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Home My WebLink About1829 ORIOLE DR - Building PermitsCITY OF COSTA MESA t�,0`'tp A'Fsgq BUILDING DIVISION > ' 0 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.costamesaca.aov v `� °� FOR INSPECTIONS CALL: (714) 754-5626 4ayn y mo ,`P PERMIT NUMBER: M12-00021 PERMIT TYPE MECH STATUS: ISSUED APN: 13960304 DATE ISSUED: 02/03/2012 PHONE: ISSUED BY: MDM JOB ADDRESS: 1829 ORIOLE DR CM Suite/Unit: Vicinity: - - SQ. FT: 0 25251 ALESSANDRO DR Unit: SCOPE OF WORK: REPLACE 48K BTU FURNACE IN GARAGE OWNER: HALL, DALE TR Address: 1829 ORIOLE DR Unit: PHONE: 714-979-8991 City/State/Zip: COSTA MESA, CA , APPLICANT: STEVE SCHNIERER - Address: 25251 ALESSANDRO DR Unit: PHONE: 951-241-8876 - City/State/zZip: MORENO VALLEY, CA - CONTRACTOR: SERVICE CHAMPIONS - License No. 799170' Address: 22911 SAVI RANCH PKWYUnib PHONE:- 714.777-7777 City/State: YORBA LINDA, CA ZipCode: 92887 - - CELL: I MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: - $37.20 - PLAN CHECK FEE: $0.00 INVESTIGATION REE: $0.00 REINSPECTION FEE: - $0.00 - TOTAL FEES: $37.20 a: - NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related i 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. r000E tl' INSPECTION TYPE DATE INTI_ CODE INSPECTION TYPE 0_AAU INTITIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical X �•ay• q. �� r,,. 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 263 Final Sign 222 Final Site 71 '204 Final Demolition 250 Final Building/Occupancy r I'�',f �C WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. XI 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: IowCr �V1S Co oQ NY (Tho settnn need rpt be competed d the permit is valued al one hundred doears (Sloe) or less.) Policy Number: ( r_ P BC f 028011 ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. AppLeant's Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. X 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.#-7ggC7O Class at Gz0 Comractor'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). Lender's Name: Lender's 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 contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, 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. Appliranfa Signature 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 fled 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 might of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes". the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify 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 above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal O der(s) Date Signature Date ]o5] -d6 (3107)JC And/or AutM1onz¢tl ApPliwnt Date Applicant to fill in all spaces except those within heavy border lines and, sign all appropriate declarations. �:ITY OF COSTA MESA CO ST UCTION-PER PERMITVi90_ _ r^' TRACT NO. LOT NO. UNIT NO. Project Address - � q A/J�/�'7� /- R, _ Applican4t's Mailing Address ,/F -;Z Owner's Name /%1,�,.�,L- Phona 4?i Address Arch/Eng. License No. " Address /- r1 Convactor's NamHH.nA��4 L+ Y7 S"78_%/ATy Phone Address(mailing),tW�S�'/-ST City License No. On ( l LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter 9 (commencing' with, section 7000) of Division 3 of the Business and Professions Code, and, my license is in full f Sce an effect. CJ License Class Li a No.,S 3 Date Signature WORKERS'. COMPENSATION DECLARATION b hereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy.tnere ( ection 00, Lab. C.)++�1 //�� / Policy No. � J / "' Company J p M 7 ❑_Certified copy is hereby furnished. I �( Certifi co y i "I with the city�+�ding Divi n. % Date (p_ Applicant (�--0��'S%411 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Th is section need not be completed it the permit is for one hundred ($100) or less). 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. Date 4Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of,the Business and Professions Code) or that -he/she'is,exempt erefrom and the basis for the alleged exemption. -Any violation of Section 31.5 by any applicant for a permit subjects the. applicant to a civil .nasty of not more than five hundred dollars ($500). L� I, as'owner of the property or my, employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for Sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove efor the purpose of Sale). I. as owner of the'property,lam exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does .not apply to an owner of property who builds r'improves thereon, and who contracts'for such projects with a con- tractors) license' pursuant to the Contractor's License Law). I am aware that Proof of their Worker's Compensation insurance should be provided to me. ❑.1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify,that 1 have read this application and state that the above information: is correct. I agree to comply with all city and county ordinances. and state laws relating to build" nstruction, and hereby authorise rept¢ sentatNes of this cit t e on the above-mentioned property for inspection purpo s ' Date TYPE OF CONSTRUCTION LJ r ❑ CONVERSION ❑ DEMOLIS DESCRIPTION OF WORK/USE OI TYPE OF PERMIT GRADING ❑ TENANT._.❑ -ELECTRICAL ❑OTHER ' _W LJ ADD LJ ALTERATION LJ REPAIR ❑ OTHER BLDG. - FOUNDATION, =STRUCTURAL PLUMBING ❑ MECHANICAL PROJECT DESCRIPTION SO. FT.- OCCUPANCY CONSTRUCTION TYPE 'VALUATION $ ZONE GRADINGCU.YDS. ACRES_ Remarks:: A.P. # S Main Buildir E :T Front B Rear. A -C Right K' Left Ping. Ref. # Planning Notes: Reinspection Fee ` $15 Boiler Duct - Under Ground Duct - Structural Duct -' Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0-100,000 BTU ❑ 100,000 BTi I Signature , i I Reinspection Fee $15 Drivers' License or SS 9F CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type 1 ❑ ' Canopy Type 11 ❑ Refrigeration System 1-10-100,00&BTU ❑100,000BTU System Repair/Alteration Fire Dampers Registers ' ' Issue Fee 4922 11(2'1/85 y Z. Accessory Building: ECTRICAL -' Transformer ❑ 15-50 KW ❑50+KW Meter ❑up to 100 amps Meter Dover 100 amps Sub Panel ' Motors ❑ 0-1 HP ❑ 1% - 8 Inc. Solar 136-15 HP 016-15+ Microwave - -- Pole Pole Light - Range Sign ;Standing Sections Trash Compactor 5e00I TL FEES t Z O N I N G R E Q M T S $ 3 PLUMBING FEES $15 Bar Sink Showers FEES! E Backflow Preventer Service Sink - Automatic Washer' Backflow Irrigation ' Sewer.Cap Construction Pole Sub. Bathtubs Sewer Connection SUMMARY $ $ $ $' $1 $ $ $: Cooking Unit Clarifiers Solar Collectors Dishwasher Dishwasher ' Solar Piping I Dryers []Gas "EIElectric Drinking Fountains Solar Tank Fan Floor Drains Swim 001 w/Spa F.A.U. Floor Sinks Urinal - - - Fixtures - Gas ServiceOutlets Water Closet -' Device Boxes Interceptors Water Heater U Outlets Kitchen Sink Water Service Switches Lavatories Auto -Wash I Garbage Disposal P—Trap Laundry Trays - Generator ❑0-5 KW ❑5-15 KW Roof Drains Reinspection Fee ` $15 Boiler Duct - Under Ground Duct - Structural Duct -' Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0-100,000 BTU ❑ 100,000 BTi I Signature , i I Reinspection Fee $15 Drivers' License or SS 9F CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type 1 ❑ ' Canopy Type 11 ❑ Refrigeration System 1-10-100,00&BTU ❑100,000BTU System Repair/Alteration Fire Dampers Registers ' ' Issue Fee 4922 11(2'1/85 y Z. Accessory Building: ECTRICAL -' Transformer ❑ 15-50 KW ❑50+KW Meter ❑up to 100 amps Meter Dover 100 amps Sub Panel ' Motors ❑ 0-1 HP ❑ 1% - 8 Inc. Solar 136-15 HP 016-15+ Microwave - -- Pole Pole Light - Range Sign ;Standing Sections Trash Compactor 5e00I TL FEES t Z O N I N G R E Q M T S $ 3 Reinspection Fee $15 Issue Fee $ 3 FEES! . DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued Bye nate Date Date BUILDING PERMIT PLAN CHECK' PLUMBING PLAN CHECK 25% •. ELECTRICAL PLAN CHECK • 50% MECHANICAL' PLAN CHECK 25% SUMMARY $ $ $ $' $1 $ $ $: ' OF FEES , SMIP PERMIT ISSUANCE ENERGY P.C. GRADING I : MICROFILM . TOTAL FEE $ $, $, $1 $ $; ;SOD $ 3 . CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOI PA - 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 r4. E lectrical,Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE 17. 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 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. 'Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20..Ro6gh Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas El 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 H. T -Bar Ceiling.(Structural) & Monocoat +75. Dry`Chemical ` -27. Frame and Flashing'� � �17 �. 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:Yrj_br/o«ri 34. Final Heating &.Air Conditioning 35. FinalGasPipe-Test , 36. Hood or Canopy 37. Final Factory Fireplace , 38. Final Plumbing (4c0 - 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final _�T. " 42. Backflow Preventer. 43. Backflow Irrigation 44. Landscape Irrigation System r- ' 45. Sound Attenuation ., 46. Handicap Regulations 47. FINAL STRUCTURE &BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison ' •' _ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. `.. Date �J OWNER MIN GIN, Ock TRACT DATE IG PERMIT NO. VALUE R snn_nn 10. INN SPECTIONS Si nature solL Dare GROUP J SUBCONTRACTOR TYPE ZONE PERMITS ISS ED Date Number $i nature GAS WATER Plumbin ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES E] FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING L- - NG — IN OUT _ F 'E R, BROWN COAT _ \t-.. STRUCTURAL, FINAL Electric rr HEATING, VENT., REF RIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL RINI nlNr, FINCI VrIlzi ( —eL Z Q V J CL CL Q O F- V) h Z 2 1-' U F- r N Z 33006 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APR 29-71BMSn001307 PPLICATION FOR BUILDING PERMIT For Applicant to Fill in Complete ECEIVED BV DATE RECEIVED DATE ISSUED .�'y �7 BUILDING ! Q'i 9 ilj� DLf; lt%L l.� ADDRESS `/l.._ /J OWNER �C I< WN t Q 6- i kiO /h� .P. NO.' 7 o PERMIT NO. / MAIL (� r�UILDING A D Dless ./2 nee y SOC&DDRESS CITY `� j /r'1 fy{JF /-I NTRACT p" LO BLOCK CONSTRUCTION NEW ADD ATEREPAIR TrV,A l'BRANCHXOWNERADDRESS LENDER �,/'VALUEARCHITECT ^'" •t$RENGINEER-�FIREADDRESS TESE ZONE TYPE GROAPPROVEDCONTRACTOR [,y.�[,.j f!J BY DATE /Jj ADDRESSp0,&)rt 112ONE ,,/gj C I T V�uN 7-Ar,I,J6/9 Lt NO_- NO. OF PLANS USE OF BUILDIN NO.I i of �T-J�pj LICVNO. 3 0 q STATE LIC ARDS APPROVED YMAIIN BUILDING YARDS APPROVED ACCESSORY BUILDING 11 `t 1.NO.OF SLOGS. �v (FROM C/L T ) OF LOT h NOW ON LOT FRONT FT. USE OF EXISTING BLDG. R. SIDE FT. FT. SIZE OF NO. OF NEW BLDG. 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. CQ VAR. # DATE �a.I L•-/� / uiL+I%i-fi / Y'ry'-/ % a V1_ C.U.P. # APPROVED APPROVED 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 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 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 $ (�� r -t7 Signature of �j `- " "'t/\ � Permittee -� $�O O PLAN CHECK $ Authorized Agent TOTAL FEE $ M 31-?1PAI11oo 824 0*****5.00 CNSA COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT q RECEIVE �DjATE RECEIVEDDATE ISSUED BUILDING d / ®.i/ !� (/ ,�-3J —/ ADDRESS /O D PERMIT NO. OWNERa— /N (v/�/ A.P. NO. MAIL BUILDING AD,S4i%� ADDRESS Z DRESS 00// rr�/t'C--�•[U,� a_U, CITV [_�!f/R /%�/%/ NO`S TRACT,(p ��..17. LOT p BLOCK Z Q' CONSTRUCTION W ADD ALTER REPAIR ON LENDER NON? am J 7 BRANCH all J!n OWNER mJ ADDRESS VALUE J Q ARCHITECT OR ENGINEER �— NEL. SE J $,3%Dr -V U InFIRE WQ -ZONE TYPE GROUP � ADDRESS d W APPROVED �' -..3 _7 W Z CONTRACTOR yo.Z C N BV DATE J Q m Z J ADDRESS Sit 0.7me/ WW w/ ZO '--�NO. OF /J USE OF NEW Z CITY ,pfryq ,�/ TEL. �i%f SS/6 / PLANSa BUILDING /C NO. O STATE CITV YARDS APPROVED YARDS APPROVED N CC LIC. NO. ' 3p •�C' LIC. N0.1�� MAIN BUILDING ACCESSORY BUILDING U SIZE. NO. OF SLOGS. (FROM C/L STREET) OF LOT (a p o n /Cn—e NOW ON LOT �� FRONT FT. —F'f-- USE OF p EXISTING BLDG. 16VS ,Dst.� R SIDE FT. FT F- SIZE OF r_, NO. OF Z NEW BLDG. ROOMS __ STORIES L. SIDE FT. _�;F.� fai EXTERIOR WALL ROOF _ COVERING COVERING REAR FT.---pT� J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & CL MAIN BLDCS. ACCESS. BLDGS. Qkt 6 / � L /C+ ,BL`s G,� C URP * APPROVED 0 H N y� ——U �G✓�J,t/,J' SGC.V/,1�040'f APPROVED DATEz 0 IV F- 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 cc F any person in violation of the workman's compensation laws of N the State of California. a1 e Z I hereby certify that I am properly licensed as a contractor under SQ. FT. O the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full torte and effect, or THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m am exempt from the provisions of the State of California Business VALUATION and Professions Code, Division 3, Cha er 9. f ^ N PERMIT FEE $ Is Signature of H r� m Permittee $ 2�\ PLAN CHECK $ E J a` Authorized Arent u_ g TOTAL FEE $ t Z ww a U Z Z_ F o- In am J cn J to M J J to a N z Q W Ly a tJ JO Co Z J W W o= z� w0 Do H Z a U_ J CL CL a O H ti Z O F- 0 U D cc F h z 30027 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 ?IPA 17-69PA00 932* ***189.75 189.75 • APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI /B I OAT RECEIyED iV'l / DA I ED /Tit% / a BUILDING ADDRESS (�/ PfiR 1 OWNER Jamaica Const. Co. A.P. NO. MAIL 2850 Mesa Verde Drive BUILDING ADDRESS ADDRESS TEL CITY Costa Mesa TRACT 6757 LOT 55 BLOCK CONSTRUCiIOffyy,� '� RREPAIR LENDER �yRC Gl%e57 %aRM BRANCH OWNER t/'D — ``� AI (N / ADDRESS h VAWVALU E SE $ 4�! NEL-5478046 ORENGINEEARCHITECR Kaltenbach FIRE v �y 1823 E. 17th St. S.A. , ADDRESS ZONE TYPE GROUP V APPROVED CONTRACTOR Jamaica Const. Co. BY DATE ADDRESS 2850 Mesa Verde Drive Costa Mesa NOL. 5490395 ZONENO. OF PLANS USE OF NEW Sin 1 fam g CITY R1 2 BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO193122 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. 0 C/L 5 B (FROM EET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. SIDE S FT. FT. OF �ItJO n 2 2760 SQ..F J NEW BLDG.SIZE iil]OMS STORIES L. SIDE FT. FT. EXTERIOR WALLROOF COVERING tuc VERING wood REAR FT. FT. USE OF BUILDINGAND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & ngleit residence MAIN BLDGS. ACCESS. BLDGS. w/att. garage VAR.# DATE C.U.P. * APPROVED Plan 276 -AR APPROVED W L. D. 4-10-69 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 SO. FT. v the State of California.7� 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 Professions Code, Division 3, Chapter 9. VALUATION and �.p PERMIT FEE $ `/L�d Signature of �9yyy / rme ' On t UCt lOn Compan Peittey $ S_ PLAN CHECK $ 111 Au[horixetl Agent TOTAL FEE $ • J OWNER GIN, 0 JOB ADDRESS 1, ERAL CONTRAC' ,.. .lo. 3.4-r)o3o4 i DATE E ZONE PERMIT NO. INSPECTIONS Signature Date GROUP J TYPE 411 ZONE R-1 GAIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Si nature WATER Plumbin ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. F] SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER D ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING 'NG — IN OUT ER, BROWN COAT SimOCTURAL, FINAL Ilic HEATING, VENT., REFRIG. AND P.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL Rini niuc c—Ai /1