HomeMy WebLinkAbout320 19TH ST - Building Permitsl►
0
PN0.IECT POONESS: 3'1 O E 1 9 TH ST
� OWNEB'SNAME:'�•HAGARD ROHF.RT WILLZAM
ADDPESS: 3 � O E 14 TH S T
COSTA MESA,CA 92627
RNCN/ENGINEEN: � S S—� 3� y qEG.NO.:
ADUPE55:
uxrt:
UNIT:
PE"miTTEE: FAIRWEP.TAER ROOFLNG ( 714 ) 997-•9449
anoeEss: 3845 E. CASSEiLF. AVE `�
ORANGE CA :'32669
LICENSEO CONTBACTOfl UECLABATION: I hereby allirm �ha� I am licensetl untler pmvisions o� C�ap�er 9(commencing with Section
7000� ol Division 3 ol ��e Business an0 Pmfessions Code. antl my license is in lulliorce antl efiect.
ciTruc.: �gzg STRTELIC.:SLSSZSnQ���'S�i�-39
Oate: � ��N 1 Si9namre: �-^��%j �f r^_
WOflREBS' COMPENSATION DECNBRTION: I hereby atlirm Iha� I have a cenilicaie oi consen� ro selbinsure ar a certilicat¢ ol Workers'
�ompensa�ion Insurance. or a c¢rtilie0 copY �hereol (Sectian 3800, Lab. C�.
-oucrNo.: 1042600-90 E%P.OPTE: O.LISOI92
� camrnxr: STATE FUND
� Cenifietl apy is ItereUy furnished. � CenilieJ copy is fnileE w�i�h �Ihe citAy B�uibing Division.
b/ C ,�/' -/�// /�y
Oate: �( // NO�Iitani: 1�/" 1 M !! �
E%EMPTION flOM WOBNEflS' fAMPENSATION UECUPATION: Qhis seclion neee no� �e compl¢teA il the permi� is la one hunUreG �5100) or less�.
I renity t�ai in the pedormance ol Ihe work for w�ic� I�is permi� is issuetl. I shall nol employ any person in any manner so as m became
su�lecl lo I�e Waikers' ComOensation Laws a� CalilOmia.
Date: Signa�ure:
NOTICE: I�. afler making this declara�ion, you 5�au10 become 5uble�� �o lhe Warkers' Compensa�ion pmvisions of Ihe labor
CoOe. you must lort�wi�� comply wit� suc� pmvisions or �his permi� shall Ge deemetl revoketl.
CONSTflUC7laN LENUING RGENCY: I hereby alfirm ihat Ihere is a conslruction lentling aAency for ihe pedormance ol ihe work for
which Ihis permit is issuetl (Section 3097. Civ. C�.
LENOEN:
pODNE55:
IOWNEB BWLDEB DECtABATION: I hert0y allirm Ihat I am exemp� Imm tAe Caniractors' State License Law for the lollowing reasan
(Sec�ion 7031.5 Business and Pmiessional Cotle: Any ciry o� caumy w0ic� repuires a permi� lo conSlmci, atler, improve, tlemolis�, or
repair any stmcmre, prior �o its issuance, also repuires ihe applicant for such permit to lile a signe0 statement that he/s�e is licenutl
Oursuani io ��e pmvisians ol ihe Conlractars' State �icense Law (Cnapter 9(commencinA wit� Section 7000) ol Division 3 0l t�e Business
antl Pmlessions Cotle) or Iha� he/she is exempt (here�mm an0 Ihe basis �or lhe allegetl exemplion. Any uiolation ol Seclion 7031.5 by
any applicant lor a permit suDlects the aDPlicanl to a civil De�alty ol nm mare I�an irve AunUreO Oollars �5500�.
I. as owner of Ihe pwoeny or my employees with wages as t�eir sole com0ensation, will ao tAe woB, and the
,❑ stmcmre is noi inten0etl or ofiereG for sale (Section 7044, Business ana Pmlessional CoAe: The Conlractors' State License Law
I does nol aDPly Io an owner of a praperiy who bui105 or impmves �hereon, an0 who tloes such work himSelVhersel� or �hrouAh
�is or her own employees. O�avidetl t�a� such impmvements are nat intended ar oflere0 tor saie. If, �owever the huil0ing or
improvemeni is solC within one year of comnletion, �he owner vnll �ave ��e burCen al pmving Ae/s�e Uid noi Um10 or impmve
� , lor Ine ourpose al salel.
I, as owner of Ihe propeny, am exclusivety conlracting wi1M1 Iicense0 coniractors lo conslmct ihe Dmle�� (Section 7044, Business
❑ antl Pmlessions Coae: The Contracmrs' SIa1e License Law tloes nol apDly lo an ownerol property who builtls or impmves thereon
an0 who comracts lor such pwiecis wii� a comractoqs) license pursuant to t�e Coniracmrs' State License Law�. I am aware
Ihal proo� o� Ih¢ir Warkei 5 CamDenSaiion insUrante S�oUld �e pmvidea lo me. �
� I am e�empl untler Seciion: 8. 8 P. C.
for Ihis reason:
Oate: Owner.
I ao hereEy cenily Inat I am aware ot anA undeRlantl Ihe reQuiremenls ot Califomia Healih anA Safety Cotle Sections 25505, 25533, an0
25534 an� Ihal I or any lulure builtling occupaniwilllwill no� (circle one) neetl�o comDly wilh said state cod¢s and�he reQuiremen�s�or a
p¢rmillor conslmciion o� moAilicaiian Irom t�¢ Air Oualiry Management Oistrici. Fesiden�ial constmc�ion applications are exempt Imm
II125¢ pt0Vi5i0115. �
�aie: Nppiicanl:
I hereby cerlily Ihat I have read Ihis applicauon and sia�e thal lhe above information is correct. I agree Ia comply wit� all cily antl counry
o�0inances ana slaleiaws�elaling�o Ouiloing con5iruction an0 herebyaW rize re resen�atrvesollhis cilylo enleruponihe aUove�men�ionetl
pwperly lo� ins c�ian Ourposes.
�ale: J�� / Sgnalure'. � �
I Ori�er's Litense or Social Secunry p: .
16aLa6 Wni�e—Bwltling: G�een—�e Enlorcamem; Canary—ApplicanL Pink—Revenua; GOltlenroE—Assessor
CITY OF CQS'I'A MESA - BUILDING PEr-iMIT
PERMIP NO: B 051529 PLAN CHECK NO; N
CONSTRtICTION TYPE; V-N PERMIT TYPE; STR
PERN, NO; H 05152_
GOVT: N SUPP; N `
PJRPOSE; AI�T
JOB DESCRIPTION : T/OFF REROOF W/ COMP SQ FT; 3,745
CLAIM VALUE; 3,745.00 CALC-VALUE: 3,795.U0 GROUP OCC: A-3 /
C'OMMEN'TS: T/OFF REROOF W/ COMP
iE �lE iF �)t �ff jf �IF�IEiF 1E-�d(� iE iE i4 iC� iE iE if �Y? lE �tE �� �lE �1E �iE �Jf �k 9E iE iE-IE �lE iE iE if �lt if �lE iE # 1F �lE dE jf �N dE df iE iE -7F iE �IF �1E �k iFdE iF 1f dF dE�)f jF #�� # iE �1E iE i(�# �1f !E �Y, k iE M i( iE
'I, O N I N G R E Q U I R E M E N T S
s E z• s� c x s
------------ MAZN BiJIiDING ---------- --------- ACCcSSORY BUIZ�DING ---------
FRNT: rT IN REAR• FT IN FRNT: FT ZN REAR; FT IN'
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REp • PROV: PARCEL: 92629115 ZNE: REF NO;
PLANNING NC)TES>
i
iE iE if�if �ElE dF If iF iF )f �If iF iF 1F !f K• �f� IF 3F ib %� 7E iF if IE 1F f(� 1F iE 1E if if Y 1E �)f ik iE IF iF iF if iE �lf if 9F ii� fE IF 1F �l(� �IE If if IE !f IElFiE % Ik IF IE if 1f� iE 1F fE lf iFlE if if if if iE K� iE 3F
D E V E L O P M E N T S E R V I C E 5 R E Q II I R E M E N T S
ZONING APPROVED BY DATE:
BUZ'LDING APPROVED HY ;
APPLICATTON ISSUED BY:
if iE M iE IF #F if fb ie f4 iF ik K� iE iE jE !E ��f iF IF fk
iF 1f k ii� If iE i'r 3! fE IE 3E iF K� iF iE iF if % IE 3E iE iF ib if N-iE iE ib if iE iF if if iF�f !F if
LEGALIZATION:N F E E ,
BLDG PM3 PLUMBING
DATn:
DATE: G ¢�
. ���+�**u•��� �... *�
!F iE1E�lElfitiFifif�iEiEiF�E%�k1EaEi(�jFiEiElFaE3FifiFlcY.�ifiFif'uifi(-ifiF�lelEii?F*
J M M A R Y STRUCTJRAL SEGNEN?';Y
I(: MECHANIC FZRE SMTP/RES�� GRADING
PERMIT 63.OU / 50
� SMIA/NUN-RES
ISSUE FEE y
BiJILDING-DIV-> PERMIT ISSi7E Pi,AN-CiiECK TOTAL PAID DUF.
TOTALS----> 63,50 0.00 0,00 63.50 63,50 ,00
REVENUE DIVISIO,1 TOTALS--> COLLECTED; 63,50 OVER/SHORT; ,UO
HLDG PMT PLUMBING ciECTRIC MECAANIC FIRn SMIP/T'nT GRADING PiAN-CiiECK
63,00 ,50
iE iF iF dF #�Y if if iF iF ie if if ai-iE � iE fF iF iE i(� iF 1F 1f %iE iF �)k iF lf 1f i!� d'r aFiF dF 3F IE iF iE )f iE iE aE if iE 1f IE iE'f �lE iE aE ii L� IE If iF iE if if iE if iF 1E 3E iE 3E iF iE if ±F 3E if 3f iF iE iFif•
I N D I V I 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 CnST TOTAL CUST
SFR �45.�a^ E�F VALUE RESIAENIAL NOZONE t.QO ,•3,745.00
� END Or^ FEES
� � �IpR 0 11g91 .
�a�r �� cosrA � . \ ,�
��V
CONSTRUCTION AND PLANNINo _
APPROVALS Permit #
1. Temporory Eiectrical Service or Pole ,
2. Soil Pipe-Undrqrnd.
3. Electrical Conduit Utility�Undrgrnd..
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement _
6. Electriwl UFER Grnd.
7. Footings .
8. Foundation
9. Water Pipe-Undrgrnd. -
10. Structural Floor SYstem
11. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains
14. Rough Plumbing
15. Rough Electrical-Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Condi[ioning
20. Rough Factory Fireplace � : -
21. Ducts, in_Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing -
25. Roof Sheathing �
26. T-Bar Ceiling (Structural) � Monocoat
27. Frame and Flashing .
28. Lathing & Siding
29. Insulation � �
30. Drywall Nailing
31. Plaster Brown Coat �
32. Electrical Power Meter�Final
33. Final Electric .
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test
36. Hood or Canopy •
37. Final Faaory Fireplace
38. Final Plumbing �
39. Water Service�Final
40. Gas Service-Final .
41. Solar pomesticFinal
42. 8ackflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cn
Date
Date
�
�
rJ0' 3PA
Inspector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing SYstem - Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
- � APPROVALS Permit #
70. Underground Hydro
- 71. Product Piping OGas ❑Oil 1
. 72. Underground Flush } �
73. 'Undergrnd. Storage Tank O Gas ❑ Oil; ��
� 74. Overhead Hydro �' '
75. Dry Chemical
76. Dry Standpipe ��
� � 77. FIXED SYSTEM FINAL
. ��
Date � Inspector
� 78.-FIRE PREV. FINAL ' -" � .'
HEALTH DEPT. REQUIREMENT
79. fINAL INSPECTION
' 80. FOOD CERTIFICATE ISSUED
Notes:
_�
�
+ � i 3?_6 �nri Z�-�cP"—I°oo ��6 ��**�5.00
crasr,
COSTA MESA BUILDING-SAFETY DEPARTMENT
� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant t0 Fill in Completely APPLICATION FOR BUILDING PERMIT
RECE. ED D l
BUILDING � �/'1 T ,
ADDRESS L/ �
OWNEP A.P. NO. �
MAIL �� � BUILDING
ADDRESS I ADDRESS � p%[
Z .
W W TEL. TFACT ��
d U CITY NO.
zZ W AD
Q CONSTPUCTION �
O N LENDER �
am
J � BRANCH
J N OWNER
� J ADORESS `�
J Q AFCHITECT TEL. A� S
N OR ENGINEE N . �T
V Q ' PIRE
W � ADDRESS ZONE "/ T
�- W APPROVED 'A�
J O CONTRACTOF ' _ B�' /��
m Z �
J � ADDRESS � �
W W TEL. ZONE NO.OF �
Z= CITV NO. `— P�� J
F
W � STATE CITV �'ARDS APPpOVED
(n CL L1C. NO. LIC. fHO. MAIN BUVLD{NG
7� SI2E / (� I NO.OF BLIX'>S. IFROM GL STREET)
� OF LOT � � NOW ON LOT FRONT FT.
USE OF �
EXISTING BLDG. T,
F 512E OF NO. OF
Z NEWBLOG. ROOMS STOFIES L.SIDE T.
a EXTERIOR WALL,.• ROOF
�% COVERING J COVERING I!�6CC REAF T.
J U OF BUIL ING AND WOPK TO BE PERFORMED � OISTANCE BE .
a MAIN BLDGS.
a
Q VAR. 3k
O C.U.P. �`-
r APF'ROVE�
y
Z
O
VI hereby atknowledpe that I 1+ava reatl this application end state
� thet the above intormation Is �orract antl agree to comply wlth
� all laws repulatin0 builtling co�struction, antl I shall not employ
F any pe�son in vialatlon ot the warkman's compensation laws of
y the State ot Celito�nie.
? 1 hereby cartify 2hat I am properly licansatl es a contrector untler SQ. FT.
ihe Stete of Calitornle Business antl Profealons Code, Divisicn 3, THE AMOUNT SHO1
Chapter 9, antl that such IicenSes are in full torce antl affect, or I THE PVRPOSE OF E5
am ezempi trom tha Orovisions of t�e Staie of California Business VALUATION
antl Professians Cotle, Division 3, Chapier 9.
SIB^aturaot /D� �
Permittee /� $
Authorizatl nt
i
VALUE
DATE
USE OF N
BUILDING,
BET. MAIN &
ACCESS. BLD
DATE
APPROVED
/N UNDER VA�UATION IS F(
ABLISHING A PERMIT FEE ONL'
..JtY�
PERMIT FEE $
PLAN CHECK $
TOTAL FEE $ �•�
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P,.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
, For Applicant to Fill in Completely — Use Ink Only
ADIDRESS ��D E l�T!'L ��s Rm�-s�,J�
_.,,,,�..�CNN/S 6.S��rtONSO.U^
MAIL
ADDRESS � �
TEI
CITV ' NO
CONSTRUGTION � /
IENDEfl p E
T
BRANCH
ADDRESS
ARCHITECT TEI
OR ENGINEER
ADDRESS
CONTRACTOR �,�/�J� I.6_Pr�f0.Cp-� (�,
TEL. �-�
CIT�y��� NO. J%,
STATE CITV
LIC. NO, 2�-'9��%� LIC. NO.
SIZE / / NO.OF BLDGS.
OF LOT .3p NOW ON LOT
USE OF
EXISTING BLDG. �
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED ,
I hereby acknowletlgo that I have read this eppllcoNon antl state
that ihe above intormetion is tarrect and agfaa to comply with
all lews ree��axt�e b�ildlnB construction, antl I shall not employ
eny parson in violation of thd workman's componsation laws of
tho Siate of Calitornla.'
I hereby cartify that I am proPerly Iic¢nsed as a contractor untler
the Stata of Califarnie Buslness entl Protessiona Cotle, Dlvislon 3,
Chaptar 9, antl thet such Iicenses e�e in tull force und eftact, or I
am axempt from the provisians ot the Staie of Californla Business
end Professions Code ivislon 3, Cheptar 9.
Sipnat�re of
Parmittee
Authorizad ABani
IduT I/I.li7�
�.:i�so� I / I'I /79
d�H07 00004478 65
�n�. – - - — _
APPLICATION FOR STRUCTURAL PERMIT
EC I DATE RECEIVED Dp=E�1 5�Eq
� � / �
A.P. NO. I� V`� 1 I �� 7
BUILDING� 7 .� � jn'
ADDRES <..L/ J
OWNER'=r
Sii��
FIRE
ZONE
APPROVED
BV
ZONE � �
T•-�,7 LOT ' BIOCK
iLTER P
'N/S �SQS/MO/.lSO.IJ
iN MiGHA�E�- 1�iER��/
VALUE
,OK ,i �• � 5 Ma
�'id C�
�
T PE GROUP
DATE
NO.OF USE OF NEW //V �
?L4N5 BUILDING d1 .
VARDS APPROV ED
DI5TANCE BET. '
MAIN BLDf3S.
VAR. 9W
�.�.P.� zE_
APF'ROVED /1 .
THEAMOUNT:
THE PURPOSE O
VALUATION
s ��0 BO
ACC
APPROVED
5�50 IL,.
5.50CATD
IA --`-
l:�/
n
m
m'
m
N
VN UNDER- VA�UATION IS FOR m
'ABLISHING A PERMfT FEE ONLV: �
PERMIT FEE $ � QO �
v�
m
PLAN CHECK $ ^�
0
TAX $ � sO �
U
TOTALPAID 5
��,
21568
CbSTA MESA BUILDING-SAFEfY DEPARTMENT
� P.O. BO%91] COBTA M89A� CALIFORNIq
For Appllcant to Fill In Complately
TYPE OR PRINT
DRESS � L � � � % � � � -
COSTA MESA, CALIFORNIA
� MAIL
E. /9�/
STATE TBL.
LIC. NO. NO.
OF LOT /� O� I No. op B�nae.
NO'
USHOF J�es
EXISTINO BLDO.
88TBACR LINB PROM
CBNTeROP8TPE6T � REAR
81D8YARD LHFT �X p�p{{7
DESCRIPTION OF WORK
�
■ E%TERIOR
ROOP
'6
I HlREBY ACKNOWLCDaB THAT I HAVe ftGO THIB APPLIGTtON
ANO BTwTB THAT TH! ABOVB 19 COHR6CT I1ND AOqBH TO COM.
PLY WITX �LL C�iY ORDINANCBB AND 8TAT8 I.hWB RBOULATINO
BUIL�INO CONHTPYCTION, �.L_
SIGNATUREOF � � �� ./_
PERMITfEF �Z�/�y/�L
AUTHORIZED A6ENT . .
FEE RFCEIVED
FEB 1964
FINANCE DEPT.
APPLIGATIUN�Fdk. PE�F�i'f
BUILDIN(3
For Offica Usa Only
eu��o�xa
LBML
-�S 6
A.P.NO. a�
NOTE:NOEAVBOVHRHANOHHALLBELE89THAN �
80' TO SIDE @ REAR p. L �
HAVES
ALLOWBD �U.B.C.REQUIRBMENT) , ^
YARD8APPROVED YARDSAPPROVED V�
MAIN BUILDIN� AGCESSORY BUILOINO
f FROM C/L 6TRE6f �
PRONT ' PT. �
R. HIO6 PT. F7. �
L.SIDH. �RT. FT. �
% O t� _ �- �
iiPJ1R RT. .
D16TA�
MAIN 8
VAR. �F
DATE
n
� SC. PI. ^
THE AMOUM eHOWN IINUER VALUATION IB FOq TN6 S
PYHP08H OP 68TABL18HIN0 A P6flMIT F88 ONLY. �
VALUATION � � m
PERMIT FEE $ � �
D
J� 0
g � !/0— c ec �" `o
/J C "
TOTALFEE S J /
.��' •;`� 2 I I I 3
COSTA MESA BUILDING-SAFETY DEPAR7MENT
P.O. BOX D17 COHTp MBBA. CALIFORNIA
For Applicanf to Fill In Completaly
TYPE OR PRINT
� STATE
■ USE OF
'IrS
COSTA MESA, CALIFORNIA
h-
THL.
NO.
.. � � �! � o /1 � I NO. OP BLD09.
DESCRIPTION OP WORK
FEE RFCEIVED
FINANCE �DEPT.
APPLTtATISN FbTtT'pElUJI1T'
BUILDINf3
FOI' OfflC9 �/f9 �n/y
I nscc�rt Ho. I r.ep� ,raq�
9ac-i } ! (
(i� � �.Z �.z ���3 . Td 88._t ��
OE /
ZONING
►� u-r �r -� T
EAV E OV ERHAN6 6NALL 6E LE88 THAN
EAVES
ALLOWED
YARDSAPPROVED
MAIN BUILDING
vwR. #
YAROSAPPROVED
ACCESSORY BUILDII
DATE
1 HEHEBY ACkNOWl8p08 TN�T 1 XAVB RBAD TNIB APPLIWTION 'MB �MOUNT 9HOWN UNDBH VALUATION IB FOP TXE
AND 8TRT2 THAT TM6 ABOVH I8 COqRBCT AND AOp88.T0 COM. PUPPo88 OP 68TABLIBNINO ♦ pERMIT PEE ONLY.
PLY WITH ALL CITY ORDIN�NCBq ANO iTAT6 I.AWB HiDULATINO �I/�LUATION O(
BUILOIN� CON9TFU -
PERMITTE E OF � � PERMIT FEE $��`
. . f��JI✓ G ECK O
AUTHORIZHDAGENT . /1 . _
�