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HomeMy WebLinkAbout3129 VAN BUREN AVE - Building Permits 41 • • CITY OF COSTA MESA � :. BUILDING DIVISION >• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us pir4 FOR INSPECTIONS CALL:(714)754-5626 Shso 4` PERMIT NUMBER: BX08-00363 PERMIT TYPE B_MISC STATUS: ISSUED APN: 14169135 DATE ISSUED: 12/19/2008 Zoning: ISSUED BY: BJK JOB ADDRESS: 3129 VAN BUREN AV CM Suite/Unit: Vicinity: ENTRY DOOR AND BEDROOM WINDOW Primary Occ: Const Type •72 SQ. FT: 0 Valuation: $400.00 SCOPE OF WORK: NEW BEDROOM WINDOW AND REPLACE ENTRY DOOR AT AN EXISTING SFD. OWNER: ANDERSON, KEEVIN G Address:: 3129 VAN BUREN AVE Unit City/State: COSTA MESA, CA Zip Code: 92626 Phone: • APPLICANT: ANDERSON, LINDA Address: 3129 VAN BUREN AVE . Unit: City/State: COSTA MESA, CA Zip Code: 92626 Phone: 714-979-1107 CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit: City/State: Zip Code: - Phone Cell: ARCHITECT: • License No. Phone ENGINEER: License No. - Phone FEE SUMMARY Building Plan Check: $15.28 Building Permit: - $23.50 Electrical Permi : $0.00 SMIPResidential $0.00 TTP Commercial $0.00 TOTAL FEES $38.78 4 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. MEI INSPQTQN TEhg INin1AL4 DOPES /NSPECTIWN TYPED)A�F ONTMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2 -11-49/ 10401-- WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver nse. NJ Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Drivers.License:Nor Expires: Z I-) ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by • •• section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carder: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thissedon need 7701 be competed the peons rsoe('al one hundred JOAars($IXX)or less.) 2 Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant's Signature Date Division of Industrial Safely Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one lime has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:My city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code that he or she is licensed pursuant to the provisions of the Contractors requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five undred dollars($500).): of the California Health and Safety Code). I, as owner of the property. or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other C-)compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No (hereon;and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. ' ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penally of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purpos I a e not to occupy or allow occupancy of any building authorized leper nti mal inspection. r/aSignature of Legal Ownees) _Dale g .Date 305746(3/07) �—Si -nature And/or Authorized Applicant Date 3129 vnaN\ 113GLi2CI•-1. • Al ? 440\'r. f) CCS A .n . Si D. , :' 1 RI.G. E0(15tS14 Cf.V.A 1© .HTU\\' I, IV' ',HAI I Itl c` • 21`1 ' ..1..1\'inti • { If Y. ! Y!T' ilitiPirla DIVISION OF BUILDING SAFETY CITY OF COSTA MESA APPROVED This sol of absurd specifications MUST be kept on this jab at as tires and a is WSJ b grimawedtages or alterations m tarred/0i wiampemraim from the!XenondWI at Safety.City of Costa Mesa e,,,-„AaDIS . • Westartling dthis plan all apeaakatneMailNOT beheld abbeanappva/ d the violation of any praisia s 0 any City of Costa Mesa Ordnance atdlor Sale fa. Thew Ptae and pend shin apke by hidden end pecans S and sold a the biding of sakIsm commenced aril misled alaspit CIE SKIMS Win ttl tip dimam ADDRESS OF WILDING: 3129 VAN BUREN AV uMT: CITY OF COSTA MESA — BUILDING PERMIT oxNEBsfMYEIR KNOWN:KEV IN ANDERSON FLOOD : X 46 BERM NO: B 077241 075.3129 VAN BUREN AVE COSTA MESA,CA 92626 PERMIT NO: B 077241 PLAN CHECK NO: N GOVT: N SUPP : N 4PPL.YAHING AD ESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH I ARCHITECT OR ENGINEER: uc.NO.: JOB DESCRIPTION : T/OFF RESHEATH & REROOF W/COMP . SHINGLES SQ FT: 5, 300 ARCH.OR ENG.'S ADDRESS: MAT: CLAIM VALUE: 5, 300 .00 CALC—VALUE: 5, 300 . 00 GROUP OCC: R-3 /U-1 cONTRACTORSNAPERFORMANCE ROOFING CO. ( 714 ) 645-2382 cGNTRAcroR'sMMUNG 2476 NEWPORT BL COMMENTS; SMOKE DETECTORS REQ PER 91UBC ADORES&COSTA MESA CA ucND.: 661267 *****R6*Rtat*****Rtatat***********R6it**R6A6****** -Rr+A*****xatA6rt*R6RtR6*Ar*********at**** -**R6**x- 92627 WIT: 1 /2 Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby alum under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Proles.•. Code.end my Ike is in full force and effect. c NO.05 9 . 3 uc.cuss:C-39 ole: /8 4 con,. Fj uC.if•61, 6 EXP : 12 /96 MAIN BUILDING ACCESSORY BUILDING X FRNT: LEFT: FT IN REAR: IN RGHT: FT IN FRNT: FT IN REAR: FT IN FT FT IN LEFT: FT IN RGHT: FT IN • R BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am mem on License Lew for the following reason(Section 7031.5 Busies°and Pnaedsion Code:Any city or county which uirss permit to construct.aver.improve, PARKING REQ: PROV: PARCEL: 14169135 ZNE: REF NO: .1 ' smash,or repel any structure.prior to is issuance.who required the applicant for such le a signed statement that he or she PLANNING NOTES> .licensed pursuant to the provisions a the Contractors License law(Chaps 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > s 1 7031.5 byanY applicant for a permitsubjeds the applicant to a awl penally of not mwethan rate hundred dollen 155001). ******************************************************************************* ❑ I.es owner of thepropeny or my employees will wage*ea their sole compensation,MO do Om work and Me structure isra intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044.Business and Professions Cade:The Contractors License Law does not apply town owner of property • who builds a improves thereon.and who does such work himself or herself or tivo gh his or her own employees,provided that such improvements are vol intended«offered for sale.If,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden d proving he or she did not build or improve for the purpose of sale). ` ❑ 1 as owner of the property.am exdusiwy contracting with licensed contractors to canmud the project(Section 7044.Business and BUILDING APPROVED BY : DATE: Professions code:The Contractors Licenserid Law does rapply to an owner a Property who builds or improves thereon and whor contractsfor edit projects with a conmctoes)licensed pursuant to the GOntradas License Law). o lemexempt undeSection: B.&P.C..for this reason: APPLICATION ISSUED BY: � DATE: *************************************CR a ***********iF**********�6* * * * . Date: Owner: LEGALIZATION:N F E E S U M MIA R Y STRUCTURAL S MENT:Y Ido hereby certify that I em aware el end understand the requirements or Caliomia Health and Safety Code Sections 25505.25533.and • 25534,and that laany future bugging occupant will/will na(amb one)need to comply with said date codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit tor construction or modifvmionflanthe Ar OuaMyMaegem en District.Residential construction appicatonsare exempt from these provisions. PERMIT 112 . 25 . 53 Date: Applicant: SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby effsm under penally of perryry one or the following declarations: ISSUE FEE ❑ Ihave and wmainaiecertu�teofardemloesd.irearefa wrkers'eopa matiorLasprovidedforwof by BUILDING—DIV—> PERMIT ISSUE PLAN- 1CHECK TOTAL PAID DUE ode.for penamanceame work for which copermitnepermit is issued. TOTALS----> 112 . 78 0 . 00 0 . 00' 112 .78 112 . 78 . 00 I have and will mainsail workers'compensation insurance,es rallied by Section 3700 at the Labor Code,for the performance a the . I work for whits the permit Is issued.My waken'compensation insurance caend policy number e: a Can : STATE ms ol FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 112 . 78 OVER/SHORT: 00 Policy Number: 1334836-9b 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC I:i FIRE SMIP/TOT GRADING PLAN—CHECK (This sonor b o,need ncompleted i the parol is for one hundred dred dab 00l or less) 112 , 25 ' . 53 ❑ I certify that in the performance of the work for which this permit b •,I shall • em•• any penin in any manner so as to became sud tot wads'compensationlaws of Ceid. . i.•ree/.. d Ir. •. become subject to the waken' ******************************************************************************* Pen i Prodso s of Section 3700 of the Labor Cade.I Mel .. - ' .provisions. INDIVIDUAL y E E B R EAKD OWN 1r4 no Applicant: �I'� i Y Mg:Fd/ to secure workers'compensation covrage la unlawful,and shall are • 'criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Fins up to one hundred thousand dollars(fI W,0o0),In addition to rhe coat of damages es provided for In saDon3706ot Me Labor Cods,Interest andertomey'etees. SFR 5300 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 5, 300 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is : .. ..ruction lending agency for the END OF FEES performance of the work for which this perml is issued(Section 3097.Civ.C). LENDER'S NAME: • ,i LENDER'S ADDRESS: I certify that I have read this application end state that the above information is caned.I agree to comply wih all my and county ordinances /r and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection pur..•.,- - TERR D`�'CRUZ / , astriltii" St mac, ,. (5151-46,WP) White-Building&Soley:Green-Flo:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING / POO 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•Undrgind. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test •' 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Unargrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines,P-Trap, 0.Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK,:" - I 11, Property Sewer Line & House Connection 62. Backwash & Receptor-Fipa1 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-Ear 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 ; otes: 34. Final Heating& Air Conditioning G '- 'q_14 - r / _/y 35. Final Gas Pipe-Test L G ( (� f/aCE�{s!L 36. Hood or Canopy fin- cy _ 0-fr - (tib 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 11,26-1-(0 ri &,y4 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Oo 51. CERTIFICATE OF OCCUPANCY _ No. Date 20743 FEE RECEIVED OCT 7 19ba COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 917 COSTA MESA.CALIFORNIA CITY•0F COSTA MESA For Applicant to FBI In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only 2g= 3129 Van Buren Ave. RECEIPT NO. 2R 1� 43 COSTA MESA, CALIFORNIA _ �1 RECEIVE Y OATS RECEEVED DATE SUED OWNER Northgate. a Partnership iii-5,-63 y6 C� BUILDING MAILDD 15939 LasFlores S . ADDRESS ADDRESS t id. _ TEL. ZONE TYPE / GROUP J:gt CITY Fountain Valley NO. 5316792 APPROVED AARCHIT NEER C. Hiller NO. KE 52007 BY DATE ZONING ti 1 ADDRESS Anaheim F ,; _ . °- PLANS / NO.OF ^/ USE OF NE " I PLANS �C I BUILDItie ��I . CONTRACTOR Bons er Const. Inc. l 1._-OT- (/(^/ ({r'/� LEGAL Y-O I 3 c �V l ) o C i LEHCRIPTIon S-- ADDRESS 159J9 La.aFlores Fountain V 11ey A.P.NO. (24)----- CITY a NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LCT NO. 215049 No 5316792 90"TOSIDE a REAR P.L. EAVES OVE07118 I X641 NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT) NOW ON LAT none YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. none (FROM C/L STREET) SETBACK LINE FROM CENTER of STREET 45 I REAR YARD 30 I FRONT j O FT. FT. SIDE YARD I LEFT 8 ' I RIGHT 51 1 R.SIDE ) FT. FT. DESCRIPTION OF WORK L.SIDE 78 SFT. FT. I X ALTERATION _ ADDITION REAR >OFT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.SLOGS. VAR.# DATE BUIL 1 G NO.OP SIZE 59 ROOMS 5 STORIES 1 - C.U.P.# APPROVED EXTERIOR WALLS t1,1 CC ROOF shingle APPROV 'I/J DATE @C�L IQ ' (4''/I✓' COVERING l ng-COVERING `� BY Illi fV1�f�VVM-IVWWVbb3 USE OF BUILDING AND WORK TO BE PERFORMED single fam. res . in. atta,chearase (,------/ /015-`/ N SQ.FT. D I HEREBY ACKNO . _- . I HA READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE TH THE •tF CQRR CT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O BUILDING PLY WITH CO•BTRUCf •.•/ D TATE' LAWS REGULATING VALUATION 'L(Ji cli SIGNATOR •F / 4' / PERMIT FEE $ 7/7 r _, j ta PERMITTEE �� ��� $ // 715 A CHEC 07 C AUTHORIZED AGENT L - TOTAL FEE $ 7'�f OWNER I�cRHEEN, Richard DATE 5_21_Z� JOB ADDRESS 3129 Van Buren Ave. BUILDING PERMIT N0.NERAL CONTRACTOR 1.' . . .B & G Bldrs. Spa No. 141-691-35 LOT 35 TRACT 5005 FIRE ZONEDESCRIPTION of WORK VALUE b 1500.00 42029 SPECTIONS Signature Dote GROUP TYPE ZONE RL Pool Location IR%-t. 6-14-10 SUBCONTRACTOR PERMITS ISSUED Date I Number I Signature r, Forms::::,,i ' Main Drain • Steel Reinforce Elec. Bond • t\ Electric n n Approval to Cover \ !/7•d'/-/� I(� 5-2.1-71, 416.57‘e— . 'zl-7 41Os7‘r Underground Electric Gas Piping Test Plumbing �j, (�, Filtering System Lines \I 6+ i. v.1"2-ksn_ • J -' I-7c V?/3 5- Backwash Backwash Lines and Recep. R+S.t. 504/ Electrical Final RSC_ 4 rx 'eater and Vent Final ilter System Final / Backwash and Recep. Final jC-• 6•1-7b Fencing Final /s?'C. t'1-? PAI_ 42029 "1-f j1-76g:001413* *'::*t23 co COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only ''',,,ssss���� RECEIy. DATE RECEIVED jS�� BUILDING �t " //�� // --- — // ADDRESS .a Up,..-W i&tr /-r/� (.( ((rj OWNER 2 &/ fZ-r `'' /4 _ ' _ S PERMIT NO. IY�� A.P. NO. `f e MAIL do's's"'. BUILDING J I ger S O(r I'6/� A) 1j PreA /VC. ADDRESS d ADDRESS 7 D TEL. CITY NO. S TRACT LOT' BLOCK CONSTRUCTION NEW ADD ALTER REPAIR (MOVING nFMOLISH LENDER BRANCH OWNER I (d V P'P ,...) ADDRESS 7W1„msVALU /az)ARCHITECT TEL. . USE OR ENGINEER( NO. ADDRESS r FIRE C/ /� �/���- ZONE /�, TYPE GROUP Q CONTRACTOR .35t, (,a 130 IIF-a ar---E APPROVED / DATE JAG/7/G ADDRESS d 3� 9 � / ,Jf).Qc- USE OF y NO.OF ,,(('' CITY I3ill�n_f3r-/vlC NO.Cs1�Jq-/cV lig I PLANS BUILDING, F STATE ^"7 1 CITY ( /� YARDS APPROVED YARDS'�aA//PPPP//ROVED gLIC.NO. /J/'1J�p // LIC.NO. MAIN BUILDING ACCESSORY BUILDING IL SIZE LOT b (0 l NOW ON LOST . / (FROM C/L STREET) 3FRONT FT. /0 �t�f Q USE OF m ,I ...SF EXISTING BLDG. L_t41 r R.SIDE FT. .� FT. FSeparate permits are required for L.SIDE FT. SUET! electric,plumbing and heating work. - REAR FT. _ e-2T. VSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q /A// I MAIN BLOCS. ACCESS BLDGS. T L JJ�n� No� VAR.# DATE ', I T;et C-9-ci VAR.+ APPROVED Q � aROVO� IJ KrD iY ATE 1pi4, am - a o I hereby acknowledge that I have read this application and state to IX that the above Information is correct and agree to comply with m Co all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u the State of California. o I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and am that s hiI chvllicensesf theeint tel f Cellan neffect,orsI TME PURPOSE OF ESTABLISHING A PERMIT F NLY: exempt from up VALUATION PERMIT FEE S 00lt and Professions C de, (vision 3 ap r 9. _ u, /� m PLAN CHECK S . Signature of /rat) \`O ?L o Permittee $ `d TAX S OLi LL Li 3 Authors; d Agent TOTAL PAID S Z 0V vnlvLrt BURKt J. LJ JOB ADDRESS X129 vein Buren Avenue BUILDING PERMIT NO. 28642 .,,GENERAL CONTRACTOR : • . u= .. t DESCRIPTION of WORK : , p 'l ' a. 14o 1-691-35 LOT 15 TRACT 05 FIRE ZONE VALUE $2R4.o0 I, ACTIONS Signature Date GROUP J TYPE III ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES ❑r FORMS ❑ STEEL REINF. Q 4JiJ ,r-3/-6t FLOOR SYSTEM BOND BEAM n STEEL REINFORCE in SHEATHING FRAME AND FLASHING LATHING - IN in OUT n PLASTER, BROWN COAT 'UCTURAL, FINAL Electric ,TING, VENT., REFRIG. AND A•C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL eq�J �p BUILDING, FINAL prjro E-5-666 - 'ti j 28642 COSTAMESA BUILDING-SAFETY DEPARTMENT NAY 29-68�w10 rsA001428 d***+*3.00 P.O. BOX 120* COSTA MESA, CALIFORNIA 9462E For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR P INT BUILDING BUILDING w 7_L For Office US. Only ADDRESS I2 �fl/t? �`ILr Q•1/�� .0 RECEIPT NO. P(BNIiIJO. �__ COSTA MESA. CALIFORNIA L Diti /A� L�%� P(/,/' C)C r/yL/rte_—Ace f/ RiCC1VwQjYiLi /-...2Y: 957-7-,_,2DATE Ac owNER e-1 �C/]{f/ BUILDING MAIL ADDRESS RE CITY � � �L 2.1-$4-4�ctL fNEVED TYPR�/ 2 1.___ /l �GROUP __ IHITHCY TEL. BY' DATE {NGINH[R NO. ZONING ;1--tet, ADDRESS //!/�J� /J zp/� NO.OF USE OF NEW CONTRAQTQR` �C�1 !/7 -' I PLANS ']/I 'BUILDING / /30"1-14.Z_ _ O 1 LEGAL "� ADDFI (�I,C-/ /30 ' ( - D[SC11ITON ,-/ / -; pS ' & 5-36 ') CITY l/{(�.^'� ca_. NOA.P.NO. I L/'/ - �}/ I - J S STATE /J(��I(;` ` ter/ T8L LO'rT0 SIDE&REAR P.E: NO EAVE OVERHANG BNALL BE LESS THAN LIC.NO. (i Jp!/d`'J CS '/ - sIzE 6 • Pic ) (O 0 •T 6 I I NO.OF BLDG[. ALLOWED (U.B.C.REQUIREMENT/ OF LOT �/. 7/ (.If 7.1-4 NOW ON LOT USE OF I YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) / SETBACK LIN/FROM FRONTPT` C t CENTER OP STREET REAR YARD CCCC SIDE YARD I LEFT I RIGHT R.SIDE IT. FT. DESCRIPTION OF WORK L.SIDE PT, PT. 11 _ ALTERATION_ ADDITION REAR FT' IC DISTANCE BET. BET.MAIN a REPAIR MOVING _ DEMOLISH MAIN BLDOB. ACCESS.BLDGB. BUILDING NO.OF VAR.rf DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL I APPROVED tVVA COVERING COVERING . /[? E 1/144/4 LjND WO/kJG R Da. f et SO. I HEREBY ACKNOWLEDGE TNAT.I NAVE READ THIS APPLICATION TEE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OP ESTABLISHING A PERMIT PES ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS EEGY 0 VALUATION 7 BUILDING RE OF Y N. G` -� PERMIT FEE E E SIGNATURE OF PeRMITTBC j//j��17yam 0...°14.-A,....,61/4e /� �//J.•(., )'i�Lj�..ys�7 � PLAN CHECK $ w AUTHORIZED AGENT % vv a, . . .. .. •...,.: - - .. .- .; TOTAL FEE 5