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177 19TH ST - Building Permits
• ' CITY OF COSTA MESA • t BUILDING DIVISION c,„;.._... ,s. ; ,,,,', DEVELOPMENT SERVICES DEPARTMENT /B02-01996 RMIT NUMBER � t �� PERMIT ono 4. (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT .lob Address: 177 E 19TH ST Status: ISSUED Suite: Applied: 12/10/2002 Vicinity: ROOF Issued: 12/10/2002 Parcel Number: 42523414 Zoning: Applicant: VAZQUEZ, ADRIAN - - __ ISSUED BY: ------- - _ -. Address: 1653 SUPERIOR AVE - „/7 '' „- - - , ' ,/; - - ' Phone: (949)642-7222 - - ;'- COSTA MESA,CA:-"--- Zip: 92627 Owner: STAPLETON;'RICK C Address /701 TEXAS: ' /,-') / ,.„A` ' / Phone: REDLANDS,CA- Zip: 92374-3035 '-`' / Contractor: LEE ROOFING OF COSTA MESA �• �� - Address:: 1653 SUPERIOR AVE VV'-''' / � Phone:'x(949)642-7222 .� , / COSTA MESA CA Zip: ' 92627 License:` 349686 - - Arch,: , , Address: / N`� _.- - Address - - - Phone:- z \ ' ,, Phone: ','\ � V' ,\Zip: - i' - License: S License: . . ;.,. .r �. SCOPE OF PERMIT_,rr,,,_. ' _ TEAR OFF EXISTING ROOF.INSTALL 20 YEAR,COMPOSITION SHINGLES/15#FELT,USE EXISTING SHEATHING.1,280 S.F. INCLUDES ATTACHED GARAGE. - " ,- FEE SUMMARY_[[ Plan Check: $0.00 — - - / /- . - Calc Valuation - $2;300.00 Permit: $83.25 (,� -Claim Valuation $2,306.00 • vN:SMIP-Res: , -. $0.50 'SMTP Com: $0.00 • ' Other: " $0.00 � _ _ ,� ,Inspection:" \$0.00 _ ,: 7, / Total: $8375 : , , , V\-v`. 27 /-. ` v ' PLANNING 8,ZONING ! , SETBACKSN� ;/,. � .�, _ MAIN STRUCTURE Front 0-0 N Rear _ 0-0 Left . 0-0_ Right , 0 0, ACCESSORY Front - 0-0 Rear 0.0 - Left 0.0 Right 0-Of; ' , l V PARKING Existing: `0. - - Required: .0 " Proposed:- 0 !- I NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. / 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. FOR INSPECTIONS CALL: (714)7545626 244648(WOO) DECLARATIONS WORKERS'COMP AT1ON DECLARATION: - I hereby affirm' r pelf y of perjury one of the following declarations: -" ❑ I hay d will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the w for which this permit is Issued. -r 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 permit is issued. _ - My works]'co pen n Insuranceeterrier and pot' number are: -Carnal-C./ Ji��' e !' ..�( Policy,__- N�rnC_r:X166 S Z86'" ©l ' -(Thfs section need not completed 11 t Insure: permit Is valued at one hundred dollars($100)or less.) ' ❑ I certify that in the performance of the work for which this permit Is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California,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 provisi• s. ) pliaantSig " "� "On _ P - • Dale:/�'z, l-' ie- ••• WARNING:FAILURE TO ECURE WORKERS'COMPENSATION COVERA E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. 1 LICENSED CONTRACTORS DECLARATION: I Juareby affirm that l am licensed under.rovisions of Chapter 9(commencing with Section 7000)of Division 3 of.the Business and Professions Code,and my license is in full force and effect.Lic.pr' _ de- - / / Class x 4 1C— 7 7 .._, - _Contractor's__Slgnature:c i = �� - /'Date /o .17 s7 ' CONSTRUCTION LENDING AGENCY: / ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty Of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .0 I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (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 time has on hand a quantity of acutely 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 temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Calitomia Health and Safety Code provides that the 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application agpermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Calitomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomla Health and Safety Code Section 42303 been made? 0 Yes 0 No B (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Data: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owners) Date r-Amd/Orr u rued Applic • / / Date �,, CODE L INSPECTION TYPE DATE RIIIIIELE ;ODE/ INSPECTION TYPE RAIL 1MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof ,2 -17"OZ 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 I Applicant to TTTt--o fill in all spaces except those within heavy border lines and sign all appropriate declarations. F COSTA MESA CONSTRUCTION PERMIT MT ! sic. O TRACT NO. LOT NO. UNIT NO. A P # Zone ct Address i� — —� 9 / S Main Building: Accessory Building: / L e TYPE OF CONSTRUCTION . NEW II ADD . ALTERATION • REPAIR E Z r \•Applicant's Mailing Address i82"'2re2_----�3w / Jy -J4-K F 1" /7 2L j1one LOCO .%I43 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front O LAddress Namef/ ( ��y[ '� ,../. DESCRIPTION OF WORK/USE OF BLDG. A Rear - f N \ Address ( g Z L ��-L—n+'c•e"J/.e'v[ !?L t it-IO 3 • Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL K Right G Address 6-n-; � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ Left - - R 5f! n-;a Phone 0 OTHER q ' Contractor's Name Ping.'Ref.# ParkingRe /Provitletl E Address(mailing) /YI/J1 PROJECT DESCRIPTION SQ. FT. TIONOCC $ Nj j M V C.J CON STRVCTION TYPE VALUATION$ PlanningNotes: T City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION ^ S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: hjn ----'t't,d� _11ily.ya • with section 7000) of Division 3 of the Business and Professions Code, and '�� my license is in full force and effect. r fti.i Y ,� IIIELECTRICAL FEES License Class License No. Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. 0 50+ KW heby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink ShOWefs Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps ..u00, Lab. C.) Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant • Fan EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors 00.1 HP'01X-8 (This section need not be completed if the permit is for one hundred ($100) or Dishwasher F.A.U.IKh -� less). Solar Piping • - Inc.Solar ❑9.15 HP ❑16.15+ • i certify that in the performance of the w for w ch this permit is Issued, I shall not employ any person in any man ei so o bedi/Subject the Drinking Fountains Solar Tank Fixtures Microwave Workers' a ws of California. a�sJLif D¢VICe Bnxe$ Date Signature Floor Drains Swimming Pool w/Spa Pole Light NOTIC : f,of er ma ng this declaratio you should b come subject to the Outlets Workers' Compensation provisions of t e Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign I hereby affirm that there is a construction lending agency for the performance Garbo a Disposal Of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9Standing Sections Lender's Name• Lender's Address Kitchen Sink Water Service Generator 00-5 KW ❑5-15 KW Trash Compactor OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays 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 Roof Drains Contractor's License Law(Chapter 9(commencing with Section 7000)of •ision 3 of the Business and Professions Code) or that he/she is exempt • Reinspection Fee $15 Issue Fee refrom and the basis for the alleged exemption. Any violation of Section • $ 3 .5 by any applicant for a permit subjects the applicant to a civil ' , malty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: I, as owner of the property pelf-sole— Reinspection Fee I $15 Issue Fee $ 3 --aewapemet+04,-.will do the work,and the structure is not Intended or-offered - Zoning Approved By Date Au -for sale (Section 7044, Business and Professional Code: The Contractor's -' MECHANICAL - FEES Building Approved By /Z/� VI(L License Law does not apply to an owner of a property who builds or improves l\ Date ` 'Ir7'1 thereon, and who does such work himself/herself or through his or her own Application Issued By (`/L{//yJ� Date employees,provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, tne-building timprovoment Is sold within one year of com- Canopy Type II 0 SUAIARVOOF FEES prove , the owner will have the tin en of proving he/she did not build or im- Duct-Under Ground S (, so prove for the purpose of sale). \ - BUILDING PERMIT $ SMIP $ J v ❑ I, as owner of the property, am excl ively contracting with licensed con- Duct-Structural Refrigeration System tractors to construct the project (Section 7044, Business and Professions Code: PLAN CHECK $ PERMIT The Contractor's License Law does not apply,to an owner of property who Duct-Ventilating I❑0.100,000 BTU 0100,00o BTU PLUMBING $ ISSUANCE $ builds or improves thereon, and who contract5\fof such oroiects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. Ir ELECTRICAL $ $ ❑ 1 am exempt under Section & P.C. or this reason Firepl/Fact:Bit. ICBG'# Fire Dampers G GRADING LM $ ,/ n G•L HeatingSystem& DuctingRegisters PLAN CHECK 50% $ Date 7 Owner - t' 9 MECHANICAL $ I hereb cert ft' th I have read Is application and state that the above 00-100,000 BTU 0100,000 BT TOTAL FEE $ as 30 information is correct. I agree to empty with all city and county ordinances PLAN CHECK 25% $ , and state laws relating to building construction, and hereby authorize repre- sentatives of t s ity enter p the ova-mentioned pro erty for Inspection purchase /q�n� .y • Signature ^4_' , s^'" Date a r Reinspection Fee $15 Issue Fee $ 3 DUPE ICATE IRECETP r,, Drivers' Licer}s� r SS /<� -� F' 0865-46,rev. 5/88 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00034528—00034524 I'III (i 50 DATE: 06/02/89 TIME: 14:37 ONSTRUCTION AND PLANNING PC '' 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:\ r 54. Forms f,. 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 85: Steel'Reinforcernent \ 56. Rough Plumbing & Pressure Test 6. Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings •11 ' - 58. Electrical Conduit-Undrgrnd. • .. 8. Fotindation - • ) 59. Gas Pipe, 0 Undrgrndi,Test •- :9. Water1Pipe-Undrgrnd. . . 60. Backwash Lines,P-Trap, 0 Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK - ,- -1- 11. - y11. 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 -171 Rough Wiring Sign 68. APPROVED FOR PLASTERING 1.18. Rough Electrical-T Bar Ceiling. 69. POOL/SPA SYSTEMS FINAL •19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT X20. Rough Factory Fireplace • ,. APPROVALS Permit# . 721. 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 ❑Oil 03 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Mouocoat 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 Coatr7 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 --1 42. Bac flow Preventer i `.'=,/ (.Y n, 43. Backfl w Irrigation :J 44. Landscap Irrigation System 45. Sound Atte uation\ - 46. Handicap Regiulations [/ 47. FINAL STRUCTURE & BUILDING frf/�//}j7 LY.f/'- 48. Special Requirements Completed r! //" c ��7 49. Electric Release to Edison , 50. Gas Release to Southern California Gas CO \ ;L `51. CERTIFICATE OF OCCUPANCY , •••,, r7 ('7 No. Date "-7 — El'V Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. ct- 3ef CITYOF• PERMIT NO. TRACT NO. LOT NO. U P.# Lf'a 'J - 3G.f _/!1 v Zone �`L Address MESA CONSTRUCTION PERMIT . Project Address \ �/� r S Main Building: Accessory Building: Applican/$s Mail;1 A dress (SL-z- vL-AM r BL-307 TYPE OF CONSTRUCTION NEW LI ADD LI ALTERATION REPAIR E I y- Z , 4K . MBERL E_ (o ' —5/63 0 CONVERSION ❑ DEMOLI H ❑ OTHER B Front lu 1 N twner's'NamePhone DESCRIPTION OF WORK/USE OF BLDG. I A Rear /2 I Address `' . I �}�./. y �� ^ f Arch/.Eng. " ,v ml "�2 r�t"��� Licen a No. _ `des TYPE OF PERMIT M GRADING U FOUNDAT ON ! STRUCTURAL I C Right L N (750--S11-fw/-/V A-N A— L EZ C TENANT ❑ ELECTRICA ❑ PLUMBING ❑ ME ANI • S Left /L3f • G Address D3Sgi Lf✓.A ' • % � x7'ST. °�� ' R Contractor's Name 6LVN er-' Bk I C Peg- Phone(r.�0-S%63 ❑ -OTHER 0 — .a .. . , — __rt • Ping. Ref.# RA-- ER -Q Parking Req./Provided 4 4 E A PROJECT DESCRIPTION SQ. FT. •CC PAN v _��•_ p� • (1 III / 0 Address(mailing) S YT1 �� CONSTRUCTION TYPE — - --- Planning Notes: now FOR SPECIAL REQsIIREMErv" M VALUATION$ CiY✓Y goo FY T City License No. ZONE GRADING CU.V S. ACRES — LICENSED CONTRACTOR DECLARATION - f��ff //�� �In/�s..��/ � �,y� •,, ,1,, .rt 11 _ S I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: f3w( 0 '17 C. p�t 3 33 .� , ?a n/�•U rx-1„koozz s-�ILLUL-a-�ti 11 ' cu-D I t with section 7000) of Division 3 of the Business and Professions Code, and T" �s z q f v p my license is in full force and effect. P. c , �. ICir a, _SI1c 7 I— p/)•11p ,(`� intuit 1419,I-cLE( l3)S, i "hizu License Class License No. I v V I Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW - KERS'COMPENSATION DECLA ATION COnstructiOn Pole Sub. 0 50+ KW / ay affirm that I have a certificate f consent to self-insure or a certificate Bar Sink Showers c prkers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab. C.) - - Dishwasher Meter Dover 100 imps Policy No. -Company Backflow Irrigation Sewer Cap __ BCertified copy ie hereby turn lshed. Dryers OGas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection - Date Applicant • Fan EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors 00.1 HP 01%-8- (This section need not be completed if the permit is for one hundred ($100) or F.A.U. Inc.Solar 09-15 HP:❑16-15+ less). 7 Dishwasher Solar Piping I certify that in the performance of.the work for w ich this permit is i ued I Fixtures. Microwave .�� ' shall not em toy y erson in any man so to ( e subj to the Drinking Fountains Solar Tank <y Worker Laws of Californi tyy2Device Boxes Pole Light •el` Date Signature e/_ Floor Drains Swimming Po01 w/Spa 9 NOTICE: ,aft maki g this declaration, ou should ecome subject to the Outlets Range Workers' ompensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance w7 ' of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heater - :Garbage Disposal Standing Sections Lender's Name - Lender's Address - Kitchen Sink -Water Service 'Gene'raior 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash • following reason (Section 7031.5 Business and Professional Code: Any city or - n county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - 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 Roof Drains d `, 'ontractor's License Law(Chapter 9(commencing with Section 7000) of - -• ion 3 of the Business and Professions Code) or that he/she Is exempt • Reinspection Fee J $15 Issue Fee $ 3 ' efrom and the basis for the alleged exemption. Any violation of Section ' 7031.5 ,by any applicant for a permit subjects the applicant to a civil -- penalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICE REQUIREMENTS: CO' r I, owner of the property my employees with wages as their soleReinspectionFee I $15 Issue Fee '?!Doing Approved By compensation, will do the work,and n the structure is not intended or offered Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building'Appraved By Date 6 License Law does not apply to an owner of a property who builds or improves ® __. _ _- I'�' thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 Application Issued By Date employees, provided that such improvements are not Intended or offered for Boiler sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II ❑ ., SUMMARY F FEES pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground ' ./ 6"•+•0O rove for the purpose of sale). .-BUILDING PERMIT $ SMIP $ 6r 4 -7 C C I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System tractors to construct the project (Section 7044,Business and Professions Code: 134L, PLAN CHECK $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU - PLUMBING $ ISSUANCE $ builds or improves thereon. and who contracts for such orolects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I ;PLAN:CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me., - GRADING $ "❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG* Fire Dampers y ELECTR ICAL $ . PLAN CHECK 50% $ MICROFILM $ / p Date Owner Heating System&Ducting Registers -MECHANICAL $ ��O 9 I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTL - - TOTAL FEE $ tl Information Is correct. I agree to comply with all city and county ordinances _PLAN CHECK 25% $ and state la . relating to •ulitli construct •n,and hereby authorize repre- sentatives �S41u� city en r 'portt`tt bove-mentioned property for Inspection ph $q‘ x 8C) Signature -- • Date¢- 0'-9DD374:3-(}D037415 TO �.'S „' Drivers' Licen SS - �® Reinspection Fee $15 Issue Fee $ 3 ' DATE: D7/?• ,D!89 TIME: 14:48 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor �� - ' ' CONSTRUCTION AND PLANNING a I • PC. &SPA APPROVALS Permit# Date Inspector APPROVALS ,"ermit# •Date Inspector 1. Telnporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil PipetUndrgrnd. 53. Steel Reinforcement V 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical;Conduit-Undrgrnd. 55. Electrical Bonding 5.°Steel Reinforcement, I 56. Rough Plumbing & Pressure Test A 6. Ele'ctrical'UFERGrnd. .5f 31 b`1 ad- 57. APPROVAL TO COVER-GUNITE 7. Footings :, ,r ".- tri 58. Electrical Conduit-Undrgrnd. •' 8. Foundation -. 59. Gas Pipe, 0 Undrgrnd.,Test - r rg 9..Water Pipe-Undrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK f,,,, 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap t- • 63. Heater & Vent-Final -1.3. 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 171 Rough Wiring Sign 68. APPROVED FOR PLASTERING 18"Rough Electrical-T Bar Ceiling "69. POOL/SPA SYSTEMS F I NAL 19. Rough Heating & Air Conditio`ning FIRE DEPT. REQUIREMENT 20. Rough Factoryfireplace - t' APPROVALS Permit# _ 21. Ducts,in Structure • ,_ 70. Underground Hydro 1J 22. \. -I Ventilating , I, ' ' 71. Product Piping 0 Gas 0 Oil •23. Gas Pipe-Rough.&Test 72. Underground Flush - • I 24. Roof Framing ,- ' -1 .n 73. Undergrhd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing" it; V3'/c 74. Overhead Hydro 26. T-Bar Ceiling (Structural):- Monocoat a 75. Dry Chemical 27. Frame'and Flashing f; C/3l/s� OA 76. Dry Standpipe 28. Lathing&"Siding: /i 0 / `/ 77. FIXED SYSTEM FINAL • 29. Insulation ...1 78. FIRE PREV. FINAL )A-iLQ'f 1,:k\ 30. Drywall Nailing. { I HEALTH DEPT. REQUIREMENT ri.J4 Plaster Brown Coat' :' 79. FINAL INSPECTION 32! Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33'. Final Electric•‘.:!,,l) 4 • Notes: 1 34. Final Heating & Air Conditioning HOLD FOR SPECIALSPREQUIREMENTS-;IR/ /' ,�t� 35. Final Gas Pipe-Test _ B/3 si' !'1`G, L�cce�i -t f�i23-t i6iiit .+J)° 36. Hood or Canopy /,l JeL1 37. Final: actor Fireplace '�/'(/ 38. Final Plumbing ' ` / 39. Water Service-Final ! 40. Gas Service-Final C; 41. Solar Domestic-Final %.`. 42. Backflow Preventer , -in 43. Backflow Irrigation • A 1, Ir 44. Landscape Irrigation System {Pr Pr 45. Sound Attenuation; !J•µ.- • 1 .'t; 46. Handicap Regulations • • - 47. FINAL STRUCTURE & BUILDING 4)9/.9y 4l4 r , 1 48. Special Requirements Completed ‘,2•/g-g .'i 49. Electric Release to Edison . {- , 50. Gas Release to Southern California Gas Co j' �'% 51. CERTIFICATE OF OCCUPANCY t - No. Date 4, • Applicant to fill In all spaces except those within heavy bora all appropriate declarations. !- PERMIT NO. TRACT NO UNIT NO91 / CITY OFCOSTA 17'7 CONS�RU,�CTSQ PERMIT � s,� Es s-oat X77 l /y/.� /A.P.# 14.2.5— 234.— /T IZone Project Address•• �3 n/ l7 I`� L CJ. , -ILI ,, o✓ s Main Building: Accessory Building: Applicant's Meiling Ad rens 18 Z Z J/Z- - N'eGopeg / u,r TYPE OF CONSTRUCTION F EW MI ADD LJ ALTERATION LJ REPAIR E _ - Z ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front O Owner's Name ") ��� BE2L � Phone�'SO��/'� 8 - N -,t, DESCRIPTION OF WORK/USE OF BLDG. I Rear Addrel; U617- I'�S^2 Z �I2�-QN-�w/x'�� az- , - 3 O j A I Arch/Eng. U�`NI •7,-F hl'o4-ip License No. TYPE OF PERMIT LI U GRAPING II��❑Dy FOUNDATION LI STRUCTURAL ' C Right N Address /Ca 70 — C-- 4 , a-nsi.. ❑ TENANT,. ELECTRICAL YJ,PLUMBING I�MECHANICAL $ Left G Contr¢actor's Nama 131__� ./5"/Z-L Phon 65o / ❑ OTHER I Ping. Ref.# Parking Req./Provided R E Address(mailing) 4l' Atc___, PROJECT DESCRIPTION SQ. FT. OCC UPANCV Planning Notes: M CONSTRUCTION TYPE VALUATION$ CityLicense No. T ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION ���/// S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ,� Q Z 1 with section 7000) of Division 3 of the Business and Professions Code, and / i+/ my license is In lull force and effect. ELECTRICAL FEES License Class License No. - Dat¢ SignaturePLUMBING FEES Automatic Washer Transformer 0 15-50 KW "" I KERS'COMPENSATION DECLARATION IBar Sink Showers Construction Pole Sub. 0 50+ KW 'eby affirm that I have a certificate of consent to self-insure or a certificate d Yorkers' Compensation Insurance, or a certified COPY thereof (Section Cooking Unit ' Meter �up to 100 amps ' 0 :sa00, Lab. C.) v Backflow Preventer �_Service Sink — Policy No. Company - Backflow irrigation Sewer Cap Dishwasher - Meter p over 100 amps B Certified copy is hereby furnished. ' Certified copyls filed with the city Building Division. 3 Bathtubs • Sewer Connection ! Orr Dryers OGas ❑Electric / Sub Panel �/' QO Date Applicant - L Fan L EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers Solar Collectors Motors 00-1 HP 011/2-8 (This section need not be completed if the permit Is for one hundred ($100) or F.A.U. Inc.Solar 09-15 HP ❑16-15+ less). / Dishwasher _ Solar Pipings_ . I certify that In the performance of the, o k forwhich this ermitpppi issued I, - Fixtures Microwave shall not e loy'a person in any ann r s as to dna su to the Drinking Foufiteins Solar Tank Worker q Pon • ws of Calif rola ( Device Boxes Date _5_ yC �aft making deure Floor Drains Swimming Pool w/Spa I Pole Light NOTICE: f,aft! making this declared , you should become subject to the `z Outlets Range Workers' Com ensation provisions of he Labor Code, you must forthwith Floor Sinks Urinal / g comply with such provisions or this permit shall be deemed revoked. - / L Switches CONSTRUCTION LENDING AGENCY / Gas Service Outlets 2 3 Water Closet $e0 2 Sign I hereby affirm that there is a construction lending agency for the performance Garbage Disposal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors / Water Heater t1•0 g p Standing Sections i Lender's Name Lender's Address / Kitchen Sink / Water Service 41-0--0 ^^ Generator 00.5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION {- I hereby affirm that I am exempt from the Contractor's License Law for the 3 Lavatories r Auto-Wash T 00 following reason (Section 7031.5 Business and Professional Code: Any city or - 1 county which requires a permit to construct,alter,Improve,demolish or repair P-Trap / Laundry Trays 1.-•e7n any structure, prior to its issuance, also requires the applicant for such permit . to file a signer' statement that he/She is licensed pursuant to the provisions of Roof Drains Contractor's License Law(Chapter 9(commencing with Section 7000) of i +p inion 3 of the Business and Professions Code) or that he/she i5 exempt Reinspection Fee ! $15 Issue Foe $ a- 60 iefrom and the basis for the alleged exemption. Any violation of Section •.r31.5 by any applicant for a permit subjects the applicant to a civil mnalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: U I, as owner of the property or my employees with wages as their solo Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By Date compensation, will do the work,and the structure Is not Intended or offered - -- - - for sale (Section 7044. Business and Professional Code: The Contractor's MECHANICAL FEES • Building Approved By `Ai A. Date A License Law does not apply to an owner of a property who builds or improves • �—S • thereon, and who does such work himself/herself or through his or her own Application Issued By ,���..,IargG__.�• Doh employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 •� s _ sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ SUMMARY OF FE'.' pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of Sale). . BUILDING PERMIT $ SMIP $ • ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • PLAN CHECK $ PERMIT tractors to construct the project (Section 7044, Business and Professions Code: - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU .PLUMBING $ b S •00 ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ Proof off their Worker's Compensation insurance should be provided to me. ELECTRICAL $ yyrsrV GRADING S ❑ I am exem under Section : : P.C or this reason Firepl/Fact.Blt. ICBG# Fire Dampers , PLAN CHECK 50% $ MICROFILM $ Date ZG - Owner . �� 111Heeating System& Ducting Registers MECHANICAL $ "' 1.-00 I�3 . I hereby ertif that I have read th application and state that the above I 0-100,000 BTU 0100,000 BTL �� TOTAL FEE ' $ 50 inlormati n is c• ect. I agree to comply with all city and county ordinances / t • PLAN CHECK 25% $ and state laws el.•ing t builds onstru on, and hereby authorize repre- sentatives of his Ut t ons pon ove-mentioned pr••arty for inspection Pu pos- r/ • Signature / D.te / '-- ID Drivers' Licen-•-or SS# �� -� Reinspection Fee $15 Issue Fee y 01 0003344'.-,r[0389U4 Y41 lT 0865-46,rev. 5/88 White - Building; Canary • Applicant; Pink -Accounting; Goldenrod - Assessor 111 DATE: 07/2i,89 TIiiE: 10:37 __ ik—_ • d'ONSTRUCTION AND PLANNING PO 1 SPA APPROVALS, Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location ___t 2.,SCiI Pipe-Undrgrnd. 7/,Vn,„ r 53. Steel Reinforcement ' 3'Electrical-Conduit Utility-Undrgrnd. 'en' 54. Forms t� 4. Electrical Conduit,Undrgrnd. 55. Electrical Bonding 5'. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6,. Electrical (JEER Grnd. 57. APPROVAL TO COVER-GUNITE - T. Footings. , i 58. Electrical Conduit-Undrgrnd. 1 81 Foundation - ' • ., 59. Gas Pipe, 0 Undrgrnd., Test p 9.' Water Pipe-Uridrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System / - 61. APPROVAL TO DECK - : ; ✓'i' r 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final /. ._ r_' 12. Sewer Cap r • i 63. Heater & Vent-Final 13! Roof Drains r . 64. Plumbing System - Final / 14. Rough Plumbing; 41-ltle1 (,,/p 65. Electrical-Final j 15_ Rough Electrical-Conduit _ 66. Solar Sys 18ct4tem-Final : Rough Electric Wiring 5/3/A ///fff 67. Fencing & Access Approval 1'7! Rough Wiring Sign � 68. APPROVED FOR PLASTERING ! 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 119. Rough Heating & Air Conditioning /4/44 ( FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21�. Ducts, in Structure 70. Underground Hydro 1.22. Ducts, Ventilating era. 711. Product Piping U Gas 0 Oil • 23. Gas Pipe-Rough & Test (7„l 72: Underground Flush 24. Roof Framing (,/ 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25j -Bar Roof Sheathing V 74. Overhead Hydro - Ceiling (Structural) &<Monocoat 75. Dry Chemical , Frame and lashing 76. Dry Standpipe 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 0a:S'C19 ,/ r 80. FOOD;CERTIFICATE ISSUED 1- r:1 33. Final Electric -2-QQ pa, Not): tyi. r 0AT. el/ .' t 34. Final Heating & Air Conditioning /,4%r ;�j/1"G '' •i. 7,2..S-Y, 72.4A1 tom- t 7 1/2CGer er.t•w 35. Final Gas Pipe-Test AL-7-1- Y/,�� �� / F rJ• "��A _A e 20 - 36. Hood or Canopy !-p/• 4.49'4 / '�� !Ll jft��iG A� 6*^ �/J 37. Final Factory Fireplace •/ v/a s-Sv NcELS /-Ai eAttic /($.1( X38. Final Plumbing /i%7 ���i�L 39. Water Service-Final . • 'J 4 '40. Gas Service-Final . - -I .41. Solar Domestic-Final S, t 42. Backflow Preventer - ,_ -9.4 1r 43. Backflow Irrigation 44. Landscape Irrigation System '-N. %i- 45. Sound Attenuation /,' y 46. Handicap Regulations - �j 47. FINAL STRUCTURE & BUILDING r 48. Special Requirements Completed ' 49. Electric Release to Edison t.. - 1 50. Gas Release to Southern California Gas Co • 1i) 51. CERTIFICATE OF OCCUPANCY t-I1 PC! ,� No Date •v 6 i+ Costa Mesa Building Department APPLICATION FOR PERMIT P. O. Box317 ;49q9 " BU " DING 'tOSTA MESA, CA' 'MIA - '� h. FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN„ 1 Receipt No. 1 P rmlt No. Building �7 � '% ii -3 9/_ 0 Address P 7 / l'-1 Div ' .. i. . (!� Costa Mesal, California Receiv d by Iy Date Recd. Date Issued (-y Nearest r� /� .�i g k-/6 ' t ����&-c Er Cross St. 7 ,/,/..,U y(J (l(//j,(�/ Buildi g Address OwnerO,L(,p�(�'.La ti-.441. -a'�, Costa Mesa, California Mall /7� j! �) 9�-�. 9 Nearest ACross St. rchitect("Ctor 72 , '/1t�/ tic. IN�' /" Zone b . I Plans No.of I Type .V Group Engineer No. — Approved V by 1242,_ ccc www Address (,fal:. � 1\ City Lic. f Contractor No. �`� '', CITY OF LUSTA MESA .........."----C) Address /7'7 Q tz_77E.. ��' PLANNING D M. Legal DE VI.I Lot Inn I SUBJECT ID RI nr. D �'T. REC. Description No. Block tC.� I Tract 377 � (Attach Metes and Bounds) ,,/7 — /2 4 —2b— f� % Z �.,No.of Bldgs. BY DATC�f �.J Size of Lot 157,3 %,3J•VK Nowon Lot / PLAN TECH. / / , Use of No.of / No. of XI Existing Bldg. 4,1,/e Q,,,I,Gr J Families I Rooms ' EX Setback Line fr • Rear Yard S , 2 Center of Street r�/ '��+ tyt,Side Yard . DESCRIPTION OF WORK /R r New I `i Alteration I I Addition I (- Repair I I Moving I I Demolish I Building , No.of Size �G - I p Rooms / Stories / .p Exterior Wall Roof Covering °t p y �{_ Covering `L mtnt t. APPROVALS I BuUse ildof ing w t .44t4/ Foundation Location Inspector Date Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts N I hereby acknowledge that I have read this Applibation 0 and state that the above is correct and agree to comply Lath. Int. o with all City Ordinances and State Laws regulating Al building construction. ) Lath.Ext. Signature of x-17 _ _.t/� /�^� '�--" / , Permittee //�/ I�G�'Lf KJ �(��D-p'� Plaster, Int Authorized Agt. Plaster,Ext e Valuation Permit Fee $ �t - I Masonry Reinforced 0. {` • • Plan Check$ Bond Beam $� Total o Fee $ FINAL o �oRM los 10.35 0.P.a 5. 111 ,tu - V. d ✓ u J C a O 6 0 0 a. • • • Street PLOT PLAN Show location and distances from property line and between buildings. VI ty 7. G I • Q 0 `! .- r ` I � PAIL ,' } /...”(r1}20 au . .is 17-77f. -:00103..' 4 .171 1 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 RE I V D BY DATE R CEIVED O•• ISSUED s BUILDING rf (Ci}�-�. C� t � '71 .7 — A I /�'. C``, p R 1 / lI P�Cypy�yp�Jj OWNER �EW 1� t IASSUED - 77 V7.2-2/�/�7 ADDRESS VA-✓- t (Y ADDRESS / 77 /1 /%Q�/ C TEL. _ toec TRACT 7 led �CLI_70•(73J BLOCK CITY NO. `'�7, f,](7 CONSTRUCTION _ • NEW [gPALTER IREPAIR MOVIN(; DEMOI ISCL _ LENDER BRANCH OWNER ADDRESS dr / I VALUE ARCHITECT TEL.— E i r / ' $ i// OR ENGINEER ♦ a' 1 ../ •• — — t ( FIRE411 ADDRESS I aao .1�C al l ZONE /TYPE , GROUP APPROVED ��/�.I f_ 72/7 CONTRACTOR •� �t�, BY '/�//WET DATE G ADDRESS b 3o I a C-Qcie Hj4-w /2-1/4,461 'n- ra \ TEL ZONE/122._ USE OF NEW/'CL C� /� CITY {l A. "ej(�/� NO,-Aa1 `( y PLANS, BUILDING . _..• !�� `-rcti .H. STATE s� 1 CITY YARDS APPROVED YARDS APPROVEDPP' /" LIC.NO. &2j y I I LIC.NO. MAIN BUILDING A ESSORY BUILDING 93 SIZE NO.OF BLOCS. (FROM C/L STR ) o. OF LOT NOW ON LOT I FRONT a O r FT. cfs Q USE OF �'Wim. R. /r/ EXISTING BLDSID e2 FT.' G J FT. VS1 F Separate permits are required for L,SIDE (2 FT. FT. electric,plumbing and heating work. CW WREAR C W FT. FT, f.. USref BUILDING AND WORK TO BE PEREOpkED DISTANCE BET. BET.MAIN& xt 4 l0 Cr)0 I ' c, fzrt 15 KEGS. BLDGS. ACCESS. DGS. VAR.# DATE I C L3t'V I1 I ��'b/ C.U.P,�S APPROVED AP APPRDVSC 3/7- 77 / A. ,,,,otic_.--DAZE ceW a 0 1 hereby acknowledge that I have read this application and state In n Cg that the above Information Is correct and agree to comply with m M all laws regulating building construction, and I shall not employ i Z any parson in violation of the workman's compensation laws of m SSSW the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses aro in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from the provision of theState of California Business 'O VALUATION PERMIT FEE $ v end Professions Code,Division 3,Chapter 9. l p--� m a m PLAN CHECK $ m Signature of /n� o / Permittee F 9/_ / ^— TAX $ •� 1- J Authorized Age ��"� 610U TOTAL PAID $ • eke J , COUNTY OF ORANGE • - ,f1 [,y ' BUILDING DEPT. Permit No..._ -.V...`:... 636 No.Broadway Application for Building Permit • Santa Ana,California Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy • kDate 2 i2.... 4 . 196a 1. OWNER'S NAME FLOYD V. and r&ia .L,Jana. • PHONE• - MAILING ADDRESS.......1626., Ne.4Ipart._laid. • CITY CQSt.a..M.esa....Ca e. Name none. Name O.amer — Builder (Architect or Engineer) (Contractor) . • Address — Address ...16-261....IIevport---$1vti.. CityCity, Coates__Mesa.....Calif. State . State none •: — Lic. No Phone Lic. No Phone PROPOSED USE• • Private Residence. & Garage 2. JOB LOCATION 177, 19th Street. . , Costa Mesa. Calif. . (House No.) - (Name of Street) (Town or School District). 3. LEGAL DESCRIPTION: Lot a. Block • U • Tract, 377 (Metes and Bounds Description—Use reverse side of form) )( 4. CORNER LOT ( ) INTERIOR LOT ( 8 ) THROUGH LOT ( : ) SLOPE OF LOT ( ) 5. SIZE OF BLDG - 47' 8_..24' AREA- 1128...ft....SIZE OF LOT• 57.5_-X._y5q12SEA. \ 8625 6. HEIGHT OF BLDG • app ro.X...a.a.tC" CEILING HEIGHT- 81o" NO. OF STORIES 1. 7. NO. FAMILIES • 1 ' ' Size of Smallest Bedroom:..12-.22.1!8111-0 Size of Kitchen.._.9.Y..o°81.0' 6" 8. EXTERIOR WALL CONSTRUCTION:....atucco, INTERIOR WALL COVERING ' Plaster (Frame, Stucco, Etc.), • (Plaster-Drywall,Etc.) ' 9. SETBACKS: Front Yard From Center Line of Street 5z; D o Nearest Side Yard 5 t o" Rear Yard 1021 Distance in Feet Between Bldgs. on Same Lot none •10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width 14" Depth in•Ground 121: Width of Wall ---- ce ory SI s. and Si lar (b) Size of Studs:....$ XU4 Spacing 16. "CC Material of Floor....doncxetB a Structures: (c) Size of Floor Joists- -- Spacing — "CC (d) Size of Rafters 2 x i6 Spacing_.24 rr -CC ll 12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $..9a.0.Q0 t 1 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS _ .APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA ��AIlPPLICA�BLE THERETO.� R� 7sSigned-Cf4...../ll; 1 /( - Plans Filed ' ' (Owner) By• I (Authorized Agent) FOR DEPARTMENTAL USE ONLY • FEES: / ING BY Bldg. Permit - $ / 7,C 0 GROUP - -'�/I-d� APPLICATIO CE. HEALTH Plan Check - $ 3_ ..i? TYPE +.fa; ZONING /tji__ FIRE Total • - +- $ it/ ep.Q.Q DIST. / PLANS AND ' MARSHAL Receipt No. P/c ...Q>.Y MAP /[ � SPEC'S A STATE • Paid to - - .. .... .� SHEET NO....✓ CORRECTIONS ENGINEER Date 5S.'" "I' . VERIFIED CAL PERMITISSU),D : INO E COUNTY BUILDING �Yr� (/ .- r NSPECTOR DATE {J / -...5- ,,.,r J ,. 4: ., 5 M-B-•vt 1I METES AND BOUNDS DESCRIP""7N: ' 10 i 2 0 3,0 4.0 5,0 6110 L iLl_ I I I I_ — — —j_ I I I mmnim 1IIEIEjEP!lil_:En__ ii --_- ii_!E!Ei, .11 ....1.. 11@@ - ■i _ ====111111I■ ■ ill,_ i - 77 mmil . o ---Pfl9III1 :iI i ��=■ ■i i ■ L -In:At III- 1 .1 . i =a • ___ tilulilil:::::::::: i ° -- - I iI�■i rr - 1-1 r il i i = - i ..11s . , L[-H- ___ i ■ '■•�=iI -■1 -- - _ -' i L ■■■■1�i i _ i�� ��f -EL. MO 11..1-- U _■ _ . I I ■■■1J■■■■om■■ — ■ir 11 ■n ■■■■11■n -_ ■ ■■■. . ■■■ II_i1III1I i 1- i _ i■i■■ ■ . ___ =__- i i - i � nl '1E • __ -- u ■ i ■ i. � � i = -' � _ _H Ilia _iiI 11111111111111 ii� ■ ii11i ILEII � ■ i iii -- U. I ' i 1i _ - .i - ____ __ ■I ■ii •i -- -iI = r -__ i�L- IIIi 1177 F--__ 1 MO i ■ - -i. I i _ - ' ■ ■ -- ■ 1-LEI L__L ■ -- =� i- -- rim , � • II LLLL r-L ■ II ----=-L I - -I ■ ■-- I_LLI LLL ■ ■ - - v --� •- i- --IHI I-i;= I -f ( ■ of I I ; Ell ! I I • I I -T