HomeMy WebLinkAbout2134 IRIS PL - Building Permits,. _ ,
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BWiLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2134 IRIS PL
Suite:
Vitinity: RESIDENCE AND ATTACHED GARAGE
Primary Occ: R-3 Dwellingsl Cong Res <10 Type of Consiruction: V-N
Parcel Number: 42615139 Zoning:
AppliwnC BURR, STEVE -
Address: 711� WEELO DR �
COSTA MESA, CA
Owner: MC GAVRAN, FRED ALLEN TR
Address 21341RIS PL
COSTA MESA, CA
Contractor: BURR ROOFING
Address: 711 WEELO DR
COSTA MESA, CA
Zip: 92626
Arth :
Address:
Zip:
Phone:
License:
Phone: 949-548-2965
2ip: 92626
Phone:
Zip: 92627
Phone: 949-548-2965
Lic^nse: 635586
Eng:
Address:
ISSUED BY:
Slatus: ISSUED
Applied: 05/172006
Issued: OS/17/2006
Phone:
License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING WOOD SHAKE ROOF, 17/64 OSB SHTG, 1 LAYER 30# FELT, APPLY 50-YEAR
CELOTEX PRESIDENTIAL. 22 SQUARES
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$167.25
$0.84
$0.00
$0.00
$0.00
$168.09
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0.0
PARKING Existina: o
Rear 0- 0
Rear 0. 0
Reauired: 0
FEE S11i�1h7A�:'i
PLANNING & ZONING
Left 0- 0
Left 0. 0
Pr000sed: 0
Calc Valuation:
Claim Valuation
Right 0-0
Right 0-0
$8,400.00
Sa,aoo.00
�. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
� regulatlons. (Ord. No. 9248, § 7, 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 euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapaetlone and final approval must be abtained. Failure to obta(n Inspections and final approval will result in the expiration of this permlt.
FOR INSPECTIONS CALL: (714) 754-5626
tmo-se �eroo)
WORKERS'COMPENSATION DECLARATON: �
I hereby attirm under penelry ot perjury one oi the tollowing dedaratlons: , . - ,
❑ I have and will malntain e cenificata ol consent to self-Insure for workars' compensetion, es provitletl tor,by section 3700 0l ihe Lebor Code, for the peAortnance ot t�e
work tor whiCh IhiS pBrtnil is IssueA.
� I heve erM will malntain workers' compensatbn insurance, a5 requiretl by sectlon 3700 0l Ihe LehOr Code, for Ihe peAortnanca of the work lor which this pertnit Is issued.
My wo r' compensatlon Insurance carn end poliry numEer are: '// [� �J ��
Carrier._ �—'��� �vc-_C� � PolicyNumber.�Y V + �7
�(Th19 secf�eed nof be aompleted if rhe permitls vaNeO et rne �untlred dW/ars (S I00) or less.)
❑ I cenify that in Ihe peAartna�e of the work lor which this permit is Issuotl, I shall not employ eny person in any manner so es to hecoma sublect to Ihe workers'
compensation laws af Celilo ie, end e het II I 5hould became sub�ect lo the workers' compensatlon provislons ol Secllon 3700 01 the Lebor Cotle, I shell fOrihwllh
comply with these ion .
Ap, plliwnt Slpna[ure: �� ` .. _� Dete�� S I7 �'Q �
WARNING: FAIIURE TO SECURE wORNERS' COMPENSATION COVEMGE IS UNLAW R1L AND SHA�L SUBIECT AN EMPLOYER TO CRIMINAL PENALTES AND CML FlNES UP TOONE MUNDRED
THWSAND Dd1ARE (5100,000). IN ADDRION TO?HE C06T OF CqAPENSATION, DpMAGES AS PROVIDED FOR IN SECf10N 3)OB OF THE UBOR COOE.IMEREST, AND AITOHNEYS FEES.
LICENSED CONTRACTORS DECLAHATION:
I hereby eflirtn that I am Ilcens d der pmN c
�a�ce ane enea. uc.x L'�.5 S�
CONSTRUCTON LENDING AGENCY:
Chapter 9(commendng wlih Sealon 7000) ol Dlvision 3 ot t�e
Code, end my license Is In full
❑ I hereby aHirm that there is e consiruciion lendinp epency lar t�a peAarmence at the work lor which Ihis pormil is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Len0eY5 Atltlress:
Signeture:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby aHirtn Ihet untler penelry of perjury Ihet I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for Ihe lollowing reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires e permit to conswct, elter, imprrne. tlemdis�, or repair eny swciura, prior to its issuance, also requires Ihe flpplicant tor such pertni�
to file a signed statement that he or she Is Iicensetl pursuem m Ne proWsions oi the Contractors License Lew (Chapter 9(commenGng with Section 7000) of DivLsion 3 af tha
Business antl Professions Cotle) or t�at he or she is e:empt therelrom end the besis for the alleged ezemption. Any violatlon ot Seciion 7031.5 by any epplicant for e pertnit
sub�ecis the epplicant ta e civil penalry ol nat mare than live huntlreA tlollars (5500).):
❑ I, es owner oi the property, or my employees wit� wages es t�eir sole compensation, WILL DO THE WORK, and Ihe structure is not intentletl or oHered tor sale (Sec.
7044, Business an� Professions Cotle: The Contrectore License Lew does nm appty to an owner of property who builtls or Improves theram, and who tloes such work
himselt or hersetl or thmuqh his or �er own employees, proNtled Ihel such improvements ere nat Intentled or ofleretl lor sele. It, however, Ihe building or improvemeni is
soltl within one year oi completioq �he owneo-huiltler wili have IDe 6urtlen ol proving ihal he or she did noi build or improve for purpose of sale.).
❑ I, es owner of the properry, em E%CLUSIVELV CONTRACTNG WITt UCENSED CONTTiACTORS to con5lruct the prqect (Sec. 7044, Business antl Pmtessions
Cotle: Tha contractors License lew tloes no� apON �o en owner ol propeny who builds or Improves thereon, antl who contracts for such projeci wiih a contractor(s)
license pursuant to tha Contractors License Laws.).
❑ I em exempt under sec. Bu51ne55 end Professlons CaAe lor thi5 ree5on:
Signawre: Date:
Owner ID veniietl by drivers license. Yes ❑ No Dnvers License No. Expires:
Venlication of Ownarship by (type of tlocument, i.e. � property 1aa blll ar tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I �ereby certily Ihet no excavetlan five (5) or more teet in depth into which e person Is required to descend, wlll he matle in wnnection with work euthonze0 by Nis
permil, end Ihet no building siructure, scaHoldinp, falsework, or demoll�ion or dismemling ihoreof, will bo more ihan thirty-six (36) feet high. (Chep. 3.2, Gry 2, A� 2, Sec.
341, 71t1e e, Califarnla Atlministretive Cotle).
❑ As owner-builtler, I will not employ enyone to do work whic� woulA require a pBrml� trom tha Division of Industrial Salety. es noted ebove. unless such person has e
permit to do such work trom the tlivision.
SigneNre: Date:
Division ot Intlustrial Sefery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORVAiION OF ENiAV: I cenity under penalry ot perjury that I have read this application and state ihat the infortnalion given is
conect. 1 agree to compy wIN all slate laws end dry ortlinances relating to �uilding construction, antl authodze representaGves ot Ne Ciry of Costa Mesa to enter upon the
ebove-described properry tor inspection purpa5es. I agrea not to occupy or ellow occuDancy ot any builtling authonzed by this permit until finel inspection.
COOE �. INSiECTONTYPE � - �
i618 FIaeG System Final Fire Preventlon
1288
200
201
202
203
Pool Spe Flnel
Finel RaRool
Finel BIocWRetelnlnq Well
Final Fectory Fire Place
Finel Sign
204 Final Domdition
Pdg It�L&
6-z_6 L2T
.cooer iNsvecrannae
20G Final Mechanical
208 Final Plumbing
210 Final EleCidCal
212 Final Fire Prevention
220 Final Planning Apprmal
222 Final Sita
250 Final Bulltling/Occupanry
Date
P� QID�L4
■ i
VPQIECTAUOflE55: �139 IRTS PL
OWNEfl'SNRME: MC GAVRAN, FRED Ai'�EI3 TR - -
eooeess: 2139 IRIS PL
COSTA ,'�ESA,CA 92627
AflCMIENGINEEB: � 7 S 4� 6 4 6—G 2 7 3 pEG.NO.:
nooeess:
UNIT:
uxir:
PEXMITTEE: ABC HEAT'ING 6 A/C ( 714 ) 540-0972
aoosess: Z95! GRACE LN
CUSTA MESA CA 92626
tICExSeo COxTN4ci0n oECIABRTION: I nereey atlirm ttut 1 am licencea unaer pmdsions of ChaDter 9 �cammenunA wit� Section
7000) oi Division 7 0l i�e Business aiM Prolusions CaOe. ana rtry krnu is in IW lorce antl ellect.
CITY LIC.: $TRTE L1C.: MS
/ OQ�604p+� 13329P C20 �
Daly � � � � �(, SipnaWr� �� .
WOBKEBS' COMPENSpTION OECIAflRTION: I OereOy a um �hai I �ave a cerlitica�e ol en� Io SelbinsUre or a tetlilita�e ot Workers'
Comoensa�ian Insurance. a� a cenihea covY ��ereol (�ciwn 3800. Lab. C�.
roucrNo.:943535 E%P.OATE: OS�OS�J3
LOMPANY: �EPUBLIC I DEM
^] CCtlili¢4 COOY �5 h¢reGy W��6�EG. C� Certdie0 copy� Ii�O vnN Ihe cit�70inp avi5i0a L
Datr�� �OV � I ��AODfififfi` � _
E1fEMPfION iNOM WOflI(Efl5' COMPENSA710N �EClAR1TI0N: (iNs sec9on neM (ai Ee com� the permt 6 tw one MmAaU �St00) a lar�.
1 cenify tlwt in t�e peAormance ol ��e work �w whic� tNs permii a issue0. I stw0 no� em arry Derwn in any manner w u �o become
5u01e�� lo IAe Workeri CAmpenSaiion LawS a� CdGtomia.
Oate: Sipnalure:
NOTICE: II. alter maiting iNs EecWratian. you sMuIC betome suGje[t to itle Workeri fAmDenutian Dravisions of tlle La�ar
COUe. you must lonhwi�ll compty wit� such prohsons or t�is permit sAail Ge aeemea revaked.
CONSTflUCTION LENOING AGENCV: I �ereDy allirm ihat ihere is a wnsWction IenOinp apenry lor Ihe pedormance ol Ihe work lOr
which ims oermi� is issuetl �Section 3097, Civ. C1.
LENOEP:
nooeess:
OWNEB BWlOEB UECIAMTION: I �ere�y allirm inai I am exem0� ��om ihe Contractors' S�me License Law for tAe followinp reason
(Seclion 7031.5 Busineu an0 Pmlessional CoOe: Arry ury ot CWnry wNU repuires a permit to cwntmct. atleL imD�we, Oemolis�, ar
Roair any siNCWre. prbr lo ils issuanro. ais0 repuire5 ine aoDlicant lor suCh permil to �ile a sipneE statemenl ihdt APlshe is licensea
pursuant to ine Ormrivons ol ine Lontnctori State License Law (Cnapter 9(rommencmp with Section 7000) af Diuivon 3 0l Ine Business
antl Vmlessians Coae) or �lut hNshe is eKempt t�eretmm anG Ne Ea515 lor tlle allepeG eKemO��� �Y ���ion ol Sec�ion 7031.5 �y
any ao7liwm ia a permit suDi��s ine apWiwnt to a uvB penalry of irot mom rtwi live hunEred do0ars (t5W).
1, as ovmer ol tAe D�aVe�Y o� rtry employees xit� waqes as t�eir sole compensaiion, vrill Ea t�e xrork, anA ihe
❑ suucture is not intenOeU or ollereA lor sate (Secuon 70aa, Business anG Pwtesuoiul COEe: Tne Contractors' Siata License Law
Uoes nol aOVN �o an owner ot a O�openy wtq OuilAs ar imprOves t�ereon, anE who Ooes suc� wad himsell/�erself or t�roup�
�is Or her own employee5. pmviaed I�ai 5ut� imD��emen�s are noi inlentlt0 ar otlere0 lor ule. It, however Ihe builtlinp or
impmvement is so10 wilhin one y¢ar of cOmpleiian. I�e mmer will have ihe Eurden o� prodnp �e/stre Oitl not bui10 or impiove
lor Ine purpose ol Salel.
i, as owner of ��e D�operty. am e�clusively contractinp wii� IicenseC comractars io consimct ihe pmlec� (Section 7044, Business
❑ anE Profesvans Caae: The Contranars' State Liceiae Uw Oces rroi appty io an owner ot pmper1yrAro UmIOs ar imD«SlAemon
antl who caniracls tor sucn o�ojects witA a contractorls) license pursuanl to Ine fAniractor5' $tale LKense Law�. I am aware
t�at proai oi t�nr Worker's fqmpensa�on insurzxe stwNC Oe provke0 ta me.
I� I am eaempt unEer $ection: B. b P. C.
br I�is reawn:
Da�e: 0«oer:
l eo nereoy cenity thdt l am aware ol anE unCers�ana Ne repuirements ol California Heattn ana Safeiy COOe Sec�ions 25505, 25593, antl
2553d an0 IAaI I or any NWre DuilOing acupanl wiNwiA no1(cirtle One) nee0 �a Camply wil� SaiU siate mEM anE IM reQuiromenls lor a
Oermit lor conSlNclion or mo�iliWtion irom IM1e Air OWlity Mdnagement Di5incl. H¢Siaenlial con5tmciion applicaiians are erempl imm
�Aese pmvisions.
�ale: pODlicanl:
I �¢re�y cerlity I�al I �ave ieaC t�is application an0 s�a�e �twi ihe aEove inl0rmation is correct. I aqree �o cOmpty wii� all ciry antl counly
o�CinancesantlslatelawsreWtinqla�uildinA��slmctionanA re6yaultnntereD��nulivesoi�Itisdlyloenieru n��eabove�menlioneA
O�opetly IorinsDecuon OutpOses.
Da� ' ' Sign re
Oriver'S License ar Social $eariry •: � �
16aLa6 W�ite-9uilaina�. Green—CoOe En�o¢emenL Canary—Apoliram; PinN—Revenue: Goltlenro�—Assessor
CITY OF COSTA MESA — BUILDING PERN.IT PERM NO; N. 060499
PERMIT NO: M 060499 PLAN CHF.CK NO: N GOVT: N SUPP: N
CONSTRi7CTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE; O'fH
JOB DESCRIPTION ; REPLACE ONE FORCED AIR UNIT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS; NO '3UILDING' PERMiT INVOLVED. MECHANICAL WORK ONLY.
iE iF�ik if iF if iE k 1F;� 1k iF i(� Y.-f #'k ih if # ii� Y� ff iF ft # iF if -0F 1f iF # M� iE If iF x?F iE IE if iF if if if if itif ii if i iE ii Y.1f iE iE 1E ih if x# i4 � 1E iF iF ic 1f 3E 1E?f ##!F lf IE iP Y
Z O N I N G R E Q U I R E M E t3 T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDiNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARKZNG REp • PROV: PARCEL; 92615139 ZN£: REF NO:
PLANNING NbTES>
>
?t * �7E it� * i(� �%* �F � �E iFif * �F i� i� *+t� i� # lE i� f� * tE it� IE iE �!� * iF * * * *+F * �f ,� �lf it� �lE±t� * �e if iE iF �+i� �e iE it� �r ��Fii *+f+tiE iFi(� u� * � * �e iE * if ik i� i�� * � � i�• rt
D E V E L O P M E N T S E R'l' I C E S R E Q U I R E M E N T S
20NING APPROVED BY �� DATE;
HUILDING APPROVED BY ;
�
APPLICATION ISSUzD BY;
i�iEiFiflEiEiEififi(�iEiF?EifiE3EifiElF±Eif-if : t 'TF'�"iF;}
ilifk�lfifiE�lfif3tffkikififlf�FiFlFit�lflfiE!f�Mil�if�lhiflfi(�ififiElF�%�iFitk�EifitkdC �iFdf3EiF)F
LEGALIZATION:N F E E S U M M A R Y
DATE:
DATE: /.2 -30
�iFlfkif�l(�IFiFiF1(�3fk . r. Rft �if#
dliFiF�M�i( IFiFk*iftl�ilkifiFfF�Ek#-kiEki: kiF1FiE
STRUCTURAY, SEGMENT;N
BLDG PMT PLUNBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9.00
25Y SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15,00 0.00 29.00 29.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 29,00 OVER/SHORT: .00
BLDG PMT PLUMBING EL6CTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
'lE iF 1k iE if ih if ik 1f if ik 1f iF M' iF M iE IE iE if iE iF?Fif iE iE 161E iE il' if jF 3E il' if ih iF iF iEif iE'N- ih M� k iF'lE?E'IF il� if if -1E iE if iF IF iF 1r il' 1I' iP i%iE iF Y jE 3f'1E if 1f iE if if 1E ic 1F DF �I'
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
MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00
END OF FEES
CONSTRUCTION AND PLANNING ' POO �PA .
APPROVALS Permit#'p ` ,Date Inspector qppROVALS Permit� Date Inspettor
i. Temporary Electrical Service or Poie 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. �" 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. � 55. Electrica� Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd. 57. APPpOVAL TO COVER•GUN�TE .
7. Footings � 58. Electrical Conduit•Undrgrnd.
8. Foundation " 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, � Undrgrnd.
70. S[ructural 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 Dreins 64. Plumbing System � Final
14. flough Plumbing 65. Electrical�Final
15, Rough Electriwl-Condult- 66. Solar System�Final
i 6. Rough Electric Wiring 67. Fencinq & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T 8ar Ceiting 69. POOLISPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Strutture 70. Underground Hydro
22. Ducts, Ventilating 77. Product Pipin9 OGas ❑Oil
23. Gas Pipe�flough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74, Overhead Hydro
26. T-Bar Ceiling (S[ructurall & Monocoat 75. Dry Chemi�al
27. Frame and Flashing 76. Dry StandpiPe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing � • HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coat � � 79. FINAI INSPECTION
32. Electriwl Power Meter�Final , 80. FO00 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning �y�3J/y �
'i
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Reg�lations
47. FINALSTRUCTURE&BUILDING ,
48. FINALPLANNING '
49. Electric Release to Edison ,
50. Gas Release to Southern California Gas Co �
51. CERTIFtCATE OF OCCUPANCY
No. Date
i
.'I _ . '. i?� i . r y ,
' 'i'� , ` i.-.
� � .
i (' . � 2� 'i�� �'�^�,� . ������`3�� ���������i8�� of �o�El'E�,Z C'a%foL:ta, J/,u.
�2� !� I `I�I O�y , 7.0. AO� s7 . 3i10 h:A?C2T WAY . lC?:G SEhCH, ULIF. 9C801 • j213� <26�7355 •(213j 676QI86 . �71�) 828�64;1
� ;xnn'C4 OvnCEs: '
Tc5TIN6 � rsi..oue,.•�,.�..s��,.� �a:-:., no,o„�..�r...r.�i,., . .
$n.!eAne.C+f.(arrfecl:C) %� '• P.O.la.�l
� a......-
' 1>I�� 511.}O�i `) Ir�^"1 �'. �
.. �� �I�..��'.�i1� Lo.g 9.eaF. CJ�I. VOB01 11q1 ele.t�ee
�+++��{
. � - �� `'V`�
. �. Y�.'��-,rl
,Tu1y.8, 1976 `
Examination: 76-4268
GUNITE
� � COM?RESSION TESTS ON YX7{�C3�`c'� CYLINDERS �
Bob lienderson
17817 San Ra:ael
� Fountain Valley, California 90708
PP.OJECT SWIMMING POOL ��I�/ .
ADDR'e55. 2134 Iris P1., Costa Kesa, Calif-ornia
� SAMPLE FROM .A11 6 cyl�inders taken from floor of pool � �
� ' ARCMIiECT . , ' � CONTRACTOR
Owaer
' ENOINEFR � ' . SUBCONTRACTOR
Les�er Paley �nte.prise Gunite .
SFECIFIED
MIX 6 sack yd STRENGTH 2,000
' � DATE CAST ��1/76 SLUMF
DATE TESTED � 7%8/76 .
. CYLIiVDER NO. 1,, 2 3 �
CO1hPRESStON 7 days 7 days 7 days
� TOTAI LOAD, LBS. , 128,000 118,000 102;000
, POUNDS PER SQ.IN: 4,530 4,1i5 3,610 �
.' COMPLIANCE 7 day tests comply with specifications.
��
AUDE EY DELIVEREO BY lECEIVEO ON
' CYLINDERS Crews Sob Henderson ' 7/2/76
, I D�SiR10UilON: .
Bob Henderson - 2
Cos[a P;esa Building Dept.
, �
���Ca��.�.f/�
•lL 9[VORTS ARC SUEVITT[p A$ TY[ CONfI�CNTI/�L POOPCRTY OF CLIE11i4. AVTMOAIZ�TION iOR IV�LICATION Of OUN MLPORTi. CONCLVO�ONS, O�f CI.
TRI.CTS (ROM OP RCG�NDIN4 Tv[v IS FESCFV[O I'f.NOiNG OVA WNIiTEN A„PqOVAL /.S�A MUTVAL FPOT[CT�ON TO CLICNTI� TI�E PVGLIC �ND OVPlCLVC3,
93092 . '/
Gunit
- AEPORT OF INSPECTION ON Mason
Concrete
Bill '+'0:
Address:
0'd:. E R : �Al� / 7�/J (� „/2�iAr.��,.c
� �
f'':t0•iECT: �/„�� �Ga(! Report No. � _
Adtirc.5s: �%3 �% /�f S p� - Permi t No, (.T��f ,��
Ar:hfCect:
Aidr:ss:
[ag(neer:
lcir'ress :
In,:ector:
i, �, � �.
��-
_ �i6'. �
.! Q � ..� .s
Mix Used: � � •
Sluinp, Inches:^
Admlxture: —
Ilesignad Strength, PS1: �.a�
Inspector:�� �i.�.,�,s.,t
Contractor: ��/y�p� _
Address: �SCZ�.•�Q
Subcon[ractor: �e====� .. Co
(Gun([e, n
Masonry or �a�L�o�azY
Loncrete)
Address:
Rebar:
Brick:
Block:
The following inspectlon was performed in eccordance with the approved drawings.
DA7E5
7'�i ?�
Cu.Yds. No, of
Placed Cy1•
Remarks
d
^op'es of Reports to: (INDICATE WHICH BLDG. DEPT. 6 FURNISH ADDRESS OF ANY NOT U STED)
33o z
PflQIECf p00PES3: 2 S 3 q I R 1$ P L
owxen�sxune: FRED 6 MAXINE MCGAVAAN
nooaess: SAME
646-6273
RRCM/ENGINEEH:
flE0.N0.:
uxrt:
^ RDOHESS: UNIT:
PEflMiTiEE: MAXINE MCGAVRAN ( 714 ) 646-6273
nooxess: 213Q IAIS PL.
�i C.M. CA 42626
UCENSEU CONTMCTOB OECIAMT�ON: I �ereDy affirm ttwl I am Iicense0 un0er pmdsions af ChaO�er 9(cammancinp wit� Section
7000) at Division 3 of I�e Buslne53 and Pmiessions Cotlo, anC my Ilcense is in lullforce and efleci.
CITY LIC.: ST�TE UC.: , CUSS:
Oate: S�Onature: '
WOflKEBS' COMPENSRTION DECLANNTION: I �ere0y affirm Ihat I have a urtifiwta oi wnsent to selbinsua or a ceNfiwte oi Workers'
ComDensation Insurance, or a certi�ie0 copy [hereof (Sectian 3800, Lab. C�.
Pol1CY NO.: E%P. ORTF:
"OMPRNY:
Certllie0 copy is �ereEy fumi8hed. ❑ CertitieE coDY I5 fileE with t�a dry Bu1lElnp DiNsion.
Daie: APPlicanC �
E%EMPt10N FflOM YlOflllENB' COMPEN&1TION DECUIUITION:' Rrys uNm nee0 not Ue com0leteA if IAe permit is tar ane hundreE
I certiry ttat m the peAmmarae oi tM work to� which tMs permit is ksueC, I shatl iwt employ any pe�so,� in any man�u� so
sublect ro IAe Warkers' Compensalion Laws oi Cafifamid. ;„_ l lL,n i[�
�ate: - '1 u SiOnawre: � / �(.�!�!�i� � � i .uanit �� w.. 1
NOTICE: It, atler makinp this Geclaati n, you s�ou10 Eecome subject ro the Warkers' Compensation prwisions ol IAe La�or
coee, rou mus� mnhwim wmoN w+�n sucn o��+ or ws permrc sna�� ee aremee rewkea.
CONSTBUCTION LEXUING �GENCY: I herehy attirm that �here is a consWction IenGinp a0ency far IAe pedormance of tAe xrod lor
whic� I�is De�mit is iuuetl (SeclioP �7. CN. C�.
LENOEB:
RODNE55:
OWNEB BUIIDEB OECUMTION: I hea�y amrm ihat I am eeem0� �rom the Contrapors' State Liceme Law lor IAe IOAowinp masan
(Section 7031.5 Busineu aM Pmlessional Cotle: My ciry al wunry which reQuires a Oe�mit ro construct, alter. imDrove, Eemolis�, ar
repair am� sWctu2, D�<<o its iss�a��e. also ro0Na5 Ne applicant tor such permt to fle a siyneC statement ttwt �elslre ¢ IkenseE
pursuant to the Drovislons ol tAe COMractors Suta License Law (Chapter 9(cammendn0 vrit� Section 7W0) of ONision 3 0l t�e Bus�ness
anG Pmlessims CoOe) or that hrlshe k exempt ttreretrom an0 Ihe Eavs lor the allepeE exemptbn. My dolatian ol Sectlw 7031.5 �y
any aD7�icant tar a Dermit suEiects t�e aDDliwnt to a civil penalry of not moa ihan INe nunOreE tlallars (5500).
,y 1, as axnar of lhe proparry or my employees xith wapes az[heif sola com0ensation, will Eo th0 work, anC Ihe
U simcWreis nolinlenOeE oroflerad lorsale (SecUon 70G4, Business an0 ProlessionatCOAe: The Coniractors' Stata Licanse Law
does not apDty to an owne� ol a properry who 6uilas ar improves ihereon, an0 who Eoes such work �imself/herself or lhroup�
his or Aer own empbyees, 7rovitleA ihat wch imD�avements aa not intenEeE or ottera0 lor sale. If, however I�a builtlinp or
im0�ovementi5 solG within ane yearai wmpletion. IAe owner will havetha hur0en ol pmvinp he/she Oitl not Euiltl orimD�ove
fw ihe W� of sale�.
I, az owner ot t�e D�opeM. am exclusiveN wntractinp with Iicenu0 wntractars to canstrutl tAe prole�� (�lion 7044, Business
❑ aM Professips COEe: Tha Cwi�rzpars' 3tate Lkense Law Eces nat appy ta an ovmer ol properry wlp bml0s or imprwes Nereon
an0 who contracis lar sucn Orojects c;th a contractorls) license pursuant to ��e Contracfors' State License Law�. I am awam
tlut D�� of t�eir Worker'S CumDens.tion mwrance SMuIC Ge proviEeC ro me.
� I am evempt unEer Saqion: B. 8 P. C.
for this aamn: /
Dare: �, ��� U � _� Owner�A���� �i1L
I Jo AereUy certity thai I am awam ol an0 un0erstan0 t�e repulrements of Califomia Health antl Safery Cotle Sections 25505, 25533, ana
25534 anE that I or any future DuilGinp occupant wilUwill not (Nrde ane) nee0 to compty wit� sab state co0e5 anE Ne repui2ment5 �or a
permit for consimcti0n ar moJilicaUon from tha Nr Dualiry Manapemem �istricl. flesiUential wnswction apDliwtions am exempt Imm
Nese pmvisions.
Date: Appliwni:
I �are6y certiy IAat I have reaA Ihls aDVlication and stale that Ihe a6ove inlarmation is carrec�. I aAree to camply wit� all ciry anE counry
ordinancu an0 state laws alatinp co �uilCinp consimcuon an0 �ere0y aucMrl:e reD�eunutives of is ciry ro enter upon tha abovamenGweO
pmperty far inspeclion pujrp�oses. ��/] /����n'.,�,, �.,//��/�� �
Date: �'� R V Spnature��l 1-�I—(��M/N.c �/- �1 �1—
Omtr's Lkenu or SaialSecunry N:
47L � T_
1841A6 W�ite—BUIMi�p; GrpOn—�e Enforcamang Cenery—Applicant; Plnk—Revenua; GOltlenroE—Aesenwr
CZTY OF COSTA MESA - bUILDING PERMIT PERM NO; B 047141
PERMIT NO: B 047141 PLAN CHECK NO: 03818-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: OTH
SOB DESCRIPTION ; 126LF-6FT HIGH CITY STANDARD HLOCK WALL SQ FT; 126
CLAIM VALUE: 2,000.00 CALC-VALUE: 2,520.00 GROUP OCC; M-i /
COMMENTS: �g �g ��� p
*�e�+�*x*�t+�****x�t�t*�rx�r**�r*�e* rt�*�*+��+��at*�**�r****+t�ar*****�**+�ilVl�l'�C*��C�%'��P`1
Z O N I N G R E Q U I R E M E N T 43
sETBA�Ks REQUIRED
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42615139 ZNE; R1 REF NO:
PLANNING NOTES> SOFT, LONG, 6FT. HIGH BLOCKWALL ALONG REAR P/L• 76FT.LONG
> 6FT. HIGH BLOCK WALL ALONG SIDE P/L. SETHACK AT LEAST 20FT.
*�r*�r�r�e���rx*�r*�*n�r�r�r*�**��r�r*�r�*�+r**�rx*�**�rx**�r��r�r*�*�***�*+r�r�rx*x***�r****�r*+�*****
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�Y' S
ZONZNG APPROVED BY �-� , DATE: � � � �„O
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE;
i! iE ik if ik 3t iF �k it iE 1F 7f iE ik it it �lE if �N� iE if iE iE k 1f iE �E if !F iE iE IE3Fi�F��iFiE i(�
iE if 1F �k if if �E iE iE iElf 1E 1f iE iklf iE iE �F iE 1f if it iE iE iE if ik ff if k fklE iE iF iE iklf 1FlE iE iE iF 1f * ip iE it iE iE iP iE iE it 1E iE 1E it 1E if iE ik it iE if if if if if if iF if iF if iE iE iF if ik
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC ,MECHANIC'� FIRE SMIP/RES GRADING
PERMIT 54.00 • SMIP/NON-RES
PLAN 35.10 - _ `�, � '
ISSUE FEE "
HUILDING-DIV-> PERMIT ISSUE PL'AN=.CHECK ' ��TOTAL pAID DUE
TOTALS----> 54.50 0.00 i-35,10,: � 89.60 89.60 ,00
REVENUE DIVISION TOTALS--> COLLECT�ED: 89,60 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC `FIRE SMIP/TOT GRADING PLAN-CHECK
54.�� " ; 'J f ,50 35,1�
iE iE M 1E iE 3f M 3f 1E iE if if !E iE iF ik 1f if it iE iE iE iF iE k ff iE iE iE it iE iF if iF if iE iE iE 3E iE ik if if iF iE �E iF k if if 1E iF iE %3E ik iF iE iE if %iE iE �f iE iF iF k iE iE iE if iE iE �f jE iF if M
,_ I N D I V I D U A L- F`.'E E B A E A K D O W N
rn
TYPE QTY D E S C R I P T I O'.N�^; UNIT COST TOTAL COST
SFR 126 RES-CONCRETE BLOCK WALL 1 ',�/ FT:: 20.00 2,520.00
END OF.FEESf ;_
iii
�� O1 00059840-0005",S4'2 T Ca'p' C5,6p
DATE: O5/OS/9Q TIME� 09:14
CONSTRUCTION qrlD PLANNING - P�� ' SPA
qpPROVAL$' PeTmit # Date Inspector APPROVALS Permit # Date Inspector
1.,7emporary Electrical Service or Pole _ 52. Pool & Equipment Location -�
2, $oil Pipe�Undrgrnd. 53. Steel �Reinforcement -
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrica� Bonding .
5. Steel Reinforcement - 56. Ro�gh Plum6ing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings C�l�-�� L s y0 � 58. Electrical Conduit-Undrgrnd.
.8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11, Prope�ty Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sewer Cap � 63. Heater & Vent�Final �
13. Roof Drains 64. Plumbing System � Final
14. Fough Plumbing � 65. Elecirical-Finaf �
75. Rough Electrical-Conduit 66. Solar SYstem•Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring $ign � 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYS7EMS FINAL
79. Rough Heating & Air Cqnditioning FIRE DEPT. REQUIREMENT �
20: Rough Factory Fireplace -� ;„ -� APPROVALS Permit # `
21.'Dutts, in Structu�e' ' � ' 70. Underground Hydro
22: Ducts, Ventilating � � �� 71, product Piping O Gas OOiI
23. Gas�Pipe�Rough & Test ,_ � � - _ ' 72, Underground Flush '
24. Roof Framing � � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheaihing - ' _ ' r 74. Overhead Hydro .
26. T•Bar Ceiling ISvuctural) & Monocoat - � . 75. Dry Chemical �- •
27.= Frame and Flashin9 ' , ' ' 76. Dry Stanii'pipe � ; ' . '.
' 28. Lathing & Siding � ' '`��' � ' ' " • 77; FIXED SYSTEM'FINAL � �
29. Msulation • ' �_ • _ � ` ' 78c FIRE PREV. FINAL '
30. DrywallTNailing � � �HEALTN'DEPT. REQUIREMENT
31. Plaster Brown Coat '- - �''79. FINAL INSPECTION
. 32.�Electrical Power Meter-Final - 80.= FOOD CERTIFICATE ISSUED '
'. 33.�Final Electric . - ' �_ ' Noies: ; p " � _ �
"t34. Final Heating & Aii Conditioning �,� , � ' � ''�
35. �Final Gas Pipe�Test � •• � • _� �j� '7 i
Z� �'
� 36. Hood or CanopY w , . .,_ �
37. •Final Factory Fireplace � ' + � d `„`
, 38. Final Plum6ing , N� : .
39. Water Service-Final .- � + + - � .. � �. „[,�, � _ /
�� v ml
40. Gas Service-Final � ' ' • , , _ .
- q7. Solar pomesticFinal - � - �. - , _ - �
42. Backflow Preventer � * `' . � : �
} . . .
43. 88ckflow Irrigation - � ' - � � .
44. Landscape Irrigation System. _' - • " "
' 45: SOund �Attenuation ' . .. . �
46.� Handicap Fegulations • � ' .- -
47.�FINAL STRUCTURE & BUILDING � 5-(��j (pyv � � -
48.�.FINA� PLANNING � ' �
49�.� Elearic Release to Edison -
:a
50. Gas Release to Southern California Gas Cn
51. •CERTIFICATE OF OCCUPANCY
No. Date
'' �p� ( v2 8 ��
�. .- APPROVED
� i
, urr of cosr� �+ ,
r�wwu+o nErt•
�� ro wa. nsT. na !
�Y �l_�---DA I �� ,
.�. a �•
� �j�vc�C. w c� ��•
�
�
W
W
Q
r
N
1
��aoara
6�A e `r � ���:����
City of Co�"a Mesa Buildirg r�i�'?,
BY � DAT�=L 19y�
THESE PLANS MUS i BE ON J03 AT ALL TIMES MAKE
NO CHANGES WIiH0�1T PRIOR APPROVAL OF DEPT.
`�'��.�y�
THE{ISSUAtdCE GP, GFANTVhG OF PFAM � O'1 A4PROVAL OF
PLANS ANC SPEC:FlCAilONS SHALL :7�i BE CONSTRUED :J 9E A
PERn1T i0:2. OR AN i.FPROVq! OF. AIVY VtGiAi+01t pi AVY OF
THE F�G�^StGNS OF THIS CODE. NO FF.cnlf fRESU!AfNG TO GIVE
AU'iFCZItt ?O YICLAiE O& C...\CEt T�c .'BO\;SIOtu$ pF TMIS
CO�E SriAl1 dE VALI'J, 6XCEPi 1N Si: FAEt A> itE N�ti 081}5:
Wii1CH IT Abi�'�n:'cc IS !n\YFUL.
�TNc' ISSGA?:CE C% P PZF:',li Ed5�6 C�J: .'_pK5 AhD
SPECIR.ATIUN$ $HP.LL t�0� PF3'ENi 7.:� 8U':i:Nv .FFIGIAL
FR07d T192EnFTER GEQU�4ING TF'E CO?'.2Cf'v-+ Ci Er.'CRS IN
5413 MAN$ A(JD 5?EG�ICATI045 c.�7 %•'7- cqE�c�iWC
� BUI:D:NG OaERAnJNS BEIN3 CARRc„ J a(niF.dvr.�Ef Nn"crs
�'N VIOLq710N OA TF"5 CODE OR OF A�:Y OTYf% i.?L.f.A�tLE OF
� :Ic CITY. .
i. � . _
�auoarci
nnouct
STREf 1 e �� I S
2ti 34
u�atrea
ly�s PI.
P�a«.
Fe„ �
z°f+-
Ceme�t Coping Optional —'
Channel8bck With 1�3/8�
HoriiooUl Top ol all
Fenca
For Feneef 5' or Lesf
Ven. Bars 3/8" � at 4' �0" O.C.
fnr Fencea Nigher Than 5'
Ven.Ban 3/8"� at 32" O.C.
Fill Cells $olid With Grout
W here Steel Oecurs
Reinlorcinq Steel Shall
Conform to Set.A-15-39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURALGHADE
TWO 3/B"4 BARS
CONTINWUS TOV
d BOTTOM
HOQI2.STEEL MUST BE TIED IN
PLnCE AT TIME OF TRENCH
INSVECTION.
T Y PI CAL 6�� CONCRETE BLOCK FENCE
z
� �A^ J�
n�
�K'IOTH
p SEE CHd
� BELOW
ol-
WIDTH 14
THICKNESS 10"
DEPiH OF EARTHTOOTH 24��
SPACING OF EARTHTOOTH . 12%
=00TING REQUIREMENTS CHART
5
14"...
10"
20"
14� . .
City of Costa Mesa, California
Building Department
��P•: �,al� 1�InV. P^
) � � �' O �, P S . '. P .
GENERAL- NOTES•
,. �
MORTAR; pna Part Plaslic.Cemenf, an,d
TAree Parts. Sand
GROUT; One Port Cemenf Ttvee and
O�e Hol( Parfs �ond
COPING: `""One"Porf'Cemenl;�7Aree 5
.P,arfs Sund .: .
CO!uCRETE: Weii�MiKee C2-1i2:3-i/2
Mati. ol 7-I/2 Gallons ot
Waler Per Sack of Cement
GROUT MAV BE POUNED FROM THE TOP
OF TME FENCE IN CELLS WHERE STEEL
OCCURS.
CELLSANDAREASOF HORIZONTAL REIN�
FORCEMENT SNALL BE CLEAR, CLEAN 6
FNEE OF ALl MORTAq OEBNIS. ETC.
�N Gf E4RTHiCOTM
�/� TNE HEIGTM Of FENCE
BELOW BOTTOM Of fOGTiNG
SCALE: I/2"= I'
IL . . 12
9�. 8"
I6" . . . I2"
16'. 16'
r
PARTY WALL AGREEMENT
2sI5 AQt��. made and entered into this
. by and betveen
hereinafter referred to as "LAt�ID OfdII�dt", and
hereinafter refetced to as •ADJACZ't�TP PROpE[rPY Ofd�R".
day of
It is hereby agreed that a party wall vill be constructed on the
property line betveen
(Address of Adjoinirg Properties)
in the City of Costa PSasa, C.amty of Orange. State of California, as pet
map recorded in Book , Page of Miscellaneous Maps, in the office
of the County Recorder of said Coimty. 7t�e party vall shall be �.+�;tted to
encroach
IN WI� f�R60F� the parties have entered into this Agreement the
dap and yeac first above vcitten.
,u �..�,i:�•
Signature
Name 7yped or Printed
• i � «r • •,� • :�• • , iv•
Signature
Name 7j+ned or Printed
� : f:F : �Z'-S:'r-1
Permit �# T3 4< 7/�/ 1•
THIS NUMBER MUST ACCOMPANY
ALL INSPECTION REQUESTS
FRED McGAVRAN
2134 IRIS PLACE
COSTA MESA, CALIFORNIA
92627
April 26, 1990
Pat Stephenson
2135 Santa Ana Avenue
Costa Mesa, CA 92627
Dear Mrs. Stephenson:
We propose to erect a block and wood fence on the property line
to he used as a common wall between the properties at 2135 Santa
Ana Avenue and 2134 Iris Place, Costa Mesa, California.
If you are in agreement with this proposal, please sign below.
Thank you for your co-operation.
.'� �--�
'"�-------
Fred GN�
-----------------------------------------------------
-----------------------------------------------------
Permission is hereby granted for Fred McGavran to construct a
block and wood fence as described above.
S/S'�rC/ - - -----
Pat Step�renson
�p`l
�j, 199�
������,.L92p -----
te
i
April 26, 1990
Permit #� � �l-71 �- (
THIS NUMBER MUST ACCOMPANY
ALL INSPECTION REQUESTS
FRED McGAVRAN
2134 IRIS PLACE
COSTA MESA, CALIFORNIA
92627
Glen and Fran Sorensen
2138 Iris Place
Costa Mesa, CA 92627
Dear Glen and Fra�:
We propose to erect a block and wood fence on the property line
to be used as a common wall between the properties at 2138 Iris
Place a�d 2134 Iris Place, Costa Mesa, California.
If you are in agreement with this proposal, please sign below.
Thank you for your co-operation.
//� - ----------
------- -
Fred Mc avran
Permission is he�eby granted for Fred McGavran to construct a
block and wood fence as described above.
---�''���- ==-':�i'�t-/�-�-L-Q'Y1 --- -------------------------
Glen orensen � Fran Sorensen
--- �� _G!(� -----------
Date
MR'f 1 t99�
G" �-
�. , 2,�s���
�OSTA /v1ESA �LDING-SAFE
• � P. O. BOX D f 7.. COHTA M¢S
For Appllcant�.�f�o Fill In
TYPE � R� PRII
1"
ADD E'S9 � � �� �Si
COSTA MESA. CALI
CONTRACTOR OW�E� -
ADORHSS 1 / � � I/t I
��TY Coas rA ,<-/�sa
STATE
LIC. NO. ' � 1
OF LOT /. x� $ % /�i�o
USE OF
EXI6TING BLD6. �K S� L
6ETBACK LINH F0.0M
��, ��ti�'c FEE RECEIVED
t`,.�, .;. ,; � ;
Y�DEPARTMENT AUG 24 I9E4
�CAL'IFORNiA .. � fiNANCE DEPT.
Comple�e APPLICATfbN FOR���MESA
iT ' BUILDING
„ for Office Use Only
�I, . RBCHIPT NO. PERMIT NO.
TEL.
DESCRIPTION OF WORK
NO. OP
EXTERIOR WALL
COVERING
U66 OF BUILDIN
Q
,
a
�77 iALt �,JcLOSc �Y o
1 HEfiEBY ACKNOWLEOOE THAT I HAVE REAO THI6 APPLICATION
AND BTATE THAT THE ABOVB �9 CORflECT ANU AOREE TO COM�
PLY WITH ALL CITY OflO�NANC88 ANO 8TAT8 UW8 R80ULATINO
BIIILOlNO CONSTR CTION. ''� �
P RMITTE E OR `
AUTHORIZEO A6ENT
ZONINCi
rvo. ov ue[ or ncw
vue+e aw�o�r�o
YARDSAPPROVED
MAIN BUILDINO
VAR.$C �a
—i� s—�r
IAN6 BMALL BE LE59 THAN
VAR�SAPPROVED
ACCESSORV BUILDING
BET. MAIN R
AGGE55. BLp03.
DATE $ �' � ��
APPROVED
. �i _ \ _/ –/
�� N
84. �. �
TH8 AMOUNT SXOWN UNDEP VM1Ll1ATION �B FOp TNE 4
PtIFPOSE OF 68TABL�BHINO q PERMIT PE6 ONLY. �
VALUATION / m _
dD PERMIT FEE $ 6 — " � . -
� �
m
� 9�� E s
, �
.. . _ ; , . � ����.=�
CflSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 COBTA MEBA. CALIFORNIA
For Applicanf io Fill In Compleiely
TYPE OR PRINT
COSTA MESA.,CALIFORNIA
A�DRE66 QD-Ne DY't BlVd.
c�rr Ner ort Beach �
ORCENGE EER D• Southtaorth �
ADDRESS CO9t'i$ Mesa
CONTRAGTOR ��� l �i' ^`�
1 SIZE
� 6HTBACK LINe PROM
1 EXTERIOR
8811
5161
�o: ox3 8811
� r I NO. OR 01D09.
� I LEFT S� O', I RIGHT lO � O��
DESCRIPTION OF WORK
I X II ALTERATION I II AOOITION I
$
�� � � �ECEI��E�
r� APR 2 o t"..t'i1
fINAi!CE DEPT.
CIIY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
� nsceivr NO. PQiW1T�N0�
�'�t..c�s ►
BY IUA'[E RE�EIVFD� I UATE IBSIIED
7 % J tv ADR `� 4 �9ot
COSTA MESA. CALIFORNfA
FIRE
ZONE
APPROVED
ZONING
ZONe I NO. OP I 116H OP N6W /
R-1 PLAN9 2 BUILDIN6 W •d t
�;a�o,�,,,,, Lot #4 Tr. r�3856
APPROVED
USE OP 6UILOING ANO ORK TO BE PERFORMED
Res, w att. ara e
Plan 161 B I 16 0 sn. ft. r
J 620 sq, ft.
1 HEPEBY ACKNOWLHDOH THAT 1 XAVE READ TH18 APPLAGTION ����_.,,�
ANO BTATE THAT THE AGOVE IB CORflECT ANO AORE¢ TO COM- �������
PLY WITH ALL QTY ORDINANCE6 AND BT�TE L�WB itH6OtATINO RP06
BUILDINa CONBTRY�oN. %� VALUATION
SIGNATURE OP I f �� . � \ ' � � �.�
8T. )
IAUTHORI2ED AGENT ��/ -��-�t '$ �� ��7 � P�N CHECK 5 lU � J��
- • � 74:.• 6
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BO% 1200 COS7A MESA, CALIFORNIA 92626
For Applicant to Fill in Complefely
ADIDRESS /�� 3 7 L IZ IS PC.-�
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OWNER
MAIL
CITV
BRANCH
ADDRESS
ARCHITECT
ADORESS
CONTRACTOR
ADDFE55 ��
CITV
STATE
LIC. NO. � �("'
SIZE
OF LOT `Q
USE OF
EXISfING BLOG.
SIZE OF
r.va��
USE OF
� NO.OF
Y ROOMS
�« ROOF
OVERI
WOfiK TO BE
TEL.
No.s-yG-G9� 8"
cirv
LIC. NO.
NO. OF BLOGS.
NOW ON LOT I
1 heraby aeknowledge that 1 have reatl this epplication antl itete
that tha ebove informetion is correct antl apree io comply wlth
all taws resoiei��e a��m��o construction, entl 1 sheli noc empioy
any perwn in violat�on ot Me workmen's companseilon laws of
Ma Stata of Califorq�a, '
I he�eby certity thai � am prOpe�ly licansed as a contractor untler
ihe State of California Businass antl Professions Code; Divisicn 3,
.Chapter 9, an0 Nat such licenses are In tull �orce antl etfact, or I
am eaempt from th> p�ovisions ot the State ot Calitornia 6usinass
and Professionz Cociu, Division 3, Chapiar 9.
SiB�ature of y///�
Permittee �r �%/1 � •�-/<t-! -
Authorizetl Agent
FOR BUILDING PERMIT
'L�i -�
I U�I�3~ •� I rcr
A.P. NO. I
BUILOING I"1'� � ^f�`s
ADDRESS L .,�,-r
p ��
TRACT �a —� LOT
OWNER
FIRE
NO.OF .
PLqry$ �
VARDSAPPROVED
MAIN BUILQING
./� �i
/�' FT�
� G� i.
VAWE
DATE /O' ��,
USE OF
BUILDIN EG.�OC
YARDS APPROVED
ACCESSORV BUILDING
REAR L I FT.
DISTANCE BET. BET. MAIN &
MA�N BLDGS. ACCE�. BLO
�-�-% �O�F� DATE
-i.S -
� �
O SQ. FT. T o
THE AMOUNT SHOWN UN�ER VAL N IS FOR �
THE PURPOSE OF ESiABLISHING A PERMIT FEE ONIV: m
¢
VAWATION / ��,C m
PERMR FEE $ �I �
7
LV(l m
S� D� � PLAN CHECK $ E
� LL
TOTAL FEE $ � �
�
e
��A II �'d�y' l':.u::�.. � �r�.;��;1 I
OC� 2 � ��,:,-
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING . . ._ .� �-n. _ ��
OWNER �
MAIL
ChlIFFAA
CANSTRUCfION
BRANC}i
ADDRESS
ARCHITE�
ADDRES:
CITV
F STATE
� LIC. NO.
{y SIZE
a Of LOT
a USE OF
� EXISTING I
N
S
F
C]
�.�., USE OF e
Q
�
..1
a
>
r
.�
�
�
a
TEL.
NO.
TEL.
NO.
/�Y
NOL��6
CITY
LIC. NO.
NO.OF BLDGS.
NOW ON LOT
$eparate permits are required for
electric, plumbing and heating work.
i/1lDING AND WORK TO BE PERFOFMED
�ti,�
ill�� � �-�^�r;'e 00? 87�� =.. ��u0.5�
R
A.P. NO. /
BUILOING
ADDRESS
FIRE
ZONE
APPROV
E NO.OF„
� � vurs
VAROSAPPROVED
MAIN BUIIDING
FROM C/1„STREET)
DISTANCE BET
MAIN BLOGS.
VAR. 3Y+
C.U.P.9W
PERMIT
� i/ —
VALVE
5
GROUP
DATE � �
E OF N�tlQI
LDM9'��
VARDSAPPROVED
CCESSORV BUILDID
BEf. MAIN &
p 1 hureby ecknowledpa t�et I huve read thls applicet(on antl state
� thot the ebove INormetbn ls correct entl eprae to comply w{th
a all laws rep�lotinp bullClnp conctt�ctlon, antl I ahall not employ
Z any parwn In violetion ot Ma workmen'a compensatlon lawa oi
w the State oi Celifomla.
3 I heraby cart�fY that I om ptoParly Ilcenutl es e contractor unEar �. FT.
tho Smro of Callfornie Bustnau entl Profaviona Cotle, Olvlelon 3, THE AMOUNTSHOWN UNDER VAW,
Chupnt 9, P�tl thet �uch Iiconws ere in full (orce entl effxt, or I THE PURPO6E OF ESTABLISHING A PERA
em axompt irom Me provlsionsof Ne Smta oi Colifornla Buainoss VALUATION PERMIT FEE S
entl Profoaslonn Cotle, Divialon 3, Choptar 9.
� �� AN CHECK S
Sipnuturs o�
PBrmitteo �� '='��-�� 5 TAX E
/
Authorizatl /+Bant TOTAL PAI D b
n
m
i
m
m
FOR m
JLV: e
a
N
m
m
0
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