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HomeMy WebLinkAbout1787 NEW HAMPSHIRE DR - Building PermitsNOTICE: 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE r. INFECTION TYPE DATE INTMAE6 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final R`e-Roof 201 Final BlocidRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition CODE f INSPECTION TYPE 206 Final Mechanical 1014 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildingiOccupancy 73i WORKERS' COMPENSATION DECLARATION" . . I hereby aRml 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. G©, 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: Carder. U (C. (Trus set: ion non,nol6e mn glee acne pe"d is valuedat/e//.l��areo"ars is 100) w less) Policy Number. �(OT � -' 1 - S—C-) It ❑ 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 )hemworkers' compensation provisions of Section 3700 of the Labor Code, Tall f hwilh comply with these pr visa ns. r ­—App ig ure rDate, —t 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 DOLLARS ($100,000), IN ADDITION 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 Cotle, and my license iso full If and,, (eIffect. L�# V Class # _ 17 C� f"C trano Date . 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: 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 property; am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct 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: Owner ID verified by driv. mse. ❑ Yes ❑ No Driver's 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, a demolition or dismantling thereof, will be more than thirty-six (36) feel 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 Safely, as noted above, unless such person has a permit to do such work from the division. Applirant's Signature Division of Industrial Safety Permit Number: Dale 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? ❑ Yes ❑ 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 file a registration form for acutely hazardous materials? ❑ Yes ❑ 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? ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building pemtits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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? ❑ Yes ❑ No 8. (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify Iiat under penalty of,perjtiry the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 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. $ygaluregal Ownens) gDa7e, `O Signature Date (/ ' '/�/•I� U 305746 (3/07) K11 u,Mido, Awliorizee Applicant-'' CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. —� J LOT NO. I ADDRESS Z7f 2 '�/2e, to l DATE a C/"-/ The developer of the above entitled tract desires to sell 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 (fie -they) (�x were) 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 assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. f BYE_ Lender 1 ISI Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C OF COSTA ME A� C NSTR U TION PERMIT PER IT NU. I' TRACT NO. LOT NO. UNIT NO. a 9gp 6 19J= Address z� -Applicant's Mailing Address G Owner's NameF12 )/�-'� �/ Phone _ W2 Address y%GG AIL,n/J• Arch/Eng. License No. Address �� r -•- Contractor's Name E 'V/Z-}�Z,rl/ ' Phone Address (mailing) b �n� A--�tZ- City License No. > LICENSED CONTRACTOR DECLARATION 1 hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Vvision 3 of the Business and. Professions Code, and my license is in furc ffect. Licen,V W -M e Date Signature WORKE S' MP NSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 00, Lab. C.) - Policy No. Company _ ❑ Certified copy is hereby furnished. , ❑ Certified copy is filed with the city Building Division. Date Applicant 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 a performance of the work for which is permit is issued, I Shall not a plo any person n so a ¢come su bect to the Workers' on La WSrof Calif Y Date Signature NOTICf, a er making this declaration, you should become subject to the Workers' Co pensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall. be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm'Ihat there is a construction lending agency for the performance of the work lfor'which this permit is issued (Section 3097 Civ. C.) Lender's Name L'ender's Address - - - - - - OWNER BUILDER DECLARATION I I hereby affirm that; 1. am exempt ,from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of _the Contractor's License Law (Chapter 9 (commencing with Section 7000) of .-the 3 of the Business and Professions Code) or that -he/she is exempt 'erefrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil Li of not more than five hundred dollars ($500). LJ I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business 'and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, -however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- prove for the purpose of sale). ❑,I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law doeslnot apply to an owner of property who builds;or improves thereon, and who contracts for such projects with a con- tractor pursuant,to the Contractor's License Law). I am.aware that. proof of their Worker's. Compensation insurance should be Provided to me: ❑ I am exempt under Section S. & P. C. for this reason Date Owner I hereby certify, that 1 have'read this application and state that the above Information is correct. I agree to comply with all city and county ordinances' and State -laws relating to bbl ing construction, antl hereby au, riz repre- inspeive5 pt this-yity r upon the above-mentioned Oq�rty for inspection Ss-' ignature Data TYPE OF CONSTRUCTI I NEW LJ ADD LJ ALTERATION REPAIR ❑ CONVERSION❑DEMOLISH D..QTfJER I,PT l C/USE F,BLLDG. TYPE OF PERMIT GRADING Ll N Ll STRUCTURAL AA . ❑'TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MEC ANICAL ❑ OTHER ���� PROJECT DESCRIPTION SQ. FT. OCCUPAWCCY CONSTRUCTION TYPE VALUATION$ 5057c> ZONE GRADINGCU.YDS. ACRES' Remarks: ' PLUMBING FEES Bar Sink' . _ _I I . Showers _ F:JBackflow Preventer Service Sink " Backflow Irrigation Sewer Cap Clarifiers Solar Collectors Dish Washer- I Solar Piping SUN]�ARW FEES '$' ,J•SMIP $ - PERMIT $ - ISSUANCE '$ ENERGY P.C. $ GRADING, $ MICROFILM ,$ TOTALFEE $' Drinking Fountains SolanTank ZST' U , Floor Drains Swimming Pool w/Spa ' Floor Sinks Urinal Gas Service Outlets Water Closet Interceptors Water Heater r. Kitchen Sink -Water Service Lavatories Alltri-WRSh Roof Drains Reinspection Fee 4 $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ `Multiple ❑ Eirepl/Fact. Bit. ICBG # Heating System & Ducting 00-100,000 BTU 0100,000 BT Drivers' License a SS x I I Reinspection Fee CMF 0865.46, rev. 10/84 White - Building; Canary - Applicant; Pink . Accounting; Goldenrod - Assessor $15 Issue Fee Hood or Type ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,0006TU 0100,000 System Repair/Alteration Fire Dampers - Registers Issue'Fee A.P. # S Main BuildinE Front A Rear C Right SLeft Ping. Ref. # Planning Notes: 3724 8/17/87 i Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washer Transformer -11 15-50 KW Construction Pole Sub. —d 13 50 + KW Cooking Unit Meter El up to 100 amps Dishwasher Meter []over 100 amps . Sub Panel I ; Motors 1-10-1 H P ❑ 1'/: - 8 Inc. Solar 09-15 HP El 16-15 Dryers LJGas LJElectric Fan . , F.A.U. ' Fixtures Device Boxes Outlets Switches - Garbage Disposal Generator 1-10-5 KW 05-15 KW Pole Light Range Sign Standing Sections Trash Compactor $ 3 Reinspection Fee $15 Issue Fee FEES' DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By _ Building Approved By BOp50 'TL -71 Z O N I N G R E Q M T S $ 3 U BUILDING PERMIT PLAN CHECK ( PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK, 50-A MECHANICAL PLAN CHECK '25% SUN]�ARW FEES '$' ,J•SMIP $ - PERMIT $ - ISSUANCE '$ ENERGY P.C. $ GRADING, $ MICROFILM ,$ TOTALFEE $' $ ,$ $ $ ZST' U , — ' $ 3 CONSTRUCTION ANb•PLANNING • c ' APPROVALS PQrmjh# Date Inspector POOL & SPA . ' 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 rc 56. Rough Plumbing &P I ress.ure Test 6. Electrical LIFER Gr'nd.: 57. APPROVAL TO.COVER-GUNITE 7. Footings 58. Electrical Conduit* Undrgrnd. - 8. Foundation } 59. Gas Pipe; 0 Undrgrnd., Test 9. Water Pipe-Und'rgrnd. - 60. Backwash Lines, P-Trap,-El 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 APPROVALS Permit 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro. 22. Ducts; Ventilating - 71. Product Piping 0Gas 00il ' �r7= 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0Gas 0Oil 25. Roof Sheathing y_S•� J 74. Overhead Hydro - I� 26. T-Bar Ceiling(Structural) & Monocoat - 75. Dry Chemical fig - 27. Frame and Flashing 76. Dry Standpipe1' 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 'r 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning •-Y` 35. Final Gas Pipe-Test 36. Hood or Canopy 37C Final Factory Fireplace is 38_-,Final Plumbing - ! 4 , 39: Water Service-Final 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- 48�SpecialRequirements Completed 49: Electric Release to Edison " ,z 50. Gas Release to Southern California Gas Co - p' 51. CERTIFICATE OF OCCUPANCY No. Date •1 '' , OWNER APOLLO DEVELOPMENT DATE 1-22-70 JOB ADDRESS 1787 New Hampshi- Drive BUII -"IS PERMIT NO. 31309 GENERAL CONTRACTOR Same DESCRIPTION of WORK idence []/Attached Garee AP No. LOT 61 I HACT 6694 FIRE ZONE VALUt $26-638.00 INSPECTIONS Signa areMOO GROUP TYPE ZONE SOIL GAS SUBCONTRACTOR PERMITS ISS ED Date Number Si nature WATER C ( p PI mb'n ROUGH PLUMBING / PROP. SWR. LINE HOUSE CON. i SPRINKLING SYSTEM - MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING O - O TEMPORARY SERVICE OR POLE UNDERGROUND POWER D ROUGH WIRING _ 7,T0 eating ond+VeM TRENCHES FORMS STEEL REINF. L3 - Or FLOOR SYSTEM T' BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING _2z' 7a LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL, FINAL }i HEATING, VENT., REFRIG. AND A.C., FINAL `y % PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL G .�c : j Ivo9 Q/ JAN 26- 751 COSTA MESA BUILDING -SAFETY DEPARTMENT - / P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Z . W w a U Z Z_ O to a CO J7 J N Y J J CO Q U N Za wLY aw W Z JO Lb z J � W W _Z F= - w0 CC �CC r Z a U_ J CL a a O F - fn Z O F U 0 cc F N z APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIY I DATERFjCEIVEQ Y //����JJ DATE ISSUED BUILDING /' Q"7 ADDRESS f% / 1140, o� 7V 6u1 f PERMTINBl�(� OWNER Apollo Development Corp. A.P. NO. 1.3JJ MAIL 1104 E. 17th Street BUILDING ADDRESS ADDRESS _ , CITY Santa Ana TEL '547-9673 TRACT 6694 LOT 61 BLOCK CONSTRUCTION U. S. National Bank REPAIR LENDER X BRANCH Main Office OWNER Apollo Development Corp. ADDRESS 190 S Broadway, San Die o VALUE S Dwellin $ 15.700 ARCHITECT TEL. OR ENGINEER N .675-1 FIREry� I ADDRESS 3111 2nd Ave.,Corona Del Mar ZONE TYPE GROUP / CONTRACTOR Apollo Development Corp. APPROVED BY DATE ADDRESS 1104 E. 17th Street f TEL. ZO E NO.OF USE OF NEW 111 CITY Santa Ana NO. 547-9673 P�%� BUILDING f nI o. 252549 CITY 1690 YARDS APPROVED YARDS APPROVED LIC. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. -� 100 (FROM C/ STREET) OF LOT 50 X NOW ON LOT FRONT FT. FT. USE OF --- EXISTING BLDG. S 1/ FT. FT. 1752 S.F. $ 1- 0 NEW BLDG. ROOMS STORIES L. $IDE FT. FT. EXTERIOR WALL anS ROOF Shin 1e g Y COVERING COVERING REAR T. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLDGS. Construct new dwellingwith at- CAR p C.U.P,* _, DATE _ APPROVED tached garage. APPROVED DATE A,L WP I hereby acknowledge that I have read this application and state HOLDFOR SPE 'IAL REQUIREME that the above information is correct and agree to comply with TS all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of y,yh (J�ZSO. the State of California.7O m 1 hereby certify that I am properly licensed as a contractor under FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Divisicn 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: v am emP' from the ?visions of they State of California Business VALUATION antl Professions Cotl ivision 3, C y"/ m PERMIT FEE $ -9 100 N J Signature of Permittee $ "lf 1 J b� PLAN CHECK $/�C�lj E m o` Authorized Agent u TOTAL FEE $ tJOB ADDRESS 1787 New•Har-,hire Drive BUILDING PERMIT NO. -16769 !GENERAL CONTRACTOR sane DESCRIPTION of WORK patio Cover AP No. LOT r. I I KACT FIRE ZONE VALL_ d 500.00 IINSPECTIONS Signature Date GROUP TYPE ZONE Rl 1soIL SUBCONTRACTOR PERMITS ISS ED :GAS Date Number 5i nature )WATER Plumbin ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ED ROUGH WIRING Heating and Vent. TRENCHES FORMS STEEL REINF. Lj FLOOR SVS EM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING. FINAL 1� 36769 i COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING ADDRESS 1787 Neil Hamps`iire Dr. -1 OWNER Richard L. Hargrave MAIL ADDRESS 1787 New CITY Costa. Mesa CONSTRUCTION LENDER '�— BRANCH ADDRESS ARCHITECT OR ENGINEER ADDRESS CONTRACTOR ADDRESS CITY STATE LIC. NO. SIZE OF LOT USE OF EXISTING BLDG. SIZE OF W 0. EXTERIOR WALL COVERING USE OF BUILDING AND alspshire Dr. TEL NO.545- TE C f7 L. LI` TE 4,4 y TEL. NO. CITY LC. NO. NO. OF SLOGS. NOW ON LOT NO. OF ROOMS STORIE'. ROOF COVERING K TO BE PERFORMED I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am operly licensed as a contractor under the State of California sin ss and ProVss,�IcI Divisicn 3, Chapter 9, and that ch li nses are in efft,orIam empt from ,e pro ions of theornia Businantl Professions sue, isicn3 ha Signature o Permittee Authorized AAht J0 11-73%M—s"00 PAID * ***** 73„ .A 75z 5.50 APPLICATION FOR BUILDING PERMIT RECEI D 6AT ECEI D D TE I UED A.P. NO. 3_0 PERMIJJ � BUILDING ADDRESS ADDRESS r-.�GO 14 �,ON1 6 ��jj�j �( TRACT L-6 l I LOT (A BLOCK W ADD ALTER RrPA VI NG OWNER �1 I j rT{ A USE A_ Co Qdj C,LVALUS ✓ V FIRE ZONE APPROVED DATE ZONE NO. OF n `l USE OF NEW ,;, / (J PLANS BUILDING CJP% C(tir YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUIL ING (FROMC/LSTREET) -� DISTANCE BET. BET. MAIN & MAIN SLOGS, ACCESS BLD VAR. # DATE C.U.P.# APPROVED ,/� APPROVED of Q) A L) 7 11 J m m TAX SO. FT. o THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION ' m ®� PERMIT FEE $ N m l— $ 500 PLAN CHECK $ E 0 4r TOTAL FEE $ (✓ OWNER HARGRAVE, RICHARD DATE 7-21-70 JOB ADDRESS 1787 New Hampshire BUIL NG PERMIT NO.32084 GENERAL CONTRACTOR Maddux f Const. DESCRIPTION of WORK Ac len to Res. AP No. LOT 61 TRACT 66 FIRE ZONE VALUE $ 1 INSPECTIONS Si nature Date GROUP TYPE ZONE GAIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number $i nature WATER P umbin ROUGH PLUMBING ' PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING 7 Heotin and Vent. TRENCHES FORMS STEEL REINF. L• /� tY FLOOR SYSTEM BOND BEAM STEEL REINFORCE Lj SHEATHING 8 FRAME AND FLASHING D LATHING — IN OUT n /V Tp PLASTER, BROWN COAT STRUCTURAL, FINAL ti HEATING, VENT., REFRIG. AND A.C., FINAL — (� PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL-13— BUILDING, FINAL -7�' z z a U J CL a a 0 F- W W Z _0 H U cc H N Z 82084 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 926261 111.21-70P001959* ****21.00 f -M$ � r APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI D �a/7E% 7� iC65 DATE ISSUED —2���� BUILDING .I ADDRESS 1 L—tti (1.�Lti Srlll�i`� PERMIT N . OWNER IC ,&iue 2 �J..- A.P. NO. +�^ 3'LO MAIL BUILDING _ /.. ADDRESS S.dME ADDRESS �iLl1�( TEL.,- Oim �j' clry epSTA t�cS.et No. �/S-3fli� TRACT LOT BLOCK CONSTRUCTION W ADD A P — LENDER U d -I17 - BRANCH BRANCH OWNER ADDRESS VALUE USE - $ ARCHITECT TEL. OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR p� QOS. CaJN :ol% BY DATE JJ/I ADDRESS lV (aL2 13oAC4 fl -W 7 TEL. ZON NO. OF USE OF.NEW PLANS BUILDING CITY Lt�cS7 h•[ I rJ I ST�rZ NO. dj%�`hrj rJ STATE CITY YARDS APPROVED YARDS APPROVED U0. No.LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. USE OF s e EXISTING BLDG, IhICoLC FAMI L. R. SIDE FT. FT. SIZE OF NO. OF NEW BLDG. ROOMS STORIES L. SIDE O FT. FT. EXTERIOR WALL ROOF NUT MON COVERING STi%CCO COVERING REAR T. / FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLDGS. 0C,j ^ A'DOi T IOy) VAR. * DATE C.U.P.# APPROVED APP OVDATE O I hereby acknowledge that I have read this application and state /f -�L•/ that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of If Vm the State of California, I hereby certify that I am properly licensed as a contractor under SO. FT. �a 0 THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Div IsIcn 3, Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. VALUATION ` W BV' PERMIT FEE $ / r a"(I N ] PLAN CHECK $ / r" r/ Signature of r MADDOX t32o< C -4S7 Permittee �• S � �O m E p LL �f Authorized Agent �„/1 " TOTAL FEE $ r