HomeMy WebLinkAbout1773 ANAHEIM AVE - Building Permits 410114 CITY OF COSTA MESA
1:00111t) BUILDING DIVISION
$• DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER
F 1 •.,ma•
PERMIT
- ` B -00337
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1773 ANAHEIM AV Status: ISSUED
Suite: Applied: 03/02/2005
Vicinity: GARAGE Issued: 03/02/2005
Parcel Number: 42426324 Zoning:
Applicant: MUSTEDANAGIC,AMIR ISSUED BY: Jet a
Address: 1773 ANAHEIM AV
Phone: 949-254-6798
COSTA MESA,CA Zip: 92627-3606
Owner VEJZOVIC; MUSTEDANAGIC; BOSTANDZIC
Address 1773 ANAHEIM AV
Phone:
COSTA MESA,CA Zip: 92627-3606
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
DEMOLITION OF AN ILLEGAL STUDIO UNIT IN THE GARAGE AN EXISTING'DWELLING.
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
REF:C05-0309
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $300.00
Permit: $23.50 Claim Valuation: $300.00
SMIP Res: $0.50 _
SMIP Com: $0.00
•
Other: $0.00
Inspection: $0.00
•
Total: $24.00
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE 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 -
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(WOO)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
❑ 1 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 I.e,Ied.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(This, section need not be completed if the permit Is valued at one hundred dollars(5700)or less.)
y� `;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 tdrthwith
comply with these pro Bions.
Applicant Signature: 1 x. -AP_��` Date: - -
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOt.LARE($100.000).IN ADDITION 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 full
force and effect.LIc.a 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,Civil Code).
Lenders Name: Lenders 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 for a 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 and 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 end Professions Code for this reason: " m IC
Signature: ' l-`\- — -_
Expires: :16-12e-
Verification
16-12 ^Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feel 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Op 2,Art 2,Sec.
341,Title B,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:
I 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 lime 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 end 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 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.
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 appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information bo fumished on applications for non-residential building permits).
6 Will any part of the facility t0 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 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 California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penally 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 penally 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.
K A a'-- { '' _z - oa-
Signature Of Legal Owner(s) Date )
And/Or Authorized Applicant Date
INSPECTION TYPE gdTE IDIS CODE0 BISPECT1ON TYKE PEU IB L$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final 208 Final Plumbing '
200 Final Re-Roof _ 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
5Tp M CITY OF COSTA MESA
1 BUILDING DIVISION
j � • DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
R�j/� . PERMIT
vro�oa /B05-00338
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1773 ANAHEIM AV Status: ISSUED
Suite: Applied: 03/02/2005
Vicinity: Issued: 03/02/2005
Parcel Number: 42426324 Zoning:
ii
Applicant: MUSTEDANAGIC, AMIR ISSUED BY: r
Address: 1773 ANAHEIM AV
Phone: 949-254-6798
COSTA MESA,CA Zip: 92627-3606
Owner: VEJZOVIC; MUSTEDANAGIC; BOSTANDZIC
Address 1773 ANAHEIM AV
Phone:
COSTA MESA,CA Zip: 92627-3606
Contractor OWNER-BUILDER
Address:
Phone:
Zip: License: 000000 '
Arch : - - Eng:
Address: Address:
• Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
LEGALIZATION OF THE CHANGE-OUT OF 10 WINDOWS AND 1 SLIDING PATIO-DOOR IN AN EXISTING DWELLING.
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
REF:C05-0309
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $s,000.00
Permit: $111.25 Claim Valuation: $5,000.00
SMIP Res: $0.50
SMIP Com: $0.00 - - -
Other: $0.00
Inspection: $0.00
Total: $111.75 ,
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left . o-0 Right 0-0 ,
ACCESSORY Front 0-0 Rear - 0-0 Left 0-0 • Right '0-0
PARKING Existing: 0 • . - Required: 0 , Proposed: 0
•
•
•
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(6100)
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 carrier and policy number are:
Cartier: Policy Number:
(This section need not be completed If the permit is valued at one hundred dollars($100)or less.)
❑.r1 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 provisions.
Applicant Signature: 115\---1/4..tw--'l .k/V..a—i,1^ek O' ' ' • Date: 3—2— ,
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOI-LARE($100,0110),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S 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 full
force and effect.Lic.# Class B
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,Civil 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 for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
aid,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 and 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: - ce
Expires: I L
Verification of Ownership by(type of document,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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)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? ❑Yes ❑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 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes D No
(Section 65850.2 of the Califomia Government 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? ❑Yes 0 No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control districi or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safely Code Section 42303 been made? ❑Yes ❑No
8 (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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property forinspectionpurposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.ron
AV-AFI JJ-"-a�CA�L�� -2 - C i
Signature Of Legal Owner(s) _Date 7
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE DATE If1TI11ALS T,ODEE INSPECTION TYPE 2I MALI
1616 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 Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site �( J_�
204 Final Demolition 250 Final Building/Occupancy /—17--0 fi g
COSTmr ESA BUILDING DEPARTMENT 240 B
N1 East 20th Street N°
Costa Mesa, California C--
8;pa��
Date /~ /� d_`.'
CITY OF COSTA MESA -L_
CERTIFICATET{� OF31Cf PANCY
Building Permit�No:f.'... [..E}ectrical Permit No ..I Plumbing Permit No//rent-
s-
.� K i - r' .�. 3'7 Sal
Use of Building... .f 4 A 14 IG.Ct2J.14'Az,
4t r
The building located at / /7.....? 3 A./...,A... _e..t.''n A.z.,..5
.ltii..rs 4 - 6. __ C .2 _Q
Lot b Block Tract 4 eJ
Vr
(See reverse side for Metes and Bounds)
h- b�eq inspected and found to comply th the provisionsviof all City of Costa Me 'Or-
a ices applicabl thereto for a Gro pi Vdcupancy.
I SUED TO. ° A. J.gV�JL' I
ding) C1.)7 City n !h
(Owner of Building) By • �sL //Al
CC: 0 Original—Owner Q 1st copy—Gas Co. 0 2nd copy—Edison Co. 3rd copy—File
Form 206 C-H 1M 12-63
✓ )! 1
:•`_ 5581 FEE RECEIVED - - Q31,
COSTA MESA BUILDING DEPARTMENTS e)--1 I 1 �,�^ t-.
"
P.O.BOX 317 FINANL'E DEPT.
COSTA MESA, CALIFORNIA
CITY OF COSTA MESA
FOR APPLICANT TO FILL IN A PLICATION FOR PERMIT
ADDILRESG/// 3 /� f7 Les%,ry p ,. c BUILDING
BUDRESS /
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
• RECEIPT NO. PERMIT NO.
OWNE-00" of / I _ .3t,7
//�[[��.. RECEIVEDy�� BY ypt TE
/RECEIVED or_
ISSUED
ADDRESS An ' / I - ' � V " ` j—S7 o+ ,'c -" •,'
__ // TEL. BUILDING
CITY ( b'�VI.�JJ O. ADDRESS
ARCHITECT (/ LIG. COSTA MESA. CALIFORNIA
OR NEE- '„ Wa.G/ 1�10.
•
FIRE
ADDRESS ZONE •
��, • CITY LIC. ZONE / NPLANSO.OF TYPE / GROUP
��
CONTRACTOR JI�I'•l*���`��✓t✓�A�,�A//�.,' NO. ) a/ 9y y�p��.// V /yJ
_ADDRESS/in Ch L%�_'-_' - _` TN0 6JD/'I:BV,i" ele.: • DATE (/ ' /I.
LEGAL LOT /p^ (- CORRECTIONS
DESCRIPTION NO. v BLOCK TRAC' (j 7
A.P."° APPROVED
SIZELOT N L 162—
0 2- NO.OF BLDGS.
OF NOW ON LOT
USE OF CITY OF STA MESA
EXISTING BLDG. PLAN t,G DEBT
CENTER F ST FRom J�.--. /•
.+-� l SUBJECT TO LDG. DEPT. REG.
CENTER OF STREET REAR YARD 4.2 O t /j IATE �/]
SIDE YARD RIGHT e, LEFT /�i Wilt—A° DATE ^' /��t'/
DESCRIPTION OF WORK PUM I
I -
NEV ALTERATION ADDITION �'Y'y'yyI 1
REPAIR MOVING DEMOLISH V S� T A I ` E
BUILDING NO.OF 11
SIZE ROOMS STORIES I'^.I ':'1 (r "t Fi i li It
COVERING EXTERIORWAL COVVERING ,G'�`4,ROF •'`� .�..f (r"; i?, 1U
USEIOF NEW / "f- /I, Tj�A�_
BUILDING i" L/ jS P"�`�f/ 1R
VAR, No; APPROVED
tact,: AG It. -) — 99S""' — i>
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL /Jc/zJ _ '
CITY ORDINANCES ANDLS ATE LAWS REGULATING B LDING CONSTRUC- __ / /G
TION. / VALUATION �) 0 0
••,...SIGNATURE •. / PERMIT FEE $ 3 T,
PERMITTEE • A /
7O•<PLAN CHECK $ /7 S C
/
AUTHORIZED AGENT TOTAL FEE S 4-4-1, ‘5.---a 1.---,
•
COSTA MESA BUILDING DEPARTMENT
• P. 0. BOX 317 I • 5595
COSTA MESA CALIFORNIA•
FOR APPLICANT TO FILL IN �t /
C.L. OF STREET- I '. ‘.5
I BUILDING "'RES RES "
J ` 1
_. PROP. LINE 1:-TN
Owner �.>.iZ./
// r- —— —— r - -{- 12�t TINT R -1 \\ I •r a L /' / i
10 FT. FOR 60 FT. STREET-,-
I
TREET J �50 FT. STREET I Mail Addre s
I City ../ t• , Ph. No�D�u'L36`�'O
• I I —
I APPROVED I I ' Contractor *1 N �`t- Ph. No.
Address
CITY OF COSTA M'�*11IF FRONT
PLANNING DEez. OF PROP City Lic. No. State Lic. No. - -r.:71_ _
SUBJECT TO BLDG. Df Pi. REGI - ~
150 FTS / � W �p Size of Lo 0 X t v z AP No.�1�/ �J `T
` I pBYth .of. ` DATF -/ -�'1 in ~ Setbacks: C/L Street `SQ' ReariCa 0• ��
K I I PLAN T:CH. QCYf-J� Z y N .y _•S r O"Left 0"
>C u. i. Side Yard - Right �r
• ___ ^ 0
ai r 6 L. a. v J Type of Fence C` .d t`!CV? iGT F Ttt-.nc"4i
d ' ' I (�,• I'o,... '° PROP. YLINE ¢I •�
W I �.ti , 0.1
ti .P ' R.L•TP 1 w A ‘ L '.2-a(204: l�:�l i=•w?ipib
• (t (c0 �" ,ca-iz a .av c 1.4" t#. C—rC, Hi..x_ 36'• IA-t co i1 .
J ., , -, II , I hereby acknowledge that I have read this application and state
�j IN= C�'� i MAX .{�{�•GlFT U • that the above is correct and agree to comply with all City Ord-
,-;.0-4,-.)... - v �I-�? / oFF S�ETM 41141G- inances and Sta - • s regulating building construction.
I-- 1 l' I ' WA�� Tom' I Signature'
._,, . - 'i t I " 6• Coitt4o't 10I of Permitte- �aAlf _
`/ 33 I _ a 3Cfl� FT Agent
O
•
37 611N.- �e. I . `+ IZ Sto I 49 FOR OFFICE USE ONLY
FT. IW I 40
I Z i. 1-j' •
I FT
Permit No.
J
• \ In: I s 'F I 5'6/6
100 1 C reIgt , 19” • 0,49E 100 I 60 F ST. Rec by Date Recei _d Date Issue
If t 'ifoa' v: a.— v GURU SEE Op 1 O 5 7
p2 FT. ST. H t • _ / }-ex �I E VED
(r; PROP LINE " o
M J/ - -- y i - l _/,.,'_sr R E �! VALUATION Permit Fee $ '" 6
I FI CE`1EIiirsAa;fd,e,
/6 �l/ eCITY F CO Q $ 986-0-t_ Plan Check $ �"
•
C.L. OF STREET` O. O
TOTAL FEE $
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- ----
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
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COSTA MESA BUILDING DEPARTMENT -
nov -i -S�PDtlESAA 921a re ir3 it i.4fj•(��
P. O. BOX 317 I 5973
f • .ti . COSTA MESA CALIFORNIA • I
• FOR APPLICANT TO 1 IN
C.L. OF STREET- I ��� —
. BUILDING An DR S jy,_1?s =_-
.IN
___ __�iPROP LINE _ _ _ I Owner_ r V - i,
rsow
10 FT. FOR 60 FT. STREET{� 12 FT. TIFF ;FT I Mail Addressi/ n.i/ ' n i
I �50 FT. STREET
• I . Ci /�' :Ph. No.
I
. I
Contractor ` 9'""-'^ 4~' Ph. No.
• I Address
50 FII IF FRONT •• City Lic. No. _ State Lic. No.
I I0F PROP- 1 — // —
A
50 FTS w Size of Lot k�0•X I ClQ AP No////‘—/ :,• -r..3¢ '/ ar
t- • W \ f Setbacks: C/L Street �7 Rear
W CO
¢ -I Cr Is. Side Yard - Right // Left a A/
N f ---- o� CD) 0 Type of Fe (1 �� -
0�---- I /�/q/g
• ALLEY QR PROP, LINE I\ aI O 7( /� , , / b p_ f / •
r
O. I b/
i F• . / I �� Q w —7 I hereby ckn• ledge that I have read this applicat' n and state
m u _ / N s that the above is correct and agree to comply with all City Ord-
6 Ir UJ cure O"\LS d it w .> inances and Sta Laws regulating b 'Ming construction.
a
I'—' ,t ¢ 0 o Etl'„ Signature
• �1. Ol(
�] h 0 o Q 10 I of Permitt ..-�
•
o U ! m FT I Agent
u. - o
11 $7 6 IN. i ' O ¢ �
y FOR OFFICE USE ONLY
FT. @I 1- ° = z 40 I
zI m •
J t� a FT I 6-7 5‘ Permit No.
o ss i C� 1/4,5—,..1
1 60 FT ST. Received by Date Received Date Issued
0. I , r -s7
p6,2 FT ST. 2 1 h'j F J GLv I �� S ��'
PROP LINE r t` VALUATION
-- _- 12- - - - - - - -�
O Permit Fee $
to
j270 I - $ •—• Plan Check '.
C.L. OF STREETS I
TOTAL FEE $ .
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - -- •
—
' MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS '/
ADDRESS OF BUILDING: 1773 ANAHEIM AV LINT: CITY OF COSTA MESA - BUILDING PERMIT
I OrtRSNAYEIFKNON* WALTERS, RUSSELL ARTHUR PERM NO: P 075791
/ ASORESS: WALTERS, DIANA FAUST
337 SPINNAKER WAY PERMIT NO: P 075791 PLAN CHECK NO: N GOVT: N SUPP : N
SEAL BEACH,CA 90740
APDL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
RC
ANOECTOREMANEER: VALLEY CONSULTANTS INC UC.MD.: C-29329 JOB DESCRIPTION : INSTALL NEW DRAIN LINE " SOME GRADING" SQ FT:
ARCH.OR ENG.'S ADDRESS: 10516 PO BOX714<0 650-5430 WMT:
N.B . CA 92658 CLAIM VALUE: CALC-VALUE: • -' • GROUP OCC: R-3 /
CONTRACTORS NAME: SUNSET DESIGNERS ( 310 ) 424-0771
CONTRACTORSMMIWG 3220 E WILLOW ST COMMENTS: REF: B-75790 /•.` ' `-e ei
ADDRESS: SIGNAL HILLS CA uaxO.: 126230 **SE'* (';'ES('atS('�E** '+F�rx'***aE***iEi'EituiE*Sfx xx'x'�(' 'x'ate('ate'at�t*TF4'SF*ii*?:***** SE*********'SE****iE*** '**
90806 UNIT: Z ONING R E Q U I R >E M- N. T S
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of pe' ,"i i. licensed under provisions of Chapter 9 S ET B A C K S7 n
(commenting with Section 7000)of Division 3 d the Business and Professions ...,and my „.is in fug force and effect. 4.-
CITY
CITY LIC.ND.: LIC.CLASS: B1 i :RE. 6230 EXP: MAIN BUILDING •
ACCESSORY BUILDING
""2----2- FRNT: FT IN REAR: FT IN FRNT:./ FT IN REAR: FT IN
°°' Contractor: = LEFT: FT IN RGHT: FT IN LEFT• : ;S FT ' IN RGHT: FT IN
/ O R BUILDER DECLARATION:I hereby affirm under Penalty of perjury 1.10 pt from the Cantramom License Law for the
' -
eason(Section7031.5BmuessandanceslomCods:Ammorre°dresapemma«ntnl ,alte,improve, PARKING REQ: PROV: PARCEL : 424263.24-J,ZNE: REF NO:
'°meleet or repair any stmcture.prior to as issuance.also requires the awl-, permit to fib a signed 00)cit Dt that he or she
Biased pursuant to the that d thetheContractorsitexempt License Law(Chapter 9(commencing web Sermon 7000)d DMcion 3 d the PLANNING NOTES>
Business and Professions Code)or he a she is etherefrom and the b®e for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permn"ubjecs the applicant to d civil penalty dna more than fee hundred dollars moo *******************************************************************************
❑ I,eaownerdtho property or myempoyeee withweges as their sole compensation,will do the wort,and teanudure is not intended DEVELOPMENT S E R V I C E S " R E Q; U I R E M E N T S
or offered for sale(Section 7044,Business end Professions Code:The Contractor,License tedoes not appy to an owner of property r vitt
who bolds or improves thereon.and who does such work himself or herself or through his or her own employee*,provided thin such
improvements are not intended or offered tor sale.If,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY -1 •
DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner d the popery.am exd usively contradlg with licensed contractors to construct the project(Section 7044,Business and
Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon end who BUILDING APPROVED BY : 721 DATE:
contracts for such projects with a contractors)licensed pursuant to the Contractors License Law). / ‘:::k.-1
❑ I am exempt under Section: B.AP.c.,fammreason: APPLICATION ISSUED BY: . DATE : 57
******************************** ********* *
Date: Owner; •
LEGALIZATION:N F E SUMMARY STRUCTURAL SEGMEN :N
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,end
25534.and that I or any future buildup occupant will/wit not(circle one)need to campy with said pate codes and the requirements for /
a permit for construction or modification born the AinTMErrykIanacement Dieda.Reeidentielconpmdbnepplcduan are exempt iron these BLDG PMT PLUMBING ELECTRIC MECHANIC / FIRE SMIP/RES GRADING
prad8ion. PERMIT 20,00
In
Dene: AppyceeL 25% SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I herebyaifirtn under penally d perjury one d the following dedatior
ama: PLAN
ISSUE FEE 20 . 00
❑ Ihave and wilmaintain acertifcatedmrenttosispeurabrsued. wmpenspbn.asprwWedtor bySection 370odthe Labor BUILDING DIV-> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
toes. mmep«amameduawakraw�nwaPammaeaw, TOTALS----> 20 . 00 20 . 00 0 . 00 40 . 00 40 . 00 . 00
C] I have and suit maintain workers'compensation insurance.an red d',squired by Section 3700 the Labor Code,for the performance the
7C work for whish this permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier: g�'�A1� FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 40 . 00 OVER/SHORT: . 00
Policy Number: 4"iSA90Q-95 11 /15/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(his section need not be completed I the permit is for one humated dollars(3100/ot less.) 40 . 00
❑ I cents that in the performance d the work for v4,' . .'. .-••••• . '..ued, shell employ any person in any manner so as to '
become subject to the workers'°ompemd'• ,sue a Celiania, .. ill should become subject to the workers' *************************************aE*****************************************
co nation provisions of Section 3700 of the se.. Code,I . .• ply rilh those provisions. I N D I V I D U A L yF E E BREAKDOWN
1 `% fAwT - a s ...ant: ..: .tom
zoo--
Warning:Failure to secure workers'compenndpn• �jr� y subject anerrrproyer to criminal penalties and TYPE QTY DESCRIPTIO N1 UNIT COST TOTAL COST
civil fines up to one hrndrad thousand dollars($103000A M add'r of compensaW"damages am provided for In
Saaeon37Osolthe Labor Code,lnnnagend aroma/afees. PLU 1 STORM DRAIN SYSTEM/PER DRAIN 20 . 00 20 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury the there is a construction lending agency for the END OF FEES
performance d the work for whish this permit is issued(Section 3097,Ch.C). /
LENDER'S NAME . , /
LENDER'S ADDRESS:
I certify that I have read this application end pate that the above information is correct.I agree to comply with all city and county ordinances
• and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned popery
for inspection purposes.
J BRY T GADDIS
-( Print Name �r
_y i _ Dme:,Z 'LQ'{ s U3 4L'14r••2. J,,117425 Yt=4T ;[,_^it
are i ,..canvu�lRFaard� PATE: 12, ".r.nc T11 -...•. :J
(5151de.WP) While-Building A Safely Green-Rio:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
'CONSTRUCTION AND PLANNING - POO 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 - . t.
•43: Electrical Conluit•-Utility-Undrgrnd. 54. Forms
4. Electrical Gonduif-Uridrgrnd. 55. Electrical Bonding ,
-5:. Steel Reinforcement 56. Rough Plumbing & Pressure Test
' 6. �EigttricaI-OFERGrnd. 57. APPROVAL TOCOVER-GUNITE -
.y .
'_7.. Footings. r 58. Electrical Conduit_Undrgrnd• ,
r
-8: Foundation-- - 59. Gas Pipe, 0 Undrgrnd.;Test
'97' Water Pipe-Undrgrnd. ; 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural floor System - 61. APPROVAL TO DECK' -
11. Property 6e ver Line & House Connection 62. Backwash & Receptor-Final^•t
•
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
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18, Rough Electricaf=T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19, Rough Heating &Air Conditioning FIRE.REPT.REQUIREMENT
20. tough Factory'Fireplace ' ' ` . APPROV41:. 2i_Perfnit # _ .
21. Ducts,in Structure ,. •' _ •- - ' 70. Undergrou6M Hydro "
22. Ducts, Ventilating ,• - " . , 71. ProductPiping O Gas boil
` , .
•
23. Gas Pipe-Rough &Test - "i r- • •' 72. Underground Flush x r.
24. Roof Framing _ 73. Undergrnd.Storage Tank 0Gas 0 Oil
25. Roof Sheathing - . 744' Overhead Hydro
26. T-BarCeiling (Structural) & Monocoat 75. Dry Chemical -
27. Frame and,Flashing . - - 76. Dry Staridpipe - '• _ r
28. Lathing t-H ''- -r% '• ' .; 7f.• FIXED SYSTEM,=FINAL .r
29. Insulation' o- , [• - 78. FIRE PREV. FINAL t '•
30. Drywall Nailing � 7HEALTH DEPT.'REQUIREMENT
31. Plaster Brown Coat r'79. FINAL INSPECTION • -
•32. Electrical,Power Meter•Final • '80.. FOOD CERTIFICATE ISSJ, ED 1
33. Final Eleciric " Notes: -
34. Final Heating& Air Conditioning /• , / -
Z _(A / ..FGAtAZ A �I SIJ
35. Final Gas-Pipe rest '; • �� ', • l�J��6Ju
36. Hood or Canopy r - ' . r
37 r.,tai. tutu rore piace r •
38. Final-Plunbing cz(Jn.1+ct PPM/.( .)_- ii. L--��
39" Watef Service-Final y[ C ! i -
'' Wl-rd-Raerin40. Gas Service-F Mai teir- O r - - ` . -
Solar nrri cr{r.C.•.-r _ -
3
•
42. Backflow Preventer c
43- Backflow Irrigation • ' ,-
44. Landscape Irrigation System - - •• - '
45. Sound Attenuation - • •
46. Handicap Regulations - . • - _ -
47. FINAL STRUCTURE & BUIIbING . .
48. FINALPLANNING 4 • . •
49. Electric Release to Edison ' ' - .
50. Gas Release to Southern California Gas Co _ - •
•
51. CERTIFICATE OF OCCUPANCY
No. Date _