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PROJECT ADDRESS: 1854 NEW JERSEY ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 059869
OWNERS NAME: HOLW AY, DENNIS B
ADDRESS: 1854 NEW. JERSEY ST PERMIT NO: B 059869 PLAN CHECK NO: N GOVT: N SUPP: N
1 . COSTA MESA,CA 92626 •
Iti CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH •
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O EXISTING ROCK ROOF, . APPLY 25YR COMP SQ FT; 3, 864
'
ADDRESS: UNIT:
CLAIM VALUE: 3, 869 , 00 CALL VALUE; 3, 864 , 00 GROUP OCC: R--'3 /M-1
PERMITTEE: ORANGE COUNTY ROOFING ( 714 ) 771-0781 • '
ADDRESS: 17972 STEARNS DR - COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC
SANTA ANA CA 92705 �E* * *>E#***,r,E *->E******** ** **** * **** 6 **ts*******u**>F* ** **u ,E +6***x-**+kx*-
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENT SMOKE DE1ECTOFI
7000)of Division 3 of the Business and Professions Code.and my license is in tun force and effect SETBACKS
CITY UC.: 051262. STATEUc.:528433 D C—x139 oC�11
Date. ' d�bkrea--� MAIN BUILDING ACCESSORY HURG.t UIRE0- -
WORKERS' 1l1 Q1 Sgnawe _ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; , FT IN
mpensaCOMPENSATION DECLARATION: Ihereby of(Setimthat ILhave acertificate ofconsent toself-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
Compensatiortlnsurance.or a certified copy thereof(Section 3800.Lab.C) , .+
POLICYNO.: 1042002-92 ' EXP.DATE: 09/01 /93 • •
COMPANY: STATE FUND PARKING REQ: PROV; PARCEL : 13910338 ZNE: • REF NO:
D Certified copy is hereby furnished. 2 Certified copy is filedwith the city Building Division. PLANNING NOTES>
r' —.....-. Date-
Date: _ Applicant: Ceuta" "'-L. *'**:********************M**********IE********** LEW**************X•*****t.******-1F***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1W1 or less). DEVELOPMENT SERVICES REQUIREMENr-!t S
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. ZONING APPROVED BY - DATE:
Date: Signature: .
BUILDING APPROVED BY DATE;
Code, :It,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor :
Cade.you must forthwith comply with such provisions or this permit shall be deemed revoked. fit,
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• per, \_— CS'\.!�r—_, DATE: //�1Jl7
which this permit is issued(Section 3097,Civ,CI. **********************ft*f .,**it*tie.A'***r it***ft**1t it Niru lir x x9e**if******x-r.x**iv*x*fr**
' LENDER: . *************************************fE***********} * 4****i(-*#*******%***********S:
ADDRESS: •
LEGALIZATION; N F E -E S U M .M A R Y STRUCTURAL SEGMENT: e '
•
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC ' MECHANIC FIRE SNIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit 10 construct,alter.improve,demolish,or PERMIT 63 . 0050
.
repair any structure,prior to its issuance.also requires the applicant for'such permit Co file a signed statement that he/she.is licensed . SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/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($509). ISSUE FEE - . •
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ' DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTAL S----> 63 . 50 0 , 00 0 . 00 63 , 50 63 . 50 • , 00 •
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through '
•
his or her own employees,provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED • 63 . 50 OVER/SHORT: OO
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve PLAN—CHECK the purposeof sale). . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/•POT GRADING '
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 63 . 0 0 . 50 •
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware, *********************************************************************"********-X.*
that proof of their Worker's Compensation insurance should be provided to me. ' . I N D I V I D U A L F E E B R E A K D O W N
O I am exempt under Section: B.8 P.C. •
forthisreason: TYPE QTY DESCRIPTIO N •� UNIT COST • TOTAL COST
..
•
Dale- Owner: SFR 3864 REROOF BY VALUE RESIDENTIAL NOZONE . 1 . 00 3, 864 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES •
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a .
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ,
these provisions. .
Date. Applicant:
I hereby certify That I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
properly for inspectin � n41-
( purposes.• //��'''^/ )
Date:i�l lr� Signature.�`^'k^�� """ __r _
10I oc1�,.
Drivers License'or Social Security#: On1E7 - :4',- '?,,_, ,r_
•
1641-06 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor -
rFilliti I
♦* .
- CONSTRUCTION AND PLANNING POOL & SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit #
: 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 UFER Grnd. • 57. APPROVAL TO COVER-GUNITE -
7. Footings • 58. Electrical Conduit-Undrgrnd. -
8. Foundation "" 59. Gas Pipe, 0 Undrgrnd.,Test •
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. _7
.,
10. Structural Floor System 61. APPROVAL TO DECK I
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
2B. Lathing &Siding - 77. FIXED SYSTEM FINAL
1
29. Insulation i !• 1 _. 78. FIRE PREY. FINAL
30. Drywall Nailing j I ''=1 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat I i _j 79. FINAL INSPECTION
-32. Electrical Power Meter-Final I I ♦ .I 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' I
Notes:
34. Final Heating & Air Conditioning I i i,
35. Final Gas Pipe-Test I
I i I
36. Hood or Canopy I\
37. Final Factory Fireplace 12/1
38. Final Plumbing •�,j
r
39. Water Service=Final I I 1.:1
40. Gas Service-Final I
41. Solar Domestic-Final I - 'i •
42. Backflow Preventer I 1
43. Backflow Irrigation (0
44. Landscape Irrigation System
45. Sound Attenuation1/411 jCC
•
46. Handicap Regulation's)`[ tg.( •
47. FINAL STRUCTURE$I &WILDING
1
48. FINAL PLANNING.' . T,• / I I'%i
.
49. Electric Release to Ea son 1-1-1 1 ",� .
50. Gas Release to Southel/n Zalifornia Gas Co I j 0
51. CERTIFICATEOF`CCUPANCY
No._ rTOate
OWNER DYKES, OSCAR DATE 4-u-68
JOB ADDRESS 1854 Next Jersey Street BUILDING PERMIT NO. 28438
GENERAL CONTRACTOR A{r Wirt t Awning CQ. DESCRIPTION of WORK patio Cover
AP No. 139_103_14 LOT 92 TRACT X648 FIRE ZONE VALUE $82p,00
INSPECTIONS
solL Signature Date GROUP ,T TYPE iiiZONE R-1
SUBCONTRACTOR PERMITS ISS ED
�GAs Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM •
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS H STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE fl
SHEATHING
FRAME AND FLASHING
LATHING — IN f] OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.G.. FINAL
PLUMBING, FINAL AND GAS TEST ❑
ELECTRIC, FINAL
BUILDING, FINAL PAIT 4'- o (J
corriei oeniuorerrux
` 28438 APfi :6O LOo 667 d*****6.00
COSTA MESA BUILDING-SAFETY DEPARTMENT .
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
ADDRESS �(ll54 N 1/ r Sr
RECEIPT NO.
.7 47
COSTA MESA, CALIFORNIA .23
RE ETECg VED TE ISSUED
(... a -e
OWNER i DY/V—iaS // Gf 4//. 6/
) P-�/� BUILDING
MAIL
ADDRESSIger" flmt..i sjeroesy Sr. ADDRESS
FIRE .
//�� TELL,�--��/� ZONE TYPE GROUP
CITY C.�STiif f�c'sA NO.y70-�}18 / i //-4 /
4RCHITFQT TEL..
APPROVED _ / .ATE t3(J
_419-ENGINEER 2c41-6.e 49tCr NO. 179 a If
ADDRESS 3/71 Ne //EhCrnoxir 2. ZONING
AIR-VENT ALUMINUM AWNINGS ZONE �-/ NO.OF
a BU"NG(O9 /
CONTRACTOR _
LEGAL p,
ADDRESS 1809 S. MANCHESTER, ANAHEIM DESCRIPTON di / c� l ... , .'i 6/Q
A.P.NO. 7- Le 3 — I
CITY
ATE ``,,`` )) NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
LIC.NOL..�pj( /'/)�/O Z NO. 530-RUE EO'TO SIDE&REAR P.L.
SIZE '{0 n G, 6 ', ! j� I NO.OF BLDDB. I ALLOWED _ (U.B.C.REQUIREMENT) - --
OF LOT / 7 1 Lf 2 F NOW ON WT
USE OP ( I Cdr L QQ YARDS APPROVED YARDS APPROVED
EXISTING BLDG.S/NC.ytC' f/ain/zy RePC&Cj MAINBUILDING ACCESSORY BUILDING
(PROM C/L,1�/TRT¢y,�'f)
SETBACK LINE FROM I FRONT e/d(�(/.FT.�J PT.
CENTER OF STREET �y..
REAR YARDQ/
SIDE YARD I LEFT .-3% I RIGHT /C� R.SIDE 7,-Ifi FT. FT.
DESCRIPTION OF WORK \/f L.SIDEC39 PT. FT.
NEW I 1 ALTERATION I ADDITION /\ a REAR „4_5*--FT. PT.
L _ DISTANCE BET. BET.MAIN 8t •
REPAIR MOVING .44MOLASH MAIN BLDQS. ACCESS.BLDGB.
BUILDIN )� NO.OF VAR.* DATE
SIZE 2/ }C ,/ ROOMS / STORIES / C.U.P.# APPROVED
EXTERIOR W 1l��.W�/ ROOF /I APPROVE°(//4)//
J/I DATE �� 4/-6S2
COVERING4'cy A-'s^%r% COVERING f'1L,Om IA7 AIM BY / /f'�'J/
USE OF BUILDING AND WORK TO BE PE FORMED V M
/A/S fltl_ Ejvcc.os Oa )1*n n ....ve e w
��7rGc.Aaoyi �j IPC-rAc DYE S,AI[/ ,r
F--.4,77 /s,r //C, .npn-7YC. - . SQ.FT. g
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. Z13
PLY WITH ALL CITY ORDINANCES AND STAT[LAWS REGULATING VALUATION , - /_— 0
BUILDING CONSTRUCTION.N./ > ` ��y / C/U
PERMITTEE OFl N ��/ ! •Y `��"(?p �J/J/� / PERMIT FEE $ E
. /J so /I PLAN CHECK S ICS
AUTHORIZED AGENT Aic—t/ v A(.um Hi✓,V/A.,;-- / I,
TOTAL FEE $
` 1248'7FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 11 1960P. O. BOX 917 COSTA MESA. CALIFORNIA JUL
For Applicant to Fill In Completely APPLICATIOaPE VA MTs
TYPE OR PRINT BUILDING
BUILDING 1854 New Jersey St.
COSTA MESA. CALIFORNIA ForOffice Use Only '
RECEIPT NO. -PERMIT $O.Q'
OWNER New York Avenue properties, Inc. .••FGrjj/YYA�1I•(��j i
MAIL RECEIVED BY DATE REC VED DATE ISSUED
ADDRESS 419 E. 37th St. Lam- I
7 bo I UL 1 1 1966
. BUILDING
CITY Costa Mesa 'NO. Li81159 ADDRESS
ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA
OR ENGINEER Middlebrook NO.
^ -
ADDRESS Garden Grove FIRE 1/ / 9
_ 53r - ZONE TYPE GROUP rJL 7
CONTRACTOR Dike &( .Cole?rove, Inc. 9-2--
APPROVED DATE
ADDRESS _ 43-9 E. 17th St. ZONING ( ,ti
ZONE �J NO.OF USE OF NEW L�y/��/
CITY Costa Mesa /` t PLANS BUILDING
/�/IU
LEGAL
STATE NO. 167293 NO.LLi. 8-3159 DESCRIPTION Lot 92, Tr. 3648
SIZENO. OF BLOCS. /� /A
OFFLOT 52 x 100 NOW ON LOT none A.P.NO. P .1-1---- (A-
USE
12-
USE OF YARDS EVES
EXISTING BLDG. none APPROVED ALLOWED
SETBACK LINE FROM1 1 (CENTER LINE ST.) //��
CENTER OF STREET 65G REAR YARD 25 FRONT () 5 FT. IN.
S
SIDE YARD I LEFT 1 RIGHT 51 R.SIDE ) FT. IN.
DESCRIPTION OF WORK . •
L.SIDE 17 FT. IN.
NEW I X H ALTERATION I II ADDITION I REAR , 5__ 4._,
//�� IN./
REPAIR II MOVING II DEMOLISH APPROVED LA4 / DATE,-3--(C,�
O. OF
SIE BUILDING 1365 sq.ft.IooMS 6 STORIES 1 / /(�
EXTERIOR WALLI,, 1 ROOF
COVERING STrUCCO COVERING CO➢1D. & Rock
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage. Plan lOC
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 OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
VALUATION
SIGNATURE OF L-..-172--""? '-/ PERMIT FEE $ 34• N
PERMITTEF p
$ 14,179• PLAN CHECK $ 17• 4AUTHORIZED AGENT Dike & ?olegroael Inc. S
Le
TOTAL FEE $ 51. i
I.