HomeMy WebLinkAbout134 18TH ST - Building Permits ADDRESS OFBIIILSWO: 134 E 18TH ST mit, CITY OF COSTA MESA - BUILDING PERMIT
OJI4WSNAMEI mxk LORAINE KNICKERBOCKER -PERM NO: P 078944
smut 132 E 18TH ST '
C.M. 92626 PERMIT NO: P 078944 PLAN CHECK NO: N GOVT: N SUPP: N
MPL.MAUNO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR ENfb,FFa; MSC: I JOB DESCRIPTION : REPLACE PLUMBING FIXTURES SQ FT:
ARM OR ENG•s ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /
CONTRACTORS NAME COMMENTS : AS DESCRIBED ABOVE
CONTRACTOR'S MIMIC 1E3E3E3E11.1.,T4 **3E...1 ., **3E*iE*1E3EV.3,3E3`a.*3E3E343E3E1E*34*iE*34*3E3E*3E3E*3E3E*3E3E34*3E3E343E*3E3E1E*3E*1E1E3E1E1E1E*3E**3E1E
ADONES'' `ND ZONING REQUIREMENTS
• Mr:
LICENSED CONTRACTORS DECLARATION:I hefty atim atdw penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 d the Business and Professions Code,and my license is in full force and effect.
CITY UC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: Conbadoc LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
h WEER BUILDER DECLARATION:I hereby elfum under penalty of perjury that I ern exempt from the Caartlors License Law for the
owing reason(Section 7031.5 Bien and Professions Code:Any city or coontywhrA requires permit tomnswa.alter,improve. PARKING RE PROV: PARCEL : 42545141 ZNE: REF NO:
.radish,or repair any°In se,pdorro b issuance.rhosq requires theepplicam fa such peril to Be a°gned Salem"DW he a she PLANNING N TES>
' S 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 eiasplion-Any violation d Section
7031.5 by any appiianl for a Permit subjects the applicant to a cid penalty of not more than five hundred dollars IS50011. *141E3E***W*3E3E3E**iE33E***3E***********************SE Wit.**W WW WW WW**3E**********3E********W
0 I.aowner o w
the Pronam
yy employees wilt wages es their sole compensation,will do the weds.and the°tncture i not intended DEVELOPMENT SERVICES ; REQUIREMENTS
or offeredfor sale(Section 7044.Business end Professions Code:The Contractors License Law does not appy to an bad properly
who bolds or improves thereon,end who does worktinseltinselsuch ha heal or through his or hei own employees,provided that such
improvements are ltd intended or offend la sale.1.however.the building or inawrnoa a sold within one year of oopletbn,De ZONING APPROVED BY t�: DATE:
owner-builet wit have the burden of proving he or the did net bufd Or improve to the purpose of sale).
❑ L as ownerd the property.enesdeshety oodfactng wish Staswwe
e°aaa°romvaMl
retMOS Medics lal,BasvenAnd BUILDING APPROVED BY : r' DATE:
Professions Code:The Contractors License Law does rot apply to en owner of property who builds or improves thereon. `
afloat°for such Projects welt ao�a rador(a)Scented pursuant to the Contractors License V
am exempt ander Seation:BP044 B.6 P.D.,fa Na WNER DING WO i. / APPLICATION ISSUED BY: �-- DATE: ��,�
*3E**********************3***********3E 1E 3E3EiE***4fi****1E3E1E3E3E3E1E3E3E3E3E3E343E3E3E r Ts(
g)
5k-• �� owe P /�/l LEGALIZATION:N F E E SUMMARY STRUCTURAL SE�ME T:N
I do hereby certify that I are aware of and understand the requirements of CaBads Neth rd Safety Code .25533,end
2553x,and that I or any Mum building occupant will/will nol(circle one)need to=imply with said state cedes and I requirements ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modificationfromtheAir Welly Management Dinka.ANr
eaaafudkn
l oorm };ions are
exempt from these
provisions. PERMIT 62 . 50
Date: Applicant 2 5% SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby elf=under penally of perjury one of the folios/To declarations: ISSUE FEE 22 .00
o Ihave and wit maiden a°erteweoconsent losed;raeefor workers'°onQerwbn,asprovidedlos bbySaman3loOolheLabo BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,for the performance of the work for which lhisperenaisued. TOTALS----> 62 . 50 22 . 00 0 . 00 84 . 50 84 , 50 . 00
0 I have end M I maiden workers'compensation insurance,is required by Section 3700 d the Labor Coda for the performance o the .
w° for whichNa°rmtaa°ed'" "akr°'°°m°re°°e"''°f`° ad° °"°°d"" ""err`` REVENUE DIVISION TOTALS--> COLLECTED : --"" 84 . 50 OVER/SHORT: 00
Canter: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
' Policy Number:
84 . 50
(This aeatipn need not be completed r the permit is fa one hummed dYrs/11031 or lass.)
•
❑ become Nmlett thee of workers' woaon taws thisCaMoradagree
ial sb/°MPormneect the
w°kss. **..K.3E1E1E1E3E3E3E3E3E3E3E3E1E3E3E3E3E3E3E3E3E3E3E3E3E3EiE3E#3E3E1E3E3E3E3E3E3E3E3E3E3E3E3E3Ek3E3E3E3E3E3E3E1E3E1E3EiE#343E3E1E3E3E1E1E3E3E3E3E3E1E3E3E3E
became wtinct to the mance' the work for
was of C.I tall and issued,I shall that t I sheets become subject Ine so as to
compensation provisions d Section 3700 d the Lada Cade,I shag forthwith amply with those provisions. INDIVIDUAL F E E BREAKDO W N
Date: Applicant: \
Warning:Failure tosecure workers'compensation coverage Is unlawful,and al WI sre/gt an rrpfoyr to Criminal Pasahl end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up fo one hundred thousand dollars(1104000).In addition to the coat of compensation,damps es provided for In
Section 3700 of the Labor Code,Interest,end attorney's fess PLU 2 SHOWER 8 . 75 17 . 50
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is e construction larding agency for the PLU 2 WATER CLOSET ( TOI li ET) 8 . 75 17 . 5 0
CS.performance of whichissued ). PLU 2 WATER HEATER AND/OR VENT 11 . 00 22 . 00
LENDER'S NAME PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 50 5 . 50
LENDER'S ADDRESS: END OF FEES
I certify that I have read Na application and date that the above information S cored.I agree to comply with all SW and aunty ordinances
and came laws relating to building conrudion and hereby authorize representatives of this oily to enter upon the above-mentioned property
fa imPecton praPaaee.LOUIS KNICKERBO/ ER 41
dr
Q {�/' /y�/�/1/
P I, Noma �� Dale: 4J 'v 4.C/
Sgnetur. a 411i-.. A....... .
(5151d5.WP) White-Building&Safety:Green-FIe:Canny-Applied:Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING - F & SPA
Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit#
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 / I 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit %66. Solar System-Final
16. Rough Electric Wiring • .,67. Fencing & Access Approval
17. Rough Wiring Sign : 68. APPROVED FOR PLASTERING
18, Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air 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 ❑Oil
23. Gas Pipe-Rough & Test _ 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas O Oil
25. Roof Sheathing - 74. Overhead Hydro
26: T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical •
27. Frame and Flashing - - 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREY. FINAL
•
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION
32.-Electrical Power Meter•Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:)O‘rtp_Cl FINALE_ b
oC0
34. Final Heating & Air Conditioning t IZ/ � .
7,2
35. Final Gas Pipe-Test •
•44 Vh
36. Hood or Canopy
1 -
37. Final Factory Fireplace
38. Final Plumbing )0
ao_c36
39. Water Service-Final U �V 11
40. Gas Service-Final
41. Solar Domestic-Final
42. Backf low 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
PROJECT ADDRESS: 134 E 18TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064982
OWNEWS NAME: FIRST AMERICAN TRUST CO
ADDRESS: TR PERMIT NO: B 064982 PLAN CHECK NO: N GOVT: N SUPP : N
421 N MAIN ST
14f SANTA ANA, CA 92702 CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: ALT
r/"i1CHIENRESS: flEG.NO.:
ADDRESS: UNIT: : SQ JOB DESCRIPTION T/OFF REROOF W/COMP SHINGLES FT: 1, 800
PERMITTEE: CLAIM VALUE: 1 , 800 . 00 CALC—VALUE: 1 , 800 . 00 GROUP OCC: R-3 /
DALE ' S ROOFING ( 714 ) 550-1180
ADDRESS:
2302 W. 2ND ST COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PER 1991 UBC
SANTA ANA CA 92703 *+r****ar***************dr**+rdcaFaFdrar**********+ + *********akak •,E -*#****aF*3E*** ****** -*x-
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 my license is in ml force and effect. SETBACKS
CITY LIC.: n45R68 STATE UC.:503508 CLA C— 9
.'. Date:_ ./ --9' 3 Signature: _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to se 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 ND.: 0 7 3 9 9 7 9—9 3 EXP.DATE: 11 /01 /94
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL : 42545141 INE ; REF NO:
Certified copy is hereby furnished. Q Certified copy I with th icy Buil 'ng Divi
//$$JJ//��//. PLANNING NOTES>
iii
Applicant. •
�i �> ��� >
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(4100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
•
DATE;
Date: Signature:
NOTICE:If,after making this declaration,you should become subject 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. 11
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y : DATE: j l
C).which issued **************if*********************—rc .,,3t . . .. i **********7li:R-4-F.R Z /**
LENDER: ***************************************+f***************************************
ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 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 4 1 . 0 0
repair any structure,prior to its issuance,also requires the applicant for such permit to life a signed statement that he/she is licensed 5 0
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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(5500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 41 . 50 0 , 00 0 , 00 41 . 50 41 , 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
116 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 : 41 , 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 progeny.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 41 , 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law),l am aware **.****. *..***.,*.**.H.*.*.**.N,*,*,*,*. ..N,*.*******.****,**,N,*y,*.*..N,*,*,**,*,*****,*,******,**„K,*,*,*,******,***,*
that proof of their Worker's Compensation insurance should be provided to me,
o I am exempt under Section: B.s P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner: SFR 1800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 800 . 00
Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. '
Date: Applicant:
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 DET EC70R
ordinances and state laws relating to building construction and he horde re entativ of this G ter upon the above-mentMned
property forfoinspection purposes.p �, SMOK
Date:—(��(�— l Signature: �� REQUIRED .,,- 01 00150973-00150976 TOT 41.50
Driver's License or Social Security x:
?ATE: 11/19/93 TIKE: 16:25
164146 Whue—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor —— —
gib
CONSTRUCTION AND PLANNING PO6JSA
APP;YDVALS 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 UF ER 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, ❑ 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
-„i
25. Roof Sheathing u*on..Q7 664,01,-- 74. Overhead Hydro N ' f •
r _
26. T-Sar Ceiling (Structural) & Monocoat 75. Dry Chemical
• Lt
27. Frame and Flashing 76. Dry Standpipe wi
28. Lathing & Siding 77. FIXED SYSTEM FINAL 2 • rr
is
29. Insulation 78. FIRE PREV. FINAL '`"� ni
30. Drywall Nailing HEALTH DEPT. REQUIREMENT r"
31. Plaster Brown Coat 79. FINAL INSPECTION �•.L'1
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .I(
33. Final Electric Notes:
34. Final Heating & Air Conditioning -
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
fr' 45. Sound Attenuation
IV
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
ADDRESS OF BMLDwc: 134 E 18TH ST WIT: CITY OF COSTA MESA - BUILDING PERMIT
• ovnoTwPWEIE IelowN: LORAINE KNICKERBOCKER •PERM NO: B 079826
WDRESS: 132 E 18TH ST
C .M. 92626 PERMIT NO: B 079826 PLAN CHECK NO: N GOVT: N SUPP : N
574-9126
APPL.MAILRIO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR DOWER: UC.NO.: JOB DESCRIPTION : REPLACE WINDOW WITH SAME SIZE SQ FT: 100
ARCH OR ENC:S ADORERS: WIT:
CLAIM VALUE: 100 . 00 CALC-VALUE: 100 . 00 GROUP OCC: R-3 /
CONTRACTORS NAME:
CaITRACTORS MIAOW COMMENTS : REPAIRS /
ADDRESS LIC NO. WWWWWWWWWWWWWWWWWWWWWWWEEWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW
um: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penny of perjury Net I am licensed under previsions of Chapter 0 SETBACKS
(commencing with Section 7000)of Division 3 ol Na Business and Professions Code,and my license i in hp force and ailed.
CITY UC.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: Contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penny of perjury that I am exempt from the Common License Law for the
lowing reason(Sedim7031.5 Runless and Professions Code:Anyray a county with requires permit to consbu=atter,improve, PARKING REQ: PROV: PARCEL : 42545141 ZNE: REF NO:
maisedpue cant ir to the prrre.ovisionor ens d theaContractorssuance. LicenseLaw requires (Chapter t o(commencing such mend twiheSeamn 70ned 00)d Division she prof she PLANNING NOTES> .
schen and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.TMy violation of Section > •
1.5 by any applicant for a permit satiate the applicantalty of to a civil pennman than five hundred dollars lS5001). W W W*ick W W W W W W W W W W W W W W W W W W W ick W W W W W W W W W ick W W W W W W I(;W W W W W W W W W W W W W W W W W W W W W W W W W W 9 *W WW WWW W WW
❑ I.as owner of thepmpeny omy employees with wages otheir sole compensation,will donne work.and theebucture iv not intended DEVEL OP MENT SERVICES R EQUIR E M E N' T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply lo an Owner of properly
who builds or names thereon.end who does such work himself or herself a trough his or her own employees.provided that such
improvements are not intended or altered for sale.li,however.the Luning or inprovemen is sold*Rhin our yea of completion.the ZONING APPROVED BY : OA DATE: -
owner.bdlder will have the burden of proving he or she did not build or improve for the purpose of sale). t 10- /
❑ I,asMoto dthe ampeM.amexdrmContra"' m
a"'1°eoructNed
eaa (Bedion7044'Busy" BUILDING APPROVED BY : IA)s6 DATE: 7 - 3(0
Professions Code:The Contractors License Law dna nor apply to en owner of properly who builds or improves thereon
contracts for such projects with a contractor(al licensed pursuant to the Contractors License Law). p
,` M lameetemaurd«Bediogn:BP044 B.AP.C.,forgis WNER DOING WO' APPLICATION ISSUED BY: DATE: ) 0 - i • !b
/' Dale: /(0� 7� C� Owner: — / 5 /�j 1E ick lE iE iE 1E iE 1EkfFiF 1f 1E 1E 1E iE lE llflk it iF aE iE iE iE iE iE aE iF#iE if iF aE if if iF iF iF iF 1f 1f 1f If 1F 1F iE 1f iE iE iE lE iE iE iE 1E lE 1E lE 1E 1E iE dE dE(E iE if 1E iE lE IEK
"`GCC LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware d and understand the requirements of CeNade health and Safely Code Sect'.. - - 'anted
25534,and Net I or any future building occupant will/lay not(circle one)need to comply with said suds codes and I . i'. . for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
afor mnnmctionamodifiationhomlheAa aWy aregmentDistrict.RefidenlWconstrWionappicatianwe- • .' e PERMIT 21 . 00 . 50
Da,,: Applicant: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby elfem under penny of declensions:ane d the Slowing decle: P LAN
ISSUE FEE
❑ Ihave and wlmania acertificate of consent toself-insure for workerswmpenWion,espro
' idedfarbySedon3700dtheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,fathe pednmansd
onlp»wakl«wlKthis h permitwi..uee. TOTALS----> 21 . 50 0 . 00 ,,j 0 . 00 21 . 50 21 . 50 . 00
❑ I have and wit maintain woiun'compemation insurance,a required by Sedan 3700 d the Labe Code,or the performance of the
work for which the permit is issued.My waken'compensation insurance carder and policy number are:
Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 21 . 50 OVER/SHORT: . 00
Policy Number. BLDG PMT PLUMBING ELECTRIC `MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
section need ad be completed(the penal is for one hundred dollars j5o001 or less) / 21 . 00 . 50
I rattly that in the performance of the work for which this permit is issued,I shall not employ any person in any manner
become abject to the workers'compensation lawn/California,and au - 1 I should become subject tot 1. WWWWWWWWWWWW WW W W W W ick W W WWWW WW W W W WW WW.*********************************************a
compensation o"n ((/ionse/�� on 3700 d the Labor Code'I shell forth ate with those provisions.
INDIVIDUA F E E BREAKDOWN
C
X. Dale: /'2"" 4 Applicant: i _.G _ y —amellalV
Wanting:pairing to secure workers'cornpensation coverage Is unlawful,and shall subject an end. , nW •esw TYPE QTY D E S C R I P T I O 'N UNIT COST TOTAL COST
civil fines rpt SO one hundred thousand dollars(5104000),In addition to the cost of coops ratio : . , as provided for In
Section 3706of the Labor Code,Interest and atronny'sfees. SFR 100 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 100 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally Of perjry that there is a doamcton lending age.ty for the END; OF FEES
performance of the work for skid,this Fermi is issued(Section 3087.Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I=Myths I hat read this application and dale that the above alternation is correct.I agree to comply with all coy and county ordinances
anacme lawsrelatigtobw =instruction haberepresen: ivesdtisdywnose-mentioned d 01 00216519-00216520 TOT 21.50
for inspection purposes. LOUIS KNICKERBOC• R • DATE: 10/07/95 TINE: 13:49
1.S. t Print Name/ /ate: •
(5151-46.WP) While-Buildig A Safety;Green-Fes: •• :Pink-Revenue:Goldenrod-Assessor
,I PO�PA
.,ONSTRUCTION AND PLANNING
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
AI
1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location , t
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 l
12. Sewer Cap _ t 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 Electric Wiring , 67. Fencing & Access Approval
17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS-.F I NA L
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
It 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing `' - 74. Overhead Hydro -
11
26. T-Bar Ceiling (Structural) & Monocoat _ 75-. Dry Chemical - -
27. Frame and Flashing s 76. Dry Standpipe -+
28. Lathing& Siding77. FIXED-SYSTEM FINAL
29. Insulation - 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION - .
32. -Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes: /4f.t /tot r 41
34. Final Heating& Air Conditioning- - -- ea
Poll/W.&
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 - r -
45. Sound Attenuation -
46. Handicap Regulations - ' - •
-
47. FINAL STRUCTURE & BUILDING (, 6-97 6'(„i.
48. FINAL PLANNING ,
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -
No. Date
ADOf;SSOF IAMB: 134 E 18TH ST Wim: CITY OF COSTA MESA - BUILDING PERMIT
t ONNEWSNAMEIFKNOWtt LORAINE KNICKERBOCKER r PERM NO: E 079828
omm: 132 E 18TH ST
C.M. 92626 PERMIT NO: E 079828 PLAN CHECK NO: N GOVT: N SUPP: N
574-9126
APPL.MAIUMOADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: OTH
ARCHITECT OR ENGINEER: sic.No: JOB DESCRIPTION : REPLACE ELECTRICAL SEVICE SQ FT:
ARCH.OR ENO'S ADORERS: WIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /
cONNMCTOWS NAME:
CONTRACTORS MNIAI0 COMMENTS: REPAIRS /REPLACE ELEC SERVICE / REF B-79826
ADDRESS: AC.ND.: *******************************************************************************
WMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby alliin under penalty of perjury that I am licensed under provisions of Chapters SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Profession Code.and my Boanse is in full force and Wel.
CITY UC.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: Contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am awnp from the Contractors License Law for the
owing reason(Section 7031.5 Business and Professions Code:Any city county whim rewires a permit t000nauud,alter,improve, PARKING REQ: PROV: PARCEL : 42545141 ZNE: REF NO:
nol'ih,Or repel'any structure.prior to is issuance,also requires the appkrarl far such permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License taw(Chaplet s(commencing*eh Section 7000)of Division 3 of IS PLANNING NOTES>
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.5 by anyappiiau for a permit subjects the applicant to a Ova penalty of not more than TWe hundred dollars(55001). ***ill***illill****illill*****ill************ill*****ill*********************ill******all***ill******
❑ I.ere amen of Me properly or mY emPloRn wish wages as thee sole comperoeuon,will do the wont.and the structure is not imsded DEVELOPMENT S E .R V I C E S R E U I R E M E N T S
or offered for sale(Section 7044,Business end Profonions Code:The Contractors Licenseor Law does napply to an owner of Orogen),
•i
who budds or improves thereon.end who does such lemma liea or hersel or through his or her own employees,provided That such
improvements are not intended or altered for salt If.howara,the building or improvement a sold within one yew of completion.the ZONING APPROVED BY DATE:
ownerbuider will have the burden of proving he or she did not build or improve for the purpose or sale).
❑ I,as owner of the properly.am exclusively connoting with licensed contractors to construct the project(Section 7044,:
Professions Code:The Contractors License Law does no apply to an owner of property who builds or improves I . 4. who BUILDING APPROVED BY : DATE:
contracts tar such furious wind a mmrador(a)licensed pursuant to the Contractors License Law).
) 8J Iant exempt undelSedion:BP044 B.&P.C..w this . OWWN�E�R (pOING • APPLICATION ISSUED BY: �� DATE: !o`,�
Date: /0 7-4 Go Owe./ /.4.... r>/ ************************************************** **************** *** ** ***
and understand Health LEGALIZATION:N F E. E SUMMARY STRUCTURAL SEGMENT: N
25530�tmOor anythat!am Mum EukmM oodrpem will/will notorequirements
b one)Cr ed Mtacompy ih said sate•:.- 1r' . ants�
a perms for construction or modification from the As Ouaky Management Destdd.Residemad mrgrWionappfmf. • .. exempt from Mese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 31 . 2 5
Date: Applicant: 5 0% SM I P/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the blowing dxLratiom: ISSUE FEE 22 . 00
❑ I hews and eil maintain a certilkale of consent io sell.insure for waken'compensation,as provided for bY Ueda,3700 of the Labor BUILD ING-DIV_> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
cede.fathe Pedormenceathe weak for which me peralemued. TOTALS----> 31 . 25 22 . 00 0 . 00 53 . 25 53 . 25 . 00
❑ I have and vii maintain workers'compensation insurance.as required by Section 3700 of the Labor Code.for Ihe performance of the
work for which this permit is issued.My workers'compensation insurance renin end policy number ere:
Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 53 . 25 OVER/SHORT: . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed l the permil is b one hundred dollars(5100/r Am) 53 . 25
® I certify that in the pedanence of the work for with this permit is issued,I shall nit employ any person b'sumer •n I
become subject to the warkeri mmpenealion taws a Catomb.and agree that f I should become tot. *******************************************************************************
compensation nn/oof Section 3700 a Me Lobar Code,I shall lam ply"°n Moes. . I N D I V I D U A L F E E BREAKDOWN
Date: %�! lW Applicant: 1 .
Warning:Fellurefo secure workers'compensation coverage Is unlnMu.and shall sublet,an • •yer •�• 'Mlpenelfiss and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(5104000).b a M
!don to s cost of compensation,da • asprovided for In
Section 3706 of the Labor Code,Intrest,andsUomaYslootELE 2 RECEPT/OUTLET ' 1 ST 20 EA. 1 . 00 2 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm oder penally of perjury that then is a conmWy ta
tdion lending agency the ELE 2 RECEPT/SWITCH 1 ST 20 EA. 1 . 00 2 . 00
pent nancealheworkforwhimtheperm.iee (Section ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 27 . 25 27 . 25
LENDER'S NAME
LENDER'S ADDRESS: END OF FEES
Icxrya
thIhavereadtisapd�tionanddaethattheaboewormtstidniscorre Isomata ocmp&wihaDane
city and 01 DQ215`21 QQ2I6521 TOT
and state laws relating to building construction and hereby authorize representatwn ofthe ay to enter upon the above-mentioned propend 53.25
P for inspection purpo es. DATE: 10/07/95 TINE: 13:49
• LOUIS KNICKK=O . Ey'
l Pnnt
�� Dale:/D-7-16
Sgrmure a Omer/
(5151-46.WP) White-Building A Safety.GreenFnb:Canary-AppFan:Pink-Revenue;Goldenrod-Assessor
IfCONSTRUCTION AND PLANNING I PC SPA
APPROVALS Permit# - Date Inspector APPROVALS Permit # Date Inspector
f
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,
I 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 . I 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection • 62. Backwash & Receptor-Final
12. Sewer Cap - - 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing „Q5. Electrical-Final
15. Rough Electrical-Conduit r66, Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
I
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 O'Gas 0 Oil
23. Gas Pipe-Rough& Test - 72. Underground Flush
24. Roof.Framing • - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - . - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical •-• - '
_ -
27. Frame and Flashing _ _ - 76. Dry Standpipe -
28. Lathing& Siding . . - 77. FIXEDSYSTEM 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 42 �j9�� 80. FOOD CERTIFICATE ISSUED
33. Ffw --����__\\'Final Electric - 3076ti GQ'�.✓. Notes:
34. Final Heating& Air Cdnditioning- t -U -- a�-� .�� i
35Final Gas-Pipe-Test - `
36. Hood or.Canopy . . x - - - - .
-
37. Final'Factory Fireplace -
38. Final Plumbing - - - - - - . -
39. Water Service-Final " r -
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
• ,
AMISS a ButDt)0: 134 E 18TH ST WIT: CITYOF COSTA MESA - BUILDING PERMIT
'.r a NNEflNaErclao*N: LORAINE KNICKERBOCKER PERM NO: E 078943
) ADOREsS 132 E 18TH ST
{ C .M. 92626 PERMIT NO: E 078943 . PLAN CHECK NO: N GOVT: N SUPP : N
APPL.KAPJNG ADORES& CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: OTH
ARCHITECT ORENa4EER: uC.ND.r JOB DESCRIPTION : REPLACE ELECTRICAL FIXTURES SQ FT:
ARCH.OR EM'S ADDRESS: WIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: . R-3 /
CONTRACTORSNAYS.
COMMENTS. AS DESCRIBED ABOVE
CONTRACTORS
CIOR9 Magri *****db****Bt BH tE**dE dE li**RH dH gag SE******df dH SASE******RH**SERF****fl***SSSS****RH*BH*****gag dt***RE*di**♦E*
• ADDRESS: IRC ND_
UNIT, ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Slim under penally d pe jury that I am licensed under doeskin d Chapter g SETBACK S
penally
(commencing with Section 7000)of Division 3 d the Business and Prolamine Code,and my license is in hat lace and effect.
CITY UC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under praly d prjey til born the I an ening IConned*Liss Law for the
Marg reason(Sedan Trots Busbies and Professions Code:Any city county which requires a pane to construct.Met,improve, PARKING REQ• PROV: PARCEL: 42545141 ZNE: REF NO:
rn
dsh,«repeiarcysudae.pinbb imumme ,aba rperoslheappamdlasut permero Bleasignedeiatmeed bathe«Me PLANNING NOTES>
b licensed pursuantprovisionsw C
Rothe provisions d pmnedas License Law[Chapter9(commentary with Section 7000)d Deleon 3 d w
Business and Prolamine Con]or that he or she is exempt therefrom and the basis for the aaeged exemption.Aro violation of Sedan >
7031.5 by any applicant laawnuubpaa the applicant to advi pan*dnot mon than True hundred dobn]SSO3U. iHdfifdtdEiElFiEifgtildE#gEdFdidEli BEgiiEdEdfikiFifdifiiFdPik MifiEdEdERfdEdEdEN-fEREdE1E1EdEdidHiERE1E#gEgFiFiEdHlEiEdHiEdEdEiFdFdFdfiEif REikififgPdfifdEdp
❑ I,as owner tfepmwned nT mpmleea with wages as their sole compensation,will n thewoM1,endo structure is notieerdee DEVELOPMENT S •E R V ICES REQUIREMENTS
or offered ler sale(Sedan 7044.Business and Prdsaioe Can:The Conrad*License Law does not apply to an wrier of property
who buids or improves thereon.end who does such work tinsel or Nasal or enough his or her own atmpvyw,provided that such
impra.anrb are not iserded or thane 1o we.I.homes.the hubby or aris w
inpronl soilihn wd r,the one catkiZONING APPROVED BY DATE:
owner-0rldr wig have the d proem burden orihe or she did cot bald or improve for the pupae of sale).
❑ I•asaw^rd the party am spdvey aonredag weh gneesd coaradas rocmeMn de Prpra(Sadam Mea,By • • BUILDING APPROVED BY : DATE:
Professions Code:The Contact*Liens Law does nil appy to en Meer of properly who hole« I /
octants for nth pmjeas wih a mrador(e)licensed pursuers to the Contractors luso .� /A
tanner w erBP044 B aoz Ioreip OWNER D� W�1' : APPLICATION ISSUED BY: �j]��. DATE: ��tn
!� / _� q o at iE iE if lE lE iE iE iE iE iE+ElE+t iF it iE iE lE iE+E it3F£7t 1F dF if if dF 3f lF tE tF iF iE iFIWFlEiFlF iE iF iF iE iE iF IF iF iE iE aF iF aE+E iF i4rtlE iF lE lE i(-iE iE iF • iE 4E
ata: 77 `�' " '—� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL ' GMEN :N
I certify Nat I am aware d and understand the requirements of Catfomie Heath end Safety Code Sections .,..255.33,and
me)haw*building occupant Pecks - ase ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a panni for*smanno modificationaamthe Ai Quaky Mmeenent[Minot.Reaidaa I*mrnionappratwe an armpl horn wee PERMIT 12 . 00
prada'ns.
Dols: : 50% SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:!hereby dfrm oder peneli'of Prauy ore of the blowing declarations: ISSUE FEE 22 . 00
❑ Ihave end wilmroanaccededadconsent toseimaafor workers'compesation•spro.NWl« raA(Id
bySn3the LaM BUILD ING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,tor the pedamancedwdmane TOTALS----> 12 . 00 22 . 00 0 . 00 34 . 00 34 . 00 . 00
❑ I have and sell mvm'n waken'compensation insurance.s required by Section 3700 al the Labor Can.ler the perlorman e d the
Wadi for wtkthth m"blead.MywperCompensation insurance cattier and play number are:•
REVENUE DIVISION TOTALS > COLLECTED: 34 .00 OVER/SHORT: 00
`rem
Perry N*ler. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not las competed l the pant is tor ons handcar,dcdIns.) 34 . 00
❑ I become thatjd t the*vibes'c whichatsabral this a IM d,I ogre. mI 1 shoddyby Pram inanyto the .& ********dl***********3 *****RE*********RE*****REdi***di*******************************
bccome a ki to the seance compensate/1 work
or ih d CefnS'e ail pies due i I Scorch Masons sigma ny to til sr lm to
mmpruatien provisions d Section 3700 of the labor Code.I shag bramth comply wm'those proWere. IND I V IDUAL F E E BR E AK DOWN
Date: Appltant:
Warning:PO*as sac*waiters' rt
conpsadon coveru
age Is unlawful,and sial ub/ect an employes to Mains,prwaes and TYPE QTY D E S C R I P T I O •N UNIT COST TOTAL COST
dna fines up to one hundred thousand ddWa 0104000A In addition lo It.car of conpansrbn dampens as provaed for In
Section 3706 of ma Labor cade,lgL and atromysleea ELE 4 FIXTURES, LIGHTING 1 ST 20 EA. 1 . 00 4 . 00
CONSTRUCTION LENDING AGENCY:I hereby dr=ads peregy d perjay that them S a mulnalan landing Dray for the ELE 4 REC EP T/OUTLET 1 ST 20 EA. 1 . 00 4 . 00
performance ofthe work for which this prmabissued(Section 3Dg7.Cie.C). ELE 4 RECEPT/SWITCH 1 ST 20 EA. 1 . 00 4 . 00
LENDER'S NAME: END OF FEES
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is caned.I agree to comply with al*and many ad a.oee
and state laws relmkg to buddig construction and hereby meliorate representatives d this city to enter upon the above-mess breed property
for irePedimwrpoeea.LOUIS KNICKEOC�R •
A
! - - A>/ /, Date: c-e-t7 ' 1 1(/
Y Signature d e^lar;l % , -•a
(5151'fe.WP) WhieAWdiy&Safety,Gnemfb:Caney-Appicrd:Pink-Rewe:Goldenrod-Assessor
CONSTRUCTION AND PLANNINGPC & SPA
APPROVALS Permit# Date Inspector
r� 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 UF ER 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 1 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 a 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. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing _ 76. Dry Standpipe
28. Cathing& 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 a / 80. FOOD CERTIFICATE ISSUED
33. Final Electric � `e� Notes:
34. Final Heating& Air Conditioning «rr (, i-'__l^� -C�r71 I' n`a/)�f
35. Final Gas Pipe-Test l y
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
•
` BUILDING PERMIT LOGffe /
41 ))eqiure
EMPLOYEE: 7
ADDRESS: / v Ai tE. I'k "ST
PERMIT NUMBER: 6 ne/L! -3 TYPE OF PERMIT:
VALUATION: SQUARE FOOTAGE:
PERMIT FEES:
DATE: TIME IN TIME OUT ACTIVITY
11-13 -1(0 roils ulfcckel necte
ONLY ONE ADDRESS PER SHEET-TIME IS TO BE CACULATED TO THE NEAREST 15 MINUTES
PLEASE BE AS SPECIFIC AS POSSIBLE IN RECORDING ACTIVITIES
ti ADgwwss
ccaM.wm: LORAIN N 13 q E KBIC KERBOCKER weir CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 078942
gNEWS NAPE IF KNOWN::
ADOREsS: 132 E 18TH ST
C .M. 92626 PERMIT NO: B 078542 PLAN CHECK NO: 03249-96 S GOVT: N SUPP: N
APPL.MAWR]ADDRESS CONSTRUCTION TYPE : V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO4 JOB DESCRIPTION : REMOVE WINDOW & INSTALL DOOR SQ FT: 200
ARMOR EKG's ADDRESS: uNr: CLAIM VALUE: 200 . 00 CALC-VALUE: 200 . 00 GROUP OCC : R-3 /
CONTRACTOR'S PLAIM
SUNG COMMENTS: AS DESCRIBED ABOVE
CONTRACTORS RASING 3E4646464E*4E3E44**K6*KE46*464E46*K6 K6K64E 36 K6 K64E 4E 4E 4E444E4E4E44K646K6 KE iF 3E 36 K6 KE**K6*#K644E 463E 4E4E464E**3E4E**4E3E46*4E46464E46 K6K6***
ADDRESS UC.NO.:
ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aim under penally of perjury that I am licensed under provisions of Chapter 9 S E T B ACK S
(commenting with Section 7000)of Division 3 Of the Business and Professions Code,end my limns is in fug force and Bled.
CRY UC.NO.: LIC.CLASS: LIG.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dale: Corcador LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby Winn under party of perjury that I ant exempt from the Corrredora License Law for the PARKING REQ: PROV: PARCEL: 42545141 ZNE: REF NO:
towing reason(Section 7031.5 Busies and Professions Code:Any cry or ch n
easy which a permit to construct,alter.improve.
mash,or repair any structure,prior to as issuance also requiasthe applkad d for such pento Me a signed statement that he or she pLANKING NOTES>
licensed penman'to the provision d the Contradors license Law[Chapter 9(commenting with Seaton 7000)d Divsion 3 of the >
Business and Professions Code]or that he or she S exempt there/men and the basis for the alleged exemp'un.MY violation of Section
7031.5 by any applicant for a permit alibis=the applicant ofd anl to a ON;penalremore than Me hundred dollars[SNOOD. 3E 4E 4E**3E*4E 364E 36*36*46*KE 36 3E 3E 3E 46**4E**436*36 46**K6 4E*44*3E 3E 464E 3E 3E 4E 4E**46 36*3E 4E 4E 3E*4E 3E 4E 4E*4E 3E 4E*4E 1E*4E 4646****K6*3E
❑ I.as owner of the properlyor my employees with wages astheir sae compensation,sen do thewo&and the structure is no intended DEVELOPMENT SERVICES R E Q U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to en owner of properly
who buids or inpmwhoves thereon.and wdoes suchwork Nmself or herself or Sough hs or her own employees.provided that such '
improvements are not Wended o offered for sale.If.however.the buiM4p or improvement s soil within one year doompletion,the ZONING APPROVED BY DATE: ..-
ownetbuider wig have the burden of proving he or she did not bid or improve for the purpose Of sale).
❑ L as ownerd the popery.am exclusively contredro sew Wised contractors to=stud Me project(Section 7044.Business and BUILDING APPROVED BY : DATE: ar,
Professions Code:The Contractors License Law does not apply to an owner of properly who hull's or improve,thereon and
contracts for suds The
eda a ceder(a)licensed pursuant to the Contractors License Law). `Jr.4
I.exempt under Seclion:B P 044 8.8 P.C.,bthia reuyrOWNER DING Wf ' . APPLICATION ISSUED BY: DATE: d
re" et
) 4E 3r 3f 3f 3f-3k 4E 4F 463E 4E 3f 3f 3E 4E 3F 4f if 3E 3f 364E 4f 3F 4f 4F 4f 3F 4E 3f 4E 30443E 463E 4E 4E 4f 4f 3E 464E 3E 3E 4E 4f 3E 3f 3E 3f 4E 3E 3E 4E 3f if if if 4t 4E 3f•.-.-• - '4E 4E
Dal [ Owns �L LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGME ' : Y
o hereby certify that dam aware of and understand the requirements d California Heal h and Safety Code Sed'• - •••.,?5533,and
25534.ani Mat'or any future buildup occupant wig/wil nod(circle one)need to comptywbh said stale codes and the -• '- eras kr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for constmdcn or modification from the Air Duality ManagementDistrict.Residential condrudion applications are exempt from these pERMIT 21 . 00 . 50
provisions.
Dale: Applicant: PLAN 13 . 65 SMTP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby Slim rider peagy of perjury one d the lollowing declarations: ISSUE FEE •
❑ Hume and will maintain ecertificate dconsent losell-insure tor workers'compensaan.as provided labySection 3700dthe Labor BUILDING-DIV—> PERMIT L ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the perf manceofteworkfotwhichtispermiis issued. TOTALS----> 21 . 50 0 . 00 13 . 65 35 . 15 35 . 15 . 00
❑ I have and will maint.n workers'compensation insurance.as required by Section 3700 of the Labor Code.for the performance of the
ark for which Me permit a issued.My workers' insurance edpolcvnMSwr ae: REVENUE DIVISION TOTALS--> COLLECTED : -- 35 . 15 OVER/SHORT: . 00
Carrier BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
Policy Number: 21 . 00 . 50 1 3 . 6 5
is section need nal be compered I the permit a/or one hundred dollen/5100)or Aka.)
❑ Icengy final in the pee wakes of the work for which tub permit S issued.Kees
rice employ any person in any mew at as to3y.3E3E3E4E3E4E4E4E3E4E3E3E4E464E4E3E464E4f3E3E363E364E36463E464E4E4E4E#3EK{-363E3E4E4E464E#46463E4E3f46363E4E4E3E4E4E3E4E3E4E4E3E363E3E3E4E4E364E4E3EiE4E364E
become smbito the workers'campenrkion haws d California.end agree Met d l Mould become subject to workers' *************************************K-*****************************************
compensation provisions o Sedion 3700 of the Labor Code,I Wag forthwith campy with Mose provisions. IND I V I D U A L - F EE BR EAKD OWN
Date: Applacd: -
Warning:Fe/lun to secure workers'compensation coverage Is unlawful,and shall as)/act en employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST•
civil lines p to ons hundred tlouure,dollen($104WOA In addition to the ct of compensation a pensation damages Provided ler In .
u
Secdon3706ofthe Labor Cods,Interest,and etommesleea SFR 200 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 200 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there S a construction lending agency for the END -OF FEES
performance or the work for whkh the permit is issued(Section 3097.Civ.C).
LENDERS NAME
LENDER'S ADDRESS:
I certify that I have read this application and date that the above information is coned.I agree to comply with aD city and countyordnancee
and stme taws relating to building emnrudian and hereby authorize representatives of the cry to enter upon the aboe'mentiored property
binspedionpurposes.LO IS KNICKERBOCKER
Print Nemo n �y /�
Dae: a —[7- IL
Signature / or
(5151-4&.WP) WMe-Buildi g A Safety;Green-Re Canary-Applicant;Pick-Revenue:Goldenrod-Assessor
• I CONSTRUCTION AND PLANNING400
-' 1 PCfPA
Date Inspec{or / Date Inspector
APPROVALS Permit# _ APPROVALS Permit #
10
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 - 1
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, O 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 O Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27: Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 76. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Srown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning /Z -/f--q6 / / k //v
35. Final Gas Pipe-Test - Gt.B/T FehaLIG
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 !-C - et7 &
48. FINAL PLANNING _
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
- --
51. CERTIFICATE OF OCCUPANCY
No Date
•
CITY OF COSTA MESA
BUILDING SAFETY DEPARTMENT
DATE - '7'
In consideration of the City of Costa Mesa granting a permit for
the erection of a sign to be located within ten (10) feet of the front
V
property line at /3ce /17� ' '
the undersigned, for himself, his successors, executors, administrators,
and assigns, hereby agrees to move said sign at his own cost and expense
in the event the City desires in the future to widen the right of way on
which said sign fronts, as provided in Section 8506 (c) of the Municipal
Code of the City of Costa Mesa.
4 ? /.�Qi /�j
dh
1-62 -
A/14 V/
.
V BUILDR •AFETYDEPARTMENT
P• O. Boa _.J. 317 N? 1575 e
Costa Mesa, California
Date / — 1/S..—
CITY OF COSTA MESA
CERTIFICATE OF OCCUPANCY
Building Permit NNo..15 U 7fr Electrical Permit No. Plumbing Permit No
Use of Building ( it-t - '"-r-5`e ('Z:.t2 A,.
' , . - -rp- 4..t4V.
The building located at / 3 /I f /4 Al -- 7-, 1
Legal Description
(See reverse side for Metes and Bounds)
has been inspected and found to comply withhe provisions of all City of Costa Mesa Ordin-
ances applicable thereto for a Group - 7— 2 Occupancy.
ISSUED TO: n n City Bullding�Ofticial
(Owner of Building) By -'-I .'t /i s�4 c,,
r — <
CC: 0 Original—Owner ❑ 1st copy—Gas Co. 0-2nd copy—Edison Co. 0 3rd copy—File
Form 200 s-n P IM 1-60
t54 9 FEE RECEIVED
•♦ OCT 251961
CO'TA MESA BUILDING-SAFETY DEPARTMENT .FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA _
For Applicant to Fill In Completely APPLICATION FOR PERMIT •
TYPE OR PRINT BUILDING
ADDRESS i 3 4 C . ( 8 Th .37--
COSTA
jt'COSTA MESA. CALIFORNIA For Office Use Only
OWNER g Q C L yM P. Q R E ZC N I RECEIPT NO. I PERMIT NO.
4.-4 79
MAIL REZi Br DATERECEIVED /
/
MAD 7 0l30K -no / ^�J - / z o
)
CITY , OSTit MOSTe' NOA/ C¢¢/e/fADRE6$ 1 L O /Q/
ARCHITECT GE TER M SPR 1 n►6 E NO. YnClo COSTA MESA. CALIFORNIAS/ {�L
ADDRESS1.2 D //LTH ppVSTA - A C O N R IRE
ZONE TYPE J GROUP 'J 2.-
CONTRACTOR OW NC•t aU lL biet APPROVED • '- DATE /r / "/
ADDRESS CONING t
20N[_ I NO.OF I USE OF NEW
CITY : PLANS BUILDING
STATETEL. LEGAL HS
D /J �/1, I/( 4.
LIC.NO. f NO. /_� / J��j 6
DESCRIPTION Aire-��
SIZE ` NO. OF BLOCS.OTrs /
OF LOT S� K //J O NOW ON LOT / A.P.NO. //7 -- /o z 0.7
USE OF _ Xf1 � ypRD6 EVES
EXISTING LOG �LciI /
_ � _
APPROVED ALLOWED /1
SETBACK LINE FROM Si y`"� (CENTER LINE ST.) _GNn- ata.. net Ctvav
CENTER OF STREET REAR Y /l - FRONT 3-s FT. IN.
SIDE YARD I LEFT .5L I RIGHT R.SIDE L-• / FT. ----
IN.
DESCRIPTION OF WORK —
L.SIDE J FT. ,.p IN.
•
N I II ALTERATION I II ADDITION I REAR I/ 9-p- FT. e- "' -1 IN. __
REPAIR I II MOVING 17,11DEMOLISH I APPROVED e(J� _n9 "DATE DATE 9�6A. r
BUILDING '/ ; NO. OF "/,IOC
SIZE d$.Y y L ROOMS '� STORIES / • HOLD FOR SPECIALpREQUIREMENTS
EXTERIOR WAL I ROOF // NO �.(. �I .aL G
COVERING .0-oL'O COVERING [�_/NnL.� .. . �y ,"QJ�fy"y��� 'J7
USE OF BUILDING AND WORK TO BE PERFORMED 1e `O MMa4Cl c// ay /�/fnwW _
R(�-s/44'3
fo U.(J9 R T.�D "/ D N L j/' FOIL olc,. " °y' -7 c^y",eA.
t E I.o c A T/D iq Z. 4-4._ euro( : are, nn
II HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDE VALUATION IS FOR T
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH AU. CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. UATOIN �� 60-0SIGNATURE OF . • ‘1..-e-.41:-...-," . alas, /
PERMIT FEE Sla N
PERMITTE e
Sil eft) PLAN CHECK $ ZI alC2X_
AUTHORIZED AGENT y (s'CS
TOTAL FEE $ /U
0
`I
•
n ?; ,tin
.t‘; P..• Li(.)-.]".1 ..
• VARIANCE
REQUIRED
9/6, DATE
VAR. No " • APPROVED 771/C,
OWNER SERTNGE & LNNDBERG V DATE 11-3—c,5
JOB ADDRESS 13h E. 18th St_ BUILDING PERMIT NO. #2 32
GENERAL CONTRACTOR Owner-Builder VALUE $ Ao2G.GG
Lt., AE 117-102_7 BLOCK TRACT Sign
GROUP TYPE ZONE FIRE DISTRICT 2051
PERMITS ISSUED
INSPECTIONS DATE N SUBCONTRACTOR DATE NUMBER
Footing Trench N
Foundation Forms and Grade to Garage _ j/1 /
Rough Framing I
Plumbing,Rough to Slab i Ii /
/-
Plumbing,Rough Complete A ,�;CY
Temporary Pole 111 11 7' _
Wiring,Rough n III
Heating,Rough ' IMES
Heating,Final M/S. _ Ir
Sewer, House Sewer,St. A Al I U/
Sr -'1 Tank or Cesspool 1lWA u`
t
L. ig, In Out ii
Plastering
Plumbing,Final,Fixtures Complete
Plumbing,Final Gas Test
Wiring,Final _
Occupancy
0
t, All Applications Must be Eiied Out by Applicant
Application No. 2053 DEPARTMENT OF BUILDINGS Permit No OZa 3 2"--
APPLICATION
APPLICATION FOR THE ERECTION OF SIGNS
To the Building Official of the City of Costa Mesa. Calif.:
Application is hereby made for the erection alteration:❑ removal:❑ of an advertising structure
in accordance with information herein set forth (Check square what is to be done).
/�
/ (Use Ink or Indelible Pencil)
LotA ( / �— /03-
-3 Tract Application No._
Owner's Name prD 7 a if-LNrxd .gir Owner's Address no+E.IFSV,
,retractor's Firm Name /vO 41'e- State License No.
Contractor's Address /U 6 a ae_- City License No.
LOCATION -
Number 1334 E. Jt ' S'}. Street Valuation to-e`
Sketch showing location of proposed sign on back side of this sheet. Plans and other data must also
be filed.
DESCRIPTION OF SIGN
i
Size of Sign 4- ft. Height •r Z._Ft. Height above Grade 4 Ft.
State location of other signs on buildingcs•+K--Thickness in. Weight lbs.
Including Electrical Transformers, Etc.
undersigned hereby agrees to construct the advertising structure in strict accordance with the
provisions of Ordi ante 95, Section 39 of the Electrical Ordinance of Costa Mesa, and all amend-
ments �reto
® � l
ALL A .ptyliO�FSi MUST B FILLED OUT BY THE APPLICANT. INSPECTION MUST BE CALLED
FOR UPON COMPLETION. c ,
//.
11/ 2 1955 Sign Here _.---• e /
By ..
CITY OF COSTA MESA FOR DEPARTMENT USE ONLY U
Permit No. Fee Plans checked and found to conform to Date Permit Issued
inances, S e Law, Etc.
as fl W-2c± °--
$ -2 - .44
Plan Examiner.
• t
FILL IN ALL;DIMENSIONS •
SHOW ALL STRUCTURAL MEMBERS
S 1 G. N town
FOR SELF-SUPPORTING SIGNS -44
Cv 35i,��tfccn ;goo •fl(
Size and Location r
Section 7 of Ordinance No. 95 T
• • Sec. 6 of Ordinance No. 95
•
Width of Lot
C/L
Sign Area 'cent .n,rarr USC 1
r tet
10'/o Deviation I
from C/L of lot 11
C/L of Lot • - L i.t; S
--
"rOs 205•9
Property
Line
•
Curb
STREET OR HIGHWAY
i- "j3 4- E . I ytis•
1 /
OWNER GREEN, EVELYN, F. 1 `T> DATE 6-26-62
JOB ADDRESS 13)1 E. 18th St. BUILDING PERMIT NO. 17414 V
GENERAL CONTRACTOR Owner-Bldr• VALUE $ 7.00
AP No. 117-102-07 LOT TRACT FIRE ZONE DESCRIPTION OF WORK non-Elec.Grnd.
i' `ECTIONS Signature DATE GROUP TYPE ZONE C-1 Sign
Si,.. PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop.Swr.Line 0 House Con. 0 St.Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power ❑
Rough Wiring
Trenches U orthi steel Keret. U /1."0_/_00_atoy e T a t/ _
Floor System
I3ond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing fj ,b( lo`�3
Lathing — In 0 Out 0
PI- 'ter, brown coat
ft . 0 Air Cond. 0 Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final ', _. ftj '-40—‘:;
OCCUPANCY
FORM BU4•5M — 7-61 17414
CITY OF COSTA MESA)? ie ' 1 7414 'FEE RECEIVED J
Building Safety Department 10112 51962
•
•Application for permit for the fabrication and erection
�j FINANCE DEP1.
of awnings, advertising signs or devices.
--J/11/1.17 CITY OF COSTA MESA
FOR OFFICE USE ONLY
LOCATION
Building Site Address
13 Il E . I gam- 5*, Date Issued v `- :' E-v-- Permit No. i "
OW N i`2 Fire Zone �pe Group
Name ofteecee G � kI. YN r, aQET1 Phoney �/o��
` _ Approved by Date 2 r
Contractor O �U F R. I3 V Ll.. DER. , State License No. •�
/I ZONING
address �� —City Phone — Zone r / Use of Bldgs:
Architect or _ ___ // / e2- — 07
,gineer _ State License No. A. P. No. 41
Bldg. Site Address /a7 c, l 8 J4
address —City- -- Phone-
DESCRIPTION Legal Owner I/y AT gjfg&e— N
Description of awning, advertising sign, or device: v-1S" /'T/
Awnings canvas 0 metal 0 Width: � Address_ft. in. Length: �0 fr. in.
City Cin Phone
Ground Sign tin Projection Sign ❑ Roof Sign ❑ Wall Sign ❑ Metal Letter Sign ❑
Yards Approved.
Banner LI • Canvas Sign n Gas Tube Electric Sign (Sub-section 1.44, Ordinance 313) ❑ Large Sign in excess of 8 sq. ft. Setback from center line
Combination Sign n Special Device (other) ❑ Explain: of street to front property line .-.. Oft. in.
From property line to edge of sign 5—ft. in.
Two copies of plans and specifications shall be submitted with application for permit for each sign. Plot on Side Yard Setbacks:
plan sheets proposed location of sign and locations of all other signs at site. Minimum size sheets must be 18" -/7e9/p
ft. in.
by 24" and non-erasable. Left Side
f within the 10-foot area of front property line, owner is to sign written agreement with the City. Right Side 0 ft. in.
r �� O v Building Line Setback from
5•
of Sign — Thickness ft. in. Heightft. in. Length / ft. in. center line of street -��3-ft. in.
Weight lbs. Height above gradef4. in. Projection ft. in. Area of Sign __ ft. in.
The undersigned hereby agrees to fabricate and a ct awning or advertising structure within the intent and S.4 1
meaning and in strict accordance with the provisions of Ordinance 95, Ordinance 313 (Electrical Ordinance of Height above Grade c ft. WO.
the City of Costa Mesa), and all amendments thereto. Projection ft. _a_in.
ALL APPLICATIONS MUST BE FILLED OUT BY THE APPLICANT. ALL FOOTING, FRAMING AND ELECTRICAL IN-
SPECTIONSAwning ft.SHALL BE CALLED.
Length ft. in.
Signature o1 �zsce The amount shown under Valuation is for the purpose of Awning Height above Grade ft. in.
Permitee ('s` _yam: Lc.G_/
/ establishing a permit fee only.
Authorized Agent $ `� — Projection ft. in.
9 VALUATION Permit Fee
Location and size
e.� / $ /�j� Plan Check $ approved by ' !
Recd. by — Date r�,�-6Y Total Fee $ —r Date —‘a 6---- .1-----
Form 214-1M-11-60-5-B P