDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2991 GRACE LN Status: ISSUED
Suite: pplied: 09/1212005
Vicinity: REROOF UNITS B AND C xp T' • E ssued: 09/12/2005
Primary Occ: Type of Construction: L r 1 ilk
Parcel Number: 14122113 Zoning: �/
DATE / /
Applicant: GALITSKI, GUY e
Address: 19792 POTOMAC 7
Phone: (714)965-2387 ISSUED BY: t
HUNTINGTON BEACH,CA Zip: 92646
Owner: GELKE, CHRISTIAN J TR & MOELLER, HEINO
Address 9614 SMOKE TREE LN
Phone:
FOUNTAIN VALLEY,CA Zip: 92708
Contractor: G G ROOFING CO INC
Address: 19792 POTOMAC
Phone: (714)965-2387
HUNTINGTON BEACH,CA
Zip: 92646 License: 364151
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF THE PORTION OF AN EXISTING COMMERCIAL BLDG WITH UNITS B AND C:T/O EXISTING B.U.R.AND INSTALL JOHN MANVILLE B.U.F
BASE,2 PLY#11 PLY AND 1 PLY CAP.NEW FLASHINGS&SCUPPERS.
7000 SQ FT
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $15,000.00
Permit: $251.25 • Claim Valuation: $15,000.00
SMIP Res: $0.00
SMIP Corn: $3.15
Other:. $0.00
Inspection: $0.00
Total: $254.40
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 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, 12.21-92)
EXPIRATION: This permit shall automatically expire and become void it work Is not commenced within 180 days,or If work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2448-46(6/00)
DECLARATIONS' - -'
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is Issued.
let have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cede,for the performance of the work for which this permit is 1«led.
/� My workers'compensation Insurance carder and policy number are: '-•1
'Ce'rrier S ft—� \o-c5'4 Policy.Numyyer: 11.-(.3 �4 L� I r
(This"s`ect/on need not be completed it the permit Ls valued at one hundred dollars($100)or less.) 1 !
❑ I certify that In the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro ons.
C4 (2-0C.
AppllcanLSigne-, Date:
WARNING:,FAILURE TO SECURE W KE PENSATION COVERAGE IS UNLAWFUL SUSIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND OOLLARE(S100A00),IN AD TO THE COST OF COmPFNSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am II ed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effectAIc:kr' St 11 r Class 4_ C. 3
Con`ractoasSlgn e:_ it Date; r tel — 12- 0 5 _
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that lam EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not appy to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I am exempt under sec. __ Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,I.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Dale:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature_ _ and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? •
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 10 Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disciosures prescribed by California Health and Safety Coda Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct, I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describedyroperrty for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
� Signature Of Legal Owner(s) `� Pala_
9—!2 —0"-- —
And OcAuthorized Applicant ( Date-
ME I INSPECTION TYPE PATE MALS ;ODE. INSPECTIONTYPE PATE Its
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
-4
PROJECT ADDRESS: 2991 GRACE LN UNIT: - ' CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 069025
OWNER'S NAME: GELKE CHRISTIAN J TR
ADDRESS: MOELLER HEINO PERMIT NO; E 069025 PLAN CHECK NO; N GOVT; N SUPP ; N
9614 SMOKE TREE LN
FOUNTAIN VALLEY, CA 92708 CONSTRUCTION TYPE; PERMIT TYPE; ELE PURPOSE; OTH
ARCHIENGINEER: REG.NO.:
F ADDRESS: UNIT: ; SQ
JOB DESCRIPTION RECONNECT SERVICE FT ;
CLAIM VALUE: CALC-VALUE: GROUP OCC : /
bAV PERMITTEE: HEINO MOELLER ( 714 ) 556-3910
ADDRESS: 2991 GRACE LN COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT
C ,M, CA 92626xxx**xxxx**********************************************************************
LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I R EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T BA C K S
CITY LIC.: STATE LIC.: CLASS: EXP:
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3803.Lab.Cl. LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ:_ PROV; PARCEL : 14122113 ZNE; REF NO:
Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This sec'on need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I cattily That in the performance of the work for which this permit is i u I shall no employ any person in any manner so as Io become
subject to theXoorkerss''Compensation Laws of California. - ZONING APPROVED BY DATE;
Date: 'L 2 4 Signature:
NOTICE:u,user making this declaration.you should become sub( t to the workers' Compensation provisions of the Labor BUILDING APPROVED BY DATE:
Code.
you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; • Si ppp
which this permit is issued(Section 3097.Civ.C). DATE: * -1*
*
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT;N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 18 , 50
repair any structure.prior 10 its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 50% SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15,00
I. as owner of the property or my employees with wages as their sale compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Q structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 18 , 50 15 , 00 0 , 00 33 , 50 33 , 50 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or
improvement is sold within one year of completion.the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED ; 33 , 50 OVER/SHORT; 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33 . 50
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of properly who builds or improves thereon
and who contracts far such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).l am aware *,*.*,*,*,.**,*** ,*.**.**,*,********,*,*,*,*,**,*,*,*,*,********************************************
that proof of their Worker's Compensation insurance should be provided to me.
INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
wrtnis(J/�ason: / TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Dale: 1"2Y`5.y ___ Owner: / .. //./�.
7 I do hereby certify that I am aware of and understand the requirements of California .Ith and Safety Code Sections 25505,25533,and ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50
25534 and that I or any future building occupant wit/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from 4/
these provisions. -
Date: Applicant:
1 hereby certify That I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby a -Drize representatives of this city to enter u,rr rhn"hnuc optioned 01 00168540-00168540 TnT 33.50
property lo
inspectppion purposes. DATE: 09/28/94 TIME: 11:26
Date: / Za!4"`T' Signature: /
Driver's License or Social Security 4:
164646 Mae-Budding:Green-Code Enforcement:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
U CONSTRUCTION AND PLANNING PO( SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd,
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd, 60. Backwash Lines, P•Trap, 0 Undrgrnd,
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
.23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Root Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final / ,/ 80. FOOD CERTIFICATE ISSUED
33. Final Electric /DJ!`/(jy Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
. 48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
JPROJELhADDRESS: 2991 GRACE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 069082
umulNAme GELKE, CHRISTIAN J TR
ADDRESS: MOELLER, HEINO PERMIT NO; E 069083 PLAN CHECK NO; N GOVT: N SUPP: Y
9614 SMOKE TREE LN
FOUNTAIN VALLEY, CA 92708 CONSTRUCTION TYPE ; PERMIT TYPE : ELE PURPOSE; OTH
•
ARCH/ENGINEER: REO.NO.: JOB DESCRIPTION : RECONNECT SERVICE & EQUIPMENT, RE#E69025 SQ FT;
ADDRESS: UNIT:
CLAIM VALUE; CALC—VALUE; GROUP OCC ; /
PERMITTEE: HEINO MOELLER ( 714 ) 556-3910
ADDRESS: 2991 GRACE LN COMMENT' ; NO OTHER WORK AUTHORIZED BY THIS PERMIT
C.M. CA 92626 ********4***a6****ar* -xxxxxiexx*ar**x*ir***************x****************** r*******x*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENTS
7000)0l Division 3 0l the Business and Professions Code.and my license is in full force and effect. S E TB ACK S
CITY LIC.: STATE LIC.: CLASS: EXP ;
Date' Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certilicate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C), LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL ; 14122113 ZNE; REF NO;
' 7 Certified copy is hereby furnished. 0 Ceneied copy is filed with the city Building Division. PLANNING NOTES>
> '
Date: Applicant: *******************************************************************************
EXEMPTION FR M WORKERS'COMPENSATION DECLARATION: )This ion need not be completed if the permit is for one hundred(Slip)or less). DEVELOPMENT S E .R V ICES REQUIREMENTS
I cenlly that' he performance of the work for which this permit issued.I shall n employ any rson in any manner so as to become
subiect lo' w kers'Compensatio a ICalifornia. ZONING APPROVED BY DATE;
Date: r ,OI` Signature: •
BUILDING APPROVED BY ,
NOTICE:I,alter making this declaration,you should become su ect to the Workers' pensation provisions of the Labor DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. aI
CONSTRUCTION LENDING AGENCY: I hereby attirm that there is a construction lending agency far the performance of the work for APPLICATION ISSUED BY; DATE: LP5 13 I L K/E
which this permit is issued(Section 3097.Civ.C). ************************ ************************x******************x*******.-**
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT;N
OWNER BUILDER DECLARATION: I hereby alfirm that lam exempt from the Contractors State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3650, -
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 Cit SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt Iherelrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 4 , 50
• I. as owner of the properly or my employees with wages as their sole compensation, will do Inc work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
0 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 36 , 50 4 , 50 0 . 00 41 . 00 41 , 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS——> COLLECTED; 41 . 00 OVER/SHORT- . 00
improvement one year of completion.the owner will have the burden of proving he/she did not build or improve
lorthepurpose of sale)
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 41 0 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F .E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
or this reason' _ TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: b—?4y Owner - r5 ELE 1 MOTOR/POWR APPARATUS 0 , 0 — 1 . 0 HP 3 . 00 3 , 00
I do hereby cenify that I am aware of and understand the requirements of California Heal and Safety Code Sections 25505,25533.and ELE 1 MOTOR/POWR APPARATUS 1 , 1 10, 0 HP 7 . 50 7 . 50
25534 and that l or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 1 MOTOR/POWR APPARATUS 10 , 1 — 50. 0 HP 15 . 00 15 . 00
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. Q ELE 1 M I SC CONDUIT NOT• LISTED REQ PERMIT 11 , 00 11 . 00
Date.14-S' % Applicant: END OF FEES
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereb authorize representa; 's of this city to enter upon the above-mentioned
property for inspection purposes. / ' 01 00168780-00168780 TOT 41.00
Date'/r3'7 f Signature: y �i....fra, DATE: 10/03/94 TIME: 11:08
Driver's License or Social Security n:
1641.46 While—Building,Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
it CONSTRUCTION AND PLANNING POC SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole
- I
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 1 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
•
8. Foundation - 59. Gas Pipe, 0 Undrgrnd„Test • - y
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd.
{
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final
12. Sewer Cap _ 63, Heater & Vent-Final
13. Roof Drains • 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Fin& ' •
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 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
f
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77, FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I j
33. Final Electric { - ) 'I- Notes:/O_/7-qf -tik..s 3
34. Final Heating&Air Conditioning 7 --- i-
Ps. .c."9--5 foto"- s
SAle- i
35. Final Gas Pipe-Test I_
36. Hood or Canopy 4pL t t,
37. Final Factory Fireplace w.x. �
38. Final Plumbing QM? - /4'. , m�(�., e4,16,1 : 1
39. Water Service-Final p
40. Gas Service-Final WO
. 7Q ,I /
41. Solar Domestic-Final /34444.
`ry - •'O'lJY�/,,
42. Backflow Preventer t%u'r-K. 'f.+v
43. Backflow Irrigation V{/
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE &BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
•
50, Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
• PROJECT ADDRESS: 2991 GRACE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 060325
OWNER'S NAME: GELKE CHRISTIAN J TR •
ADDRESS: 9614 SMOKE TREE LN PERMIT NO: F 060325 PLAN CHECK NO: 04600-92 L GOVT: N SUPP: N
FOUNTAIN VALLEY,CA 92708
CONSTRUCTION TYPE: PERMIT TYPE: FIR PURPOSE: OTH
(714 ) 835-8572
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : BACKFLOW RETROFIT SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: 3, 200 . 00 CALC—VALUE: GROUP OCC: /
PERMITTEE: THE BAKER COMPANY ( 714 ) 835-8572 •
ADDRESS: 1202 HUNTER COMMENTS: THE "ECONO MOTORS"
SANTA ANA CA 92705 AERP:ERe:P*+kik:P**** ESP*Rr**RP+E*RP****+Pyr+:*****RPRERP************:E**CPRE:P:P*******x:E******+P*****">t
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and ii ' •nse is in full forc and effect. SETBACKS
CITY LIC.:047g 9 STATE LIC.:554 • • 2 cuss:C— 6
„........---Otte: ieete. 17- i i �(17 Si . , _ .u� ' Ftv+ti MAIN BUILDING ACCESSORY BUILDING
WORKERS'CMPENSATION DECLARATION: I hereb . irm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation.l'}suranapr rtJn o thereofon 3800.Lab. ) LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: PTC /1+ 3' 4 ed iEAP.DATE: 07/01/93
COMPANY:CNA INS CO PARKING REQ: PROV: PARCEL: 14122113 ZNE: REF NO:
C3,Certified copy is h reby furnished. X Certified cop ' h the city Builds Division. PLANNING NOTES>
>
ne: L 5�7 L Applicant: Le/r *******************************************************************************
EXEMPTION ROM WORKERS'COMPENSATION OECLARATIO,. This section need not be completed if the permit is for one hundred(8100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which thi permit is issued,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY ; DATE;
Date: Signatureyou
houl BUILDING APPROVED BY . • . DATE:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �jr'"7
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• •
DATE: P •— *--7
which this permit is issued(Section 3097.Civ.C). *********************** * * ****** ** ***********************4****** ******
LENDER: ***************************************** ************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 63 ,00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 65% SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 40. 95
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(8500). ISSUE FEE
I. as owner of the property or my employees with wages as Meir sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 63. 00 0. 00 40 . 95 103. 95 103 . 95 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sate.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 63. 00 OVER/SHORT: 00
improvement
rptheepurpose soldwithinone year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63.00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P. C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: FIR 63 FIRE EQUIP FEE ( FROM BLDG VAL TABLE) 1 . 00 63 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ��
these provisions.
• Date: Applicant: a
I hereby certify that I have read this application and state m. e above information is c ect.I agree to comply with all city and county x..ordinances
ordinances and stale laws relating to building construction d hereby au orize representat s of this city to enter upon the above-mentioned j//
property forfJin pectjos
o purposes.�
��Qate: ' "�I L (/ Signature: t'^"
Driver's License or Social Security ei:
1641-46 While—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
' /Th' POO' :PA
CONSTRUCTION AND PLANNING
APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
-
1. Temporary Electrical Servi,Cre or Poletr 52. Pool & Equipment Location
. 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement
. ,.•
2 t• ilictrical Conduit U.tillty-Undrgrnd. 54. Forms
`-'fi. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
ti:,5.Steel Reinforcement; 56. Rough Plumbing & Pressure Test
6. 'EIbctrlcal UF ER Grnd. - - 57. APPROVAL TO COVER-GUNITE
:Yt�Fotings _• if_ - 58. Electrical Conduit-Undrgrnd.
$.'inundation 4' 59. Gas Pipe, O Undrgrnd., Test
9„tNater Pipe•UndTgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
J
10. Structural Floor System - 61. APPROVAL TO DECK
11. Property Sewer Line-8/ Horise Connection - 62. Backwash & Receptor-Final
12. Sg,er Cap a - _ a 63. Heater & Vent-Final
1
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough ElectricWiring 67, Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
C i . ' (- , if re-1- 'i '•1 4i '1,:-,.:P- a. •• ft
20:'Ro h lctor' FiVlace I Y•l f i; 1 V*. ! APPROVA S 'CPerdtit 4 .
.-4a 's I Hei . • H ' J 1+, .... '. -1, VI ..
21..Dupt's, iniStrvctuee- , r ... •7 I t++r A0. linderground.Hytlro '
22. Ducts, \tentiI ting-` l arc; � d •� CA' '71, ProducLi
P {�g ❑Gas CI;DiI
. 6 r a,
23. tas Pipe_Rough &•'[est I I. ;n J •r -i: A . Flush:,72. Underground FlY 'vc
_ c• �U �^
24.n'RoQi Framing t--., l . -- p =' '^ `t 73.tUndergrni�'.StoregPTank t7 Gas 0 Oil
25. Roo} Sheathing c , ?• ', • , `; -. 4. x '
.:< g '-. '_' verhead Hydros
If
1 `
262%..,T-BT Ceiling (Steoctural) &•Monocoat A - - y r 75aDry Chemical . x I r-
27."-Frame and Flash . 76. Dry Stan¢gipe -
28. Lathing& Siding.* t- -.4.,:f n _ $T
: 7771FIXED SYEMiEINA�^ _ .
29. lnsulatiop = , ' '■®° 78.- FIRE PREV. FINAL -- - ' 7-2043 (til;"
•30. DrywallNailittg IIIHEALTH:DEPTIrR•EQUIREMENT
;
;.31. Plaster 8rown,Coat' , - 79.' SINAL INSPECTION r s
•32:1Electricat Povver Meter-Final t--
.430. FOOD CERTIFICATE ISSUED
,
. 33.,final Electric - a. Notes: y -3,-. ., -_.
'$4;Final Heating`y& Air Conditionigg, /hi . k.•i hi- -S "
35._Fin`al Gas Pips-Test' - t 'ns t-211-1Y "•T'
36: Hood or Canopy . _ i
>_
•-37.cFina1 Factory Fireplace, .- . " ,r,
i
38t-Final Plumbing - • - - - i
39:'Mater Service-Final' - ` ^ •
40.-Gas Service-Final -
.•41. Solar Domestic-Final - •• - ' ` -t
42. Backflow Preventers - a '
43. Backf low Irrigation- +• =S x Z.- _
144. Landscape lrfigation System, -T .. - -
_
45. 'Sound
•-,
ttefoatiorr - � ' - -' �` "'.. - 4. c
s.
--.46:1Nandicap•Regulatiops '' ' •f + - _
t
-47. FINAL STRUCTURE & BUILDING -r � _
48::FINAL PLANNING: r - . K
. 49. Electric Release to Edison - . r
' 50. Gas Release to Southern California Gas Co • 1 l' ' r • - •
51. CERTIFICATE OF OCCUPANCY • a _, z -
No. Date
4.1.414 CITY OF COSTA MESA Tag No.
SIGN PERMIT
\I
Plannin & BuildingSafetyDepartments Type of Sign 17.50
S — /" ��jC�—1 9 P LL APR -1-76c 000 069* ****1
CJ S_Electric ❑ Non-electric
(,�.,�jw�.0 `1 ^ Location --. Office'Use Only : -: - .. .
[�C `�+ � c_ ��e- Phone _Property
ions
Building Site Address �-1 l` Z' 1
A.P.No. �4l� �i �'�3 Zoning " 'M I.
St //%( 1J S ay ee,E 1 SSy(2�r. Sign Dist 5 .Date!Received': 3"1'l,°-?G,
Name of Lessee Phone _ , ' /
^ p� State License No. /t Received by: PPW
Contractor ! e ee!?C ) 5/&A) K /C S City License No. l b
CI �1G f Street frontage:
Front: �o it Street:
� r
Address 2 30 G7 , CE 'N6 CryGQS%/4' alESX- Zipp -6, '/Q Right: ft Street:
(='
Legal Owner of Sign 541'SOA)' Cqe e�y /L ,/ 3 O Left: ft. Street:
444
Phone 52/6—41/1
Rear: ft. Street:
�„ Address Z`� ? / 674.Arc c LA PG City G'oSfe4 /tars, Zip /f Z-"'6 Building set back from center line of street ft
.7 Master Plan Highways ultimate right-of-way ft.
WO. Sign Location
Q Descriptions Illumination Front Right Wt4441-`- Left
CO
O.
0 Ground /f sq• 0 Canopy 0 Non-illuminated Between property line&ultimate right-of-way
,� Wall 40 FT. 0 Attraction Board Ground Signs
0 Roof 0 Advertising Statuary
0 7 ft.& 15 sq.ft./or 0 Table 2 Planter Area=
W Projecting 0 Other 0 Directly lighted
0 Construction 0 Tract Sign(Security&Right of Entry Agreement) Sign
F 0 Convenience 0 Special Event(Request form submitted)P f q Area of Signft.'e•in.x I d ft"�� in.=4c..)
[1.1 0 Super Graphic 0 Change of Copy(amortization) 53. Indirectly'lighted sq.ft.
114 Ground Clearance
w
Programs Overall height
Letter height 1.(ei
lI.
❑ Planned Signing
0 Shopping Center/Integrated dev. 0 Variance Items of Information
C.U.P.No.
pt. By Owner/or El bx City Total sq.ft of all Signage
PW.. /"\ (Date letter sent Z- C 7c ) 0 Minor Variance Amortization .
Subject to Amortization: yes ❑ : ..no a,
All applications must be filled out by the Applicant,all footing,framing,electrical and final Inspections shall be called. (714)556-5273 ,Expiration Date
VValuation: - O
Signature of Permi[teC\ Planning fee. `0O -
$�� Buildin:fee
UU Inap.B Px B Px No: Fus:., Px A Px No
Authorized Agent Plan a fe
Tot. Fee $ WASri ,:5.et r X'Z �
Received by HI Date 1I1r'� Date Approved �^ ^I� - / b `e fl tvvi �'s s' '' `i ` riLsie- rIc f'
Signature(9'J` Signature(Planning Staff) Y jy�r'? ` " �"" • an, e c s
Date (Approval subject to the condition of Ord..-74-25 Sea-Ill 3.d)
CMF 0068-26 White - Building; Green - Customer; Canary - Planning; Pink - Finance; Goldenrod - Assessor HOLD FOR SPECIAL REQUIREMENTS - -- -- - -
:OE OF i1Mgr� ' •
W
OTC
A .
- CER IFICATE OF . °.ENSEE CONFORMANCE
HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES
' that the products identified below and.on attached sheets Nos. • and the principal mem-
bers of which are marked with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER
l CONSTRUCTION (AITC) were manufactured in confoxmanc: with applicable provisions of U. S.
Commercial Standard, CS 2534 , for Stru •- .I GI -. L.- in.t;. Timber, and that such manufac-
ture has been at our plant in .s i "F1te.... /V _ 1 , which plant has a quality
control system approved by the Inspection gffeau of the AM 'ICAN INSTITUTE OF TIMBER
CONSTRUCTION and inspected periodically by such Bureau. The undersigned manufacturer further .
certifies that the work has been done in accordance with the applicable job specifications.
• COMPLIES WITH SECTION 91-2515 LOS ANGELES
io JOB NAME: �� 'lt W444 •l/•��. CITY BLDG. CODE
s.uJTy,T CHA?PER 25 OF U. Y .C.
JOB LOCATION: `/�I L `/��{�',]�y"���/�.�QI l 09Q 0KCIr t
CUSTOMER'S ORDER NO.�c ` DATE MFGR'S ORDER NO. I/ L+ ,
•
- _ . as - _ • �� ,mss / di Sr j1 i11���_q.
dr Lit ornir,- ons, 30-o C e f ,
NATUREliar / SadI �/�� " - 1 _
COMPANY
'.Y9U "�iLf
diry
TITLE alto MLADDRE4 /pe / ta.pa . DATE VVV ...7-
ITC HEREBY CERTIFIES that the said company at its said plant is licensed by
the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in
respect of products which comply with applicable provisions of said Standard, that the adequacy
of the. quality control system in effect at said plant is periodically inspected and verified by the
Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the '
judgment of 'the undersigned, said company is capable of complying' with applicable manufactur-
ing and testing provisions of said Standard in respect of products manufactured at said plant.
Conformance with the Standard in respect of any specific or particular product is the sole responsi-
bility of the manufacturer; AITC's guarantee hereunder being that the said company is qualified
to produce a product meeting the said Standard and that its plant is periodically inspected and
verified by the AITC Inspection Bureau. - • .
•
"` , AITC Certificate Na 33218 Signed for
ne- . , , ,, ,ir,4; AMER•ICAN INSTITUTE OF TIMBER CONSTRUCTION
..'- ti: L.s �r+v V.. 1.Ac(a�.._.,,` . .. i
y4� �'a .h.. it I i
_ qty
Le,-----,:.� - `)- BY
atle-"It----/
Authorized Signatory
eiV\l\ ,
- Y.- (J 1963 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
AITC FORM 15.1-63 f
tqyzioas
IMPORTANT
INSPECTION REPORT FOR BUILDING
INSPECTOR. DO NOT DESTROY OR MISPLACE
FOUNTAIN LAM-LOC CO.
•
•
•
- :It]
•
CERTIFICATE OF IN ;TION _ • 4
th`..E TO LUMBER DEALER:
FOUNTAIN LAM-LOC TIMBERS THIS INSPECTION REPORT SHOULD BE DELIV-
6218. S. Hooper ERED TO THE BUILDER FOR TRANSMITTAL TO
• Los Angeles 1, Calif. Phone: LUdlow 31-381 THE BUILDING DEPARMENT HAVING JURIS- .
MEMBER A.I.T.C. L. A. CITY FABRICATOR'S LICENSE NO. 111 DICTION PRIOR TO ERECTION OF BEAMS.
Inependent Inspecting Agency: L. A. Testin Laboratory
FILE NO. q/ fL SOLD TO: "fre 7,M be'- DATE: — L7_4s
SPECIFICATION: U.B.C. L. A.
CITY_ID /// TITLE #21 0 OTHER ❑
SIZE• BEAM 5�0 I �� y -i 54X9 / ' •
40
NO. PCS. & LENGTH A` /L• as
NO. & SIZE LAMS /�1 y .. > 3 i-3,---/3.1 11f7%5
COMB. OUTER LAMS ) Lrn3.
I )LW-J 3L2- ail OL•9--
NO. 4.. • INNER LAMS 3 L,3 L3
CAMBER 300 Loop P ,?oo
APPEARANCE PREM. ARCHIT. 'PREM. ARCHIT. PRE. HIT. PREM. ARCHIT. PREM. ARCHIT.
• _SLST% NDUSl1 INDU '. INDUST. INDUST.
. GLUE RESORC AJ RESORC. al RESCOR.ICASEIN RESCOR. CASEIN RESCOR. CASEIN
MANUFACTURER /�.2( ,c Y:)j_ -// 4- �glfI
BATCH NO. ,Y06s5 -10--S . / ‘eS . �c/'/�S
•
rr
HARDENER
SPREAD lb. M SQ. FT. 53á9-
TEMPERATURE • 410 6 b (v
MIXED BY a. -Vt9 , (lt 1 "
• POT LIFE %!v!
17
}MOISTURE CONTENT jf /3 #/..--45 3
LUMBER TEMPERATURE
SCARF SLOPE /-1411 • )^7- J 9-- j--
ROOM TEMPERATURE 78 L� ' t
(DRY & WET BULB) 70 '/cB-Jb NNN
REL. HUMIDITY & 7 r 7q/ V/-7--� 7 f
- START 3- fo 5 / /--3,..s
' ASSEMBLY FINISH 3 ,S 1- Sr.,. 9].-a
TIME OPEN• _ / v
CLOSED
PRESSURE: # SQ. IN. / 13j .- /c•;r0 77:- />�fl�
PRESSURE PERIODBYt^- ;�A -� `CvLa� „"cam
•
INSPKTED BY '9?7il�"1AJ
• IDENTIFICATION •
e-oq(QW PeeNsab 9Th sna
9oggq �saj
•
lesaQd 7 Vtaruce, Tote. . GENERAL BUILDING CONTRACTOR
929 BAKER STREET, UNIT A, COSTA MESA, CALIFORNIA : '
KIMBERLY 9-3036 e
June 15 , 1964
City of Costa Mesa
695 W. 19th Street
Costa Mesa, California
Attn: Building Department Re : 2991 Grace Lane
I agree to bring the live load up to 70 lbs per
square foot before the building is completed, over office area.
We will also provide a stairway to rear of offices
and change pilot door to an oUtswinging exit .
Respectfully,
GERALD F. BRAME , INC .
Gerald F. Brame
President
GFB : jhk
'GENERAL TESTING & INSPECTION AGENCY, INC. 2019 N. KILPATRICK . PORTLAND 17, OREGON
lumber & Preservative Inspection——Fieldwork— —Laboratory P. O. BOX 5622 . BUR.' 5-3631
CERTIFICATE OF CONTINUOUS INSPECTION Page J_of .2
OF GLUE LAMINATED MEMBER o/ e_ pate JUL 1 D 1964
FOR: BRAME OFFICE BLDG, Costa//Mesa, California No. 6-8199—AF
WELDWOOD STRUCTURES, INC., 13701 Cormenito Road, Santa Fe Springs, Calif.
9 10
AT: AMERICAN FABRICATORS CO. THEIR NO: 6698 4P RfCE ° c,
P. 0• Box 7
Bellingham, Washington N x71954 11:\I
City of Costa
�l Culldin8 Dep 8 - ,
SPECIFICATIONS `� ��
MK NO. LUMBER LAMINATIONS GRADE PARA. SLOPE INSPECT* - -' � \L RKS
COMBO OF GRAIN
B-1 104 1 Top & Bottom Dense Select 123aa 1 : 16 5P",\ n K,.r k r-„.zT,"
4 Inter T & B " Constr . 123bb Tyr_1..:R.;-.1 <�_i «c:` VIE oc1
Inner Construction 123c Fc 1F Co?4- S,rz1�1-: c,=tat
CC"3S-t. 1‘.11J=v_ zo..a ga cnl.o',t,
B-3 6 Two Top Se I Structural 123a 1: 16 i3', c1.Jo -col- k r.n-cT,-,
Inner Construction 123b S�L . s7Kv_. %La).n... I Al-IS
Two Bottom Se I Structure I 123a 1: 16 cin_,«.
—n"? )E v,,,-c-tc, 1 O 4 v.“,E-e,A.11J Fa cc?_� _<A"t'Ca 1L
Slope of Grain Top & Bottom 10% 1 : 16 Is. Gii_c1FIt-.it,
All lumber graded per: WCL IB Ru les 15 As modified by: Standard Specs
for Structural Glued Laminated DF (Coast Region) Lumber 1960 A5 S77=c \ct_o
Moisture Range 7-16% Variation per Member 5% 5/ Cfat)1->JT
Slope of Scarf 1 :8 Separation we I l scattered in tension areaMl ,)t\11,)-tj ' M1.KCv
Type of Glue Casein Glue Spec. MMM-A-125 INC_.r S,kc41rI,Z7.1n
Type of Glue Glue Spec. "i5prtc 0-,c, - 4.
Code or Specifications per Amer i can Fabricators print 6698 Standard
Specifications for Structural Glued Laminated DF (Cnns+ Reglan)
Lumber 1960 A,s c....9-7...c\rya,
Appearance Grade for AITC INDUSTRIAL Appearance AS SYzc1Ac+Ho
Finish Coating End Seal Wrap Load Wrap t\SS4=c1r1>t,
Inspector's Remarks:
THIS IS TO CERTIFY THAT THE WORKMANSHIP, LUMBER AND GLUE IN THE GLUED LAMINATED STRUCTURAL
MEMBERS AS COVERED BY THIS REPORT WERE CONTINUOUSLY INSPECTED BY THE UNDERSIGNED AND FOUND
TO ONFORM TO THE SPECIFICATIONS AS NOTED ABOVE.
e. Zi
t&// - t`gCERT I PIED BYt _�if�J/�e=f -/
CH VI. ar = INSPECTOR
THIS IOREFERS ONLY TOTHE FOR AND
CONDI / •N OFF THE MATERIAL AT TII
ME OF NSPEC-
TION,
6-1
CENTRAL TESTING & INSPr'ION AGENCY, INC. _2019 N. • '4TRICK . PORTLAND IJ, OREGON •
•
' LUMBCR INSPECIION FIELDWORK - CONSULTATION - ' LABORATORY P. ... BOX 5622 BUtler 5-3631 •
ya• Continuation of report P c__2_ ..c 2 Date j 1- 1 0 1964
�;.. ., of the Continuous Inspection of the No. 6-8199—AF
Glued Lam Hated Structural Members. AT: AMER I CAN FABR I CATORISIo. 6698
•
FOR: BRAME OFFICE BUILDING, Costa Mesa, California
• MATERIAL TALLY
•
2 8-1 5-1/4" .x 24-3/8" —' 48' 0-1/8" one end wild 1333 ' Radius .
7 B-3 5-1/4" x 19-1/2" — 49 ' 5-1/2" ditto Camber per diagram
•
•
•
•
•
•
•
•
LUMBER TEMPERATURE GLUE ASSEMBLY CLAMP
MARK PCS. GRADE M C OB - RH - LBR GLUE WT, ST-PULIN CLAMP OPEN-CLOSED CURE PRESS REMARK'.
� \ " 1 .c "\oa 'ICY 77/ 4,3. 75- sos 1'Oti t.,:4n 9ttPSI 7,4.,4-
=1 —4 " CC 77/ ',3- 7-3 otic- Mc) in"LO \h'.SO '10 \Oc, tco ._ —
1x C.-, -7 ` G' & -1t/ in' 77/ (o(0'. 7t` CSS` -3• XS SS c,c \1 — --
•
•
•
•
•
•
•
•
•
Specifications per page one • CERTIFIED BY�j���a�` �//J
• FO GENERAL TIN ' INSPECTOR
City of_Costa Mesa
Building Safety Department CERTIFICATE OF OCCUPANCY N° 2277 C
P. O. Box 317
Costa Mesa, California
The Building located at 2991 Orate Teens
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group :E2 Occupancy.
Use of Building OPPSCOa ant warehouse
Legal Description A. Pe 414142143
(See reverse side fpr Metes and Bounds) 43665®
Building Permit No. 7- Z 3 t� "? Electrical Permit No. 9 Plumbing Permit No. V 5
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
•
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments _ and/or guest rooms
ISSUED TO: Building Officiala
&t20 & Tttitaam by Cl? 0‘91.:7
C . r��� f iH
Date t_ 20, 196G5
This Certificate of Occupancy SHALL'BE posted in a conspicuous place on the premises and SHALL NOT BE'removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form 73034—IM-11.63--s-13 P
.. .. ..........�� ...� _ ,--2.--w}
JOB ADDRESS 2991 Grate Ln. , #3 BUILDING PERMIT NO. 25540
GENERAL CONTRACTOR Owr $ldr. DESCRIPTION OF )RK Lnt Part & Spray japatia
Al' No. 11+1-221-13 LOT TRACT FIRE ZONE VALUE $ 400.00
INSPECTIONS Signature Date GROUP E-1 TYPE V ZONE M-1
$ Soil SUBCONTRACTOR PERMITS ISSUED
Gas I Date J Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0 I ..y/c_
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing—In 0 Out 0
Plaster, Brown Coat / /
Structural, Final d 'r /�/4' Electric
Heating, Vent., Refrig. and A.C., Final tY y/C
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final rrre 13c9-4c
Special Requirements
X350 FEE RECEIVED
COSTA MESA BUILDING-SAFE. . DEPARTMENT FEE 1965
P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT.
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
/y //'.p y} �/� •� xi For Office Use Only
ADDRESS �I// l%�C/S'��r //V 1 RECEIPT NO. „piRW JJO,
COSTA MESA, CALIFORNIA -EJ.`<l`NI`i'1?lf J1
cent.-a--gAr&51--eall2") RECEI Y DATTtREG/WINED /0 EE IISSSUEDOWNER2( / 10�,�/ !/ '„MAIL pp 'ADREISS teNG r') i //_7/1vADDRESS A,0 `- ✓ '� / `--a- KCI^ •Y
CITY CS• ,ITt All NO. ) ZONE TYPE GROUP
/p.c` S IF
APPROVED tait /
ARCHITECT r I TEL. DATE
OR ENGINEER NO.
/ I ZONING p_
ADDRESS r sPq
( NLONNOBF 0 h BURS IELOFNGEW
CONTRACTOR J L{i 4/el` lg(zi /" / I -,
ADDRESS / LDECEGSCARLIFIIION v l/J r A-
3 3 ( i
,
CITY , / ------------ A.P.NO. Ii/ -d-..)-7 -- 7 3
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE ' TEL. SO'TO SIDE 8 REAR P.L.
LIG.NO. NO. _
EAVES
SIZE I NO.OF BLDG.. I. ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. Cd/I/\ ) MAIN BUILDING - ACCESSORY BUILDING
'" (FROMC/L STREET)
SETBACK LINE FROM
CENTER OF STREET '�� FRONT FT. FT.
REAR YARD
SIDE YARD I LEFT I RIGHT R.SIDE FT. FT.
•
DESCRIPTION OF WORK L.SIDE FT. FT.
NEW ALTERATION ADDITION
REAR FT. FT.
DISTANCE BET. BET.MAIN 8
REPAIR MOVING PQM041HH
MAIN BUNS. ACCESS.BLDGS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES C.U.P. APPROVED /y; //,' 1/ z
EXTERIOR WALL I ROOF APPROVED/i1✓ / 1(/ /
COVERING COVERING • BY L �A L
USE OF BUILDING AND WORK TO BE PERFORMED ___ bbb///��`
/A oQ j el 2 �7 %t�7CA✓ r- -0 az-. / 96 .r &', 8, �'
ttTr ss
SQ.FT.
1 HEREBY ACKNOWL1 OOH THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOV S CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLT WITH ALL CITY ORDI A ATE LAWS REGU ING VALUATION q
BUILDING CONSTRUCTIO r� 7
SIGNATURE OF A• '� PERMIT FEE S 3 B
PERMITTEE
$ 00 PLAN CHECK $ i
AUTHORIZED AGE T �7/ O
, ., \ TOTAL FEE $ J
•
OWNER BRAME & PUTNAM Unit 3 . DATE 1-19-65-
JOB ADDRESS 2991 Gr<'' a_ Le.ne, B & C BUILDING PERMIT NO. 23429
GENERAL CONTRACTOR Gerald F. Brame, Inc. VALUE $ 1,9.40.00
AP No,141-221-I.� LOT TRACT FIRE ZONE DESCRIPTION OF WORK IIIc,Part•_
INSPECTIONS Signature DATE GROUP TYPE _ ZONE u-
n ISSUED
Gas SUBCONTRACTOR DATE NUMBER _
Water
Rough Com. Refrig. .q Air Cond. ❑ //
Rough Heating � 11y_ — Kc- s (:. .- _ /e/.6 CI
Rough Plumbing /
Miscellaneous
Prop. Swr. Line 0 House Con.0 St. Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power 0 _
Rough Wiring c w-Cey‘. e",-• . j-/S-•`S' a 3 5'/7
Trenches 0 Forms t] Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing {�
Frame and Flas'�rilja 1• J, �/i9
Lathing -- In,p Out p /�(
Plaster, brown coat
Refrig. Q Air Con. 0 Final q
Heating, Final liU --MA
Plumbing Fixtures, Final -""�'
23429 i FEE RECEIVED
COSTA MESA BUILDING-SAFEI. DEPARTMENT JAI` `J9 1965
P.O.BOH 317 COSTA MESA.CALIFORNIA FINANCE DEPT.
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT u - _.-at _ BUILDING
For Office Use Only
BUILDING ?,t9i /ego- in,ua-
ADDRESS //``�� C"> RECEIPT NO. P{RNI)�^
pCO�STA MESA. CALIFORNIA ///JJJ (, 1/JD/ //D/CAgV{(� tVl
OWNER li edgit 76r- y �/riVASEr /MAILR[C[ r� G�p)( !/I+Y$ �/ / I/��E�
ADDRESS 2991 CEP/it-Car Lae
ADDRESS rG / ! C#'aM .�- `/�/�
FIRE • Z-
CITY CdST71- Ift
��y�j TEL..-... ZONE TYPE I GROUP
-11 NO (J )
ARCHITECT TEL APPROVED�P• • 1�}/ • DATE // -
OR ENGINEER Todf�AT/t/,41n't NO.ST( _piyap ZNING
Illi ,
ADDRESS .277// aCeee.e tiA/(/E /
ZQQ�1lM1l��At /I I
PLANO.ND 7� BUILDOR USE O :clew I
FI /
CONTRACTOR -cre.fl'_✓ 'C B/2PtFF19,2R/G
LEGAL Lot 3 f 2 -O n ](
ADDRESS a 2'997 �/�yCI�7Ce" G'87✓$- , DESCRIPTION V,4}/1/ fl r` /)l/ LI
CITY !r9 Cr-"- /i/CC-/9' A.P.NO. I l 1 —
�•��// NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC..NO.ATE 21.926 NO. �V-ro 90'TO SIDE a REAR P.L.
EAVES
OF LOT 13 ) I\ 3y.. 6,I NOW BLDOS.ON LOT ALLOWED (U.B.0.REQUIREMENT)
/` YARDS APPROVED YARDS APPROVED
USE OF EXISTING BLDG.Flee-5'tP9z4T7ozJ AZILE.L MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBACK LINE FROM FRONT Ff,n FT.
CENTER OF STREET REAR YARD `/JL/
SIDE(YARD LEFT I RIGHT R.SIDE FT. i FT.
DESCRIPTION OF WORK L.SIDE Fr. FT.
NEW ALTERATION,)< ADDITION REAR FT. FT.
DISTANCE BET. BET.MAIN O
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
VAR.# DATE
BUILDING NO.OP
SIZE ROOMS STORIES C.U.P.# APPROVED "/// �j�
EXTERIOR WALL I ROOF( APPROVED (}_ " " _ / II �Y/�
COVERING COVERING PY ` IIL/!N)V//I�VATE ( 11
USE'OF BUILDING AND WORK TO BE PERFORMED
L..)-14:4.. L..% till r./( DAA16 _
JM176,EIo/Z /�)27/7'i0Ads SG.FT.• u
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY OR NANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCT OLa d� n
SIGNATURE F PERMIT FEE S o
PERMITTfif' ) 1
/// $ 1 0 0 0 PLAN CHECK S C
AUTHORIZED AGENT -4,6".../ / O V LL
a TOTAL FEE $ (fj
UWNtK -SPIPSON'S CYCLER!
AI 4-1-76
JOB ADDRESS "12991 Grace I --
BUILDING PERMIT NO. 41414
GENERAL CONTRACTOR Pi rkerson Sign & Graphi(-DESCRIPTION of Wt,RK -Elec. Wall Sign
AP No.141-221-13 LOT TRACT FIRE ZONE VALUE E 650.00
.�N SP ECTIONS Signature Date TYPE GROUP ZONE
SOIL
GAS
SUBCONTRACTOR
Plumbing MI
PEIT5 ISSUED
Date I Number I Signature
WATER
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES n FORMS El STEEL REINF. Q
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT in
PLASTER. BROWN COAT
HEATING, VE, FINAL ^ // _ Plan'a`r. q�,_^h._ 3�f-x. ye/oaf."
HEATING, VENT., REFRIG. AND A.C., FINAL V(aC' Jt'XLIY�,,1�"`(p'""°
PLUMBING. FINAL AND GAS TEST n )�.nL Y
ELECTRIC, FINAL 49EJ1 ;2-.'1-t77
BUILDING, FINAL ..1--.7--'e, 2'34'77
FEL rstuoTr:)—
ct 2238'' 5 : s 1964
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 CITY OF COSTA MESA
For Applicant to Fill In Completely / APPLICATION FOR PERMIT
TYPE OR PRINT / 7 BUILDING
BUILDING L d 3 For Offke Use Only
ADDRESS 27W cYn'ce Zane i
RECEIPT NO. PERMIT NQ,3
COSTA MESA. CALIFORNIA ,� , Ls r
/1e::-.7.
� /
RECTO DAT[ ECEIVE TE ISSUED
OWNER .�rorne 4 rc,14 coma
�'= 6 G°. /S ,
/® �j �-�
MAIL 9a?7 Fdji' ADDRESS OC-77/ ��
ADDRESS
/J �yJ _ FIRE
CITY ( F3S�a ///P SQ NO. 50 - ZONE 3 TYPE' OROj{P/i,
ARCHITECT z
/ TlL le-ii APPROVED e S//
OR ENGINEER veie/J n,Si'n/(� NO.n BY I , DATE
ADDRESS S„ S. d cern / C..n. �- ONING � 0
/ =74 :,...„2„,__USEOF NEE[���1'''7{I(V�''�i Cj/7/_'Ir ,,�C-�
/�A- qra e / /vi / Au1LDINq�J�' "V ( 7
CONTRACTOR �7�q�� �j/� L.V/-T_ //+ 1/[�7
9..G/ Ty ,moi/
DESCRIPTION (,� D r 3 .I,p 2V
ADDRESS 6.7:,--
.. ,p.. DUCRIR1oN ,�}/. U� ✓/ Z
CITY (�/r�'7i- /�/eSGL A.P.NO. I / I / —I J
`p NOTE: NO NAVE OVERHANG SHALL BE LESS THAN
STATE 4- [�/7. NMOL. �r /-303, So'TO SIDE&REAR P.L
LIC.NO. q / / J�
OF LOT /541x L 3Y i 6 I NOW O I LOT A EAVES
SIZE NO. SLOGS. ALLOWED (U.B.C.REQUIREMENT)
USE OF /�[/"/�/I/'�//y� YARDS APPROVED YARDS APPROVED
EXISTING BLDG. 44e-SII (Are°Aj�jg MAIN BUILDING ACCESSORY BUILDING
// (FROM C/L /17R[ETT)
SETBACK LINE FROM ` A_ /7 Y FRONT / (/F�. FT.
C¢NTER oR NE FRO �d REAR Y EO //��2- - ..—
SIDE YARDI LEFT �// I RIGHT 6.5- .. R.SIDE(31:PT. FT.
DESCRIPTION OF WORK L.SIDE C) PT. 3 ii FT.
NEW I ALTERATION _ ADDITION REAR V FI.. V FT.
DISTANCE SET. BET.MAIN&
REPAIR MQyINQ `9EMOLLSH MAIN BLDG!), ACCESS.SLOGS.
V
DATE
BUILDING
I
SIZE ‘
VILDING‘e� i//./ ROOMS STORIES /
C. P.# APPROVED
SIZE o .0 .2 J,��
EXTERIOR WALLy / ROOF / APPROy[D('jl '�), ,,• c -�`.-G
COVERING /i�rY/� I COVERING deli,-a.° BY I1_J N� / �"' DATE C
USE OF B 1 INS AND WORK TO rye PER ORMED �v P.
lit N'I.S (.(ALl'P H-Ilea./A N
Cei,--g n9 Qaag J-o CAM-40-01w
4 I rw b L—_ / / is SQ.PT. I a
I HEREBY ACKNOWLEDGE THAT 1 VE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOS THEE
j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. li
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION CONSTRUCTION. PERMIT FEE $ 75-67-51/�<5`I 1
SIGNATURE OF [ " V4 >
PERMITTEE 7 7 -IO
k
S /"yc2 PLAN CHECK 5
r. AUTHORIZED AGE / (2-74-a---‘-4-12,7-- .c..7 9 ; r
® TOTAL FEE 5
_
•
232.23 J FEE RP.EIVD
COSTA MESA BUILDING-SAFETY DEPARTMENT NOV 17 1h9([pp ,
P. O. BOX 817 COSTA MESA. CALIFORNIA FINANCE U`I 1,
For Applicant to Fill In Completely , - LICA IOCOSTAOMESA
PP P Y APPLICATION FOR PERMIT
TYPE OR PRINT
BU LDING
ADDRESS �`/1/ Grope Lo�c .r<...tR-o �1J �
BUILDING ��� b
COSTA MESA. CALIFORNIAf / For Office Use Only
OWNER ,8rome !_UT I RECEIPT NO. I�d Z NO.
MAIL ��` n RECHIVuo DY DATE/RCCJVED•/ DATE ISSSUEDs/
ADDRESS 799/ C7/arr /C/1G D I //-I/'C7 I //-/�'/#7
CITY �S / �/ (lad agfrt-$O _C BUILDING 7 (� 9 l 4 l '/ • •_
/� SCC /iY' +� ADDRESS r ! / /`%17-r /�.L////I _—
ARCHITEGT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO. �/
FIRE
ADDRESS ZONE TYP/E r OUj
�
'
}
r
APPROVED
CONTRACTORRCCarn�C/ A' eranP /or, /�4/ I DATE/ / ,'
ADDRESS 29 / & 2cLf77 ONING rA
CITY afar_ "Wesa_ S.% E,{L / I NPLAO.NOS -rI HUHLDNEW) nI
O
,
LICTO. 25470 TO. -,,4_672b LEGAL
1 [}��
'SIZE / / DESCRIPTION rI �l -r.�I 1 /� ,) /I
OF LOT ./f3 X 237 I No. O SLOTH. / A.P.NO.' i i f ^ ) )1 / 3
NOW ON LOT t /
USE
EXISTING BLDG D _ /,1�CG/p6 fp F YARDS EVES
/X� APPROVED ALLOWED
SETBACK UNE FROM '/ / (CENTER LINE ST.)
CENTER OF STREET YO REAR YARD i7-1 FRONT /n�
�_\I FT. IN.
•
SIDE YARD I LEFT Q/effy I RIGHT 65/ R.SIDE FT. • IN.
DESCRIPTION OF WORK
' L.SIDE FT. IN.
N V �(
NEW I II ALTERATION I ADDITION I ` REAR 0/..../0,,,/// FT. IN.
REPAIR I LOVING I V DEMOLISH I APPROVED / /�//// /I/1 C/j
SBZLDIN6 X/S/(,� ROOMS ~Cn�STORIES// Z `II /(// 0iii of
EXTERIOR COVERING WALL Ln-C, I COVERING 4.tC///r• Uo ��/
USE OF BUILDING AND WORK TO BE PERFORMED
// -24-&-- ; , .' 7. ti ,
C}f' re tory/Qns //>J .CJ7.1-7n.e/ iLr-C-/-L an.o , C21-4.2z /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. VALUATION 9—
SIGNATUFIE
OF a, A. ,5ryp77e, //7C. pJ{ -,7 //I PERMIT FEE S /y =
. S/Jll (/OV— PLAN CHECK $ X 5-0
AUTHORIZED AGENS , '/ ' (� E
( E
TOTAL FEE - `� y
23757 J CITY OF CMA MESA
COSTA MESA BUILDING-SAFEI. DEPARTMENT MAR 22 1965
P.O.BOX 317 COSTA MESA.CALIFORNIA
For Applicant to Fill In Completely APPLNSATIpr }+I' rlii IT
TYPE OR PRINT • I -
BUILDING „2$/ C For Office Use Only
ADDRESS
2991 4. c . ZZ.i
/ RECEIPT NO. PERMIT Njj.
COSTA MESA, CALIFORNIA I. _
DASD
yy�� � DA/t D DATE ISSUE•
OWNER ,.C57, 'f}Jl9cr T' �i/7,(1~
MAIL /�I BUILD NG�n� r /T Z il.//�.
ADDRESS 29-9 / cCf�L Lary-/i//-? ADDRESS ,(Q �J/I
��J�j Sy/e FIRE 1
CITY C'' . ///C�f}- NO. , -s I ZONE y�I, T,Y^P�E GROUP /Z
ARCHITECT �•--�� TEL. BYPy, I. • r r �/ DATE yf'J
OR ENGINEER NO. ` ',++
V• /
ADDRESS I I� INC /�
20.• NO.OP USEOPNEW ((/1 v
/� PUN; YI BUILDING '
CONTRACTOR C^)Are. .. 7) ) fY/A/Fs' rid Co or
�� '
/ LEGAL
ADDRESS .299/ (�-PtM S DESCRIPTION 'I
CITY CBS YJ} o7ESi.�'- A.P.NO. /�/ /�'/ �/ 3
`/ NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
LIC.RO.Z(3 77 �0 TEL `crTh 90'TO SIDE ft REAR P.L.
EAVES
SIZE ' `, NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 4J43,g- /23Y, L s- I NOW ON LOT /
YARDS APPROVED YARDS APPROVED
ESISTING BLDG. L/7ET (a rriG6-; MAIN BUILDING ACCESSORY BUILDING
EX
(FROM C/L STRE T)
SETBACK LINE FROM FRONT FT.
CENTER OF STREET REAR YARD
Ql R.SIDE FT FT.
SIDE YARD I LEFT ' - I RIGHT
DESCRIPTION OF
WORK. L.SIDE
NEW ALTERATION JL'I ADDITION REAR
�I DISTANCE BET. BET.MAIN S
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDG'S.
BUILDING ,....-, NO.OF VAR.# DATE
SIZE ROOMS STORIES C.U.P. APPROVED
EXTERIOR WALL IVAPPROVED //✓✓UUVEXVE COVERING Wo /DTE 3 -l 0. _6' J
USE OF BUILDING AND WORK TO BE PERFORMED
%,Ur_/ate a4. 77 7/ncrkA"'
res--- 40 e/CG S
N
SQ.FT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION ��I m
BUILDING CONSTRUCTION. r '�^ �O N
SIGNATUREOF r) F� Yc /HYDE•T4IC' PERMIT FEE / m
PERMITTEP • $ l/JO/0(5/1 •' • X
AUTHORIZED AGENT _ , • /' 2
TOTAL FEE $ (e7
2433 J CITY OF ' S to MESA
COSTA MESA BUILDING-SAFE'. DEPARTMENT -
P.O.BOX 317 COSTA MESA.CALIFORNIA JUN 28 1965
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING �.'�}/� //))��,�.� ��JT -For_ ! : . JIn
ADDRESS 991 ea - c4Ne'
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA
r1� �T /9ATE REGRIV{Dc. /'DATE I(8)9UEQ.
OWNER /'f—/� .,. 77_4/7-4 _a
/l -�O (P Z h-v3
MAIL O w� BUILDING 2 99/ r cede {)/{ Q, .
ADDRESS 29 / �,P o� L„Top/� ADDRESS J�-
/�f //7_ TEL�/' y/sz ZONE PE /GROUP Z
FIRE
CITY ( �Fj OGENGLNEER 'T'; ,1 ^�J�.�jyG�.a/� NO._1TC6^p(y�.+ PE /��y9 /�,
3 I A/ X11 v. 1n NO. ' I*P BYAPPROV6{� DATE4.-2g G a 61�
p�n++ ZONING ,} ��
ADDRESS 25 � C�P�/ 1s- ;;;0���111[ 1I NO.OF USE OF NQIYI/`� (I I
/� ( I PLANS ry I SUILGIN /
CONTRACTOR (../9•46/4/2) Z��
/lam� LEGAL t- 1
ADDRESS/ jg/ Ce--t eir GA7L/�A� DESCRIPTION�� 3 11 /� J
CITY C_.0e flt / A.P.NO. l� lam /
NOTE: NO EAVE OVERHANG SHALL B LESS THAN
LIC. En .2/34/ / EOL VC. - � 90'TO SIDE Et REAR P.L.
SIG.NO. H OYI
EAVES
SIZE I NO.OF BLDGS. / ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. �O.e•nen,
' (FROM C/L STREET)
SETBACK LINE FROM FRONT FT. D PT.
SETBACK
oP NE FRO EXl'isndc REAR YARD r /Sr !/
SIDE YARD I LEFT EST / 7 I RIGHT exJjT R.SIDE Fr. FT.
DESCRIPTION OF WORK L.SIDE FT. Fr.
•
NEW ALTERATION ADDITION k REAR FT. FT.
DISTANCE BET. BET.MAIN a
MAIN BLDGS. ACCESS.BLDGS.
REPAIR MOVING DEMOLISH
BUILDING//pp f-'J Y NO.OF VAR.# DATE /
SIZE ATX 2/Z ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL ROOFAPPROVED `'
COVERING i '.g•' COVERING C..^? PO. BY A 1 DATE / / / •
USE OF BUILDING AND WORK TO BE PERFORMED
•
N
tv/ _ SQ.FT. o
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION ID FOR THE X.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION C� m
BUILDING CONSTRUCTIO �� /L� ...� N
�!A�E�-� l /h//al-a? �� PERMIT FEE
SIGNATURE OF //
PERMITTEE G
�jy� s ,OD0.
AUTHORIZED AGENT�`� r/�i� �.//L g
TOTAL FEE