HomeMy WebLinkAbout3233 NEW YORK AVE - Building PermitsPflOJECT A�OBESS: '- 3 2 3 3'� NEW YORK AV
�-0WNEH'SNAME: STURLA MICHELLE
PUDPESS: O 3 Z 3 3 {�EW YORK AV
COSTA MESA, CA 92626
719) 557-1894
AFCNIENGINEEN: NEC.NO.:
p00HES5:
UNIT:
UNIT:
PEFMITTEE: COLLINS ROOFING COMPANY (719)891-7975
nooeess: 15672 WILSON ST
MIDWAY CITY CA 92655
LICENSEO CONTpACTON OECLANATION: I hereby aftirm ��at I am litens¢tl under Dmvisions ol Chapter 9(cOmmenCinp with Seaion
7000� of Oivision 3 of Ihe Business ana Pwlesvons Code. and my license is in tull force antl Hec�.
ciTruc.: 30�q�$jareuc.:357 � C
Oate ��—� `] �� .SiAnature. —
v
flRF COMPENSATIDN �ECIAflRTION: I hereb irm th I have a ce�ificate of consent �o sell�insure or a certiliwte ot Workers'
Compensa�ion Insurance or a certitied copV Ihereol eciion 00. Lab. C).
roucrNo.: 1016568-93 P.OATE: O%IOSI9A
comrnNr: STATE FUND
❑ Ceni�iea copY is hereby tumi5hed. � Cehif opy is fileU vR ' y Builtl��ivi'eq.
ba�e '� ApDlica � �
MPTION FflOM WOHNEBS' fAMPEN5ATI0N 0EC ATION: his sectian neetl iro� be comple�e� ii �he permi� is ior one hunare0 (311p) or less�.
I cer�ily Ihal in ihe Oedormance o� the woB �or w ch ermi� is issue4 I shall not employ any person in any manner so as to become
subject Io I�e Workers' Compensa�ion Laws ol i amia.
Da�e: Signalure:
NO710E: II. after making this declaration, you should become sublect lo the Workers' Compensation provisions of ihe Labor
Cotle. you must btlhwith complY wi�� such pmvisions or I�iS permit SAart' e
CONSTBUC710N LENDING RGENCV: I hereby affirm t�at UGie is a wns, t✓r�] in a f t ECy fo n ri�o �ork for
whicn Ihis permit is i=sued �Section 3037. Civ. C). ' -�. �.
iexoee: REQUIfl�6d Y
FODPESS:
i :.,wB+
OWNEfl BUIIDEfl OECLAflFTION: I Itereby aifirm ��a� I am exemD< «om the Coniractors' Staie License Law Por �he following reasan
(Seclion 7031.5 Business an0 Pmiessional Code: Any ciry o� counry which repuires a permi� to cons�mc�, alter, impmve, tlemoliSR or
repair any stmcWre. prior �o its is5uance, also requires Ihe aODlican� for such permi� to lile a signed statemeni Iha� he/she is licensetl
pursuant lo I�e provisions of t�e Conirac�ors' State License Law (Chapter 9(commencing with Seclion 7000) ol Division 3 01 ihe Business
antl Pwfessions Cotle) or that helshe i5 e�emp� �herefmm an0 i�e basis br �he allegeA exemp�ion. Any violation o� Section 7031.5 by
any applican� �ar a permit su0lecis �he applicani to a civil penalty o� noi more I�an �ive AuntlreC tlollars (Y500�.
I. as owner o� I�e pmperiy or my employees with waAeS a5 Iheir sole compensation, will Uo �he work, and �he
❑ s�mdure is nal imenaetl ar oHerea tor sale (Section 7044. Business and Pmiessional Code: The Contractors' State License Law
tloes not apply lo an owner ai a pmpehy w�o Ouiltls or impmves t�ereon, and wAo Ooes such work himseltlherself or Ihmugh
his or her own employees. pmvi0etl Inai suc� improvemems are not iniended or oflereA lor sale. If, hawever �he huilding or
impmvemen� is soltl wi�hin one year o� comple�ion, �he owner will have �he burtlen o� pmving hels�e Uitl noI buil� or impmve
far the purpose o� sale�.
I, as 6wner ol Ihe property, am e�clusively conVac�ing with IicenseJ conUaclors �o cans�mci �he pwleci (Section 7044, Business
❑ antl Pm�essions CAOe: The ConlratlOrs' S�a�e Litense Law tlo¢5 n0� apply ID an Owner o� O�OD¢nY wh0 6uiltls af impmv¢5 �heBon
and w�a conlracis lor such pmject5 wilh a conlracloqs)license purSuanl ta the Contractors' Slate License Law). I am aware
Iha� pmo� at their Worker's Compensalion insuranre shoulA be pmvitletl to me.
� I am ezemp� untler Seclion: 8. 8 P. C.
for tnis reason:
oaie: ow�e�:
I tlo nere�y cetlily Inai I am aware ol antl untlerstand Ihe requiremenis of Califomia Health an0 Safety Cotle Sections 25505, 25533, and
2553a antl thai I or any iWure �uilding occupant willlwill not (circle one) need to comply wi�� saitl state codes and the requiremenis for a
permi� for cons�mction or motlAicalian imm ��e Nir Ouah�y Managemem District. qesitlenlial consimc�ion a001ica�ions are exempt �wm
Ihese provisions.
Oate: NpplicanL
I �ereby cetli�y Ibai I have read I�is application antl sta�e ��a� Ihe above i ormalion is correct. I agree to comply wi�h all ciry an0 counry
oramancesandstalelawsrelalin �obutldin conslm tlhere0 a or ere r liveso eru onlheabove�mentioneU
praPeny Ioyiy,Pectionsurpay� _ �9 �� y �j ���i P t ) -�
License oi Social Securiiy
t6ai�a6 WNte—Budtllnq; Green—Coae EnlorcemenC Canary—ApplicanC Pink—Revenua. Goltlenrod—Assessor
CITY OF COSTA MESA — HOILDING PERMIT PERM NO: B 066681
PERMIT NO; B 066681 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PORPOSE: OTH
JOB DESCRIPTION : T/O, REROOF W/COMP. SHINGLES SQ FT: 3,300
CLAIM VALUE: 3,300,00 CALC—VALUE: 3,300.00 GROUP OCC; R-3 /
COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 FIALLWAY, UBC 1991
**�**�r�rir**********��r**�r+r�*+�+tir+rx�*�r**itit�r**�x�+tir*�**�*+t+t�*�*****�*+��rx�*�**+�*� *******
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PAAKING REQ • PROV: PARCEL: 13910217 ZNE: REF NO:
PLANNING NbTES>
�
1! iE iE 1ElF iflE if iE 1E iF 1E iE iE iE fF iE 1E ik ik 1E iE iE if ih ih it fE 1! i! �E iE iE iE 1E f! iE 1F i! iF ff if iE iE iE 1E iElE 1E if iE iF if if if iE iE 1E iF 1E if iE if 1F if iF it iE ff iF 1E 3E if iE iE �! iE iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: ��� DATE: ��F��l ��
*�r*fe�frf�xx��it+�it+�+r�r+��ri[��rx�it3F3F�F3F3F3FiF3F3F�F7FiFiFiF3F3F3F'iF'iF3F7F'{F�iF3F�iF�r��******� *
��***�r�t�r*x x�*x�x ��x�*x�x�*x�x�**��r+t*******�t*�r**x�*****�r*+t�tx *x��*x�*x x��t*x�*+�*�x�****x���+t�x�t*x
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63,00 .50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMI'L ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.50 0.00 0,00 63.50 63,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SROAT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63.00 .50
if iF iE 1Elk if if 7E if IF iE iF 1f if iP iF iE f! iE * 1E fE iE 1E 1E 1E 1E 1E iE iE 1E iE if iE iF iE 7! 1ElE if 1E �E 1E iE 1E 1E 1ElE fE if �E k 1f M it iE iE'if if !E tt iF fE iF 1f iE iE iE 1E if 1f 1E iF iF iE i� iF iE %
I N D I V I D U A L F E E H R E A K D, O W N
TYPE QTY D E S C R I P T I O N UN•I,T COST TOTAL COST
SFR 3300 REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
1.00 3,300,00
01 OOi5E394—OO1SE400 T�3 T 63.Sd
DATE: �4/0�/94 TIt1E: �3:25
i
� POOL & SPA
!CONSTRUCTION AND PLANNING ' �
. APPROVALS Permit # Oate I�spector pppROVALS Permit � Date Inspector
' 1. Temporary Electrical Service or Pole � 52. Pool & Equipment �ocation !
�� � ^ O
� �:
2. Soil Pipe�Undrgrnd. -:'',. �-..; "''�+ 53. Steel Reinforcement .
• 3.�-Electr�a� Condvii;Uti�iry-Undrgmd ��� , � 54. Forms
�' '4_'.4Elgctrica� Conduj;-Undrgrnd`�. r- 55. Electrical Bonding ir
� 5:�Leel Reinforcemen� '�'� 56. Rough Plum6ing & Pressure Test
�: s z� i
';��'E�ectrica� UPER.G nd. 57. APPROVAL TO COVER�GUNITE `;')
�.3. :Pootings -, �� 58. Electrical Conduit-Undrgrnd. �'
r_
'�&�Fbundation ' `� � � `�- � 59. Gas Pipe, � Undrgrnd., Tesc #- " I
�- -
... 9.'.Water Pipe-Undigmd, .-�.� _ 60. Backwash Lines, P-Trap, C Undrgrnd. �
70. Sfr,ucturai Ploo;.SYstem �- ' ` �'i�' �•� � 61. APPROVAL TO DECK 1
11. Property Sewer`Linr�,& Non5.��nnection �, . ,�•�� ; j� 62. Backwash & Recepta��Final .,
12. Sewer Czp .L �;n " ' �A �.,� � q63. Heater & Vent�Final , •i
73. Roof Dra�ns 70 '�-� _'�� r� ` �.�64, PWmbing System � final �.,
14. flough Plumbi'ng �� � �� � � � 65. Eleclrical�Final +�
15. Rough Electrica):Condua �' �y. -' `� 66. Solar Svstem-Final �
i6. Rough Electric Wiring ^. ✓1 i^ 67. Fencing & Access Approval ,.X
17. Ro�gh Wiring Sign �• _ 68. APPROVED FOR PLASTERING t✓A
18. Rough Electrical-T Bar Ceiling �69. POOIISPA SYSTED;IS FINAL
19. Rough Neatingr& Air Conditioning FIRE DEPT. REQUIREM1�7ENT -
' �y -� - - �U:� '; . ... C:
20. �iough Fzctoty Fireplace i `:;,7 �'7 � O � �'�+� �* P.PPROVALS�-� _Permit # �+ +�'
� r-� . n
21..`Ducts, in_Structur,'e,' ' `�;`' ':� `. .- � ��• ' . "� � ` ,y ' x `�'
�,. � r.- a � � .yx. •: ]0. triderground�HY�1ro �+
i_. - - • _
22. Ducts. V,entilating- a i � r �S �*';�1. Product:PiPiing Q��Gas �Oil
23. .Gas�PipeFRouyh &"Tzst ; �' a`, u - �;. : 72. Undergrou_nd Flu"s,h��„� ' '� "�
24.,Roof�'rraming: __ r � �--, ��r� +� : ,j c � .'_73.;UndergmdlStorag�e?Tank OGas ��O�t
'-+ -� Y i [ J
25. Roof'ShE�thing � Y � • T �� �p[.�/ . �74, Operhead 'Hydro � `Jv °�
�� �(-Z-4H; �-_ ,
26.-7-8a`r, Ce�ling (Str.xturalf & fAonocoat �- 7 t�*�. �� 75?Dry Chemical i'7 *-• -- S
r-i � : r r_ • -t
27.'Frame and Flashing' ; ,�, � �; ,T, ; t 76. Dry Standpipe � � � �' ,ti
H l:] l.' U' - J� . ' ' 1' .
'28. Lathing&Sidjngp.� � t^�: a� . - � 77,sFIXEDSYSTEM�FINALX � -
,�, ��i« . .«-
� . `� �: a r, i .� -.
•29. Insulatio� - �}.� �-" � •. r I � ii � 76�FIflE PREV. FIf�A:I• . y r� r
' n ri K r. ' J . � ' �+
�30. Drywall8�ailing *s . I �� � �� MEALTH:DEPT*REQUIREMENT
_ `> .
; 37. Plaster BCown.Coa'� � �. � .,,n� x � i i* - -79.` FINAL If�tSPECTIO�N " G . �
�i ^ -• � t• - - : . i
'.32.-Electrical-Power fi9eier¢inal , . � �- .:. '��SO.,�POOD CERTIFICATE ISSUED
33. Fin51 Electric; - ' ' ;� j �! " ?Note:: � ='= ' �
�, � -� i t�,.
.34.�Fina�He3ting'& Aii�Coi�ditionipg� -. - � I r��� i r ' �'� ,,, �' -' J
- 1 �. -
35..Finai�Gas Pipe-Test • T -� � i " S= ` , '" ".. � =• -
� _ " H �* �' ..l .�v:'. " t-� Y �``.
-36.'Ho . 'r �. �; . .i � �.
oifor'CanOPY _ �y . ! � �e r _ ��,_ . •�,_.
T'� t.
'37. FinaflFacfory Fire'pCace'.r � `�"� - `" '� ` ', `^ i :.: .
- ' ' �. . .. .. c. � I i i' • � � _ ---
38. FinalyPlUrn6ing > x � � ,� A ' � � r. , •
�' , i
�39. Water, Service�Pinal � � � -- � � f ;+' ? r � - '
1 ik y .�
40. Gas Szrv�ce-F�nal � � - -. " . ` `` ,�, � t� ' "
i
•41. $olar OomeSticFinal � C. � �.: .r ' a �'_ •-. �+
� ' I I ,x+ _l� v -. �, . _,
•42. �Backflow Prevente� �. � ,; '� ; '' Y (,�-l�,R(� '
- h:e<?� r ` �'. -1
43.8ackflowlrrigation: - .• � -- Cf._ � _ . "C.
c � � .
44. Landscaee Irdgation SYstzm7�,::�J �' : r - :, �-� �; ,n �u ' ;y �� ` .
- , . . V :� .. ` - -`-- - -
'45. Sound Attenuationi '-- - •- � "" ; � -' ''' �'�' '"�• �
:;� :.i� �y.-.
46. `Handicap`,Regulations ;� - 4''� > ; "� ��� -� x
. - --
47. �F,IN9L STRUCTUf4E & BUILDING T ( vo5 . -.
_, ,,:
- z -.9Y � 6� : ' - , � �.,
48. �INAL PLANNIf�Gf ; � `� , ;, � '"--'. � .r7 � .• �. ,
.,
-49.•Electqie Release to Edison � � � �,--= _ � -
i.. 's , -�
� .. . -,... . _J L ' ., �
50. .Gas Release to Southern Califbrnia Gas Cv �� 1 � �-:'' _ _, - . � ,:; . `� �
�_,
5L CERTIFICATE OF OCCUPANCY' ,; � , • , .
No, Date
PHOJECTAOOflESS: 3233 NEW YORK AV unir: CITY OF COSTA MEfiA — BUILDING PEftMIT PERM NO: M 059126
OWNEH'SNRME: STURLA, MICHELLE FLOOD: AE-37 -
aooAess: 3233 NEW YORK AV PERMIT NO: M 069126 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYFE; MEC PURPOSE: OTH
AflCH/ENGINEEfl:
aoosess:
NEG.NO.:
UNIT:
PEflMITTEE: MICHELLE STURLA ( 714 ) 557-1849
p00PE55: 3 Z 3� NEW YORK AV
C,M. CA 92626
LICENSEO CONTppCTOfl OELL�IPATIQN: I hereby allirm t�atl am licensed untler pmvisions ol Chapter 9(commencing wii� Section
7000) ol Oivision 3 oi Ihe Business and Professions CoOe. an0 my license is in full force an0 effeci.
CITY LIC.: STATE LIC.: CIASS' EXP ;
Oate: Signamre:
WOHREflS' COMPENSATION oECLABA710N: I hereby aflirm ihat I have a cenificale o1 consent to self-insure or a cenificate of worker5'
Compensation Insurance. or a cetlified coDY �hereof (Section 3800. LaD. C)
POLICY NO.: E%P. ORTE:
COMPANY:
❑ Ce�ilie0 Copy is her¢by furnished. ❑ Cetlified cDDY �5 filetl wilh �he tity BUiltling �ivision.
Oaie: ApplicanP
EXEMPTIONFBOMWOBKEflS'LOMPENSPTIONOEClA8RTI0N: (Thi55ec�ionneeUno�becompleteDil�hepermiti5�aroneAunAred�8lql�orle55�.
I certity ��al in the pedarmance af the work for whlc� �his permiljs issuetlYI shall noi em loy any person in any manner so as �0 6ecome
sublect lo I�e Workers' Co pensatmn Laws oi Calibm1ia.'/�r,',,/� `p�AI//'p e
Date: �, '—� �� SignaNre`�j�Mj,�[,/,,,/ f`i
NOTICE: II, afler making Ihis tleclaration, you s�oultl �ecome suClect to lhe Workers' Comp¢nsalion pmvisions oi the Labor
Code, you must lotlhwith camply wiih such pmvi5ions or this permii shall be Ueemetl �evoke0.
CONSTPUCTION LENOING RGENCY: I hereby allirm tha� �here is a constmc�ion lending agency �ar the pedormance o� Ihe work �or
which �his permit is i�suetl (Sec�ion 3097. Civ. C�.
LENOEfl:
aooeess:
SOB DESCRIPTION : INSTALL NEW FAU SQ FT:
CLAIM VALUE: CALC—UALUE: GROUP OCC: /
COMMENTS: NO OTHER WORK AUTHORIZED BY THI5 PERMIT
*�r***�r�r*�r**#�*�****�r****��-�r+��t+r**x��-*x�*****+�+���**�r��c�***�*****x�*�*x-�******�r*****+�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILUING ---------- -------- ACCESSORY BUILDIPdG --------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV; PARCEL; 1391C217 ZNE; REF NO;
PLANNING NOTES>
� •
�IE if iElE if iE iE i:* f(� iE jF iE if iE?E iF if 9E iE iElE X- iE iE # iE iF iE iE 1f iE W� iE 1F if 1E if if iE if i! iE �IE iE �F iE iE iE jE if iF jE 1E 1E iE jE ic k jF iE iE iE IE iE iE ik 3f jF iE �1E �If iElF iE � iE iE iE if
D E C� E L O P M E N T S E R' V I C E 5 R E Q 0 I R E kt E N T S
ZONING APPROVED BY DATE;
BUILDING APFROL�EU BY ; DATE;
..a.r p�
APPLICATION ISSUED HY: -� DATE; �� ��1
i'iEiEfEiEiflEifiEifiliEi(�1Eit-iF1EiE?FiEffiEiE tt iEi! itiE ltifiE itil-iE itit RiFiF itiFx ilfEiFiEifiEiEiEiEilkiE iFiE' ik�lE
iE iE 1E iE it if iElc ib iE iF if iE IElF i!!E if iF if� i! iE iE iF fE if itlE it 3f �IE iE 1t iE i!'rt 1E if i4 i! if if iE iE iE 3F �f f! �fE iF �It # iE iF iF iE aE i! if !E i4 if 1E jE iF ik �?' �)E iE if iE iF iF'M- ir i! 1f N� iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
OwNEBBWloEFOECLANnTION: Iherebyattirmlhallamexemp�iromiheComracmrs'S�a�eLicenseLaw�or�he�ollowingreason BLL1G PMT PL[IMBING ELECTRIC M$CAANIC FIRE SMIF/RES GRP,DING
�Seciian 7031.5 6usiness antl Pmlessional Catle: Any ciiy o� counry which reQuires a permi� �o cons�mcl, al�er, improve, Oemolis�, or P ERM I T - 9, 0 0
cepair any SimcNre. Orior to its issuance. also repuires �he aODlican� lor such permi� to tile a signetl s�atement that he/she iS IicenSeA ' Z S% SM I P/ NON —R E�
Dursuanuo Ihe pmvisions ol l�e Contracmrs' S�a�e License Law (Chap�er 9(commencing with Sec�ion 7000) of Division 3 of �Ae Business PL�N
and Pmlessions COAe) or iha� he/she is exempt therelrom an0 ihe basis for the allepe0 exemption. Any violation of Section 7031.5 by
anY applican� �ar a permi� 5u61ecI5 ihe apDlican� to a civil penatly of not more �han live huntlretl dollars (5500�. i$SUE FEE 1 5, ��
� HDILDING—DIV—> PERMIT ISSUE FLAN—CHECK TOTAL PAID DUE
I. as owner oi the Dmpeny or my employees wi�n wages as their sole compensa�ion, will Oo ��e work, antl �ne TOTALS----> 9, �0 1 5, �0 �, 00 24 , 0� 29 . 00
s�mc�ure is nai inlen0e0 or oifereA for sale (Seclion 7044, Busmess antl Pmtessional Code: The Contractors' State License Law . O O
Ooes not ap01y to an owner ol a D�opetly w�o �uilAs or impmves Ihereon, and who does such woM himself/hersell or Umug�
his or her own employees. o�ovitletl mat such impwvemenis are not intenAeO or oifere0 for saie. Ii, however ihe UuilOing or REVENUE D I V IS ION TOTALS--> COLL ECTED • 2 4, 00 OVER / SHORT � 0 0
impmvemen�issdAwilhinoneyearalcom0letion,iheownerwillhavetheUurOenolpmvinghe/shediano�buildorimpmve HLDG PMT PL[IMHITI('i $I.ECTRIC MECIiANIC FIRE SMIP/TOT GRADING PLAN—
mr ine vurpose oi saie�. CAECK
I. as owner of ine propehy. am eMclusively coniracting witn Iicense0 coniractors to cons�Nct the pmject (Sectian 704d, Business 2 a, Q �
❑ an4ProfessionsCoae: TheContractors'StateLicenseLawOoesnotapplyloanownerolDropertywho0uiltlsarimprovesthereon **********************�*********�****�*****************************�****��
an0 who contracis for such pmjecis wi�h a conVactor�s) license pursuani Io �he ConUac�ors' S�a�e License Law�. I am aware $ if 1F {E�M.
mal pmof ol �heir Worker's Campensaoon insurance shoultl be pmvidetl m me. 2 N D I V I D(J A L ' F E E B R E A K D � Sd N
� I am exempl untler Section: 8. 8 P. C- '_
mrtnisreason -�I �j� TYPE QTY D E S C R I P T I O Nr [JNIT COST TOTAL COST
�oaie ��'S�� Owner���Q e.Xl�dCLYl�1.� MEC 1 INST FORC—AIR /GRAV FURN <= 100 K BTU 9, 00 9, 00
I Da hereby cenify I�a1 I am aware al antl un0ers�ana I�e requirements al Califomia Heatlh and Satery Cotle Sections 25505, 25533, an0 END �i F E ES
25534 antl Ihal I or any �uNre buil0ing occupan� willlwill not (circle one) neea Io comply with said s�a�e codes and Ihe repuiremen�s �or a .. ,
permi� lor consimdion or motlilicaiion Imm ��e Air Ouali�y Management �isiricL FesiOential consimction aODlica�ions are exempt �mm ,
t�ese pmvisions. -,
Date'. Applicant:
I hereby cerlilythal I �ave reatl Ihis applicalion ana slale tha� I�e aDove iniormation is correc�.lagree lo comply vn�h ail ci�y and counry
or�mances antl sta�e laws relaling to building constmdion antl hereby au�harize represen�atiues o� ��is ciry to enle� upon Ihe above�mentionea
pmperry for inspeclion purpose , ///�����- /� J'V" ^'—
� Date: �� Signawre�.—'r� Or,l �
od�er's ucense o� sociai secudty
, 16a1-a6 Whne—Bmlaing: Gieen—CoOe Enforwment: Canary—Applicant: Pink—Revenue; GolCenroa—Assessor
V
0. 0�15E953-4016E953 T�]7 y;,�}�,
�ATE: 10/US/94 TI{7E: D3:`L�
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspecior AppROVA�S Permit # �ate inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement �� �
3. Electric2� Conduft Utility�Undrgrnd. " 54. Forms 'l
4. Electrica� Conduit-Undrgr�d. 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, O Undrgrnd., Tesc -_�
9. Water Pipe-Undrgrnd. 1 60. Backwash Lines. P�Trap, O Undrgrnd. I
..
10. Struccural Floor System 61. APPRQVAL TO DECK -�
i t. Property Sewer Line & House Connection 62. 8ackwash & Receptor�Final
72. Sewer Cap �" 63. Heater & Vent-Final ��� ;-,
13. Roof Orains - 64. Piumbing SYstem - Final • � J' �
14. Rough Plum6ing . 65. E4ectrical-Firta1 • l "'
-i i
15. Rough Electrical-Condu�t 66. Solar System-Final �
76. Rough Electric Vdiring 67. Pencing & Access Approvaf �
17. Rough Wiring Siyn 68. APPROVED FOR PLASTEfiING j
78. Rough Electricai�T Bar Ceiling 69. POOL/SPA SYSTE4-iS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Faccory Fireplace APPRQVALS Permit # I
Z7. Oucis, in Structure 70, Under9round HYdro
22. Ducts, Ventilating 77. Product Piping � Gas � Oil
23. Gas Pipe�Rough & Test .72. Under9round Rush
24. �Roof Framing 73. � Undergmd. Stora9e Tank � Gas ❑ Oil
25. Root SNeathing 74. Overhead HYdro
26. T�Bar Ceiling (Structural) & hAonocoat 75._Dry Chemicai
27. Frame and Flashi�g � 76. Dry Standpipe
28. Lathing & Siding � - � 77. FIXED SYSTEM FINAL
29. Insulation � ' 78. FIRE PREV. FINAI
30. Drywall Nailing �- � , - HEALTH DEPT. REQUIREMENT
.:37.. Plaster 6cown Coat. . . 79. PINAL INSPECTION
;�32. Electrical Power Metec-Final� � 80. FOOD CERTIFICATE ISSUED
33. Final Elec;ric � . Notes:
34. FinalHBating&AirConditioning .13 _ _ ,/�' 3 qil �,�L'� ��
. ! l`T- �v�y�Lf-
35.�Final G0s Pipe-Test � ;
36. Hood or Canopy � . � � ' �
37. Pinal Factory Fireplace � � '
38. Final Plumbing � � �
39. Water Service�Final
40. Gas Serv�ce-Final
41. Solar pomestic-Final �
42. Batktlo�' Preventer �
43. Backflow Irrigation
44. La�dscaPe Irrigation Sys2em
45. Sound At[enuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUICDING �
48. FINAL PIANNING ,
49. Electric Release to Edison "-
50. Gas Relaase to Southem California Gas Co - -�
51. CERTI�ICATE OF OCCUPANCY
No. Date
%
_ - � 1238�
COSTA MESA BUILDING•SAFETY DEPARTMENT
P.-O. BOX 917 C08TA MEBA. CALIPORNIA
For Applieanf fo Fill In Complefely
TYPE OR PRINT �
BUILDING Nevr vork Avenue
ADDRES6 3233
� COSTA MESA CALIFORNIA
own,Fa Vermont kvenue Land Co., Inc.
,ARCHITEGT C3T']_SOIl & TEL.
CONTRACTOR Dlke & ColP. roV
ADDRES6 419 E• �.%ti�l `Sti•
c,T,r Coata �iesa
STATE � i........ TE�.
NO. OF
�EE RECEIVED
1�-� JUN 211960
FINANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDIPIG
For Office Use Only
NECEIPT NO. ��'J.] �NQ�
�n ri
FELEIVED !Y �ATE qECE�VED OATE �6311EO
�Y A� L� f 11 -- L�/ �O0.1 ef � �14P�
_ COSTA MESA. CALIFORNIA
FIRE / K
ZONE TYPE !/ GROUP
ZONING
� f/ I NO. OF �I U6E OF NEW
PLANB 9UILDINO''n
LEGAL � . _ _ _ ,,, _
88TBACK LIN6 PROM IceNien uNe eiJ
esMBn ov8trseai � REAR YARD Z2� FRONT
SIDE VAR� I LEF'f �� I RIGHT � R. SIDE v
DESCRIPTION OF WORK
L.SIDE
NEW I X II ALTERATION I II ADDITION I C
REAR
REPAIR ' I IIMOVING I IIDEMOLIbH I BYPROVED
S ZED�NG]_ Q SQ • f'tGOOMS V STORIES ]_
PJCTERIOR WALL F;OOF
GOVERING 1- .. GOVERING .-. i � y�j
L16E OF BLIILDING AND WORK TO BE PERFORME ..
!
I HERBBY ACHNOWLBDaE THAT � HAVB RBAD THIB APPLIWTION }H6 AMOIINT BHOWN UNDER VALUATION 18 FOR THE
ANo BTATE THAT TXE ABOVE IH CORRECT ANO AGREE TO COM-
PURPOBE OF EBTABLIBHING A PEqMIT FEE ONLY.
PLV WITH ALL CIiY ORDINANCEB AND BiATE LAW6 6EQULATIN6
am�mNo coNeTrsucTloN.y. n ' VALUATION
81GNATURE O � PERMIT FEE $ �JS•
PERMITTE "'� - n
� S 15,045• PLAN CHECK $ 1/�SO
AUTHORIZED AGENT �lie & olegrove IIli7• TOTAL FEE 52�50
F
4
GENERAL CONTRACTOR
INSPECTIONS
OCCUPANCY
Vermont Ave. Land Co., Inc. DATE
Dike & Cole rove Inc. vnLUE S 15 0�
12 T1tACT 3 S FIRE ZdNE DESCRIPTION OF WORK Res.w att.Gar.
I DATE I GROUP I& J TYPE V ZONE R-1
SUBCONTRACTOR
Form 210-5M-11-59 5-B P - -