HomeMy WebLinkAbout1961 ANAHEIM AVE - Building Permits • CITY OF COSTA MESA -
4 BUILDING DIVISION
o 'I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
o j ' • PERMIT
B03-02085
s,
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca,It 1LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1961 ANAHEIM AV CU Status: ISSUED
Suite: Applied: 12/03/2003
Vicinity: Issued: 12/03/2003
Parcel Number: 42214211 Zoning:
Applicant: HANSEN, DUKE ISSUED BY:
Address: 260 E ALTON AVE - -
- Phone: (714)557-7440
SANTA ANA,CA - Zip: 92707 .
Owner: O'CONNOR, JOHNNY L TR
Address 359 22ND ST -
,� - - - Phone:
,COSTA MESA,.CA I Zip: 92627-1800 - -
Contractor: ROSS & BARROWS INC. .
Address: 260 E ALTON AVE - -
Phone: (714)557-7440
SANTA ANA,CA
Zip: 92707 License: 327802
Arch : - Eng: •
Address: Address:
Phone: Phone:
Zip: License: License:
, - SCOPE OF PERMIT - • -
TEAR OFF EXISTING ROOF.INSTALL 1/2"CDX, 15#FELT,30 YEAR FIBERGLASS SHINGLES. 10 SQUARES INCLUDES 4 UNITS FOR FRONT
AREA ONLY.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,550.00
Permit: $97.25 Claim Valuation: $3,550.00
SMIP Res: $0.50
SMIP Com:. $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75.
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
2446.443 l6rool
• i
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 wo ars'compensation Inance carrier and policy number are: _
Cartier: e� re r, Policy Number: 00(0 2( (3 - 203
(This section need not be completed if the permit is valued et one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of Ilfornie,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 Ss' ns. /1
Applicant Signature: e Date: 72._--- 1 — d3
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 DOLLARS($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 lice sed 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.# ,, `Z 7 Y 0Z Class#
!7 I
Contractors Signature: ,- _6 Date: /"7 — oX-o.>
CONSTRUCTION LENDINGIAGENCY:
❑ 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: 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).):
❑ 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 and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,I.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the Califomia 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 en 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 apermit for such construction or modification
from the South Coast Alr Quality Management District or from any other air pollution control district or agency? 0 Yes D No
(Section 65850.2 of the California Government Code requires that the requested information be fumished 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 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 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 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.
D nature Of Legal Owner(s) Date
An Or Authorized Applicant Date
gen I INSPECTION TYPE PATE JN1iAL$ CODEC INSPECTION TYPE PATE III'ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final ) 208 Final Plumbing
200 Final Re-Roof /'�0 3 210 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
A90RESS OF BUILDING: 1961 ANAHEIM AV DMT: CITY OF COSTA MESA — BUILDING PERMIT
OWNERSNAAlE IF KNOWN: 0 CONNOR, JOHNNY L PERM NO: B 074461
"MEW' P 0 BOX 1942
NEWPORT BEACH, CA 92663 PERMIT NO: B 074461 PLAN CHECK NO: N GOVT: N SUPP : N
APPL.MAKING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UD.NO.: JOB DESCRIPTION : T/OFF REROOF W/ 4PLY B . U.R SQ FT: 2 , 000
ARCH.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 2, 000 . 00 CALC—VALUE: 2, 000 . 00 GROUP OCC : R-3 /M-1
CONTNACTORIKAME: ROSS & BARROWS INC. (714 ) 557-7440
CONTNACTORSMMUNO 260 E. ALTON AV COMMENTS : CARPORT ONLY
ADDRESS SANTA ANA CA Ucim.: 327802 ********;4* tio--x*****et*err********ire-**ie**+tit**v****->Fat*afit*ar*Re***Rt*+t+E**-x********RF**** -*
92707 uN: --- Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter B SETBACK S
(commenting with Section 7000)of Division 3 of the Business end Professions Code,and my['cense is in fun home and affect
DITYUC.NO.: 020924 UC.CLASS: C-39 WC.NO.: 32 802 EXP: 11 /95 MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN
°atB1 /d/`S � Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUIL 6ER D CLARATION:I hereby alfrTn under penaky el perjury that I am exempt horn the Contractors License Law for the
Ialowing reason(Section 7031.5 Business and Professions Code:Any city or county whin requires a permit to construct aper,improve. PARKING REQ: .' P ROV: PARCEL: 42214233 Z N E: REF NO: ' "
' demolish,or repel any structure.prior to eSatan:*ance,also requires the applicant for such permit to file a signed statement that he or she O
•licensed pursuant l0 the provisions of the Contractors License Law(Chapletnpith 9(oommenwSection 7000)of Division 3 s the PLANNING N TES
Business and Profemnns CCdel or that he or she is exempt therefrom and the basis for the alleged exemption.My vitiation of Section „>
7031.5 by any applicant for a pence ssteects the applicant toe civil penalty of not more than five hundred dollars 14500]). *******************************************************************************
ElI,asowner a the popertyor my enplolees with wage as their ads compenadan,wiu dome work,and the'throws s not intended D E V E.; L O P M E N T SERVICES R E M/� U I R E M E N eT S
or offered for sale(Section 7044,Business and ProfesskxProfessionsCode:The Contractors License Law does nor appyto an owner of property
who bolds or Symms thereon.and who does such work lensed or herself or through ha or her own ampleyess,provided the such L`
improvements we nor intended or seared for sale.II,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I.as once o mny.
the am exdmudy contre°"gwith Ebnsedcontracm"to construct me project(Section 7044,Business and BUILDING APPRS ED BY DATE:
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who
contracts for such projects with a mntrador(s)licensed pursuant to the Contractors License law). j
❑ Iamexempt under Section: B.AP.C.,for die reason: APPLICATION ISSUED BY: A il” DATE:
Date: Owner **************#******* * **fit,*******
LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sea ions 25505.,sc+a,end
2.55,34.and that Mfuture building hit �mhungl
. a permit frcosbenrmdfcationfrom teaanagerneru dct.RetidentdEtmdm imanezmmm for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provaiws. PERMIT 45 . 00 . 50
Date: Applicant: S M I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalyd perjury one of the following declarations: PLAN
ISSUE FEE
❑ Ihave end maitanaedoamnchthisinsueMwrkers'crnpsnmion,esproidsdforby5edbn3700oftheLabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.for the pMorme cis of the work for which this permit is issued.
A Ihamend witmaintaiworers'compensationinsurance.as required bySediOn3700ofIMLabor Code.lerthe perfrmanceothe TOTALS-- —> 45. 50 0 00 0 . 00 45 . 50 45 50 . 00
work for which this pencil a issued.My workers'compensation insurance carrier and pole/number are:
caner FOUNDATION EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 45 . 50 OVER/SHORT: . 00
PolicyNumbec W4S /1114 + 4 07/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
rata section need nor be completed/the perms is for erre hundred dollars(Sf00)or leas.) 45 . 00 . 50
❑ I candy that in the performance of the work for which this permit is issued,I that nor employ any person in any manner so as to
become subject to the workers'compensation laws of California.and agree that e I should become subRd to the modems' *******************************************************************************
compensat woods' so Section 3700 of the labor Code.I shall forthwith ply with mom provisions.
Derr. /CI / /T6
Applicant: �CeINDIVIDUAL F E E BREAKDOWN
Warning:Failure to/icue warfront'compensation coverage is unlawful,an shell sugecf an employer to criminal armadas*and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil Ries W to one hundred thousand dollars($104000),hi addition to the cost of compensation,damages as provided ler In
Section 3a5shthe Labor Code,Interest,arid aromyslees SFR 2000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a conemdion lending agency for the END OF FEES
performance of the work for whin this prmi a issued(Sedan 3097,Civ.C).
LENDER'SS:
LENDER'S'SADDRESS:
AFL 11
I certify that I have read this application and dee that the above information is conec.I agree to comply with all dry and county ordinances
II!
101
end state laws relatingof to building construction and hereby authorize representativesThis city to enter upon the above-mentioned property .
Ir aapedien purposes. NANCEE KILBOURNE 1995
Print Name OCT 0 5
c.enVAp .� Date: le/071,< _ F CO.C7A MES.l1
Signature 1 r/ppenVAPfilwhi/Conlrector O_�_ $Th
(5151'46.WP) White-Buildisg&Safety:Green-Re:Canarydppicanl:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING - POOL WA
• APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or P&le_ 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
•
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms•
4. Electrical Conduit-Undrgrnd. 1 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. •
60. Backwash Lines, P-Trap, 0 Uridrgrnd.
10. Structural Floor System • 61. APPROVAL TO DECK
11. Property Sewer Line & House Conrtction 62. Backwash & Receptor-Final '
12. Sewer Cap - _. - 63. Heater& Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final ,
15. Rough Electrical-Conduit 66. Solar System-Final •
16. Rough Electric Wiring - - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical.T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing (Hc7-15 &tA41 74. Overhead Hydro
• 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation •
78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes;
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ,
39. Water Service-Final
40. Gas Service-Final `"'a }-___A
41. Solar Domestic-Final / r:
42. Backflow Preventer r f
43. Backflow Irrigation T'
44. Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations
47:FINAL STRUCTURE & BUILDING (� 5=76 4 - ' ' -•` -
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
4 5 7 2 6 8177 50 51:1 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 .
APPLI TI N FOR%STRUCFURAL PERMIT 5. Ti
For Applicant to Fill in Completely —Use Ink Only - -
/� �I RECEI DATE RECEIVED DAT=IS
BUILDING ADDRESS j9& 14141uc/M 3 �yp'� (�
OWNER TOM A/b7 0 C0/au 00 A.P.No. //J `2. 2•- ///J� PEFiyt- I�` /,�/V
MAILDBUIL ! / /(/�/'�(/Jj' " /�(/t
ADDRESS '/Ip PT,ant6OL,pTEADDRES/S .tie
CITY t'QII,O N(� pc& /7y�!(- NO. GYZ-Yth. FA/ TRACT,�/ts 10T2C BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFM&I ISH
LENDER Mnnudtn-s - f
BRANCH Petition- ft Ckl .....---
OWNER 00 Mu-a ' Y DCO .---a tie
ADDRESS I7,c-A .�i7- 79A ..--- G VALUE
ARCHITECT ��Ij r- TEL.// p
OR ENGINEER in us /R.. roccy N0. 291f.-5"6m /I4 t -§
LL,--17 A 2/1 . (3 * W.ket FIRE
ADDRESS iTJ'1 z• ZONE PE GROUP
APPROVED
CONTRACTOR P. 12 5pQOVt BY DATE
ADDRESS 7/6 MAI?/how
s TEL. ZO NO.OF USE OF NE
CITY COILONli 'PCL r"��/Aft NO. 6'IO-790 `2_ PLANS BUILDING /plf/t7°/I tie,
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. 2 01 LIC.NO. 731 MAIN BUILDING ACCESSORY BUILDING
z2 SIZE NO.OF BLDGS. (FROM C/L STREET) ��•]1
IL OF LOT INOW ON LOT FRONirrr 4FT. S`IGG IIT. "a-
4 USE OF /C.//��cJT
EXISTING BLDG. R.SI /�T.r C��.J0 �f
ti K (�,
F Separate permits are required for L.SID /JFT, FT.
electric,plumbing and heating work. REAR /�[F,/9 FT. 1
W FUSE OF BUILDING AND WORK TO BE PERFORMED I :/ J
(Sze DISTANCE BET. BET.MAIN&
Q -PLASH saw:xi lSze MAIN BLDGS. ACCESS.SLOGS.
CI
VAR. `7/" /LC.U.P. DATE
APPROVED s2'- X
22
'C APPROVE � 2?
__By DATE J
C
W
a •
C I hereby acknowledge that I have reed this application and state n
IX that the above information Is correct and agree to comply with m
CLI all laws regulating building construction, and I shall not employ
Zany person In violation of the workman's compensation laws of o
.iW. the State of California. o
I hereby certify that I am properly licensed as a contractor under SG.FT. n
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ 5:00— m
und Professions Coda,Dlv'�•p3 Ch.•te +
/ , �, PLAN CHECK $ G
Signature of �
Permittee • TAX $ 5re U.f
U
Authorized Agent O TOTAL PAID $ .4f SO
r` r
43962 P:10
MAY 11-77rrI D00 563* *****5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LIC IO FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
//{{,,//-- / /,/J� RE El E BY DATE RECEIVED D/A.-TE/I`nUE •�/
ADIDRESS /96 i / „../xti,eI/,l Co rmi r ' 7 %/ ' �/
PERMIT NO.
' /nl,voy 6 y J
OWNER I/ / O/(/ 0 /� A.P.NO. /�
ee
MAIL p �t a 44_ BUILOIN t9 J
ADDRESS P.0i 3 I/ Itt Z .v AD S ` / / C ,
TEL
CITY�JZcc,$, /,/2>`c•-CI.. NO45/�Z 3C3«, •
a�RDD ALTER REPAIR
LOT�J BLOCK
CONSTRUCTI NEW ADD ALTER REMOVING OFMOI IS.
LENDER `/ (/(/�/
BRANCH OWNER 1' / /- 4• rl / -�
ADDRESS TE _ 'J.4 J r� A UE '
ARCHITECT TEL. SE L��. / A. $ a° �-
OR ENGINEER NO
FIRE
ADDRESS OZONE TYPE GROUPrj
APPROVED
CONTRALTO .W40 BY DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW...„....-------
CITY NO. NS BUILDING
.* STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY :UILDING
lil SIZE NO.OF SLOGS. (FROM C/L STREET) I
G. OF LOT i NOW ON LOT FRONT FT.
Q USE OF
,F_, i EXISTING BLDG. R SIDE F . I. T.
CS li r
FSeparate permits are required for L,SIDE F / FT.
electric,plumbing and heating work.
WREAR r T. FT.
[.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& '
QMAIN BLDGS. ACCESS BLDGS.
Q /�I �//J � VAR. . /1 APPR ,/
,(J APPROVE( /
APPROVED VE�7 / 17
a j
w
0 I hereby acknowledge that 1 have read this application and state
n
rig that the above Information is correct and agree to comply with
C• all laws regulating building construction, and I shall not employ co
si
Z any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under SO. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business 'a
and Professions Code,Division 3,Chapter 9.
mVALUATION PERMIT FEE $ V
• ��
Signature of �J�',/� /� `J PLAN CHECK E LL
Cf L-AYry9 /'v o
Permittee O a,.�j $�,r/� TAX $ a �Q 2
/ lT� /'� /,/ U
Authorize gent TOTAL PAID $ ✓ .7a
Pani
= 43525 FFR 16-77—e-pr 00 924:1 ***166.111
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
,_/p l-- APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Oq
RECEIVED BYDATE RECEIVED -DATE IU .92TL
)/.
BUILDING C / „fins
Il 4 `I
ADDRESS (7 . -
r 1
/ /� A.P. NO. /0."- 322--//168
PERMIT NO. G�A,1 Fj
OWNER f/ ,2. C e/f�/f/ GY /P1-ic4
MAIL Q nr� �J�( BUILDING -QA//}(/E/N•I Avg
ADDRESS 3 c ( 2.2" " 1/t . ADDRESS i 9&' a0/-a4
TEL F(/1RyIFU/ FARMS pCN.
CITYI� TRACT LOT Zy BLOCK
�. A r� /��q p\ NO.G[�-��^)
CONSTRUCTION NEW ADO ALTER REPAIR MOVING DFMOLISH
LENDER
BRANCH
MEP T, L . U G`''f °I.0
ADDRESS VALUE/ • e
ARCHITECT • TEL. irs...-iii-.1/, .1 $ /4 ni
OR ENGINEER NO,
FIRE / -• - ✓t�
ADDRESS ZONE
CONTRACTOR l �.- AP �r� DATE % " ,
u -".
ADDRESS
2ONEfs NO.OF USE OF NEW!/('- "T
CITY TEL.NO /(-Z PLANS G. BUILDING /ftpr
STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
"LI
SIZE O.OF SLOGS. (FROM C/Lss FyET) `f
Mi OF LOT I NNOW ON LOT Z FRONT F-r/' ANCY FT.
USE OFO.2{.• l' ! r
cm EXISTING BLDG. ce be Qanne4l T A ed. R-SIDE? T. FT.
cn ( -� ar
FSeparate permits are required for L.SIDE 7 FT. '^ ` - FT.
electric,plumbing and heating work.
l A. i
Cl- - _ __ REAR FT. FT.
F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
AMAIN BLDGS. ACCESS. BLDGS.
n dUi(/t r 4, DATE
C URP - --�G-2/I., APPROVED' /7-17
> APPROVE�i a )O raj lr DATE 8�7 —/ /
W • OR SPEC AL REQUIREMEN •
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p I hereby acknowledge that I have read this application and state n
n
pf that the above information Is correct and agree to comply with m 4
0. all laws regulating building construction, and I shall not employQ
{Zz,l any person in violation of the workman's compensation laws of x: A,
S the State of California. (/�//� // �`
I hereby certify that I am properly licensed as a contractor under / �O FT. �`s- / (tom'
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR D's tV
Chapter 9, and that such licenses aro in full force and effect,or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLY: -
am exempt from the provislo of the State of California Business o n,
VA Lyft$ PERMIT FEE E ION
and Professions Code, i ,Chapter 9 L9A PERMIT in
J (/ en Aft4
�7jp ,'J. PLAN CHECK E/ ^_
Signature of -/ G a! o
Permittee $ TAX S�I E �,��,at
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Authorized Agent TOTAL PAI E. Alb• ,�L
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crlsa 283.85
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
/- `1/� I^, ern
�A -// RECEIVED BY DATE RECEIVED DA E(1 U�,()
ADIDRESSG L I NAf91 E7V1 ANC J ) ///� (JQJ / %,
0115--1/4902:2 - /4 Lg PERMIT NO.
OWNER A.P.NO
MAIL BUILDING �/`�
MAIL rADDR{�ESSfS(1n6 / C� ,fit jo/,n 4--a e.."
CITY TOTEL ` ihW 0 rr !DT BLOCK
CONSTRUCTION NEW I ADD ALTER REPAIR MOVING DFM1111SH
LENDER
BRANCH
OWNER
ADDRESS VALUE
ARCHITECT TEL. USE S
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS ZONE INO.OF USE OF NEW
TEL. PLANS BUILDING
CITY NO.
F-. STATE CITY YARDS APPROVED YARDS APPROVED
`F LIC.NO. LIC.N\ MAIN BUILDING ACCESSORY BUILDING
W SIZE 'NO.OF BLOCS (FROM C/L STREET)
Q. OF LOT NOW ON LOT FRONT FT. FT.
a USE OF
4 EXISTING BLDG. R.slop FT. FT.
In
E Separate permits are required for L,SIDE FT. FT.
IQ
electric,plumbing and heating work. REAR FT. FT.
[.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
0
MAIN BLDGS. ACCESS.BLDGS.
• VAR.+ DATE
'—I • C.U.P. APPROVED
D.
APPROVED
NJ —_/1Y DATE
06
W
0 I hereby acknowledge that I have read this application and state 'n
tk that the above Information is correct and agree to comply with m
L all laws regulating building construction, and I shall not employ i•
Z any person in violation of the workman's compensation laws of o
'U the State of California. m
I hereby certify that I am properly licensed as a contractor under SO. FT. re
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m_
Chapter 9, and that such licenses ere in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business 'p
VALUATION PERMIT FEE E �r ///���
and Protesslons Code,Division 3,Chapter 9. i J 7/ . m
Signature of I`aL ^ PLAN CHECK $ YYY��. o
Permittee $ / 11 TAX E /� s�_b.
2
Authorized Agent (/- TOTAL PAID scR 73 sg
. . >FB 16.777N<°00 921* ea,**31.77
4352C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RE EI
I AT ON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
D DATE RECEIVED DATE I SUE
BUILDING //p .�7 A Sys/
ADDRESS �yG / acole., y� 52: 4 -a / ¶-
A.P. NO. its —70Z �{/ 1!68 PEk3S2(
OWNER GJ ,A, (/ COss/t/�(/ OS/��I p/ swJJL,®
AMAILDDRESS-3 S �� 2f- �+-t
ADDRESS /��I ���NCV�'1 ArE
TEL, /54fs(UIGiv FARM-1 tint LS-
C IT ::,5-PTO ��L NOQ99.39/2- TRACT LOT BLOCK
CONSTRUCTION 1`{EW ADD ALTER REPAIR MOVING DFMOI ISH
LENDER \
BRANCH y
OWNER T C O' GO,V.f/e/f.
ADDRESS ��(/� y/- j/ /J/% VALUE X�,`,�/J/////�/
ARCHITECT TEL. Li moi744-24 rX/�/ V//Vf/
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE ' G UP
/ / / APPROVE•
CONTRACTOR L / / `, i/ BY /� DAT4'
ADDRESS
TEL. ZONE.r NO.OF USE OF NEW 4/ c4. eT-
CITY NO. r�'Z PLANS BUILDIlra.e. ,9.41-/F .
��
1-1 STATE • CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING
(FROM C/L STREET) ACCESSORY BUILDING
(.4 SIZE NO.OF BLOCS. Q
0. OF LOT INOW ON LOT 2 _FRONT FT. /[J
USE OF
N /J"_ yT-./ T
EXISTING BLDG./1°4Z/ To A AzgmQ4:24—) R.SIDS FT. 8 1' FT.
CR
FSeparate permits are required for L.SIDE FT. OFT.
d. electric,plumbing and heating work. REAR FT. cis, 1Q4 /
W USE OF BUILDING AND WORK TO BE PERFORMED ca Q DISTANCE BET. BET.MAIN 0
MAIN BLOCS. J/ �A}CACESS.BLDGS.D �/
n 1( 42 (/RHS-Pt/L� CURP,dIwi "/6 o4aPPROVE / -77
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a L��L- V 4Je�G,-7 APPROV69//c /t�,iQ. .e ---_.—
W at)Af 2�'//�
Abu) /aI/ECt
O.
I hereby acknowledge that I have read this application and state vz
a that the above information is correct and agree to comply with -
co
LL all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of
the State of California. /Q2
I hereby certify that I am properly licensed as a contractor under 2/SQFT. a co
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Q
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: <
am exempt from the provls ns of the State of California Business VALUATION PERMIT FEE E [�`b\
end Professions Code, I Isl n 3,Chapter 9. in
///i Z o
�sf� PLAN CHECK $ 3/ eno
Signature o ////��((;4.� n�OO ! LL((��`
Perm lttae �,lLJfrl' $ (J/� TAX $ �j f mss,
/) (/// / U /�`
Authorized Agent ' TOTAL PAID $ I,y:s
• v .
4 SS' AUG —4-77cwsa00 84648.00
•
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
�,/y/ RE 'IV D DATE RECEIVED {J1JQ.T E,II SUED
ADDRESS BUILDING /lr!��AlitEl /I V / '��
/— PERMIT NO.
OWNER IC D' /MCP A.P. NO.
MAIL ABUDILDDRIENGS` y,7Avvepn 47,44
ADDRESS
TEL. TRACT I. LOT BLOCK
CITY NO.
CONSTRUCTION NE/W�I ADD ALTER REPAIR MOVING DEMO)ISH
LENDER r/AJC\
BRANCH /�, /�j+
V
OWNER v (I17/IOIh
ADDRESS VALUE
ARCHITECT TEL. aninienr $
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS ZONE fNO.OF USE OF NEW
TEL. PLANS BUILDING
CITY NO.
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLOCS. (FROM C/L STREET)
0. OF LOT NOW ON LOT FRONT FT. FT.
hUSE OF
EXISTING BLDG. R.SIOF FT. FT.
Ca
F Separate permits are required for L.SIDE FT. FT.
G electric,plumbing and heating work. REAR FT. FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET.MAIN&
QMAIN BLOCS. ACCESS. BLDGS.
VAR.tis DATE
MI
C.U.P.# APPROVED
APPROVED
a _BY DATE
W
0 I hereby acknowledge that I have read this application and state n
p( that the above information is correct and agree to comply with m
4 all laws regulating building construction, and I shall not employ i
Z any person in violation of the workmen's compensation laws of - o
the State of California. -
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ce
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F E ONLY:
io
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $
and Professions Code,Division 3,Chapter 9. �� n
• PLAN CHECK $
Signature of o o
Permittee . $ TAX $ 2
U
Authorized AgentPV U
` TOTAL PAID $