HomeMy WebLinkAbout1830 ORIOLE DR - Building PermitsPROJECT ADDRESS:1830 ORIOLE DR
CrW.ft,ANAME: MC PHAIL
ADDRESS: SAME
UNIT:
'-079-2172
ARCH/ENGINEEhi. REG.NO.:
ADDRESS: - UNIT:
PERMITTEE: A. J. - CUSTOM POOLS (714)539-5824
ADDRESS: 12342 LOUISE
GG CA 92641
UCENSEO CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3'af the Business and Professions Cade, and my license is in full force and effect.
CITY uc.:9__Z6041228
2 2 8 STATE UC.:4 5 2 6 5 2 S: 5 3
Date:1F0 Signature' -
WORXERS' COMPENSATION DECLARATION: I hereby affirm that I hav ificat nsent to self -insure ora certificate of Workers
^'oensation ns mn r tied copy thereof (Section 3800, L ).
Y ND.: � T b�/ 8 U EXP. DATE: 01 / 01 / 91
APANY: SRARE
C+J Certified
�Copfy is herebbyy'fumished. ❑ Certified copy is filed wi ip Building Div cion.
Date: Y1 4� �7�J Applicant `
EIIEMPDON FROM WORKERS' COMPENSATION DECLARATION: (This secli n not be ted d Me permit is for one hundred ($100) or less).
I ceNty that in the performance of the work for which this permit is i , I shall not employ any person in any manner so as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
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: I 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:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of 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 Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions 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 than five hundred dollars ($500).
I, as owner of the property or my am layers 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 Contractors' State 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 wmpledon, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
Eland Professions Code: The Contractors' State License Law does not apply to an owner of propewho builds or improves thereon
and who contracts for such projects with a contractor(s) license pursuant to the Contractors State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason: .
Date: Owner:
I do hereby Certity that I am aware of and understand the requirements of Califomia Health and Safety Code Sections 25505, 25533, and
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 -
permit for construction or modification from the Air Quality Management District., Residential construction applications are exempt from
these provisioned' i' - •i_k 1„ - • - •"
Date. '' Applicant ••�•""`
I hereby cannily that I have mad this`application and'stale that the above information is correct. I agree to comply with all city and county -
ordinances and state laws relating to building construction and hereby authorize re resent .ves of this Wo enter upon the above,menboned
property for inspection purposes.
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Date: v �',� - � Signature:'- _
Driver's License 'or Social Security' e:
1641 WN✓ ^ mien—(;ode Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA —'BUILDING PERMIT PERM NO: BEP 048702
PERMIT NO: BEP 048702 PLAN CHECK NO: 05400-90 S GOVT: 'N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PLU STR PURPOSE: NEW
JOB DESCRIPTION ; NEW SPA .! EXISTING POOL SQ FT: 40
CLAIM VALUE: 10,000.00 CALC—VALUE: 480.00, GROUP'OCC:'R-3 / —
COMMENTS: ADD'SPA TO EXISTING POOL; "
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Z O N I N G R E Q U I R E M E N T S.
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING.------ =—
-
FRNT: FT IN REAR: 6 FT IN FRNT: FT' IN REAR; FT IN
LEFT: FT IN RGHT: 13 FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 13960211 ZNE: R1 REF NO:
PLANNING NOTES> ADDING SPA TO AN EXISTING SFR WITH POOL.
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D E V E L O P M E N T S E RV I C E S R F 0 ITrR E M E N -T S
ZONING APPROVED BY :� / r DATE: G�Zl1�
BUILDING APPROVED BY DATE.t CAZzAk)
APPLICATION ISSUED BY: DATE: i:: --;,,P-2_3'9 0
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LEGALIZATION:N F E E, S U r .M A R Y STRUCTURAL SEGMENT:Y
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BLDG PMT PLUMBING ELECTRICMECHANIC FIRE SMIP/RES GRADING
PERMIT 15.00 2.00 30.00 .50
PLAN 9.75
25% 508 SMIP/NON—RES
� '
ISSUE'FEE 3.00 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
.TOTALS ---- > 47.50 18.00 9.75• 75.25. 75.25 •00
REVENUE DIVISION TOTALS--> COLLECTED,;' 75.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
15,00 5.00 45.00 .50 9.75
4E 9E iE iE aE 9E 9E iE 9E 9E BETE it TF 9F deiE 9E aF iE aE iE 9E jt eE 9f iE 4E iE 9E iE * iE eF 9F 9EdE 9E X� 4E jE 9F'9E aF iE iE iE * * iE it 9E 1E dE dF iE iE iE 9E aE dE iF 3E 9E 9F iE * aF-0E eE TE 1E # iE 9F �. # eE dE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
QTY D E S C.R I P
T I O N - UNIT COST TOTAL COST
SFR
40 RES—POOLS PER
SQ FT OF SURFACE AREA 12.00
480,00
ELE
1 SWIMMING POOL
— IN GROUND — NEW EA. 30.00
30,00
PLU
1 SWIMMING POOL
- 2.00
2.00
END OF 'FEES
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Inm®KE DEiEC70 09/23/90 TIME:
10!0?
DATE:
REQUIRE®
08/23/90 TIME:
ir, 09
55, J
.' CONSTRUCTION AND PLANNIN
APPROVALS Permit #-
Date
Inspector
& SPA
-
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
-
52. Pool & Equipment Location
2. Soil Pi e-Undrgrnd.,
-
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
.Y
5. Steel Reinforcement
56. _ Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. -
57. APPROVAL TO COVE R -G UNITE
a. f!
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9: Water Pipe-Undrgrnd.
60. Backwash Lines,.R-Trap, 0 Undrgrnd.
10. Structural Floor System - -
61. APPROVAL TO DECK
I
11. Property Sewer Line & House Connection
'i
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
d
�'
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
L
19. Rough Heating& Air Conditioning
-FIRE. DEPT. REQUIREMENT. -,
APPROVALS' -�'-Permit-
20: Rough Factory Fireplace
-'
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21. Ducts, in Structure -
-j
'
;70. Underground•Hy-dro '
22. Ducts, Ventilating
'71. Product -Piping GGas 0Oil
_
23. Gas Pipe -Rough & Test•
-��'
-72. Underground Flush `
24. Roof Framing
••73.'.Undergrnd. Storage Tank O Gas ❑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
2 � �
77.�FIXEDSYSTEMFXNAL..•
29. Insulation
78:'FIRE PREV. FINAL
30. Drywall Nailing�.HEALTH-DEPT.
REQUIREMENT
- 31. Plaster brown Coat
F�
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
I
-
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
r
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Laboratories 4-S-044, n4ict Ata, ffne.
`4 F(
3310 Airport Way
Long Beach, CA 90806
Mail: P.O. Box 47, 90801
(213) 426.3355
TESTING (714)828-6432 FAX(213)426-6424
CORRECTION
CUSTOMER: VOLDEN ELMER G
Compression Test on Gunite
14509 DALWOOD AVE
NORWALK, CA 90650
JOB NAME: SPA MR MCPHAIL
ADDRESS: EZX412XKGUXEEXST
VARIANXAIWARXXCAA
ARCHITECT:
ENGINEER:
B C ADAMS
----------------------
SAMPLE FROM: Spa.
1514-0 North Susan Street
Santa Ana, CA 92703
(714) 554-2645
FAX (714) 554-4960
EXAM NO: 90-1-055666
DATE: 09/13/90
JOB NO: 00911004
PERMIT NO:
OSH PD:
OSA AP #:
1830 Oriole St. FILE #:
Costa Mesa PAGE #: 1
CONTRACTOR:
A J CUSTOM POOLS- 12342 Louise
SUBCONTRACTOR: Garden Grove
D -J GUNITE
-------------------------------------------
MIX: 4.5:1 SPEC. SIR. (PSI): 2000 SLUMP: ----- CAST: 08/28/90
------------------------------------------------------------------------------
DATE TESTED 09/11/90
SPECIMEN NO 1
AGE (DAYS) 14
TOTAL LOAD (LBS) 104000
LBS PER SQ IN 3680
SPECIMEN SHAPE: Cylinder SIZE: 6 x 12 AREA/SQ IN: 28.27
--------------------------------------------------------------------------------
COMPLIANCE: 14 day test complies with specified strength.
Lab #8050
SPECIMENS BY: Phil DELIVERED BY: E. Volden RECEIVED ON: 09/11/90
--------------------------------------------------------------------------------
DISTRIBUTIONS:
VOLDEN ELMER G, 2
COSTA MESA BUILDING DEPARTMENT, 1
)JohnMTVerrocch`l, Sr.
ALL REPORTS REMAIN THE PROPERTY OF TWINING LABORA70RIES OF SOUTHERN CALIFORNIA, INC AUTHORIZATION FOR PUBLICATION OF OUR REPORTS, CONCLUSIONS, OR
EXTRACTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES
1\
ELMFR VOLDEN- INSPECTOR 1980-1990 (213) 863-6049
14509 DALWOOD AVE.
NORWALK, CA 90650
CERTIFICATE OF REGISTERED INSPECTOR
Cuy d Www Imp.nlon 9odbn
711/911 i `1U.00
TMrw df!Y rrtlob^btlbMGq dYrMr�gq�
ELMER G. VOLDEN t+�°'e
d
Gunite
.DEPARTMENT OF BDILDINO k SAFETY
This is to certify that: N9 ___ __ 1418
ELMER VOLDEN
w Is a REGISTERED INSPECTOR for the
CITY OF LONG BEACH. CALIFORNIA
u Cert. No. 0559
MASSOONRYE)REINFORCED CONCRET
EIINFOORCEDCONCRET
E
,r REb4,CEpWjFDING
Date:,/ Dires: 5/5/9
1
�CI L-
�P' woos
F
e�O Zso
�0o Twining Laboratories
P.O. 80x <2 3310 AIRPORT WAY . LONG BEACH, CALIF. 90601. 12131 4263355 . 1213) 636-2386. (714) 828-6432
0¢nNCH 0=4CE5:
TESTING ISL . m,ae I e.d<, s:,,.. Eco DHL,..L.. r.,+ry
Senla n+e Ce6.onle ox)o] :° 2155 ROdO^Oo A—PO Bo, 41
pLl Sly 10.5 L-1B—cA CeGC;06011x131062306
September 6, 1972 Examination: SC72-5546
COMPRESSION TESTS ON GUNITE CYLINDERS
L. E. Sprague
1411 Windemere Lane
Tustin, Callfornia92680
PROJECT Swimming Pool for A. B. McPHAIL'
ADDRESS 1830 Ariole Drive, Costa Mesa
SAMPLE FROM Bond Beam, Deep End and Shallow End
ARCNITECT
CONTRACTOR
ENGINEER
SUBCONTRACTOR
SPECIFIED
MIX
Premixed Gunite
J STRENGTH .
DATE CAST
8-30-72
DATE TESTED
9-6-72
9-6-72
CYLINDER NO.
I -BB
3 -DE
COMPRESSION
7 -Day
7 -Day
TOTAL LOAD, LBS.
84,000
78,000
POUNDS PER SO. IN.
3,235
2,877
SIZE:
5-3/4"x12-1/411
5-7/811x12-1/2"
COMPLIANCE
7 -Day test complies
with specifications.
Permit$35026
2,000 PSI
9-6-72
2 -BB "HOLD"
5 -SE 4 -DE "HOLD"
6 -SE "HOLD"
7 -Day
74 ,000
2,230
5-7/8"x)2-1/21,
MADE BY DELIVERED BY RECEIVED ON
CYLINDERS L.E.Sprague LES 8-31-72
DISTRIBUTION:
'eBUILDING �.r
'eta -Mesa Bldg. Dept. 1 u spArI77 I! I
L. E. Sprague - 4
SEP 11 1511 /.
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ALL REPORTS APE SUBMITTED .S THE CONEIOENTI.L PROPERTY OF CLIENTS. AUTHORIZATION FOR RVBLICATION OF OUR REPORTS. CONCLUSIONS. OR E[
TRAC15 FROM OP RECAROINL THEM IS RESERVE. PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES
330.12
OWNER Mc PHAIL, Buck DATE
Y JOB
GE
API
INSF
T
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. Lj
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER E]
ROUGH WIRING
TRENCHES ❑ FORMS ❑ STEEL REINF.
FLOOR SYSTEM r�
BOND BEAM STEEL REINFORCE L J
SHEATHING
FRAME AND FLASHING
LATHING - IN F] OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMPING. FINAI AND GAS TEST I-1
FIRE
SUBCONTRACTOR
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APLI ATION FOR BUILDING PERMIT
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3547
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
P41U
s[r 72C1,5i100 957' ***>•r10.07
For Applicant to Fill in Complete/
R I E
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DW ISSUED
BUILDING
ADDRESS
OWNER ' "/ yam//C
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ADDRESS jVs�— LQLC,
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OWNER C'e- � 't
ADDRESS/,J
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SE "I'll $
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ADDRESS --
ZONE VPE ROUP %
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ADDRESS B .�i/j/C/.9
ZON
NO. OF
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USE OF NEW�/fL0 L
CITY NO
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BUILDING
STATE CITY
YARDS
YARDS
LIC. NO. � f' LIC. NO.
MAIN BUILDING
SORY LDAPPROVED
ACCESBUILDING
SIZENO. OF BLDGS.
/
(FROM C/L STREET)
L
OF LOT �C �d NOW ON LOT
FRONT FT.
FT.
USE OF
EXISTING BLDG. �JIO.BN
E FT.
(./ FT.
SIZE OF NO. OF
NEW BLDG. ROOMS STORIES—
Lo SIDE FT.
FT.
EXTERIOR WALL
ROOF �—
COVERING
COVERING
REAR FT.
D FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN&
MAIN BLDGS.
ACCESS. FLOGS.
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VAR+
G.U.P. #
DATE
APPROVED
APPROVE(i
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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 1 shall not employ
any person in violation of the workman's compensation laws of
epy
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the smte of C.Ufornie Business and Professio Code, Divisicn 3,
Chapter 9, and that such licenses are w full f ce and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the Ste California Business
VALUATION
and Professions Code, Division 3, Chapter .�
PERMIT FEE $
Signature of
Permittee
$O
PLAN CHECK $
IIIII Authorized Agent
0�
TOTAL FEE $
OWNER McPHAIL C. B. DATE 8-3-72
JOB ADDRESS 1830 Oriole Drive BUILDING PERMIT NO. 35026
GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Pvt. Swim Pool
D�11 AP No.139-602-11
\p INSPECTIONS
�� SOIL
GAS
WATER
ROUGH PLUMBING
E
Signature I DateGROUP J TYPE
_ SUBCONTRACTOR
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND'® POWER [�]
ROUGH WIRING Heating and Vent.
TRENCHES X FORMS STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT
PLASTER. BROWN COAT
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
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COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
PAI^II,, tt�t r�
-7T�I,E!'00 ?52* irtY"*-39.?7
APP IC TION FOR BUILDING PERMIT
For Applicant to Fill in Completely
R49EIVED
DATE El%/EDNP ED DATE ISSUED
�� _
BUILDING" p0 ^ �_� J.
ADDRESS
OWNER �• /�
/ P REIT
MAIL y
ADDRESS/93o LJ�{•.
BUILDING
ADDRESS Q�.E
C0/5/v&�
CITY J LJ�. 41�NOL ..a�
TRACT ,;
LOT BLOCK
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ADD A T
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LLEENDER�ION
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BRANCH C%//4`
% /4`
OWNERUE
ADDRESS ��/ G1061
VALUE 2
S /✓� G O'D"l..i $ d �OO
ARC TEL.
ORHITECT
ENGINEER N
.
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED / �._
CONTRACTOR (/
BY / DATE
ADDRESS
TEL.
ZONE
NO.OF
USE OF NE
CITY NO.
�—
PLANS
BUILDINGN
STATE CITY
YARDS APPROVED
YARDS APPROVED
Lhe-NB-- LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE NO. Of BLDGS.
(FROM C/L STREET)
�J /�J
,/170
OF LOT NOW ON LOT
FRONT FT.
pf FTb
USE OF
EXISTING BLDG. GLR
qlnP FT
FT.
SIZE OF NO. OF
NEW BLDG. ROOMS STORIES
L. SIDE FT.
FT. '
EXTERIOR WALL
ROOF -
COVERING
COVERING
REAR FT.
FT.
USEfiF BU ID AND WORK TO B� �PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLOCS.
ACCESS. BLOCS.
VAR. *
DATE
C.U.P.#
APPROVED
!/
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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.
1 hereby certify that 1 am properly licensed as a contractor under
50. T.
����yy
THE AMOUNT SHOWN UNDER VAL TI'M R
the Stara or Carlforme Business and Professions Code, Diyisicn 3,
Chapter 9, and that such licenses are in full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERM\ �v
am exempt from the provisions of the State of California Business
and Professions ode, Division 3, Chapter 9.
VALUATION
PERMIT FEE $
ca a
3
Signature of
Permittee Adl'1.� // •
$ ���0
-Do
PLAN CHECK $ Z
Authorized Agent
��
TOTAL FEE $
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COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APR 17-69Pat .Q0 916* *c * nr
crl�e. 100.00
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECE D
D(q �,T�E RE EYI E
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DAT�zISSU D/q
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BUILDING
ADDRESS 1830 Oriole Drive
—6/
OWNER Jamaica Const. Co.
A.P. NO.
PERMI �.
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MAIL
ADDRESS 2850 Mesa Verde Drive
LDING �/
ADIS /Q 3d 41- /L
DRE
CITY Costa Mesa NOL.5
TRACT 6757
LOT 39 BLOCK
CONSTRUCTIO
W ADD
A TER
REPAIR
LENDER
BRANCH ,
\
OWNER`.Ja.'n 1�,\C.� 1riS� CQ.
VALUE
S S �'T� `OILY' $ �JQ doc
ADDRESS '74
ARCHITECT Kaltenbach TEL 478 a6
OR ENGINEER NO.
FIRE.
ZONE TYPE GROUPJLVV
ADDRESS
APPROVED
CONTRACTOR
BY GATE
ADDRESS 2850 Mesa Verde Drive
CITY Costa Mesa NOL. 5490395
2 E
_
NO. OF
PLANS
USE OF NEW Slt1 1 fall)
BUILDING garg
STATE CITY
LIC. NO. 193122 LIC. NO.
YARDS APPROVED
MAIN BUILDING
YARDS APPROVED
ACCESSORY BUILDING
SIZE' NO. OFBLDGS.
OF LOT NOW ON LOT 0
(FROMC/LSTREET)
FRONT OFT.
FT.
USE OF
EXISTING BLDG.
FT.
FT.
NEW OFr� rr�tNJOO
2620 SQ•FaROOMS 9 STORIES �'
L. SIDE 1/0F
FT.
EXTERIOR WALLOF
COVERING wd StUC
ROVERING wood
%7
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
single family residence
MAIN BLDGS.
ACCESS. BLDGS.
w/att . garage
C URP #
APPROVED
I
APPROVED
I
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
st
�(t0 SO. FT. Q _
the State of California.
I hereby certify that I am properly licensed as a contractor under
THE AMOUNT SH WN 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 1
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
VALUATION
PERMIT FEE $ iaY
✓�
PLAN CHECK $
Signature of
Permittee 10 Om an
$ Ff Asa
Authorized Agent
TOTAL FEE $ (/