HomeMy WebLinkAbout3448 LUPINE CIR - Building Permits� r �
(714) 754-5273 • F2x (774) 754-4856 • wvnv.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, GOSIA MtSA, GA 92626
.lobAddress: 3448 LUPINE CI
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 41217819
Applicant: SELL, RON
Address: 18032 LEMON
YORBA LINDA . CA
Owner: MAGGI, MARIO L
Address 3448 LUPINE CIR
COSTA MESA, CA
Conuactor: SELL ROOFING COMPANY
Address: 18032 LEMON
YORBA LINDA , CA
Zip: 92686
Arch :
Address:
Zoning: R1 R1
Phone: (714) 52&1758
Zip: 92686
Phone:
Zip: 92626
Phone: (714) 528-1758
License: 323842
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 17I08/2002
Issued: 11I08I2002
Phone: � Phone:
2ip: License: License:
SCOPE OF PERMIT
REROOF: TIO EXISTING SHAKE, 1/2" OSB SHTG, 2 LAYERS 30# FELT, APPLY "CLAYMAX TILES " ICBO #3523; 5.5 PSF 28 S�AURES
Plan Check: $0.00
Permit: $167.25
SMIP Res: $0.89
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: 5168.14
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0. 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0
58.900.00
$8,900.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes and related
regulations. (Ortl. No. 9248, § 1, 72-27-92)
EXPIRATION: This peimit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
for a period ol 180 tlays.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlons end final epproval must be obtained. Failure to obtain inspections and (inal approval will result In the expiratlon ol this permit.
FOR INSPECTIONS CALL: (714) 7545626 \
zua.e �a�oo� .
WORKERS' COMPENSATION DECLARATION: �^
I hereby ettirm untler penelry oi per�ury one of the lollowing tleclaratlons:
❑ I heve end will meintain e ceNlicate ol ��sent to self-Insure lor workers' compensation, es provided lor by sealon 3700 at I�e Lebor Catle, tor the peAarmance of the
ork for which �his permit is issued.
I have entl wlll melntain workers' compensatlon Insurence. es requiretl by sectlon 3700 of tha Labor Cotle, for the pertortnance ot the work lor which this permlt is Is5ue0.
My workers' co saf n Insuren rner en0 p y number ere: /�/ / /� /�
Cerrier. i � Policy Number: / CC� N J 3
/TNi< cGi!�inn naail nn� Nn �mm�lalnAl I�n n!`TII le vnh�a/ a� nnn Fr�nAiaN Nnllero /61M1 �i /nnn 1 1
❑ I certlry that in the pedarmance ot lhe work lor which this permit is luued, I shell not employ eny person in eny menner so es to become subJect lo Ihe workers'
compensation laws ot Calllornle, eyyytltltl���aaa8ree that it I s ultl become sub�ect to the workers' compensation provislons ot Sectlon 3700 of the Le6or Cotle, I shell forihwith
comply wi�h these provisions. // /j � � rO �
Applicant SlgneNre: ��OL(— � oe�a:
WMNINO: FAILUFE TO SEIXIRE WORKER$' COMPENSA710N COVERAGE IS UMAWFUL AND SHML SUBIECT AN EMPLOYER TO CqIMINAL PENALTIES M'D CML FlNES UP TO ONE HUNDRED
T/IOUSAN� DOLIARE (5100,000), IN ADORION TO THE CQST OF WMPENSATIIXJ, DMNGES A$ PROVIDED FOR IN SECTION 3]OB OF THE UBOR CODE. IMEREST, ANO ATTOMJEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I em Ilcensed untl prov15��
force antl ettocL Lic. a__�
CoNrectofs Slgnamre:
(commencing wit� Section 7000) al Division 3 0l Ihe Business end f,rofessjqPs�otle, entl my license Lq in fW
�_ Cless a __ Ci � y
oa�e: �6 — 3 / —O
CONS7RUCTION LENDING AGENCY:
❑ I hereby attirtn that l�ere is e construction IenOing apenty tor the peAormanco ot the work tor which lhis pertnil is issued. (Sec. 3097, Civil Cotle).
Lenaer'g Neme: Lendefs Atltlreu:
Signature: Date:
OWNER-BUILDER UECLARATIONS:
I hereDy eHirm Ihet under penalry ol perjury tpat I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW lor the tollowing reasan (Sec. 7031.5, Businass antl Profassions
Code: Any ciry or counry which requires a pe�nit lo construct, elter, improve, Comolish, or repair any strucNm, pnor to its issuence, also requires the applicent br such pertni�
b tile e signed statement that �e or she is Iicensetl pursuant to t�e pmvisions ot the Conirectors License Law (Chepter 9(commencing wlth Sedlon 7000) ot DMsion 3 ot Ihe
Busineu entl Pmfessions Code) or t�et he m she is eaempt Nerelrom end the basis tor the elleged exemption. Any viUation of Sectlon 7031.5 by any epplicant tor e pertnit
subjects the epplicant to e civil penalry ol not more lhan tive hundreA tlollars (5500)J:
❑ I, as owne� oi the property. m my empfoyees with weges es lheir sWe compensetion, W ItL DO THE WORK, sfM the structure Is �rot iniar�tletl or offered tor safe (Sec.
7044, Business antl Professions Cotle: 7he Contractors Licensa Law dces not apply to an owner ot propetly who builds or improves Ihereon, entl who does such work
himself or herselt or Ihrough his or �er owo employees, O�ovidetl Net such improvemenis are not intendad or oHered for sele. If, however, the builtling or imprwement is
soltl wit�in one year ol completion, Ihe Ownorvbuilder will heve ihe burden ot provinq ihat he or she ditl not Ouiltl or improve for puryose oi saleJ.
❑ I, es owner of t�e pmporty, em EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business ena Professions
Code: The conirectors License Lew tlo65 noi epply to an owner of property who builds or improves thereon, entl w�o contraas br such pmjact with e comractor(s)
license pursuant lo the Conirectors Lice�se Wws.).
❑ I em e:empt under sec. Business enA Professions Code tor this reason:
Signeture: Date;
Owner ID verilied by drivefs license. ❑ Ves � No DriveYs License No. E:pires:
Verilicatlon of Ownership by (rype ot tlacumen4 I.e. - properry tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby canify that no excaveUon tive (5) or more teet in tlepth inm which e person I5 required to descenq will De matla In connectlon with work euthodzetl by this
pertnit, and Ihat no building structura. s�eMoltling, talsework, or demolition or tlismantling t�ereol, will be more then Ihirry-sia (38) feet �igh. (Chap, 32, Grp 2, An 2, Sec.
341, 710e B, Celilomia AdminislretNe Cade).
❑ As awner-builder, I will nat emplay enyone to tlo work which would require e pertnit fram the Divislon ol Indusiriel Selety, es notetl eDove, unless suU person hes e
permic to tlo such work Iwm ihe tlivision.
Signeture: Date:
Division of Industrial Salety Permit Number:
CERTFlCA7E OF COMPLIANCE IWD AUT1fORIZA710N OF EMRY: I ceNty untler penalry of perjury that I have reatl this apDlication end state that the infortnation given is
wrrect. I egree ta comply wlth ell stete lews end city ordinances relating to Ouilding wnstructlon, and euthodze representatives of the Ciry ol Costa Mesa to enter upon the
ebove-tlescnbetl D�aGerty lor inspectian purposes. I egree not to occupy or ellow occupancy ol eny 6uilding euthonzed by Ihis permit umil finel inspection.
i nat OI Legal er( �/ �atez ^�
�� -r�
An r Au oAzad App�kaM Date
COUE 1. INSPEC710NTYPE
1618 Fixed System Finel Fire Preventlon
1288
200
201
202
203
Pool Spe Flnal
Flnal Re-Rool
Final BIocWRetelning Well
Final Fectory Fire Placo
Finel Sipn
204 Finel Demolitlon
QAg U�45
l - -oL�
yODE 1 INSPEGTON TYiE
206 Final Mechenical
208 Finel Plumbing
210 Flnal Elecirical
212 Finel Fire Preventian
220 Flnal Plenning Approvel
222 Final Site
250 Final Building/Ottupenty
Q� I��
AVD���ant to iill in all spaees exceo� those within neavY oor0er lines antl sign a1l aoo�opriate tleclarations.
CITYOF.COSrnME C NSTRUCTI �NPERMIT
Project Address
Applicant's Mailing ddqress • � J„
Owner's Name (d � � ' Phone ��.,�£%
�zi �
Addres
Arch/Eng. Licenu No.
Address �
Contractor's Name - Phon
Addreu (mailing) � �I
City License No. ,
LICENSED CONTRACTOR DECLARATION
I hereby aHi�m lhat 1 am licensed untler prOvi5iOn5 of Charte� 9(commenGing
with section J000) of Divizion 3 of the Busine55 antl Protesslons Gotle Q
my licenze i in i l�tt{ljqantl eilecL � �
License s ��v L�c z
Date 519nature
WORK I ENSATION DEC RATION
1 hereby atfirm that 1 have a rertificate of conient to It-insure o� a certi(Icate
1 Workers' C mpens5tion Insurance, or a certi ' copy there i(Section
800,'l.ab. C -
Policy No. Company
8 Certiti � cop is hereby fu�nishetl. �
Cert letl with the city Bui '
Date APPllcdnt
EXEM N ROM WORKERS'.COMPENSATION D CLARATION �
(Thissectwn n etl not Oe com0leletl if Ihe pe�mit is (or on¢�huntlr¢tl (E300) o��
lessj.
1 certify ihaf in the oerformance of the work for whicn thls perm�t is.issuetl, I
sha11 not employ any person in any manner so as to become subject to the
Workers' Compensation l.aws of CaliPornia.
Date Signature
NOTICE: Ii, after making this tleclaralion, you snoultl become subject to the
Wo�ke�s' Compensatlon provision5 Of the ISbo� Cotle, you must torthwith
comply with such provisions or tnis permit shall be tleemetl revoketl.
CONSTRUCTION LENDI,NG AGENCV -
I hereby af(Irm tltat t�erp Ik c;__onstructlon lentlin9 agency for the pertormance
o( the wo�k tor wnN,U�� Aermit is issue❑ (Sectlon 309� Civ. C.)
Lentler's Name �_�
Lender's Atltlress .
OWNER BUILDER DECLARATION - �
1 hereby aHirm that 1 am exem0� f�om the ConVactor's License Law for tbe
followinq reason (Section 7031.5 Business antl Professional Cotle: Any cltY or
county which requires a permit to construct, alter, Improve, tlemolisn or repalr
any sbuc[ure, prio� lo it5 i55uance, also reqWres lhe appliGant f0/ Such permlt
to tile a si9nea statement that ne/she is liconsetl pursuant to tne provisions ot
the Con[ractor's License Law (Chapter 9(commencing witn Section 7000) of
DiviSion 3 of the Business antl Professions Cotle) or that be/she is exempl
'herefrom an0 the basis to� the all¢qetl exemption. Any violatlon of SectiOn
031.5 �by any applicant for a permlt subjects the applicant to a civil
enalty of no[ more than five huntlretl tlollars (550�).
❑ I, as owne� of the property or my employees with wages as their sole
mmpensation, will tlo chc work, antl the sVuctura is not Intentletl or oiferetl
tor sale (Section �on4, 9usiness antl Profeszlonal Cotle: The Contractor'S
License l,aw tloes not apply to an owner of a property wno bulltls or improves
thereon, antl who tloes sucM1 work himselt/he�self or Ihrough his ot ber own
employees, provitletl [hat such improvements arc not Intentletl or otferetl for
sale. I1, however, the builtlin9 cr improvement is soltl wlthin one year of com-
ple[ioq tne owner will have tne burtlen of proving he/5h¢ �itl not bufltl or Im-
��rove for the purpose of sale).
I, as owner of tM1e property, am e%clusively Contracting wlth Ilcensetl con-
t�acM�s to cons[�uct the project (Section 7044, Business antl Protessionz Cotle:
� The Contractor'S License Law tloes nOt apply to an awner of property who
builtls or improves tnereon, antl wno conVacts tor such projects wlth a ron-.
tractor(s1 license pursuant�to the�Contractoi'i License Law). I am aware that
proof of Ihei� Wo�ker's Compensallon InSurance ShOultl be Orovitletl to me.
❑ 1 am exempt unaer Section B. & P. C. lor this reason
Date
1 herGby certi
information is
antl state laws
sentatives of �
inspecUon purp
Signature
Drivers' LicenS
— Owner
iat I have reatl this appliwtion ana state that the a�ove
2t. 1 agree to comply h all tlty antl county ortlinances
:in9 �o builtling con ruc on, antl hereDy authori re e-
city to enter yp �/t pqbve-mentionee prpp�ty�p�
JNPE OF CONSTRUCTION LI NEW LJ ADO LJ ALTERATION LI REPAIR
�J,❑ CONVERSION O DEMOLISH ❑ OTHER q.p, �6
DESCRIPTION OF WOftK/USE OF BLDG.
S Main Building:
TVPE OF PERMIT GRADwG FOUNoaTIOrv �rauCTURa� � T Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING •L•�'IOrCHANICAL � A Rear
❑ �OTHER C Right
PROJECT DESCRIPTION Sp. FT. OCCUPANCV K.
COIVSTRUCTIOIVTYPE VALUATIONS S L¢tt
ZONE � GRADING CU. VDS. ACRES Ping. RCf. #
Remarks: ' . Planning Notes:
Sink
<flow Preventer
eflow Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap �
Roof Drains
ReinspeMion Fee
$15
Duct- UnderGround
Duct - Structural
Ducl - Ventilating
Exhaust System ❑ MWtiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑aioo,000 sTu Oioo,000sr
55 � _����' �_�— I I F7einspeetion Fee
CMF 0865-46, rev. 4/84 Whi[e - Builtling; Cana�y - APPIIWnt: Pink - Accounting; Golaenrod - A55essOr
$15
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
FEES
0
Issue Fee $ 3
2593 5/OB/c^�
Zo�e
Accessory Building:
Parking Req./Provided
ELECTRICAL
AutOmatic Washer Transformer 0 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit Me[er ❑up to 700 amps
Dishwasher Meter ❑over 100 amps
Dryers ❑Gas ❑Elecvic Sub Panel �
Fan Motors � 0-1 HP � 1 Yh - 8
F,A.U. Inc. Solar �9-15 HP 016-15+
Fixtures � Microwave - -
Device Boxes Pole Light � -
Outlets
Switches
Garbage Dispoul
Generator �0-5 KW 05-15 KW
Sign
Standing Sections
Trash Compacror .
Rainspection Fee I$15 luue Fee
IANICAL FEES
Hoodor Typel ❑ DEVELOPMENTSERVICESREQUIREMENTS:
Canopy Type I I ❑ 2oning Approved By
Building Approved By
ie(rigeration Svstem �� Appliption Issuad By
❑0-100,000 BTU ❑ 100,000 BTU
System Repair/Alteration �
Iswe Fee
$ 3
BUILDING PERMIT � $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL 5
PLANCHECK 50% $I
MECHANICAL SF
PLAN CHECK 25% $
OF FEES
_ SMIP $
_ PERMIT
ISSUANCE $ �
ENERGY P.C. 5
GRADING S
MICROFILM $ �.
�
— TOTALFEE $ .
10�66
FEES
$ 3
Z
O
N
I
N
G
R
E
�
M
T
S.
CONSTRUCTION AND PLANNING . POO, SPA
APPROVALS Permit# Date Inspector AppROVALS Permif# Date Inspeotor
�,1. Temporary Electrical Service or Pole� , , - 52. Pool & Equipment�Location
. 2. Soil.Pipe-Undrgmd. - � 53. Steel Reinforcement , � �
3. �Electrical Conduit Utilify-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
, Z. Footings - , 58. Electrical Conduit-Undrgrnd.
.8. Foundation . �- 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. - , ' 60. Backwash Lines; P-Trap, � Undrgrnd.
10. Structural Floor System �• � � - 61. APPROVAL"TO DECK
11. Property Sewer Line & HouseConnection 62. Backwash & ReceptorFinal
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 O Gas ❑ Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monbcoat 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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
. 33. Final Electric � ' Notes: -
34. Final Heating & Air Conditioning b��5_ L�
35. Final Gas Pipe-Test •
36. Hood or Canopy � � , .
37. Final Factory Fireplace
38. Final Plumbing � � . . �
39. Water Service-Final �
40. Gas Service-Final '
41. Solar pomestic-Final ' . -�
42. Backflow Preventer ' � �
43. Backflow Irrigation � ,. , . , � - �
44. ,Landscape Irrigation System �
45. Sound Attenuation '
46. Handicap Regulations -'
47. FINALSTRUCTURE&BUILDING � ' �
48. Special Requirements Completed , ,
49. Electric Release to Edison � . . . . � •
50. Gas Release to Southern California Gas Co
. 51. CERTIFICATE OF OCCUPANCY � -
No. Date ' � '
2� Z�
� A
• � ���' � ``�� Twininq Laboratories �f ���«t�=�,� �«��f�=,=«_, '�,_�.
.
_�� �I , I Oy o <',�07355.17U e3c�
� � �O. BOY. �� . i3�0 n vPO:' wA• . iO�+G 2EqCH CA�iF OeOi .;iU� � 2366 . I��'I Bd8�6�37
Pen�.c� OcpCEs
TESTING t. ....�.. ..s•...• .—. n.o,,.......•..,c
�-a G��,..a>Iq .^ }a350..an..r n.. v0 b.�, a
��� 53' 1G'. c •�' " �.� 9.e r Ce . a0d0i ITI� ele.118e
7:-
*;4 .'n', `7 ,
November 16, 1973
Examination: 5 C 7 $-7370
COMPRESSION TESTS ON GUNITE �1'�INDERS
Nr. L. E, Sprague
5041 Doanoke
Irvine, California92705
PROJEGT
ADDRESS
SAMPLE FROM
Swimming Pool for L. LADENHEIM
344II Lupine Circle, Costa Mesa
1-4 Deep End: 205 Shallow End:
Per 1tB 37470
3-6 Bond Beam
•ACNIfFCT CONTRACTOR
Continental Pools
ENOINFER SUBCONI0.ACTOR
C083 L GU71I Le CO.
SPECIFIED
MIx Gunita Verdugo Pre-mix STRENGTH 2,000 pst
DATE CAST
DATE TESTED
CYIINDER NO.
COMPRESSION
TOTAL LOAD, LBS.
I1-9-73
11-16-73
1
7-Day
87,000
SLUMP
11-16-73
2
7-Day
167,000
POUNDS PER SQ. IN. 3�2�0 6,160
51ZE: 5-7/8" x t2-t/2" 5-7/8" x 12-I/2„
COMPLIANCE ]-dgy test complles wi[h Speciffcatfons.
nuo[ er
CYLINDERS L.E.Sp�ague
p msr4iwnoN:
-Lesta Mesa Btdg. Dept.
continencal Poola
Coast Gun(te Co.
DEIIVERED BY
11-16-73
4 "NOLD"
3 S "NOLD"
6 "HOLO"
7-Day
141,500
5,005
6" x 12"
NECEIVED ON
Dave I1-12-73
BUILDING SAFETY DEPT,
NOV 1 g 1973
L. E. Sprague - 2 �,✓�
, �.�...- � -S�t,....�
i./ . s` -'- �i
G ,{=- f'"�p"� -' • �
�lL AECON}S �RL $VBMIiiEO �5 1NE CONCIOENl1�L PROPERTV O� Cl1ENl5 �llTH0412�TION GOR PVBLIC�TION O� Ol1P REVONTS. CONCLVSIONS, OR E�-
iP�CiS fPOM OR vFG�901NG ir�[u �5 9ESE4VEO PCNO�NG OL'4 WRITTEN ��VROV�L �5 � MVTV�I VROTECTION TO CLIENTS. TNE VJBIIC AN� OIlYSELVE$
ii0'�2
�
�A
Mr. L. Ladenheim
3448 Lupina Circle
Costa Mesa� California
Dear Sirs
October 29, 1979
�
92626 �
v
A building permit-has been aued to Continental Poole to conatruet
a privata swimming pool on yo property.
In order that your pool vill be a safe one end for the purpoae of
adviaiag you.of your responaibility regerding the raquiremente of
the Coeta Meaa Nu ipai Code� we rafer you to Section 8107� a
copy of which ia at hed.
Thia letter !a direcced to you in order that you vill ba avara of
our ozdinaacea aed can make a complete'aafety eheck of your pool
area.
RHieb
Sincerely youta�
RICHARD HANNAAT
Building Safety Dizector
CI1 OF COSTA �SESA REQUEST s0R OCCL +CY
TRACT N0. �� ��
i,or tio, //D �
a�Dzu.ss 3 � -
DATE �(J � i �
T'ne developer of the above entitled trac� desires to sell the abeve set
farth lot prior to the tine that the tract has See^. co:�pleted aad its street�
accepted by the City of Costa Mesa.
The undersigned, by executing tnis agreement, ac?cnowledges that
�-they) were)� :.�. advised that this tract has
not beea given fin ir.spection no: has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval c;�ic:^. were i�posed by the Ci:y
at the ti.;.e the final tract map was approved. 1
The City asst:mes no Iiability for t'r.e enforcement of the cor.dit_:ons
necesse.-y for approval other thzn those conditior.s orotected by surety bond.
The undersigned agrees to'�zde,;.r.ify and hoid the City nar,aless fro:n
any claim resulting in da^�age o: personal ��jLry to tne undersign�d 'oy reason
of the afore.�entioned uncomoleted cendition.
RECEfVED
CITY OF CQSTA MESA
PIANNING DEPT.
OGT 3 19�3
AM eM
?'�8i9,14��..�fx�i�r4r5�6
�
BY \i% �-'-+�-✓ �G�--c�-�r�-f'f'�L-�--�..�
Purchaser
�_ - ��-
BY �— C _` <_ <� �� ll--;`-z=l">� �
��- � —
Developer and/or authorized
zepreseatacive
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BY ��i,.�i'/�i l�l.r.,/'y�:
Lender
OWNER
JOB ADDRESS
DATE
BUILDING PERMIT
GENERAL CONTRACTOR same DESCRIP710N of WORK Res, w/ att
AP No. LOT �in TRACT 7S5'7n FIRE ZONE VALUE 8 29.800.00
GAS
WATEfi
ROUGH PLUMBI
PROP. SWR. LI
SPRINKLING 51
MISCELLANEOI
ROUGN HEATINi
TEMPORARY SE
UN�ERGFOUND
ROUGH WIRING
TRENCNES
FLOOR SVSTEb
BON� BEAM [
SHEATHING
FRAME AN� Fl
LATHING — IN
PLASTER, BRO'
STP"^TURAL,I
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IONING
STEEL REINF.
SUBCONTRACTOR
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� COSTA MESA BUILDING-SAFETV DEPARTMENT
301 A P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVE BV D,9TEREGEIVED DATEISSU
nooaess 3448 Lu ine Circle 7�G�� APR 10 1�
PERMIJN
owNeA Larwin Southern Califomia, Inc. A.P. No. f,[�'. '�
MAIL .�C BUILDING �[�� Lv /N� C�/! r
ADDRESS �6/�5 entura Boulevard P.DDflESS i
CITV Encino, California No`986-8890 TRACT7SS%—B LOT11O BLOCK
CONSTRl1CTION W A p' P
LENDEF e n alifo nia nc
BFANCH 16255 Ventvra Boulevard
nooaess Encino Califomia 91316 OWNER //✓ .SO ��.0 t-
ARCHITECT TEL 5 S!/�1 W�J% �jA/l•�LUE /y�OL
ORENGINEER Larwin �O� CQ�If� 273� d
nooaess9100 Wilshire Blvd. Bev. Hls. Ca.
ZONE VPE GROUP DL
APPROV E /y _
CONTRACTOR a them California �IIC Br DATE
ADDRESS 16255 Ventura Boulevard
CITV NO�. ZONE P��Z/ BUILDING E�� �
9 -8890
l C No. 191311 UCyNO. B�� VARDS APPROVED YARDS APPROVED
MAIN BVILDING ACCESSORV BUILDING
SIZE NO.OF BLIX'aS. O (FROM C/LST EET)
OF LOT %�. X 12�} NOWON LOT ROM FT. FT.
USE OF
EXISfING BLDG. I F
SIZE OF NO. OF r
NEW BLDG. 19H7 ROOMS STOflIES 1 L.SIDE FT. FT.
EXTERIOR WALL ROOF �J �
COVERING StUCCO COVERING WOOC� Shll1 I@ REAR / FT. FT.
USE OF BVILDING AND WOqK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. AOCESS.BLDGS.
Construction Sin le Famil Residence CURP # APPROVED
FPPROVED 'J z
J
pOLD FOR EC L E UI E S
1 hereby aeknowlatlge that I hava reatl this application antl state T
Ihat thB above information ia corrett anC aBrBe SO comply with
all laws regula[ing builtlinp cOnstruction, antl I shall noi employ
any person in violation of Ihe workman's compensaUOn laws at
Me Srote of Celifornia.
I hereby Certify that I em prOperly Iicansetl es e convactor untler SQ. FT. � d
the Stnre of Calitorniu Businoss entl Professiona Catle, Division 3, HE MOUNT SH N UNDER VALUATION IS FOR
C�ap[or 9, antl thet sueh lieerlms ere in full forea antl effect, or I THE PVRPOSE OF ABLISHING A PERMIT FFE ONLV:
nm exempt from the provislony of the Stete of Californlu Buzinass VALUATION
entl Professions Co o, Division 3, Chaptnr 9. PERMR FEE § 1�1. 5�
SIB^ature o p . pOWnS
Pormittae 3 2'9 � 800 pL4N CHECK S 5�. 75
Authorizod Apent TOTAI FEE s 152.25
OWNER LADENHE7M, L.
.�j JOB ADDRES:
'>v GENERAL CO
� 4p No._ 412—]
�ECTIONS
� Pool Location
Forms —
Main Drain
Steel Reinforce
Elec. Bond
Appro�al to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines and Recep.
Electrical Final
Heater and Vent Final
' � System Final
Backwash and Recep. Final
Fencing Final
DATE 10-26-73
BUILDING PERMIT
< Pvt. Swim P
E ZONE VALUE $ 3, 5�•�
ROUP TYPE III Z(
SUBCONTRACTOR _ PERN
Electric
Plumbing
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: COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 60X 1200 COSTA MESA, CALIFORN�A 92626
For Applicant [o Fill in Comp(etely R
BUILD�NG �C; ' y�/v��(j
ADDRESS 7 �
OWNER A .N Q/�� A P. NO. `
MAIL (Jf BUILDING ��j
ADDRE55 JA� ADDRESS ]
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�W ON � QN� � OD! BYPqOVE
J O CONTRACTOR
m¢ ADORESS 9y� �'i� �,g��ry
PAIL
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TION FOR BUILDING PERMIT
� DATEFiECEIVED pATEISSVEf
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Z�I��� Iq P�RMIT C
vv� ��� .:_ � l',
'� 7 LOT BLOCK
P
7 %%6 /1/ ��-' / ✓YJ
�j% VALUE
ao�,A00 $�I.sOZ!
/TYPE �_GROUP
r � /���
' oATE//f-LCi—.
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�= CITY �jy /y��n.j NO� � �O/3O \ P�� � BUILDING ��Q�
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WO STATE CITV n �'P.ROSAPPROVED VARDSAPPROVED
j O IIC. NO. �$ O%�% � LIC. NO. p�/ MAIN BUILDING ACCESSORV BVIIDINC
SIZE NO.OFBLDGS. � (FROMGLSTREET) r/,ti [ �,�
OF LOT NOW ON LOT ONT
VSE OF �
Ex4STING BLOG {ryji
I" SIZE OF NO. OF
Z NEW BLDG. � Fi00MS STORIES L. SIDE
a EXTERIOR WALL ROOF
V COVERING COVERING REAR
J USE OF BUILDING .4ND WORK TO BE PERFORMED DISTANCE BET.
a MAIN BLOGS.
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Q / ' VAR. #
O Lfi: �i� � Od � C.U.P.#
F APPROVE
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VI hereby acknowleCga that I have reotl this applicatian entl smte
� the[ xha aCova inlormation is correcx and aB�ee to comply wlth
� all laws repulating builtlinp constructlon, antl I she�l not employ
� ony person in vlalaHon of the workmen's campensation laws of
y Ma State of Califomla.
z1 hareby certify that 1 em proporly Iicansetl as a convactor untler S�
the State of Califomie Business entl Protessions COGe, Divisicn 3, THE AMOU
Chapter 9, antl thas such licenses are in full force and effect, or I THE PURPOS
am exemPt tron U�e pmvisions ot the State of Calitom(a Busin¢ss VAWATION
and Profezslons C ie, Division 3, Chapter 9. '
SiB�atweof �7/';—' /f // L/ `�
Permittee ••G �r.•h�'� p�vl 9��JV✓
Avthorizetl ApenS r � 4i
DATE
APPROVED
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IN UNDEF VALVATION IS FOF �
ABLSHING A PEFMfT FEE ONLV: m
¢
� N
PERMIT FEE $ ]
m
PLAN CHECK S E
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LL
TOTAL FEE 5