HomeMy WebLinkAbout2650 ELDEN AVE - Building Permits •
�r- CITY OF COSTA MESA
BUILDING DIVISION
F �
, a DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4. VC7� ®0 PERMIT
g P06-00884 bboRmso
(714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBI •
Job Address: 2650 ELDEN AV Status: ISSUED
Suite No Applied: 10/27/2006
• Issued: 10/27/2006
Vicinity: ROOF DRAINS
Parcel Nunmber: 43922112
Applicant: ELLIOT, JAMES ISSUED BY:
Address: 324 S EARLHAM ST
Phone: 714-997-4938
ORANGE,CA Zip: 92669
Owner: WENDLER, HARRY ENIS TR
Address 18472 DURFEE CIR • - -
-Phone:
a 'V
VILLA PARK,CA - --- Zip: 92861 - ,
Contractor ELLIOT ROOF MAINTENANCE AND INSPECTION SERVICES
Address: 324 S EARLHAM ST - .
Phone:714-997-4938 '
ORANGE,CA Zip: 92669 ,
License: 465344 .
SCOPE OF PERMIT
REPLACE(E)ROOF DRAINS W/COPPER ROOF DRAINS AS NEEDED IN CONJUCTION W/REROOF OF APT
GARAGES FOR UNITS I-P. .
REF#:806-01818 -
-FEE SUMMARY ; ' '
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 LaundryTub/Washer $0.00 0_ Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 •_ P-Trap - . - • . $0.00 0- ,-, -- Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 ' 0 ` T. - 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 Bkflow(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 $0.00 . 0 Wash Basin Set • $0.00 0
Drain,Floor $0.00 0 Sewer Connect _ 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line - H $0.00 0 Water Closet(Toilet) " $0.00 0
Drain,Roof $9.80 1 Shower ' $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00- r 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) ' 2' - - $0.00 -- -0 '- .PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 - - - - - REINSPECTION' , $0.00 0
Interceptors(Sand Auto) $0.00 0 - - i �, '
. TOTAL CALCULATED FEES: $33.30
COMMENTS/'SPECIAL CONDITIONS .
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under.Califomia s ue as nd 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. 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)7545626
2446-46(WOO)
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'iidinpensallon Insurance carrier end policy number are:
C %Carrer: ST rt Fid di/i Lea6cy:siumber._ 0.060 // OCT
_(This section need not be completed/f the permit Is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
,Applicant Slpnature: //////i�11-A `fJ r"—
_WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(S100,000),IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirmthat I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect Lic..H. t't 5-30 4 Class#+ c-7 f
ctoes-Signature-.: J3 .y it 4,¢G.-- Date: /GI 2 7/0 6
ai
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,end 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 properly,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. 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 feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8.California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one lime during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds.or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature 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 Safely 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 akermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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? 0 Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
Coast
Quality
. It Management
7 If a permit athe South iscost s prescribed
ed by CaliforniaiDistrictHor other airtpollution control district3 agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by CafoHealth and Safety Code Section 42303 been made? ❑Ves 0 No
8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of f Legal Owner(s) Date
,f ft /O/�-.7/h
rAAnd/Or,Authorized Applicant•
ODE I INSPECTION TYPE PATE INTMAj CODE I INSPECTION TYPE QMTE RM AU
1616 Fixed System Final Fire Prevention 206 Final Mechanical (�
1266 Pool Spa Final 208 Final Plumbing 9'a9 -tO (AN
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
• CITY OF COSTA MESA
o
;
< BUILDING DIVISION
H" .,I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
I. I -----. t
PERMIT
banana P06-00883
(714)754-5273 • Fax(714)7544856 • www-cl.costa-mestca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBIJob Address: 2650 ELDEN AV Status: ISSUED
Suite No Applied:" 10/27/2006
Issued: 10/27/2006
Vicinity: ROOF DRAINS
Parcel Nunmber: 43922112
Applicant: ELLIOT, JAMES ISSUED BY:
Address: 324 S EARLHAM ST
Phone: 714-997-4938
ORANGE,CA - Zip: 92669 ,
Owner WENDLER, HARRY ENIS TR . -
Address 18472 DURFEE CIR .
Phone: _ ,
VILLA PARK,CA • . - Zip 92861 '
,
Contractor: ELLIOT ROOF MAINTENANCE AND INSPECTION SERVICES <H' `
y '
Address: 324 S EARLHAM ST
Phone: 714-997-4938 ,
ORANGE,CA Zip: 92669
License: 465344
•
•
SCOPE OF PERMIT
•
REPLACE(E)ROOF DRAINS W/COPPER ROOF DRAINS AS NEEDED IN CONJUCTION W/REROOF FOR
APT GARAGES FOR UNITS A-H.
REF#:B06-01817
FEE SUMMARY ,%
AMT QTY AMT Q _ • AMT QTY.
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 ' 0- Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $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,ete) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(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 $0.00 0 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 $9.80 1 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': t ' , 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 2 -2- .-PLAN CHECK - - $0.00
Interceptors(Grease,Oil). $0.00 0 - .; :REINSPECTION / $0.00 0
Interceptors(Sand Auto) $0.00 ' 0 - - '-, y ;i �,,"
TOTAL CALCULATED FEES: $33.30
COMMENTS/SPECIAL CONDITIONS .
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia Mutes and related
regulations.(Ord.No.92-28,§1,12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Ls not commenced within 180 days,or it wo s 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 '
2448-48 mmol
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:
� 4ZAj TM P oo0vilo- )DC
CardeC Pol' Number
:
1 c-(This`section need not be completed 1Y the permit is valued at one hundred dollars($100)or less.)
❑ I certify that In the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these p ions.
Applicant Signature: 7/of
(WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO GRIM! PENAL ES AND CML FINES UP TO ONE HUNDRED
THIXASAND DOLLARE(5100.003),IN ADDrnON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION Sloe OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
force.and effect:Lic a 7 1 4-9 9 Y- Class a C-31
Contractor's Signature' Q- ,. /t cr4>" CDale: - 10/17. De
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 Corte).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ 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 properly,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. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax 6111 or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the ONision 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 lila 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 Mese 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 Cafe provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑NO
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes DI No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
the-facility
_ wit feet
m the
_._...._...._._
8 Will any part of the facility to be constructed under this permit be within 1000 feet from thouter 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).
7 If a permit from the South Coast Air(Duality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have reed this application and state that the information given is
correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Date
/o/3.7/Co
/And/OrAuthorized Applicant-_— CDale_�'__s
SODEP INSPECTIONTYPE 263 RALE SODS t INSPECTIONTYPE DATE INIDIALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing 7-net- to
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retalning 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
V CITY OF COSTA MESA
` 4 .•: r. BUILDING DIVISION
>et- ; DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER
IP
. PW4PERMIT ,
•
BO6-01818
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesas fLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2650 ELDEN AV Status: ISSUED
Suite: Applied: 10/27/2006
Vicinity: GARAGE ROOF Issued: 10/27/2006
Primary Occ: MR Type of Construction:
Parcel Number: 43922112 Zoning:
Applicant: ELLIOT, JAMES
Address: 324 S EARLHAM ST
Phone: 714-997-4938 ISSUED BY:
ORANGE,CA Zip: 92669 •
Owner WENDLER, HARRY ENIS TR
Address 18472 DURFEE CIR Phone:
VILLA PARK,CA Zip: 92861
Contractor ELLIOT ROOF MAINTENANCE AND INSPECTION,SERVICES - N - '
Address: 324 S EARLHAM ST
Phone: 714-997-4938 •
ORANGE,CA
Zip: 92669 - License: 465344
Arch : - - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
•
• • SCOPE OF PERMIT -
REROOF APARTMENT GARAGES FOR UNITS I-P WORK TO INCLUDE:TEAR OFF(E)ROOF MATERIALS AND REROOF W/A BUILT UP ASPHALT
ROOF SYSTEM AND 4 PLY GRANVLAR SURFACING ON FLAT ROOF ONLY,APPROX 4,500 ONLY.REPAIR AND REPLACE RIDGE AS NEEDED.
lac POEr 0314 Li
FEE SUMMARY
Plan Check: $0.00 ' Calc Valuation: $16,328.50
Permit: $279.25 Claim Valuation: $16,328.50
SMIP Res: $1.63
SMIP Corn: $0.00
Other $0.00 •
Inspection: $0.00
Total: $280.88
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear "0-0 Left 0-0. •,.. Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right. 0.0
•
PARKING Existing: 0 Required: 0 Proposed: 0
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes•anrelated
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: suspended or abandoned
fora period of 180 days. •
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46 WOO)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under.penalty of perjury one of the following declarations:
❑ 1 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.
El 1 have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
----My workers'compensation Insurance carrier and policy number are: /
"Carrier, ; STe- JNL
Te F/.
v PoliciNumberL•aleo 1/0 - 8'VOC
'(iliis'sectiar need not be completed If the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Cade,I shall forthwith
comply with these provisions. /m '�
Applicant.Sgnature: //Q., n-yi Dste: /O 27/06
--
,WARNING:FAILURE T CURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EM%AYER TO GRIM PENALTIES AND CML FINES UP TOONE HUNDRED
THOUSAND DOl1ARE(Sloue%IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that 1 am ll used under provisions of Chapter 9(commencing with Section 7000)of Division,3 of the Business and Professions Code,and my license is in full
force and effect:Lk5 aL%cdast#' C-3 9
M..�
COnt Ys Signature: v., 4, Jr Idle- Dater- - tOti-7/O/
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agony for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Soc.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(commendng 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 properly 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. 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 feet in depth Into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health end 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 or will thent applicant or present or future building occupaneed to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Cale provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of en RMPP by businesses which ere required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such instruction or modification
from the South Cnnst Air Quality Management District or from any other air pollution control district or agency? U Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
........._...._..._.._ __......._..._.._facility
�.. ._---arses o-a'sc _.. -- —
6 Will anypart of the to be constructed under this permit be within 1000 feet 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 Califomia Health and Safety Coda).
7 If a permit from the South Coast Air Quality Management District or other air pollution c ntrol district or agency Is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,end authorize representatives of the City of Costa Mesa to enter upon the
above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Date
fere /0 7'/ 06
v Arid/Or Authorized Applicant ('/ate'
CODE# INSPECTION TYPE PA/E EIIm9L5 CODER INSPECTION TYPE QAIE Riima
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 250 Final Building/Occupancy
• CITY OF.COSTA MESA
4 BUILDING DIVISION
i g:14,1117...4 DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER
F r ,i PERMIT
J r�
,�� BO6-01817
(714)754-5273 • Fax(714)754-4856 • www.cI.costa-mesa.igtLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2650 ELDEN AV Status: ISSUED
Suite: Applied: 1027/2006
Vicinity: GARAGE ROOF Issued: 10/27/2006
Primary Occ: MR Type of Construction:
Parcel Number: 43922112 Zoning:
Applicant: ELLIOT, JAMES
Address: 324 S EARLHAM ST
Phone: 714-997-4938 ISSUED BY:
ORANGE,CA Zip: 92669
Owner WENDLER, HARRY ENIS TR
Address 18472 DURFEE CIR
Phone:
VILLA PARK,CA Zip: 92861
Contractor ELLIOT ROOF MAINTENANCE AND INSPECTION SERVICES . •
Address: 324 S EARLHAM ST
Phone: 714-997-4938
ORANGE,CA., \��
Zip: 92669 License: 465344
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT . '
REROOF APARTMENT GARAGES FOR UNITS A-H WORK TO INCLUDE:TEAR OFF(E)ROOF MATERIALS AND REROOF W/A BUILT UP
ASPHALT ROOF SYSTEM AND 4 PLY GRANVLAR SURFACING ON FLAT ROOF ONLY,APPROX 4,500 ONLY.REPAIR AND REPLACE RIDGE AS
NEEDED.
//tEr P:6-03n3
FEE SUMMARY •
Plan Check: $0.00 • • - - • - Calc Valuation: $16,328.50
• Permit: $279.25 Claim Valuation: $16,328.50
SM IP Res: $1.63
SMIP Com: $0.00 •
Other: $0.00
Inspection: $0.00 •
Total: $280.88 -
• PLANNING &ZONING
SETBACKS •
MAIN STRUCTURE Front 0-0 _ Rear 0-0 Left 0-0, • Right - 0-0,-
ACCESSORY Front 0-0 Rear 0-0 - Left- 0-0 Right 0-0'
PARKING Existing: 0 Required: 0 - Proposed: 0' - '
� -
•
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is s pended or abandoned
for a period of 180 days. CO
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(am)
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.
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.
l
workers n
7 !m eation!Laurance carrier and policy number are: _ _
Carrier—TSS/fJ - G/14,2 Poil num ear:-0D O� (J ' 2 O0Z-
(,ThLa section need not be completed ll the permit Is valued at one hundred dollars($100)or less.) �� l
❑ I certify that in the performance of the work for which this permit is Issued,l shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro ' ions. JJJ
Applicant Signature: if_ `Lf" roma: ,----/:112- 70X
WABMNG:FAILURE TO EC IRE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENAL S AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(51 W,W%,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effecL.Lic.p-.—r % 5 29-4- (Cass 4.A (. 77
'Contractors Signature: 7/!!:
-
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address: _
Signature: Date: _
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Dhasion 3 of the
Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business end Professions Code for this reason: _
Signature: Date:
Owner ID verified by drivers 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 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,lalsework,or demolition or dismantling thereof,will bo more then thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date: _
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health end 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 entl 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? ❑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 plication appermlt for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? DDI Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Wit any part of the facility to be constructed under this permit be within 1000 feet 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).
7 If a permit from the South Coast Air(Duality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
.__......._.._ ._
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE MID AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end state that the information given is
correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Date
An& F — . - /C27/7/0.6"
Or Authorized Applicant- f L pate --a
CODE INSPECTION TYPE Qd1E MALE CODE t INSPECTION TYPE GA71: 9NIEIALB
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final / 208 Final Plumbing
200 Final Re-Roof //A "Q 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 Bullding/Occupancy
Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations.
P MIT NO. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA CONSTRUCTION PERMIT rG� A.P.94hI Zone
Pro ect Address 2650 Elden Ave. -13 3 / c'3 CO
I S Main Building: Accessory Building:
TYPE OF CONSTRUCTION LI NEW U ADD Xi A TERATION U REPAIR
Applicant's Mailing Address 324 So. Earlham St,,Orange rf E - ' - - Z
I
❑ CONVERSION ❑ DEMOLISH ❑ OTHER ¢ / T Front O
is Name Essex Realtor Management Phone DESCRIPTION OF WORK/USE OF BLDG. Tear off F. re-roof ' B N
Address 18022 Cavan Suite 202 B, Irvine pregtique_ II Shing1 e.. & Built- Up Asp2hlalt/granular A Rear 1
Nth/Eng. License No. TYPE OF PERMIT U GRADING U Y]
FOUNDATION J STRUCTURAL . K Right G
N
A•
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ! $ • Left R
V-, ❑ -OTHER
Contractor's Name El J i Ott Roof Mai ntenanmelne 997-re-3.8 O , 1 Ping. Ref.# Parking Req./Provided E
'.i PROJECT DESCRIPTION SQ. FT.
Address(mailing) 324 So. Earlham, Orange CONSTRUCTION TYPE , O VALUATION$At' 00'00 ( Planning Notes: M
City License No. 039965 I T
ZONE GRADING CU.YDS. ACRES
S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �� ,/i '
with section 7000) of Division 3 of the Business and Professions Code,and \!i ammizmnimmew
my license is in full force and effect. ELECTRICAL FEES
License Aug. 4, 1 g(�Oat lire Class C-3
Date9 License NNo. 465344 PLUMBING FEES Automatic Washer Transformer 0 15-50 KW '
WORKERS' COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 0 50+KW
Q thy affirm that I have a certificate of consent to self-insure or a certificate
orkers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps
J. Lab. C.) Backflow Preventer Service Sink'
Policy No 571785 Company State Fund Dishwasher Meter Clover 100 amps
Backflow Irrigation Sewer Cap
�µI Certified copy is hereby furnished. ,,
IA Ce fried copy i fuep with the city Builtlin5 Division. Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel
�x Date ug• �, 51N2f9 Applicant By• ,Tames H El lintt,Pres. Fan
'` EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors❑O-1 HP ❑ •15--8
(This section need not be completed if the permit is for one hundred ($100) or •Dishwasher F.A.U. Inc.Solar 09.15 HP 016-15+
less). Solar Piping
t certify that in the performance of the work for which this permit is issued I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California. Device Boxes
Date Signature Floor Drains Swimming Pool w/Spe Pole Light
NOTICE:If,after making this declaration,you should become subject to the Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCYSwitches
Gas Service Outlets Water Closet Sign
I hereby affirm that there is a permit
lending agency for the performance
C.)
of the work for which this permit iz issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I 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
county which requires a permit to construct,alter,improve,demolish or.repair P—Trap • Laundry Treys -
any structure, prior to its Issuance, also requires the applicant for such permit I
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
• --.ion 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee
from and the basis for the alleged exemption. Any violation of Section P I $15 Issue Fee $ 3
5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
U 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 Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES Building Approved By - AO Date
License Law does not apply to an owner of a property who builds or improves 'Z'
thereon, and who does such work himself/herself or through his or her own r Application Issued By I _ e'���.— Dat: '"�i�
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 - . ..._ --�.
sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 �, SUMMARY •F F 1S
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). • BUILDING PERMIT $ /.0-100 SMTP $ r rep
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
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 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon.and who contracts for such oroiects with a con- ENERGY P.C. $
tractors license pursuant to c Contractor's License Law). I am aware that Exhaust System 0 Multiple El System Repair/Alteration I PLAN CHECK 25% $
proof o� the
their Worker's Compensation insurance should be provided to me. IF ELECTRICAL $ GRADING $
❑ I am exempt under Section B.&P.C.for this reason Firepl/Fact.Blt. ICBG dk Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers = f MECHANICAL $ S J0
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $ l
Information is correct. I agree to comply with all city and county ordinances e PLAN CHECK 25% $
and state laws relating to building construction, and hereby authorize repreid
-
sentatives of this city to enter upon the above-mentioned property for
Inspection purr oses. L 8-4-89Sir
Drivers' � . Reinspection Fee $15 Issue Fee $ 3 le 1-2.4
lcA I .cDrivers• license or ss01 00039655-00039656 TOT .57
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 03/04/89 TIME: 15:31
1•
•
COIRUGIJON AND PLANNING POC 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 ReinforcementK,
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE r
d
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ 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 i •
64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electricdl-Conduit 66. Solar System-Final
116. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18 Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
19; Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
t.20: Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough&•Test 72. Underground Flush
24. Roof Framing •r^ 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing .14 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 'N / 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing 's' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meier-Final 80. FOOD CERTIFICATE ISSUED
•
33. Final Electric Notes:ofP'/E,p1 Veep CMOIGc Per Lem---2
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy -�
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer • J
43. Backflow Irrigation '
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations - T
47. FINAL STRUCTURE &BUILDING 11/s'4, at-
48. Special Requirements Completed �•
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
e •
51. CERTIFICATE OF OCCUPANCY ,1
No. - Date
Plir
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.Q 4 •
A.P.SW I Zone
Project Address 2650 Elden Ave. - l� `�9 �`3
TYPE OF CONSTRUCTION Li NEW LI ADD ® ATION S Main Building: Accessory Building:
Appli ant's Mailing Address 324 So. Farlham, Orange LI REPAIR E 0
❑ CONVERSION ❑ DEMOLISH ❑ OTHER Qf T Front Q
Owr� s Name Fes4PX RPal tor Mana amant Phony 1t t a1,I,•1� DESCRIPTION OF WORK/USE OF BLDG.Tear off & re-roof B Rear N
Address 18022 Caaans Suite 202 B, Irvine Prestique II Shingles f& Built-Up As�p1halt/granular
��.__ a TYPE OF PERMIT ❑ GRADING LI FOUNDATION UO STRUCTURAL C Right N
A•ibhhng. License No. * K G
Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL ' s- Lett
R
Contractor's Name ione
Elliott Roof Maintenan 997-4938 0 OTHER I Ping. Ref.# Parking Req./Provided E
Address(mailing) 324 So. Farlham, Orange 92669 PROJECT DESCRIPTION SQ. FT. ‘O 0 00 OCCUPANCY Planning Notes: M
039965 CONSTRUCTION TYPE VALUATION$ It;OD Q
City License No. ZONE GRADING CU.YDS. ACRES - — S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: v u �" A .r-�Lp6T t(1 FJ,
tat
with section 7000) of Division 3 of the Business and Professions Code, and J S �ttz"'�-' ELECTRICAL FEES
my license is in full force and effect.
License Cllass C-39 License No. 465144
Date ""s• 4r 1989Signature PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
(� WORKERS' COMPENSATION DECLARATION Construction Pole Sub. 0 50+ KW
'-ereby affirm that I have a certificate of consent to self-Insure or a certificate gar Sink Showers
Vorkers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps
Backflow Preventer Service Sink
°' Lab' c.5/1785 State Fund Dishwasher Meter Dover 100 imps--
Policy Policy No. Company Backflow Irrigation Sewer Cap r
8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel '9
Certif' Jfi,c Riled with the city Builying Dlyjsigq, Bathtubs Sewer Connection
\ Date %�'j � 7 Applican PY: na.- H. Ell inti -clr_rth Fan Motors❑0.1 HP ❑1%-8
EXEMKTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100)or Dishwasher Solar Piping F.A.U.
less). Inc.Solar 09-15 HP 016-15+
I certify that in the performance of the work for which this permit is issued I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Sol;r Tank Microwave -p,
Workers' Compensation Laws of California. Device Boxes P e Light Date Signature Floor Drains wimming Pool w/Spa 9
NOTICE: If,after making this declaration, you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal
comply with such provisions or this permit shall be deemed revoked. Switches
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service - _ Generator C10-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION -
—
I 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 -
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays '
any structure, prior to its Issuance,also requires the applicant for such permit r•,
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
Olvision 3 of the Business and Professions Code) or that he/she is exempt — Reinspection Reinspection Fee $15 Issue Fee $ 3
".i :efrom and the basis for the alleged exemption. Any violation of Section
b'a+-1.5 by any applicant for a permit subjects the applicant to a civil
,-,
' ;salty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS:
U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zonin�Approved By
compensation, will do the work, and the structure is not intended or offered __ - Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
License taw 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 or Type I 0 Application Issued By Dat
employees, provided that such improvements aro not intended or offered for -
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 • • summARY OF FE
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground •- p
prove for the purpose of sale). rBUI LDING PERMIT $ ` •S0 SMIP $ •s�
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Ref!' "ration System PLAN CHECK $ PERMIT
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 0.100,000 BTU 0100,000 BTU :PLUMBING $ ISSUANCE $
System
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 0 Multiple 0 System Repair/Alteration I'PLAN CHECK 25% $ ENERGY P.C. $
proof oftheir Worker's Compensation Insurance should be provided to me. r-ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO dk Fire Dampers A.
PLAN CHECK 50% $ MICROFILM $
Date Owner - Heating System& Ducting Registers MECHANICAL $
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000 BT ^! �)- TOTAL FEE $ 77._s—k•
is correct. I agree to comply with all city and county ordinances ''PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for
Inspection pu oses. 8-4-89 ��y� /tli
Signature
01 00039657-00039658 TOT ”.r!i
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DA1Et 09/04/89 TINE: 15:32
•
fid • ,
CONSTRUCTIONYY�� AND PLANNING POO" SPA
APP3OVALS Permit# Date Inspector APPROVALS .Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
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.
B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test •' 1
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ 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 Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
f16.' Rough Electric Wiring 67. Fencing & Access Approval
1.7: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating _ 71. Product Piping 0 Gas ❑Oil
23. Gas-Pipe-Rough&Test 72. Underground Flush r
24. Roof Framing ". 73. Undergrnd.Storage Tank O Gas 0 Oil, '
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing & Siding •
77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:08v 4_ )CS� �C U -r-� /s o.-
34. Final Heating & Air Conditioning 1 f�
35. Final Gas Pipe-Test
0911 Ftoj Nps 5.4o c _a. .ate'
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing _
J
39. Water Service-Final
40. Gas Service-Final L '
41. Solar Domestic-Final '
42. Backflow Preventer 11 ,
43. Backflow Irrigation •
44. Landscape Irrigation System
45. Sound Attenuation -'
46. Handicap Regulations {/ '/
47. FINAL STRUCTURE & BUILDING �f/ i�
48. Special Requirements Completed //"`/'`l
49. Electric Release to Edison
50. Gas$ielease to Southern California Gas Co v'
51. CERTIFICATE OF OCCUPANCY ' , t'
No. Date ''
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ,
I„ - :TIT NO. TRACT NO. LOT NO. UNIT N0; ;�/� /� J
ACITYlelF COSTA MESA. CONSTRUCTION'PERMIT .IY< c� 9 l// /
Project Address 2650 Elden Ave I_,
Applicant's Mailing Address 324 So. Earlham, Orange • TYPE OF CONSTRUCTION U NEW ❑ ADD LJ9 ALTERATION Li REPAIR - ,
❑ CONVERSION El DEMOLISH El DESCRIPTION
-- q.p.# __ Zone
Owner's Name ESSeX Realtor Nffi73iH1a1t Phone 756-2505 DESCRIPTION OF WORK/USE OF BLDG. Tear off & Re-roof
Addres 8022 CCManSL1
s 1_te 202 B, •Tr-i;lie Prestique II Shingles & Built-Up Asphalt/granularl� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ' IE GRADING LI FOUNDATION LS STRUCTURAL E Front' . Z
Addr�l -. '• a❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL B Rear - - • ' N
❑ OTHER.
Contractors Name Elliott Roof Maintl=}irTPphdne 997-4918 A - - - - I
9
324 So. Farlham OranPROJECT DESCRIPTION 50. FT. {O CI O� OCCUPANCY C Right
Address(mailing) r Orange 92669 K G
039965 CONSTRUCTION TYPE VALUATION'S !• 1OOo•DD $ Left - - R
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ret. .Pal king:Req./Provided • E
I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing ,• Remarks: TC -• - Planning Notes: - . ' 0
with section 7000) of Division 3 of the Business and Professions Code, and ••)i-3 5 Z e nvLiH P M
my license is in full force and effect. , ' T
License Class C-39 License Np. 465344 - - - -
DatR9 Signature _ PLUMBING •FEES' I
_ ti7_• 4, 19
O
WORKERS'COMPENSATION DECLARATION • - Bar Sink Showers - ' ' ' - ELECTRICAL -• FEES
t hereby affirm that I have a certificate of consent to self-insuie ora certificate ,
X ' Workers' Compensation Insurance, or a certified copy thereof (Section - '2 ,
\ too, Lab. C.) - Backflow Preventer Service Sink Automatic Washer
Transformer'0 15-50 KW
Policy No. 571785 Company State Fund Backflow Irrigation Sewer Cap0 50+ •KW•
\ Construction Pole Sub.
❑ Certified copy Is hereby turn lshed. _
[i Ce Hied cp p ed with the cityBuilding Division. .y Bathtubs .Sewer.Connection z. • Cooking.Unit ' - •• ' Meter ❑up to 100 amps . )
Date\. 4�. 1,0, Applicant ' •� f-L P•111 ']t, - - -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . • Solar Collectors Dishwasher ' Meter Cover 100 amps -
(This section need not be completed if the permit is for one hundred ($100)or - -
less). ., Dishwasher- Solar Piping _ Dryers 7Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issuetl;,l -� - - . ' '
shall not employ any person in any manner so as to become subject to the C • Drinking Fountains Solar Tank Fan •
Motors 00-1 HP ❑1'h-8
Workers' Compensation Laws of California. . - -
Date Signature Floor Drains Swimming Pool w/Spa - F.A.U. ,
NOTICE: If,after making this declaration, you should become-subject to..the — Inc.Solar ❑9.15 HP ❑16-15+'
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks I Urinal - • I Fixtures
•• comply with such provisions or this permit shall be deemed revoked. - Microwave '
CONSTRUCTION LENDING AGENCY Gas Service , Outlets Water Closet Device Boxes Pole Light• I hereby affirm that there is a construction lending agency for the performance - 9 '
of the work for which this permit Is Issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets
Lender's Name Range , • •
Lender's.Address Kitchen Sink ' __ Water Service •- - , Switches- - - Sign
OWNER BUILDER-DECLARATION •
•
I hereby affirm that-ram exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ' '
following reason (Section 7031.5 Business and Professional Code: Any city or 11-
_ 9 P Standing Sections
county which requires a permit to construct;alter,improve,demolish or repair P-Trap . - Y•Tra S
Laundf
any structure, prior,t0 its Issuance, also requires the applicant for such permit y Gen¢latOr 00-$KW OS-15 KW Trash Compactdr
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's.Cicense Law(Chapter 9(commencing with Section 7000)of ,
- Division 3 of.the Business and'Professions Code) or that he/she is exempt - - - - - - .. - - '
therefrom and,the basis for the alleged exemption. Any violation of Section 1 '
031.5 by any applicant for a permit subjects the applicant to a civil - - - I
,enalty of not more than five hundred dollars($500).
' • 0 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 '
• for sale (Section 7044, Business and Professional Code: The Contractor's - - MECHANICAL - Reinspection Fee I $15 Issue Fee $ 3
t License Law does not apply to an owner of a property who builds or improves - - FEES
thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: ' -
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0
sale. If,however, the building or improvement is sold within one year Of com- Canopy Type II ❑ Zoning Approved By I Date
pletion, the owner will have the burden of proving he/She did not build or im- - Duct-Under Ground Building Approved By • Date
• fill prove for the purpose of sale). r/ i
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural , Refrigeration System Application Issued By litMinarr fri....t...... DatB O
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 ❑0-100,000 BTU ❑100,000 BTU - •
builds or Improves thereon,and who contracts for such projects with a con- S MMI V OF FE' ,•
tractor(s) license pursuant to the Contractor's License Law). I am aware that, Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ T •00 SMTP $ Sel
• proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ .PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers •
PLUMBING - $ ISSUANCE $ ,-
Date Owner - Heating System&Ducting RegistersENERGY P.C. $ '
PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above 60-100,000 BTU 0100,00067E ELECTRICAL - $ 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 upon the above-mentioned property for • ' ' - �/'
inspection pu oses. o','�, MECHANICAL $ iris-6
Signature �
- 41111111.
- '- - Ul-L' J31 JS-V.:UJTOJ9 I +.Y I
CMF 0865-a6,rev.10/84 white - Building; Canary -Applicant; Pink -Accounting;Goldenrod - Assessor
� , DATE: OS/04/29 TIDE: 15:30
•
CONSTRUCTION AND.PLANNING 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. •
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test
•
6. Electrical OF ER Grnd'. 57. APPROVAL TO COVER-GUNITE
7. Footings58. 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 Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating .71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro -
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL '
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION •
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
•
•
35. Final Gas Pipe-Test
36. Hood or Canopy , )
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final Mal p.)660 brastaii phi. a a
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 7/.��t n/1
48. Special Requirements Completed �/r"" P"�
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co I 1
51. CERTIFICATE OF OCCUPANCY _
No. Date -
. 293b9 PAID
/ NOV 12 68cnsA00 413* * �233,Z5
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1209 COSTA MESA, CALIFORNIA 0262E
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
Mu1LDING L,N/TS For Office Use Only
ADDRESS 2650 Eldon Ave. A ._ II
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIAI.
REcyv[O BY DATE RECEIVED DATE ISR p
OWNER Harry E. Wencher �c1tAO //-/'/J----/vim //-//�' &if
MAIL 10712 Katelle Ave. ADDRESS.0'aumnitio V �•�R'F.�/�'� FTN'
ADDRESS
FIRE �G
CITY Anaheim No-5356791 ZONE PrPET Q OUP �T6�
ARCHITECT
R71
HITEC SRPitcher-1('ernaid TEL b4titi'/LJ4 APPROVED t L DATE///L (�i7
CRESS 418 San Bernardino NB ZONING
ZONE No.OF un or NEW 8 IDw je.�GIM
CONTRA Berney Construction co. T7^T I PLANS Z I BUILDING IIn Ih
cT4 KK ! r�. �I hh
ADDRESS 1234 E. Edinger LEGAL
A i��yi 1�-�¢`t Th`kr 37E
Santa Ana
CITY A.P.NO.
STATE 247 329 T - 542-8891 NOTE:OSloe B ROVERHANG. SHALL BE LESS THAN
LIC.NO. NO.
VES
SIZE NO.OF RL . ALLOWED (U.B.C.REQUIREMENT)
OF LOT 1321r:305 I DM
NOW ON 0
YARDS APPROVED YARDS APPROVED
USE OF -- MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
- - (FROM C,L STREET)
SETBACK LINE PROM �yO,R CO �,
E1J)cN Fr.
CENTER or STREET 501
REAR YARD 10 1
51 I 51 tl_ FT.
SIDE YARD LEFT RIGHT R•SIDE 5 FT.
DESCRIPTION OF WORK L.SIDE89-7,7. //fl,! Fr.
_ X ALTERATION ADDITION REAR r( / PT. IL PT.
DISTANCE BET. /jJ '_A I/ BET.MAIN O
REPAIR MOVING DEMOLISH MAIN BLDGS. `(lF T ACCE69.BLDGH.
BUILDING.�8 NO.OF VAR.JF U- tO, DATE ,�,f/Q2 18
l9�
SIZE 38x270 ROOMeB ap oR1ES 1 C:#bpr. V /' APPROVED /Y/
EXTERIOR WALLStUceo' ROOF AFPROV[DDD/�/JJ wH-1 / �
COVERING TTnnld COVERING come. SY (//f w DATE Q- 1648
USE OF BUILDING AND WORK TO BE PERFORMED } IL
HOLD FOR SPECIAL, REOUIREMFI 4Ts w
Multiple dwellinge (#1 thru 8) _ t' Co un. c ,Ir/7TDIel.
AttatCS8i1 L{uiaBus (113290,6,7' �/ /7
��a SQ.FT. / 6(3A//, aa P7 1
I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C
l.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING13/4
VALUATION c � ['J� 5
BUILDING CONSTRUCTION. Op PERMIT FEE f /3�/ 5- O
SIGNATURE OF PERMITTER ///���
l /i i/ 3/6 PLAN CHECK S 7//�/ 7i g
..- AUTHORIZED AGEN'� / Z.7J r.2.
TOTAL PEE s
PAID
29360 HIT! 12-68 00 417* ***?ZS:15
COSTA MESA BUILDING-SAFETY DEPARTMENT
Z
P.O. BOX 1206 COSTA MESA, CALIFORNIA 92620 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING U i i IT5 For Office Use Only
ADDRESS 2650 Elden Ave. r - P RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA 25136n
ITEC[VED SY DA ECE ED DATE ISSUED
OWNER4Y
L10712 K.Katona
-e)ea 1/'�'
MAIL 10712 Katella ADO. moo RIYY -7-94 P
ADDR FIRE
TYPE GROUP'y/r
CITY Anaheim N[O.535-679 ONA
-y/ q-/ �//
ARCHITECT T BYP•
ROVQD 'Ir7
DATE/�-/` 1C/
?NGINEER • - • a - • .10 N•. :-: • ZONING
ADDRESS 418 San Bernardino NB •
• ZONE $ pWeii��
.OI OPN
. ^�I NOPLANE yl BUILDING U141Ts
coNTRAcTORBerney Construction Co. S•Iletar 61
ADDRESS1234 Edinger (East) 'GA'.TION milt % Le/-4nTtAcT- '37G
CITY Santa Ana A.P.NO. I19 - 680 - 09 h0
' NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE 247329 TEL. 542-8891 BO•TO SIDE&REAR p.L.
LIC.NO. NO. •
SIZE NO.OF MAHN. EAVES
OF LOT 132x305 I NOW ON Lm O ALLOWED (U.B.C.REQUIREMENT)
• YARDS APPROVED YARDS APPROVED
USE OF -- MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET)
II CENB[TSACKROP STERER LINPROtl 50 1
REAR Y • 10 ,.1 R•NT •N CII_ne FT.
TE
SIDE TARO I LEFT 51 RIGHT 51 R.SIDE 89-1z PT, at; 2. FT.
DESCRIPTION OF WORK LSIDE FT. 2- Fr.
X ALTERATION _ ADDITION REAR /0 FT. FT.
DISTANCE BET. A/II BLT.MAIN G
REPAIR _ MOVING DEMOLISH i., MAIN BLD'/S/. 714L.d ACCESS.BLDGB.
DATE
SB ZeLDIN038x270 NO.OF ROOMS 8 &P %RIES 1 VO. ►`I6- FXJ1 APPROVED B rIR in,
I (�
EXTERIOR WALLStL10CCII� ROOF comp • A►PROV[�wLi/ /
COVERING COVERING S7 4/•dddd/•N- DATE I 0- 1G - (C f1
USE OFBUILDIN ORK TO B[PERFORMED M
HOLD FOR SPECIAL REQUIREMENTS w
Multiple dwellings (##9 thru 161 I
ALL atdstd gsruFScio �r14) See ��td . � D ��1r�/cvdl
1u 500 SQ.PT. 4;36' `0�I x
I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION /THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 2
AND STATE THAT THE ABOVE,IR CORRECT AND AGREE TO COM. -
PURPOSE Or ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 2 SO 0.7
BUILDING CONSTRUCTION.
SIGNATURE OF PERMIT FEE $
PBRMITTBL j ,,, s 7`56C1 PLAN CHECK S 7625' W
AUTHORIZED AGE Jmis if �f 01 75'
:,..�... TOTAL PEE $ O
NOV 12-68 1418* ****`3`
• 29361 MRSA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92820 r 4
For Applicant to Fill In Completely `` APPLICATION FOR PERMIT
TYPE OR PRINT / BUILDING
For Office Use Only
ADDRESS 2650 Elden Ave. �y,
RECEIPT NO. GiV.1 96 I
COSTA MESA. CALIFORNIA J
RiCE}�D�BY DATE RECEIVED DATE ISSUED
<>man Baru E. Wendler ///t -63- /f—/,,--a
MAIL 10712 Katella Avo. ADDRRIee a'dJ-b ng,--,
ADDRESSFIRE T
CITY Anaheim Tilt 535679] ZONE TYP. . GROUPV a/
ARCHITECTRPitchar-FornaldrT+o 548879E BY
?ROVED /f' /o/ DATE// /Z-6/
AVDRESS 418 San Bernardino NB ��11 ZONING Z_&� GAR"(`
mon No.OF YSE OP NSW
Berney Construction CO. Rai
run• BUILDING Gni .f
CONTRACTOR LEGAL g i y Pi 14; 4(
ADDRESS 1234 E. Edinger DESCRIPTION M'ly f. far 4n Viiecr 17 6
Santa Ana A.P.NO. H4- OAn - 09410
CITY
NOTE: NO CAVE OVERHANG SHALL BE LESS THAN
STATE
LIC. 247329 TEL 542-8891 SO•TO SIDE&REARp.L
SIZE 1321E305 NO.OF BLDOS. 0
ALLOWED (U.B.C.REQUIREMENT)
OP LOT NOW ON LOT
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. -- MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBACK LINE FROM FRONT FT. 144'8 "Fr. C�-ne7J
CENTER OF STREET 1 41.1 REAR YARD]651
SIDE YARD I LEFT 72' I RIGHT 39' R.SIDE PT. FT.
DESCRIPTION OF WORK L.SIDE FT, 71-4-
-4PT. Li-.
X ALTERATION. ADDITION REAR PT. 1(94-6iFT. 't
DISTANCE BET. BET.MAIN& /_
REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS.
l0
BUILDING 21)(21 NO.OF 1 1 VAR.}r ti DATE /� '[
SIZE ROOMS STORIES S-i'�PiEt `�10-68 APPROVED MB) 10, //�;7L4
L th
EXTERIOR WALL ROOF APPROVE /�
COVERING StUCCO COVERING COM*• It- DATE ;b- it, -6R
USE OF BUILDING AND WORK TO BE PERFORMED D,
G
Detatehed Garage (#3,4) /J/S
. SQ.FT. % L.o T 2
I HEREBY ACKNOWLEDGE TNAT.1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 9 o-o
BUILDING CONSTRUCTION. PERMIT FEE / 1 PI
SIGNATURE OF E
PERMITTED // �p.0 ,�Iv.
>i / d� PLAN CHECK S /`7 V w
AUTHORIZED AGENT / /✓(��
TOTAL PEE 5
. NOV 12-68 f OO 419* *i**13.50
2g362
COSTA MESA BUILDING-SAFETY DEPARTMENT 4 .L
P.O. BOX 1200 COSTA MESA, CALIFORNIA 9262E Yrs
For Applicant to Fill In Completely 1 y/ APPLICATION FOR PERMIT
•
TYPE OR PRINT BUILDING
QUILDINe For Office Us* Only
ADDRESS 2650 Elden Ave.
Raclin NO.NO. PERMIT NO.
COSTA MESA, CALIFORNIA 2$a2
Y DATE RECEIVED._ DA'1'E��
OWNER Harry E. Wendler //R[-C[}�'�[D /,--", -br l//t-b'
MAIL 16712 Natalia Ave. ADDRESS an4Sa GP
ADDRESSFIRE
T
TEL ZONE 3 GROUP V
CITY Anaheim NO. 5356791 �� /�
�HOI fiN sR Pitcher-Fernald T�,5488794 BYPROVED frt DATE m/2 -6r
No.
`'" ZONING
, REBS 418 San Bernardino Co.N _
Berney Construction CONE R2 PLANS Cj BUILDINGS Z Ca r
CONTRACTOR5 C� Caarza4e
ADDRESS 1234 E. Edinger
LEGAL
W/yYa Lor 4n T-aacr 174,
Santa Ana A.P.NO. H9 - 680 - o9i- 10
CITY
E: NO EAVE OVERH
STATE 247 329 Tom- 542-8891 NSo TO SIDE Q REAR p.L.O SHALL BE LESS THAN
LIC.NO. NO.
EAVES
SIZE NO.OF BLDGS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 1 39•E' fl c NOW ON LOT n
YARDS APPROVED YARDS APPROVED
USE OF -- MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. (FROM C/L STREET) 06-Zr,
SETBACK
M 2841 REARTARp OI FRONT PT. 5091?'PT. c- FLDt t(
C L pp S
SIDE YARD I LEFT 55Q1 I RIGHT 55& R.'SIDE PT. /7E43 Pr. II—
DESCRIPTION OF WORK L.SIDE PT, SV-Purr. 1?
L
X ALTERATION_ ADDITION REAR PP. 3 FT'.
DISTANCE BET. BET.MAIN a / /
REPAIR MOVING _ DEMOLISH MAIN BLDOS. ACCESS.BLDGS. I(O
BUILDING NO OP VAR.* I/ ,Q DATE MA ,� /�/�
SIZE 21x21 ROOMS 1 STORIES 1 avorp EF` -IO-0" APPROVED 'Z,& /165
EXTERIOR W� ROOF APPROVED (J(�L vU I/n / p
N COVERING ``7 b1Z C+Ci� I COVERINe Comp. PT I `/I MIjh- DATE b-itl-6,9
USE OF BUILDING AND WORK TO BE PERFORMED J {y
. N
Detatehed Garage (#8.9)
r i
SQ.PT. 41,G0
I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE,IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. ]
SERMITUESIGNATURE OF , PERMIT FEB 5 gibe)at / I a / PLANCHECK S /l� w°P.
AUTHORIZED AGENT ] -
de - ... TOTAL FEE 5 /J,J v
• 29363 NOV 12-68Fp'D00 420*
[N5A ****13.5C
COSTA MESA BCOSTA MESA,
DEPARTMENT
P.O. BOX 1200 COSTA CALIFORNIA 92620
Jer: i
For Applicant to Fill In Completely • 'APPLICATION FOR PERMIT
TYPE OR PRINT `./ sBUILDING
I For Office Use Only
Y ADDRESS 2650 Elden Ave.
a RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA • •
. RICED MY DATE�f ' .0' '"
OWNER Harr E. Wandler '
'j MAIL 10712 Ks-tella Ave. I ADDR-INO O3-065se/`/
- ADDRESS V
cm/ Anaheim N&535679l :
ARCHITECT Pitcher-FernaldNHL5488794 - _- ,/
NOINEER N•.
ZONING
ADDRESS 418 San Bernardino NB
Berney Construction Co.
BUILDING
• CONTRACTOR y i 1_0/-
ADDRESS 1234 E. Edinger DESCRIPTION Ar/y IIA Lor 40 raRcr 37(c
Santa Ana A.P.NO. 119 - O[)O - 09 4_ to
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
,- STATLIC.NO. 247329 pL- 542-8891 4 130*TO SIDE&REAR P.L
EAVES
S, SIZE I NO.OP BLDGS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 132x305 NOW ON LOT O YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
` EXISTING BLDG. n
SIOBADXLINE PROM I (PROM C/L STREET �� R �W
i ceNT6R OP eTREeT 209 1 REAR YARD 92' 1•RONr .
SIDS MARDI LEFT 401 I RIGHT 711 It.-SIDE FT. 71-411 rr. R17IL,
DESCRIPTION OP WORK -' L SIDE R. R.
X
r►
ALTERATION ADDITION - REAR R. —
. R.
II : DISTANCE BET. BET.MAIN& / I
, REPAIR MOVING JL DEMOLISH MAIN BLDGS. ACCESS.BLDG'S. lD
BUILDING _Og NO.OF
SIZE 21X-29 ROOMS 3 STORIES 1 - 0 -- • •i
i; EXTERIOR WALL ,__ ROOF /
-+ COVERING scco COVERING Ccxiii ..n/ DATE i • 0 :
USE OFBUILDINS AND WORK TO BE PERFORMED 1 M
W
Detatched Garage (#11,12)
SCL FT. J"7? J-
- ACKNOWLEDGE THAT I NAVE RIAD THIN APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE is CORRECT AND AMUSE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STAYS LAWS
- VALUATION p
G'6 PERMIT FEE 5 9; 00 €
SIGNATURE OF
Li
5 /0 Z PLAN CHECK S / /� k'
�j�j q
"�� •o-. ... TOTAL FEE $ I3,,r0
• 29364 • ;
COSTA MESA BUILDING-SAFETY DEPARTMENT4
P.O. BOX 7813 COSTA MESA, CALIFORNIA 02323 I .A / p5t/
For Applicant to Fill In Completely i A ' APPLICATION FOR PERMIT
TYPE OR PRINT / BUILDING
BUILDING For 00ke Use Only
ADDRESS 2650 Elden Ave.
RECEIPT NO. NO, /
COSTA MESA. CALIFORNIA 3(O/ Y.'
R[CZI D BY DATE RECEIVED DATE ISSUED
OWNER Harry E. Wandler l/-/Z4 ' //—/? 4V
MAIL 10712 Katella Ave. EUILEI LAID -41%/1
, ��
ADDRESS ADDRESS v
TEL- ZONEFIRE TYP L& GROUP S
2
CITY Anaheim No. 5356791 TQ
whinCT Pitcher-Fernald I- .5488794, APPROVE $ DD ATE//-/2-'a'
GINEER NQ.
ADDRESS 418 San Bernardino NB ZONING
/�
ZONE NO.OP USE or NEW Z_ �,AR
Berney Construction Co. �Z PLANS 2 BUILDING e,4RAAag_
CONTRACTOR LEGAL 5.1y 1/- to r 41
ADDRESS 1254 E. Edinger DESCRIPTION Al li, %@ Lir 40 Teat r 376
Santa Ana A.P.NO. I !9-OCC - 09 4- 16
CITY
NOTE, NO HAVE
STATE TEL. 542-8891 [O•TO B DEe REAR P OVERHANG SHALL BE LESS THAN
LIC.NO. 247329 NO.
SIZE 1327[305 I No.or eLooe. 0 ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OP MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. -- (FROM C/L STREET) d Q (/y
CENTER OF STREETSITIBACK LINE M IA.T 751 REAR YARD 2341 FRONT FT, I,_V'PT. / CLI Y)I
�7 II
ADS YARD FLU"'
I RIGHT 71r R.SIDI FT. / I�4 PT. IL', 1?
i
DESCRIPTION OF WORK L.SIDE PT. PT.
X ALTERATION ADDITION REAR FT. 231118FT. fa-
DISTANCE BHT. BET.MAIN O
REPAIR _MOVING DEMOLIIN MAIN BLDOH. ACCESS.BLD08. 1.0
BUILDING 27,7[21 NO.OF 1 1 VAR.# / / Mar,
/ m
SIZE ROOMS STORIES O:�t-_P. ,/# V -IG .6A APPROVED aT; /g ffbg
EXTERIOR WALL _ ROOF APPROVE��� (GA.Rllcco COVERING OOE1}. eY !1
/...et .�
, DATE IO-Ih -6n
USE OF BUILDING AND WORK TO BE PERFORMED (/\ C.
EI
Detatchei Garage (#15,16) _ ,` t
eQ.rr. T Z5 `r E
I HERESY ACKNOWLEDGE TNAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE G
AND STATE TWAT THE ABOVE IB CORRECT AND AGREE To COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 1
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION p ,R/{ ]
BUILDING CONSTRUCTION. E 7 r lam✓
SIGNATURESCO
TU[ OF PERMIT FEE
a Z 300 PLAN CHECK s Y,.r) '
AUTHORIZED AGETrf l/�� �y�
Rfi7le�# TOTAL PEE $ /J, I/