HomeMy WebLinkAbout1796 ANAHEIM AVE - Building Permits CITY OF COSTA MESA , 4 ,
4 BUILDING DIVISION
rJ "4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4. arra st 4 PERMIT
ee 803-01134
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1796 ANAHEIM AV Status: ISSUED
Suite: Applied: 07/03/2003
Vicinity: Issued: 07/03/2003
Parcel Number: 42427209 Zoning:
Applicant: TRUJILLO, BASILIO - ISSUED BY:
Address: 1796-98 ANAHEIM AV , T
Phone: 949-642-0909 -
COSTA MESA,CA.=, - - Zip: 92627 -
Owner: PENA',/ALFREDO& TERESA ' • ' .
Address j TRUJILLO,BASILIO&MARIA _ -
P COSTA MESA,CA _ - Phone: - - _
"/,t796-98 ANAHEIM AV - - Zip: 92627
Contractor: OWNER-BUILDER " -
N.
/Address: �,/!�
Phone:-
, Zip: , , - License: 000000
• ' Eng: - ,
Address: . , - \-', Address:, '
- - _ Phone:
o ..
Zip: % License: License:
•
. - - SCOPE OFPERMIT - , - '
CHANGE OUT 11 WINDOWS THROUGHOUT S.F.D:TO COMPLY WITH1997,U.B'C. REQUIREMENTS.
FEE SUMMARY
Plan Check: " $0.00 - Calc Valuation: 54,000.00
Permit: $97.25Claim Valuation: 54,000.00
SMIP Res: $0.50 '
.SMIP Corn: ' $0.00
Other:. ' $0.00 ' . ,
r Inspection: • $0.00 '
v:,.
`Notal: , $97.75 ,
PLANNING & ZONING
SETBACKS", , , -
MAINSTRUCTURE 'Front 0-0 - Rear- 0-0 Left - 0-0 ' Right -0-0
_
ACCESSORY -Front 0-0 - '' Rear 0-0 Left 0-0 - Right 0-0
PARKING Existing:. 0 - Required: 0 Proposed: 0- / ',
NOTES: --,. 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)754-5626
2446-46(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: \
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and 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
work for which this permit Is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carver and policy number are:
Carrier: Policy Number:
is section need not be completed if the 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'
mpensatlon laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3 00 of th Labor Code,I shall forthwith
comply with these provisions. r
Applicant Signature: �
�o Date: 772 GiZt
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DCLLARE(5100.000),IN ADDNLON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull
force and effect.IJc.ft Class 0
Contractor's Signature: Date:
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,CM!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 Ucense Law(Chapter 9(commencing with Section 7000)of DMslon 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 for a permit
sucts the applicant to a CMI penalty of not more than five hundred dollars($500).):
7( I,as owner of the properly,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 Ucense Law does not apply to an owner of properly 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 and Professions
Code:The contractors Ucense 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 rectors U :ose Law .�/
❑ I am exempt under sac R /.w ., -./._.e' j Business and Professions Code for this reason:
Signature:
Expires: (0- I U - n,7
Verification of Ownership by(type of doc e L i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 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 al 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 ❑Yesr will th0 applicant or present or future building occupant need to prepare an RMPPweight of and Program for acutely hazardous materials)?
No
(Section 25534 of the California 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.
_ —......_...— _.r.__.._..._._...._._._...... _— --
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification
from the South Coast Alt Quality Management District or from any other air pollution control district or agency? ID Yes LJ No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building_permits).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 II a permit from the $outh 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 California 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: Date:
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 CI at Costa.Mesa to enter upon the
above-described properly for insp tion,pu es ree not to.occ py or allow occupancy of any building authorized by thisit/nlil 11 Boit
lig Signature Of Legal Owner(s • Date
r"?��
And/Or Authorized Applicant Date
gnDP 1. INSPECTION TYPE PAIS iHImALS CODES INSPECTION TYPE 263 NILE
1618 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Flre Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site ^' '
204 Final Demolition 250 Final Building/Occupancy 7.-t.q -�s �'" -'
PROJEr ADDRESS: 1796 ANAHEIM AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06539
!, oWNt'sNAME: KILBOURN MICHAEL B TR
4' ADDRESS: 3867 ARUBA CIR PERMIT NO: B 065399 PLAN CHECK NO: N GOVT: N SUPP: N
HUNTINGTON BEACH,CA 92649
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF W/COMPOSITION SHINGLES SQ FT: 2, 644
ADDRESS: UNIT:
CLAIM VALUE: 2, 644 . 00 CALC—VALUE: 2, 644 .00 GROUP OCC: R-1 /
PERMITTEE: BEST ROOFING ( 714 ) 557-4040
ADDRESS: 765 ST CLAIR B COMMENTS: SMOKE DETECTOR REQUIRED PRIOR TO FINAL
COSTA MESA CA 92626 *+HSE*****************+r****************+r**+ETH*******************+E*+E+E***+r**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY LIC.:051718 sTATELIc.:603323 � c�S: C-39
O. t.an �3 Signature: / ` MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
,'KERS'COMPENSATION DECLARATION: I hereby affirthat I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
Compensation isnot 5112021 appy thereof(Section 3800, Lab.t16/0 1 /94
POLICY NO.: EXP. ll
STATE FUND PARKINGPROV: PARCEL: 42427209 ZNE: REF NO:
COMPANY: IN REQ
Ti •rtified copy is hereby furnished. N Certified copy is filed th the 'y ilding Division. PLANNING NOTES.>•
Date'/ • etlis Applicant' •')� *******************************************************************************
II
MPTION FROM WORKERS'COMPENSATION DECLARATION: (Thi section need not b completed if the permit is for one hundred($11)0)or less). D E V E'.L O P M E N T S E R V I C E S R E Q U I R E M E N--T S
I certify that in the performance of the work for which this permit is issued,I shall nor'employ any person i0 any manner so as to become 1 e-
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE;
Date: Signature: BUILDING APPROVED BY :
%
NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: c DATE. '/C-- T—A)^ 9
it' 1
3
which this permit is issued(Section 3097,Civ.C). ******* ***i4*1L'-******************* B���FFFF ***************************** - - - - **
LENDER: ********************************************************************1 **********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
,I
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or - PERMIT 54 .00 `` . 504
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed ( 1
SMIP/NON.RES
pursuant to the provisions or ofthe /shtrisslexe'State License and(Chapter 9(commencing with ioinn Any i a ni fn 3 of the Business PLAN + I.
and Professions Code)m that he/she ppmat totherefrom and lty fbasisnfor the alleged exemption.huneddoll violation($ 0of Section 703L5 by -
anY applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE i
I. as owner of the property or myemployees won wa es as their sole compensation, will do the work, and the BUI ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL _ PAID J. DUE
g -> 54 , 50 0 . 00 0 .00 54 . 50 • 54 . 50 ' } • 00
❑ structure is not intendedne offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License L � •
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herselfx v
his or her own employees,provided that such improvements are not intended or offered for sale.Il, howev9 'I g REVENUE DIVISION TOTALS--> COLLECTED• 54 . 50 OVER/SHORT: 00
improvement is of satelhin one year of completion.the owner will have the burden of proving he/ of w burn mve�e.A BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose so sale(. QQhs f
I.as owner of the property,am exclusively contracting with licensed contractors to c jecP , va 54 .00 r;S O f;{
❑ and who contra contracts
The protects with
atcnntralnse law does pot rsuly atpo the Ce ctorsrty'Sat thereon *******************************************************************************
and who Professions
Co for such projects with a e License La license pursuant to the Contractors'State aw am aware
That proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K- D• O W N C'
❑ I am exempt under Section: B.8 P.C.
for this reason. TYPE QTY DESCRIPTIO N UNIT COST ,TOTAL COST
Date: Owner: .r
_ SFR 2644 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 , l 2, 644 . 00
I do hereby certify That I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a • I
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions -,
Dale: Applicant:
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize r resen yes of this city to enter upon the above-mentioned 1 1
n•rly four inspection purposes. ,I'
D.e: I 4• D`V� Signature: J
•'• £.01.7,60-00152551 TOT 54.50
Driver's License or Social Security e: 5:rE?''12/2d/ys TINE: 1314
r
1641-46 WOde—Building:Green—Code Enforcement Canary—Applica :Pink—Revenue:Goldenrod—Assessor '
' ' CONSTRUCTION AND PLANNING POG SPA
Date Inspector Date Inspector
i f APPROVALS Permit# - _ APPROVALS Permit# _-
• 1. Temporary Electrical Ser ct'r PQ .v - 52. Pool & Equipment Location
2 Soil Pipe-Undrgrnd. L. --:? 53. Steel Reinforcement ,
;,-,1 ciectrical CorgAttit'{JtiktRJ;fdrgrr 54. Forms
a.z.---: _t-. _,rt.
'j O4. Electrical Condu'kCndrgrnd. -! p 55. Electrical Bonding I
Eeel Reinfor&ryjk `'c 56. Rough Plumbing& Pressure Test ....11
.CC. 6;'&lectrical UFER'GEnd. 57. APPROVAL TO COVER-GUNITE
S- :1 :-c.^ tipotings �' 58. Electrical Conduit-Undrgrnd. a
- au �• '-
''•-•2s. Foundation _ 59. Gas Pipe, 0 Undrgrnd., Test
'8. �IYater Pipe-Undrgrnd, 4 __.2.1' 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 4• 61: APPROVAL TO DECK ".
?d. Property Sewer Line & Heuse'Contection- ' 62. Backwash & Receptor-Final _
12. Sewer Cap o✓ y y, 63. Heater & Vent-Final
Lt 6.
13. Roof Drains •'t 64. Plumbing System- Fi',ial
Ji
14. Rough Plumb(gg " 65. Electrical-Final ,)
15. Rough Electrical-Conduit 66. Solar System-Final,' `
16. Rough Electr' Wirin �•t
9 (E' 9 67. •Fencing & Access Approval
1 1c
17. Rough Wiring,ign 68. APPROVED F,611A''S
PITERING
18. Rough Electr`trai-T Bar Ceiling 69. POOL/SPA SYSTELWS FINAL
19. Rough Heating & Air Conditioning 'FIRE DEBT. Il,:t UIREMENT
tP r, ":- ..1 • r---7 -'- . cs „ <, -.. -) 7:-. 1:1-36, to. . ,- F ;U 1
201; Raugh(nactc y Fireplace 1 - t' - '? X 0 _) t✓•= 4 APPROV7 1,115 ?'aPOlnit 0 ` > rr'
.t S tO '' E • 1 S r" Q`,'< X S 1 t �:. .,;: ;'' • 1._,1'1,- l '> ' -^ S
2' NJ 1-, ' a , F r-, . ,_ I-1 4 r II-4r--77.=-'.."1-1-) . to
ets, Stucta; 1 .. .- ,,,5 t j :-it . 70. 'UndergtOnnal Hzdro x.
- i ..,
22. D6, s,Nen�fatiis t i C5 e -3 ` , t _171. `Proclu hlpingu as CD Oil
232Gd=Pili-Ra gh&.''`,fastJ.S * rt pT ; - 72. Undergigxid FI ,411 )I) .t CI
24u Roof Framing fl ' '.:11-• JF * 7 2 - st =-- 73 Undergrn'21.Sto�?lank20 Gas ❑'en
25. Rdof S Bathing ; �: ;l/>.�Z'-3 7.7-77 444.4>, t-' 74, OverheadyHYdr�-,Ha
' 26o T-Sar Ceiling (St1,tx:tural) tfnoFrocoat 4 t7 7 tit 1 7F Dry Chemical .- r '-' - '�
,i..
ZN Fr me and F,�as j o1-'^ ' b • v �rrr11,, Y Y S c�
o, t-, p^.:tr: 'f: o, „ sax 76. Dry Ste RVRipe Fm 4 G -I
172511 i 1} H�:,r' z �•.: f . 4,71-
1374
`,.- -' rl ..) {i
Li)! 2S L ting1& a;tiir c- `+QZ u; * t • + 77r FIXED t STE'i'%F>`-INAt.
tr,_c �+ hrCE r,,0:
..1 ..F . 1 G' ntrl . ..t
29. Insulation `� " C S ' 7 * rn, 1 l = 7t}_ FIRE PREV. FINAL ,
'30. Drywati;Naiiingr7r * I I It - -HEALTH.
hDEPT.-REQUIREMENT
c'I
,.. 31. Plaster` rosn Ca' it r 79 ' FINAL IIISPECTN J _ft
:i. -r �
o i 1 Tr N I- 14 • Pv 77717.7,777.=T
~ 32r Electrical PowerMttr-Fnal
* to I., * 0)800 FOOD CERTIFdL'ATE ISSUED
v, ir:'r :'i , t:e_q `7 k,- . .� a ...-1
33$Fig' Ef'eCtri'c 0* M I y n `-1 Ni. 7or&eS: 7t m t '' 0 07,..11
S
I .,,H ----; t �. t: ' .. K. t:▪ .: ,-•S l
c 3¢.1 Fir l ti' atiaJ &mit nnd;tip[nt{xjv 1 I . _f„ ^ CI T. S -ter
< ,-3 , fa-, .a ; -1 -.. 7 1- . r tom-, F-��; .n
35-;'FiisalG Pine-T-es 01 * H 1 .rr 1' S� It .cr gip_
La - .,
v 36�'He od of Canopy_+.1. ;3✓` 1 t,+.-1 a. F• r. ( ,'y, =- t• 0 *TB- `•"-- --
'r :-1 ' -r. .` - p- t -, i ntr+ -
- 37JFiffal F,tstory FIFea13C 1 Sm * 01 I I Ir.,,, # .� x n1
F f'
_zd 38. Final Pksmbing:y, 07 -' -- *.
,- ii I O - - y , •
39. Wafer Service-Fina! a' * I * 'R (1 . n.✓rl v x O
•
';40. Gas Se11:4ce;finalan <rr• .= .7i-: ,,1 - t' ' I
:}� -ten; 1-
, . •1
'.. .c� I $
41. Solar t7omestic-Final C' •' S.
Ca I I* • .rsty . . ,•
-4 r.. s r.. r17 77 N -C
42.;Backflow Prevent F ' '• =' 1 1 4 * /2::-...2..2.-q 'U3 5E:514 IIS
43. Backf low Ircigatior, ti:"7 * t x :CH 0 '+t
vt; tip: -
n .
.'44. Landscape lfrigati in Systeo,c,: s x• t' u t, Ctx x ,::� * .;'; c
7.' 4 ;,Sound `Attenuation 1-,x at. -- C744.3. -4▪ '
- -r' * Z c -. F ' � r-�
_ h _
I 74 . '-+ M to res z F o- e a, -'I
467 Handichp R•egulati$ns 0 •. I M "• • x ' - ~�' '
t n •s c 4
•47•,, FIbIAL ST1IItJCTU.RE & 8lrft, LDING itir-q3 !EG'i i- i.:s' .1 . I
4$V FI 4LPLIt1JNIN 1 F+F, 7
4. U _ .` a ? F C.1
atric
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ktelease tgj:Edison I .: ( c;k a : -z , Y., .1
'-'50_Gad,,Relrease to Sottthern Caeornia Gas Co y . - of e C.EH : , J�. ' C ":
1-',.51. CERTIFICATE OE OCCUN4NCY x ; Z s t`
No. Date
• _c_.._ ____:.. .. 4833•
FEE RECEIVED
COSTA MESA BUILDING DEPARTMENT A ,
P.O.BOX INv_433-1-S,ANCE DEPT'
COSTA MESA, CALIFORNIAL
CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION APPLICATION FOR PERMIT
ADDREISS /794 AN.(3 4-n.e..1.�Fee. d'►, C'm BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. ?�NO.
OWNER��.>1LEfi r U
{{{{{{ ����{{ !!
RECEIVED BY DATE RECEIVED /GATE�1J35U ISSUED
MAIL 3 76 / 7 � �_.l � , "J'"A �S /
ADDRESS
04414144
,4_,., �/ BUILDING
L NOA, 5140/... ADDRESS
ARCHITECT LIC.
OR ENGINEER NO. COSTA MESA. CALIFORNIA -�.}
FIRE
ADDRESS ZONE
//�� /A/ CITY LIC. ZONE N/"moi PLANS TYPE ' / GROUP
CONTRACTOR
✓/,{ ,41,x.44 ; A NO. / ; ////t-�--� any !/q��tf y/��� //�a II_
ADDRESS/ //y-2 �,_ - /y , �,IT r ry0 ' 7y y yp BYPROVED l !� DATE //i'/,{' r
LEGAL Lor /// i^ CORRECTIONS
DESCRIPTION NO / BLOCK TRACT / O L.
A.P.NO. / /CJ .— / �, /• —�/0
7
OIZELOT 68 x L) oZ NO.OF BLDGS.Abut
OF ,NOW ON LOT •
USE OF
EXISTING BLDG. •-----
SETCENTER oACK r STREET 0 / REAR YARD:9-4 / ? /- j.- �`_ Uj[.�
/ 0 / /
SIDE YARD RIGHT � LEFT /
DESCRIPTION OF WORK
�e pR®Vc1D
LI I Y Oh GUS I A N,:Ca;
NEW ALTERATION ADDITION PLANNING DEP I
REPAIR MOVING pI DEMOLISH SUBJECT TO BLDG. DEPT. REG.
BUILDING/702:47 NO.OF N
SIZE 41° ROOMS /0 STORIES / / / (J/. -S j
EXTERIOR AeA ROOF BY DATC// �`
COVERING a 1:-C-O COVERING _ PLAN TECHG�71_/
USE OF NEW ( biligi l
BUILDING
if
hP e-- ..1/cu 1c q/ 7p0
/ 2 d� C
4s Pil? Arse/Di i /3, c, a D f
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT ANP AGREE TO COMPLY WITH ALL
CITY ORDINANCES �STa TE,_ ,pL.Aw3 EGULATING BUILDING CONSTRVC•
te,
TION. !� e ✓ VALUATION
AC_L�/•N/(/'/ PERMIT FEE S ..3c4
SIGNATURE OF
PERMITTEE
O /%' /_a 51 PLAN CHECK S / 7 —
5 / T' 0
AUTHORIZED AGENT
TOTAL FEE $ LC/ - jai
OWNER ♦ EL% Wni. E. '-- - DATE x_8_57 .
JOB ADDRESS 1796 A & B -Anaheim BUILDING PERMIT NO. 11810
GENERAL CONTRACTOR Armadge Inc. VALUE-S -1 621z _
AP 116-192-10
L. 27 BLOCK D TRACT18 Duplex w/det. garage
GROUP 1 & J TYPE V ZONE Rh FIRE DISTRICT 11833
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
,/ DATE NUMBER
Footing Trench - 7-2q-s)cid/4f /r�
Foundation Forms and Grade to Gara �+S"+4S-S7 1 CCw-st
Rough Framing /GeV>. -J -,7t '--a 2 1 V�
Plumbing,Rough to Slabtbl's /�ff,< -r'O-'3 7 (�Q- ry &OW n _ / - to 92 �' ,✓
Plumbing, Rough Complete - /0$13 .S-Z3-S-7 Y
Temporary Pole
Wiring, Rough MAY 1 l 195T VCB .t ;rose. S-/6--S 2 421c OG 10°...--
Heating,
Heating, Rough /PINS. s-2?—r7 / I-i-. 'ParA•...• - - tY7/ s----
Heating,
Heating, Final /YI ALS 1{r,-�46 -5-7 /
Sewer, House •j()O(y"1Sewer,St.417c1f1 ""<-I( - .a
Se-sic Tank or Cesspool �,,,/y/
L. Ig, In OAR-- Out f/� H 6-�1-• 7
Plastering u Mk V-(7 •
Plumbing,Final,Fixtures Complete //.S Pit.-s7 /
Plumbing,Final Gas Test/S/S d/!?NS r-es -S7 �> -ref r h �/�. /1e
Wiring,Final �///i/( 6.22-4,126-cc-
22r� 2C�C`- / _ 1 \\
Occupancy /JfbY p111 1. .22,17 ,
FORM 210 3M 10.55 4810