HomeMy WebLinkAbout430 19TH ST - Building PermitsJob ndtlress: 430 E 19TH ST
Suite:
Yciniry: LIVING ROOM
PrimaryOcc: R3
Parcel Number: 42631114
Applicant: STEVEN JANOSIK
Adtlress: 1621 E ST ANDREW PL
SANTA ANA, CA
D6923436
owner: CLARK, WILLIAM D
Address 430 E 19TH ST �
COSTA MESA, CA
Type of Construdion: V-N
Zoning:
Phone: 714-259-5120
. Zip: 92705
i
Phone: �949-548-0317
Zip: 92627
ISSUED BV:
Contractor: DIAL ONE WINDOW REPLACEMENT SPECIALISTS
Address: 1621 E ST ANDREVJ PL . ,
, Phone: 714-259-5120 � -
SANTA ANA, CA � �
Zip: 92705 .
Arch :
Address:
License: 523043
Eng:
Address:
Status: ISSUED
Applied: OSN2/2007
Issued: 051022007
Phone: ' . � - � Phone:
Zip: , -License: - � - License:
SCOPE OF PERMIT -
RETROFI7 3 WINDOWS LIKE FOR LIKE (NO CHANGE IN HEADER) IN LIVING ROOM, SAME LOCATION. .
�
FEE SUMMARY `
Plan Check: $0.00 � •Calc Valuation: St,soo.00
Permit: $54.00 Claim Valuation: Si,soo.00'
SMIP Res: $0.50
SMfP Com: $0.00
Other: $0.00 ',,
Inspection: $0.00
TotaL•, $54.50 '
SETBACKS
MAIN STRUCTURE Fr�ont;, 0- 0
ACCESSORY Front 0. 0
PARKING Existin : o
.
. �' .
�,
Rear
� - '-Rear
� � _Re uired:
00.0. � Left �0.0•• Right 0;0 � � �
' �i :
0•0 ' Lefl 0.�0 " . � - Right.-�.0,0 '
0 , .Pr000sed: 0 . ' , �
"_ _ - . . . . �.` -
,
NOTICE: 7ha work aufhorized by this permit shatl comply with all applicable handicap access requ(remenis under Cali(ornia 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 ebantloned
br e period of 180 days.
INSPECTIONS: In order for lhe vrork authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Insp9ctions end finel approval must be obtained. Failure to oblain inspections and Iinal approval will result In the eupiratlon of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
zmaas la�ao)
WORKERS'COMPENSAnON DECLqpAnON: •
I hereby atllrtn untler penalry of perjury one of the lollowing dedarations:
❑ I heve entl will malntaln e caniticete of consent lo sell-Insure tor warkers' compensetlon, es pravidetl for by sectlon 3700 oi the LeDor Cade, tor ihe peAormence of Ihe
work for which Ihis pertnit is issued.
� I heve end wlll mainlain woAcers' cdnpensaUon insurence, az requlre0 by sectim 3700 ot the Lebor Code, tor Ihe peAortnance of the wark for which Nis permit is Lswed,
�-M"y workers' compensation Insurance certier antl poliq number are: ^� (� / _
Ceriier. E Poll� Numbec R R �O ` � 2S0 VJ
(Thls sectlon nee0 nof be oompleted I7 the permit 4s veNetl et one hundred tldlars (Sf00) a less.)
❑ I certify t�at in the pedormance of ihe work tor which thls pertnit is LssueC, I shall not employ eny person In eny manner go es lo become subject ro Ihe workers'
cornpensetlon laws at Cellfomla, !ntl epree tha� H I should become sub�ect to the worken' compensetion proNsions o1 Sactlon 3700 ot the Lebor Co0e,1 s�a0 forthwiih
comDly wlth these PreO' a�ns. (� ��y-�
Applicent Signeture: _ 7—� �Det� � � 2' '� /
i ��
WARNINO: FAII.URE TO SECUHE WOHICER$' 1PEN, iION COVERAGE IS UMAWFUL AND SHAIL SUBJECT AN EMPLOYER iO CRlAUNAL PENALTIES AND CNIL FlNES W TOpJE HUtl�RED
i/pUSAND DOLLARE R��.�). �N ADDRION T OST OF COMPENSATION, DAMFGES lS FROVIDED FOR IN SECTION 3'l080F THE IABOR CDDE, IMEREST, M!D ATTqVJEV'$ FEE$,
LICENSED CONTAACTORS DECLARpTION:
I hereby eXirtn ihat I em Iicensed under p oNsions ol Chepter 9(mmmendng wlih Sectlon 7000) ot Division 3 ol.lhe Business a d Prafeulons Cotle, end my Ilcense Is in lull
fofce� ettett. IJc. M '� �Cles�`M � ,
Oontr�rsSlgneture: e yy� A Date: �-Z��
CONSTRUCTION LENOING AGENCY;
❑ I hereby eXirtn Uat there Is e mngtructbn lending egenty tor Ihe peAormance ot the work for which this pertnit Is Issued. (Sec. 3097, Civil Cotle).
Lenders Neme: Lendefs Atltlress:
Slgnetura:
OWNER•BUILDER DECLARATONS:
Date:
I hereby eHirm thet under penelry of peryury Nat I flm EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Protesslons
Code: Any city or county which requires e permit to consWct, alteq Impmve, demolish, or repaG eny sWCWre, pnor to ifs issuance, elso requires t�e eppllcaN tor such pertnit
to file e slBnetl stetemem Ihat he or she is Ilcensetl pursuent ta the provlsians at the Cantrectors License Lew (Chepter 9(cammencing wit� Sectlon 7000) of Dlvision 3 of Ihe
Business and Protessions Cotle) or that he or she Ls exempt therefrwn end the basls for the elleged exemptlon. Any Wolatlon ot Sectlon 7031.5 by eny epplicant for e pertnil
suD�ects the epplicent to a cNil penalry p� �ot more then iive huntlretl tlollars ($500).):
❑ I, es owner o1 the property, or my employees with weges as their sde compensation, WILL DO TTIE WORK, antl ihe structure is not intendetl or oflered for sale (Sec.
76M14, Business and Protessbns Code: The Contractors lJcense Law tloes not appty to an owner of property w�o builtls or improves Ihereon, end who does such work
himself or herselt or through �is or �er own employees, pravided ihet such improvements ere not intended ar oNered for sale. It, however,lhe buildng or improvement Is
sold vrithin one yoar of wmpletion, ihe owner-builder will have the burden of proving that ha or she did not build or Improve lor purpase oi sa�e.). •
❑ I, es owner of the property, em EXCLUSIVELY CONTAACTING WI7H LICENSED COMAACTOiiS to consiruct t�e pro�ect (Sec. 70a4, Business end Professions
Cotle: The contrectors Llcense law does na� appty to en owner of property who Oulltls or Impmves thereon, and who wntracis for suU proled w�th e contrector(s)
license pursuant to the Coniractor5 License LBwsJ.
❑ I em exempt under sec.
Signature:
Owner ID veritied by drivers license. ❑ Yes ❑ No
Bu5ine5s Bnd Profo35i0n5 COde ior ihi5 re85on:
Vedllcatlon ai Ownership Dy (type ot tlotument, I.e. - pruperty tan Dill or Caetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Drivefs License No.
DetB:
Explres:
❑ I hereby cerfify (hei no excavetfon ftve (5) ar more feet tn depih tnro wh(ch e person Is requireA to Eescend, wfll be made fn conneclfon with work euthoAzed by th(s
permii, antl Nat no building structura, scaHdtling, falsework, or demdltion or dismantling thereot, will be more t�an Ihirty-six (36) feet high. (Chep. 32. Grp 2, Art 2, Sec.
341, Title 8, Celtlomle Administretive Cotle).
❑ As owner-Duilder, 1 will not employ enyone ta do work w�lU would require e pertnit trom the Divislon of IndusMel Salery, es notetl ebove, unless su�h person has e
permlt to do such work irom the divlslon.
Signature: Dete:
Dlvislon ot Intlustnel Sefary Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTNORIZATON OF EMRY: I certity under penelry oi perjury that I heve reed lhis epplication and state that t�e information gNen is
conect. I egree to compy with ell stete lews erM ciry ordinances relating lo bullding constructlon, and euthorize representatNes ol t�e Ciry o1 Costa Mesa to enter upon Ne
ebove-descnbed property tor InspecUon purposes. I egree not to occupy or ellow xapanry ol eny building euthonzed by ihis pertnit until final inspection.
COpE�. INSPECTIONTYPE p�¢ ��i
1616 Flxetl System Final Fire Preveniian
1288
200
Pool Spe Final
Finel Re-Root
201 Finel Bbck/Retaining Well
202 Final Faclory Fire Place
203 FIna151gn
204 Final Demolition
COUE I INSPECfION TYPE
206 Finel Mechenical
20B Finel Plumbing
210 Finel Electdcal
212 Finel Flre Pravenllon
220 Finel Planninq Approval
222 Final Site
250 Finel Building�Occupency
Date
�]�— ZrD�
� io'°� t�
�oonwaew�owa: 430 E 19TH ST
pYNER4WYEIFRlN1N: CL�K, WILLIAM D
.00x�ss: 4 30 E 19TH ST
COSTA MESA,CA
�vv�. wuu� �ooxEu:
ARCXffECTOXFN[91FEP:
ANCN.OF FNG.'4 NUXE55:
92627
uu xo.:
u�: CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 073766 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
JOH DESCRIPTION : T/OFF /REROOF W/25 YR COMP SHINGLE
uNr:
conm�cTarseu�e: WALTON ROOFING ( 310 ) 865-2796
COMHACTOASMNIIIIti 19918 NANCY CIRCLE
mm�ss: CEFtRITOS CA ucxo.: 358121
90701 urn:
LJCENSED CONTR1CTOfl5 DECLAflAT10N: 1 Mrsby ellim under peroly d pe�wy Ntl I em Iicm�mE uMx prwiebna W GAeqr 9
(cammarcin0 wilh Senion ]000) d OMisian ] d Ne Buv�wo ud PMaaaiona CaEe. eM mY liwnae u in hA fan xM eMaf.
cmuc.No.: Q uc.cuss: C39 uc.No.: 358121 E�X`P: ,
Dete: �+/I�/T `-' Comreeor. �/� �%� � � 1�/��_
OWNEN BUILDER OECIANAT�ON: I heieEy ��m undar perally d perjury ihel I em uemp Imm ihe CoMrapae Licenee law la IM
Idbwvq reeaon (SeGbn 1W 1.6 Buaiieaa eM Prdeeeiom CaEe: AnY cIY d couniY �� nVuirea e pertnn to mretrud. q11x. impma.
demdeh. w ropei eny eiiueWrq, pKK m X�'vaueMe, eLeo repuiree �he epplieent lor eueh permn to fJe e egmC eletemeni that M a eM
i litenfed W��I �a IM ptoNsims o1 IM Conl�edore Lioansa Law ICheqer 9(mmmeMi�q xn� Sedion )aa0) d D'v6ion ] d iM
�uaineas eM PrNneona Coda� rn Ihe� he m Ne is s�amq Ororehom eM iM basa Iw the ellpeE memqvn. My violaton W Sepion
n1�1.5 b/ enY eOWiunt lor e permC wEpd� �he epplicaM b e avil paneXy d� mwa then livs hurdreA doAen �5500�.
� I,a+ownerdiM1epropenyormyampbyeeaxihweB�a+iheieolecampenaeiion,willEOlhexwk.arMtheavuclunqndinieMed
w ollered iw eeb (Section ]014, Budrr» eM Prdeasians Code: The ConlreGon Limua lew Eoea rol apply�o an awiw d prapeily
wlw buida a inpovea IM�ean. eM Mq doee euN xqk limadl a MneP a Uvuq� he a Iwr axn amP�M�. V�detl �hel cuc�
Imw�eim e.. na vYadea o aneea �v m�e. n. nowew.. ine wiNu,p v:nw�em u edd �.nnin ma raer a candaun. me
ownerbader �w0 nm Ne WMan d pw'up ha a ehe did mi diN a hnpo.e ta IM W�pma d eebl.
❑ �. m owns. a �he o�P«�r..m sstl�w �wmawv wln Ycen»a m,o.m. �u canw�,a m. wd� (swun la.. eu.m.+.ne
Pmtesvms Code: The Laurecm L'pn+e lew Jma nd eGVN u en ows d puD�Y who buitk ar "unpw'm IM��on xM who
mnlrecb In wdi pqeeb wuh e aqtlratlala) Icenaed qusueM Io IM ConlreCps limrue law).
� I em eeemq uMar Secliqn; B. 8 P.C., la tAis reaeon:
PERM NO: B 073766
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT: 3,494
CLAIM VALUE: 3,494,00 CALC—C'ALUE: 3,494.00 GROUP OCC: R-3 /M-1
COMMENTS: 3 PLY HOT MOP ON FLAT ROOF / GARAGE INCLUDED/SMOKE DETECTORS REQ*'
iE1E1ElE1EIEiEiEiFiklflFlEifiE�E1E1EiE3EfEif�3EiF1E1f1FiE1F'IE1EiE�E1EaEiEiElElE1E1EiE1E1f�1EjkiEiEfEiEif-lklfiEfElEiEiE3E1E�1EiEiE1EaElEiEikiklElEiEif 1EiE3Eifif
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUZLDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42631114 ZNE; REF NO:
PLANNING NOTES>' �
%
ih 1E 1f !E 3f IE if 1E �Ih iE if iE if iF if,1E 1E IE 3E iE iE 1E iE 1E 1E Ik ff if 1E �IE iE 1E 1E 9ElE iE 1E iE i41E 1F jf 1E iE if� if if ifl61F iE 1f if 1f 1E ib iE 1f 14 if 1E 1E ik iE 3E �E IE if� 1E'iE iE �lE iE iE iE iF 1E 1E 1E
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
G
ZONZNG APPROVED BY DATE:
HUILDING APPROVED BY : DATE: '�''
APPLICATION ISSUED HY:
o°'° °x"°` I LEGALIZATION;NFryR^^�^^^^FFFFFF�EFEn^^S�UFM�M�A R Y
I Eo Mreby cenily IAeI I em ewye d eM uMsielentl IM reQuiramema d CelAomie HeeXh and SdMy COEe Sediap 25505, 255]3, eM
ASS3a,eMlheilaenyMureyuilEirqmwpeniHill/wYlrwl(rircbme)�a.a�o�p,..ro.w.�.�.�e�n�,�v���mMv� BLDG PMT PLUMBING ELECTRIC MECHANIC
rmilfamroWclionamodi(�tianhan�M�i ue�y ere6amentD'ntriqFevtleivielmw�utlianWD�iomeneweinMlromtMsa
/ DATE: �� `
�iF1EiE1EiFifiFiffElEjE iPiF
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
w�,;,�.. PERMIT 63.00 .50
Dete: Apd��
WORKEP'S COMPEN4ITION p[-�uq�TION: I hmeby elfvm urder pe�y d perjwy ar d tla bllowiip Cadumions:
� IheweMwilmainiene�e�e'�adoonemlioeatlieuumbrv.akas'eompenWion.uprorideElorbySeetion])OOdtMlabar
coe.. ia me oM�e a me .m i« �n inn o� A m�.e.
�] in�.�a,.u�m.:,,wa.��w����...Acw.anysw�a�ooaub�«caae.m.m.v.���.am.
wwk la whirA Ne VamC 6 usuM. MY wwken' can ' im�r ' vd pdiry munbar ere:
�,,,;,,_ S'�ATE F[�ND EXPIRES
Pd� N�m,,,: — 12 / 01 / 9 5
lhia eeciion need rrof be comolered'I fhe perm�} is br ona hvMrad dolkrs /'J100) w bae.)
� I eenity ihei in Ihe paelamenea ol ihe xroA ia whch ihia permit ia ieauad, I ehell nd em0loy any permn in eny menna ao a� lo
e«a��a .�bix. �o �he .on�.e �w�m�o� e� a cwiomr, ana eere. uw n i eno�m c� .�4ea io ina �..o�x.n
compenation pmv[i]aio�ro �o/5xfun �)00 d �M lebar Code. I e�helllMh ' h mm/p,N wuh Noeep�/�
Dme: ��//7J MWtant: / ///i �/L�/�"�'(13N
W�mlip: F�flvn ro i�e�n woiken' eomp.ru�tlon roverps Is unlewN( anJW/l rO/�ef ur wrployx ro ulrNnsl pxi�ltlu uH
clNl flroa �p ro one M1,nGistl tho�uM aol/arI (S1IX{PWA M�ddlfbn b fM cwl o/ mmpNwfbM1 tlamspe� u poHWOloi In
S�ctlon 9106 0l M� LeDor Cyye, Inhna�, �ne �ttomsy'a I�u.
CONSTfiUCT10N LENDING GGENCY: I Mmby elfirm uMer pmeMy d perjury IIW Ihae u e oonmwfon kM'uq qpenry br ihe
plf�0lTBM! O� 1�IG WOIk �Of Milll�l �hG plf111� If GfllOj (SBtlDII' h). CN. Ci.
LENDEF'S NANE:
LRlDEP'S AqDPE55:
1 ceniN �� I have'eeC the app�K¢�p� yM mele �Mt �M ebwa iMammion b cortap. l prse io compy Milh ell dry eM counry adi'aMes
end etme lews rele�iq to W iMing conpruaim vd heroby eNlwr¢e reprananietivea W Ihn dly lo enier upon iha ebava�mentbned properry
r«i�s�am�v��o�. TTM WALTON
v�oi Neme ' I/
0 (/ 0�: �5 /'��
" Sq�aNre d Ox�wl rma 7
15t5t��.WP) �uy.g�iNip 8 Sdny: amen-Fle: Genery-Appicent: Hnk-Rew�ue: (3alEen�od-Aswxa
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.50 0.00 0,00 63.50 63,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 63.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63.00 ,50
1E iE if 1f 1f iE iflE fE iE 1f� 1F jElf iF iE iE 1E 7E iE fE 1E 1! it if 1E 1E 1E 1E IE iE iE iElE 1(� iF 1F fF iE 3ElF if if 1E 1E if if 1F if iE iE iE IE iE iE If iF iE 1E 1E iE 1E 1E iE iE 3E 1E iE 1E ik iE 1E IE 1f if ik 1E iE aF
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 ONIT COST TOTAL COST
SFR 3494 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 3,494.00
END OF FEES
�1 OOlEE203—Qf18E204 TdJ �' 63.50
DATE: C3/11/95 TI11E: 13:17
. �
, CONSTRUCTION AN� PLANNING P40L PA I
APPROVALS Permit # Date Inspector qppROVALS Permit # Date InspaCtor
�
i
1, Temporory Electrical Service or�P�e 52. Pool & Equipment Locatior(� ���!
2. Soil Pipe•Undrgrnd. " 53. Steel Reinfo�cement %� � J
3., �Electrical Conduit UtilitY-Undrgrnd. _ 54. Forms - �
4. Electricaf Conduyt�Undrgrnd. 55. Electrical Sonding - ;�.,
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ��
6. Elecv�cal UFER G",nd. 57. APPROVAI TO COVER-GUNITE : �
7, Footings ,� 58. Electrical Conduit-Undrgrnd. '
8. Foundation .' � 59. Gas Pipe, � Uodrgrnd., Test
9. Water Pipe�Undrgrnd. - i 60. Backwash �ines;.P�Trap, � Uiidrgrnd.
, �
10. Structural Floor SYstem �- 61. APPROVALTO-DECK '!
U, Pioperty Sewer Line & House�Cortnection 62. Backwash & Receptor�Final �'
12. Sewer Cap � •} 63. Heater & Vent-Final �
13. Roof Drains -k 64. Plumbing Syscem • Final �
14. Rough Plumbing. - r. 65. Electrica6Fina� � ,�;�
15. Rough ElecvicaF-Conduic -� -�;1 66. Solar System-Final �r
16. Rough ElectricVJiring 67. Fencing & AccessApproval �`
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING I
78. Rough Electrical-T Bar Ceiling fi9. POOI/SPA SYSTEMS FtNA�
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fi�e�lace ' T `�, � . - t ; APpROVACS"� Peimit # � _ �,
21, Oucts., in Structure� •�• ' . ��' 70. Undergro"und HYdro
22. Ducts', Ve�tilaiing . �. -, - `Z' � 7�, Product�Piping OGas OOiI
23. Gas P�pe-Rough & Tesc �_ �• r � . 72. Undergro�nd Flus"h
�
24, iiooFFraming , " " . ` , � �.. 73. Undergrhd.Storage,Tank QGas ❑�Oil
25. Roof Sheathing ' . � l�p��qs�[y�- 7q, pverhead HYdro• -
26. T-Bar Ceiling (Structurel) & Monocoat - ''" 75. Dry Chemical � _ � .
27. Frame and Flashing - � .. •� 76. Dry Standpipe
,
28. Lathing & Siding _� �. � _ = j; y •`- '" "' 77. FIXED�SYSTEM-FINAL. � - '
29. Insulation ' � 78, FIRE PREV. FIWAL � '
30. DrywaVl fYailing � .HEALTH DEPT."REQUIR�EMEf3T
.
� 31. Plaster Brown Coat v : � • , • 79. FINAL WSPECTION '. .
32. Electrical Power Me[er�Final �' � _' 80; PDOD CERTIFICATE ISSUED_ -
. r
33. .Final E�ectric ' � � ' Notes: -. • '
34, Pinal Heating & Air Conditioning ' , _ i � ' � , • � _
fi :
r
35. Einai Gas Pipe•7est � � : , .. � � � � - � �
36. Hood or CanoP4 ` - '- _ �- -
- i:
r . ..
37. Finai Factory Pirepface • ' ' . � ' _ •
38. Final Plumbing - � - -
39. �vater Service�Finaa , ' , '
40. Gas Service-Final - . - � � -- .
_r
41. Solar pomesticFinat' , ' � • �r _ '_ , - ��� �
42. 'Backflow Preventer �� � n. . ' ' , - �
-43. Backfiow Irrigation . , -- '. r., - �
44. Landscape trripation System 4� �" ' ' � `
.; v ' - �
. 45. Sound Attenuation : �. ' � - - � - `• `. '
.. � _ .
46. Handicap.Regulat�ons � � • • =� -'^- ; �
47. FINALSTRUCTURE&BUILDING � ZZ-�js�(�/�L.. '`' . _
48. FINAi PLANNING - - ' '
x
49. Electrie Release to Edison r , � � ' ,
50. Gas Release ta Southern California Gas Co ' �"
-- .
51. CERTIFICATE OF OCCUPANCY - ' �
No Date
COvNiY OF ORANGE� � �
BUILDING DEPT,
636 No. Broadway Application for Building Permit
Sann Ana, California
Phonc: KI 2•6211
AND FOR A
Certificate of Use and Occupancy
. �
Permit No....._c1.-1�1-b-�-'
Dace.__. ���`r_�-� A----'_'-"-------`-'--------
�. OWIVER'S NAME---------��__�S.-�S---------..._...._------------------------------------ PHONE: H�A06t1._.Q2Q�
MAILING ADDRESS-----�*�--S.--l�i _S�9ti--------------------..------- ---.-CITY -----OG��.I�I6D8----
Name ....
Address
c��y ---- -
State
Lia No.
(Archi[ect or Enginecr)
Phone
Nam W.�� �1� H�i9ti0�,ii � 8iiii8
� --_.---------�--...-""-'-------'--'-'_-------'---------
. (Contracwr)
Add«ss .._iE� _F� -l�iii�l-_gtl`80L....--------------------------
c��Y ----QoetB__tIeea------ ------ ----_.
---- � ------------- ------�---
s�a«
Lic. N�9�..-'---'B�- -----.. Phone�8a4Qil...��----
PROPOSHD USE: ----�8%BOAQO-�---------- --- -------- - ------�-- -- ---------- -. ... ---------- - -- ---
z. Jos [.oca.Tiorr----`{��---------------E--��--�a----------------------------QDBQli_.I�eAd------------- --------------- -----
(Houxe No.) (Nam¢ of Streei) ('I�own or $chool Disaricc)
3. LEGAL DESCRIPTION: Loc ------7 - -'-------- ----- -------Block -- - -- --^ -- --- --- - -.-` Tract __.�/.�� -- - - ---- ` --- -
(Meces and Bounds Descrip�ion—Use rexne side oE Eocm)
4. CORNER LOT ( ) INTERIOR LOT (►/ ) THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OF BLDG.: _28..,�'--i%J.'.AREA:._._.L�ZL_�i.-�------_._.__.SIZE OF LOT:..�.?..IE.L.Z.T__.AREA:...Z.7J.a_._____..._.
0 t
6. HEIGHT OF RLDG.: -__18-_------------------_-_.CEILING HEIGHT:..----.-_8---_-.--_-__.__.._.. NO. OF STORIES_-_---1-_-_-_---
7. NO. FAMILIES _.______i_.__...____._:_____....Sizc of Smallest Bedroom: ..../....G_x._��__.._ Size oE Kitchen: ._LD..)r_./_Q_6__
8. EXTERIOR WALL CONSTRUCTIO[��0._B�DO(i____..___INTERIOR WALL COVERING ...__.P�i'i81�--__-------
(Frnme, Smcco, Etc.) (PlaaoenDrywall, Ecc.) ,
9. SETBACKS: Front Yard from Ccntcr Linc of Stree�.---f�_/_----------------_-_--'_-.--_-----------__---_------_----_--'-_--------.-------------_-
p i ,/c
Neares[ Side Yard _.._..__p.______._ Rear Yard.......7e�(._�___.Dis[ance in Fcet Between Bldgs. on Same Lot __.."7`p.�../__... ... .._.. ..
1G. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
1 I. For r ..._._ De th in Ground._.......'n w_..._.__ ._.. Width oE Wall __..__ w
(a) Footing: Width ""- -'--'-'----_'-'-'-- p ii.- 8 "-_' -"'-
Accessory �Q �
Bldgs. and � Size of Studs: ._y._i% 4_'---__...5 acin J�VA " x
Similar O P 8- ----"'--"-"-----'-"- CC Material o£ Floot .��Q.'_'_..__-_ _"-
Struccures: A Q �Q N
(c) Size of Floor Joists: .Y__�._Y....__"__'-'_._Spacing ......iV--_---"-'---'-------` CC
(d� Size of Rafters:,----.�._�i_d`-------------------Spacing ---��---..-`----------"CC
IZ. VALUATION OF PROPOSED WORK: Inefuding nll laboq plumbing, efectrical wiring, hea[ing, firo sprinklers, pain[-
ing and sewage disposal $----���-/_-'---'_""-'_--------------
i;. 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
LAVi�S OF THE COUNTY OF ORANGE A[VD THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed:------- -'-' -'-�--"-"-'-'_'-'------- --- -'-�"---------"-----'-
Plans F;led:------•---��-' " �d C%�-� ��-
3 ( ner
------------------------------------
BY� -- ------ - ------- -• � -- - --------- ----------------- - -- - --
(Au[horize gen[)
FOR DEPARTMENTAL USE ONLY '
FEES:
Bldg. Permit -
Plan Check -
To[al - - •
Receip� No. -
Paid m -
DA
Sm-] 5a
� m
� ------ 8 00 --- ----
$�----__�.�--------
GROUP---.....�_._..-- .....
TYPE_--------• -�--�^- ---/ - --
DIST. /�,, �
MAP.----- ---[�sL'.�---------
SHEET NO.----.�-----------
CHE,CI�ING BY
/G�
APPLICATIONd`��'__ HEALTH____________________._.___.
FIRE
ZONING.------------ MARSHAL.-------------- --�-
PLANS AND
SPEC'5.------------------------- STATE---------------------- ---
CORRECTLONS ENGINEER
VERIFIED ..-------------- ---- CAL..----------�--------------------
PERM SLIED-BY; �,,. �.,,�•Ty BUILDING
C. W. D�,'1 , ._� �toR
--- ------ ------------------------------------------------------ ---�------------ -------------
p_pUTY
���
COUNTY OF ORANGH
BUILDING DEPT,
636 No. Broadway
Snncu Ana� California
Phone: KI 2�6211 -
Application for Building Permit
AND FOR A
Certif�cate of Use and Occupancy
Permic No._..� 1.5.__6.'�
.
Date----'--------- %--p� �`JZ%-------"-------
1. OWNER'S NAME--------QOA�--""ii�"'�-�_------_--`--------------------------------- PHOIVE.H9AOOA--�-
�
MAILING ADDRESS------�-�-��-��---------------- ------ - CITY-QO�-�----------------
. ,
Name .-.
Address
C�cy ---..
State
Lic. No.
Name��y�� � � ��oliiPdl��o�--�--------'-"-"__-
Address._.iMV..}�li �._.ir�%�iii..V��--'----------------'---'--------
C��y ---QOpt�t -2�'B�
Statc
Lic. Noli�....._.i
PROPOSED USE: ----aARAaFt- - ------- ----- -- ------------------- --� --- ------- -
JOB LOCATION____._. '�30
(House No.)
(Name of
------------ ----- --
_Ooata__tieap_
(Town oc $chool Dis
i. LE-GAL DESCRIPTION: Lot ------7---------------------------Btock -------- -------
-' -
(Meres and Bounc{s Description—Usc reserse side of form)
4. CORNHR LOT ( ) INTERIOR LOT (✓) THROUGH LOT ( )
5. SIZE OF BLDG.: _�..�±._�.__.AREA:__..�BO..-SQ_.%O_.__.SIZE OF LOT :............
"_.Tract ___�_'_'___'
SLOPE OF LOT (
._AREA:
6. HEIGHT OF BI.DG.:..._���_..._.._._.._.._.___.CEILING HEIGHT:.... ........____....NO. OF STORIES_.3 .................
7. NO. FAMILIES ....------------------_-__.-----_---..Size of Smallese Bedroom: ._---------------_-_---'-- Size of Kitchen: ...--.--_----.__---_----_--_-
8. EXTERIOR WALL COIVSTRUCTION:.tj�_.8�0�...._.INTERIOR WALL COVERING .........................................
(Framc, Stucco, Ecc.) / (Plmrer-Drywall, Em.)
9. SETBACKS: Front Yard from Cen[er Liae of Street.-_---.--'-"'l.'� �'_-__'--__""-"_--------'-"'--'-"'-------------------"-'--" ----"---"-'
-' _-_'
y' 3� //p'
Neare"st Side Yar�j _.__�/�_______._._.Rear Yard___.______.__._____.Distante in Feet Betwcen Bldgs. on Same Lot ._-7.p_____..__._... _......._..
IG. A COMPLETE PLOT PLA[V IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width -_�4�--_'__-_'--_'-"--- Depth in Ground_--�M_-___..._--_ Widch of UVall ._�w__.._-_"_----
Accessory
Bldgs. and �
$imilar (b) Size of Studs:---._.Z_�_.�---_.Spacing._-'-----I..�--"-__-_-_"CC Material of Floor �����"_""'
$trucmres:
(c) Size of Floor Jois�s:
"CC
(d) Size of Raf[ers:........-$--;_.8..-----------'----Spacing .----`-�l-_ ............._"CC
I?. VALUATION QF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heacing, fire sprinklers, paint-
ing and sewage disposal $.___:J.?.O"__'___ _-_•_ ___._
1'>. I HEREBY CERTIFY THAT TO THE BEST OF MY KIVOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTIO[V WORK WILL CONFORM TO ALL
LAWS OF TH$ COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
----- Signcd:.------- --- - -/"=---��O��---�-----------
�o^ 3,✓7i _' �� /J// /���
Plans Filed:.----'-----' -"--_"----'-'----------' '-----
Bldg. Pennit
Plan Check
Total - -
Receipt Na. -
Paid to -
Dace'-' - ---.--
DA
31.!-9�50
FEES:
�- -- ---� -�-----
�- - ----� � --O'_Q-----
By:.."-"_--�T- v-`-'�"+�%�-`�'�--"'_"-'--"'-'--'-'_'_---'-'__'-___"'_'-'
(Auahorized Agent)
FOR DEPARTMEIVTAL USE OIVLY
GROUP--- -�-- � -- -----
TYPE-------=�-----`-"' ---
DIST. �� ��
MAP-- --L:��'.....------
SHEET NO._____�..._.._.._._
�CH/ECI�NG BY
APPLICATION�!.::._�� HEALTH____________________________
�j�j FIRE
ZONING --�`�----- MARSHAL.-------------------
PLANS AND
SPEC'5.-- --- --- - ----- ----- STATE — - - ----- -- --._---
CORRECTIO[VS ENGIIVEER
VERIFIED. --------_.--- CAL..-- -------------------�
PERMIT ISSUED BY:
C1.� (� -�-i� � ,,�_. Y BUI�DING
. ��I. 1+ . -� .hdP�CTOR
__ �.Purv G'2cJ