HomeMy WebLinkAbout3375 MARIGOLD CIR - Building Permitsi
veaecrnooeess: 3375 M,ARIGOLD CI
owxexsearne:ALNEIDA WIiLIAM
aooeess:3375 MA{ZIGOLD CIR
COSTA MESA,CA 92626
AHCN/ENGINEEP:
aonncss:
NFG.NO.:
�T: �
21 ,
uxit:
PEPMITTEE:ACORN ROOFING ( 714 ) 524-7887
nooecss:17891 LINDA DR
YORBA ;.INDA CA 92686
LILENSEO CONTBRCTOB OECUNATION: 1 �ereGy allirm Iha� I am Iicen5e0 un0er provisions ol CtwplOr 9(commencinq wil� $epion
7IXI0) ol OmvM 3 0l Ine Bu4neS5 an0 PmleSsions Cotle. antl my littnse 6 in lull lorce ana e��e[I.
cirr uc.: .y��Q sTaTe uc.� 4 314 8 SS C- 3 9
Oaie: y/� /J�— Signawre: _ _l'!.'����""����,p�'�'
WONNEBS COMPENSRTIONOECIAMTION: I�ere�yaffirmi�atlhaveacenilicatealtOnSen�loSell�in5ureoratetliliWieO�Work¢rs'
CompenSalion Insurance. ar a cendie0 copy inereol (Seclion 3900. Lae. C�.
roucrNo.:1296649-93 E%P.OATE:O4IOI�99
COMPANY:STATE FUND
r] Cenilied co�Y is nere0y Iumis�eG. � Ceriilied copy is liled wilh t�e Ciry BuilOing Oivision.
�aie: �1 ApDlicant /7�J-!R� ROOF�
E%EMPTIONFROM HREflS'fAMPENSATIUN�ECIAPATION: (Thissec6onneetlnotbecomDleletlifNepermlislarmehuM�eU�S100)Orless�.
I cetlity tlw� in I�e Oedormanu al the work lor w�ich Ihis Oermit is issuetl. I s�all no� employ any p¢r50n in any manner sa as to become
sublect �o Ne Work¢rY Campen5aiion Laws ol Califomia.
pyi¢: $igna�ure:
NOTILE: II. aftef making IhiS Geclaralion, yUu s�oula Uecame sublett Ia IIk Warkers' Campensation provi5i0n5 of I�e La�ar
CoEe, y0u musl IortR+nt� tomDN �^�� suc� Omvisions or Ihis p¢rmil 5�all �e DeemeO r¢vOk¢E.
CONSTBUCTION LENDING RGFNLY: I AereDy a��irm I�a� I�ere is a constm[Iion IenOing agency lor t�e peAormance ol ��e work for
wnicn mis Dermn is issuM (Seaion 3097. Gv. C1.
LENOEfl: �
RODNESS:
OWNEN BWLOEB oECIAPATION: I �ereby aifirm rtwi I am eKempt �mm t�e Coniractars State Lkenu Law for t�e Idlovnnp reawn
(Senion 7031.5 Busule55 an0 Pmf�ssianal CoEe: My dry ol munty wNc� rCpuires a ptrlrvl to wnstruct, alter, im0�'e, Uemolis�. ar
reoair am/ slrudure. pri0� toitsiswance. also repuires Ihe applicant far sut0 permit to file a Sipnttl statemenl ihal he/sne ¢ licensea
pursuant io �ne provision5 oI �ne Conuactori State License Law (Chapier 9(commencmg wit� 5ection 70W) ol 0ivision J o� ine 8uvnew
and Pro�es9on5 COtle) or I�ai Oe/sne rs e�empl ��erelrom antl I�e basis lo� t�e all¢q¢G exem0���. �Y �oWtion o� Sttlion 70.31.5 Uy
any applicani lar a Dermi� SUDIeti5l�e aOUliwni IO a tivil p¢nally 01 no� mOre Itun Irve �unAreC Gollars (5500�.
I. as owner af tlle OroDeny or rtry emVloyees vnt� wages as I�eir sMe tampenution, wiA tlo It1e waA, antl t�e
❑ stmcwre ¢ noi intenaea or ollerea lor sale Iseciion 7044, Business anC Pmiessional CoOe: T�e tontracmri Slale License Law
Ooes not aoo�Y lo an owner ol a D�ooeny wno builtls or impmves tnereon, ana wno aoes sutn xroA Mmsell/nersetf or inwupn
�is Or �ei mvn employees. omviaed Iha� Suc� impmvemenl5 are n01 inlenC¢0 Or oflere0 Por Sale. II, hOwever 1�0 buil0ing of
imD�ovement is 5010 vn�hin on¢ year oi completion, I�e owner will have Ihe burGen ol pmving �e/she aid no� UuiIG ar im0�ove
tor ine Durpose ol Salel.
I, as owner of I�e DroDehy, am excWsively conlraciinp with licensetl conVactors Io conSiNct ihe Oroject (Seclion 704d, Business
❑ anJ Pmle55ion5 fAOe: Tlle Coniractor5' Siate License Law aoes no� appty �a an owner o� propetly who GuiI4S or impmves lhereon
ana who comratls lor such Dmlecis wi�� a contrac�m�s)license pursuan�lo I�e Canlracbrs' S�ale Ucense Law�.l am aware
I�al O�ool ot I�eir Worker'S Compensalion insurance ShoWd �e pmvitleU Io me.
� I am exempl unCer Seclion: B. 8 P, C.
lor I�is rcason:
Date: Qwnec
I Uo �e�e0y cerlily Ihal I am aware al an0 untlerstand l�e repuiremenls ol Cali�ornu Healt� an0 Saleiy Cotle Seclions 2550.5, 25533, antl
2553d an0 tliat I ot any lulure Ouilainp otapanl wilUwill nol Icircle one) neeU to fAmpty with Saie slate COEu ana Ine rtpuiremenis lor a
permillor consuuction oe moOJication Iwm�he AirOualily ManaAemenl Di51rk1. flevG¢ntialconsiruction appliwtbns are eKemplimm
t�eu D�oviswns.
oaie: Aooiicam:
I�ereUy Cetlilyl�alllwvE rtaG I�iS aDVlicalion an0 51alelAal Ihe aCwein�armati0ni5 CorreCi. lag2elo comply wit� allcily anA coun�y
orCinances an0 state WwS relatiiq lo OmMmq consVudion ana �ereby auihor¢e repreSenlaliv¢5 0l �65 qry to ente� upOn 1�e a6ovtmMtionea
pmp¢ny Ioi i�ysp¢t�w� DutposCs.
Date: ���� SiAnaWre: `_L�
omer's Lkense or Saiai Secunty +:
t6<t�n6 W�ne—BviMing: Gre¢n—COEa EnlorcemenC Canary—Applicanl: Pink—Rav¢nue; GdEenraE—Assessar
� CITY OF COS?A N.ESA - BUILDING PERNIT PERX NO: 3 051817
PERMIT NO: B 06:817 PLAN CHECK NO: N GOVT: N SOPP: N
CONSTRUCTZON TYPE: 5-N PER:^.IT TYPE; STR PIIRPOSE: ALT
JOB DESCRZPTiON : T/\O, RESHEATH & APPLY 30YR "ELK" COMPO SQ FT; 5,300
CLAiM VALuE: 5,300.00 CALC-VALUE: 5,300.00 GROUP OCC: R-3 /N.-1
COyKENTS: s'MOH DETECTO RE�'D PER 1991ED.THE UBC,/ NEW SHEATHZ`� /""Cn�`��'��`�Q�
;�***?��**�*<;r�*#tr�*#tt��r�t�r ;�#u�r***�,�����*±�*��*u#x���e*��#��u�*�����a1J�� �'
2 O� Z N GS ERTEBQAi]`IxRSE M E N T S �v'
,,-REQUIRED
------------ MAIN HUILDZNG =--------- --------- ACCESSO BUIi,DING --------- "''
FRNT: rT IN REAR: FT IN FRNT; FT �� REAR; FT IN
LEFT; FT IN RGHT: ��'T IN LEFT: FT IN RGHT: FT IN
PARRING REO• PROV; PARCEL; 41218218 ZNE; REF NO:
PLANNING NGTES>
i
iE iE �lf ?e iE jElF 3ElE �E iF iF ft iE ## it ## iE iE ik 3E # iF if fE?E!f iE iE .' !E iE 1E iE f' iE iE iE iE if iE?E if if iE �ElE i! iE k#%iE i!� iki!� 1E iE if� 3E if iF 1E ##iE iE iF �E iF �1k iE iE �)t 3E?E �1i�
D P V E L O P M E N T 5 E R V I C E S R c Q U Z R E M E-icl-,T S
ZONING APPROVED BY DATE: �z
BUiLDZNG APPROVED BY ; � DATE;�'
APPLICATION ISSUED BY: `�
1f#lfiflFiFifiEiEiFiEi!�ifif#�lf#if#!E#if it it �z: 3�tFiF�< � i'
1E ik iE 1E 1e iE 1ElE ik iE if fF iE iE if i4 iE i! k 1E 1E k###?f it iE fh if iE ii iE iE iE ' if E 1f if it it #?t � F# iF if iF
LEGA�IZATiON;N F E E S U M M A R Y
BLDG PMT PLUMBING ELECT IC MECHANZC
DATE: Y/� j�
�£?{iFiEiFff#iF#iE�]E�xrr-iitf�' uxt—fiEif
1F#�f#iE#1E#iEiE##if#�lEjt.##ifik%iFiFiEiEiE
STRUCTURAL.SEGMENT:Y
FIRE SMZP/RES GRADING
PERMiT 81,00 .53
� SMIP/NON-RES
PLAN
ISSUE FEE
BUILDZNG-DZV-> PERMIT ISSUE PLAN-CHECK TOTAL PAZD DUE
TOTALS----> 81,53 0,00 0,00 81,53 81,53 .00
REVENIIE DIVISZON TOTALS--> COLLECT"'U: 61.53 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MEC?IA�IC FIRE SMIP/TOT GRADING Pi,AN-CHECK
81.00 .53
it iE 9E iE k� iE ie+e iE iE iE iE!E !E 1E iE #�E it if iE if� if� if 1E iE if if ?f?F 1E?E iE')£•%3f iE iE if q?(� if 1E?E N� lf iE �%� K fF iE�k?E iE iE iF 1F if iE i!?E iE if ik if # iE iE iE ### it iF # iE # if 3!
I N D I V I U U A��. F�,t'. E B R E A R D O W N
TYPE QTY D E S C R I P: I O N � ONIT COST TOTAL COST
ISFR 5300 REROOF BY VALUc RE6ID=NTSAL N020NE 1.00 5,300.00
END OF FEES
b�
f,
01 D0137578-U0137579 TO T 81.53
OATE: 0</20/93 TINE: 13:44
-�� �
---4 --- - � � -- - -- -
CORSTRUCT100. AROPLARNING � POUI. �A .
Dam � In.;pc:ior I -_� Date Insi.�; ���
APPROVflL5 P=rmit �? i � APPROVALS !'� re�,it =---
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l �-noDngs------ i 58. EicctncalQ,r:�u-�.,�.l�r,��.: i �_--
8. � o,.�dat�nn ' 59. Gas P�pe. �i �;rv�� .t '��,.--t I - .
_.-.- - +- ---� - - --------�---�--- -
9 '.= P.pe.U'-q,•u-_'-'_ �_ - , E0. Badu:csh L : ' ' ��� .'_'_ _ �_� -_ -_" I __ _" -
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12 E�. - C�r � ' I 63. ;-Ic.te� 6. V�� �� � �
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14. R::� .�', u�.�.n ��i � G5. C-�e,•��i��i i: .. �i � I
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15. Flo�:�:, L.ur1��c..��Gon].,,; ._' I_ _ - _ � 66. Soler SYata : i" . - _. '_ _-_I
1G iJc�h�lrctrc'7ir�,n�'__-___ __ .__ i_ ___-I 67 Fencin�&Ac�.;�:�n��.� , -�__-'__ __ __�_ _. .
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1
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' ( l( �
I 48- '.l �„� PLA�;�ii.G � --�} ' !
d9. Etec.�;c Ra'etse to ��d�:x F
I . � j � - - - --- --
50. Gas W_Ic�;e to Snu':'�:n Cz!.tomiaGas
5i. C�RTI�ICATE J� GCCUPA�CY
R'o.__ _ Date
Applicant to filt In all spacas except tnosa wilhin heavy Goraer Ilnes ane slgn a11 avo�oDrlate tlaclarations.
CITV OF COSTA M]E�SA CO�j/�j �S/T�R{rUICTI PE NUT PEBMIT NO�. � TRACT NO. LOT NO. UNIT NO_
Project Address �[J�� (J_U�d � '
Applicant's Mailin A dress
Owner's Name PhoneSyn nns,
Addreu
Arch/Eng. License No.
Address
- Convocror's M �� Phon G
Address (m� �'��� ��� ��
Ciry Licensc No. c�
LICENSED CONTRACTOR DECLARATION
1 tlereby atlirm lhat I am Iicensetl untlar provisioni of Charter 9(commanCin9
witn mctlon �000) ot Division 3 of the Buslness antl Vrofesslons Cotle, antl
my Iicense is in fuli i and eltect.
lJcensefsJ�� l' e
Date� Si9nature
'40RK RS' COMGENSATION DECLARATION
iereby aftirm that I have a certifiwte ot consent to self-7nsure or a certiticate
Workers' ComDen3ation Ins rance, Or a certi{�f%ietl yco�py t�h�are/of (Se6tion
3800, Lab. ,CrJ/„' ^,.� j �� K ��L�.� AC/.i�/Ci
Policy No. �y�:�aT.� �-f Company �_�.,,
ertifietl copY Is hereby fumishea.
Cer[ py is fi�etl with the Uty 9 kI�oi/.�1. siop{%n
Dat¢ ' ADplitdnt-j�l�L�t..�t�'�F�
EXEMPTI N FROM WORKERS' COMPENSATION DECIARATION
(Thiz seclion neetl no[ be compleletl il the permit is for one huntlretl (5100) � r
less).
(� 1<ertify tnat In tne pe�formdnte Oi the wo�k Por whlc� tttls pe�m�t is ISsuetl, I
shall not employ any person In any mann¢r 50 a5 to b¢wm¢ Subjecl [o Ihe
� Worker5' Compensalion LawS ot Califomla.
Dale Si9naturc
�NOTICE: If, atle� making this tl¢Claration, you shoultl becoma subjoct to thp
Workers' ComOe�salion provi5ion5 of lne LabOr COtle, you mu5t fOrthwith
<omo�Y �+ith such orovlslons or this permit sha11 be tleemotl rovoketl.
�, CONST0.UCTION LENDING AGENCV
1 bereby allirm tba[ tnere is a construction lentling agency tor tha per(ormance
\of Ibn wOrk lor which thi5 pCrmit Is issuetl (Sec[lon 309] Clv. C.)
Lentler's Name
LenGer's Atltlress
OWNER BUILDEH �ECLARATION
�, I hereby a�firm that I am ezampt irom tne Contrattor's License Law Ior the
/ollowin9 reason (Section 7031.5 Business antl Professional Cotle: Any cllY or
<ounly whlGh r¢qwres a p¢rmit lo construCt, alt0q improve, tllmOlish or �Opalr
any structum, prlor to its issuance, also reqWrei [he applicant lor such permlt
lo Iila a 5ignc4 StdtCment Ihat h0/Sh0 IS Ilconsetl pursuant [o tna provl5ions ot
tna Contractor'i License Law (Chapt¢r 9(commoncing wlln Sactlon 7000) ot
DiviSion 3 of lhe Busine55 anA Professlons Code) or that he/ihe Is ex¢mpt
❑�erefrom antl the basis tor tne allegetl exemption. Any vlolaUon ot Soction
7031.5 by dny ap0��canl tor a permll Subjects ltte appll<ant to a civll
�enalry of not more than fiva nuntlretl tlollars (5500).
LJ I, as owner o/ me oropertY or my amployees with wa9os as lheir solo
comDensation, will tlo tne work, ana the structurn is not Intentletl or olteratl
lor sala ($etlion 7044, Bu5i0e55 antl PrO/essional Cotle: The Conlrattor's
Licenso L. w tloes�not appty to an ownar ol a property who bWltls or Improvos
thcreon, antl who tloe5 such wo/k hIm5C1//herSClf or tbrough hlz or hOr own
employCes, p�ovitletl [bat suCh improvements are nol In[entlatl or ofloretl for
sdle. If, howOver, the builtling or improvemant is zoltl within one y0ar of com-
plation, lhe owne� will bav¢ the burtlen Ot proving'he/she tliE not buI1C or Im-
prove tor the purPose o1 saleJ. �
❑ I, as owner ot tM1e property, am ezclusively contracting with li<ensatl con-
lractor5 t0 conslruct the projeCt ISectlon 7044, Business antl Protesslons Cotle:
The ConVaclar's Llcense law doas not aOPly Io an owner ol property wh0
bulltls or improvas thereon, ana wno conVacts for such projecls witn a con-
tractar(sl Itcense puRuant�to the Contrattoi'z Licensa Law). I am aware that
prool of their WOrker's Compensatlon InSuranCG ShOultl ba provltletl to me.
❑ 1 am exempt unEer Section B. & P. C. tor this reason
Date
I noreby certity Ihat I hx
Information IS COIlCCI. 1 d5
antl stato laws relating to
sentatives nis ity to
inspeclion u o
Si9nature
Drivers' License or 55 �
Owner
upon
TYPE OF CONSTRUCTION LI NEW U ADD LJ ALTERATION �/SREPAIR
❑ CONVEftS�ON ❑ DEMOLISH ❑ OTHER q,p, *,
DESCRIPTION OF WORK/USE OF BLDG.
S Main Buildi
E
TYPE OF PERMIT GanDwG FOurvDAT1oN STaUCTURnI T Front
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL A Reaf
❑ OTHER
PROJECT DESCRIPTION So.Fr. oCCUPArvCv C Right
K Lett
CONSTRUCTIONTVPE VALUATION3 $
ZONE GRADING CU. VDS. ACRES p�ng. Ref. #
Remarks: Planning NOtes:
Sink
PfeVenter
Irrigation
king Fountains
�r Orains
v SinkS
Service Outlees
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fao � $15
Boiler
Duct � Under Ground
DUCt - $VUCtUral
Duc[ - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ a� oo,000 aru O � oo,000 s7
Reinspection Fee � ffi15
CMF 0865-46, rev. 30/84 White � Bulltling: Canary - Applicant: Pink - ACCOw[in9; Goltlenrotl - Assesm�
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa'
Urinal
Water C1o5et
Water Heater '
Water Service
Auto-Wash
Laundry Treys
Issue Fea
Hood or Type I ❑
Canopy Type I I ❑
Retrigeration System
❑0-100,000�BTU ❑100,000
System Repair/Alteration
Fire Dampen
Registers
laue Fee
FEES
6207 5%27/86
zo�a
Accessory Building:
Perking ReqJProvided
5.00 �TL
ELECTRICAL FEES
Automatic Washer Transformer O 15-50 KW
Construction PoleSub. � SO+KW
Cooking Unit � Me[er �up to 100amps
Dishwasher Meter �over 100 amps �-
Dryers ❑Gas ❑Elecvic Sub Panel
Fan �+ Motors O0.1 HP O7'h - 8
F.A,U. Inc. Solar �9�15 HP �16�15+
Fixtures Microwave
Device Boxes Pole Light
Outle[s Range
Switches S�y�
Garbage Dispasal ;Standing Sections
Generator �0�5 KW 05-15 KW Trash Compactor
Z
O
N
1
N
G
R
E
Q
M
T
S
$ 3 I
�. Rninspection Fea $75 luue Foo 5 3
FEES
DEVELOPMENT SERVICES RE�UIFEMENTS:
Zoning Approved By Date
Building Approved By /� Dato
Applintion Issued By / Date r27 �
SUMMARV OF FEES
BUILDING PERMIT $ SMIP §
PLAN CHECK $ .�_ PERMIT ,
PLUMBING $ _.�� �� I�UANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM 5
MECHANICAL � $ TOTAI.FEE $ �O�
$ 3 PLAN CHECK 25% $
CONSTRUC710N AND PLANNING POO� a SPA �
APPROVALS Permit# Date Inspector p�ppROVA4S Permit# Date Inspector
7. Temporery 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O 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 O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnci.StorageTank �Gas ❑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 CEflTIFICATE ISSUED
33. Final ElectriC Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test �
36. Hood or CanoPY
37. Final Factory Firepiace
38. Final Plumbing ;� �.c/-�% LE/�
39. WaterService-Final '�
il
40. Gas Service-Final �• �
41. Solarpomestic-Final ��
42. BackflowPreventer ��
.r
43�Backflow Irrigation .
44�. Landscape Irrigation System "-
45� Sound Attenuation
4�� Handicap Regulations r, ;
41V FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
N
5}� CERTIFICA7E OF OCCUPANCY
No� Date '
�-a:
�NSVECTIGN 6 iESiiNG EN�iNEERi
CHEMIC�I { PHVSIC�L AN�.�S'S
RADIO6RAFHY X R�r G�MIA♦ 0.wY
P 0. B a � 1] • I l � 0 A�, p o, r w. y
lanq BucF, C�I�� vaeo�
(]Il� QN155 ' �101 olb}ib ' 114. B}BdU]
April 9, 1973
5{n<e 1898
PESEw4CH � EHviROrvMENi�I iESi1N6
C00.0.05'ON ENGiNEEN�N6 { ANALYSIS
�IiAASONIC �AGNEiIC L GENEi5AN1
iSi��D No.rF H�.p�r S�r���
S�n�. ♦n. C.IIlorni. fi)O1
n,�� 5��.�0.5
Exumination: SG)j-210J
COMPRESSION TESTS ON GUPIITE �Y��NDE&5
Mr. Jack Hub6ard
3106 Os[rom Avenue
Long Beach, Gailfornla 90808
PROJECT
ADDRESS
SAMVIE FROM
•PCMIlFCi
EMGIhFE�
R. J. Kolodziej
MIX
DATE CAST
DATE TESTED
CYIINDER NO.
COMPRESSION
TOTAI LOAD, IBS.
i
POUNDS PER SQ. IN
COMPLIANCE
CYLINDERS
Swirrantng pool for W. ALMEDA /
3375 Marigold Gr., Gosta Mesa
Shallow end, deep end, bond beam
CONTNnQOP
Anthon� Pools
$UBCONiR4 iOR
- Same -
SPECIFIED
�6 /��
PermitN 17970
B�Y� .
4 Lo I STRENGTH 2,000 pSi
4-2-73
4-9-73
1
7-Day
69,000
2,545
l: 5'7/8" x 12-1/4��
CYIINDE& SIZE 2: 15-3/4" X �2-5/8"
3: 16� x 12-1/8"
4-9-73 4-9-73
2
7-Day
]4,000
2 ,850
7-Day test complfes with specificattons.
MGDE BY
oisroi0urioN
Jack Hubbard -3
Costa Mesa Bidg, Dept.
DEUVFNED !V
Dave
4"HOLD"
3 5"HOLD"
6"HOLD"
7-DaY
62,000
2,195
RECEIVED ON
4-3-73
�., ���� c�-��� G�, .
��.����1` � _, .
,�? ; i 1 1S73
.., u�. . .. . � . ..,. �. .. ..� . .,. .. .., ,�� . . �..s ... . ., .. r.v .or v e. ... .. � � ar� o s . . s ons rn �.
a. s .o ......� ... .. .�w . .i ... .ta �.. ., n�. .��...�. ., ... « r .. P� . . .. .. . . ...c os�i.es
Mt. William Almeida
3375 Marigold Circle
Costa Mesa� Califomia 92626
FeDruary 28� 1913
�
Dear Sirt
A building pexmic has been isaue Anthony Pools to.cons[ruct
a private ewi�ning pool on your proper[y. •
In order that your po 1 will be a eafe one and for che purpose
of advising you of yout res nsibility regerding the requirementa of
the Costa Hesa Aluncipal Code� e refer you to Section 8107, a copy
oF which is atteched.
This letter directed to you in order that you vill be aware
of our ordinancea d can make a complete safety check of your pool
area.
Sincerely yours,
RICHARD tiANHART
Building �Safe[y Dixector
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0. ��I I� DATE � l j L I��
I 1
r.oT No. r�l� _
annt�ss �3 7 S I,n`�C�ntit_,�.E-��
�
The developer of the above entitled tract desires to se11 the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he-she-they) �_A (was or were) ��J..aQ_ advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assinnes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agreea to indemnify and hold the City harmlesa from
any claim resulting in damage or peraonal injury to the undersigned by reason
of the aforementioned uncompleted condition.
BY ��f���L�dwv�� C��2-C�///�C��
Purchaser
BY /i�=�C6"�-��-/� v` �
eveloper and/or authorized
xepresenta[ive
BY ���� ��C��C�.z+�
Lender
OWNER AIMEIDA, Y
���,JOB ADDRE55 3375 P
GENERAL CONTRACTOR E
ti ��� nn :��yet LOT
1. . �ECTIONS
` ePool Location �
�Forms
Main Drain
Steel Reinforce
Elec. Bond �
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines and Recep.
Electrical Final
HPater and Vent Final _
. r System Final
Backwash and Recep. Final
Fencing Final
2Z-73
DATE
E ZONE VALUE
ROUP .T TYPE
SUBCONTRACTOR
Electric
2-27-73
`� b
�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to fil! in Completely
ADORESS 3375 �Go�n .
OWNER WM AIaSEIDA
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TEL.
CITV NO.
CONSTRUCTION _ _
BRANCH
ADDPESS
R. Kolod.zie.i N�`'
CONTRACTOR pnthony Yools
ADDRESS 5871 Fir e stone �Vd.
TEL.
c�rv South Gate No. Sp;
$TATE r� CITY
U0. NO. Z�OZ/7 LIC. NO.
SIZE I NO.OF BlOGS.
OF lOT NOW ON LOT
USE OF
ExIS71NG BLDG. I`2S].d6YfC8 and �ara�e
SIZE OF NO. OF
NEW BLDG. FOOMS STORIE;
EMERIOR WALL ROOF
COVERING COVERING
USE OF BVILDING ANO WORK TO BE PERFORMED
peivate swira pool : rear o£ single
fami.]� dwelling /f ]. ,/�jyX/J�
I hereby ncknawletlge ihat I have reetl this application ontl stare
zha[ the abova Intormation is corract antl aBree to comply with
all laws rep�la[inp b�iltling conzvuction, antl I shell not employ
ony parson in v101a[ion Of the workman's compensatiOn lews of
Ne Stnto of Celitomle.
I heroby certify that I nm properly lic¢nsetl az a contraccor untlar
tha Stete of C a eusiness and Professions Cotle, Dlvlsicn 3,
Chnpmr 9, tl that soth I(canses are in full torce antl affxt, or I
am eaa t irom the provisions of M at of Callfomia Businacs
antl Pr ossions Code, Division 3, apter 9 �
Au[horizetl
,-F;i �7-7���10G01061:r t��:::.
3�.CG
APPLICATION FOR BUILDING PERMIT
RECE� OIT� EC-IVED DATE ISSU�
�2-a �
A.P. NO. NO �/ f� PER
BUILDING 3375 �Go� °
ADDRESS •
TFACT i%�A LOT 1`W BLOC
OwNER jnjjl AT,MF:jllp
surimming pool VALUE p
USE 5 2JOO�OO
FIRE \/�y �
ZONE TVPE t.ROUP l4
APPROVED
gy DATE
ZONE NO.OF USEOFNEW j,�jl��
.R PLANS Z BUILDING �Q �
VARDSAPPROVED VAROSAPPROVED
MAIN BUILDING ACCESSORV BUILDING
(FROM C STFEET)/ y/ /� o I
FRnNT � FT/ S FT. / /7c
VAR. �
C.U.P.qW
� � FT.
�
FT.
BET. MAIN &
ACCESS. BLOGS.
DATE
APPROVED
� .,�r� .�-,z�-�3
THE AMOUNT SHOWN UNDER
TME PURPOSE OF ESTABLISMING
VALUATION
PERMIT FE
2900.00
5 PIAN CHE(
� C.%
TAX �
0
ION IS FOR
FEE ONLV: Q
� ��
J
m
/�, S'— e
� O
� � LL
144
- 35167
I COSTA MESA BUILDING-SAFETY DEPARTMENT
SOZCRP�O. BO% 1200 COSTA MESA. CALIFORNIA 92626
For Applicant to Fill in Completely
BVI�DING �.��7�Mariaold Circle
ADORESS
2 .
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OWNER
MAIL
ADDRESS
CITY
CONSTRUC
LENDER
BRANCH
ADDRESS
ApCHITE�
OR ENGINE
ADDRE55
16255 Ventura Boulevard
Encino, Calif. No`986-8
ADD(iE55
CITV
STATE
LIC. NO.
SI2E
OF lOT
USE OF
EXISTING BLDG.
SIZE OF NO. OF
.LJ�FO ROOMS STORIES
GALL StllCCO COtlEflINGWOOd SLIL
JIIDING AND WORK TO BE PEFFORMEO
�ruct Sinele Familv Resid
16255
65 x 100
lif.. Inc.
f. No?j86-88
CITV B_�
LIC. NO.
NO. OF BLOGS. O
NOW ON LOT
R CEI E 81
A.P. NO.
BUILDING �
ADDRESS`
TRACT
FIR
hUG 15-7r^PAI�001092� ***
cwsc 14Z.8S
fION FOR BUILDING PERMIT
DATE RECEIVED DATE ISSUED
' � ' �- / - %
��, PEFfv]�T�[JQ' �
R � Ii2�A1
�ESI�EI
ZONE NO.OF �
rwr�s �
VARDS APPqOVED
VAR. #`
C.U.P.aW
APPROVED
LOT '/ BIOCK
'C. INC
r VAWE �
RF-. s ��
' GROUP
AATE �I'� Q � 7 Z�
USE OF NEW � K/ fj
BUILDING � �
VAP�SAPPROVED
ACCESSOPV BUILOING
BET. MAIN &
ACCE�. BLOi
OATE
APPFOVED
Z
pV
I hareby actnowletlae thet I nave reatl mi: applicetion antl stexe HOLD FOR SPECIAL E II4C�'1E
that iho above informotion Is correct antl nproe ro comply with
all lows reBulatinB builtlin8 �onstructlon, antl I shall not employ
eny person in vio�etion ot the workmen's compansetion laws Oi �.
tha State af Califomie. m
GA� �o e
I hereby cer[Ify thet I am proparly Ilcansatl as a conttector under SQ. FT. o
the Stete of Celifornta Business ontl Protossions Cotlo, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, entl thot such licanmz ara in full forca antl effect, Or I THE VURPO6E OF ESTABLISHING A PERMIT FEE ONLV: ¢
am uKempt from the provlslonsof Me Stete of Cellfornla B�sinass VALUATION d�f7
antl ProteSsionf Coda, Dlvision J, Chaptar 9. m
�_.n PERMIT FEE S �
CT — P� J
SIg^otura �7 m
Permirtee����'�� D. Downs g„(G QQ P�qN CHECK $ E
�i o� o`
Authorizetl Agant LL
TOTAL FEE $