HomeMy WebLinkAbout854 CENTER ST - Building Permitsr
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�.�sEss: 854 CENTER ST
OWNEfl'SNAME: DODSON, TREVOR S
nooeess: DODS�TA{iLINGRLNA K
LAGUNA HEACH,CA 92656
ANLHIENGINEEfl:
flEG.NO,:
UNIT:
AOOflE55: UNIT:
PEpMiTTEE: A,P. HIRSCHMAN (714)960-8329
aooncss: 8855 ATLANTA 285
HUNTINGTON BEACF[ CA 92646
IICENSEO LONTNACTOP OECLANATION: I hereby aflirm Ihat I am licensetl under pmvisians ol Chapt¢r 9(commencinp with Sec�ion
7000� ol Divi ion 3 0l Ihe Business ana Pmlessions CoOe. and my license is in lull force anG etlect.
ciTvuc�.n: ��38968 STPTELIC.:47�`�'�� cuss: C39 EXP; 04/95
Date��✓ _����� Signat�r��--�
WOHNEflS' COMPENSATION OECLAPFTION: I hereby aitirm that I have a cerlificate ol consent m seA-insure or a certiticare of Workers'
Comoensation i1su��ry��z�c�iliegr�ov inereoi (section s&oo. �ah. �1.0 / O 1/ 9 5
eaucr r+o.: STATE FUND EXP. DFTE:
COMPANY: �(
7 Cenified copy is hereby Nmished. L7 Certifietl copy is tiletl wil� the ciry Builaing Division.
. Da�e: l� �C' %/ AOPIi I v
E%EMPTIONFflOMWOflNEPS'COMPENSRTIONOELtABAT10N: �ThissectionneeAno�betompl¢teGil��eperim�illoronehuMre0�S700�ofless�.
I cenify Ihat in the oedormance of tne work for whicn this permit is issue4 I snall not employ any person in any manner so as to 6ecame
Suble�� �0 I�e Workers' Compen5a�ion Laws ot Calitomia.
Dare: Siqnature:
NOTICE: II. aller making Inis aeclara�ion, you shoWd hecome sublec[ �o Ihe Wo�kers' Compen5a�i0n pmvisions oi ��e La�or
CaOe. you must fon�with comD�Y ��� sucA pmvisions or tNs permit shall be OeemeO revoked.
CONSTBUCTION LEN�ING AGENCY: I hereby atlirm �hat �here i5 a tOretmtlion IenainB aAenCy to� Ihe pedOrmante ol lh¢ work lor
wnicn I�is Oermi� i5 i=sued (Sec�ion 3097. Gv. C�.
LENOEfl:
aoosess:
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: B 06940
PERMIT NO: B 069409 PLAN CFIECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE; OTH
JOB DESCRIPTION ; T/OFF REROOF W/HUILT—UP SQ FT: 3,648
CLAIM VALUE: 3,648.00 CALC—VALUE; 3,648.00 GROUP OCC: R-1 /
COMMENTS: RE—ROOF 2400SF APARTMENT W/BUILT—UP SMOKE DETECTORS RE UIRED
,�,�,�*�.***»*,�»,�*,�**�***�.****,�***����*�*,�*�*wx��*�*****,�***�,�**��� p�.�**,�*�
Z O N I N G R E Q U I R E M E N T S ETEC 1��
S E T B A C K S ��n
------------ MAIN BUILDING ---------- --------- ACCESSORY BUIL17It�iFr4�d� —4
FRNT; FT IN REAR; FT IN FRNT; FT IN REAA; FT �tT
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN �"
PARKING REQ• PROV; PARCEL; 42419120 ZNE: REF NO;
PLANNING NCSTES,>
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; DATE• (� a-��
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LEGALIZATION;N F E E S U M M A A Y STRUCTURAL SEGMENT:Y
OWNEB BUILOEB OECL�1flATI0N: I �ereDy affirm �hai I am exempt irom ihe Contractors' State License Law tor t�e follawinA �eason B LDG PMT PLUMB I NG EL ECTIZ I C MECHAN IC
S Y 70.3t 5 8 sineu ana Protessionai Caae� an ca ot counry wnicn repuires a permit to conswct auer impmve aemolish or P ERM I T 6 3, 0 0
1 ec ion . u . y y . , •
reDair any SVuclure. prior lo iis issuance. also repuires Ihe apP�ican� lor such permii lo lile a 5i0n¢G Slatement Ihal he/5he is li[ensetl
pursuanl Io the O�ohsions a� th¢ Caniracmrs' Slaie License Law (ChaD�er 9(commencing with Seciian 7000) ol DNisiOn 3 oi lAe Buvness p],� j{j.J
anG Pmlessions COOe) or Ihal he/She is erempi I�eretwm antl �he EasiS far Ihe alleged exemp�ion. Any violaiion o� Sedion 7031.5 Gy I SSUE FEE
any apDlicant lor a oermi� subjectc me appliwnt to a civil penalry o� not more than tive nundren Aallars (55001. B U I LD I NG—D I V—> P ERM I Z' I$ SU$ PLAN—CHECK
i, as owner oi tne pmpeny or my emo�oyees witn wages as tneir soie compenuiian, wi11 ao ine wone. ane tne TOTALS----> 63. 50 0, 00 0.00
❑ slruclure is nol intenGeE or oflereG �or sale (Seclion 70a4 Buvness and Pmfessional CoEe� T�e Comractors' State License Law
FI.AE SMIP/RES GRADING
50
. SMIP/NON—RES
TOTAL PAID DUE
63.50 63.50 ,00
tloe5 nol apply Io an Owner o� a pmperly wh0 �uilds or im0�ove5 �here0n, and w�0 Ooes SUth wOrk M1imSell/herself af ��roUOh
�is ar Aer mvn employees. OroviUetl that such impmvements are not intendeJ or otlere0 for sale. If, twwever the huilUinq or REV ENUE D I V I S ION TOTALS --> COLLECTED ; 6 3, S � OV ER / SHORT ; 0 �
impmvement is sa10 wi�hin one year o7 completion, the owner vnil �ave t�e GurEen oi OmvinA he/s�e Oi0 noi EuiIG or impmve BLDG PMT PLUMB I NG ELECTR IC MECHANIC F IRE SMI P/TOT GRAD ING PLAN—CKECK
ior tne vuruose oi saie�. 6 3. 0 0 , S 0
I, as owner o1 the pmpeny. am e�cWsively comrac�ing vnth licensed con�ractors to constmtt Iha Omleci (Sec�ion 7041, Busine55 ,
❑ anaProlessionsCotle: TheContraciors StateLicenseLawGoesnotaDDN�oanownerolpropertywAOUudAsorimpravesi�ereon *x,****�**�*********,�***********�****�*,*x,K,*�****,*********�***,*****�*************
anC who contracls for such pmlect5 wiih a coNracioqs�license pur5uan��o Ihe Coniractors' State License Law),I am aware
ma� o�oo� oi mcir Warxers Campenu�ion insurance snoum oe D��aee �o me. I N D I �7 I D U A L F E E B R E A K' � 0 W N
� I am exempt untler Seciion: B. 8 P. C.
�orteisreasore TYPE QTY D E S C Fi I P T I O N UNIT COST TOTAL COST
Oate: �ec I SPR
I ao hereby cenily Inat 1 am aware ol antl un0erstantl ine requiremenis ol Calilornia HealtA and Safety Co�e Sections 25505, 25533, an0
25594 ana ��ai I or any luture building occupan� will/will noi (circle one) need Io comply wiih saie sia�e coJes anA IAe reduiremenis for a
Oermil lor consVutlion or moUilication Imm ihe Air Ouali�y Managemeni OisMcl. flesiden�ial consimction apDlicati0ns are exempl Irom
Ihese provisions.
�a�e: AODiicam:
1 �ere0y Certily I�a� I �ave reae Ihis apPliCation ana Sta1e �hai I�e ahove inlormaiion i5 wrt¢ti. I aA�e¢ Io tomDN `M�� all Ci1y an0 wuniy
ordinances and slatelaws relalingio Ouilding constmc�ion anU �ere�y aut�orize represenlaliveS o�this cirylo en�eruponihe above�menlione0
pro0eriy tor inspet��on purpa5e5.
Daie��� �Z�''� �
i6aba6 Whpe—Bmltling: Green—CoEe En�orcemen�; Canary—Ap0licant; Pink—Ravenuel Goltlenrod—Nssesso�
3698 REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
EXPIRE�. s
{ncomP!ete !^SP�
Ct�
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1.00 3,648,00
0!.OD15999p-00169991 T C�T
DATE''10/20/94 TIME: 13%29
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CONSTRUCTION AND PLANNING P00. SPA
APPROVALS Permit# Date Inspector qppROVAIS Permit?k Date Inspector
� 1. Temporary Electrical SerG3ce or Pole 52. Pool & Equipment Location
u -�u
2. Soi� Pipe-Undrgrnd. < :n¢ 53. Steel Reinforcement
Y�
_,:;3�;EIActricalCondu�cdtility'-ilndrgmC:" 54. Forms
y•.J
�: j4.�EIe4t��cal Conduit�Und�grnd. 55. E�ecirical Bonding
5.'S�e71 ReinforG�fieiii ,' -" 56. Rough Piumbing & Pressure Test _
r >•
�':6: ^� ,, � ._ .
.��ieGtrical UF�{i.,,�md. ;. 57. APPROVAL TO COVER-GUNITE ._
����'.:Fodtings - r -` 58. Elecirical Conduit�Undrgrnd. �
.,,�. .`.,.
.. '$,�Fc�ndatfon �" �� ` 59. Gas Pipe, O Undrgmd., Test �
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor Syscem . 61. APPROVAL TO DECK
17. Pra:perty Sewer Line & Hpuse Conpection 62. Backwash & Receptor-Final
12. Sewer CaP �' c.,
63. Heater & Vent•Final
73. Roof Drains 64. Piumbing System - Final
14. flough Plumbkrg 'O 65. Electrical�Final
15. flough Electrical�ConduiL'• 66. Solar SVstem•Finat
76. Rough ElectriC�Wiring �; 67. Fencing & Access Approval
17. Rough Wiring�ig;t "" 68. APPROVED FOR PLASTERING
18. Rough Electritai�T Ba� Cel�ing 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
. i � , • a � _ . .. �r . ^ �^ _'Z1r. l" F .. r.:
20;?Rciggh�iactorY �'ireplace : 'r,m 4 � j � =T4 : ; •APPROVaL'SDO PeRtnit # + �_+
.r w� r �-rr m•s i r ' i• r r••
21rD�c}.s,i� S �uct�r,e � E'"r x'.: !� .� �7* + -' _ -�^�� r x :y
.-. ,� � i • :�S , .-,* s ��i 70. iJnderg`r:qvr�yl Hyxiro �
22.Oucts, ,entidatiruge � C:_: + •� � . �=71.,Produc�,P��inyC7'�as ❑Oil
R 1 � `1
23uGa�s'PipT Ra�i gh A: Test ' � �` ~ �" .�' T � - -.
� _, + tr1::: ' :+: .�k � �� 72. Undergroiind FFusfj.. , �, ,r.
24:�Roqf Fiaming :;+ � ��- ��. ' �; r"I�Undergr�d.Sto/, Tank�OGas �Oil
n � ,
25. flob'f Sk2athing =�' ;'l(�+z y�(�r6 �� � _ � 7q� pyerhead Hydro � ` ' - � --
26;�T-�ir Cei4ing 1S� ucwral) &�jvlpnocoat a n :, c:ts w 7�' pry Chemical "` + ' � -
n
27�Frameand Flash�rh� ��.^ x C, r r.:', 76�Dry Starf'¢,_pipe �'•= t' �� �; .
,
�28:'' La{hinq;& Siding'>, ;� -�j:��: a; t�; .. a� 7fi FIXED S�'STEhA�iNAI '
�.
'"29. Insulati$n � :'•# n r� .: .. �, ": �� �, 7� FIRE PREV. FI�V�L � r -
; 30. Drysvall:iJa'�ting `• -` �� � Fi + �� �MEALTH:DEP�. REQkJIREMENT �
'37. Plasrer B�o�mn Coat� r, � r,.,, a � �� ; ,79.�FINAL I .�N�SP�ECTI�N , � ` '
��32�Electricai Power�?'iletep�Finah `�' � . � � �, �� , ;80r•FOOD CERTIFfEt1TE ISSUED �
�
�33Kfinai Elactr't ." x .. - ' � � " Notes: " �Ji .• Y
r � j � I k '7 :*i �� 'l.�
r. T ' " 1[ T ' -' J: s¢: � s. �
134.�Fina1 H¢�ting &�ic CTooditioniny. i I ' �` R r 5 �,w � �
i'
�35:�Final Gas Pfpe-T�3H `i' . � I � . ;"� ^ '. .,' '. %
i -. r �� .-� i � r � r± s� �,.n
t:36! Ho�d o4'CanoPY�..� ^7�`� � ,r �- .. : , I ' � r .r;�� .. � f :� r
Hn•
^37.-Firial Factory Fiiedlacp,.,, : � ^' ' �•� � F � � i "
,;,38. Final Plumbing � s' : � 1 � � � � � ` -
� 'l ,� 1- V • S
.�39. Water $ervicrFir'Fal- .. + c:. .r � I `7 . � , Q O
T i i rt; i �- �
�T Y � •
�,40. Gas Service-Finat.: � �� ,��..C„ - :;� � � � r M �„ y
.'41. Solar pomesticFinalS %-� � ' : ` :a I � - �2" ~'-+ # .`
n� a ,� � �,�� �,
E"42.=8ackflow Prevent�j; E" ,.�1',. v ~ � �.. x �� Z ^ .- •�L///��_/��f _%� ��/
!- Y �F`� _ (I(G� \
43. Backflow Irrigatio.n � r�r fl � � �. » " acE•c < � _ -� ����
�- ; . n� . . .r •
�,44. Landscape liripa(;on SYstem � �� T �. * ... .� r- ;; � .�. c; .^l n; �:,' - � � -�
�5�`.Sound �Aitenuation '-� �*' ' " �- F * � F- c• °:'" +
n , s r �r r... C r.• �t i-�^ �
.- ... ... .. .. . . .. .
� a ^ - .. n• .. .. ... � � �� •�.-�
�46� Handica`P Regutatibpns F., ` k' t� �: c, •<� �^o ' �
47 �FIf!}:AL STRUCT:URE & BUTLDING � � � � �_ + : ^:�o`.: _ !
c.
48.'F1�7_AL PLANNINC� � i�•Y" ; .p � � - . � ` .;- -' , '�
,
� �.
�49 =Eleetric Release co� dison i ; � j �C a r', -� - , c
P � �t �il a'
•�50..GasRelease to Southern Cali�forni Gas Co � I E` " _ ', :'� • , �• ;.
. -� ;� �+ . ..� �� O
�51. CER7IFICATEOFxOCCUPANCY , ', � ' ,- ., � . � -
No. Date
,C�� ADD��unt to (ill in all sDaces eace0� those wltDin heary EorOer Ilnss an0 sign all aDVroorlate Eeelarations.
COSTA MESA . . PERMIT NO. � TRACT NO. LOT NO. . .
'•:�� 'TRUCTION PERMIT ' — %7�Z�p e �O �
. ' Applicent's Mailing A dress TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR `
PfOj2ttAddf ❑ CONVERSION ❑ DEMOLISH ❑ OTHER V
Owner i Name \ L h � D 5 RIPTION OF WORK C �
iW o �T� f-FE� OW P� cnJS �
Address - TVPE OF PERMIT GRADING . FOUrvDATION .ST�y � A.
- Gtisrx�FSan� � N ❑ (� ❑
Arch/Eng. �cens0 0. TENANT ELECTRICAL PLUMBIN6 MECHANICAL . _� PLNG. REF. *-
Addrass � �� ('��,/��,� ❑,97HER �- . ' TOBUILDING-
Contrecior's Nam ' Qw�+E � OhOne 172SLL} PROJECT DESCRIPTION SQ. FT. OCCUPAN V 7E V I E
'CONSTRVCTIONTYP VAlUAT10NE��� �EFTSIDEVARD
Address (meilin9) � , •
' . ZONE GRADING CU.YDS. ACRFS PKG.SPACE REQ.
License No.
' LICENSED CONTRACTOR D6CLARATION Remarks: - - � ��: i STREET WIDTH
I hereby affirm that 1 am IlcenSetl unCer D�ovislons of C�arter 9(cammenclnq .
with saction 7000) of Dlvlsion 3 a� t�e Business antl Profeulons COCe, anO SP
, my Ilcenx Iz In tull folte anC effet[. . -
ucenu clau Liunse No. � PLUMBING -
Date Sl9natula
� . Bar Sink � Sewer Cep
IqKERS' COMPENSATION DECLARATION , ' � - -
Ireby attlrm that I nave a certlflCdte of consent to Salt�nzuro or a CertltiWte. g�kflow Pr@Venter ' $BWBr CAnn2Ction .
. Workers' Compensatlon Inzurance, or a cartHleC copY t0ereo/ (Sectlon� - -� '
3800, lab. C.) + . • 88ckflow Irrigetion Solar Collettors . :r; . • ^ "
PoII<y No. Company ^'��� � � "`"' -� -"
8 Certifletl copy Is hereby furnlshetl. � p: Bathtubs '$olePPiping h:� ;_ v
Cartlfietl Copy IS filatl wit� t�e clty,Bulltlln9 Divislon. �
� Data qppllunt r Clarifiers � �SotarTank „`
EXEMPTION'FROM WORKERS' GOMPENSATION DECLARATION Di5hW25h2r � � SWlmmin Po01 W/Spe•�
(Thissection nee0 not be completatl If tha permit is for,one ntlretl (E300) ov • _. � 1 ___ 9 a
, iesz) . . . , " "'
I cerlity Jhat In the DerlarmanGe r w c Is �m�t is l � Drinking FOuntains � � U�inal ��_ V`
� shdll nOt Gmploy any pllipn IP any Tdn co suEfe .[o - -- _ , ,
' Wo�ket s' DBp SaL q� LawS of Ca���r .� . Floor Dreins ��Water'Closet � �
� Date 1)�w�T 4 1 5�y�pture
NOTICE: Ii, a7ter making thiz declaration, you shoultl become suD7ect to a Floor Sinks � Water Heater ;, 1�- -
Workers' ComDenutlon provislons ot the Lnbor. Cotla, you must farth " ' -
' comply witn sucn .provisions, or'thls permit snalb De'aeemetl revoke . GasService -Outlets WaterServica': • . � "
CONSTRUCTION IENDING AQENGV '
I hereby afflrri� that are Is a cbnstructlon�l ntling agency for the performan<e Inte�cepto�s '. r, � . � ' �: �.'
' of the work for w�y�� t�ls `Po`��'�t li `S tl- e tion '3p�B7 Civ. C.) •� ,,
Lonaer's Name' ���"���y�N- Cv�tM��l�,i' • KitclienSink ' - � � � � 8
l.enCer'S Atltlres � " �VL_ ����KS� ' ' _ , ..
�, OWNERBUILDERDECLARATION' ' ' .. ' .. ��atOriCs• • . . . , ,/6,
Automatic Wazher
Construction Pole
Cooking Unit
Dishvrdsher
o.�e.: oca: ❑
Fan
F,.A.U.
Fixtures
Device Boxes
Outlet5 "'t�:
'� IQ77 6/23/93
. �
REAR VAFD (TO P/U ':
flIGHTSIDE VARD
PROVIDED
PARK FEE $
-Meter Uover 7W amps
Sub Panel
SubPole , �'
�Motors �0-1 HP ❑i'h8 �
InaSolar�O9-15HP �1645+
Micwwave • . .
Pole Light • ��
Range � '� �' ,
Trash Compactor
, I hereby�affirm Ihat I am eaemPt'from the,Contractor'S licensa Law for the p_7ra ' - � Generator �0�5 KW �5-15 KW '
� following reason (Sectlon 7031-5 Busineis anA Protesslonal Cotla: Any citY or P. -� • �'
county whichi reOWres a permit'�10 construct; alter Improve, Eemoltsn Or repalr
� any structure; prb� to Its I55uaP�e, also requires tl�a applicant for such ermit Foof Dreins '
� t� file a signetl itatement that pe/she Is Iltensetl pursuantto tha'provl5�on5 0/ i ' ' ,
� p.� Contractor's LJcanse Law�,(Chapter 9(commencing wlth Sectlon 7000) of '
7slon 3'of.the Business'and ProfeSSlons�Cotle),or�that he/she.is,exempt � � ShOw2�5
�-�efrom antl t�e basls Tor th0 allegeC ezemptlon: Any vlolatlodof Sectlon
1.5 by.any applicant for a permit sub�ects t�e aDO��cant to,a civll I - �- ' ,
�enalty of not more than tive h4�tlmtl tlollars (E500): � S2rvfEE Sink
I, as owner oi�the propertY or�my employaei with wages as thelr sole
F�mpensation wlll tlo lhe worK, antl the slructura is not IntanAatl or offeretl - . . ';
tor sala (Secllon 7044, Bu51nBs5 an0 Profez5ianal Cotla: The Conl�actor'S � , ,
• Llcense Law tloes not apply to An owner ai a proparty who Dulltls or irnProves , gOilE� �. i
� t�B�eon, antl who UOBs,suCh wOrk hlrti581f/he�ielt o� th�oug� h15 0� h0� own �
' em loyees, provltletl that such improvaments are not Intentletl or of(eratl for � Duct='Und2r�Ground�
I It, howaver, tne buil0in9 tlr Improvement it SOIC within ona year ot com- , .
n, the ownar wlll have tne burtlen of proving he/S�e tlitl not build or Im- . .
ve for the purpose of sale): ' ' � ' , ' � Duct - Stfuctulal ,
I, as owner of t�e property, am exclusively tonlratting with Iicensed con-
t�attars to conitruct the'project (Sectlon 7046, Business antl Rofeisions Code: . . Duct - VCntilating. . ._
The Contractor's L:Icense Law doas not aDPly to an owner of property who
' buil05 or, improveslt�ereon, antl w�o contracts /or suc� pro7ectt with a con- ' ExhauSt,System ❑ Multiple
I, � tractor(s) Iicense pursuant to t�0 Conlractor'i Litensa Law).' , � -
. ❑ I'am axempt untler Sectlon ' ' 8. & P. C. for this reason , Firepl/Fs[t. Blt. ICBO # �
1 1
Date ' � • � Owner � - � � � Heating System & DuCting
, 1 nerebyrcertl(y�that-I have�rBaC�thl applicatlon'antl s[ate that tne aCove - �❑P100,OOOBTU �100,000
, information is co ct I. agree t m wiih al ity.antl county ortlinances .
antl �sta a a uii ng on ructlon a tl ereby autnorize repre- �
sentatl es f tni a e u on the a ve entloneG o� ty for ' Hood or TypB I ❑.
�Inspection roo � j� Cano T e �� C7
� Slgnature � � y , Registers
• Drivars• License or 55 �
�� CMF 0865-46 rav. 12/82 White - Bulltling; Canary - Applicant; Pink - A«ounting; Goltlenrotl -Assessor
� . .
`; Transformer ��5�SOKW � �
- ' ❑5U+KW ReinzpactionPee $15''
Reinspection Fea ',' ' ,
. Meter ❑uptol00amps � �Issue'Fea �$ 3
� laue Fee �� 1� a 3 ����a pPP�owd By �pate /
iANICAL - ' qpplication Approved By ' � � ate - f'�
�,Refrigeration System ' � "' � � '
� � ' Applicatia� Iawd By 'Date •
❑o-ioo,oaoaTu �ioo,000aru ' , �
' � ' � " '- ' SUMMARV OF FEES ` ' � '
System Repair/Alteration � - BUI4DING PERMIT $� � SMIP ' $ �' S6
- - - - - - - • ��• PLANCHECK � $ SZ- i PERMIT �
. ' � ' ,PLUMBING . $ �O ISSUANCE � $ �
� • �• -� .PLANCHECK $ — ': GRADING S
i .
r ��� $
, , r ELECTRICAL $ � ' - �
' ' `� ' ' MICROFI�M • $ �
- - PL.A,N CHECK E
� � � � . MECHANICAI , $� � " TOTALFEE; $ ' �
�
� , Reinspactian Fee . E75� '-p�,qN CHECK � $ � LESS �
- . , ADVANCED PC ' $ �
� Iswe Fee S 3 -. . � . ' , FINAL FEE $ � � �
\ � �
. _ . .. . . .. 1
':�'GONS7RUCTfON�AND,PI'Ar1NING �- y �-� �4 -^--i- -- -r _ ` : .- �O iPA• � - . - -\ � '' �'- �'_
= a ' = � _. " :.Date � �- ! �nspector Date Inspecior -
.PPROVALS .;, Permi(# � - - - �-APPROyALS� : Permit�# ,
�_ � _ . .. . - -- -
�� ;1�; Temporcry,,Electrical Service dr-�Pole ' D' �?.`. r`;'k : _;52; �Pool &�Equipment Location . . � � �
o': ' ,r . e: � �;. �.
�a a) `Soil Pipe-Undrgmd`r 2� � � ,�">; I E= p. V ' � ''- = � 53 Steel Reinforcement � � � � � ,� �
� _� 3: Electrical Conduit Utilitv-Undrgrnd� � -- , �- v� ' a .• �54� Forms''��" • . --" - i ��' �' , � .,
:�- �. �
� 4: Electrical Conduif�Undr;grrid� - �" _ i � � ! : i„ �. �55� Elec[rical B�onding�'� : � - _ ', - - : i ,��
u' - �= ! ' ' ' ' ' = ° �' � � = = � 56., Rough �Plumbing & Pressure Test ` i ' � �.
5. Steel R2inforcement � ; a: _ „< <� -
i -
8: 'Electiical UFER Grnd. � q�•' �, `� :' �� "" : 57'..` APPROVAL�TO COVER-GUNITE= - .
i �: I -
7. Footings .' ; ' I � ~ �" ' i ��; � '' "'" r,•-_ � ��58�'.Electrical��nduitlUndror�'r1.' ' _ �
�� .
� i id r ��
�
8. �ounda[ion-� � 1 � i � � � � � � � ':, t`; "„� • I ;�59. Gas Pipe,��0 �Undrgrnd�., Test ' �''
, ��
9. Water Pipe-Undrgrnd. � � o,' v; �� �� .60. Backwash� Lines �P:Trap, O Undrgmd. � ..y
10. Stiuctural Floor Sy,siem � T P �Y � , � � ^` '_'' � ; 81. APPROVA"L'TO�DECK , . . _ '
11. PrbpertySewei Line'&�House�Connection�� � . ri: �r<''t; � � - - . - " ' .
� � p � _ �� �y � ' 62. Backwash & Receptor-Final
12. Sewer-Cap,'�� I � -- � I ;, � � ; � �� '' `j '-'63. Meater,& Vent-Final ' � . �` , � ,
13. Roof�D'F,ain's i �`i � � � � � r � '� �� `64. PlumBinySystem�-'F,inal� � �,, ' �
q 14. Rough'Plumbing � ;� I I � � � � � '' 8��%� ' 65. Electrical=Final�= � ° � - � � � � � '"' " .
7 � ,:
^"% -�---�ry -x -ry r T? . _.��..__ . .. Y ', ^. .�
tl �, 15.`�Rough'�Elect�Yical=ConHUit' � T i�� Y"� i I+' 66. Solar,System-Final ; •. � . � �
. i : I.i-. 1:,_ I i , �
c.., . � , . . , .
. ',oi 6:•iRough�Electr�ic Wirip9� �+ I ,F; � �I � Q T :r+; g3- f � � � � �� -6Z.� Fe`ncing &>AccessP.PProval -• ' -, - -� �--- - � ,' --
.,s�v�i •at i �' m,. �_' r n n
i'17; tRough W�'riYg'Sign� ;, w " � '� ��'' � : �= ! � , '° I ' �68 � APPROVED, FOR PLASTERING � -
I ' �� � � '� o r � I l� . J! i. r _ � 1_
= 1'18. 'Rough_Elec;rical,-:7;BapCeiling� i �` � _ ; � � � � % j'' � � . 69.� POOL/SPA $YSTEMS FINAL . . . .
�� 19..• Rough'Heating &'Air Gonditioning '�''- � � j � I �.: ,' � 1 FIRE DEPT. REQUIREMENT � � ' , I
��I: �-�:i 6� i-: � �,�I �fl&� i,' -. �
(� } 20; Rough`FecCory, Fir�place � � �� jl � I, � ��; � APPROVALS tPeimit'# ' ;.'' . �
� � ' I ! � �
' h 21 _` DuctS„in Str.uc[ure" ,�� � �� i� � � � � I � qp,. Underground Hydro, �� ; ' ' � �,
. 22r�Ducu,�Venf�la4ing � � � ii ;i � j' �' � � 77.; Product Piping O Ga5 ❑ Oil � i �
�: ;`43.� Gas Pipe-R.ough & Tey�t i� � !�� u � �, ��� I - �: •-7 ,� Underground Flush � �.
.
, �� 24.'Roof �Framing�; � I �? ( ( (• = � , � g, j��`f� f 3.' Undergmd. $torage Tank O Gas ❑ Oil '
� i �:,��,
• i 25.� Roof Sheatfiing ' � 1 � ' '� pf � �� � 74., Ov,erliead Hydro ' - ' : � '
m• � A4.�'. � �S, 383
�_ k-26. T-Ba� Cei�inj ($tructural)'. & Mi nocoat� � :, � 1 j �+ ' ;� � � ;� � ' 75.� Dr�y Chemical � •. � - � .
_ �.�27�.',Frame and Plashin9 ` � � j P �i � '�'j-� �L� : 76.� D 'ry Standpipe '� � - . � . !
- 'c� _�� � ,i �
'° 28. 'tethlny &;Siding P?,�d?"9, f,�(?s/iF,y 9����j �� � � 77.� FIXED SYSTEM FINAL •
.��� 29_�nsulaIion T- � Q�� �' li !I I f � � i� i i!78.� FIRE'PREV�. FINAL ' � � '
a ��i I
� �� 30. Dr waH Nailin � > �� .` j �� �{ � ( � � Notes.�
_ i v s � �� I �� � �� /NS
� - ' . , (,p . . �Y..�
:. � 31. Plaster B wn atCai�k:� i , .��) d'-��'�3 � 1J.�T .I � �U n(/J ' .l� � �aG �
,- � . , i i � 7 � . . . , ..i ��,.�..�i . �� .
� iF32. Electrical Power Meter;Final � � �� � � +,' I ��� �- (,� '' � �-i .-0 o
I , f
'. 33. Final�Electric '_�ITi'sy ,I,I. �l' iS 1„' e-C,'� �'� o
34. Final.Heating &'Air'.Condiiioriinog ;i � ' � � `��
� l �
-V � �nv� n� n �� aJ
35. Final'Gas�Pipe-Tiist� �� 1" i m f - � l � �l / g3 � � �y• ' .�' -. ' ,P '
36.HoodOr ����j�c'�:� I�f�l �I i. 'g .�=��I.� - �.� , , . .
e Canoqv_ ,ri i^I o� 'J t� Ir �` '� . . �. 'tss. .b
. � . � � ' � _ ..,
37. Final Faaory Firepla�e ^ � I � 'v_' ;� I � � � � � -. � `6 i I � � �. , , , .
�
38. Final P,lum6in t� =� •{ '.� c .b I _ � � . '� �� - .� . ..
9� f., �� , �'i � � ' i � ,. �-
39. Water Service-FinaG� ��� ��� �; � i � � . � � t i � �
!r.
' �� � - -
40. GasSedviCe;Finai� ��_'I � � � � � � � � ', i I � I.,' � � ; ., . -. . ,
, •.
41. Solar DOmesiio-Fin�l i � � �l I- � J-_.�-- -' -'---- ' -�' �-w' -.-''. - - � . . , . .. , i
� � , �
42. Backflow Preventer� � ��„�i �' I i _ � � � ' � � ' � � .� . '
�e!� - I _.� 6I I I n^f!-'t�-- - -i- �-i�-- ' - - 'i -' i
43. Backflow�Iriigat�io�I F �P I � I �'�til, 'S1„' �°� r' i V =� ' � � i I ' �
44. LandscaPe-irciga�tion System � .r I_ I � � ° i ' :� i :: � ", ' 1 I - � - � ' ' ' '' . . .
.0 , , , i _ i ��- i
45. Sound;'�Qttenuetion� ' I � j c � i f� � � i� � �" 'l � i � . . . . � - � -
vi � 1 f� Wi 1
1
46. Handicap�Regulations� � � R � j, � �`- :'' � �• � � - ' , ,. , � � . � :.,
47. FINALSTRUCTUFjE & BUILDING � � � �� ' ' I • � , '
i � � o � i f' . ij� . .
48. Special R�quiremen[s Compleied� �) I � � ' ' � r ' i ' ' � � I . � ' '
, i
49. Elec[ric Releaseio Edison, � � _ _� ' � � �.��.-�-- �--;--'-'- - ' _ , � '
�: i i - �--: - - 't"'
50. Gas Release to Southern Califbrn �a GaM Co ".` � � � i i �' I � �� � , .� ' '"
51. CERTIFICATEOF"OCCUPANCY �� '_._._.�__�._ �_�._1_ '.��_ �--�J...-'._ --- -� / .
� No � �� f l � Date . i L � '- - � - - - -- --� � ..
1 , ,. �-,. � �- „.��-- ' -r _. ,,��-. .._�_ -.� - '
.
.^
� �* � isos-�. n ���� R�,��,���1����
? lVOV 1 196P � `
C6iTA MESA BUILDING-SAFETY DEPARTMENT �INH�!CE OEP7.
P. O. BOX 9f7 C08TA M68A. CALIRORNIA
CITY OF COSTA MESA
For Applicant io Fill In Complefely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
ADDRE'SS 8� Center Street A B C D
COSTA MESA CALIFORNIA FOr Off7ee VS@ �Il�j/
OWNER Dillman & Brummell �terprises ""`�� "o. `����
MAIL 1322 E. Ocean Front "H��� �' o/��/p/na rveo�,I/ o�re issuco
ADDRESS I!"� I{ �'�DV 3 Il '�{
•_�TM Balboa N Or31807 BUILDING �/� !� � �`
• ADDRESS
�RCHITECf W.T. Jordan rE�.Li87151 COSTA MESA CALIFORNIA
��OR ENGINEER NO. �
ADDRESS 771 W. 19th St.Costa Mesa FIRE l/ ,
20NE TYPE ✓ GROUP �
CONTRAGTOR " '���� ��eT BZC�i• APPROVHD
BY DATE �
ADDRESS ZONING � �:r
C/�
ZON ( NO. OP I166 OP NCW
GTY �_____ .�� I PLANB � BUILDINO QQQ
STA7E ������� TEI. �--��� �goAL �� �
LIC.NO. NO. OEBCP�PT�ON �� .I ' btt• � �]6
e�ZE �o�x4zo� ��o. oP a�oa-- 3— 33
OF LOT Now ox LOT A. P. NO.
USE OF YARDS EVES . �
EXIBTING BLDC. -���-- APPROVED ALLO ED �.
66TBACK LINH PIIOM � �j � «MBM IJNQ 8T.1
caxiere or ernaei SQ REAR YARtrS FRONT ,S O FT. IN.
8' 8' G
SIDE YARD LEFf I RIGHT R. SIDE `�-� FT, C� �N ,� M
DESCRIPTION OF WORK L. BIDE / 6 FT. � �N.
NEW I X II ALTERATION I II ADDITION I REAR � FT. IN. �
REPAIR IIMOVING I IIDEMOLIBH I BYPROVE pATE �Q-�� �5 z
BUILDING 28�5 ROOMS 20 BTORIE$' � W
81ZE
EXTERIOR WALL ROOF Rock � �
COVERING S'�'iUCCOI GOVERINfi a'
USE OF BUILDING AND WORK TO E PERFORMED
t.Bl . w det.Laud.Rm. = r� _ y�/ p�
w
C
� y�00�� n' ,
¢
1 H¢pB�Y �CKNOWLCDOB TNAT 1 NAVE RGD TNIB MPLIGTION THB �MOUM 9HOW UNOBR VALUATION 19 FOR TNH U
♦NO 6TAT8 THAT TH8 A OVE 1 CORR¢ AND AORCB TO COY- �UftP09H OP HBTABLIBHING � PERMIT PEE ONLY. �
PLY WITH ALL GIT' 1 AN 9 AND ATE l.AWB REGULATIN� d
eul�nlNo CONB VALUATION L �%
SIGNATURE OF PERMIT FEE $/�J �Sd C
PERMIITE ' / y'/� .s / y�— o O
S / �/l �` D� pU1N CHECK $ (�c��� /J
AUTHORIZED AGEN7 � r �
TOTAL FEE S 4 O
i
-.; I8�0
�COSTA MESA BUILDING-SAFEfI' DEPARTMENT
P. O. BpX 91] G09TA M6HA. CALIFONNIA
For App�lcant to FJII In Completely
TYPE OR PRINT
COSTA MESA, CALIFORNIA
� MAIL
no. or etnoe.
■ BETBACK LINB PHOM �
DESCRIPTION OF WORK
BUILDIN6
SIZE
EXTERIOR
'1 X8Il8BY ACKNOWL8DO8 TNAT I MAVB RBAD TNIB ApP{,ICATION
•NO 9TAT6 TXI�T TH8 ABOVB IB COpp@CT ANO AOH88 TO COM.
PLY WITH /�LL C�Ty OPDINANCBB ANO BTATB LAWB PBOULATINO
BU�LOINO CONBTpUCTION.
, AUTMORIZEDA6ENT�'�� ��JyJ)Brt��
rtt KtI;tIUtU
EB 2' 0 1963
FINANCE DEPT.
aPvucahliY��D f�d`iO��Gn�fkSA
BUILDING
FOr Office USB Only
PBC81V BY
BUILDINQ I
L80�L
IBBUED
ZONINt3
NO.OR UBeOPNBW
�LANB OUILOINO
�n-A '2.✓� �O �
o. !( G— o a/— 3� '
NO EAV E OV BRHAN6 BHALL BE L@88 TMAN
YARO9 MPROVED
MAIN BUILDINO
oierwn
rnwiN e
VAR. SF
YARD9 APPROV ED
ACGESSORV BUIL�IN6
I•T.ii�
TX6 AMOUNT 9HOWN UNOeR V.�LYAT�ON IB POF TH8
PUPPO88 OP BBTA6LIBHINO A PEPMIT PH8 ONLY.
VALUATION
PERMITFEE S
s l� �a�� c J��
TOTAL FEE $ I�� ��
�
�
GENERAL WNTRACI'OR �
nr No. L16-o31-33 L�T
7N5PPCTIONS
OCCUPANCY
BUILDING P�AMIT NO.
TRACT FIRE ZON� DESCRIPTION OF WORK
� Signature� DA1'E GROUP �J TYP� V 7.ONE
SUBCONTRACTOR