HomeMy WebLinkAbout1860 NEW JERSEY ST - Building Permits , r
r CITY OF COSTA MESA
E4, BUILDING DIVISION -
+ >:J • `1 DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER
4. PERMIT
�, EO 1104
4jIPPICII
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1860 NEW JERSEY ST Status: ISSUED
Suite No Applied: 10/18/2004
Vicinity: REAR OF PROPERTY Issued: 10/22/2004
Parcel Nunmber: 13910340
Applicant: KARL DULAKE ISSUED BY 1
Address: PO BOX 11027 - - - , ..
-
, - ' Phone: 714-549-8770 ' --
COSTA MESA,CA -',1 Zip: 92627 / .. - "
- '- .
Owner �SCHMEISSER;DAWN ' - -
Address' 1860 NEW JERSEY ST :
', ' / - _ Phone: 714-754-5307
. ,COSTAMESA,-CA: Zip: 92626-2257 .� \
,
Contractor: -
Address: - , / • , e
. .
Phone: . ...-
-
- License: - ,
. - .
SCOPE OF PERMIT \ .'
- UPGRADE ELECTRICAL SERVICE"FROM:100 AMP TO 200 AMPS.,, - _ L. ', •• I
FEE SUMMARY
,Quantity?: ^ate - <.- Quantity l /
ISSUE FEE \ ' $23.50 -- z/-".4- -Temp Dist-System/Lighting= $0.00 0 1,;,
Temp service test' ' ' $0.00 -. - • - . ^ Busway/100 ft %/ ' - - $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0 , , ,
New Res(1-2 units) ' $0.00 0 Misc Electrical'Equipment _,$0.00 0/e,",% , ,)
New Res(3+units) /
�� $0.00 0 Transformers up to 1 kva/kw '$0.00 0; �.
Pool/Spa V', \\,, -" $0.00 0 up-to 10 kva/kw $0.00 %0'/ �/ /:/ /
Lighting`Fixts ,\--"' i .�V v $0.00 0 • $ ✓ - up to 50 kva/kw $0.00 /-,,b,' e, -- / %iI i
Recept OutletsV N'\,,'c$0.00 0 4�;< ,• -up to 100 kva/kw $0.00/;,�/0 v /, "f
Switches,` = x'50,00 0 `t . :' 'over•100 kva/kw $0.00:_%/ 0
Non Res Appl\ . �' \$0'.00 0 , Low Voltage Equipment:.a ,..4,$0:06'/ 0 - " . ,i //
Res Appl . , $0.00 - 04 Low Volt Wiring System/Ckt" $0.00 0'
Service to 200a'\ �,2$30.50 V ` 1 - / . ' Misc.Conduit "', .<$0.00, " z,0 / , �
Service to 1000a --,. /-'" $0.00 0 -Misc.{Conductor , --)..).4.2"S0.00 '; 0
Service over 1000a . $0.00,,, _-0-;� , Circus(genyor ride) $0.00 ., 0/ ' /
Motors to 1hp Nv A .;$0,00` 0 - `; Circus(meth-ride or lights) /= $0.001 . 0•
Motors to 10hp A z. /A $0.00 : ' ,0 -. , • Christmas Tree Stand c -\ ;$0.00 /0% ,',/
Motors to 50hp �-$0.00 / 0 - Fireworks Stand • ..$000 , 0'
Motors to 100hp ' ,- $0.00 - - -0 -'- Other Electrical Fee ' $0.00-z . '
Motors over 100hp "x$0.00, 0 ,
Communication drops $0.00.' •--..0 • 1 - -Investigation Fee $0.00
Sub panel to 200a -0 Plan Check Fee, - $0.00
Pole Light Pkg $0.00 '''-0 _ ' - Reinspection Fee' ' - ' $0.00
Sign Circuits $0.00 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 suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-48(8/00)
DECLARATIONS �^1
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: - • - - Y
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued. •
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number: •
(This section need not be completed it the permit is valued atone 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 Signature: Date:
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 DO LARE(5100,000),IN ADDION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby 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.#_ Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction tending 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).):
1 r 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.
C7044,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.).
(+ ❑ 1•a
e7pt undo Business and Professions Code fort is reason: - / y
" i.g re ]'Sag -y r5 �
ate: ) ! 7-H C7
Owner ID verified by driver's license. ( 57 0 NoDriver's License No, /✓ frxpires: G/ 7( ° S
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 persoh is required to descend,will be made in connection with work authorized by this
permit,and that n0 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:
1 W III 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 Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the Califomia 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 apermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes D No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
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 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 Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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 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.
Signal lureOf Legal Owner(s) / _/L 1 Tie° V
g r
(wenAuthhbrizedA'pplicant L� y. ' Date-?/
CODE# INSPECTION TYPt .. 4dIE tNTRIALS ;ONE INSPECTION flee PAIL • INTTT1r1L4
1616 Fixed System Final Fire Prevention 206 Final Mechanical •
1266 Pool Spa Final 208 Final Plumbing I
200 Final Re-Roof 210 Final Electrical I i\J 14-
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 •
1
•
Q i ea" "D [ Wait �q'tQ V rucdia�
OWNER-BUILDER
VERIFICATION
r6-46-- i<
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
UI personally plan to provide the major labor and materials for construction of the proposed
property improvement. ' Yes ❑ No
2. I (have I ave no ) signed an application for a building permit for
U the propose work.
•
�3'�Phave contracted with the following pF rson (firm) to provide the proposed construction:
\/ Name VC
r es5As\Q
Address �1oQd� City C•�'�1
Phone�ly ) en k ' 3,0°)'—{ Contractor's Lic. No. 1s toa.D.0\
4. I plan to provide portions of the work. hut I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
•
i
J
1042-46 (REV.9(98)
P_J
•
DECLARATION OF AUTHORITY Bldg. Permit# r
FOR AGENTS OF PROPERTY OWNER This Permit# CO`'t—Ct OLi .
TO APPLY FOR PERMITS
Street_\ t. \y DW�c _S AP Number:
1. I (we), \ w,Q\V(V'SS-S , declare that I am the Owner of Title of the above
referenced real property, and that I (we)hereby authorize:
�^ r
Name: �t �+nS � Telephone Number:
Street Address:
City: State: Zip:
to obtain permits in my behalf,as owner/builder,for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa,as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct. .
Executed this day of 20 , at ,California.
GP_iint:Name:: ' &1A it _\SSC t�
Signature�;l-A M^/f SC a-\pJ�S1�Q�-�R'
10 - -oy
Note: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attorney to secure this permit in any behalf.
•
0779-46(revd 100) •
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. •
CITI OF COSTA MESA - " ' PERM,' NO • - ' " 'TRACT NO: - `COT NO. ' •BLDG.NO. . . - '"-- '- . --'
.CONSTRUCTION PERMIT /— 9,97 ' • 5i25 ' '-5/'15/91 • 6.00 T�
_Project Addres�u�G0 - A.• .�A-,a^"-" TYPE OF CONSTRUCTION -- - - .
Owner,] Phorl D NEW --0 ADD. D ALTERATION 'ni 'I - - - ,
Address/7' •L./ 4J` . '- - - ' 0-REPAIR D;CONVERSION, ❑DEMOLISH
«s"'KK���II///
ZONING REGULATIONS-, r ,.-
Arch/Eng. - - _ Licepe No. -• - ❑ OTHER A.P.$ - - - -
AddresA - -
F . - -- -- ' - .. DESCRIPTION OF WORK • - _
•
ZONE PLNG REF.
Contractor P/ - Ps:r. ' -- • • - •
,BUILDING Tp Bt1 ILDI NG -
/ v - 1(2224.4./.....,,,,
� � � �/ ,(39 77' TYPE OF,PERMIL, SETBACK C/L ST- PROPERTY-LI NE •
�Address �i�/ [7 - a-�Y /j,���rjRAPING - D FOUNDATION - 0 STRUCTURAL SLIDE _ •
CICENS D •CONTRACTOR-DECL`A RA ON- 0 TENANT ❑ ELECTRICAL OPLUMBING OMECHANICAL/ SIDE VARU - - - - -
Ihereby affirm that I am licensed under provisions of Charter 9 (com- _ _ RIGHT `
mencing with-section- 7000)"of 'Division 3'of -the' Business'and- ' O'OTHER '
Professions Code, p.1 my license is In full force n f c REAR YARD(TO P/L)
jt. - .- -- _jJ 9l� _ PROJECT DESCRIPTION !
License =s Licens: No. - PKG.SPACE REO. .PRO V,IDED .
Date Signature�� -•
WORKERS"COMPENSATION DECLARATION-
.1
ECLARATION - OCCUPANCY' CONSTRUCTION TYPE :STREET WIDTH PARK FEE$ '
ZONING APPROVED BY DATE
I hereby affirm that I have a certificate of, nsent to self-Insure or,a - , -
'VALUATION ZONE
certificate of Workers' Compensation Insura ce, or �'certified=copy' - SPECIAL CONDITIONS: -
thereof(Sect' 38 Q0, Lab. C.I. / 'GRADING CU.YDS. ACRES '
Policy No 09394//Compah .. __ .. _ ___._- - _ _ _ _ •
.. - _ ..
0 Cerci ' y is hereby furnished. - - - - - - - -- REMARKS:- - - - - • '
edified copy is filed with the city Building Division. -_ ,f
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION . .. _ _ '
(This-section need-not-be completed if the.permit is for.one hundred _ __- _ -. _ _ -. -_ _ '
($100) Or less). •
I certify that in the performance.of the work for which.this permit is _ _ _ - - _ _
Issued, shall not employ any person in any manner so as to become PLUMBING • PLAN CHECK - ELECTRICAL PLAN CHECK - .
subject to the-Workers-Compensation Laws of California. _ - -GARAGE_ -
Date BATHTUBS SHOWERS SO FT IN0 - - - ~
Signature _ _ ___
NOTICE: If after making this declaration, you should become subject ;+TOILETS-•', URINALS • - 'GENERATOR " '0-1 KW_1-10'KW
to the Workers' Compensation provisions of the Labor Cotle,you must -, -- . . - -_
TRANSFORMER RM__ER -
forthwith comply with such provisions or thisAPPLIANCE-- 30-50 KW_50'+ KW, o , - .
permit shall be deemed LAVATORIES DOUBLE L`AVS-
CONSrevoketl. - _ - -- - - -KIT.SINKS '- • DISHWASHERS • - • + Q(^/,MOTORS'- - ' - -0-1-HP' 1-10 HP' "
CONSTRUCTION LENDING AGENCY '
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS • -- - • ' (INC.. SOLAR) 10-50 HP 50 + HP - - -
C ce of the work for which this permit is Issued (Section 3097 _ •I - '
'-.___. _. ....__ _ ._ _ - -
Lender's_Name FLOOR SINKS FLOOR DRAINS - -FIXTURES - OUTLETS' SWITCHES- „
Lender's Address DRINKING FOUNTAINS - -- ' •
GAS'TUBE SIGNS - ' _
OWNER BUILDER DECLARATION -- - •- INTERCEPTORS CLARIFIERS• i.
1'hereby affirm that I am exempt from the Contractor's License Law for ' • ^`
the following reason (Section 7031'.5 Business and Professions Code: SWIMMING POOL PTR'AP
Any city or county which requires a permit to construct, alter, POLES METERED' SUB -
•
improve,demolish or repair any structure, prior'to its Issuance,also're- -
WATER SERVICE ALTERATION. ' '__- - PANELS - • MAIN- "- - SUB- -
quires the applicant for such permit to file a signed statement that he - -
is licensed pursuant to the provisions of'the Contractor's Cicense'Lzw - - - , -SERVICE- '�"' - - '"- AMP-- "- '-
(Chapter 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE OUTLETS ,
Business and Professions Code) or that he is-exempt-therefrom and'the -WATER HEATERS--BTU OUTPUT - - - • - ' - -" - _
basis for the alleged exemption. Any violation of Section 7031.5 by -
r.
any applicant-for a permit-subjects the applicant to a civil penalty - SEWER CONNECTIONS _ - - - - - " ' •-" i. - ._ `
-
of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS( _ r - - - "'" -'
•
•
sole compensation, will.do the work,antl.the.struct ure.is not intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - - ISSU E'FEE '- - -
Contractor's License -Law does not-apply to an owner.ofa property -_ - - -- at, -,
who builds or improves thereon, and who does such work himself or ISSUE FEE qpp LIGATION APPROVED BY -- •- - -DATE
through his own-employees, provided that.such.improvements.are not _ _ _
Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF,F EES •'
is sold within one year of.completion,.the owner will have.the burden ' _
of proving he did not build or improve for the purpose of sale). , BUILDING - - - ,
D '1, as owner-of the property,'am exclusively contracting with • HEATING SYSTEM 0-100,000 BTU PERMIT $ ,SMIP ,_ $ -
licensed contractors to construct the project (Section 7044, Business AND DUCTING }
P 1 100,000.+ BTU ,PLAN CHECK $ PERMIT
and Professions Code: The-Contractor's License Lav'does not apply to - -- ISSUANCE $ .•
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $
tracts-from-such projects with'a contractor(s) licesnetl pursuant-to SYSTEM -' - - --- - • - - GRADING $
the Contractor's License Law). 100,000:+BTU _ PLAN CHECK $
•
❑ am exempt under Section • - 6.& P.C.for this BOILERS BTV $ - '
'ELECTRICAL $
reason - - - ' ' - _ MICROFILM $
Date - - - Owner -- SYSTEM REPAIR,ALTERATION PLAN CHECK ' $ TOTAL FEE$ -
I.hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $-' - - _
information is correct. I agree to comply with all cityand county - - -PLAN CHECK - - •LESS AD--'
9 - $- VANCE PC $_
representatives
ordinances ansstate laws relating to construction,and hereby authorize •' ' • •-
representatives of this sty to enter upon the above entioned '/E/�.
•
•
property_for ns do pur es.
,so�6[ t • - FINAL FEE $
Signature /> _ �_� _Date_ - ISSUE FEE
Drivers' License or SS# - - • """ - '- - .. - . . - .
CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
•
CONSTRUCTION AND PLANNING POOL&SPA ' 1 'J
Date Inspector - -Date Inspector
APPROVALS Permit# APPROVALS - .. Permit# •
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - -
2._ Soil Pipe-Undrgrn •- • -' 44. Steel Reinforcement •• - - -
3. Electrical Conduit Utility-Undrgrn - - 45. Forms - .
4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding - - -
• 5. SteeFReinforce 47. Rough Plumbing& Pressure.Test - - - •
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE •
• 7. Footings - 49. Electrical Conduit-Undrgrn • -
8. Foundation , 5 0.50. Gas Pipe, ❑Undrgrn,Test _ •
9. Water Pipe-Undrgrn _ - 51.- Backwash Lines. P-Trap. ❑ Undrgrn _
10. Structural Floor System ' • 52. APPROVAL TO DECK ' - '
. 11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final •
12. Street Sewer Connection - •.. • 54. Heater & Vent-Final• •
13. Rough Plumbing _ - - 55. Plumbing System - Final - -
14. Rough Electric-Conduit - - 56. Electrical-Final - '
15. Rough Electric-Wiring -' - `- . . - 57. Solar System-Final '
16. Rough Heating &Air Conditioning_ . - . - �. 58. Fencing &Access Approval
17. Ducts, in Structure ._ . 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test . • 60. POOL/SPA SYSTEMS FINAL
20. Roof-Framing. . _ - . .
21. RoofSheathing - - - . - .
22. Frame and Flashing - - ' NOTES: - • ' -
23. Insulation - - - _ ' . .
24. Lathing & Siding ... _
25. Drywall Nailing
26. Plaster Brown Coat - - -
27. Electrical Power Meter-Final • •
28. Final Electric .. • .
29. .Final Heating &Air Conditioning - ,
30. Final Gas Pipe-Test
31. Final Plumbing ��7/F( a -
• 32: Water Service-Final
•
33. Gas Service-Final - '
34. Solar Domestic-Final . .
35. Landscape Sprinkling System ' .
36. Sound Attenuation
37. Handicap.Regulations • ;1
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed •
40. Electric Release to Edison _
41. Gas Release to Southern California Gas Co. •
42. CERTIFICATE OF OCCUPANCY .
No • Date -
:, 12485 RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 41}117n
P. O. BOX 917 COSTA MESA. CALIFORNIA E1DFor Applicant to Fill In Completely APPLICATIQJ fFO ftrfMESA
TYPE OR PRINT BUILDING
ADDRESg 1860 New Jersey St.
COSTA MESA. CALIFORNIA For Office Use Only
I RECEIPT NO. R}.IZI48[�
OWNER New York Avenue Properties, Ina '�y J
MAIL RECEIIf¢D BY DATER¢ Z- au 1DATE 181 UED
19R0
ADDRESS 419 E• 17th St• 7 J//�
CITY Costa Mesa TEL
ADDRess
ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA
OR ENGINEER MZ'ddlehrooir NO. dr
/�
ADDRESS Garden Grove Zt I -
ZOO E NE TYPE I' GROUP) (JI�I
CONTRACTOR Di kp & On]Parnve Tne_ APPROVED
AP DATE
ADDRESS 419 E. 17th St. ZONING
M.1. /1
ZONE NO.OF US¢ OF NE /'i
CITY Costa Mesa l I PLANS 11 BUILDING 441." y''� G.
LIC.NO. 167293 TE NO. Li. 8-1159 DLEGAL
ESCRIPTION Lot 90. Tr. 3648 U /•���
SIZE NO. OF /Rocs.
OF LOT 90 X 107 I NOW ON LOT non! A.P.NO. .e—en.---
USE OF none YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM (CENTER UNE STA
CENTER OF STREET 501 REAR YARD� LO FRONT • Co FT. IN.
p
SIDE YARD I LEFT 71 RIGHT /1 R.SIDE 0 FT. IN.
DESCRIPTION OF WORK•
L.SIDE 0( FT. IN.
NEW IX II ALTERATION I °ADDITION I REAR FT. /I -
`L If IN.
REPAIR 4 ,J
II MOVING II DEMOLISH APPROVED iv 142 DATE /r
BUILDING_ NO. OF
SIZE 1.560 so. ftaooMS 7 STORIES 1
EXTERIOR WALL , ROOF
COVERING stucco I COVERING Comp. & Rock
USE OF BUILDING AND WORK TO BE PERFORMED --
Sinele family rPsirlanre with
attached garage. Plan 20C
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 CITYORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF '//� PERMIT FEE $ 36.
PERMITTEE N
S 16,101. PLAN CHECK $ 18. `i
AUTHORIZED AGENT Dike & olegrove„ Inc. • f
,TOTAL FEE $ 54. 0