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HomeMy WebLinkAbout2452 ELDEN AVE - Building Permits CITY OF COSTA MESA 4 BUILDING DIVISION Y•i t-,� DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER v.� PERMIT BOO-01382 � (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2452 ELDEN AV Status: ISSUED Suite: A-D Applied: 09/06/2000 Vicinity: UNITS A-D Issued: 09/06/2000 Parcel Number: 43929106 Zoning: • Applicant: JONES, CLIFTON ISSUED BY: Address: 10945 SOUTH ST UNIT 301 Phone: (562)924-4491 CERRITOS, CA Zip: 90703 " • Owner: INFINITY HOMES CM I, LLC Address 10945 SOUTH ST SUITE 301 Phone: (949)645-4338 CERRITOS, CA Zip: 90703 - . Contractor: INTREPID HOMES INC Address: 10945 SOUTH ST UNIT 301 Phone: . (562)924-4491 CERRITOS,CA . Zip: 90703 License: 779066 Arch : - Eng: Address: Address: ' Phone: Phone: Zip: License: License: . SCOPE OF PERMIT DEMOLISH EXISTING 3121 SQ FT 4-PLEX(UNITS A-D). . FEE SUMMARY Plan Check: $0.00Calc Valuation: $5,000.00 Permit: $111.25 - - - - ---—- - -- H Claim Valuation: $5,000.00 SMIP Res: $0.00 - SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 ' Total: $111.25 PLANNING8 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: i 0 Required: 0 Proposed: 0 - NOTES: 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 // • 2446-48(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 carrier and policy number are: Carrier: Policy Number: (This son need not be completed if 0 pe ,If Is valued et one hundred dollars($100)or less.) �I certlfy that in the pianoof the ark for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compenLsation laws• alley ree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the,. •rovis'• `. Applicant-Signature:- ^ / F" C Date: 9-,l.Y---w WARNING..FAILURE TO SEC 'E WORK- 4 COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE IMO.?a),IN AD•'TI• TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTOR •ECLARATION: ' I hereby affirm that I am licensed uupder pr vis on ommencing with Section 7000)of Division 3 of the Busines d Professions Code,and my license is in full force and effect.Lie.k /-� •7 i' �r • r CIaaS M-- j ContractoYSSigneture:`—� �• CDate.:"'� -Cir---b-VC) 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: 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 and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers 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-sfx(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? 7:1-Ter--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). n_..._ .._ Manage.enta ..._._.. __._.. 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management end Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire partment 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 a plicatlon a erect 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 U No (Section 65850.2 of the California Government 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 feel from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _..-it .__ _ ._..__.._ h_..___.._ _ 7 application,If a icatioit from tae South Coost res prescri ed by Heal or nd Sr et po deion control 303 be or aadecy ls requlretl for the work which is the subject ai this ____have all of the disclosures prescribed by CaliforniaCelifoia 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 AUTH•'••• • 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 - city or'Inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspect'.... . agr.e not to occupy or allow occupancy of any building authorized by this permit until final inspection. g. ? .mer s 9.-r-6-0- ii / Date d(Or Au •• ( Dat CODE 1 INSPECTION TYPE PAUE ILLS T,ODEt INSPECTIONTYPE PAIL. =AO 1616 Fixed System Final Ir. -revention 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 / �Q // 222 Final Site 204 Final Demolition //"7l /� 250 Final Building/Occupancy 41014 CITY OF COSTA MESA " - aa. `, BUILDING DIVISION F et e 4,,,4 %; DEVELOPMENT SERVICES DEPARTMENT PER NUMBER PERMIT % 00-01381 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaCfUyS DING PERMIT n FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2452 ELDEN AV IL Status: ISSUED Suite: Applied: 09/06/2000 Vicinity: Issued: 09/06/2000 Parcel Number: 43929106 Zoning: Applicant: JONES, CLIFTON ISSUED BY: Address: 10945 SOUTH ST UNIT 301 Phone: (562)924-4491 - CERRITOS,CA Zip: 90703 Owner: INFINITY HOMES CM I, LLC Address 10945 SOUTH ST SUITE 301 Phone: (949)645-4338 CERRITOS,CA Zip: 90703 Contractor: INTREPID HOMES INC Address: 10945 SOUTH ST UNIT 301 Phone:, (562)924-4491 CERRITOS,CA Zip: 90703 License: 779066 Arch : Eng: Address: - Address:• Phone: Phone: Zip: License: License: SCOPE OF PERMIT DEMOLISH EXISTING 900 SQ FT SINGLE FAMILY RESIDENCE. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,500.00 Permit: $97.25 - - - - - • Claim Valuation: 83,500.00 SMIP Res: $0.00 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total . $97.25 -` • 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 NOTES: • 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 fora period of 180 days. 2 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 244646(8100) 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 on need not be comp/et:,- I : •:mit is valued at one hundred dollars($100)or less.) _I certify,that in the perfor•. 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 o . ' •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• ••/���• , .,,,-- of �- ,.�1 IApplcant Signature: -or �� ' Dat` e: "<./ WARNING:FMLURE TO SE• S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE 15100,0.• :•MON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: }w I hereby affirm that I am Ilcens:•under pr• ...se".• i Ater 9(commencing with Section 7000)of Division 3 df the Bush and Professions Code,and my license is in full force and effect.L7c�N"- - r / •e. - Class N Lontractors.Signature:, erraa1f- CDate:-'-9 -..-Z, -ea (CONSTRUCTION LENDING AGEN ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI 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 and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers 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 feat in depth into which a person is required to descend,wit 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(36)feet high.(Chap.3.2,Grp 2,An 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 end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomla 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,ore 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 Vas 0 No 5 D _- ...o. _..._or..m..—__ 5 Dora or will the oast or present a emen buildingsoccupant at any other air toe work ontch is the t or of this a estion a rmil for such consWCilon or modification from the South Coast Air Quality Management District or from other air pollution control district or agency? �Yes U No (Section 65850.2 of the California 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? ❑Ves , 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). -77----11.a 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 prescnbed 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 end Emissions. Signature: • Date: ____ CERTFICATE OF COMPLIANCE AND '.• 0-r •TION 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 st: e laws and ty ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Ins.,,.s'•'.11*•- ._:' I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection, rDate ft-6 —ori diOr 2 •nz:• • cart --r-----.---,.__ (Date-, CODE j., INSPECTION TYPE PAIL MALI CODE I INSPECTION TYPE PAIL IMAL4 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 204 Final Demolition r.z2 250 Final Building/Occupancy • ,O ' M(c9 • CITY OF COSTA MESA BUILDING DIVISION F� ,I DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER f PERMIT J".(oq o uee P00-00490 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2452 ELDEN AV Status: ISSUED Suite No Applied: 09/06/2000 Issued: 09/06/2000 Vicinity: FRONT OF LOT Parcel Nunmber: 43929106 ISSUED BY: Applicant: JONES, CLIFTON ' f'll� Address: 10945 SOUTH ST ' , UNIT 301, Phone: (562)924-4491 - , CERRITOS,CA Zip: 90703 / Owner: INFINITY HOMES CM I, LLC Address ;10945 SOUTH ST . , SUITE 301 . Phone: (949)645-4338 CERRITOS,CA Zip:, 90703 Contractor: INTREPID HOMES INC ' Address: 10945 SOUTH ST , ' - UNIT 301 Phone: (562)924-4491 • CERRITOS,CA Zip: 90703 • , License: 779066 ' Arch / Eng: -- . Address: / i . . Phone: - Zip: • . License:' , SCOPE OF PERMIT CAP OFF EXISTING SEWER FOR DEMOLITION OF SINLE FAMILY RESIDENCE 8 4-PLEX. , REF: B00-01381 8 B00-01382 -'FEE SUMMARY ' AMT, QTY AMT -•OTY, - _ i�/ AMT OTY ISSUE FEE • $23.50 -/ Laundry Tub/Washer $0.00 " 0 -'_ -- Sump Pump J v /$0.00 0 Backflow irrigation`,, $0.00 0 ' Landscape Irrigation $0.00 0 .SwimMing:Pool / ' ;'$0.00 0 Backflow Preventers x'$0.00 0.' / , P-Trap" $0.00 0 - Trap Primer.- ; $0.00 0 Bathtub $0.00 0 'Pressure Regulator $0.00 0 '' Urinal. ` ',' $0.00 0 Clarifier System $0.00 ' 0 Process Piping(per 10 ft)" $0.00 0 - ' " Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) -$0.00 . 0 Receptors $0.00 -0 Vacuum Brkr Bkflpw(5+) $0.00 0 Dental Units ' $0.00 0 Septic Tank - $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo .$9.80 1 Wash Basin.Set $0.00 0 Drain,Floor $0.00 0- Sewer Connect '$0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line , " $0.00 0' Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0" _ Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 ,0 . Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial - $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.30 COMMENTS/SPECIAL CONDITIONS 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(600) `l 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 sell-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 win 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 carder and policy number are: Carder: - Policy Number 7Ineed not be comp:fed If N:permit Is valued at one hundred dollars($100)or less.) certify that in the performance of e 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 , nd 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 pr- I .. - / 1Appiicam'Signature:'- - -./ JT�Z Date:--�j=69/ '= WARNING:'FAILURE TO SE URE 2,11 RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT Ni EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED rx'SAND DOLLARE($100,••! , DMON 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 affirmihat t em licensed under provis'i.''•j.Ater 9(commencing with Section 7000)of Division 3 of the Busine s_an_d Professions Code,and my license is In full force and effect -77'90 4S ��/' Class a75 Contractors Si�: _�/ {Date 4-(n _-CO I 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,CMI Code). Lender's 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 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 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,faisework,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 end 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 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 a:e'mit for such construction or modification from the South Coast Alr Quality Management District or from any other air pollution control district or agency? Yes D No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any pan of the facility Io be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑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? ID 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 reed this application and state that the information given Ls correct. I agree to comply with all :•• - d city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for i .•ection p I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ii/� • .rOr A ��1.• zed Applicant - - F—Date t .- . ;ODE I INSPECTION TYPE PAIS INIDIALS ;ODE t INSPECTION TYPE GAIL IMALS 1616 Fixed System Final in •revention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing - 1) •R -cf' = 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 PROJECT ADDRESS: 2452 ELDEN AV UNIT: • CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B :046476 OWNER'S NAME: JERRY JONES • ADDRE58#2452 ELDEN AV . PERMIT NO: B 046476 'PLAN CHECK NO: 03112-90, S GOVT: N SUPP: N ; • COSTA MESA • CA 92627 . CONSTRUCTION TYPE: 5-•N - PERMIT TYPE: STH PURPOSE': AL1'. (714 )722-6711 . ARCN/ENGINEER: 'REG.NO.: JOB DESCRIPTION : LEGALIZE PATIO. COVER 6 DECK( 137#SQ FT) SQ FT: 274 ' `� .. ADDRESS: - UNR: - , • CLAIM VALUE: CALC-VALUE: .3, 781 . 20 GROUP OCC : R-3 / PERMITTEE: JERRY. JONES ( 714 )722-6711 - " • - ' ADDRESS: 2452 ELDEN AV COMMENTS: "LEGALIZATION" ' ' - COSTA MESA CA 92627 ' ">Ead** **ta*****stakytatetiE*at�tN"fE+tit•x•etaEatstat**aL******acer�t+tat+L** alar**er*eteE�E*******aiar+t**+EatELetirN•** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commendng with Section . . Z ON INC R EQU III EMENTS ' 7000)al Division 3 of the Business and Professions Code,and my license is in IW force and effect. -S E T B A C, K S CITY UC.: ' STATE LIC.: CUSS: Date: Signature: MAIN BUILDING -- ACCESSORY BUILDING - • - WORKERS'COMPENSATION DECURATION: I hereby affirm that l have a certificate DI consent to sell-Insure or a certificate of Workers' FRNT: FT IN REAR: 16 FT 6 IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section MOO,Lab.C). LEFT: 33 FT 3 IN RGHT: 18 FT 3 IN LEFT: FT 1N RGHT: • FT IN. POUCY NO.: EXP.DATE: • COMPANY: PARKING REQ;_ PROV: PARCEL: 143929106 ZNE: R2 REF NO: f4:7'.Certified copy is hereby furnished. 0 Certified copy PLANNING NOES> LEGALIZE DECK AND TRELLIS PATIO COVER ATTACHED TO THE REAR , _ ._ • > OF AN EXISTING DETACHED RESIDENCE. - - 'Date' Applicant: • **************************************************af*******************rat****1t*aE* EXEMPTION FROM WORXERS'COMPENSATION DECLARATION: (This section reed not be completed if the permit is fa one hundred(5100)a less). • DEVELOPMENT E R V, I C ES R 'E Q U I R E N E N T••S • I certify that in the performance of the work for Mich this permit is issued,I shall not employ any person m any manner so as to become ` �J'I .2,� subject to the worker'Compensation Laws m California. ZONING APPROVED BY :..... a./ D'" --��6 `/ DATE: a{-f_-! �0 Date: - - Signature: > ---(((�// C- - • NOTICE:If,after mating this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : AM - •' / DATE: �'�/7�96 Cdde,you must forthwith comply with such provisions or this permit shall be deemed revoked. • - CONSTRUCTION(ENDING AGENCY: I hereby affirm that there s a construction lending agency for the performance of the work for APPLICATION ISSUED BY: - -- - T a DATE: / O • which-this permit is issued(Section 3097.Chi.C). ********************** ' „ ' ,. . . . • • ' -********** ** ' LENDER: - ******************************************** " **it****************************** ADDRESS: ' - ' • - LEGALIZATION:Y FEE 'S U M M A R Y ' • STRUCTURAL SEGMENTIY ' • OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the blowing reason BLDG PMT PLUMBING .ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,dr PERMIT - 126 . 00 ,50 - repair any structure,prior to its issuance,also requires the applicant Ior such permit to Me a signed statement that he/she is licensed . pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the BusinessSM I P/NON--RES' • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN ' • 81 . 90 . any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE I. owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT :ISSUE PLAN-CHECK • TOTAL PAID DUE❑ sas structure is nnot Intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> . • 126 . 50 0 . 00 40 . 95 167. 45 167. 45 . 00 does not apply to an owner of a property who builds or Improves thereon,and who does such work himsei/herself or through - , • - his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTAL S--> COLLECTED: • 16 7 . 4 5 OVER/SHORT• . 00 Improvement is sold within one year of completion,the owner will have the burden al proving he/she did not build or improve • .forthepurposeofsale). " - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT 'GRADING PLAN--CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 12 6 . 0 0 . 50 • 4 0. 9 S • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or Improves thereon - - . projects who l am aware *****************************************************************aE************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E •H' R E A K -D 0 N N • in l am exempt under Section:Bp7044 B.&P.C. • for this reason: NO EEMPLOYEES , I TYPE QTY D E S C R :I P T I O N UNIT COST TOTAL COST • Date: 3 C 1 2 — O Owner: . -lie A / 1 � • SFR 137 RES-BALCONY, EXTERIOR STAIRWAY 17 . 80 1 , 890 . 60 Ido hereby tend),that I am aware of and undeistand the requirements of la Health a .Safety re Sections 25505,25533,and 7 4- 25534antl'hatlor any future building occupant MUM!not(circle one) comply with state codes and the requirements for a SFR 137 RES-PATIO coyER 6 TREI,LI 13 . 80 1 , 890 . 60 permit for construction or modification from the Air uamy men tact.Resides' 'ruction applications are exempt from 1 , END OF FEES these provisions. /////lr^/ . . 1 Date: 3— �: •- 7ry Applicant: ' ' ' • I hereby certify that I have read this application and state., he above information is rect.I a.ree to comply with all city and county • •ordinances and state laws resting to budding construction.nd here •.rue representatives of t•x to enter upon the above-mentioned • , ' I •property for inspection purposes, I ' Date: ..-1 2 7-9 0 Signature: ��/✓ /1" 01 00055832-00055834 TOT 167.45. Driver's License or Sdcsl security Aptlicant;Pink-Revenue:Goldenrod-Assessor - - • - - .- . . . . , - ls • . . CONSTRUCTION AND PLANNING ' , POOL •PA Date Inspector ' Date . Inspector APPROVALS Permit# APPROVALS Permit# .../ 1. ttTemporary Electrical Service or Pole • - 52. Pool & Equipment Location r 2.13oil Pipe•Undrgrnd. 53. Steel Reinforcement - • • •t -••,3.'Electrical Cond'uitU_tility-Undrgrnd. . 54. Forms -'''4._Electrical Conddit-Undrgrnd. 55. Electrical Bonding • --r• . f . 5`Steel Reinforcement- 56. Rough Plumbing & Pressure Test - ii _•'6.�Electrica I OF ER ti-Cr-id. • 57. APPROVAL TO COVER-GUNITE _, 7:Footings 58. Electrical Conduit-Undrgrnd. ? 11. i ...._...--48. Foundation - - 59. Gas Pipe, 0 Undrgrnd.,Test � - 7 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. �^ k"� A.,2 10. Structural Floor System 61. APPROVAL TO DECK - ,/i- ;!, Yi 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ft /JT• A' 12. Sewer Cap _ - 63. Heater & Vent-Final ? - ''-/ /� 13. Roof Drains +/ 64. Plumbing System - Final -% P - • 14. Rodgh Plumbing 65. Electrical-Final t_ • , 7 15. Rough Electrical-Conduit 66. Solar System-Final `� • , - 16. Rodgh Electric Wiring 67. Fencing & Access Approval l I i 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ( 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL _ •19:Rough Heating& Air Conditioning .7- - - FIRE_DEPT, REQUIREMENT._ 20. Rough Factory Fireplace - , „ _ • ^, -APPROVALS . ;-Permit# - 21. Ducts,in Strucule; . '• - - • 70. Underground Hydro ' 22-Ducts, Ventilating - •. . . -71. Produci-Piping 0 Gas 0011 23. Gas-Pipe-Rough & Test - _ 72. Underground Flush' . ' • 24:' Roof Framing - - • .73.-Undergrnd.Storage Tank OGas 0011. 25. Roof Sheathing - -• - - - - 74: Overhead Hydro-' 26. T-Bar Ceiling (Structural) & Monocoat • , _ - - . 75. Dry Chemical - - - 27.-FrameandFlashing c. + - • 76. Dry Standpipe - . _ + '_ • "tc '28. Lathing & Siding_ - �+` - y. . • t 77- FIXED SYSTEM FINAL - - - 29. Insulation -, ` ' 78: FIRE PREY. FINAL ` - 1 1 'K r. 30. Drywall Nailing • . -..t HEALTH DEPT. REQUIREMENT _31. Plaster Brown Coat,' 7 -' j_ j• " 79. FINAL INSPECTION " _ _ 732.. Electrical Power Meter-Final :, ' ' c, 80. ,FOOD CERTIFICATE ISSUED- _33. Final Electric _ .,: i • ', '° :: • Notes: _ . . 34,. Final Heating & Ai(Conkditioning - - - - 35.-Final Gas Pipe-Test • - . _ - 136._Hood or canopy _I `1 .' 'r - - •37.-Final Factory Fireplaces :-. .,'.•r :: ; - ,•" - - .738_ Final Plumbing i. `L„"� =�..,. . . . ''39. Water Service-Final. - ' - • -40. Gas Service-Final •• - . - i. -. n'- - . _ .. - 41. Solar Domestic-Final' . - • -• 42. Backf low Preventer -' '+ • . 43. Backflow Irrigation - - . • - - '44. Landscape Irrigation System - • r ' 45. Sound Attenuation . .. , • ; 746.-Handicap Regulations - _ - ,A7-FINAL STRUCTURE & BUILDING • 3 (31c� _b',7/-_'- - 48'.:FINAL PLANNING - - - - �49 Eleairic'Release to;Edison - . A 1,1' ,•50' Gas?Release to Southern CaliforniarGas Co • - - - . 51. CERTIFICATE OF'OCCUPANCY t - ' No. Date 45722 8153 3/28/78 78.70 IL - 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 RECEIVED BY DATE RECEIVED DATE ISSUED ADIDRESS 214c1/ EL-n6/4 /eve- //yy ,/J/ Mf[ jerky i7, Jo a es A.P. NO.J/ / 'VO/ . 05 PERMIT NO. OWNER r �/ 4ve ADDRESS 2 sZ ELLE BUILDING Z4S,�s2s - Elder.,. Ave.A _-- ADDRESS TRACT J(/r/ ��LOT r1 L BLOCK CITY Ct/S TA 1A4 esa NO. LENDERCONSTRUCTION /y NEW ADD ALTER REPAIR MOVING DEMr11 ISH / .p. -`// BRANCH f�p ,.I L 1 OWNER�7km jcrry ILVJohec ADDRESS ARCHITECT rZOY t'1 rWRTk(NSTEL. USE t �e-S/G�r $UE _i (344 -. NO 3/ 4 )�� f 4 ^ m ZONE TV GROUP FIRE ADDRESS 714 V1/1 q JT I ` I I-1 ' /� �7� / APPROVED CONTRACTOR '[/ kin_ e /� BY DATE e-2 ADDRESS ZON Erw,s NO.OF USE OF NEW TEL. CITY NO. //`2, IpIp.NS 27 f� BUILDING - -. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. ! LIC.NO. ,.2:).5-,S/J MAIN BUILDING ACCESSORY BUILDING Ow SIZE / y 3 DO NOW ON LOTNO.OF S L-- _ ONT C/ ET FT L OF LOT P x USE OF y` ..// / cn EXISTING BLDG.' 2P 5 /d, Y� 4 P • R SIDF s� FT. FT, HSeparate permits are required for L.SIDE 357 FT. FT. welectric,plumbing and heating work. _REAR aO.7 FT. FT. F. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& _ O MAIN BLDGS. ACCESS. BLDGS. n VAR.* j?ccid t /led gm 1 /34 C.U.P. DATE APPROVED > !!( !! APPROVEna / O'O' 3-a9-7- ._, >' d 4 n • a •s��ff//''�� •_ • I O . • I IREMENTS W OI hereby acknowledge that I have read this application and state al td that the above Information is correct and agree to comply with ‘1-1 all laws regulating building construction, and I shell not employ m Z any person in violation of the workman's compensation laws of 2 WZ. the State of California. . 3 I hereby certify that I am properly licensed as a contractor under SO. FT. N the State of California Business and Professions Coda, 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; to am exempt from the provisions of the State of California Business VALUATION5—.2/00N and Professio de,Division 3,Chapter 9. PERMIT FEE $ en PLAN CHECK $ /�� �s o Signature of ��..Q/� 2.(Q A0 o Permlttoe ,+ $/e3tVr TAX $ 7e U. g ryeAuthorize ent TOTAL PAID $ •/y/ zO PROJECT ADDRESS: 2452 ELDEN AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B ,046477 -. ' OWNER'S NAME: JERRY JONES • ' ' ADDRESS: 2452 ELDEN AV . PERMIT PERMIT NO: B 046477 PLAN CHECK NO: ' • N GOVT: N SbPP : N It COSTA MESA ' CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: SIR PURPOSE: ADD ( 714 ) 722--6711 �.� Ft_ BEG.NO.: JOB DESCRIPTION RENEW TO LEGALIZE. EXPIRED PERMIT 45722SQ FT: - 413 ', ADDRESS: UNIT: , CLAIM VALUE: , CALC.—VALUE: 28,'497 . 00 GROUP OCCi R-3'' / PERMRTEE: JERRY JONES ( 714 )722-6711 - . ADDRESS: 2452 ELDEN AV COMMENTS': RENEW4S722 • ( BEDROOM & BATH ADDITION) . • . ' I COSTA MESA ' CA 92627 ****************t<*3L**********it*************************3*******3-***e**3e******-t<)E* • LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS •, 7000)of Division 3 of the Business and Professions Code,and my license i5 in fug force and effect. S E T- B A C- K S . - CITY LIC.: STATE UC.: CUSS: • Date. Signature- MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cenjficate of consent to self-insure or a certificate of Workers' FRNT:: ET I N REAR: FT I N FR N T i • F T IN R EAR: F T I N :LEFT. FT I N' RGE11': FT IN LEFT: 'FT IN RGEIT: FT IN Insurance.ora certified copy thereof(Section 3110D Lab.C). POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 43929106 ZNE: REF NO: O Certified copy is hereby furnished. ❑ Certified copy is red with the city Building Division. • . PLANNING N TES> Date: Applicant *************************************************fE********iE*********ik****-**3h*** EXEMPTION FROM WORKERS'COMPENSATION DEILARARDN: (Ibis swim need not be completed a the permit m for one hundred(SIM)or less). D E V E L O P M E N Ti 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 wore for with this permit is issued,I shall not employ any person in any manner so as to become subject.wthe Workers'Compensation Laws ofCalforna. ZONING APPROVED BY DATE: Date: youSignatureshul BUILDING APPROVED BY DATE: • NOTICE:II,after making this declaration, should become subject to the Workers'Compensation provisions of the Labor ___ 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 B Y : -� 4 ,_. /�' ,�� 'DATE: r Y/ p� which this permit is issued(Section 3097,CW,C). *'***'*"***************** • ****************** ** **Wit* LENDER: *****************************sE****ick****** ' *********************************** ADDRESS: - - LEGALIZATION:D] -F E E S U M—M A -R Y - STRUCTURAL SEGMENT:Y ' OWNER BUILDER DECLARATION: I hereby affirm that lam 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 - - 278 . 00 1 . 99 ua repair any structure,prior to its issnce,also requires the applicant for such •permit to file a signed statement that he/she is licensed SMIP/NON—RES • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business PLAN and Processions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any •violation of Section 7031.5 by ' I - , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). • ISSUE FEE BUILDING—DIV—> . PERMIT ISSUE . PLAN—CHECK' TOTAL PAID ' DUE I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the r —-•> ❑ structure Is not Intended or offered for sale(Section 7044,Business and Professional Code:.The Contractors'State License Law TOTAL S—— 279 . 99• 0 . 00 0 . 0 U' 279 . 99 2 7 9 . 9 9 . . 00 does not apply to an owner of a property who builds or Improves thereon,and who does such work himself/herself or through • - • his or her own employees.provided that such improvements are not intended or offered for sale.IL however the building or REVENUE DIVISION TOTALS TOTALS--> COLLECTED: 279 . 99 OVER/SHORT: . 00 fhWmentkcoldn)hin one year of completion,the owner will have the burdenforor thaOurpose of salol. of proving he/she did not build or improve BLDG PMT PLUMBING, ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK - I,as owner of the property,am exclusively ce License with goensed contractors to construct the project(Section 7044,Business 278 . 00 1 . 99 • ❑ and Professions Code: The Contractors'State License Law does riot apply loan owner of property who builds or improves thereon • • and who contacts for such projects with a conbactor(s)license pursuant to the Contactors'•Sate License law).l am aware ,*****************************'************************************************** that proof of their Worker's Compensation insurance shouts be provided to me. I N D I• - V I D U A' L F E E B R E A K D O W N n I am exempt under Section:BP 7044. B. forthisreason: NO EMPLOYEESaP.c. 4 • TYPE QTY U E S C R I F T T. O N UNIT COST TOTAL COST • • pater 7/2'lp0Owneri— •isir' / SFR 413- ' DWE—TYPE V—WOOD FRAME —GOOD 69 , 00 28,497 . 00 I do hereby certify that I am aware of and understand the requirements of C ma Health and Safety a Sections 25505.25533,and END OF FEES • 25534 and that 1 or any future building occupant will/will not(circle one)nt, to comply with said state codes and the requirements for a . • .- permit for construction or modification from the Air Quality Man men••..trip.Residential con don applications are exempt from ' these WmTisioys, p w ' Date: 37t / c ADDOcanc I hereby certify that I have read this application and state a above infor ton a correct.I ee to comply with all city and county w ordinances and state laws relating to bulking construction hereby rim representatives of this cMjloventer upon the above-mentioned . property for inspection purposes. / lJ)\ . Date: T/�a/Q� signature: ea"` 01 00055835-00055836 . TOT 279.99 Drives License or Social Security AoolicanC Pink—Revenue:Goldenrod—Assessor - - - - - it • ' CONSTROCTION AND PLANNING - - POOLe SPA , . AP�ROVALS Permit #•- Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole . , - 52. Pool & Equipment Location -t 2. Soil Pipe-Undrgrnd. - - $3. Steell Reinforcement . - j '3! Electrical Conduit Utility-Undrgrnd. 54.- Forms - 0 • !' ,..c. '4. Efecirical Conduit-Undrgrnd. • 55. Electrical Bonding __ • -.�5_Steel Reinforcement'56. Rough Plumbing & Pressure Test. T.'6-Electrical UFERI.:Gmd. - 57. APPROVAL TO COVER-GUNITE 7. Footings _ 58. Electrical Conduit-Undrgrnd. 7 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test - ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. y) (, . /j • 10. Structural Floor System • 61. APPROVAL TO DECK i% •4 11. Property Sewer Line& House Connection 62. .Backwash &•Receptor-Final / •� 12. Sewer Cap - 63. Heater & Vent-Final ./ lV • / 13. Roof Drains - - - 64. Plumbing System Final /% �;�yf - • 14. Rough Plumbing - 9 9 65. Electrical-Final `- r i. ') -' i' a - Y n 15. Rough Electrical-Conduit 66. Solar System-Final ') 16. Rough Electric Wiring 67: Fencing & Access Approval ` t . ! I 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING / I • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19,_Rough Heating.8: Conditioning • - ^ FIRE DEPT. REQUIREMENT 20-Rough Factory Fireplace - _ . ' APPROVALS, ;.Permit # 21_Ducts,in Structure! + ' 70. Underground Hydro 22_Ducts, Ventilating ; - 71. Product-Piping OGas OOiI 23.-Gas-Pipe-Rough & Test ' ' _. ' _ - 1 ' 72. Underground Flush - - 24.' Roof Framing - -- , -, - , : 73- Undergrnd.StorageTank OGas OOil 25. Roof Sheathing '-- •- • _ 74 •Overhead Hydro r. - - - 26.. T-Bar Ceiling (Structural) & Monocoat •., • - , , 757- Dry Chemical 27. Frame and Flashing • - - _ - - 76. Dry Standpipe _ - . _ ,. _ __ _ ,28. Lathing & Siding, __ • -• •; 1.• 77.- FIXED SYSTEM FINAL - -. 29. Insulation 'f' _ __ ' • 78: FIRE PREY. FINAL - r` '.30. Drywall-Nailing , - HEALTH DEPT-REQUIREMENT - 31. Plaster Brown Coat C • • .' `•a. ; '-79. FINAL INSPECTION =- !, -32..Electrical Power Meter Final %; 180..FOOD CERTIFICATE ISSUED_, -33:_Final Electric -. _ - - r Notes: - c: •34. Final Heating & Air Conditioning _' _ _ ! - ` • 35.. . - .Final Gai Pipe-Test - - •j : - - o '36. Hood o"r"CanoPY ' :- _ ' y' - '� -.37. Final Factory Fireplace- 1 , • ' J • ^ 38. Final Plumbing • ` '7' _ -' '39. Water Service-Final :_ - _ • ":40. Gas Service-Final # ^ -1;.-' " t'• } * + .. e. r. . . . - , t ": 41. Solar Domestic-Final • • ,- 42. Backflow Preventer t i. 7 - _ 4 • 4r • 43. Backflow Irrigation _ : ' -744- Landscape Irrigation System v "•• - - •�- - _ _ 1' .7 -45. Sound Attenuation c - , . - _ :46. -Handicap Regulations - ' _ - "' - r"- ' • v c i ,47-FINALSTRUCTURE & BUILDING 340 sk, 48.-.FINAL PLANNING - ' 4.. . 4 '49. Electric Release to Edison i� ' , - - - 50. GasiRelease to Southern California Gas Co - J 51. CERTIFICATE OF OCCUPANCY _ _ - - No. Date , Applicant to fill in all svaces except those.within Heavy border lih¢i'an... v.gall appropriate declarations. �� — -'�— --_ _ _ PER T NO. TRACT NO. LOT NO. • UN-IT NO. 1'l X727 3/ 5/85 I - • CITYDFCOSAMEESAACONSTRUCTIOO�NPPERMsIITT1 f1 /1 11 2C� ti /et. . )� T Project Address e.245 - 1-11-1 )� �`I S#t r l P YS(A l Applicant's Mailing Addre s // TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION U REPAIR , / (V f _ PhoneIs (/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone ' Owner's Name - , I ,fon �+ DESCRIPTION OF WORK/USE OF BLDG. ,395 y � 2- In N IC IYIn IC E g_ Z Address I� S Main Building: Accessory Building: Arch/Eng. __ License No. • _ TYPE OF PERMIT LI GRADING�[ FOUNDATION 0 STRUCTURAL T Front , 0 Address / -1� ❑ TENANT ❑ ELECTRICAL LJ/PLUMBING ❑ MECHANICAL B Rear -• N Contractor's Nam- L a�1 —�1P llP(one -CI OTHER A C Right • N /' J/ ,/ /"' �n> PROJECT DESCRIPTION SQ. FT. OCCUPANCY`�y K Address(mailing) .3177()S-l "✓ CON STRUCTION TYPE VALUATION$ �- )C.�-).CC" $ Left _ - G City License No. ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking R¢q./Provided E lbhI hereby affirm that I am licensed under provisions of Charter 9 (commencing , Remarks: Iia 'V lLV . S Planning Notes: • i M •,./ with section 7000) of Division 3 of the Business and Professions Code, and 111-f7M ff"' 111"`�"!ll---��� '1 my license is in full o • ..d effect. , / . T /r 'W Licens- Clas + L"''cGGese No. �I '�®-��� • - , , $, I date - . Signature - v_ -.AA Sa PLUMBING FEES WORKERS'COMPENSATION D CL• • •TION-/ I hereby affirm that I have a certif lcatel. consent to self-Insure or a certificate Bar Sink Showers - ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer _ Service Sink _ //����..•7 • /' Automatic Washer Transformer 0 15-50 KW- • •000y No. 9,,) ..,4 /7 7(. COmpanyQ li �• `OOMA° . Backflow Irrigation • Sewer Cop • Construction Pole❑ Sub. • ❑ 50+KW Certified copy Is hereby furnished. ' ertifi d cagy l flielwith the cityl�{ I y�D'vi Bathtubs Sewer Connection • Cooking Unit Meter ❑up to 100 amps • Date I �%`�-( %S Applicant 1 IIV/f�1 y cane_ - M • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Z Solar Collectors bDishwasher sMeter Dover 100 amps • (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher - .- - ' I Solar Piping ZOO Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains Z Solar Tank MM Fan Workers' Compensation Laws of California. W Motors 00-1 HP ❑1'h-8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar'09.15 HP 016-15+ NOTICE: If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures • comply with such provisions or this permit shall be deemed revoked. - _ . . Microwave i CONSTRUCTION LENDING AGENCY Gas Service 'Outlets Water Closet ' I hereby affirm that there is a-construction Ientlinrj agency for the performance Device Boxes ,Pole Light • . of the work for which' this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name _ , , Lender's Address _ ' • —• - Kitchen Sink - • ' . • Water Service Switches Sign , OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's.License Law for the Lavatories • .Auto-Wash following reason (Section 7031.5 BusIness and Professional Code: Any city or • Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair . P—Trap • Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the,applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to'the provisions ofROOf .Drains - • . the Contractor's License Law(Chapter 9(commencing with Section 7000)of _ - �* (�� Division 3 of the Business and Professions Code) or that he/she is exempt . T • 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 - •enalty of not more than five hundred dollars($500). - J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself'or through his or her own Boiler - Hood Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: or employees, provided that such improvements are not intended or offered foryp sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date , pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By --- Date ' prove for the purpose of sale). • ❑ I,as owner of the property,am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System - Application Issued By Date_ tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 06100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's•License Law). I am aware that Exhaust System 0 Multiple' 0 System Repair/Alteration BUILDING PERMIT, $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $' ��7s PERMIT ` 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ 1 I,W ISSUANCE $ Date Owner, Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ • l hereby certify that I have reathis application and state that the above ' ❑6100,000 BTU 0100,000BTLELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and-county ordinances - • ' • . - • and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ , sentatives of this city to enter Alpo the above-mentioned property for inspection •. •oses. / `j_. - MECHANICAL • $ TOTAL FEE $ 7•-00Q� Signat/ire r A,_•441,... Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ • - /s MF 0865-46,re ,..• 0/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - - � , 1 , . . . • CONSTRUCTION AND PLANNING r POOL 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 3, Electrical Conduit Utility-Undrgrnd. 54. Forms 1 ' 4. Electrical Conduit-Undrgrnd. , 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER 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 Undrgrnd. • 10. Structural Floor,System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final • 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing65. 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 Electiical-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 1 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil f 25. Roof Sheathing 74. Overhead Hydro 1 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 1 27. Frame and Flashing 76. Dry Standpipe I28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL I 30. Drywall Nailing - - - HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I33. Final Electric - Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test • ..\ 36. Hood or Canopy . r _ 37. Final Factory Fireplace I 38. Final Plumbing l39. Water Service-Final 40. Gas Service-Final / 41. Solar Domestic-Final 3f'Y/is' Goo 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • . 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co • 51. CERT IFICATEOFOCCUPANCY - . - Date _ . 1 City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCYN•• 1972 C P. 0. Box 317 Costa Mesa, California The Building located at 2452 flden Avenue - tMitn A5 B. Ca end D has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group )2 T Occupancy. Z3W133 Use of Building PV nsirla K'" with attczcthd garage Legal Description 119-oma 4A (See reverse side for Metes and Bounds) Building Permit No. 20985 Electrical Permit No. 21653 Plumbing Permit No. 39912 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments 4 and/or guest rooms ISSUED TO: Building Offi al Arthur Thurston by C �� ✓ Date Awn 30, 1964 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bu34—iM-11-sa—S-B P ' 'Wsta Mesa Building Department apTICATION FOR PERMIT 111 EAST 20th STREET 1 4 41 7t:• .1:4COSTA MESA, CALIFORNIA B U I L D I N G FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. 1 Pesty. Building Y27Jiay✓rL , Address a[, Costa Mesa, California Receivtddnn,by Date _Rea� Date Issued c� Nearest — y I o�!'J 7~ ,y�,✓ Cross St lOt4Q VIZ I-&- Building✓ Address Owner C .W L i ll a e7,--y. . Costa Mesa, California Mail- Add ress 783 \r a 4..)-O -11Yr Nearest Tel. Cross St. Cit L 0.5?-a_ �esti No. �7'Zone ,� // No.of Type Group Architect or Lie. I Plans I ypv p Engineer No. Approved by Date Address !� /� Sts-/ CORRECTIONS T.D1t11.ssett No. Lic. .Cc tractor c Address 462 ma tan V , 19- Legal I Lot Ci I Description No. v to I Block Tra/ada O (Attach Metes``and Bounds),4 P 7/7-0 LVA 9 Size of Lot (p •p x,,,} 0,5� Nowoaf BLot ' Use of IQ� .p I No.of I No.of - - - 700 Existing Bldg. es9F�a� Families Rooms23 Setback Line m Center of Street 4.C• Side Yard if" - - D DESCRIPTION OF WORK - New I / I Alteration I I Addition I -- - Repair I I Moving I I Demolish I - • -- - ' - •. . Building epv 7 ,e, No.of Size Gi t�vd/ Rooms eV Stories Exterior Wall _ Roof 'ring Stum GD I Covering tack APPROVALS of New /l .✓ Foundation Location Inspector Date building 6 ir�G 77e.e `�' ��'(a,9e Forms,Materials, p Under-Pinning Frame: Fire Stops, I Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int with all City Ordinances and State Laws regulating building construction. Lath. Ext Signature of l ' ,`n, Permittee vya vV Plaster,Int Authorized Mt - Plaster,Ext a Valuation Permit Fee $ ..j..2 , ca Masonry Reinforced $ � fo 9 Plan Check$ 3O- 0 Bond Beam ....l Total. n(ra s Fee $ d- FINAL .\..,..,.. .,,,. a nn .,.. e.. 0 'C w . SIP, C C -4 J . 8 . O. _ t I . -'- - - C . - i 'i . . . . ... 1 -V' • • Street - ' •. - . PLOT PLAN ' - -`..} - - -Show location and distances from ' property line and between buildings. - .7 1 . :i - n no •. n , o - r. D. l _i � , w . . .. P i . .. .i. c- _ fV - "' - - . O FEE RECEIVED 185' 9 COSTA MESA BUILDING-SAFETY DEPARTMENT FINAN(1AK .-7 1963 V P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESP For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT/ 1 BUILDING EI ADD SS )-'+ } L 5 ' CD{= AJ 'A J E COSTA MESA. CALIFORNIA For Office Use Only — RECEIPT NO. I DIRMIT OWNER AQ.TNV TI'{J (�S-r0 A) s MAIL RECEIVED Y /DATE RECEIVE• GATE ISSUE ADDRESS SIN M6 . { -7.- i, I i 7- 3 TEL. BUILDING '/ CITY -- NO. �� ADDRESS 41-S �� /._. ARCHITECT TEL. COSTA OR MESA. CALIFORNIA ADDRESS ZONE TYPE ///�� -GROUP // CONTRACTOR ANA%.e AL-a`Lr (c .j Sr,u Lie J APPROVED DATE v/v/ ADDRESS 12-) Y- w - G s r ZONING ^� �,,i ANA z0 E NO.OF USE OF NEW(�O � CITY SAIOTA AMA ��/ PLANS IBUILDINO LIC NO. �63U r TEL K I 3-0 D&b LEGAL DESCRIPTION /pop,l'C� ' 7 /C�]i r 310 0 SIZE S /1 �./�/ / NO. OF EILDOS.Now ON LOT / A.P.NO. // 9—0(� O — L-( J OF LOT erieW X 1V 1 USE OF YARDS EVES EXISTING BLD@. _ APPROVED ALLOWED SETBACK UNE FROM (CENTER LINE ST.) (.-,� CENTER OF STREET REAR YARD FRONT -/ FST. �.� IN. _ SIDE YARD I LEFT I RIGHT R.SIDE ��FT. IN. DESCRIPTION OF WORK L.SIDE OFT.FT. N. � NEV I CII ALTERATION I II ADDITION I REAR _ET.--- IN. p REPAIR-k I II MOVING I II DEMOLISH I APPROVED ! ` // DATE /�7 BUILDING NO. OF (�'/-I///oJ�/ g1A'.I-T SIZEROOMS STORIES rliF EXTERIOR WALL 1 ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED 4-" k6/,C a-ORI CCHMuUITy - 4" x31-, X 4-0 ` COHHv.V( Ty 7 Lat} .4ALL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE I IS COR CT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH AU. CITY 0 ?LANCES AN STATE LAWS REGULATING BUILDING CONSTRU N. VALUATION �'7 • SIGNATURE OF PERMIT FEE $4 B (Ti/ PERMITTEE le-'-.---/) ••• `"CCC PLAN CHECK $ 47: AUTHORIZED AGENT - �� G TOTAL FEE $ u • 19057 . COSTA MESA BUILDING-SAFETY DEPARTMENT FE / ,RECEIVED P.O.BOE 317 COSTA MESA.CALIFORNIA FFJI ' �pal I iE g *a. \ For Applicant to Fill In Completely APPLIC/�, L 1 eU 1YIESA TYPE OR PRINT ll���ii �TT l For Office Use Only ADDRESS /�5{ .4-1_,o2F/V .4V/-" RECEIPT NO. FBRIT N,05,7 COSTA MESA. CALIFORNIA DAZERECEIVED �D p�A�g fi OWNER �}/QTti1vR a 'Th�vwirer !N (L7-4.3, BUILDING MAIL ADDRESS 2 y1/41-..2_.L-O454/A`efieZ# ADDRESS 1, FIRE /� CITY (,OS74 M�� NO.L/R1 AD2 I ZONE TYPE GROUP `�[ APPROVED ARCHITECT TEL. BY DATE 01, OR ENGINEER ` N0— ZONING A. .ESS to NO.OP USEOPN / /JI.'�.I PLANE Q BWLDINO CONTRACTOR — \. j I DECAL /�o& Lot xG 7R3°6 ADDRESS L DEBCRIFrwN /f CITY @ A.P.NO. L f o o. 7O • NOTE: NO AVE OVERHANG SHALL BE LESS THAN STATESO-TO SIDE a REAR P.L. LIC.NO. NO. , EAVES SIZE 3 0 ! I NOW ON LOT I Z ALLOWED (U.B.C.REQUIREMENT) OF LOT -7 YARDS APPROVED YARDS APPROVED USE OFMAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (2.-7 — (FROM C/L STR I SETBACK LINE FROM ` FRONT FT. CENTER OR STREET REAR YARD SIDE YARD LEFT ��— RiHI R.SIDE DESCRIPTION OF WORK L.SIDE FT. Fr. I I - N' ALTERATION ADDITION REAR PT. FT. MAIN BCE T. BET.MAIN Q V MAIN BL S. ACCESS.SLOGS. Rh....IR MOVING DEMOLISH BUILDING NO.OF j VAR.# DATE SIZE ROOMS STORIES / _C.U.P.Z{ APPROVED EXTERIOR WAlI ROOF �T APPROVED l / COVERING /}QQ I COVERINGY 1R PA PG'/[ BY DATE � Y_- U E OF BUILDING AND WORK TO BE PERFORMED fl- A/ V!� 4p'4l r 1-ReMo'cpd 7-0 Ov `A N A 1" SO.FT. 4 I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE Z AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. G PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION p BUILDING CONSTRUCTION. PERMIT FEE $ N _D61GNATURE OF - 4O � } GPERMITi/V/ 74 PLAN CHECK $ '--'---- a AUTHORIZED AGENT 3 a S TOTAL FEE 20985 FEE RECEIVED 'COSTA MESA BUILDING-SAFETY DEPARTMENT NOV 1 3 1963 P.O.BOX 517 ' COSTA MESA.CALIFORNIA ����TTFIINnAFNC�E���DpEPT. ' For Applicant to Fill In Completely APPLICATIt7l7 FOR'PERh1RMESA TYPE OR PRINTBUILDING BUILDING For Office Use Only ADDRESS 2452 Elden Avenue ` RECEIPT NO, PERMIT NO. / COSTA MESA. CALIFORNIA EJ 9f7 RECEIV[D.Y DAT/RECEIVED.3 DATE jori/,. OWNER Arthur Thurston /I/ /,/ 6 /j�'-�( fes. BUILDING MAIL FIRE DDRESSEl ADDRESS 2/L52 (IP!) Ave �/.J, J TEL ZONE PE GROUP N/ (- CITY Costa Mesa TO.I.I-8121 APPROVED L �� 6 ARCHITECT TEL BY DATE OR ENGINEER NO. ZONING _� AL as y ZONE LNG.OP ^ I UBEOPNEW�I PLANE ,GL BUILDING CONTRACTOR Southern Counties Bldg, Co. C/ / / p� Inc. LEGAL /1/L(4l/ /�f b I 1-4-41 ADDRESS 31.3 South Harbor Blvd. DESCRIPTION YY .Y/ CITY Santa Ana 0-0 A.P.NO. I' O 66- NOTE: NO SAVE OVERHANG SHALL BE LESS THAN LIC.NO,221162-B1 NoLJe 18200 3O TO SIDE&REAR P.L. EAVES OF LOT 66 X 330 I NO.OF NOW ON LOT BLOCS. 2 ALLOWED (U.S.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF BUILDING MAIN ACCESSORY BUILDING EXISTING BLDG. garage and single fam.res. (FROMAI L ) SETBACK LINE FROM CENTER OF STREET 501 REAR YARD 1.761 FRONT SFT. 7t�- RT. SIDE YARD I LEFT 361 I RIGHT 51 R.SIDE v Pr. / PT. DESCRIPTION OF WORK L.SIDE." /�. PT. NE" X ALTERATION ADDITION I REAR ( . ��• FT. DISTANCE BET. / BET.MAIN fl MAIN BLDGS. 1/r 1! ACCESS.BLDGS. RE, a MOVING DEMOLISH BUILDING NO OP VAR.# DATE SIZE 25 x 104 ROOMS 13 STORIES 2 C.U.P.* APPROVED EXTERIOR WALLROOF APFRpVr/- COVERING `StUCCO I COVERING rock _ sr LC/. I b� ' �r DATE 1/—/?'t% USE OF BUILDING AND WORK TO BE PERFORMED I �L_/f/// construct unit a artment with a..�-e_�--e-LI-' a7 • 1I 4 stall garage under center units yi J6-3580.FT. X600' H r. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN NDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND ATE LAWS REGULATING VALUATION ]O ,LST n BUILDING CONSTRU N. PERMIT FEE $ j3 V v SIGNATURE OF e - D B PERMITTEFr��P'�/ - (/ 3 / Licit" $ J PLAN CHECK $ ��/T �U AUTHORIZED AGENT/. 4, �.2 Y.'412:1-2 TOTAL FEE $