HomeMy WebLinkAbout3038 MADEIRA AVE - Building Permits •
PROJECT ADDRESS: UNIT:
OWNEWS NAME: 3038 MAV CITY OF COSTA MESA — BUILDING PE.RMIT PERM AO: M 063250
ADDRESS:HENKA, RAYMOND C JR
3038 MADEIRA AVE PERMIT NO: M 063250 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA, CA 92.626
CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE: 0TH
ARCH/ENGINEER:
( 714 ) 557-0896 REG.NO.: JOB DESCRIPTION : FORCED AIR UNIT CHANGE OUT SQFT;
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
PERMITTEE:GRAHAM BROTHERS ( 714 ) 546-1653
ADDRESS: 2952 CENTURY COMMENTS: CHANGE OUT ONLY
COSTA- MESA CA 92626 ***x#*+E->Exx*x#->E***x*x****x x>E*ar*-x*x*xx**#x>E *xxxx*x**x***4(********x#*x***x,Exxxxx
LICENSED CONTRACTOR DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQUIREMENTS
7000)of Division 3 of the Business and Professions Code. cense is in lull torte fleet. SETBACKS
CITYLIC.:005963 STATELID.248:,04 CLASLS:C-2
e.- 1 ��
CatSign ur _ MAIN BUILDING ACCESSORY BUILDING ---
WORKERS'COMPENIONDECLARATION: I hereby affirm that I Rave a certificate el consent to self-insure or a certificate of Workers' fiRNT; 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.:WC7161030226012 EXP.DATE: 08/01 /93
COMPANY:LIBERTY MUTUAL PARKING REQ: PROV: PARCEL : 13917305 INE: REF NO:
. ri Certified copy is hereby furnished. Certified-.• with the city Building 0 '-on. PLANNING NOTES>
rF 7 r >
..ate: L ` �q q\ ` \� Apoli ... • 1
�� #**x***XI******SEX.*******#******************#*****x****************se**it**!E##*****
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Ors section need not be completed it Ute pern0 0 for one hundred(5100)or less). DEVELOPMENT SERAFICES REQUIREMENTS
I cenily that in the performance o1 the work for which this permit is issued.I shall not employ any person in any manner so as to become , i
subject to the Workers'Compensation Laws at California. ZONING APPROVED BY - DATE;
Dale: Signature:
NOTICE:It,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.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; /�1 DATE; 7*7.1 I/2
which this permit is issued(Section 3097.Civ.CI. **************************1.* *#-#* .* •*****- * *#*. #***************It '{r" r xu -r It*
LENDER: *****************************x-******te JE x-**x-******.'31**.******************#**BE#****
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 9 , 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
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)ul Division 3 of the Business 2 58 SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 1031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 15 . 00
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 altered for safe(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 9 . 00 15 , 00 0 . 00 24 . 00 24 . 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.II,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 24 . 00 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 24 . 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contractsfor such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).I am aware *.*.#**********TH*******************'****x'*****************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ am exempt under Section: B.8 P.C. I N D I V I D U A L F E E B R E A K D O W N
tor wits reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: MEC 1 INST FORC—AIR/GRAV FURN <- 100 K BTU 9 . 00 9 . 00
I do hereby cenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and
25534 and that I or any future building occupant will ill not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or moddication from the Au Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant-
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with an city and county
ordinances and state laws relating to building construe. ••rrze representatives of this city to enter upon the above-mentioned
property for inspection purposes.g
Date-2.11 1/49/1-2 S' r t
0100143855-00143855 T1311 24.00
Driver's License or Social Security=: . DATE: 07/29/93 TIDE: 14:35
1641-46 White—Building:Green—Code Entorcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
J
- CONSTRUCTION AND PLANNING l POOL PA '
APPROVALS Parmit� Date Irspcctor APPROVALS Permit ! Date ! Irsper.a •
' 1 -
1. Temporary Electrical Servic or Pa'.: � 1 52. Pool & E4u'I'Tent Loc.it c, I I
2. Sod Pipe Undrgrnd. I 53. Steel Reinforcement j
3. Elurtricat Condu,t U- ' 'y4,rdrgrr, . . . 54. Form: -_ I __�_ '
4 E..c'•icc' Cordr. t-U'dr H. 1 55 E•31.-trical 1301 [Log I i --
- -----!---- - ' 1 --1--- - - - .
5. St. - Rr,nforc:rr.: 1 55. Fw..glt i'Iwr.b ng & •r'...Y:,u.
_--------- --- - -- - ----"-- - - -- I- --- - - _ - -_---r--_ + - - - .
6 -_tr.rn UFla Grr1 97. APPfOVAI 50 CCV" inti` I -I It.
--- - ---- - - -----t - - ----- --- --- - ------ ---- - -- - - . -,_ -- - - - --
7 Finr--. is ' 53. Dr"-ii it :' CU. ru" ..-d' w
_ _ 4.__ .
8. -ourdation 1 59. Gal P.pc, iii dig-Li , Tuct j I '
__ _. - _-I-9. V.utur Pipe•Ucdrq'ra. I _ - I 60ilac'cv:sh l inec, P.Tran, FLU.' J•mn t
10. Et :cturul Flea- SYrt^ I I 61. APPROVAL TO CLC'(
__ ___ _ _ -_ ._+ _ _ _ __ _--i_.-___ _- __ _ -_ ___ _._ _ _ - __- _ _ -
11 Pap.-'y S::.er Lir,. A H ' G f _ „ . •
12. St Cap , Ba. ,imtur a Vent-F,-... I
--- --
13 Roaf Drams -L- i ------------ ------ - - -- '
34 ' umlii^q S;'',•m F.-)1t 1 '
14. Rough Plumbing --- --- --- - - 65. Ela rtrical F,ral I - - - -
15. Rough Eiectr.ca LCD^.d .! �---- I 66. Sala 54stun ina'--_---- - _ - - --
16. Ro..gh Eiectr c`::,ring I -- - 57 Fencing & Arc^ss Apore.-_ -- - _ _-_- '-. . ._
I
17. Roug' '.7.ri^gS'gn r- 68. APPROVED FOR 'LPSI-Li-,:.G
18. Rough Electrical' 93 :- I ra69. POOL.SPA 5'157E7.73 FIRAL
I
Neatin
19. Rough ..rt cn:^,g
9 & A.r v r ' FIRE DEPT. REQUIREMENIT
1
20. Rough Factory F;repl„cc I APPROVALS Permit -_ ' I
21. D�c+�, ^ SSr uLturC -_'
-
_�. 70. . ,;del grou .0 HY...a __-- --j
_t I
.r ,..
22. ; . :, Vent,'ating I I 71. Product P rung - • -s 0.
__- _ ____ ___-r_ - -_-4-_--_- _._ --_- _ ___ _ _ __-_ _ a.
23. Gr'.. Rp_-Ro_an & 1'A 1 -
1�. L':ra.-q-u,. 1 . F'r;;
24 R.,•:.' From -7 1 -
I 25 rlur.( Sh,:aL'inq 1.___ 74. Ovrrhrarl r$yr.ro .
F h0,y _ -
T
I 26. 1 .fr Ce. nn IS .
UF , rL.., C.tOnnco_t I_--__ I 75 D y t Tai I:...
I i .
I 27, 1".. , .d r!•L'.51-•;'• 7G V St.r:.: --._-. - - -
I{
1, 28. '.L. gm5dn? - - - - --- ---^ - - - -i 77 . .;..DSV ,- � ..• L
I- -- - -- ' L ' __. _
I 29. ',.-u at-on 78 I-Ikrr. rFEV F!',.<,!-
-- I -- -,___i- a.-_ __ _ __ I _ - - .
21I , '' d:_:'_ng r F. .P.I TH DEPT. REQUIR .-.E s'T
al. P;,'ctrr Bronn Gnat ..-- 79_ FINAL II).. . FCTiC'G
,
r 32. F rcirucal Po 'er Mote '- I ' do. FOLIO OF !,Thr F """' J ..
-- --- - ---- - L-- - - :--I ---- - -- - ---- - - -- - - - -- --
32. E' a' Elctr ^, Nuts:H34 F, _ Beat & A• C. c: ,
35. ri^ as al GPipe-Test - - - --- -- -- 41------L---- - - - - - - - -
36. H«cd or Canopy
37. ,rut Factory Furep".c- I I
38. Fina. PlumbingI - I-_ _ _--____ _. _-__ - _-_ __ _ __,
39. '.Vittar Ser vice-F;nal II
40, Gar Eerv.ce-F:ra'
41. Spar Domestic-Foci --- I I - - - --- - _-- I
42. Backflow Precentor Jl._.
44 L,.r.dsc.pc Ir:gat ur 5-mitt .,.
- - - -
45_ -S'7und Attenuation
- - ------- -.1 - - -- - - - - - --- - _ . . - ----- -
46. 1;. 'dicap Rcyu'at.c ), i
47. .NAL STRUCTURE n. '.:i', DI%G
-.__ __y_
- - -
48. FINAL PLANNING
-
49. Eh ctr c Rr!ca:e to afro,-
50. Ga Release to Southern C;:.fcrn:a Gas Co I
51. CERTIFICATEOF GCCUPA'‘ICY ------ ---- - -- - --_ - - --
No. D.r.
,DDRESS
3038 MADEIRA AV eiT: CITY OF COSTA MESA — BUILDING PERMIT
rRSNAMEPFP7W*Th HENKA, RAYMOND C JR PERM NO: B 073303
WDRE53 3038 MADEIRA AVE
COSTA MESA CA 92626 PERMIT NO: B 073303 PLAN CHECK NO: N GOVT: N SUPP : N
r ( 714 ) 557—096
APPL.MAILING ADDRESS: CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: 0TH
ARCHITECT OR MINER: UC 140.: JOB DESCRIPTION : REROOF WITH CLASS A 30 YR COMP SHINGLE SQ FT: 4 , 160
ARCH.OR DG'S ADDRESS: UNT:
CLAIM VALUE: 4 , 160 . 00 CALC—VALUE: 4, 160 . 00 GROUP OCC: R-3 /M-1
cC.RRACTORSNAIE: BRENT OWENS ROOFING ( 714 ) 978-2075
cONTRACTORSMMIRIo 12901 BUBBLING WELL RD COMMENTS : REROOF OVER EXISTING /1LAYER WOOD SHINGLE/ 1 LAYER COMP
ADDRESS: SANTA ANA CA ucNO.: 600402 lE'N'it'>EiEit•*it '***x' "ifit*******iEiE*****xsEit*** ..x's(..N'*i[*'N'*'N'*'N'**rtaEirit'N"iE'N'**BtM A+ + IE�-it+®�r a TOR
92705 UMT: ZONING REQUIREMENTS J�V�IJf�
LICENSED CONTRACTORS DECLARATION:I hereby Slim at penalty of perjury Net I em licensed under previsions of Chapter B SETBACKS REQUIRED
(wwith mmenckp wSection 7000)d Dhisothe Bo
n 3 d suns and Professions Code,and my license is in hi' and force effect.
crrYUC.N .:06 174 uc.cLAss: C 39 uC r+o.: 60040 EXP: 01 /96 MAIN BUILDING ACCESSORY BUILDING
/y q�S�� FRNT: FT IN REAR:
IN RGHT: FT IN FRNT:
LEFT: FT IN REAR: FT IN
Date: �/ �Q c"°°tl°` LEFT: FT FT IN FT IN RGHT: FT IN
88
OWNER B ILOER ECLARATION:I hereby Slum under pensly of perjry that I em exempt floes the Contractors License Law for the
•.Ifow.wmown(Studio)]m15BmS55arid PMessWas Code:Any cky or county shah wadies apemito enNn,alter.impmve. PARKING REQ: PROV: PARCEL : 13917305 ZNE: REF NO:
slash.or repair any structure.prior to its isrequiressuance,also requires the applicant for such permit to file a signed statement that he or she
,icensed pursuant to the provisions of the Contractors License Law[Chapters(cmmenmN with Section]000)a Division 3 of the PLANNING NOTES>
Business and Professions Code)or that he or she is exempt therefrom and the base for the alleged exemption.Any violation of Section >
7031.5 by any applicant for a pernd legless the aPPlicent to a a vi penalty of not more than fire hundred dollen 155000. *******************************************************************************
❑ I.as owner of the propeny c•my employees Wall wages as their sole compensation.wit do the work and the structure is not intended
DEVELOPMENT V E L O P M E N T S E R V I C E S R E U I R E M E N T S
of o offered,or sale(Section 7044.Business and Prof essions Code:The Contractorsmat License Law does not apto an owner d property Q
who bolds or improves thereon.ad who does such work himself or herself or though he or her own employees,Provided that such
improvements are ratnoseded Or Weed for sale.t,hewn,the bolding or improvement is sold*thin one year d the ZONING APPROVED BY completion, DATE:
owner-budder will have the burden d proving he or she did not
bald or improve for the propose dle)
ass.
❑ I.as owner of the property.am excASWy mord°with licensed contractors to mnww the project(Section 7044,Business end
Professons Code:TheContredm Lcense Law does nit apply to en owrw d progeny wino builds a eiprovasthereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a wuador(s)licansed pursuant to the Contractors License Law).
❑ I am exempt es
under /
n: B.A P.C.,for this reason: APPLICATION ISSUED BY : iP DATE• �y
Date: Orman ********************** .. • ' 'iFTFi�iF********** • . **
LEGALIZATION:N F E E SUMMARY STRUCTUR • L SEGMENT:Y
I do hereby certify that I em°wan d ad understand the requirements d California Health end Safety Code Sections 25505,25533,and
25534,and that tor any future building occupant MR/wil not(arab one)need to comply with said state codas and the requirements for
a permitter mnmwton or modrfimnbnbomon Ain, taT renecenwe District ReskWdmmnnun sppiraaars exempt imndwe BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 72 . 00 . 50
Data: Applicant: SM I P/MON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one d do
the, wing dedar°tion: PLAN
❑ I had wG maimaintaina certifiatea consent tofeliasnebr wrkers'cemywatol.as provided for bye«9on 3700 d the Labor ISSUE FEE
w a
cp .forthe performancedthewor for which permit isSed. BUILDING PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.
❑ Ihave and Wmaintanwaken'c nprnWenknsuance.asregtuedbySecion3TWoteLaborCode,forthpalormacedtM TOTALS > 72 . 50 0 . 00 0 . 00 72 . 50 72 . 50 00
work for which this permit is issued.My workers'compensation insurance wren and policy amber are:
Carder: W*TF FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 72 . 50 OVER/SHORT: 00
Policy Number. _9,01NTT1q4 01 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not te completed I the pane/S for one hundred dollars(5100/or Ars) 72 . 00 . 50
❑ I ceniy Nat in the performance d the work for which this permit is issued.I shell not employ any person In any manner o as to
becmw'oboes b the workers'mmMnsaion laws Of Cetprnla,Sod Servo tha l I should become subject to the"WM& *******************************************************************************
dSeson 3]00dthe Labor Cads.[ .. with ..
=•��
Das: / i/Ci Awfvnt .r 1
INDIVIDUAL F E E BREAKDOWN
Warning:Failure surfers'compensation CoverM unlawful.and coat sublet:en galore,ro criminalPenalties,• • YPE QTY DESCRIPTIO N UNIT COST
TOTAL COST
Civil ones tat to ate thousanddollars(slO4000 In addition to the coat of compensation damages cc provided for In
Section 3106 of the Labor Cods interest ndattorneys fees.
SFR 4160 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 160 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a mmnnion lending agency fog the END OF FEES
performance of the work for whir h this perms is issued(Section 3097.Cs.C).
LENDER'S NAME:
LENDER'S ADDRESS:
1 cendy that I have read this application and stab that the above&donmaton is cones.t agree to comply wits at dty and wumy ordinances
and state laws nettling to belting carntrnd;m and hereby authorize representedvas(lithe city to enter upon the above-mentioned progeny
for imperils"purposes.BRENT OWENS
Date: SO� DA
TE: 4 30136430: 12:23E772.50
;; VApplksn4ConuMa
(5151 da.WP) whae_etlding d Safety,Groan-RN;Canary-Appiwd;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POC . 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. 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:
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. Backf low Preventer
43. Backf low Irrigation
7 z o- Of frmm_7(
44. Landscape IrrigatiooSystem �. - ,./
45. Sound Attenuation' Y�
46. Handicap Regulations; '
47. FINAL STRUCTURE & WILDING f-.ii �oLG17/
48. FINALPLANNING '
49. Electric Release to Edison+
50. Gas Release to Soujhein California Gas Co
•
51. CERTIFICATE OP!OCCUPANCY
No .4-Date
OWNER SYCAMORE LAND CO DATE 6-29-59
JOB ADDRESS 3038 Madeira A e. BUILDING PERMIT NO. 9737
GENERAL CONTRACTOR rtalgren Const. VALUE $ 16,936 _
AP. No. LOT 59 TRACT FIRE ZONE DESCRIPTION OF WORK yes a tt_gar_
It" °ECTIONS 7.43-1 DATE I GROUP I & J TYPE v ZONE p1
l rground Soil j.t U.G. Water/tt/ J-P2} PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating 1. N/ Q/Z-Si pT a ,.y`;2o s y_ .,1, 0,__Z6- 1
Rough Plumbing L het, -t111c , r n-c) 7--/3-51- / 9 / 7----
Miscellaneous
✓Miscellaneous -�
Prop. Swr. Lind. House Conti St. Swpa 1—x-/6.59-%^4.+/�t:� o C:�N.,�(Zsi 9-/F 0 Jf�97'31/
Sprinkling System / ! _ �� ff
its
Heating, Final ,L!// .24,-67, _(�Q}.p' 60
Plumbing Fixtures r�y�v�,, .-)
Final Gas Test /� ,�.,(-G+' 11 _ 5' /116
Construction Pole \ S /"
Underground Power me�gg--.�--.L_
Rough Wiring —Tr y- V_-)) P1- . G/!.^A�i/r� 9�1 -5-7 /o 6 S, /�
Trenchesft/3 Formsg7 Steel/f I! 7-t-CIL_
Floor System del:) 9 -3-y"- 51
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing 4414. 4 -/ -11_
I to and Flashing gfg9, 9- ; -S9
i .mg, In Out Q •71-Ty
Plaster, brown coat 1�r' 'U II-�
Plumbing Fixtures, Final /� I_ a
Electric Fixtures, Final /nal )r .l0
Building, Final A G[/ '-0
OCCUPANCY _ I
Form 210-3M-459
p)
9737 1' $ 51s59! .
COSTA MESA BUILDING-SAFETY DEPARTMENT 71;11 i Inr SCP;
P.O.BOX 317 COSTA MESA. CALIFORNIA , 11\I• " '
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT A BUILDING
ADDRESS c n 3 A &7 y� ^ Are
ADDRESS .'d AL!/c(IL-f•} )v(/
COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY
RECEIPT NO. ERMIT NO.
-o
i OWNER Sycamore Land . X73 7
., MAIL 10835 RECEIVED Y YE RECEIVED DATE ISSUED
ADDRESS Santa Monica Blvd. I `a_? f<i 0>7 -
Los Angeles -25 TEL./1r BUILDING 4
CITY NO. ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR INEERL.C. Major NO. ,�
• ADDHmSS 11015 S. Paramount $1Vd.. ZONE TYPE // GROUP 16)1
Malgren Const. STATE153335 APPROVED
. CONTRACTOR LIC.NO. BY DATE
ADDRESS 1 ORIS Santa Monica Blvd_ ZONING
LEGAL LOT ZONE NO.OF USE OF NEW (//]
DESCRIPTION I NO. Sg (BLOCK ITRAC363 IpLArvB I BUILmNO /0-S71",
r p
APPROVED 0-S r�V",
A.P.NO. BY DATE
' SIZE c I NO.OF BLOCS. YARDS EVES
OF LOT 103 38 X 68 V NOW ON LOT O REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT S7) FT. IN.
e SETBACK LINE FROM
I CENTER OF STREET 50 REAR YARD 30 R.SIDE C FT. IN.
SIDE YARD I LEFT 5,
I RIGHT 5 L.SIDE 3 FT. IN.
DESCRIPTION OF WORK
REAR fid, 7 FT. IN.
. NEV I XII ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
SIZENO.OF
BUILDING 1707•7 ROOMS 6 STORIES 1
COVERINGEXTERIOR
WAL'stucco(ROOOFFRING Wood. shingl i
' USE OF BUILDING AND WORK TO BE PERFORMED
:wclliuy New LUUSLCacLiol.
7AAR Att Gar
• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
1 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUN.
VALUATION rj�
SIGNATURE OF //q1/- PERMIT FEE $ J
PERMITTEES �j[��'YT"Y��� �'Y e, / p/
�/J �1�f���� g/G/13}� PLAN CHECK $ Q /�
' AUTHORIZED AGENT
TOTAL FEE $ S7`--
a... rviLL144.190. L. X . mint. SS—S4-00
lirOB ADDRESS 1018 Maderia Avenue BUILDING PERMIT NO. 26370
ENERAL CONTRACTOR Wayne Howard, Inc. DESCRIPTION OF WORK Add rooms to res.
P No.119-161-05 LOT TRACT FIRE ZONE VALUE $ 3,300.00
'`'q".„ CTIONS Signature Date GROUP I TYPE V ZONE B-1
PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con. []
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning 1 _
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring /71 -e/' eatenVen _
Trenches ❑ Forms ❑ Steel Reinf. 0 � ,- ib t.. . / -/l1--Jo L4t!4 C
Floor System 1
Bond Beam 0 Steel Reinforce 0 /
Sheathing IVO i,-3o-64 .
Frame and Flashing 1;, ,5,-/O-46;
Lathing — In E Out EAWD „ _2046
Plaster, Brown Coat itw „_,y-a(,
St—[ural, Final Electric
1 ag, Vent., Refrig. and A.C., Final /i /2..-/..r 1S6
Pl31- / /�_��� �/O
umbing, Final and Gas Test 0 �/ // �
Electric, Final /Kb 11+.02 _
Building, Final 4/010 Lrr( ,G
%
26370 110V 15-66 00 597* ****22.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92025
•
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
,,' BUILDING 26W fl4DER>q 4VeFor Office Use Only
: ADOReel J to RECEIPT NO. CPX5RI IT NO.
COSTA MESA. CALIFORNIA hM O
L,f W/LL //9115 �� 11iN 1, it /. I .�D
OWNER
." ADDRESSS 30/2 17n geiii l�
�t- ADDRESS
FIRE
• CITY Co574 A./ e$/ TNO.ELSV4IE
T�SJP! GROUP �
APPROVED
/� DATE ////t,{/ L
�`
ARCHITECT TEL BY
. r YGINEER NO.
ZONING ."o
ADDRESS • - _ I NO.OP ^ I USE OF NEW t-r 1
L PLANE 2— BUILDING a 1•
CONTRA •R I NLS 4/P�J�,RD /C��/nn ,
LEGAL
)' ADDRESS ///6 N, ,*MM BL 10, DESCRIPTION _ii_jk •b `TR-
CITY imr4 /51A/4 ; A.P.NO. I. -", , .--- /I 3 —c
NOTE: NO HAVE OVER
STATE 2 rzzTit-. 53/—� " /Y sr TOB DE&REAR PH ANG SHALL BE LESS THAN
LIC.NO
ES
' OF LOT // (yam, Q 1-__I NO.OF BLOTS. / ALLOWED (U.B.C.REQUIREMENT)
iLJH X 3 NOW ON LOT !
[ YARDS APPROVED YARDS APPROVED
EXISTING BLDG. ,57A/6Z-L #UC// 6- MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET/
- SETBACK LINE FROM FRONT a FT. Fr.
• CENTER OF STEER REAR YARD p /
SIDE YARDI LEFT I RIGHT R.SIDE V FT. FT.
n DESCRIPTION OP WORK L.SID[ 5' Fr. PT.
!i U IIIIM, REAR PT. • FT.
DISTANCE BR. BET.MAIN B
" MAIN BLD• -. ACCESS.BLOCS.
r REPAIR MOVING DEMOLISH
BUILDING 2 G 6 NO.OF VAR.St .ATE
Si BrZE �/1 Z�'� ROOMS STORIES / C.U.P.S APPROVED
f: EXTERIOR WALL ROOF APPROV «1 ,�
•z COVERING S•TVLCD I COVERING $i{!'�NGGC—i ��!! DATE //`/9 )&61
a
USE OF BUILDING AND WORK TO BE PERFORMED
APP ON PA/Iliv Roo M t a T
Sad/NC A001 To RAW( et G-Alyr
i Ov.SE - - ' eo.Pr. o
I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE A OUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS CORRECT•AND AGREE TO COMA PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 1ST
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION QS D
BUILDING CONSTRUCTIIO�N. '''./7 . ' I < GI
PERMITUR OF F/T / � } PERMIT FEE 5 J� s� w
, $ 3 30o ., .
AUTHORIZED AGENT e I ' r7 ^7 .6
. ., - . . ..:.ly...._..- TOTAL FEE -'i•