HomeMy WebLinkAbout710 19TH ST - Building Permits(714) 754•5273 • fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 710 W 19TH ST
Suite:
Viciniry:
Parcel Nunmber: 42226122
SIGN PERMIT
Zoning:
Stalus: ISSUED
Applied: 07/28/2005
Issued: 07/29/2005
ISSUED BY: ��
ApplicanC RICK TILTON '
Address: 11661 SEABOARD CIR ,,, , ' �: ��� yy.,,, , � �" _ . �,_ �,�:,,.r„
� - "��. �� Phone:" 714-891-5682 �' �
STANTON, CA � - -- Zip: 92680
�. �,
owner: HAMILTON, ROBERT J�';TR � �- � <i °� � g
�
Address 525-APACHE DR � � � s.�r%- � - . � ����<_". •.
. � ' - - . � _ _ .�`�.+' _
_ . � - Phone: � , . , * . - �
� �PLACENTIA, CA � - Zip: 92870 � � '_
Contracror. BLAKE SIGN �COMPANY INC � �
Address: 11661 SEABOARD CI . '
Phone: , 714-891-5682 � '
f.t , '� _
- � STANTON, CA ," _ Zip:`'90680-3427 , , . �
. . . . . . 'L`icense:. ,508422 '� �� � ��. �`.� .. . � ' .
Arch / Eng I,' - ' - � �' � i �
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Address �., .. � . . . . - . ' . . ';'..
'.� , ' . Phone: 3._'>` 5�;, �-{3 ,.
- - Zip: `�,: .. , ' _
' � � . • ' . License: � � .
_.. . . . ,. a�.vrc�vr.r�nivn � � � , ., .,
'� ONE 70.3 S�.FT. INDIVIDUAL��FOAM LEAERS AND ONE 13 SQ.FT� MONUMENT SIGN FOR �RIO'S-
� ' PAWNSHOP'. ', . � � : ,
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e.. . _. _. '-,v .,. , .- ,. k �.. - - a �
Plan Check:
Permit
SMIP Com:.
Other.
Inspectioric
Total:
� �, �` - � '- FEE�SUMMARY =� z. x�.:,.y sb,a�� ,
� $23.21 � � �� � � � � � �- �. � � � `Calc Valuation. ��', �, S9oo.o0
$0.00
a;,;$35.70 e; ,,,,, Claimed Valuation � � �' �3soo.00 ,��
�;, � < �,
_ �,.$0.50 .� .x� '
` $D.00 �. � �
F - i3
��.�� •
.. . ��.�0 � - i.
,` r. ,$`,i i _;,y�i � fi .':;i i i' ,. ,
$0.00 `. ''" " � t
� $0.00 ` ,
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$59.41 ;" , a, ..., z
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P.CANNING & ZONING
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y, � ,.
NOTICE: The work euthorized by this p9rmit shall comply with all applicable handicap access requiremenis under Californla statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezplre and become void if work Is not commenced wlthin 180 days, or ii work Is suapended or abandoned
for a period of 180 days. .
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all appliceble codes, antl ell
requlred Inepeetions end tinal approvel must be obtained. Failure to obtain inspections and final approval will result in the ezplration of lhia permit.
FOR INSPECTIONS CAIL: (714) 7545826
zsaaee larool
WORKERS'COMPENSArON DECLAFiAnON:
I hereby eNirm under penelry of perjury one o1 tha tollowing declarations:
❑ I.have end will meinteln e certificate o1 consent to seli-Insure for workers' compensatlon, as provitled for by sectlon 3700 of the Lebor Code, tor the pertortnance of the
�vOM for whiCh Ihis pe��� i5 issuetl.
D��hava end wil melntain workere' compensetlon Insurance, es required by sectlon 3700 of Ihe Labor Code, for the performance of Ihe work for which ihis pertnit is Issued.
� �My w-�or�ker ' mppi�getlon Insu�e cerder e�d �olicy number are: ���'''��,J ��y.�/-�
Cem�er�.�'� ••I i / / /� / J . Pdity.Number._ --(��...p'd — �`A' h
(Thls secti nof be /ete 1 permiN ue0 ef one hundretl tlollars ($100) or IessJ
[] 1 certity lhat in tha peAormance of lhe work for whic� this pertnit I5 issued, I shall nol employ any person In eny menner so es to become subject to the workers'
compensation lews o1 Cel' mia � hauld become sub�ect to the workers' campensetion proWslons ot Section 3700 ot t�e Labor Code, 1 shall torthwith
comDly with thesa pro�is' n.
,Appllca`�ignetu—�— re: 7 � v �� --- �Date:'�`''"i
�. _'_"
WAfiNING:FAILURETOSEWPEWO RS'COMPENSATIIXJCOVERAGEISUNIAWFULPNDSHALLSUBIECTANEMPLOVERTOCRIMINALPENALTIESANDCMLFlNESUPTOONEHUNDRED
TFIOUSAND DOLLARE (5100,00�)� IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIOED WR IN SECTION 31080F THE LABOR CODE, IMEREST, AND ATTOFNE`fS FEES.
LICENSED CONTRACTOqS DECLARATION:
I hereby attirmthat I em Ilygnsgd under provisions of Chepter 9(commencing with Section 7000) of Division
antl my license is in full
CONSTAUCTION LENDING AGENCV: �
❑ I hereby ettirm that thare is a conswction lentling egency for the peAormence ot the work for which this permit Is issued. (Sec. 3097, Civil Cotle).
Lendets Name: Lender's Address:
Signature:
Date:
OWNER-BUILDER DECUWAnONS:
I hefeby eHirtn Ihe[ untler penalry of perJury lhei l em EXEMPT FROM THE CONTfiACTORS LICENSE LAW tor Ihe lollowing reeson (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry wpich requires e permit to construct, alter, Improva, demolish, or repair any sWcture, prior to Its issuance, elso requlres ihe applicant for suc� pertnil
ro file a signed statement tPat he oi she Is Iicensetl pursuent to the provisions oi the Contrectors License Law (Chapter 9(wmmencing with Seclion 7000) ot Dlvision 3 of the
Business and Protessions Gode) or ihet he or she Is exempt therefrom end the basis for the elleged ezemptlon. Any vloletion oi Section 7031.5 by eny applicant for e pertnit
subjecis the epplicant to a G�� Penalry ol not more than flve hundred dollars ($500).):
❑ I, es owner ot the property, or my emplayees with wages es their sole compensatlon, WILL DO THE WORK, entl ihe structure Is not intentled or oXared for sele (Sec.
1044, Business and Professions Coda: The Contrectors License Lew does not epply to an owner of property who builds or improves ihereon, end who does such wOrk
himself or herself or tn�ough his or her own amployees, proviGetl ihai such improvameMs ara not finentletl or oflered ior sele. N, however, Ihe bulltling or improvameot is
sold within one year o� completion, the owner-huiltler will have the burden of proving �hat he or she dld not build or improve lor purposa ot sate.). '
❑ I, as owner ot the pmperty. am EXCLUSIVELY CON7RACi7NG WI7H LICENSED CONTAACTORS to wnsiruct the project (Sec. 704d, Busineu and Pmfessions
Cotle: The comreclor5 ��ense Law does not appty lo en owner o1 pmperty who hullds or imprrnes thereon, and who coniracts lar such project with a contwctor(s)
license pursuant to tha CaMractors Llcense Lews.�.
❑ I am eaempt under sec. Business entl Protessions Code for �his reeson:
Signature: Date:
Owner IO verifletl Dy driver'S �icense. ❑ Ves ❑ No Dnvers License No. Expires:
Venfication oi Owners�ip by (rype ot documenL I.e. � property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
❑ I hereby certity that n0 excavation five (5) or more feat In tlepth into which e peroon Is required to descend, will be mede in connection with work euthorized by lhis
pertnit, and that no 6uilding siructure, scattdGing, lalsewoAc, or demotiUon or dismanlling theraol, wi� 6e more lhan thirty-shc (38) feet high. (Cnap. 32, Gry 2, Art 2, Sec.
341, Tltle B, Calilamia Atlministrative Cotle).
❑ As owner-builder, I will not employ enyone to do work which woultl require e permit irom the Divlsion ot Industrial Safery, es noted above, unless such person has e
permit to tlo such work from ihe division.
SignaNre: Date:
Division at Industrial Safety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalry of perjury iha� I have read this application antl stete ihat the informa�ion given is
correct I egree to comply � k. II stete lews entl city ortlinances releting to bulltling construction, end authodze representatives of the Clly of Coste Mesa to enter upon the
above-described propetly� f s c ion p not to ocapy or ellow occupancy of any building authorized by t�is permit until finel inspectlon.
GODE t. INSVECl10NTYPE
1616 Fixed System Final F�re Prevention
1286 Pool Spe Final
200 Finel Re-Roof
201 FInaI BIocWRelaining Wall
202 Final Fectory Fre P�ace
203 Final Sign
204 Final Damolition
Q� �$
I
� �
CODE� INSPEC710NTYPE
206 Final Mechenical
208 Final Plumbing
210 Flnel Electncal
212 Flnel Flre Pravention
220 Final Planning Approval
222 Final Site
250 Finel Building/Ocwpgncy
�g ��
i i' . t"
(7t4) 754-5273 •�Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 710 W 19TH ST
Suite:
Vicinity:
Parcel Number: 42226122
npp�icant: MATT BAKER
Address:
owner: HAMILTON, ROBERT J TR
Address 525 APACHE DR
PLACENTIA, CA
Contractoc MC CORMACK ROOFING
Address: 4091 E LA PALMA #D
ANAHEIM,CA
Zip: 92807
A�ch :
Address:
Zoning:'
Phone: 774-630.5543'
Zip:
Phone:
Zip: 92870
Phone: 714-630-5543
License: 643700
Eng:
Address:
Phone:
Status: ISSUED
Applied: 0 717 1/2 0 0 0
Issued: 07/712000
ISSUED BY: S- Q--
Phone:
Zip: License: License: .
SCOPE OF PERMIT
T/OFF AND REROOF 260SF PAWN SHOP WICOMP SHINGLES.
Plan Check:
Permik
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$97.25
$0.50
$0.00
$0.00
$0.00
$97.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0. 0
Rear 0-0
Reauired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0- 0
sa,000.00
sa,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abendoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considared legal, such work must comply with all applicable codes, and all
requlred Inapectiona end finel epprovel musl be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545628 �
.>j
WOR. _RS' COMPENSATION DECLARATION: "�
I here6y eHirtn under penalry ot perjury one of Na tollowing tledere�ons:
❑ I �eve and will meimaln e certiticete of consem ro selFlnsure for warkers' compensation, as providetl for by sectlon 3700 of ihe Lebor Cotle, for Ihe pertarmance ot the
work lor wnicn tnis permit is issuea. .
I have en0 wlll malntaln workers' compensatlon insu2nce, as requiretl by section 3700 01 the Lebor Code, for the performance ot the work for which ihis pertnit is issuetl.
My workers' com0ensatlon Insurence cartier and policy number ere:
ca,�a�: RCC��t'F ni4rjou�� ��.1DE^1iiY C�• � P��,�,N„mha. NwAoll7>bsob
not Oe comp/efetl !! Me perml(!s ve/ue0 et one �undred dWlars ($lOB) or /ess.)
❑ I certity that in the pertarmance ot Ue work for which this permit is IssueO, I shall no� employ eny person In any menner so es to become sub�ect to the workers'
compensatian laws of Celilomia, enC agree that ii I should become sub�ect to Ihe work s' compensetlon provislons at Saction 3700 ot the Lehor Cotle, I shell foMwlih
comply with Ihese praN�fI n pp�,� �
Applicent Signeture: '"l� N�"� "' Date: 7��/2�� i
WARNING: FAILURE TO SEWRE WORKERS' GUAIPENSATON NVERAGE IS UNLAWFUL AND SHALL SUBJEGf AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TOIXJE HUNDRED
TqUSAND DOLURE (5100,000), IN ADDRION TO THE OOST OF ODMPENSATION, DAM4GE5 AS PROVI�ED f-0R IN SECfION �OB OF THE LABOR CODE. IPREREST, AND ATTORNEI"5 FEES.
LICENSED CON7RACTOHS DECLARATION:
I hereby etlirm ihat I em licePy�{1 n er provisions ol Chapter 9(commencing with Sectio 00) ol Dlvislon 3 0l Ihe BusineC aa d Protessions Code, antl my license is in tull
lorce and eHect. Lic. q Oy S �/ Cless a �"� ,
Conlrectols SlgnaNre: ! Date: � U
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirtn that there is e construction lentling agency br Ihe pertortnance ol the work br which this pertnic is issuetl. (Sec. 3097, Clvll Code).
j Lentlels Neme: Lendels Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereDy ettirm ihat untler penalry of peQury Ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Busineu and Professions
Code: Any ciry or counry which requires e pertnit to construct, alter, improve, Oemolish, or repair any structure, pnor to its issuence, elso requires the applicant for suc� pertnit
to ille e signed stetement ihet he or she is licensed pursuant to Ne provisions of tha Con[rectors lJcense Lew (Chapter 9(commendng with Sectlon 7000) ot D'Msion 3 ot the
Business and Professions Cotle) or Uet he or s�e is exempt therelrom end the basis for t�e allegetl exemptlon. Any violation ot Section 7031.5 Gy eny applicant tor e permil
sublecis the applicant to e chnl penelry at not more than frve �undred dollars (5500).�:
❑ I, es owner of the praperty, or my employees with wages as their sde compensation, WILL DO THE WORK, and the siructure is not intended or oftered for sale (Sec.
7044, Business and Professions Cade: The Conirecrors License Law tloes not appty to en owner ol properry who builds or improves thereon, and who tloes such work
himsetl or herself or Ihrough his or her own employees, provitled thai such Improvements are not intended or oMered for sale. If, howaver, the bulltling or improvement is
sold within one year of completion, ihe owner�builder will have iha burden of proving that �e or she did not builtl or improve for purpose ot sale.).
❑ I, es owner at ihe properry, am E%CWSIVELY CONTRACTING WRH LICENSED WNTRACTORS to construct the pro�ect (Sec. 7044, Business and Profeuions
Code: The comractors License Lew does not appty to an owner ot properry who builds or improves t�ereon, end who mntracts for such project with a contrecmr(s)
license pursuaM to tha Contraaors License Laws.).
❑ I am exempt under sec. Business end Professions Cotle tor this reason: __
SigneWre: Date:
Owner ID veritied by tlnvefs litense. ❑ Yes ❑ No Dnvers Ucense No. Eryires:
Veritication of Ownership by �type oi daument, i.e. - propeny ta�c bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: '
❑ I hereby certity that no excaveilon INe (5) or more feet In tlepth into which e person is requlred to descend, will be matle in connection with work authorized by tMs
permll, entl Ihal no bulltling structure, sceflolding, telsewark, or demolitlon or dismentling thereoi, wlll De more Ihen thirty-six (38) feet high. (C�ap. 32, Grp 2, Atl 2, Sec.
341, Title 8, Celilamia Administretive Code�.
❑ As owner-6uilder, I will not employ anyone to do wark whlU woulC require e permlt from Ihe Divlslon of Intlusirlel Safety, es notetl ebove, unlass such person has a
permit to tlo suc� work irom Ihe tlivisian.
Slgnelure: Dete:
DiNsion of Intlusiriel Safery Permil Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF EMAY: I certily under penalty of per�ury thet I heve read ihis applicatlon and state that the iniormation given is
Correct. I egree to comply wlih all state laws and ciry ordinences relating to bullding constructlon, anC authodze representetives oi Ihe Gry ol Casta Mesa to enter upon Ihe
ebove�tlescrlDed property for Inspection purposes. I egree not to oCcupy or allow occupancy ol eny bullding euthorized by ihis permil until linal InsDection.
� I And/Or Authori
Looe �, INSPECTIONTYPE
1816 Fixed System Finel Fire Prevenlion
1268 Pool Spa Final
200 Final Re-Rooi
201 Final Block/Retalning Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demoliiion
2as8d8
�� ��
r =� �
� ll �Gi')�1e
Date —
CAOE 1 INSPECTION TYVE
206 Finol Mechenical
20B Final Plumbing
210 Final Electrical
212 Finel Fire Prevention
220 Finel Planninp Approval
222 Finel Site
250 Finel Building/Occupency
P.sI€ It�Li
_
�ooncssocaunnu+� 'jg0 W 19TH ST
ON'MER4WIIEIFRlOWk pHM INVESTORS
"D°"� tSCHWART2, MILTON
4939 DENSMORE AVE
a � ENCINO,CA 91436
�vr�. wuwio �oo�sx
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uxr: CITY OF COSTA MESA - HUILDING PERMIT
PERMIT NO: H 084222 PLAN CHECK NO: N
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LIC@NSED CONTPACTORS DECLAFATION: I hareby eR'em uMer perietly d pe�jury that I em Ikeroed uMer prwieioro M CMqx B
(�TmaitlM wn� SxUan lW0) d Divi+bn 3 d Ne Buvi�wp end Pmfmaiona Code, end mY 4mns e in IW lace and dlep.
cm uc. No.: uc. cuss: uc. No.: EXP ;
Dme: ����
)WNEN 6UILOEX DECL�N�T10M: I hersby e1Nm uMa prWy d pryry �M� I em namq han �M Catlratlm tirsa lew la IM
rolb�q rmwi (Sed'an 10�t.5 Buvim� erd PrNmebrm Cads: AnY W a oouMY whidi �epme+ e V�^e m m'mhucl. Mx.'nnqaa.
demd"eh. a rapar vry svuc�ure. pria ro Ea waence. ebo npuirae tM eppliuM ta mdi pemW to fib e� aWemrn tlW M a�M
e na�e w� �o me ao+�+ d ub cavrma. uu�.. �.aw Icn.q« s I�d+m+o •an s.e� �000l d o�.eo� � a iro
Buunew ud Prdea'nn Codal a �het he a ehe'v uemq iMehan eM the bmu la iM Nbusd mmmqm. My violetion d baaion
)W 1.5 by e�Y WW�� lor e permn eubptls IM epplcent to a tivtl panally d M mpe then liw I�uMrad doAen jS.qOp.
[] I.saowre�dlMpupe�yamYsm{byeesxfhweB�n�MiadecanM�.dlAONew�kuWNeabW�mena'mtended
or oAereE br eeb (Section 101A, Bu&reo eM Proleeeione Catle: The Convenan licenee Lew Aoee nd apply io en owrrord qope�ry
wla Euide w Ynpwea iMreon. md Ma doee euM wqk IimuM or hena� a tivaqh he a Mr oxn enWb�am. qwidad tMl wc�
imp�m�ane�M ero m� imaMed «d1saE Ia seb. tl. lqwewr. tM bnMinp « inpwainwn b wld wXhin ms Y� d oomplrbn. iM
y�, o�.���,ude, �n naw me wb«� a v��'w ns o..n, ew �a w�u « �mo,o.e i« me wmo.e a.wl. � .
u �. ea ow,w d �ne wwMY. am eirbm.tly oavreeYro wan 4oem.e canvaaan m mmvua N. wq�+ (s«ann �ou. a�une.s e�d
Pmlaviwu Cotla: TM CaNraqon L'cenae law Eom m� epply ro en owiw d prapMy Mq buitle a impww iMreon eM Mo
oomrecb M h ic1MMCs xtlh e maiatlals) lcs�uetl W'+wm tn tM COM�atlua LiwrusleiN.
I am a�zyamq imdv See(im!:/) 8. d P.C.. br '
ets� d '���— 7 / Onvwr: ��l�'� —
heraby cerlity Net I em ewera d aiM urMaeierM IM repui nia d Celfpnie IMdih enE Sefely Code Setliam 25505. 2iR]�. end
255�0. vd thal I a eny INwe buiWi�q ma�enl wiil / wil m1(eicb wr) � b camW wih mif peb mdm eM tM iapu'vemave br
epqrmnlormrewclionorrtwEifica�ionM1amlM�i u�y arepemsnlDitlrip.RaeMemialoonpiupuneppliraliaaueuemqhomiMts
Dma: APqKaM: -
WOPKER'S COYYENS�TON DECLIP�TON: 1 hersb/ aMum iabr pr�My tl papry ans d tlr b0ow'vqledvnipu:
❑ I heve vd rri1 meimen ecmlifraie W miuent io aeX+�uina M xvke1s eompenwion, m prwided ia by Setlqn 3�O d �M LeEn
cw.. ra ms v�«,�e a w»oa r« wr:n rn� w.ma a moea.
❑ �nev..�e.e�meim.:�wonie.�oomo�o�inwrerce.m.W�weMs.aimarooam.�etc.coe..rormeqAm�anosa�n.
wwk fa wh'rh Nu Oe�^� b ivusd, MY waken' mmPemtlion irowence fans end V�Y numbx en:
c.m.�:
Pd'wy Numbr.
(iM1is esnian r�esC iwtW eampls�eE! �M W^�Y ie br wre MmliaJ ddbm IS�Oo/ a Im.)
❑ I mnA' � in Iha perlormeMa d the wak tar which ihb pamG b eeued. I Mell M anploy eiry pamn m anY menrwr o m �o
Eecm�e v�Eptl lo �M xwFst mmpammion Nv.s M Cefdamu, antl epfes Nm Y i�IpiM bacanr �uhje�f �o �M wvb�'
cwnpensetion prwis'wn d Sopion 3]00 d Ihe lebor Cods. 1 NeY lalhwilh wmpy w� thaw poMriuu.
DNe: MM�:
W1m/nD: F�Ilvn ro uc�n rolkwi c>mo�uon m'srro� l� un�wM. ure aiw� ncN�t m.mv�w> ro enmwawror �na
d«x nn.s w m«v nu,end rneu.a,e edwr. fs�MavA n.miu�n m m. mr o�mrrw�wcbn m� o cw� mr in
SKtlon 9106 0/ Ms Le6or Cob, IrrtMut, uM ertomry'� Mw
�'coNsrnucnoH �aara �aeNcr: i n�.M mr� �� o�r d�,y mr m.e o a oamNa� �.�kv ro� u»
PsHamenm N �M xork br which �he pamiY ie oaueE (Saqun ]OB]. CN. CI.
LENOER'S NNIE:
' LENDEN'S AUONESS:
I cy�y iMt I hew reaJ Utia eppliution enA mte thel tla ebovs'uJamNbn o cmw. I epras to cpnply w4� N rtiy eM cpNy ord'muior
eM atma lew ' B lo bi+2d;q mnetn�cam end hxeW eulhar¢a nqeaamNivm d Ilie diYto amr upm tM abwe�memorrtl prtpary
lor{�yp�ion ur as ��
t -�,-N�3 �L+-
PnIN
m.: s' �� c!'%
.. SipneluredOrmeHAqenJApplranVConVepv
(5151yp.WP) WNIa-BuJdiq 8 Stlery; G�esrFb: Cenvy-AppiceM: Pink-Rewiue:OdEenroaNaev
PERM NO; B 08422`
GOVT: N SUPP: N
CONSTRUCTION TYPE: UNKNOWN PERMIT TYPE: STR PORPOSE: ALT
JOb DESCRIPTION : REMOVE WALL INSTALLED WITHOUT A PERMIT SQ FT: 200
CLAIM VALUE: 200,00 CALC-VALUE: 200.00 GROUP OCC: B /
COMMENTS: RIO'S JEFILERY 6 LOAN
iE i! it �E iF iE iE if iElk �E if i! jE if if 1k 1E iE �f �F fE iE fF iE jF * ft 1k if iF if 7E iF ik iP jE �E iE iE ik iE iF iF iP 1k iE iE fElE 3f iE i! df �E ik �f if jf it iFlF ik iF iF iF iF �F iF if �f if aF �E �E * ff IE iF
Z O N I N G R E Q U I R E M E N T S
S E T B A C R S
------------ MAIN BUILDING ---------- --------- ACCESSORY BOILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN
LEFT: FT IN RGHT: FT IN LEfT: FT IN RGHT: FT ZN
PARKING REQ; PROV; PARCEL: 42226122 ZNE: REF NO:
PLANNING NOTES>
� A�
fF it if if 7f iE i! if 1f if'lf'k iE fE if ik 1f ff'1E'k �f iE �f if iF iF'lf iE if !f iE if 3f ik iE if ik if if iF iI' if ff if'1(� fF jE �lE �E �f ft iF iE iE 1E if 1E iE 1f iF iF 1k ik 1E iE iF 1E �F'IEiE�iE iF'k 1E 3f'lf iE if iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T' S
ZONING APPROVED BY 1 DATE: ''
BUILDING APPROVED BY : DATE: �'�
APPLICATION ISSUED BY; `- DATE: ��������%
iliffE�EltiFiflElfifiFitiEifikiflklEifilitif iFfFiEiFiE3tdF�Fik1E jEiE
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 21.00
PLAN
ISSUE FEE
BUILDING-DIV->
TOTALS---->
SMIP/NON-RES
.50
PERMIT ISSDE PLAN-CHECH TOTAL PAID DUE
21.50 0,00 0,00 21.50 21.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT: 00
BLDG FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECi(
zi.oa .so
i!'lf if �f �F fE �k 1f if if �E �lF 1f 1F ik fk iE iF'!f if it �f ik if if 1E ik iF �E iE i4'1E �f if iF * jF ik dE iF iF it if iE �f'lF'lE iE 1f 1E �f �E iF iF �f iF if !F iF if iE �E iE iElE'k �E �F iE �E fE'1E if'IE ii �(' iE �F iE
I N D I V Z D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TO'PAL COST
SFC 200 ALTER BY VALOE COMMERCIAL NOZONE 1,00 200.00
END OF FEES
08-13-1997/t�3:44 VH/521.50
kLGT�:�l-EJIG792
PEftP7I i c 0842`�'c
CONSTRUCTION AND PLANNING h.,�L & SPA . - �
APP�iOVALS •Permit # Date tnspector qppROVALS . Permit # Date tnspector
1. Temporary Electrical Service or Pole . . 52. Pool & Equlpment Location �
2, Soif Pipe-U�drgmd, � � 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Undrgrnd. •. 54. Forms �
4, Electrical Conduit�Undrgrnd. ' S5. Electrical Bonding '
5. Sreel Reinforcement ,' .. 56. Rough Plumbing & Pressure Test �
6,' Electrical UFER Grnd. 57. APPROVAL TO COVEfi-GUNITE
7, Footings 58. Electrical Conduit�Undrgrnd.
g, Foundation . 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd, _ � 60. Backwash Lines, P•Trap, Ci Undrgrnd. '
10. Structural Floor Svstem � � 61. APPROVAL TO DEGK
t t, Property Sewer Line & House Connection . 62. Backwash & Recepior-Final
12. Sewer Cap 63. Heater & Vent•Finai
13. Roof �rains . ,. 64. Plumbing SYstem � Final ,
14. Rough Plumbing - �65, Electrical-Final � � �
i
15. Rough Electrical-Conduit 66. Solar SVstem-Finat
16. Rough Electric Wiring � g7, Fencing & Access ApProvai '
77. Rough Wiring Sign _- , 68. APPROVED FOR PLASTEftING - �
tg. Rough Electrical�T Bar Ceilinq �� � 69, POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air �onditioning � � PIRE DEPT. REQUIREMENT -
20. Rough Factory Fireplace ' ' � • . � APP60VALS � Permit #
21. butts, in Struoture � ' 70. Underground Hydro
22. Ducts, Ventilating ' � • 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test �- � . • 7Z, LSnderqround flus4
24, Roof Framing � ' � �� 73. Undergmd.Stora9eTank.�Gas OOiI
25. Roof-Sheathing � � U� � - �� 74, Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocroat � - '�' 75, Dry Chemical � ; .
27. Frame and Flashing - � • 76. Dry Standpipe - '
26. Lathing & Siding -• �� ; 77.�, FIXED SYSTEM FINAL
29. Insulation • 7g„ FIRE PREV. FINRL '
3p, prywall Nailin9 . � ' �' HEALTH.DEPT. (iEQU�REMENT
31. Plaster Brown Coat � , . 79. FINAL INSPECTION t -�
32. Electrical Power Meter•Final '- 80." POOD CERTIFIC�ATE 155UED
33. Final Electric - i� Noies: .
34. F�nal Heating & Air 6onditi0ning �' �, -�
35. final Gas Pipe�Test ' -. .� . '
36. Hood or Canopy r � � �
t
37. Final Factory fireplace � �� ' �
38. Finai Plumbing � '
39. Water Service-Final � � , �
40. Gas Service-Pinal � � � ' '
47. Solar pomestic�Final � � ; .. . '
42. 6ackflow Preventer . �r � �
43. Backflow Irrigation ' _ � � ; �
f
44. Landscape Irriqation SYstem � ' � '
45. Sound Attenuation ! , , _. .� . ,'- .
46. Mandicap Regulations • •
47�, FINALSTRUCTURE&BUILDING _In_�� / [/./i' _ ' - .
� 1 lilM
48� FINALPLANNING • � � .
4g� Electric Retease co Ed'+son � .
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OP OCCUPANCY .
No. Date
City of Costa Mesa
Building Safety Deparfinent
P. O. Box 317
Costa Masa, Californio
CERTIFICATE OF OCCUPANCY N� 2576 C
The Buiiding located at '�Q �8E3t i,��$ Qt.TLtBi'i
has been inspecfed and fo�nd fo comply wifh�the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group $� Occupancy.
Use of Building_ sg��+�t T2�+�7A9n..
(.egal Description u�'�'�
(Sae reveria side for Mates and Bounds)
Building Permit No._.Q�i►� �Electrical Permit No. �� �plumbi�g Permit No. .�t�5�.
floor Lood Signs have been installed as � Room Capacity Signs have been instaled as
�equired under Sec. 2308 U. B. C. . req�ired �nder Sec. 3301 (1) U. B. C. _
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging hovse shall be used or occupied
�ntil The owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of o building or portion ihereof
i) The number of apariments or guest rooms •
3) Ownership
If Grovp H Occupancy, number of apartmenis and/or guesi rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments— and/or guest rooms
ISSUED TO:
� „�e�, i : . :;: : a.Ao�r:,*. i.;�"
Buildinq Official
P
ome t�g�,-?,9�g "
7his Cerfificcte of Occupancy SHALL BE posted in a conspicuous place on The premises and SHAII NOT BE removed
except by the Building Official of 1fie City of Costo Mesa UIIdO� S80. .3OG (@� U.B.C. Form BV94-1M-11-&'tiSB P
. . ���`' �� �EE RE�E;Uci�,
• "" 20 I 85
CU'�TA MESA BUILDWG-SAFEfY DEPARTMENT � fINANCE DEP�963
P• O. BOX Si] GOSTA MEBA, CALIFORNIA \
\
CITY OF C(���A �IESn��'
Far Appltcanf fo Fill In Completely • APPLICATION FOR ��
TYPE OR PRINT t BUILDING � �`,j„
For O/fice Usa Only u
eu��oiNca � -
ADDRES9
CO TA MESA, CALIFORNIA
REC 8D Y
OWNER %v 1�LJt� � C1 ke.r iL.� `
BWL�IN6 7�
MAIL � I iI pOORkAA
7E4
NO.
��I�N C,
�d !f ��! Q ,� u •
�i rt c: -
TEL. �) /��tf4
NO.
I�Q� NO.OFlLG08.
� ewn..ie�r
IS BHTBACN 41NH PROM
DESCRIPTION OF WORK
ILDINp
IE
IER)OR WALL
VERING
E OF @V ILD�N
I 11
1 HEREBY �CKNOWLED08 THAT 1 X�V¢ R6AD TXIB APPLICATION
•ND 6TATg {ryAT TN8 ABOVE I8 CORRER AND ADREH TO COM.
PLY WITH ALI. CITY ORDItUHC68 I�ND BiAT6 LAWB p80ULATINO
BYIWIHO CONBTRYCTIOry,
SIGNATUREOF,� �, _\ �,_
PERMITfEF / �-�x�
AUTHORIZ6DA6HNT �X 1 .L/ � ,I_
F
ZONING �
ZON[ NO.OP UYEOFNlW ♦♦
/` _ / PLANDZ-• lUILOINO �/� �im
< < „..
DE4CRIRION 4' a /� %JC 6 � �r
A. A. NO �`T��—
� r=��, � -8�
NOTE: NO HAVE OVERHANO BHALL BE LE88 THAN
90' TO SIDE B REAR P. L.
EAVES
ALLOWE� �U.B.G.REQUIREMENT
YAFOSAPPROVfiO YARDSAPPROVED
MAIN BUIL�INO ACCESSORY BUILDIN6
vaR. ?k
DATE
�`
�
TNE AMOUNT BHOWN UNDHR V�Ltl�TON IB FOR TNB =
PUqP088 OF 88TABL�SHINO A PERMIT PEE ONLY. 0
VALUATION m
�PERMIT FEE $ � �
i
m
s �D �— — _
6
TOTAL FEE S � � /
1/
• s; , 29939 DEC —4-68PA'o00 254'� *** 17.$.L`
" CHG.
� C�STA MESA BUIIDING-SAFETY DEPARTMENT �
P.O. BOX 1200 COSTA MESA, CALIFOflNIA 92626
APFLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely pECEI ,(��Q'�' DAT R/F��C�-IV/ED D9 TE ISSU,]E_D/
ADDRESS �/ � (�/ . � i / �"' � " u / � ��J B+
� '4R' / i� i '� PERMIT N. i,
OWNEF G . A.P. NO -'� � I
� MAIL BUI�OIM.i G �' �
ADDRESS ,� , j� �+DOREiS �
W W � TEL. / 383� yo F
ac� cirr �,p.�4,. NO. 7AACT �I� L�O � BLOCK
Z �
O~ CONSTFUCTION W D P
N LENDER , `
am
� BRANCH
� � ` 'OWNEft
`� W ADDRESS
R1 m VALVE �
JQ ARCHITECT ��j9 TEL 5 (L.�l� 5 ��!
N OR ENGINEER .w. r�6 N
Z� FIflE / N � �'
W� ADDRES o ZONE TV,PE � GFOUP
Q, w . �y
APPROVED / �/-� � �J /
mO CONTRACTaR � flY /�/ DATE�L /J -F� �\
Z /
J � ADDRESS („Lv �
w W 20NE NO.OF USE OF NEW
ZF CITV � NO�. � Z � Q P�+� BUILDING �� C^
� �
W STATE C17V VARDSAPPROVED VARDSAPPROVED �
y� LIC. NO. LIC. N0. '�- MAIN 6UILOING ACCESSORV BUILDING
7� SIZE �� � f NO.OF BLDGS. (FROM C/L STREET)
OF LOT GO ,l„f � 9i; NOW ON LOT RO�T FT. FT. {, �
USE OF / 1 1
EXISTING BIDG. � �
�� � F
� SIZE OF NO.OF
Z NEWBLDG. �i ROOMS STORIES I L SIO OFT. FT.
aEXTERIOR WALI ROOF �-D � '
COVERING COVERING K� � K. REAR FT. � FT.
-� USE'O_F �JII/,D G A D F T PERFORMED DISTPNCE BET. IBET. MAIN &
a Uik.c-(Ai1" .0 MAINeLDCS. ACC65. BlOGS.
Q � VAR.f DATE p D
O �`�D�YI. ��C C.U.P.M�' • %^� � 'Pf7ROVED I � O'��p0
~ APPR D \ I' - ^�9 ]%
VI �y V
r Z
'' O HOLD FOR SP:.CI �:L R=QUI.'.�t.1-A1TS •
VI hereby ecknowletlpe thet I �eva reatl Mia spplicetion entl steta
� that tha above informetiu� is correct and agree to eomplY with ����
� all laws r0puletinB builtlinp consnuc[ion, ontl I shall no[ employ
r a�Y Pereon tn vbletion of tNe workmen's compansatb� lews of
y tha State af Celifornia. m
C'' o
� I heraby certify thet I em proparly licensetl as a conbactor untler �� SQ, FT. '
\ the State of Calitornia Businesa and Professiona Code, Dlvlslan 3, TME AMOVNT SHOWN UNOER VAIUATION IS FOR m
Chaptar 9, end thBt such Iicenses eYe in full force entl aftect, pr I THE PUPP06E OF ESTABLISHING A PERMIT FEE ONLV: Q
� am nxempt frOm the pro�isions ot tha Stata of Cellfornia Buslnass
end Protesslone Cotla, D��ision 3, Chepter 9. VA�VATION � I /)'��� m
PERMR FEE S �/ �' �
�d�.� ` �
Signatura f ���0/ y' i 7�/'� E
Perm�fi��mf !»2"�i� g �� PLANCHECK$ /�
/ � o`
Avt riz�Agent ) TOTAL FEE $ /� .� � u
;
�. 1
=� 2
.� 3
4
5
f.� 6.
� 7.
r
C>
I 8•
I 9•
, .
An ornamental : iscaoe planter �•�ith an irrigat system shall be provided.
Planters shall be maintained in an orderly and healthy condition.
Drainage shalt be engineered to drain to W. 19th Street.
Sidewalks shall b� installed by aoplicant and/or owner at their e>:pense,
to be constructed of Portland Cement Concrete per City of Costa 24esa
standard plans.
Concrete drive•:�ay approaches shall be constructed of Portland Cenent
Concrete from the curb to the property line, per City of Costa :�lesa
standard plans by o�:mer and/or applicant'at their expense.
Type 12n driveway to be installed where possible (on �eesterly side).
Construct drive at r.equired distance irom existing street light or
relocate at the er.pense of. applicant and/or owner, under the direction
of the Street Lighting Superintendent. (Note: this would enLail moving
L-he 7ocation of tt�e buildiny to the easterly side of the property).
Provide such extinguishers as recommended by the Fire Department; must
meet all the conditions of the Uniform Fire Code.
Tree plantitig compatible �vith surrounding area under the direction of
the Street Superintendent.
I
Planning Commission action meeting of November 12, 1968 addecl the follocring �
condition:
10. All on-site utilities shall be serviced underg ound. !
� r
� � , / FJ � -� ��� � � a�. ,_ 9� - � �i P e� l�o.i-�-�
-- - — - — -- -- '
. � .
0
0
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