HomeMy WebLinkAbout1816 ORIOLE DR - Building Permits5� 9 CITY OF COSTA MESA
4 BUILDING DIVISION
0
F DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa' ffdf .DING PERMIT
Job Address: 1816 ORIOLE DR
Suite:
Vicinity:
77 FAIR DRIVE, COSTA MESA, CA 92626
Status:
ISSUED
Applied:
05/05/2003
Issued:
05/05/2003
Parcel Number: 13960216 Zoning: R1 R1
Applicant: WHITNEY, ROBERT ISSUED BY:
Address: PO 15396 (01
Phone: (949) 548-0769
NEWPORT BEACH , CA Zip: 92659
Owner: HANSON, JANE E TR
Address 1816 ORIOLE DR
Phone:
COSTA MESA, CA" Zip: 92626
Contractor: WHITNEY ROOFING
Address: PO 15396
Phone: (949)548-0769
NEWPORTBEACH,CA
Zip: 92659 License: 406022 "
Arch Eng:
Address: Address:
Phone: - Phone:
Zip: License: , License:
SCOPE OF PERMIT
TEAR OFF SHAKES. COVER WITH MONIER TILE. -
FEE SUMMARY
Plan Check:
$0.00
Permit:
$209.25
SMIP Res:
$1.18
SMTP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$210.43
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0
Rear. 0-0 Left 0-0
ACCESSORY
Front 0-0
Rear 0-0 Left 0-0
PARKING
Existing: 0
Required: 0 Proposed: 0
NOTES:
Calc Valuation: $11,800.00
Claim Valuation: $11,800.00
Right 0-0
Right . 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2446.06(6/00)
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.
ave and will maintain workers' compensation insur. nce, 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 corner and p icy number are:
Carrier: I Policy Number:
(This section need not be completed if t p it is v ed of o hundred dollars ($100) or less.)
❑ I certify that in the performa of
t ork I which this p rmit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Cal mla, re at if I should ecome subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these prov' ons.
Applicant Signature: Date: �J
WARNING: FAILURE TO SECURE W ERS' COMPENSATION COVE GEIS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE Ist0o,0oo), INAD TPONTOTHECOST OF NSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATIO .
I hereby affirm that I am licensed under pr s' of /Cpter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Llc. # Class #
Contractors Signature: Dale:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affiml 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. It, 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.).
❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by divers 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:
❑ 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, 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 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 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 en RMPP is presently required, rias 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 a eit for such construction or motlificatlon
from the South Coast Air Qualify Management District or from any other air pollution control distract or agency? � Ves � rmNo
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
................................................................................................................................................................................................................................................_....-.......................................................................................................I............_.........
6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 Ouelity, agement 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 b California Health and Safety Code Section 42303 been made? ❑ yes ❑ No
.................................................. -.................................. ,............................... ................................. ......................................................... ........................................................................ .................................................................................................
attach certificate of compliance tram the ap opiate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that unde 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 AIITIO RI T10N O ENTAV: 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 1 s a city ordi nces relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspect rp as. I agre of to Occupy or allow Occupancy of any building authorized by this permit until final inspection.
Si ature Mr(s) Cto
And/Or Applicant J CJ Date
CODE 0. INSPECTION TYPE MR INTRIAL6 CODE 1 INSPECTION TYPE INITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final`y—"(1(}[��—� 208 Final Plumbing
200 Final Re-Roof v 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
TESTING
March 5, 1973
Laboratories of 1outfz-�z,2 cCLLLpini'l'
PO. BO) 42 . 33!0 Al,�C7L WAY . LONG SEAC'N., CAVE. 9DE01 . 12131 4203355 . (213 636.2386 . 11141 8286432
31 nY.C� : Ef CES
5—e I,, Geii ��
L A
n403 ?� 2055 �eE orm n.e.G0. 0o+V
C..J 4OP0! 12UI etc -]38e
Examination: SC73-1341
COMPRESSION TESTS ON GUNITE CYLINDERS
John R. Chambers
3443 Del Monte Drive #3
Anaheim, California 92804
PROJECT
ADDRESS
SAMPLE FROM
ARCHITECT
Irvine Pools
ENOINEER
J. P. Anderson
MIX
DATE CAST
DATE TESTED
CYLINDER NO.
Swimming Pool for LLOYD JOHNSON
1,816 Oriole Drive, Costa Mesa
#1 b IA - Deep end - #2 E 2A - Bond Beam -'#3 b 3A -°Shallow end
2-26-73
3-5-73
1
CONTRACTOR
Irvine Pools
SUBCONTRACTOR .
Grove Gunite Co.
SPECIFIED
STRENGTH
3-5-73
2
3-5-73
3
2,000 psi
1A"HOLD" 2A"HOLD'1 3A"HOLD11
COMPRESSION
7 -Day
7 -Day
7 -Day
. TOTAL LOAD, 16S.
102,000
103,500
82,000
POUNDS PER SO. IN.
3,610
3,810
2,900
CYLINDER SIZE:
611 x 12-1/2"
5-7/8" x 12-5/8"
611 x 12-3/811
COMPLIANCE
7 -Day test
complies wi-th specifications.
MADE BY
CYLINDERS J. Chambers
DELIVERED BY RECEIVED ON
J. Chambers 2-27-73
DISTRIBUTION:
Dept. of Bldg. s Safety BUILDING SAFETY DEPT,
55 Fair Drive, Costa Mesa 92626
Lloyd Johnson r R� 1973
12 ,tii
Irvine Pools
4301 Birch St. Newport Beach 92660
Grove Gunite Co.
907 So. Lawrence, Placentia 92670
John Chambers
•LL Ra.fO RiS "..-1110 S 1H1 CO.1106.II.L PRORIRTV OE CLIENTS. .II.D.12.lION IOR PUBLICATION Of "R REPORTS, CONCLUSIONS, DR A.
TRACTS . OR .,t..AA.iin,. 11.1. IS RESERVED RkNDING OUR WRITIEH APPROVAL AS A MUTUAL PROTLCTJON TO CLIENTS, THE PUBLIC AND OURSELVES.
330-12
OWNER JOHNSON Llo d DATE 1/1873
JOB ADDRESS 18 -it Oriole Dr. BUILDING PERMIT N0.
J I CKAL LVPI I RNL I VR
Ic1�9-602-16 LI
InSPECTIONS
Pool Location
Forms
Main Drain
Steel Reinforce
Elec. Bond.
Approval to Cover
Underground Electric
Gas Piping Test
Filtering. System Lines —
Backwash Lines and Recep.
Electrical Final
r and Vent Final —
System Final
Backwash and Recep. Final
Fencing Final _`�,i�
I c DESCRIPTION of WORK
TRACT FIRE ZONE VA
SUBCONTRACTOR
2073
iu-73
p/.r3 Electric
�.zl-Z3
S. 73
Plumbing
HV3
Z .
n_ 0
Z
Z<
N
am
J �
J N
m J
J m
_ Q
Z N
Za
wm
o_ I{I
W Z
J Q
mZ
J CC
Lu w
Z_F-
LU 0
0 CC
=)O
F
Z
Q
U
J
D_
C16
Q
O
F'
N
Z
H
U
Cr
F
h
Z
-5987
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
' 13-74AID00
1y
ALI ATION FOR BUILDING PERMIT
For Applicant t0 Fill in Completely
REPEj7VY
I2Qi/ TE RE EI
6�UE
D TE $1,V
BUILDING
ADDRESS
OWNER
A.P. NO. /
ERM , -7
11 � p
MAIL
ADDRESS �` ��
BUILDING O�/6�� T `.
ADDRESS fes'
' T
EL.NO.
CITY C
TRACT LOT % BLOCK.
CONSTRR11CTIO
A ALTER REPAIR
IMQVINQ I1PMOIISH
LENDE
BRANCH
OWNER Ll-�V IV
ADDRESS
VALUE OD
S �. $ [400O
ARCHITECT TEL.0 (X pl
OR ENGINEER' N J �-]�
FIRE
1-
`
ADDRESS \SOD CA-T`�'PU
ZONE T PE GROUP
CONTRACTOR �� rte_
APPROVED
ByDATE
yJ/1�`�{'(x�
ADDRESS ��`\'•
T ��<<-7
CITY/ �\ NOL„jJ / 1�`
ZONE
NO. OF
PLAPS �-BUILDINGSTATE
USE OF NEW
-P
2!d � __2[
P ROVED
YMAIIN
YARDS APPROVED
LIC. NO. LICVNO. 3�
S LDING
ACCESSORY BUILDING
SIZE NO. OF SLOGS.
(FROM C/L STREET) -
OF LOT NOW ON LOT
FRONT FT.
FT.
USE OF
G. .�V�(� /lJ`�
EXISTING BLDSIZE
FT
Or Q j
/y'�
NEW BLDG. v �% ROOMS STORIES (
L. SIDE FT.
/ / FT.
.
EXTERIOR WALL
ROOF
COVERING
COVERING
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS. SLOGS.
VAR.*
VAR.#
DATE
APPROVED
APPROVE
/ v
O
1 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 1 shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SO. 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:
am exempt from the provisions of the State of California Business
VALUATION
and Professions Code, Division 3, Chapter 9.
PERMIT FEE $
f
I
Signature o
Permittee _
$ W
PLAN CHECK $
Authorized Agent
TOTAL FEE $
OWNER
JOB ADD[
GENERAL
:CTI
sG,,
JOHNSON, Lloyd
ROUGH PLUMBING
PROP. SWR. LINE ❑ H�
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR
TEMPORARY SERVICE OR
UNDERGROUND PO
ROUGH WIRING
TRENCHES ❑ FORMS
FLOOR SYSTEM
t111ii111
FRAME AND FLASHING
LATHING - IN n OUT
PIASTER, BROWN COAT
TUBAL, FINAL
_ NG, VENT., REFRIG. AND A
PLUMBING. FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
u
DATE 9-28-71
BUILDING PLKMI I NU.
K--Pvt. Swim P
VALUES a_7nn_nn
SUBCONTRACTOR
Z
a Lwi
Z Z.
ZF
am
J7
J (n
m J
J m
U N
Z Q
W �
fl W
W
JO
mZ
J K
w
0=
Z_ )-
w0
0
�O
H
Z
Q
U
J
a
a
Q
O
F
fn
Z
O
F
U
cc
F
N
Z
;60
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
P! In
sElt 2a-„LPA9�oa 8714* �'**'�31 .�u
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
flECEI D
D TER EI/V D
p T.E IS(S,U'EjD,
BUILDING 1$16 ORIOLE .STREFi'T
ADDRESS
�/�
��r /
OWNER LLOYD JOHNSON
A. P, No. 3 /-�OG/�(
P jM�i ., L
MAIL SAME
ADDRESS
ADDRESS S 1816 ORIOLE ST
TEL.
CITY NO.
TRACT 6
y.�
LOT ar{�. BLOCK
W
AD P
CONSTRUCTION CASH
LENDER
BRANCH
LLOYD JO
OWNER
ADDRESS
VALUE
S ` POOL $ 2700.00
ARCHITECT TEL's'
OR ENGINEER N
�
FIRE F11�
ZONE TVP GROUP
ADDRESS 5871 FIRESTONE BLVD.
'
APPROVED
CONTRACTOR ANTHONY FOOLS
By DATE
ADDRESS 5871 FIRESTONE BLVD.
CITY SO GATE NoP 32210
ZO
—/
NO.OF
PLANS
USE OF NEW
BUSTATEILDING
LIC. NO. 170177�OLIC. No. CTYVMA
NS BUILDING
ACCE SORYP BUILDIAPPROVED YARDS NG
SIZE / ` NO. OF BLDGS.
OF LOT {�JJ x I� O NOW ON LOT
(FROM C/L STREET)
FRONT FT.
T.
USE OF
EXISTING BLDG. RES AND GAR
S F
IO
FT
SIZE OF(} 8 NO. OF
NEW BLDG. 7 ROOMS STORIES
L. SIDE FT.
FT.
EXTERIOR WALL
ROOF
COVERING
COVERING
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS, SLOGS.
VAR.*
DATE
C.U.P.#
APPROVED
APPROVED By
DATE rC
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 properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter'% and that.such licenses are in full an effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt fro ovi!ions of the Ste of Ca fornia Business
and Prof. ' ns Code, Division 3, Chapt 9.
VALUATION
ap
PERMIT FEE $ �Ji 0 6
Signat re of
r/
2700.00
/
Permi ee
$
PLAN CHECK $ t160
L
TOTAL FEE $ '—h /' SG
Authorize tl Agent
OWNER REPUBLIC HOMES DATE 5-21=71
�G
S
I.191AM19Law aRIM11
139-602-16 LOT TRACT FIRE ZONE VALUE $00.00
It. _CTIONS Signature
Date
GROUP J TYPE III ZONE Rl
OIL
SUBCONTRACTOR
PERMITS ISSUED
GAs
Dote Number Si nature
WATER
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER ❑
ROUGH WIRING
Heating and Vent.
TRENCHES 0 FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PI 7R, BROWN COAT
E URAL, FINAL
Electric
HEA, ING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
Z
W Lua-
U
Z
ZQ
H
O M
J �
J N
Q W
M J
J m
Q
U N
Za
W
CC
W
JO
m Z
J CC
W W
Z_H
w0
n K
70
~ J I n3
NAY 21-71Pp1°00 8R0
.COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
BUILDING
REC EJtV E(O SHV �TE E EVE �TEISSU �
/
/ /
f�:77•' q(
r,
ADDRESS
PERMIT NO.
OWNER ^C.
MAIL C
Q.
ADDLDIN
RESS QiQ/J� DQ.
ADDRES (
CITY t, C,N OL�')`-�(��(
TRACT LOT BLOCK
CONSTRUCTION
NEW ADD ALTER P
LENDER
BRANCH
OWNER
ADDRESS
/, / I ( / VALUE
W LULL
ARCHITECT TEL,
S $�r.s
OR ENGINEER NO.
FIRE
ADDRESS
ZONE TYPE GROUP
CONTRACTOR ��1/
APPROVED s U
BY r DATE
ADDRESS
TEL.
ZO E NO. OF USE OF NE '
CITY NO.
PLANS p� BUILDING
STATE CITY •��.-/
YARDS APPROVED YARDS APPROVED
UC. NO. UC. NO. !
MAIN BUILDING ACCESSORY BUILDING
SIZE NO. OF SLOGS.
(FROM C/L STREET)
OF LOT NOW ON LOT
FRONT FT. FT.
USE OF
EXISTING BLDG. CS •- �• 1 J
SIDE
FT.
if
SIZE OF NO. OF
NEWBLDG. ROOMS STORIES
L. SIDE � FT.
FT.
EXTERIOR WALL
ROOF
r/
COVERING
I COVERING
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS. BLDGS.
/
VA.+
DATE
06 - `vr'��
C URP +
APPROVED
APPROVED
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.
m
1 hereby certify that 1 am properly licensed as a contractor under
SQ. FT.
19
p
THE AMOUNT SHOWN UNDER VALUATIONIS FOR
the State of California Business and Professions Code, DivisOn 3,
Chapter 9, and that such licenses are in full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
a
am exem t from the provisions of the State of California Business
p p
VALUATION
^
and Professions Code, Division 3, CI apter 9.
��
N
PERMIT FEE $
D
PLAN CHECK $ -_
Signatureof
Permittee.
$3 u
m
E
Authorized Agent
N
TOTAL FEE $
LL
in 16
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely .
FMA,L
DING
ESS 1816 Oriole Drive
ERJAMAICA CONSTRUCTION COMPANY
CITY
BRANCFYL rP y �ty�`,C
ADDRESS '(f� L (/4Z_,t.G�'-
ARCHITECT T
ORENGINEER Kaltenbach 'N
APR 1 ? 6:Pa 00 921 ��* ***171.00
C 1,.i
APPLICATION FOR BUILDING PERMIT
RECEI
J� � d
?ry r
DA�i�OC
Y GROUP O
NO.
CONTRACTORJAMAICA ONSTR ION 0
PD
BUILDING
ADDRESS �0/r
TRACT 6757
LOT 44 BLOCK]
NEW
ADDA
P
USE OF NEW singl fall)CITVrange,
OWNERQSVALUE
eUA.P.
/
USE
BUILDING
J� � d
ADDRESS 1823 E. 17th St S.A.TYPE
Y GROUP O
hereby acknowledge that I have read this application and stathat
CONTRACTORJAMAICA ONSTR ION 0
DATE
the above information is correct antl agree to comply wiall
LPPROVED
ADDRESSP.Q. BOX 1967TEL.
laws regulating building construction, antl I shall not emplany
O. OF
USE OF NEW singl fall)CITVrange,
NO.ANS
2
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. 193122 LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE NO.OF BLDGS.
(FROM C/LSTREET)
OF ESTABLISHING A PERMIT FEE ONLY:¢
OF LOT NOW ON LOT O
FRONT FT.
FT.
USE OF
Professions Cotle, Division 3, Chapter 9.
EXISTING BLDG.
R. SIDE V FT.
FT.
SIZE OF NO, OF
NEWBLDG.2210 sq ft ROOMS 10 STORIES2
L. SIDE FT.
FT.
EXTERIOR WALL
COVERING Wd/StllCC
ROOF
COVERING WOOd
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
single family residence
MAIN BLDGS.
ACCESS. BLDGS.
VAR.*
DATE
With attached garage
C.U.P.#
APPROVED
__ . __ ___ .—
APPROVED ._ _ _
_ _ _ __
(/I
hereby acknowledge that I have read this application and stathat
the above information is correct antl agree to comply wiall
laws regulating building construction, antl I shall not emplany
person in violation of the workman's compensation laws
6SO.
the State of California.I
hereby certify that I am properly licensetl as a contractor und
FT.the
V�THEAMOUNT
OUNT SH N UNDERVALUATION IS FOR
State of California Business and Professions Cotle, Division
Chapter 9, and that such licenses are in full force antl effect, oPOSE
OF ESTABLISHING A PERMIT FEE ONLY:¢
am exemptfrom the provisions of the State of California BusineNand
Professions Cotle, Division 3, Chapter 9.
PERMIT FEE $Signature
PLAN CHECK $ D p
of
JAMAICA_C/ONSTR N COMPA0
(�
7
toPermittee
E
LL
Authorized Agen �e� C
TOTAL FEE $ / O