HomeMy WebLinkAbout483 OGLE ST - Building Permits- ,.
(714) 754-5273 • Fau (714) 754-4856 • www.c�.costa-mesa.c�ILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 4H$ OGLEST
Suite:
Vicinity: RES AND ATTACHED GARAGE
Primary Occ: R3 Dwellings/ Cong Res <10 Type of Conslruction: V-N
Parcel Number: 42515215 Zoning:
Appliwnt: GARCIA, FRANK
Address: 21687 IMPALA LN
HUNTINGTON BEACH, CA
Owner: DAVISON, BRIAN W
Address 483 OGLE ST " �
COSTA MESA, CA �
Contractor. .COAST ROOFING
Address: 21681 IMPALA LN
HUNTINGTON BEACH, CA
Zip: 92646 . �
Arch :
Address:
2ip:
Phone:
License:'
Status: ISSUED
Applied: 10/O6/2006
Issued: 10/062006
Phone: 714-968-8754 ISSUED BY: I�� 1✓
Zip: 92646
Phone:
Zip: 926 �' � �
Phone: 714-968-8754
License: 450393
Eng:
�Address:
Phone:
License:
SCOPE OF PERMIT
TEAR OFF SHAKE ROOF. INSTALL SHEATHING AND COVER WITH 30 YR TIMBERLINE COMP SHINGLES. INCLUDES RESIDENCE AND
ATTACHED GARAGE
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$139.25
$0.61
$0.00
$0.00
$0.00
$139.86
SETBACKS
MAIN STRUCTURE Front 0. 0
` ACCESSORY Front 0-0
PARKING . � , - Existina:.,- a ,
� � _>
Rear
Rear
Reauired:
FEESUMMARY
PLANNING & ZONING
0- 0 left 0- 0 �-
0- 0 Left 0- 0
0 Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0-0
�
$6,090.00
56,090.00
NOTICE: The work authorized by this permit shall comply with all applirabla handicap access requirements under California statutes and related
regulations. (OM. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become voitl 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
raqulred inepectlona end 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
r-
WORKERS'COMPENSAnONDECLARAnON: �
I hereby eXirm untler penelly ot perJury one ot tne following declarations:
❑ I heve end will meinteln e certllicete oi wnsent to sell-Insure for warkers' compensetlon, es provided lor Cy section 3700 of the Lebor Cotle, lor the pertortnance oi the
�work for whlch tMs permit Is Issuetl.
I have and will m intain workers' compe tion insurence. as required by sectlon 3700 af tha Lebor Cotle, for the peAortnance of ilie work for which Nis pertnit is Issuetl.
My workers��er{setion In/p-arance rtler and policy number ere:
Carrier. � 1� TU Policy Number. �% ����i7 _%O £i �
(Tiiis sect/on need nof be crompl !ed il fhe rm/f is valued et one hundred dallers ($100) or Iess.J . �� °
❑ I certiy thel in the pertortnenc i Ihe ork for w this pertnit is issued, I shall not employ eny person in eny manner so as to become subjed to the workers'
compensation lews oi Celif ia, egree th I shoultl bacome su6�ect to the workers' compensation provislons o� Sectlon 3700 of the Lebor Code, I shall forihwlth
comply with t�ese provis n. p^(
Applicent SigneNre: Dete: I�^i ��'� l_J�e
WARNING: FAILURE TO SECU WORKERS' C/JAIPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYEii TO CRIMINAL PENALTIES AND CIVIL NES UP TOIXJE HUNDPED
THOUSAND DOLLARE �$100,000), IN ADDITIpJ TO THE dJST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIdJ 3]OB OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
LICENSEDCONTRACTORS DECLARATION:
I hereby aHirm thet I em
force antl ettect. Lic. p_
Conirecro/s Signeture:
9(commencing with Sectlon 7000) oi Division 3 of the Business and
Class k �` '
oeca:
Code, and my license is in full
CONSTRUCTON LENDING AGENCV:
❑ I hereby aitirm thet thera is a cons�ruction lentling agency for the performance ot Ihe work for which ihis parmit is issuetl. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Atltlress:
SigneWre: Date:
OWNER•BUILDER DECLARATIONS:
I hereby aHirm t�et untler penelry of per�ury Ihet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry ar counry which requires a permit to consiruct, elter, Improve, demolish, or repair any siructure, prior to its Issuance, also requires Ihe applicant for such pertnii
to tile a signed statement thet he or she is Iicensed pursuant to the provisions ol the Conirectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the
eusineu end Pmteulons Code) or thet he or she is exempt tharefrom end the besis tor tha ellaged exemptian. Any violetlon of Section 7031.5 by any applicant for e pertnit
subjects the applicant to a civil penalry cf noI mora t�en live hundred dollaro ($500)J:
❑ I, es owner oi Ihe properry, or my employees with wages es iheir sole compensatlon, WILL DO TME WORK, antl Ihe struciure is no[ intentletl or oHerad lor sale (Sec.
7044, Business and Profeuions Code: The Contractors License Law tloes not apply to en owner of properry who builds or improves thereon, and who does such work
himsetl or hersell or through his or her own employees, provitled that such improvements are not intendetl or oHered tor sale. If, however, the building or improvement is
soltl wit�in one year ol completion, the owner�buildar will have the 6urtlen of proving that he or she tlid not build or improve for purpose of sale.).
❑ I, as ownar oi tha properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Professions
Code: The contradors License Lew does not epply to an owner of property w�o builAs or Improves Ihereon, and who coniracts for such pmjea with e contractoqs)
IiCenSe pur5uan� �o the Conlrectors Licanse Lews.).
❑ I am ezempt under sec. Business antl Profeuions Code lor ihis reason:
Signa�ure: Dale:
Owner ID veritiad by drivers license. ❑ Yes ❑ No Drivels License No.
Venfication of Ownership 6y (type oi daument, i.e. - property taz bill or tleetl):
Eapires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICATION:
❑ I hereby certity ihat no excavation five (5) or more feet in Oepi� into which a person is required to descend, will be matle in connection with work authorizetl by ihls
permiL antl �hat no building structure, scaHolding, lelsework, or tlemolltlon or dismantling thereoi, will be more then thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celllomfa Adminisiretive Cotle).
❑ As owneo-builder, I will not employ enyone lo do work which woultl require a permit from Ihe Division ot Industnal Safety, as noted above, unleu such person hes e
permil �o do such work irom the division.
Signatwe: Date:
DiviSion of Indusirial SBtary Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OP EMRY: I certify under penalry ot perjury ihat I have read ihis epplicalion and state iha� the iniormation given is
wrtect I egree to compty wlth ell state antl ciry or0lnances relating to �uiltling construction, end authorize representatives of the Ciry ot Costa Mesa ro enter upon the
ebove-descnbetl property for inspecti puryoses. I ag�not to occupy or allow occupancy ot any building authorized by this permit until Bnal inspection.
COUE I, INSPECTONTYPE
1616 Fized System Finel Fire Prevenilon
1266 Pool Spe Final
200 Finel Re-Roof
201 Finel BIxWRetelning Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
�
8 T
/a— �'e ��
Daie '
COUE I INSPECTION TYPE
206 Final Methanical
208 Final Plumbing
210 Finel Eletlrical
212 Finel Fire Prevention
220 Final Planning Appro"al
222 Final Si�e .
250 Final BuildinyOccupancy
�
�
.�m_ :
- ��1C=3�� l / �OSL-'=27='^.R2C L�RC=�rc � �
.. �EPORT OF INSP�CTION C� Masonry\ ( ) =ireproo. � )
� Gunite j`J ) ReinforcinglSteel ( )
�35L T0: �5�� ni�'':x� --- -
Address
vUNER: `� �'(��5� "
PROJECT: �j(Jq Report No.
Address: �Q?� �� Permi t No.�,(�j�_
Architect: ���IprYL�L t2�J� Contractor:5-k,.e��� �L�,�j
Address
Address:
Engineer: (�..(,.(�JT\5 Subcontractor: vlOV�i '—riT�w 1l
(Guni[e) '
Address: Masonry or
Il Concrete)
Inspector: _�Yl,_� S7T�^� Address:
'(�O.'(�x3`i�J`i 1'UI r�t, V .
Mi�c Used(�a �
Slump, inches:�
Admixture:-l�'
Designed Strength, P51:� ��
Lu.Yds. No. of
DATES Placed Cyls• Remarks
��� � s 5k����_ d.�T��+�, s�-�� c:t����e �
��
�wn�t-,ro,.+�i�x�, l� �.�,l� �I�� " cr.•�a c� ��:..�
�
C�V�.si�v RC 1i� fiivtr�,�.�.. Lr'ih
Copies of Reports to: (Indicate which Bldg. Oept. 6 furnish addross of any not listed)
� �
� �� -. J.?r�' 7� Ja�.f�'6i.��d�a'3c'� =i =�_
��- � �F
�``' �� 3310 Airport `Nay
(4� O Long BeaU, CA 90806
v.2 Z Mail: P.O. Box a7, 9080t
(213) 4263355 or 6362386
TESTING (714)828-6a32 FA7((213)a26-6a24
Comnression Test on Gunite
CUSTOMER: Sitter, Kax
P. O. Box 3454
Fullerton, CA 9263?
JOB NAME
G!�)�1.��Y�
Soa
483 Ogle
Costa Mesa, CA
,': -=' -. _: �. _ ,_.
_;
7514�D North SuSan SVee[
Sama Ana. CA 92703
(71a) SSa-26a5
FAX (77a) 554-a960
ERAM NO:
DATE:
JOB NO:
PERMZT N0:
OSH PD:
OS� AP �:
FZLE �:
PAGE i:
89-1-600901
O1/19/89
90??9203
1
ARCHITECT: CONTRACTOR:
Stonec:eek ?oa:s Stonecreek Poals
?NGZNHER: SDBCON�RACTOR:
3. C. Adams Vern Anthony Gunite, Inc.
--------------------------------------------------------------------------------
SAMPLE FROM: Soa - Cvllnders #3  "HELD IN FIELD"
MZX: 4.2-? SPBC. STR. (PSZ): 2000 SLIIMP_ 0 CaST: 01/10/89
--------------------------------------------------------------------------------
T�ATE TESTED O1/19/89 9 DAY AV
SPECIMEN YO 2
AGE {DAYS) 9
TOTAL LOAD (LBS) 48000
LBS PER SQ IN 2770
SPECIMEN SN.APE: Cylinder SIZE: 4.700 x 9.400
----------------------------------------------------
COMPLZANCE: 9-Day tesr..compli'es� with_ specifi'ed, strength:.. r.
SPECIMENS BY: Don DHLIVERED BY: Max
-----------------------------------------------------
DISTRZBUTIONS: '
Sitter, Max, 3
�esta Mesa Deot. of Building & Safety, 1.
�
2770
AREA/SQ ZN: 17.35
-------------------------
RECHIVED OH: O1/17/89
-------------------------
��--��/.�
Lloyd E. Suehiro
%lL RECONTS -AE SUBM�TiEO a5 :ME CONFIDENiIaL �AO�ESTY Oc CLIE4i5. :UiHORIZPiION �OR OUBUCSTICN OF Ol1R REGORTS.'CONCI'JSIONS. OP ESTRACTS FROM OP
REWADu+G'�+E!n i5 �ESE9VE^ �°'+OwG OUA'h'P�TT�.V aooepy�� .S = MUTV>l ��0'OC'i0'� '0 CLiENiS i�E �UBUC =N0 OUASElvES
\1
.,_ `✓� �."'�� -C� \ - Applicant to lill in ali spaces�eacept those within heavy eortler lines ana si9n all aDP�oo��ate tleclarations.
'k COSTa,��q �Oj�l$T�UCTION PER
Address a� �p�� �
.nt's Mailiyyynyyy9 Apppddress � a � � �
Nam�b"rn�S' eyNaLDS p�„
._ a �� e
Arch/Eng. � �''4��m5 J,x� enseNo. ����3
Adtlress ��D�Y �/P ' •6'"�OVe-
Con[ractor's Nam ' QC CC,r s�S phone 7� ��
Addresslmailingl--�-�Od/ q�-(�G7lpIQ ��W'�
Ciry License No. � 1 7S l
LICENSED CONTRACTOR DECLARATION
1�hereby aHi�m thal 1 am licensetl untler provi5ion5 of Charter 9(comm¢nCin9
with section 7000) of Divislon 3 ot the Business antl Professlons Code, antl
my license is in tull force antl effect. �G�Oa O
License Class Licen No /
oateL3- L - £B 5iqnature
'OHKERS' COM7ENSHTION DECIARATION
�ereby atfirm that 1 hdvC a certifi[ate of cOn52nt t0 zel(-inSure or a corti(Icate
of Worker5' Compen5ation Insurance, o� a certi(ied copy the�eot (Section
3800, Lab. %) 2'_ c n /
Policy No. SR_��—G1a51�� Gomparry�7�%�Pr�E�'r �/'6a[5
eCertitietl mpy Is nereby furnisnetl. �
Cerji)ietl codyi iile0 with [he city Hui tlin9 Oi ision. v
�ate //�I � � � qppljcant �// T � = f Ii..�/
E%EMPTION�FROM WORKERS' COMPENSATION DECLARATI N
(Thi51¢Ction neetl,not be Completetl If Ihe permit i5 far one huntl�etl ($300) or
less).
I certify Ihat In the performance of (M1e work tonwhich thls perm�t is lssuetl I
shall not ¢mploy any person in any manner so� as to becoma subject to lhe
Workers' Compensatlun Laws of Califomia.
DatB Signatu/¢
'NOTICE: If, aiter making thls tleclaration, you shoultl become subjeot to the
Workers' ComOensatlon provislons of [he Labor Cotle, you must torthwith
comply wilb such pwvisions o� [nIs permit shall be tl¢emetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby aHirm that there is a consV uction lentling agency tor the pertormance
ot Ine wOrk tor whith thi5 permit i5 i55uetl (Sectlon 3097 Civ. CJ
Lender's Name
Lentler's Atltlress
OWNE�,BUILOEN bECLARATIOIJ .
I hereby aftirm tha[ I am exempt from the Contractor'S License tdw for the
followiny reason (Section 7031.5 Businesz antl Professional COGa: Any city or
munty wnlcM1 requires a permit to construc[, alte�, improve, tlemoli5h Or repair
any stru[ture, priOr t0 Its lisuance, alzo �equires [he applicant f0/ suth pe�mit
b file a sianetl sta[ement that he/She is licensetl pu�suant to the 0/ovisions Of
�e Contractor's License Law (Cnapter 9(commencing with Section 7000) of
:vision 3 oi the Business antl Professions Cotle) or that he/she is exemp[
.nerefrom antl Ihe ba5is t0/ [he allegetl ex¢mption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of not more than five huntlretl tlollarz (E500).
I, as ownnr of tne proper[y or my�employees with wages as [heir sole
� compensalion, will tlo tha wo�k, antl the st�ucture is not inlentletl or off¢retl
for sale (Section �OM14, Business anG Protessional Cotle: Thn Contractor's
License Law tloes not apply to an owner of a properry wM10 builds or improves
thereon, and who tloes sucn work hlmself/herselt or through hls or her own
em0loyeeS, PrOvitletl [hat such improvemen[s are not intentlutl Or otteretl fo�
sale. If, howaver, the bulltling or improvement is soltl wlthin one year of com-
pletion, the owncr wlll have Iha bu�tlen of proving'h¢/she tlitl nol builtl o� Im-
prove for the purposa of SaIC).
❑ I, as ownm of tM1e property, am exclusively contracting witn licensetl con-
tracton to wnstruct the project (5ection ]044, Busine55 antl Protes51on5 Cotle:
The Contractor's Llcense Law does not apply to an owne� of property who
bulltls or Improves tnereon, antl who contracis tor such projects with a con-
tractor�51 liconse pursuant to the Contrac[o�'s License Law). I am aware that
prool o� thei� Wo�ker's Compen5alion.insurance shoultl be prOvitletl to me.
❑ I am exempt untler $ectlon �' 8.�& P. C, for tbis rea5on
Date Owner ' �
I hereby certity tM1at I have rcatl this application antl stale that tM1e above
intormation is correcL I agree to comply'with all city antl county ortllnances
antl state i5ws relatin9 �o builtlin9�constructlon, antl hereby authorize repre-
sentativez oi this <ily to enter upon the above-mentlonea property'Ipr
inspection purposqs/ ,/ ppp��I '''���
Si9nature� `ZR.Ca.
� �� i 3a � y ��
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR —
❑ CONVERSION ❑ OEMOLISH ❑ OTHER A p �
DESCflIPTION OF WOFK/USE OF BLDG. � �'TG2` S
'
TVPE OF PE�GRADING FOUNDATION STRUCTURAL T Front '�% .�
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - B Rear �� I
❑ ATHER �P � A � , .
PROJECT DESCRIPTION 5� � oCCUPANCY '—�3 K Right
CONSTRVCTInNTvaF_�.�� _ VALUATION$ S Left �
ZONE GRADING GU. VDS. ACRES Ping. ReL #
Remarks: �' ���,Q's{a, PlanningNotes: �
Sink
1
Drinking Fountains
Floor Orains
Floor Sinks -
Gas Service - Outlets
Interceptors�
Kitchen Sink'
Lavarories
Root Drains
Reinspaction Fee � $15
Boiler
Duct-UnderGround
Duct - Structural
Duct � Ventilating
Exhaust System � Multiple
Firepl/Pact.6lt. IC80 # '
Heating System & Ducting
❑0-100,000 BTU 0100,000
1'.
Reinspectian Fee � $15
CMF 0865�46, rev. 10/84 White - Builtling; Canary - Applicant: Pink - Accountlng; Goltlenrotl - Assessor
FEES
Showers •
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors �
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
4Vater Heater
Warer Service
Auto�Wash
Issue Fee . � $ 3
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration Sys[em �
❑aioo,000aru ❑ioo,000er
System Repair/Alteration �
Fire Dempers
Registers
laue Fee
_ ^/ SZ —
Accessory Building:
ELECTRICAL
Automatic Washer Transformer ❑ 15�50 KW
Construc[ionPoleSub. ' �50+KW
Cooking Unit •
Dishwasher � �
Dryers ❑Gas ❑Electric
Fan.
F.A+LI.
Fixtures
DeA�Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW �5�15 KW
Zone
Meter IJup ro 100 amps
Meter ❑over 100 amps
Sub Panel
Momrs�0-1 HP �1'h-8
Inc.Solar 09�75 HP �16-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Tresh Compactor
Fee $15 Issue Fee
FEES
�. DEVELOPMENTSERVICESREQUIREMENTS:
� Zonin9 APProvad BY .
euilding Approved By �
Aonliwtion luued Bv
FEES
�
Z
O
N
I
N
G
R
E
0
T
$
SUMMARV OF FEES
BUILDING PERMIT $ '�Z�-N SMIP � $ �
PLAN CHECK $ ' PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENEFGY P.C. S
ELECTRICAL 5 —� ��� GRADING S
PLAN CHECK 50% $ / MICROFILM S
.[�QECHANICAL $ ' Z�p � TOTAL FEE S
PLAN CHECK 25% $ - __ . _
L�% � :�/L?/ov tTi�.�.� 1: .
JCTION AND PLANNING
. VALS Permit #
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd.
3.�Electrical Conduit Utility-Undrgrnd.
4:'Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6.��Electrical UFER Grnd.
7:'Footings
8. Fou�datio�
9. Water Pipe�Undrgrnd.
10. Structural Floor System
11. Property Sewer Line & House Connection
12. Sewer Cap
13. floof Drains
14. Rough Plumbing
15. Rough Elecvical-Conduit
16.-Rough Electric Wiring
17.: Rough Wiring Sign
18. -Rough Electrical-T Bar Ceiling
19. �Rough Heatin9 & Air Condi2ioning
20'�Rough Factory Fireplace '
21. Ducts, in Structure y,,_
22. Ducts, Ventilating . �
23. Gas Pipe-Rough & Test� �
24. Roof Framing � '
25. Roof Sheathing �
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing ' �
31. Plaster Brown Coat ;�
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or CanoPY
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
o. Date
Date
PC 9 SPA
Inspector AppROVALS Permit#
52. Pool &�EquipTent Location �
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test �
60. Backwash Lines, P-Trap, O Undrgrnd.
�.:
Date
!SI
t(
Inspector
L:�J
61. APPROVALTODECK 3 �'�j' ��
62. Backwash & Receptor-Final �-
63. Heater & Vent-Final ,3�
64. Plumbing System - Final 3
65. Electrical-Final -
66. Solar System-Final
67. Fencing & Access Approval 3
68. APPROVED FOR PLASTERING �j
69. POOL/SPASYSTEMSFINAL
FIqE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground HYdro
71. Product Piping � Gas ❑ Oil
72. Underground Flush �
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe '
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
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I
�`OWNER GERONIl�LL, LYN C. DATE (-30-69
�70B ADDRESS lyg3 �le Street BUILDING PERMIT N0. 3ply(�
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j(1]��7
JUP Z TYPE
SUBCONTRACTOR
UNDERGROUND U POWER U
ROU6H WIRING
TRENCHES FORMS �] ST
FLOOR SYSTEM �
00N� BEAM ❑ STEEL REINF
SXEATHING
FRAME ANO F�ASMING
LATHING — IN /J�[ OUT �-
Pl -,R, BROWN COAT
Sl. lURAL,FINAL
HEATING, VENT., REFRIG. ANO A
PLUMBING, FINAL FND GAS TEST
ELECTFIC, FINFL
BUILOING, FINA4
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4- U
Z
Za
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am
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aw
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COSTA MESA BUILDING•SAFETV DEPARTMENT
P.O. BOX 1200 C05TA MESA, CALIFORNIA 92626
For Applicarlt to Fill in Completely
BUILDING y�3 ��e S �e�-�
ADDRESS
OWNER4�/n �� Geron iw, ir
ADDRESS 7�� ORII'P ��I���''—I �/
CITV( "��-/�G /�IPS�P N01. (pr�'�J
BRANCH SO-N�t T7/�(0.
ADDRESS
ARCNITECT ��N�.�Qy..v TELS�S �
OR ENGINEER NO.
ADDRESS 3 J� �Y eS ��10 �y. �`� I� ,
CONTRACTOR OW�Qi ,�(�I I�Q�—
AODRESS�3 �� ��V�E.�+
TEI.
cirv L,CSklA �t�sq No.bYb�bSS
STATE CITV ,
IIC. NO. LIC. NO.
SI2E / O v I O Z, 3 � NO.OF BIDGS. I
OF LOT1e �� � NOW ON LOT
USE OF Des � �e„�.Q
EXISTING BLDG. ��
SIZE OF � �� �. /` /_ NO. OF 2
ROOMS STORIE:
ROOF
COVERING S a k e
KTO BE PERFOF7MED
I heraby ecknawlatlpe lhei � heva reatl this applleation entl Rete
thet tha ebova InformetioN b corract entl eprea to comply with
ell lews re9ulatlnp builtlinp conttruction, and I shall not amploy
eny per�on In violatlon of Me workmen'� compantetion lew� of
Me Steta of Celifornie.
I hareby certlfy theT 1 am propefly IICanMd es e contrector untler
tha Smte ot Cellfornie Bu�i�ass antl Prof�wion� Cotl�, Dlvi�icn 3,
Chepter 9, antl et ch Iic�nra era In f�ll forc� antl �tf�ct, or I
em exempt }ro provif�On� of the Stata of CelifOrnla Businea
entl Profa�a/jon� C a, D�lo� h tar 9. ^
Sipnature 1 ` `J
ParmlHae
Authorizatl A9Bnt '
JUN 30-69PA'�003052¢ ****61.50
CN50.
APVLICATION FOR BUILDING PERMIT
A.P. NO.
BUILDING
ADDRESS
3z7
FIRE�-i
ZONE
APPROVED
r�
VARDS
MAIN
OISTANCEi
MAIN BLOC
VAR. vi'+
QU.G. �b
APPROVED
� J V N �
� VALUE j(' 0
$ �J
T/VPE FOUPJ��
% DATE (o_ ���
/
F USE OF NEW
BUII�ING `,'L
ED VARDSAPPROVED
BET. MAIN &
(O S6 SQ. FL + .
THE AMOUNTSMOWN UNDER V
THE GVRVO6E OF ESTABLISMING A
VA�VATION
Q� PERMR FEE
$ g �9a PLAN CMECK
/
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0
4TION IS FOR
�R FEE ONLY: ¢
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OWNER K. W.
JOB ADDRESS L�$j (
GENBRAL CONTRACTOR
AP. No. LOT I�
GpnUP I & J
I._ _rECTIONS
x. w, xou _
RacT 3279 Fu� zoxe
PE V ZONE
DATE
./ /
�%�'� �Si
!e-Rod
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—.5—
VAL[lE
OF WORK F
PLAN NO.
SUBCONTRACTOR I DATE NUMBER
J.. :
. . �a�6`7
. ;'
• COSTA ME5A BUILDING DEPARTMENT
P. O. 80% 31 �
COSTA MESA, CALIFORNIA
FOR ApPLICANT TO FILL IN
C05TA MESA. CALIFORNIA
OWNER
ADDRE55 ��� 1� V �
CITY,�'y� TNO/a��
AftC :T� LIC.
OR E. NEER NO.
ADDRE55
t I n UTV UG � �
CONTRACTOq yJ O L NO.
TEL.
LEGRL LOT . '
oEscniviioN NO. B�OCK TRACT�
A.P. NO. 4 �%�j'�
SIZE � y � No.ov e�ocs.
OF LOT �0 /� � d(� Now orv �01
USE OF
EXISTING BLOG. �
SETBACH LINE FPOM I
CENTER OF STFEET REAR YARO
r
SIOE YARO �RIGHT � LEFT
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BUILDING �r. �( l NO.OF
SIZE O /�.] ROOMS STORIES
�COVERIINGWALL r/�-ST ROOF C /��/
� COVERiNG e� �
USE OF NEW � ,��' Q � i _ _, _ �
1
���E rtLl�6.�1�L9J
�i,�s-s� ��-
FINANCE DEPT.
APPLICATIO$NAFOSR PERMIT
BUILDING
FOR OFFICE USE ONLY
FIRE
ZONE
BY
COSTA MESA. CALIFORNIA
\ �/
pl�n�� DATE �
CORRECTIONS
SUBJECT TO 8�-Q'G. DEPT.
T
�
� " -�� K /G // � _
I MEREBV ACNNOWI.E GE THPT I MiVE RE4O TMIS APPLICFTION 4NO �j
STATE TMAT THE ABOVE IS CORRECT RNO AGFEE TO COMPLT WITX AlL �LLO � .�
CITV OROINqNCES I�NO 6TPTE LnNS REGVLATING BUILDIN6 CONSTRUC- � 7
TiON. VALUATI ON
SIGNATURE � PEFMIT FEE $ O�
PERMITTEE O
� $/J/ �/� PLANCHECK S 600
J �p
AUTHORIZED GENT TOTAL FEE $ � �
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