HomeMy WebLinkAbout156 MONTE VISTA AVE - Building Permits •
CITY OF COSTA MESA
4 i, pe BUILDING DIVISION
Y %l ,.,... !: , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
1. 1 t®C PERMIT
706-02005
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(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.8lHLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 156 MONTE VISTA AV Status: ISSUED
Suite: Applied: 11/29/2006
Vicinity: Issued: 11/29/2006
Primary 0cc: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: 43941102 Zoning:
Applicant: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
Phone: 949-642-7222 ISSUED BY:
COSTA MESA,CA Zip: 92627
Owner: GRIFFITH, DOUG
Address 156 MONTE VISTA AVE
COSTA MESA,CA Ph Zip: 92627P
VLia I
Contractor: / LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
Phone: 949-642-7222
COSTA MESA,CA
Zip: 92627'. - License: 349686
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: - - License:
• SCOPE OF PERMIT
TEAR OFF EXISITNG COMP ROOF, INSTALL FELT AND CLASS A 30 YEAR COMP. SHINGLES
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,600.00
Permit: $111.25 . Claim Valuation: 54,600.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other $0.00
Inspection: $0.00
•
Total: $111.75
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear. -0-0 Left 0-0 - Right 0-0
ACCESSORY Front 0-0 x •- 'Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§1, 12-21.92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(600)
DECLARATIONS
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
rk for which this permit is issued.
I have and w0 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: I /
Cartier: 5-'tz--tom I a Policy Number: IRI (QC C'i(&- Do
(This section need not be completed it the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shell 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 SSS action 370of the Labor Code,I shall forthwith
empty with these prey' Ions. yy��3 I i ?A P
Applicaeignature: • --�----�� Date:
ARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CML FINES UP TOONE HUNDRED
THOUSAND DOLLARE($100,O00),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Pr fessions Code,and my license is in full
force effect Lic-#-'- '" f\n SSCP _ Class �a
Eontractoris`$ignature PQ� aDate: ( � 7Q
r
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,CMI 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
Coda: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:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 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,Califomla 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? 0 Yes 0 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? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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? 0 Yes 0 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? 0 Yes 0 No
B (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 penally 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 Owner(s) [2;? / to
i'Ani/Or Authorized Applicant j Da e
..r
CODE s INSPECTIONTYPE DM IIlIMAU MEI INSPECTION TYPE PETE =al
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final , 208 Final Plumbing
ICe
200 Final Re-Roof �Z' 210 Final Electricalal
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
' Applicant to fill in all
•spaces except those within heavy border lines and sign all appropriate declarations. 8/ �,�j4L f
PERMIT -3O. / 2- -q T�R�AwNO. LOT '?- UNIT NO. 0� -ICOI- O- koz _^
- OF COSTA MESA ONS-JA{UCTI ON.FF (v�T L//JJR of (Yy`'t Z.j A.P.# Zone
,t ApProplicant's
Act Address __- _ •4,1A ,• ' n�`7$� �s - Iry/ S Main Building: Accessory Building:
Applicant's Mailing • •dress Coo'Lc-- / 7•1i�ia TYPE OF CONSTRUCTION ❑ NEW yADD ❑ ALTER•TI• REPAIR E z
r - ❑ CONVERSION ❑ DEMOLISH OTHER�� •
Al I ♦ -T Front n �J 0
Oviger's(NameQ�� CO l ea Phone � ... DESCR PT ION •• ORK/USE OF BLDG. o � if- ' I A Rear `�TgCJ-•r N
aAddress •R7 1 / len- � �y
Ach/Eng. License No. TYPE OF P RMIT,-j(- GRADING III FOUNDATION C STRUCTURAL C Right (�l.M:• / G
• I III TENANT LI ELECTRICAL El PLUMBING III MECHANICAL ' s • Left / Rn/all �/
A:dress �J/Jp]
Ciintractor's Name •> [ 7 Phone CI OTHER a� !Ping. Ref.# Parking Req./Provided E
r PROJECT DESCRIPTION SQ. FT-yrs_ ` OCCUPANCY P--2 1.., • Q
Address(mailing/ s Planning Notes: CLi-lJ•-� /
, 1 CONSTRUCTION TYPE -4) VALUATION$��. ,/
M
City License No. ZONE GRADING CU.YDS. ACRES /j�/''�J','(.�wr �n F1}/:71- ,p7�e�X /yn:/�
LIC SED CONTRACTOR DECLARATION - ' / T - ��.1/„yI^ t' /W,..vvfDitC�Wu.v�"`i S'�'u.
I hereby a - • rat I am licensed under provisions of Cha - ' ommencing Remarks: PCS I/O ,L- it / 07,1 43 o
with section 7000 • •' Islon 3 of the B . • •rofessions code, and 1 P —� �p l H l
my license is in full force an••.---• ��I�r////��// l�'� ,�l /1 �Y/Q/ al i, 4/ , a ELECTRICAL 5-Ogg'�C /0%) FEES
License - - 'cense No '"•GAJ .� AM WL�� -
Date Signature (/// PL ING r I FEES Automatic WasherTransformer 0 15-50 KW
-> WORKERS'LO
MPENSATION DECLARATION Bar Sink Showers 0 50+ KW
veby affirm that I have a certificate of consent to self-insure or a Certifica •
te _
—
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit / Meter alp to 100 amps 7 SQ
.JO, Lab. C.) ' . ,
Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
8 Certified copy is hereby furnished. III Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connectio •
Date ApplicantFan
' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collect. s Motors 00-1 HP 01%-8
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher - Solar Pip' • - Inc.Solar 9-15 HP 016.15+
I crtify that in the performance of the work f������////// hlch this . r ' 'ssued, I -- /tFixtures
-
• shall not employ any person in any manner as • -,fasl bject to the Drinking Fountains Solar ank •L Microwave / ��
Workers' gnnp ryy�ion Laws of California. /� Device
Date I�.4O� 77 Signature '— �q9 m Floor Drains S mming Pool w/Spa -, Pole Light
NOTICE: f,after making this declaratio•, 5 ou d •ecome subject to the • g a� Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 7 S
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY _ Water Closet Switches • Sign
Gas Service Outlets 9
I hereby work that there is a permit ue agencySc for the performance
of. the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections ''IM Name Interceptors Water Heater
•
Lender's Address Kitchen Sink. Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION - -
•
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash -
following reason (Section 7031.5 Business and Professional Code: Any city or '
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays
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 Roof Drai . •
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
'sion 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee ! $15 Issue Fee IC a.
afrom and the basis for the alleged exemption. Any violation of Section
1.5 by any applicant for a permit subjects the applicant to a civil
malty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTg:
UI, as owner of the property or my employees with wages as their sole 'Reinspection Fee i $15 Fee $ 3 Zoning Approved By l 4L Date itgo V'/
compensation, will do the work,and the structure is not intended or offered Iltrissue
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By - Date
•
License Law does not apply to an owner of a property who builds or improves q
thereon, and who does such work himself/herself or through his or her own Application Issued By _•^_-c/ Date r �n
employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 , SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground r-� /
prove for the purpose of sale). - BUILDING PERMIT $ 9. 4/' 6� SMIP $ A t I7
0 I, as owner of the property, am exclusively contracting with licensed con- • Duct-Structural Refrigeration em PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code: _
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100 0 BTU 0100,000 BTU 'PLUMBING • $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 stem Repair/Alteration /PLAN CHECK 25% $ p ENERGY P.C. $
•
proof of theirWorker's Compensation insurance should be provided to me. • - ELECTRICAL • $ p ( a GRADING $
0 1 am exempt under Section is reason Firepl/Fact.Bit. ICBO# Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date /,. Owner m4& €` Heating System& Ducti Registers MECHANICAL
I hereby certify that I have read th applicatio an state that the bove ❑0-100,000 BTU 00,000 BTU— $ TOTAL FEE $
information is correct. I a• ee to comply with all city and county ordinances 'PLAN CHECK 25% $ 312-• (0'/1"
and state laws re ting ,011 iiltling construction, and hereby authorize repre-
sentatives of t cit/4
Winter upon the above-mentioned property for
inspection pure,/ s. P/ -
Signature •0Date 1/20 ill
_
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 'Cil '_0247ta 2flDZ 6S r
1 - - • DGL.-� c
W ., • f 1 , ,,J•
CONSTRl1Ci1Q#+AND•PLANNI NG POC SPA .
• .,APPRciVALS Permit#, Date Inspector APPROVALS Permit# • Date Inspector
1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location
1
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3.Electrical Conduit Utility-Undrgrnd. 54. Forms
4S.Electrical Condui• t-Undrgrnd.° 55. Electrical Bonding
5.• teel'Rainforcemdnt r:' 56. Rough Plumbing & Pressure Test •
6.'•'Elecfrical UFER Grnd. 1 57. APPROVAL TO COVER-GUNITE i -
r
ff;footings - 58. Electrical Conduit-Undrgrnd. 2 % !
8 ;Fouridation t ', i - ,a 59. Gas Pipe, 0 Undrgrnd.,Test - ;
• 9!Wafer Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap,0 Undrgrnd.
'/%Structural Floor System .� 61. APPROVAL TO DECK it
;11;. Prpperty Sewer Line & House Connection r 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.E Rough Electric Wiring 1 67. Fencing & Access Approval
171 Rough Wiring Sign j7 , 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' •
. 20. Rough:Factory Fireplace , J jJ APPROVALS' Permit# •
21. Ducts,iri Structure .---- i 70. Underground Hydro
22. Ducts, Ventilating j 1 ;k 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 tr. 21s/� � fl/•' 74. Overhead Hydro
26.-T-Barteiling (Structural) .&.Monocoat ( , ' 75. Dry Chemical
27. Frame and Flashing / I Z((3 ft I" Cy 76. Dry Standpipe /
28. La{fii g & Siding r f' ( 77. FIXED SYSTEM FINAL
r• , •b • 7 /
29. Insplation -i' i0 78. FIRE PREV. FINAL . /
30. Drywall Nailing, ,'cl4/ HEALTH DEPT. REQUIREMENT
31. Plaste Brown Coat. ...; ! 79. FINAL INSPECTION
32. ElBZtr cal Power ♦Meter-Final. // 80. FOOD CERTIFICATE ISSUED
33. Fi al Er lectric - . • Odor e Notes: /I.L3/8? - PO-
•
34. Final Heating & Air Conditioning ,
35. Final Gas Pipe-Test rr,,FF t� i
36. Hood or Canopy •
.37. Final Factory Fireplace ',c//
38. Final Plumbing Z-IS-8; /•0 o-Ai ,e lrcJ,.c 'r A,1( t'
a( Ct
39. Water Service-Final - 6 i IW r ; (1 ASL (� vrl.
40. Gas Service-Final
L�2 w-u PIA
41. Solar Domestic-Final. •
-
42. Backflow Preventer •
43. Backflow Irrigationi
44. Landscape Irrigation System -
45. Sound Attenuation - - 11
46. Handicap Regulations i
47. FINAL STRUCTURE & BUILDING 377�jv ciliel-
48. Special Requirements Completed Il C
• 49. Electric Release to Edison ,
50. Gas Release to Southern California Gas Co • _ . ` I -
51. CERTIFICATE OF OCCUPANCY 't• �,..
tr
Ni . Date - �_ I
•
Alpi. .
COUNTY OF CHANGE
BUILDING DEPT. Permit No..3 22...27
636 No.Broadway
Santa Ana,California Application for Building Permit
Phone:KI 2-6211 AND FOR A
Certificate of Use and ;occupancy
\
Date
Dec. 27. 1951
•
1. OWNER'S NAME Ralph-TheyerPHONE:I:H. 271315--
. ,
MAILING ADDRESS 157...44thilay CITY Long Beach
, ‘
N •
Name 4k.nuar Name 1 \fttlbert. /I agar
/ n fen
(Architect or Engineer)
Address Address i14103-TOV.710- 1W-D-211113-
. •,
City City /03--eitarplas Sp
State State ! 1 \
Lic. No Phone Lic. No fil„143.01(113: Phone cir: 49el
\\ •
PROPOSED USE- Dwelling. and.. atttahecl ganule
2. JOB LOCATION • 156
(Nlii9iIrtjlet :Wealtivi (To911.13ttogitnct)
(House No.)
L 1.
\ .
3. LEGAL DESCRIPTION: Lot 82 Block 11 ' Tract 3.Q0
(Metes and Bounds Description ‘1‘.,
4. CORNER LOT ( ) INTERIOR LOT ( 3E) THROUGH LOT (, ) SLOPE OF'LQT ( )
5. SIZE OF BLDG -----4Z41 AREA- 900' SIZE OF LOT- 1\Q113 AFIEA7232
6. HEIGHT OF BLDG - .14,1 CEILING HEIGHT- ,3n NO.II., NO. OF STORIES
f \f \ .
u ''
7. NO. FAMILIES 1 Size of Smallest Bedroom• °no • •„ Size of Kitchen
i \ '
I'1,
S. EXTERIOR WALL CONSTRUCTION' ritueect INTERIOR WALL COVERING PleLetap
(Frame, Stucco, Etc.) /•Y (PlastenDrywall, Etc.)
\k
9. SETBACKS: Front Yard From Center Linc of Street...50i '
\\. No,
Nearest Side Yardir,i0/ Rear Yard 509 Distance in Feet Between Bldgs. on Same Lott-' ----------
1
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
i t • . i ,:‘ •
r-1
11. For (a) Footing: Width 4 Li Depth in Ground I 2 '1 1.,, Width of Wall i,to
Accessory
Bldgs. and
Similar (b) Size of Studs- 2X Li Spacing 1.(i/ "CC Material of Floor 1410 OD
Structures: ‘
(t) Size of Floor Joists- 2- X So Spacing / 40 ' i'CC
(d) Size of Rafter 2- •X• (0 Spacing 2 LI ' - "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $---etheeTee- 0 ‘
0 0 -,---"-
13. I HEREBY CERTir Y THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL 'CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
. _
Signed• ?, 4& . ....._.j
Plans Filed• ( yet" c,).. f (0 e )
By. (4 /VP 6-tePri9
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY
Bldg. Permit - s...2_ 0- 0 1:2 GROUPS cr APPLICATW4. HEALTH
Plan Check • $ 3 -.0.D TYPE ZONING .0 FIRE
Total • - n - $...f.k.,00 DIST. a .. ,
PLANS AND MARSHAL
Receipt No. P/c- ..1.12 MAP
/-*1""" SPEC'S ii STATE
Paid to • • Cerle1.4.... SHEET NO CORRECTIONS ENGINEE).
Date i le -Irk --ti VERIFIED CAL
PERMIT ISS " 1 it DON HUE COUNTY DIMMING
DATE or . ...
514-2-51 . .. . ... ..... ...... ..... DEPUTY
(1A/
/
METES AND BOUNDS DESCRIPTION: .5 E L y lie 4.ea.se3 t fi- SC L}' (o 4 Lelrl
r..,,.1Q. . J 1 3 i. 14-4.- ?Z t".0 -c- 3 010
110 ✓210310410 5!0 , '610
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County of Orange
'Building Department APPLICATION FOR
Room 322 PERMIT PERMIT NO. O/ 3 ;7
Court House Annex J /�
Santa Ana, California , 19 S6
Phone: KI 2-6211
1. OWNER'S NAME 1 — PHONE: G or?3W
MAILING ADDRESS 6 u^i CITY 400(4 )1 e
(Street or P. O. Box No.)
NAME NAME
(Architect/Engineer) Won't. r Builder)
ADDRESS ADDRESS
CITY CITY
State Lit. No. Phone / - State Lic. No. Phone
2. JOB LOCATION 4 aww 1/44.14., art), (At )
tio(House No,) ++�(Nene of Street) (Town or School District)
3. LEGAL DESCRIPTION: Lot ar Block Tract 3 to
4. Meets and Bounds Description — Use Reverse Side of This Form.
5. CORNER LOT ( ) INTERIOR LOT p<1 THROUGH LOT ( ) SLOPE OF LOT
THIS APPLICATION CANNOT BE PROCESSED UNLESS LEGAL DESCRIPTION
IS ACCURATE AND COMPLETE.
6. PROPOSED WORK: New Building (>9 New Structure ( ) Addition ( ) Repair ( )
Altera 'ons ( • Move ( ) Demolish ( ) Conversion ( )
7. PROPOSED USE: SNI �''�
8. SIZE OF BUILDING (K 9 S 3 7REA(L0 2a SIZE OF LOT_S'Ja(IS(?AREA 1 J 7.Z
9. CEILING HEIGHT Q TOTAL BUILDING HEIGHT /1(a ,` NO. OF STORIES
—
10. NO. LIVING UNITS / SIZE OF SMALLEST BEDROOM. // SIZE OF KITCHEN�6
11. EXTERIOR WALL CONSTRUCTION: Brick ( ) Concrete Tile ( ) Monolithic Concrete it
Wood Frame A.) Steel Frame ( ) Concrete Frame ( )
12. WALL COVERING: Wood ( ) Metal .( ) Stucco (d4 Other—
I
13. FRONT YARD SETBACK FROM CENTERLINE OF STREET 0
14. DISTANCE TO PROPERTY LINE: Side Yard 15.1 Rear Yard 7 cD
15. SHOW ON PLOT PLAN EXISTING BUILDINGS NOW ON LOT, STATE USE OF EACH.
16. DISTANCE IN FEET FROM PROPOSED BUILDING TO NEAREST EXISTING BLDG.: ??,..--411-42
17. VALUATION OF PROPOSED WORK: Includin Ey Labor, Plumbing, Electrical Wiring, Heating, Fire Sprink-
lers, Painting, Sewage Disposal $ 1 S0 O
18. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION
IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM
TO ALL LAWS OF THE COUNTY OF ORANGE AN STATE OF CALIFO' A APPLICABLE
THERETO. �j
Plan Filed. SIGNED: f «/
Owner or Authorized Agent
Date-1AR.m.Q 19- S 0 BY
FOR —DEE/PARTMENTAL USE ONLY
19. GROUP TYPE—J( - DISTRICT MAP r—h2 Q NO.
PERMIT FEE $ /(�� RECEIPT NO. . 3 98 PAID TO 72"1-44) DATE 6 - 1 9 -sD
CHECKING FEE $ RECEIPT NO. PAID TO l A
11 " ' �e Courr SU"'. JING
PERMIT GRANTED 6 6 19 3 9 )
PLANS CHECKED BY r fr. CHECK SHEET A I r/,l��:,.•::�i
APPROVED BY:
HEALTH DEPT.—
STATE FIRE MARSHAL
STATE DIV. OF HOUSING-
5M-12.49
•
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