HomeMy WebLinkAbout1792 ORIOLE DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c8UILDING PERMIT
Job Address: 1792 ORIOLE DR
Suite:
Vicinity:
Parcel Number:
13962225
Zoning:
R1 R1
Applicant:
CALKINS, JOANNE
SMIP Com:
$0.00
Address:
1806 ORIOLE DR
Inspection:
$0.00
Phone:
714-556-0993
COSTA MESA, CA -
Zip:
92626
Owner:
DEFFNER, DALE I
Address
1792 ORIOLE DR
-
- Phone:
COSTA MESA, CA
Zip:
92626
Contractor:
Address:
Phone:
Zip: License:
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status:
ISSUED
Applied:
07/23/2003
Issued:
07/24/2003
Arch : 1. 1 Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
ADD A PEAKED ROOF ON TOP OF THE -GARAGE. MAXIMUMHEIGHTIS 20 FEET. FRONT SETBACK WILL REMAIN UNCHANGED.
Plan Check:
$63.21
Permit:
$97.25
SMIP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $160.96
SETBACKS
MAIN STRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existing: 0
NOTES:
Rear 0-0
Rear 0-0
Required: 0
FEE SUMMARY
Calc Valuation: $4,000.00
Claim Valuation: $4,000.00
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right 0-0
Proposed: 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
?44646 (6100)
N
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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' co a ca::
insurance, as be r antl by section 3700 of the Labor Cade, for the penonnanca of the yiod for which this permit Is issued.
I h workers' compeny`nw rs' com ca d icy number are:
Carrier: L 7LJ1 V Policy Number:
(This section need not b -LompleWi/ the pa it is valued at one hundred dollars ($100,1 D; less.)
nity 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 I sof California, and agree that it I should become subject to the workers' compensation provisions of Sect 3700fphe Labor Code, I shell forthwith
comply with ase rovisions. - �2 �
.ApplicenbSignat is: - Date: _
WARNING: FAICOR ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL FINES UP TO ONE HUNDRED
THOUSAND S100,000), INADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OFTHE LABOR CODE, INTEREST, ANDATTORNEY'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. Uc. N Class x
Contractor's Signature: 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).
Lenders Name: Lenders 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
Vsubje 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.
77044, 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 awn 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
Cade: 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 contractors)
licens ursuant to the Contractors License Laws.).
�]_I.am axe pt nder sec. Business and Professions Code for this reason:
Signptme Date:
Owns D v died by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Vent n of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 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, or demolition or dismantling thereof, will be more than thirty-six (36) teat 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.
Signature: Date:
Division of Industrial Safety Permit Number:
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 Cade requires, with some exceptions, that a Business Plan he 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 2DO 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 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 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
....._........._.............. .........._............ __......... _.......................................................... ........................................................................................................................................... .................................................... ....................................... I.................
5 Does or will the applicant or present Or future building occupant require for the work which is the subject of this a plication a�ereit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 Of the California Government Cade requires that the requested information be furnished on applications for non-residential building permits).
....................................................................................................................................................................................................................................... __.......................................... ............................ ............................... 8 Will an an of the tacili to be constructed under this permit be within 1000 feet from the outer boundaries of a school?
y p ry p ❑Yes ❑ No
(If yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
....................................... ............. _.......... _................... _........................................................................................................._...................................................................................-.................................................................
7 It 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 (It 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. 1 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 refresentativep of the City of Costa Mesa to enter upon the
above-dogErNed property for inspec ion p rpcses. ree not to cupy or allow Occupancy of any buildingn tl p r u final inspection.
f Signature Of Legal Owner(s)J =bate
, And/Or Authorized Applicant Date
CODED. INSPECTION TYPE QSL INITIALS CODE If INSPECnomTYPE PAIL INTMAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site u+
204 Final Demolition 250 Final Building/Occupancy
aTU
DECLARATION OF AUTHORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
Bldg. Permit#
This Permit #
Street Address: ` V�y V- �S� V ��� AP Number:
ak F a��
I (we) � t� �p declare that I am the Owner of Title of the above
referenced real property, and that I (we) hereby authorize:
u p - 5Y �
"Flame: ��[:� 11i1[,% in�l° /�-5 Telephone Number:? Y
street Address:
qty: O r,� o / I ESA tate: 0 tq • Zip: 92 &-16
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. 1 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. 1 declare under the penalty of perjury that the foregoing is true and correct.
Executed this 2' � day of Tv20 O ?:> , at
k �r
Print Name: � C�, 9-^ _ Q Qom`
Signature:
j 2 '1j v v
Date: �1
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.
077946 (rev. 11/00)
.California.
✓«' A�, OWNER -BUILDER
vUr VERIFICATION
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: t
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.
I. I personally plan to provide the maipr labor and materials for construction of the proposed
property improvement.-[] YeSA No
2. 1 (havelhave not) signed an application for a building permit for
the proposed work.
3. 1 have contracted with the following person (firm) to provide.the proposed construction:
Name
Address City
Phone ( ) Contractor's Lic. No.
40 1 plan to -provide portions of the work, but [.have hired the following person to coordinate,
supervise and provide the major work:
Name r_Jt&,i4 O • eiq LKrftl5
Address 100& 091 OLE DR. City C,/Yl
Phone (f/y ) 5756-0!293 Contractor's Lic. No.0
5. 1 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
100206 (REV. 9M)
4 CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
J+� PERMIT PERMIT NUMBER /'
rV/
B98-01905
(714) 754-5273 Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
,lob Address: 1792 ORIOLE DR Status: ISSUED
elf)
Suite: Applied: 10/21/1998
Vicinity: Issued: 10/21/1998
ParcelNunmber:
13962225
Zoning:
R9 R1
Applicant:
FRAME, CRAIG
Address:
Phone:
y,.
Zip:
Zip:
Owner:
DEFFNER,'; DALE I
Address
DEFFNER, KAREN L
i
COSTA MESA,CA �.��
- Phone:
/11792
ORIOLE DR
- Zip:
92626
Contractor:
FRAME,ROOFING"
Address:
1542 SIERRA"ALTA
A� �
Phone:
714-730-0569����
SANTAANA, CA
Zip:
�.
92705 �>,. • _. � �
License"
661176
Arch / Eng
'
Address:'
-Phone r
r;
Zip:
- •-tom^,a ,,; j� ;A', "� 0
�.,V
License:
r 4 t,
SCOPE OF PERMIT V ��
,TIO EXISTING AND RESHEATH .
REROOF WITH 40 COMP. SHINGLE, ROOF, CERT ATTACHED.' k, ;
-
-$0.00
FEE SUMMARY A% �- !
//A/,,
Plan Check:
`
11„- ,
-CalcValuation: :' .. $s,000.00
i Permit:
` $99.75
—
-
"Claim Valuation: %' s5,000.00
SMIP Res`.
- - -
$0.50
1 ,
SMIPCom
$0.00
x•,$0.00
Other V
Inspection: "-
x$0:00
- ✓/
`Total
PLANNING &ZONING '
SETBACKS
MAIN STRUCTURE Front 0'0- Rear
= 0- 0
Left 0-0 Right
. : "
ACCESSORY
Front '0;0, Rear
0-0-
0-0 Right 0=01.%
,Left
PARKING
Existing: o Required:
0
Proposed: 0 =.
NOTES:
.
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.
IFOR INSPECTIONS CALL: (714) 754-5626
'DECLARATIONS --'N
WORKERS' COMPENSATION DECLARATION:
I hereby affirm und., penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate o1 consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the igpygrmance of the
work for which this permit is issued. 11
❑ 1 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 at one hundred dollars ($100) or less.)
❑ 1 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 18SZ
provision
Applicant Signature: ; v, Date: /CJ - Z/ ^ g`
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 Dd.LARE ($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 Code, and my license is in full
force and effect. LIC. # Class #
Contractor's Signature: Date:
Y
CONSTRUCTION LENDING AGENCY:
❑ 1 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).
Lenders Name: Lenders 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).):
❑ 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 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 contractors)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 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, 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 WIII 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 hoes 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 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).
..........................................................................................................................................................................................................................................................................I.........
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 a plication apeunit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Lj Yes U No
(Section 65850.2 of the Califomia Goverment Code requires that the requested information be furnished on applications for non-residential building permits).
...................................................to,b......'n'st.....................................................10,0,fe'-......,m''t........................................................... ..................................................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a schaal7 ❑Ves ❑ 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 (It 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
abolle-descdbe yroperty 1 'on purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signa ure Of Legal Owner s) Date
And/Or Authorized Applicant Date
ONA INSPECTION TYPE - gAIE It1®Al5 CODE l INSPECTONTYPE gs¢ INTITA�
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final� 208 Final Plumbing
200 Final Re -Root 210 Final Electrical
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
2446 4
O 2
2�= A10/
I
TESTING
TR
Laboratories 4outli.z,_ cld< -, ,,«2,
--- A
P.C. BOY 11 3110 AIFPO?T %%'PY TONG BEACH. OALIF. a0-01 ?13) 426-3355 X2111 636-2386. (714) 8286432
Ecn r1C- o.FlCES
., A,. C. ... 5)),,1 �` 215E Dae
1,A,ar0. E,.
,.I<i Sly 2,,,r
November 29, 1977 Examination
COMPRESSION TESTS ON GUNITE CYLINDERS
Mr. Errol F. Heesch
12921 Aspenwood Lane
Garden Grove, California 92640
PROJECT Pool for DAVID DAVIS
ADDRESS 1792 Oriole, Costa Mesa
SAMPLE FROM Gunite Swimming POOL
AR CM ITE CT
CONTRACTOR
Golden State
ENGINEER
SUBCONtRACTOR
Lou Bnnett
SPECIFIED
MIX
4} to 1
STRENGTH
DATE CAST
11-15-77
CYLINDER SIZE
DATE TESTED
11-25-77
11-25-77
CYLINDER NO.
1
2
COMPRESSION
10 -Day
10 -Day
TOTAL LOAD, LBS.
70,000
110,000
POUNDS PER 50, IN.
2,475
3,890
SIZE:
6"x12Et
6"x1211
COMPLIANCE
10 -Day test
complies with specifications.
MADE BY
DELIVERED BY
CYLINDERS
Lou
Heesch
DISTRIBUTION
E. F. Heesch - 2
Costa Mesa Bldg. Dept.
SC77-6554
2,000 psi
11-25-7
3
10 -Day
80,000
3,080
5-3/411 x 1211
RECEIVED ON
11-17-77
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. G %J g DATE -V/yLi,,��A/ 7Z
LOT N0, c--3-,5
ADDRESS
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
(he -she -they) 7-is'AeY (was or were) '&2E+Q4E 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.
Purchaser
Developer and/or auth razed
representative
BY L. A. F.F�A G
Lender
OWNER DAVIS,D, DATE 11-7-77
JOB ADDRESS1792 oriole Drive BUILDING PERMIT NO.
AP No. 119-622-P5 LOT TRACT FIRE ZONE VALUES 4-700_nn
p Pool Location -
Forms
C •
11-1
Main Drain
Steel Reinforce
Elec. Bond
Approval to Cover
e • C •
I V • i'
Underground Electric
Gas Piping Test
Filtering System Lines
Backwash Lines and Recap.
C"C•'
li _
Electrical Final
-•C...
II2
Heater and Vent Final
Filter System Final
Backwash and Recap. Final
C • C '
it --z
Fencing Final
12.f
SUBCONTRACTOR
Electric
bing
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9
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44981
PAID
OO 322* ****48.50
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1260 COSTA MESA, CALIFORNIA 92626
PIpC ION FOR STRUCPURAL PERMIT
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v..u.y.cac,•y —vac u,n vuay
RE DATE RECEIVEDQrrE
ISSUED
BUILDING % �/ I
ADDRESS
OWNER CL(Ji S
A.P. NO. /'J (.�
MAILBUILDING
ADDRESS �Q cJ
ADDRESS
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LOT BLOCK
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LENDER t44!7.J
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OWNER [/Fi
ADDRESS
VALUE
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ARCHITECT
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ADDRESS 2 �3 QC
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CONTRACTOR je J -lo ti
APPROVED
BY
DATE'
ADDRESS
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ZONE
NO.OF
USE OF NE
CITY
L elv, NO. Sag 6 E
PLANS
BUILDING JS
STATEt— J CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. �,S d LIG. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLDGS
(FROM C/LST REFT)�O
r
OF LOT
NOW ON LOT
FRONT FT.
CC l ,f¢.c+
USE OFt7
A
EXISTING BLDG. JeJ L0.('
T.
FT
Separate permits are required for
L
L. SI E v SFT.
FT.
electric, plumbing and heating work.
PEAR Ir FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS. SLOGS.
. 46
CURP,#
DATE
APPROVED
APPROVED
—
DATFZ/
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.
V SQ. FT.
I hereby certify that I am properly licensed as a contractor under
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
VALUATION
PERMIT FEE
and Professions Code, Division3, O pter 9.
O
r
S aQ
PLAN CHECK E ao[J
Signature of
TAX $ s (�
Permitteeb -
$ ®
Authorized Agent
TOTAL PAID $ S O
3360
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 _
v. For Applicant to Fill in Completely FIG .
BUILDING /
A DDRt SS
OWNER �J
MAIL 4
Z ADDRESS
W -W TEL.
d U CITY V61I7 oo/7 NO. 6a.-_
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< CONSTRUCTION -
O N LENDER
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J M BRANCH
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m ARCHITECT [� TE L; (�
J Q OR EN INFER . /7 N . O 7O 5
U N
W M ADDRESS a
d W
J Z CONTRACTOR
0D [
-- ADDRI: el D�
SEP 1.7 i�AILGG 3Ji,. ***201 G
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APPLICATION FOR BUILDING PERMIT
'FIVE BV DATE RECEIVED DATE ISSU
I -7l SEP 14 1
PE RWJ72jt6
ADDRESS / / ?r5? (1//S/MI�J ✓II .S I.
FIRE
SS
TEL.
Z
NO. OF 2,_USE
PLANSBUILDING
OF NE
CITY ,NO.syp
YARDS APPROVFr
STATE CITY ARDS APPROVED'.
LIC. NO, L�� - - LIC. NO. � p
MAIN BUILDING
ACCESSORY BVI ING
(FROM C/L6T{3FTT)
//L�
-DIF LO7O0 oX1j0 NO NOWONLOTS
FRONT S
(�
FT.
USE OF17
EXISTING BLDG. -
S E
FT.
FT.
SIZE OFNO. OF
y 6 b '
2-.
NEW B DG. ROOMS STORIES
L. SIDE
FT.
FT,
EXTERIOR WALI�•�
ROOF
COVERING �.L.L{-c-O
COVERINGREAR
p(
FT.
FT.
USE -OB BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
SET. MAIN &
MAIN BLOGS.
ACCESS. SLOGS.
VAR.#
DATE
/
C.U.P.+
APPROVED
APPROVED
LVnf,w`
a'^
I hereby acknowledge that I have read this application and state
that the above informationis correct and agree to comply with
c
SPEC�
At
all law: regulating building construction, and I shall not employ
- `-
any person in violation of the workman's compensation laws of
y the State of California. b
z I hereby certify that I am properly licensed as a contractor under SQ. FT,
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 'm
am exempt fr the or vision Pf the State of California Business
-Q.. VALUATION W ro
antl Pro" ;si ns ,ode, vision
Chapter 9. PERMIT FEE
Signature f %`( m
Perm ittee - % $ �/(% #A"6 PLAN CHECK $ )). E
Author ¢ Agent _
Al TOTAL FEE $r V/1 v-• LL