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HomeMy WebLinkAbout1822 ORIOLE DR - Building Permits CITY OF COSTA MESA *sem, BUILDING DIVISION �A .4I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us A. FOR INSPECTIONS CALL: (714)754-562 • 6 "°"° `et PERMIT NUMBER: B10-00325 PERMIT TYPE B_ROOF2 STATUS: ISSUED ' APN: 13960214 DATE ISSUED: 11101/2010 ISSUED BY: CAC JOB ADDRESS: 1822 ORIOLE DR-CM • Suite/Unit:, Vicinity: Squares: 0Valuation: '$10,400.00 SCOPE OF WORK: REMOVE COMP.TILE INSTALL 1/2 INCH RADIANT BARRIER OSB WITH 1 LAYER OF 30 LB FELT AND 40 YR COMP.SHINGLES. HOUSE AND GARAGE OWNER: MODIC,WILLIAM L TR Address: 1822 ORIOLE DR . ' - Unit: PHONE: 714-330-1828 , City/State/Zip: COSTA MESA,CA ' APPLICANT: NORM HENNIGER - Address: 12262 HESTER PL Unit: : PHONE: 714-534-7000 City/State/Zip: GARDEN GROVE,.CA . -i•-•41; - t 0--i.i,V:.„. i CONTRACTOR: ASSURED PROFESSIONALS INC License No. 760384 Address: 12262 HESTER PLUnit: . ” PHONE: 714-534-7000 City/State/Zip: GARDEN'GROVE, CA 92841 • CELL: - ' • ARCHITECT: License No. PHONE:• ENGINEER: License No. • PHONE: • FEE SUMMARY Reroof Plan Check: $0.00 . Reroof Permit Fee: $195.25. . . •. • .1e. ' '`� Reinspection Fee: $0.00 . . Bldg Std Admin Fund $1.00 • , . _ •. . i,-.h: TOTAL FEES $196.25 HOURS FOR CONSTRUCTION ACTIVITY;• EFFECTIVE 3118/2010-PER CMMC Sec. 13-279 ;1;,;;: . Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following,Federal holidays New Years Day, Memorial Day,Independence Day, Labor Day,Thanksgiving Day and Christmas Day ' ''-->"'I:`-).'.;-,U . t • • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE O. INSPECTION TYPE DATE INTITIALs CODE O INSPECTION TYPE OATE:'Q',P; INTnIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof X I I I0 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval _ ; :u i 203 Final Sign 222 Final Site ' _ _ _ _ _1 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes 0 No .� I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the Asrmance of the work for which this permit is issued. I have and will maintain workers'compensation insurance, as required by ion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carder and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a p�� �; person is required to descend,will be made in connection with work authorized (,➢--'/f j"-c_ L d I by this permit,and that no building structure,scaffdding,falsework,or demolition seaoan /parr oer rerednrtri)/i) e cerin u/ar`u'ea at one hundred dollars(s100)or less.) . or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp �r'"���Z�` ��r 2,Art 2,Sec.341,Title 8,California Administrative Code). •dr ber: v 0 As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers',ompensation laws of California, and agree that if I should become subje- to the workers' compensation provisions of Section 3700 of A kr Co•e,I shall forthwith co r•IyViilh these provisi s. Applicant's Signature Date -,at_'_` ll /0 Division of Industrial Safety Permit Number: •..Iranrs Sign.lige,.. to HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECUR WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL BJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file m license is'n full for - a • effect. WA a registration form for acutely hazardous materials? ❑Yes 0 No - i. t C----,3 C (Section 25533 of the Califomia Health and Safety Code, with some _ exceptions, requires registration with the Costa Mesa Fire Department by �\ _ _ ..-.411• � r IT 1 each business which at any one time has on hand a quantity of acutely r -a . .ure Dae hazardous materials equal to or greater than a weight of 500 pounds, or a S volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING A CY: temperature and pressure). ❑ I hereby affirm that ther is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. I ••nature of Legal Owner(s) Da Signature Dale 'n / • t -.11 /1 /7(0 3057-4613/07) V' l- AnElorAuthorizedApplicant b-_ --_ Date 'S. , s 1 '{ N / c 0 i', O d / ii,. w a 6 3 •. Q U Y • ,,,,,Aof p� li w Eo y ® vEDo c` ) L.{- ,`'�Q I C� B oQ ostoesa Building-Dep}ivUr� c� `'n✓ L 1 c0 Lf O EEEPCIIANGES W8TO OBT����V+CD i Y� ' t ii �— =THErySS HOUi PRIOI(_APPROV-jL7 Oa OFB A�P{RtNSPtCE o•FICAT oTING OF A PERIT-OR _i AN \� "OF ANY i FOR, OR AN4S-SII LA—L N'I:SOF-ERRORS- ScR0E0C_ILA0N,_ICAT "APPROVAL x 'L'--n- � SLIMING To GI PROVISIO 0 APPROVAL pBE CONSTRUED I t _RROVfSfO GIVE AUTH ANY _ F (S-q�F S T.L.A 1S�ikthile. .CANT Pa; a. OFFICIAL ' 'I, r � F L E�- . Ian��USE +�F BE VAL1T{rik , � 1� .. SPECIFI A ptis „A NCE OFA PER WHICH-IT"' - t SEIAWFU '+ .~ • CORREC4 i.''; I� .. I -IFRORPIANS REQUIRING N7BE BUIING�NS AND Ill It .� I N lOF Ot no-QF 1 HNS BEING A OR FROMPREVEOf `HE Clry, OR ANy THEREUNDER w NC ____r_.,?: I sd OF NEN _ OTHER-ORDINANCE —� t I r , sa , - TURAC-APPROVAL' ONLY, T} :pH.,ice I--SEPRATE—PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING— _ r 1 — — HATING-1M AND ! L"nk.PiRf lATtoN WORK GANG.-t Ecec.l 11-3151:uili 61 t.—,/ J 1Ji� IO t' s• :" gpARAN ] A� / r , 1 M Att—iNSP€CTION—R_QUESTS `® 1/+�s6 " —I_1 L._1--------- —. // SFAS ' I _._� I ! PV rt PSj r C' RBUILDIN( 1+31E1K1�.tpRSONS-ARE-TO _13iowe,' 7*1 S�-�- - - I MP WE�UG6£ST.IHAT IIIE • - --- - .-I.LD1 U Li-nLi- N 1 ,TATE DF€C 1fflRNIA-DIVISION IF .` -- _ _.- .__. �)— - NDUSTRIAL SAFETY BE CONSULTED FOR ;—k----E' LSL�c wa LL - 1 ODfTIONAI-REQUIREMENTS. -1- ?'E•PS( '��S¢ -`i • �——— ' rte-t r. :ti.Y I _.—J_._I II - _�t _— —_ __ %j GEw'RI- 44 • • _. J 'PROJECT ADDRESS: 1822 ORIOLE DR UNIT: CITY OF COSTA MESA - BUILDING PERMIT .. PERM NO: B 048981 OWNER'S NAME: MODIC, WILLIAM L • - ADDRESS: 1822 ORIOLE DR PERMIT NO: B 048981 PLAN CHECK NO: 05714-90 S : GOVT : N SUPP-: N • COSTA MESA',CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR. PURPOSE; ALT 540-3003 - • ARCH/ENGINEER: ANDREW GOETZ REG.NO.:C 18499 JOB DESCRIPTION : .ADD 9SF BAY WINDOW & REMOVE INSIDE WALL ,SQ FT : • 5, 000 !4ORESS: 219. BROADWAY • UNIT: 148 LAGUNA BEACH CA 92651 CLAIM VALUE: 5 , 000 , 00 CALC-VALUE: 5, 000 . 00 -GROUP OCC : R-3 1. PERMITTEE: MR MODIC ( 714 ) 540-3003 , - . y:ADDREss: ' 1822 ORIOLE - COMMENTS : REROOF 2000SF :HOUSE C .M. CA 92626 ****x********************************** ***** ** **+ * ****u***** *�r*** - ***R- ******, LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I R EMENTS 7080)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T H A C K S I - • CITY UC.: : , STATE LIC.: . CLASS: • • Date: •' "ISignature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent toseff-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: .FT IN REAR ; FT IN'- Compensation Insurance.or a certified copy thereof(Section 3800,.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT ' IN RGHT: FT •IN ,POLICY NO.: EXP.DATE: COMPANY:_ • PARKING REQ: PROV: PARCEL : 13960214 ZNE: R1 ' ,REF NO: Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> INTERIOR ALTERATIONS TO SFR . > _ - Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENT S 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 ^ 1 subject to the Worker'Comped tion Laws�f California. ' / // —7�x A / i1-ON I NG APPROVED BY l/..c-c. DATE: — �—j` e, .Date:- t/I '3 9 0 Signature: t.C/�/.LLCII x� y / v`fYL�[ (/ ' NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: • I Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. - C'�-/, p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for AP PL I CATION ISSUED BY : p� DATE: 1 which this permit is issued(Section 3097,Civ.C). **********************lE*********************** ** ***********'fE***** .41i_„5„4,** LENDER: ********************************************************************iE******* ** • ADOREss: - LEGALIZATION :N F E E S U M M A R Y 'STRUCTURAL SEGMENT :Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ' GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,'improve,demolish,or PERMIT 72 . 00 5 0 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 Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 4 6 , $0 SNIP/NON-RES and Professionsicat Code)or that he/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 thamfive hundred dollars(5500). ISSUE FEE . I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK . TOTAL ' PAID'., DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . 50 0 - 00 46 , 80 119 , 30 119 : 30, i, 0 0 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 budding or •REVENUE DIVISION TOTALS--> COLLECTED: 119 . 30 OVER/SHORT: i - . 00 improvement swithinone year of completion,the owner will have the burden of proving he/she did not build or improve forthe purpose ofle) BLDG PMT PLUMBING ELECTRIC MECHANIC• FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 720'0 50 46'. 80 n and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects sjth a contractor(s)license pursuant to the Contractors'State License Law).l am aware *************,***********************************************44*****6************ that proof of their Worker's Compensehon insurance should be provided to me. . INDIVIDUAL F E E BREAKDOWN '. I ❑ I am exempt under Section: B.&P.C. • for thisreason:, /� ason: , / TYPE QTY DESCRIPTION UNIT COST ' TOTAL COST Date: -/ , 6i0 ( owns/;64:7.44�ah / )21.,-,4 SFR 2000 ALTER BY VALUE RESIDENTIAL NOZONE . 1 , 00 2, 000 . 00 I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 3000 REROOF BY VALUE RESIDENIAL NOZONE 1-;00 ' 3a000 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a f . permit for construction or modification from the-Ali ality Management District.Residential construction applications are exempt from , ,�END OF FEES these provisions. ' Date: Applicant: EXPIRED - Lt • ' I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county Incomplete Ins e L'" 'ordinances and state laws relating to building c stmction and hereby authorize representatives of this city to enter upon the above-mentioned Inspections ' • property for inspection pu oses. �� g (\\/\\- •C Date: e (i 3 076 ionature: A�t 6G / nio ohu Date @—._-.. $I 01 00069495-00069497 TOT 119.30 ,Ddver'sLicense orSocial Security#: • DRiE: '09/13/90 TitlE: 12:47 1641-48 While—Building; Cana licent;Pink—Revenue;Goldenrod—Alae.ssor Green—Code Enforcement; ry—App • • CONSTRUCTION ANP PLANNING - POO SPA APPROVALS P4rmit# Date Inspector 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 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. • - • 60. Backwash Lines, P-Trap,-0 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 - l . 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating .71. Product Piping 0 Gas 0 Oil -+ 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 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 Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation I i 44. Landscape Irrigation System EXPIRED Incomplete lnspeclionb - 45. Sound Attenuation p / 46. Handicap Regulations _ Date /2-A4L Sig, 91- 47. FINAL STRUCTURE & BUILDING • f 48. FINAL PLANNING 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA BUILDING DIVISION • OWNER-BUILDER 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: 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. 1. I personally plan to provide the major labor and materials for construction of the pro- posed property improvement.%Yes 0 No 2. I (have/have not) 4 5 yG signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm)to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. 4. I plan to provide portions of the work,but I have hired the following person to coordinate, supervise and provide the major work: Name ` ' J� Address K4 City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted(hired)the following persons to pro- vide the work indicated: Name Address Phone Type of Work • I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my per- sonal knowledge, in compliance with this tate law. Signed: a/a id 0.44.-1 • n v Date: (3/4,0 Name: ((/ILLlAvvt I - /tIOD / C /(Printtedd or Typed) C.D.L. # or S.S. # ( 754-5273 1042-08 OWNER MODIC, William DATE 6-10-71 --?JQB ADDRESS 1822 Oriole Drive BUILDING PERMIT NO. 33154 GENERAL CONTRACTOR Thoryk Concrete DESCRIPTION of WORK Blackwall AP No.139-602-14 LOT TRACT FIRE ZONE . VALUE $ X40.00 INSPECTIONS Signature Date GROUP J TYPE III ZONE R-1 .�SOIL PERMITS ISSUED "GAS SUBCONTRACTOR �� Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. fl SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER fl ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. AI? Q.— I FLOOR SYSTEM [[[[ 77 I BOND BEAM n STEEL REINFORCE in SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PLASTER, BROWN COAT STRUCTURAL. FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL ,I c,.,A, /ohrvrn C; f/� -,--r 'b 33154 71. JUN 10-71v415 o`::***5.1^,0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE D//gg 0;,E RECJEJIV'E7D DAT/E ISS /D BUILDING /s ` / lG' �!/j/ W'y0.- _7/ ADDRESS /itz L v. -7 2Q-. OWNER `=,� /Tl—/ jq PERMIT NO. /� �1��/l A.P. NO. J C^O,Z�at/7 ADDRESS /72 ©.0/e/� ADDRESS MAIL - BUILDING ,n z.- OLL: DR. Z Q art it TRACT // (J LOT 7Z BLOCK W� U TEL. l S"/ CITY NO.J-7,;�G 6,3 ZNEW ADD ALTER REPAIR (MOVING DFMOI LSH Z Q CONSTRUCTION 1./N!T O co LENDER /X!� x ai J r r BRANCH -�_ J �� OWNER Q W ADDRESS c0 J VALUE ?// Q ARCHITECT �' TEL. USE $ '�7 - J OR ENGINEER NO.�_— Z Q FIRE / W 2 ADDRESS ZONE TYPE ROUP // i CL W APPROVED //J'C/� J O CONTRACTOR • //c /L / �(i��r/f BY --- DATE 03 Z J CC ADDRESS goy ��Ay'I� W W ZONE NO.OF USE OF NEW to.,./C . O= �J I TEL //, IJ i PLANS BUILDING Z H CITY L ...e.c.ro,y�/=% �,Of= NO.c%i -, K- Lr in L/C. NO. �.--hfl✓/�-�(.. LIC. NO.ireCITY YARDS BUILDINGED YARDAPPROVED / MAIN ACCESSORY BUILDING SIZE OF LOT /QQ / S (FROM C/L STREET) ,^/ X G�� I NOW OF ON LOTBLOG . / FRONT FT. ON 72 ober_ i2. USE OF (° EXISTING BLDG. �.r/Q iri/f/.f - B.SIDE FT. "' FT. F SIZE OF NO.OF — Z NEW BLDG. ROOMS —STORIES L.SIDE FT. D FT. UEXTERIOR WALL ROOF - COVERING COVERING REAR FT. _ON LAIC-CPT. dUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& .---- - 0- _MAIN BLDGS. ACCESS. SLOGS. Q 0 b lI X e• fi / J?agi� /v..e' C C.U.P.# APPROVED NAPPROVED ! Lwr R ( 10 I/ O . .. . . Nn rt= ' C� �LI1-(.26414111-6414111-604._ w4 I hereby acknowledge that I have read this application and state L) •' t1 I8 II aoiti LLt1[r4;,-/ that the above information it correct and agree to comply with CC all laws regulating building construction, and I shall not employ I, any person in violation of the workman's compensation laws of , C.0 the State of California. m ? I hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR• .m Chapter 9, and that such licenses are in full fo and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from the provisions of the State Calif rnia Business ✓� f _ CC and Professions Code, Division 3,Chapter 9 VALUATION `� • , •• �1 • r PERMIT FEE $ N Signature of m p ` / Permittee / \ 7 PLAN CHECK $ �- E Authorized Agent / LL • •••.. TOTAL FEE. $ .. .. . . - Lrf n • i" IF .; 30014 COSTA MESA BUILDING-SAFETY DEPARTMENT PAID P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APR 17-69LNsr 00 919 • **A 189.75 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REG Ep�BV DAT .�S RECEIV pD5/$/lJ1@D� BUILDING ADDRESS 1822 Oriole Drive PE RPQI,T .f 4 OWNER Jamaica Const . CO. A.P. NO. •,, MAIL BUILDING /�2 t) (7� �0/e /7A Z ADDRESS 2850 Mesa Verde Drive ADDRESS d t(/ aO CITY Costa Mesa NNO`' 5490395 TRACT 67 T)��jj 7 I LOT 42 BLOCK ZZtti N ADD ALTER I REPAIR MOVING DEMOLISH Q LENSTRUCTI y "� Om LENDER 1y/7/ _rei(j/((� ys-(G�r�,`I� .- - /' // #C.-+a.� £ c2n . 6 \ Myr /� ///� J O BRANCH/ •JArnr41`-t.tu \ .ons-EroC4(on • JN '/ X2 OWNER 1 , ,tr�7 �C� ,1,��1I, m J ADDRESS T�Q� (,.� IVr/ . W/A I�PiSALU$V I TT./ , m ARCHITECT TEL. 5478046 USE JQ OR ENGINEER Kaltenbach NO. UQ FIRE y WK ADDRESS 1823 E. 17th St . S.A. ZONE 3 TYPE GROUP Cs.$ aw APPROVED W Z CONTRACTOR Jamaica Const CO. BY DATE Jzm 2850 Mesa Verde Drive J cc ADDRESS w W TEL. B ZONE I NO.OF USE OF NEW singl fain. z� CITY Costa Mesa NO. 549039 R1 PLANS 2 BUILDINGto/ art gAr LU O STATE CITY YARDS APPROVED YARDS APPROVED D X LIC. NO. 19511 22 LIC.NO. MAIN BUILDING - ACCESSORY BUILDING SIZE NO.OF BLf1GS (FROM C/L ST,fiEET) OF LOT NOW ON LOT U FRONT y (J FT. FT. USE OF EXISTING BLDG. R,SIDE _FT. FT. ! I- SIZE OF2760 S/r�� Fp1O.OF 9 2 Z NEW BLDG. ` . 1400MS STORIES L.SIDE FT. FT. Q EXTERIOR WALL ROOF -�� V COVERING wd/StUCC COVERING wood REAR -WET. FT. - J USE OF BUILDING AND WOfi TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 single Iamal residence MAINBLDGS. ACCESS. BLOCS. Q w/att . garage VAR.# DATE O C.U.P.# APPROVED ~ Plan 276-CR �APPROVED 276Z -CR W. L. D. SATE 4-10-69 O Gu of �jy� UI hereby acknowledge that I have read this application and state that the above information-is correct and agree to comply with cc all laws regulating building construction, and I shall not employ I•" any person in violation of the workman's compensation laws of the State of California. �{/CJ�,�rI `,.{� B Z I hereby certify that I am properly licensed as a contractor under `' 763 SO. FT��7/B /y7 0 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 affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e IX am exempt from the provisions of the State of California Business and Professions Code, Division 3,Chapter 9. VALUATION /al /ra 6-e) - N PERMIT FEE $ /fF G ] Signature o{(. y/� f moi` B Permittee Jamaica Construction Company $ ;944/y PLAN CHECK $ (O2, d✓— E Qo � o Authorized Agent TOTAL FEE $ / D 7 , 7r"/ u- ` — '4793 10/12/79 29.50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPL TION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE I (PERMIT N° - 48956 For Applicant to Fill in Completely — Use Ink Only BUILDING ^y_ �'t ? _ T' A.P.NO. / 602 .-/C / ADDRESS 16 1 0it IC.1_.c_ Dir (� I BUILDING D2.Z. Dry' ry' _J �I"- TWN N OR (4 f W1 1 nal n- I c ADDRESS f V'7-I(�,` (,�J j TENANT ' 1 1 UNIT OR MAILING SPACE NO. ADDRESS 45, ADDRESS Ail� �` �t /�r� •�t TE `I � .-S LOT IBLK. CITY COST 1'1 I1F- S t4 NO`3y-o-3obj i i CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER W BRANCH f OWNER r-1 C....••••' NV ADDRESS ` a e9/ALUE //'� ARCHITECT (y , TEL. USE !� $/ � keirj OR ENGINEER N• t,'V lCiecr/O tvl NO. V ADDRESS ZONE I TYPE GROUP AYPROVED /orb, � �, , CONTRACTOR �/ N/ BY DATE `/ 7 ADDRESS TEL. CITY NO. F STATE CITY APPROVED SETBACKS g LIC. NO. I O ON O. 1C SIZE NO.OF BLDGS. (FROM C/L STR ET) �J S OF LOT I NOW ON LOT FRONT/t�/ )- �/r/ ,,'/�// USE OF < r,,, / >( ,I ,{/�' '� EXISTING BLDG. F E V 1 n y N C.F R. FT. (Jf/�' ��� F Separate permits are required for L.SIE FT. �' electric,plumbing and heating work.Ci R FT. F USE OF BUILDING AND WORK TO_ BE EE PERFORMED PLANNING ACTION1r ;,+�C �,'vtIl , /.) @Qy� toff ROVEEDa to-, / �.is�-+ APROVr�/CJ� � AT/6 J7 77 OI hereby acknowledge that I have read this application and state n C4 that the above information is correct and agree to comply with a all laws regulating building construction, and I shall not employ s: Z any person in violation of the workman's compensation laws of x the State of California. /40SO. FT. I hereby certify that I am properly licensed as a contractor under C...6 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FE ONLY: e am exempt from the provisions of the State of California Business p y VALUATION PERMIT FEE $ and Professions Code, Division 3,Chapter 9. , t�1 • Q o n ©d PLAN CHECK 5 4, O m Signature of / �y�// /J 0 0 Permittee ��7J lens //t tl-�� $ `ego `� TAX $ �D f ar f" ��sss. U Authorized Agent Date TOTAL PAID $ Z9 S 4792 II)/ 12/79 10,50 TL .O `-C TA MESA BUILDING-SAFETY DEPARTMENT APPL�_TIO ririri,iiiiFOR'STRUCTURALPERMIT P .BO4,7200 COSTA MESA,CALIFORNIA 92626 REC(D ' 'PERMIT N • 4 8 9 5 8 For Applicant to Fill in Completely— Use Ink Only 11 V� . BUILDING ( 1,3•.2a OtLOLE D2 A.P. NO. /3t: 7.... �/?2t 1 ADDRESS 1 /�/� BUILDING I tJ i/ /' /` • •TEN NT LL.,4N1 ' I 1 1 L 1c-p) CUNADDRESS ` GSL ttt///�����'��_��, TENANT OR MAILING SPACE NO. ADDRESS St'y1 TE .1/ T5.NO_�7 LOT 1 2 • rBLK. CITY (,�srp 111 Fta- NOL `��U-JJQ3 ``NNEW77 ADD ALTER '•R—rEPAIAIR_MOVING DEMOLISH CONSTRUCTION LENDER BRANCH let ate, lC.S OWNER IS ADDRESS USE �i�.( V �LALU E$ ©Q^( ARCHITECT �y?%2 TEL. GtJ�� dila OR ENGINEER'dC ON ICOf24'•'h NO. orS ADDRESS ZONE el VPE �_GROUP ^` APPROVED /l ,A7 CONTRACTOR , OU 1 se it BY DATE 9 ADDRESS TEL. CITY NO. -.i STATE CITY APPROVED SETBACKS t ��'///��{{{}}}I LIC. NO. LIC.NO. // (Y!j SIZE NO.OF BLDGS. (FROM CIL S RE LAvv(I/ / O. OF LOT NOW ON LOT FRS' / /F tit EXE OF (�t/,J _I / G �� EXISTING BLDG. V�'k-St -Ph/T «- :R11._ / FT.0 ES) E Separate permits are required forI FT. f (r- C electric,plumbing and heating work, ,R i 43,1.,I`���./ ' /(//f/ W. USE OF BUILDING AND WORK TO BE PERFORMED PLANNINIV !//(� ,r Q � C._) t DATE 'APPROVED < /U 7 PRO APV'F�j L// /OC /2— '�l 7 p �Y1p`. DATFaf l tt ..l IMM 14 I 0 I hereby acknowledge that I have read this application and state n y that the above information is correct and agree to comply with L all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of m Sthe State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. ry D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o 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 $ !O s► Y and Professions Code,Division 3, Chapter 9. , in m Signature ofLAN CHECK $ r9 Permittee I.-L./ [i'./e vLiY. 't /C 0 c>u-C $ 90 CoO TAX $ ^s� ` U Authorized Agent Date JD /. /� / U TOTAL PID $ /D, A