HomeMy WebLinkAbout2913 JACARANDA AVE - Building Permits�oonejoveumm� z913 JACARANDA AV
w�r�Rar+wEiFro+a+T+: MALEC—HURNSIDE, SUSAN K
♦ �� 2913 JACARANDA AVE
COSTA MESA CA 92626
714-662-26�i0
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MCNRECT OR ENmIHR
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IJCEN9E� CONffl�CTON4 OECLANAiION: I Mreby tlfrm uMw paruly d por'Wry Ntl I em IkanMd wdar prwnbn� d Cheqa Y
(rommwun0 wqh SaYian 1W0) d OAvion � al tM Budron eM Pmis��bm Cod�. aM mY bmw u m M Iva eM Yletl.
cmue.e+o.: uc.cuss: uc.Ho.: EXP:
OWNEH BUILDEX �ECL�R�TION: 1 hwWy elfum uMer paiuly al Wr�ury Ihtl 1 un �mmq han IM Cam�eCm liwm� lew la IM
Idbwiq newn (Satlian 1011.5 &qiw� W Prdxdai� Cods: �nV uY a opuaY MfikA nG� � D�i w aomtM. �Er. Lnqow.
Eamd'eh, p ryri vry �Wcluis: prior b b swms. abo �pu'um iM applimtl la ac� prmG lo fiM � dpnad petmwN tlW M«�M
s r..�..d w� m m. aw�m. w n. co�ureea: uo.�.e uw Ienaa� s(oomm.�,a wn s.e� nml a o�o�, a a �ti
Bu'viav erA Prd�wuu COGI a Ihet M a Me u wmq iharehan vd �M Ee�u la ihs abOb u�mqion. MY videtion W 9wion
]W t.5 Eq ury �pp&�N la e pmmi aibpm iM eppliceN to e dW peiWiy d na maa iM R�n Madred ANen �SSOOp.
� I.nowroetlNSP�W�YamY�^VM�r.ihwepesa�theiedemnW�.wYdothexvk.ardlheeWdu�ewml'uqended
a Mared lor Ws (Ssctbn ]ou.8mnan vd Pmte+sona Cods: Ths Comrndm limrea lew dam m�eGW wenowner d p�operiy
wno buide a inpwe� ihason. rd vRa dma suM wak Nmxll n MnM a Waqh he n Fw a.m v^PbYas*. paidad Ihet wch
unpownsaa ua eni "vueMotl a dlwed lor eele. tl. however. tM buitlieq a inpwpnad'o wk xitNn w Yeer d eomdaion. Ne
X ow,«ainw« .io iw. tl,s widm a wwino ne ar ens aq ia a,Je «imwwe �a tl,a wmas a wel.
[j I. m wner d �ne ww«n..�, s.Aa+W mureeno vAn �icemee miwxm. m mum,e ms w4w (saaion mu. Bw'vwe ud
Pmleawns COAe: TM GaNrtlm liearoa le� Ao» na e0W m en wnw d PW�Y rAa binlis a'vroewr Ilwson ud x1c
convxU b vdi popaa �nN e aNrtlor(s) Ika�wd punuem to iM Corvroeas Limma la.�.
� I em enam0 � r SWa�: B. d P.C.. lor Ihia��+/q�� � / �p � � �`� /,
Dde: Owner: � p�G.�Q W: p(.(NI'�'
I 0o Anaby ceuty Nu I em awera tl eM wtlen�ud iM reQui�emerM1� d ColAomielleelh end Selary COEe Swiora 25505. 255]�. enE
25S1,. vM tlw I a vry haun buJOvp om�eru_ wiA / wil na (ercb an) med io campfy w�� uid qaU aodr eM tM �puinm Ws b
epermnlormroWetonnmodCwionhamlMAr u�Te I�iy.erepemem0ienq.RmiEemelepmeueioneppiwbmereesemplromNma
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WOFKER'S COYPENS�TION DECLAHATON: I hereb� elfi�m unEer psnMy d pxµvy me d tM IaOow"vq Jriva�oro:
❑ �n.r.eneWm.:v.i+.mneFm.aowo.vio.w:reur.ror.ann.•mmpemmion..swwid.J�o.Ms.aionalaoa�n.lmo.
Cods. fa iM DMrcmvca tl Na w4ln.fich Nu V�G u iaaueC.
❑ �ne�e.�eM�meimen.�awnYm�w�+:M��,reMe.mrea�o.dMs«a�ma�ooam.�mu.coee.i«meron«menoeain.
im
wak la wfiicl+ IM P�� u iaued. MY workan' wnGe�+tion inauraice fartier end W�Y m�mber us:
c�«:
Pdiy Numba
1(,,1M1,is secfian med �wt 6e �vndmeC i fMW�t is lor wre huMred ddlars 1ti00/ m leu.l
p, i mnh mm n ne o�«�e w in. waw i« wncn inia w� u�d. i we �,a .mWw �rv v�� m d r m.� .o o�o
pecoms q�hjad to IM warFina' mnpamNion levn d CelJamie. vM apne dW ! I 4vtld bama wpjstl b tM �qken'
=�oeva�/f woro� n s.ao, ��oo a me �no. cem. i an.0 �onnwn .o_N /�•vn mme o�. �(/��
Dele: �/ �/9� AVdicenl: � �YV '��/iliN�/.�!
w.min0: Fauun ro rcun roiks: ro�roauetlon cww.a. b unlewNl, .nd NLI wD/M en xn➢Inl'« ro cnlNml v�neltl...ne
uw� n,., w ro o�. n�e..e w�..m eorw. ls+aa000A m.maro� ro m. oo.r o� �o�w.�w�wn am.w .. wo��e.e ro. �o
S�cf/an 91f16 0l M� l�Eor COW, Infwut ��d ettomsy'i Isu.
CONSTRUCl10N LENDINO AGENCY: I Mreby dfirm ueder periehy W per'prcy tt� IMrs u e �mvivaian WMiip epenry la Ne
peAarmaMe W IM v.ork la wAKh iAe peim� n eeueE (Seaion aOBI. Civ. CI.
LENDEP'9 NRME:
LENDEF'S ADONES4:
I cenAy Rut I M1r.a neE Ne epplratian W ume Ihel Ne ebwe inlormelion u cmetl. I epne to canp/� xa� M my end oouivy adinencee
eM etme lews Meiiq w Euddiq wuvuebn erd hereby euMrce repaueumna W th'v dryw «us upon iM ebo.e�mwioned papeM
�"��patlpiprpoa"' ROBERT W HURNSIDE
PnM Nanr
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CITY OF COSTA MESA — BUILDING PERMIT
PEAM NO: B 074120
PERMIT NO: B 074120 PLAN CHECK NO: 03603-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMZT TYPE: STR PURPOSE: ADD
JOH DESCRIPTION : 60 LIN FT OF 6FT BLOCK WALL SQ FT: 60
CLAIM VALUE: CALC—VALUE: 1,200.00 GROUP OCC: R-3 /
COMMENTS: PARTY WALL AGREEMENT/ 2 ADJACENT PROPERTIES
if fE 1E 1E k iE iF iE iE iE �E fE iE 1E �E IE 1E fE k iE k If iF �f 1E iE iE iE IE 1E �E ik iE ih fE 1E iE iE fk iE iE iE 1k fE iE 1f iE iE iE k iE IE iE iE 1E iE fE if fF 1E if 1F fF ik 1E iE fE 1E 1f if iE iE iE 1! iE If ** 1f
Z O N I N G R E Q U I R E M E N T S
S E T B A C IC S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 13928430 ZNE: R1 REF NO;
PLANNING NOTES> 60 LINEAR FEET OF 6' HIGH BLOCK WALL ALONG REAR PL TO
> MATCH EXISTING
3EfEiEiE1EjE1EiEiEiEfE1F1liEiElE1E1ElEiEiEi! 4iE1E1E1EiEif�Eik�E�EiE�FiFiEjEIE1FiliEiflElEjEfEfEltfElE�EiFlfiElFfEfEiElEiEiE3EfE�EifiEiEfldEjfiEfElElEifiE�E�E
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPROVED BY �tPJ� DATE: �-Fr-9r
BUILDING APPROVED BY :_�� DATE: p`I' $�9 �
APPLICATION ISSUED BY; DATE: 7" B'CJ�
iEiEiEiflEaliEiEiEiEi(�iEiEiElEfElEiEiki(�iE1E iElfiEifikiEiEiFlfiE� iEif
LEGALIZATION:N F E E S 0 M M A R Y STRUCTURAL SEGMENT:Y
PERMIT
HLDG PMT
29.00
PLAN 18.85
ISSUE FEE
PLUMBING ELECTE�IC MECHANIC FZRE SMIP/RES GRADING
' S0
SMIP/NON—RES
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 29.50 0.00 , 18.85 48.35 48,35 .00
REC'ENUE DIVISION TOTALS--> COLLEC'I`ED: 48.35 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
29.00 � .50 18.85
iE fE aE if iE k IE iE iE iE iE iE iE 1E 3E jE 1E iE iE iE ik iE �F iE IE iE iE iE iE iE fE iE iE iE 1E 3E iE 3E iE iE dE iE iE iE iE iE aE rt 1E iE iE 1E 1E k�)E 3E �f iE If iE fE 3E IE iE fE iE 1E if iE iF it iE iE it i! if 3E 3E �E
I N D I V I D U A L 'P E E 8 R E A K D O W N
TYPE
SFR
QTY D E S C R I P T I O N
60 RES—CONCRETE BLOCK WALL / FT
END OF FEES
EXPIRED
DATE /P / �
i
UNIT COST TOTAL COST
20.00 1,20U.00
";�'•: OD1�9E1 �:. �.,,3.
UI. I �y I_ O Q TO !' � r
UftTE: �i9/Udla` T,li'lE: 33.ou
� ONSTRUCTION AND PLANNING POOL & SPA
APPROVAIS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
Y
1. TemDorary Electrical Service or Pole -52. Pool & Equipment Location .
2. Soil Pipe-Und.grnd. 53. Steel Reinforcement
3. Electrica� Conduit Utility�Undrgrnd. 54. Forms •
4. Electrical Conduii•Undrgrnd. 55. Electrical Bontling '.
5. Steel Reinforcement G%��-LI' ��p[.�/ 56. Rough Plumbing & Pressure Test
(
6. Elettrit�l UFEft Grnd. 57. APPROVAL TO COVER�GUNITE '
7. Footin95 q�(-q� �[.(�/ 58, ElectricalConduit�Undrgrnd.
B. Foundation 59. Gas Pipe, O Undtgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, C[7ndrgrnd. �,
10, Structural Fioor System � 61. APPROVAL TO DECK • �
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final
13. Foof Drains 64. Plumbing SYstem • Final
14. Rough Plumbing � 65. Electrical�Fina�
15. fiough Electrica6Conduit 66. Solar SVstem�Final . �
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVEO FOR PLASTERING '
18. Rough E�ectrica!-T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Heating & Air Conditloning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Dutts.in Structure 70. Underground Hydro
22. Ducts, Ven[ilating 71. Product PiPing � Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. fioof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T�Bar Ce���ng (Structurall & Monocoat 75. Dry Chemical � ' !
27. Frame and Flashing 76. Dry StandpiPe �
28. Lathing & Siding 77. FIXED SYSTEM FINA� -
29. Insulati0n 78, FIRE PREV. FINAL . �
30. Drywall Nailing . HEALTH DEPT. RE�UIREMER�T
31. Plaster Brown Coat � � 79. FINAL INSPECTION •
32. Electr�cal Power Meter-Final B0. FOOD CERTIFICATE ISSUED
33. F;nal Elecvic Notes:
34. Finai Heating & Air Conditioning Q ., /SC�9Gj � �"l� � �� .�
r (/ c li�-' J
35. Final Gas Pipe�Test / �. �
� �v
36. Hood or Canopy
37. Final Factory Firep�ace
38. Final PlUmbing
39. 4Vater Service-Final '
40. Gas Service-Final � �
41. Solar OomesticFinal
42. Backflow Preventer
43. Backflow Irr'iqation
44. LandscaPe IrriQation System
45. Sound Attenuation
46. Handicap Regulations '
47. FINAL STRUCTURE & BUtt�ING - �
48. FINAL PLANNING � •
49. Electric Reiease to Edison .�
50. Gas Release to $outhern California Gas Co �
51. CERTIFICATE OP OCCUPANCY
No. Date
SURVEY OF LOT LINE
' MAY BE REQUIRED
�o � o� Exisr�a�
(o' µrGrt B�-o4C
WA �.�—
a9�Z
A+�O�oS ST
�� �
ncaocMec
2R�3
SqCAR..B,nt 0.6
Permit �# � Zo
THIS NUMBER MUST ACCOMPANY
ALL INSPECTION REQUESTS
NEw (�' IF�Gti
'g�uc wA�u—
�csiocMce
�9/7
��p.��CA-N D�
REBIOEMCE
STREET d }
i-�I1'�' �iQcaca..-��
�2 � a �ta �{-a .
9-9 tz CL.-��-rns . ,
� `� Q 2 �dl � [ ,...
..�..�.-..-----,_.... _ ...
�r �� v rJ�
� Of C05fA MESA
pLANNINC3 DEPT.
AltlC7 TO KDO. DEVT• lEG .
�'�.�== pAT�� .� g ' 1„�7
�p� Ot RAHNil10_ .
6 � b l�u'-� wa�-
DMSION OF 1
CITY OF
Th 8et i plans atM spaciflc
ane t Is Ieo�Jaary
�e nom nre o�a� a
The ing ot thts plan and
m be a apP�l at Ure v�
Th P': ��d Dermit sha0 ezpire
the uilding or work Is not commerx
„e.,1 9— 8-95
� M
be kepi�n Nb pD at eG 6rtn!
t0l3110I1 dl(93RIB YII910IA WI�1
bB heM m pBrms
arry C�r ot CAet�
AB mdl a11d VOidl
Ne pe� UBC ¢903
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this ���h�'�-- day of
� ��C�
�-I�P�wt �'1P� , by and between (2Of�12 uA�� S�� �� �tc�2N5i 0�
hereinafter referred to as "LANDOWNER;' and �-a'�`r� Ld-�”" p`:Q�
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall wili be constructed on the property line
between
(Address
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach c����o � u�n a� �-�-�(—
1
1O' � � T �_l� \)J�L'yjZ�N� +�V�,
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year firgt above written.
LANDOWN R ADJACENT PROPERTY OWNER
_ �',Q�w, i� �� �i�Yt G°�
.�� / �t.�e-- - .. : � _ _
(Si Wre) �ignature)
�O�'�2i W U ✓/L1Vs/�F'L
s«.s� .� �.�.,��_f�-�,�,�,��,�� La��ee��,e � . �a����/
Name (Typed or Printed) Name (Typed or Printed)
�3 ���curr�� Q-v� �-m .�R 1� �I� c�vo5 -�, G'h�l ,
(Address) � (Address) ,
�e� `��" ���u� ���� �..1�
NOTARIZATION REDUIRED w�u �w'�w�S'�`��r�R����"
Z� 1 � �1�CI�P-4N-O.\ l�'�li C.J.A,
1906-a6
FIDELITY NATIONAL TITLE
INSURANCE COMPANY
STATE OF CALIFORNIA
County of �r�Q/l'I�
On �/7/SJ bcforc me
personally appeared
/.�'/fi/yl.I//.�1) �-
�� ��q���
� e� � ��r,� r�1,
�i,i.,�,�10 4� 9A1,/�/B,.vi �
personally known to me (or proved to me on the basis of satisfactory evidcnce) to be the
person s�whose name(s) is e subscribed to the within instrument and acknowledged to me
that ��/they executed the same in jisLl�/thcir authorized capacity(ies), and that by
1�}�r/their signature(s) on the instrument the person(s), or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS by my hand and official seal.
Signature ci'�v(Cl � (Seal)
Notary Public in and for said County and State
Susan Schrader �
U Comm p967637
TAPYPUBIIC C�ILIFOfiNI��
� OWWOFCAUMY n
Vr comm. Espmos.Wn. �o. ,ws�
I. f1. .�jl'JV,
I, `���,
� r13-�1h.
,' '�►+��:
:ti
' °��� "'i;:iJ
Gcncral Acknmrledgmrnt I.0
UDOI (Rev. I0/74) - Fidelily Nalional "fille
Applicanl to flll In all spacei exeept tnose within �eavY �o�Cer 1(nes anC sign all appropriate Cectarations.
PE T N TRACT NO. LOT NO. UNIT N0.
CITY O.F COSTA M a CO��j��',�j` /T'R�UCTIO PERM�IT/ A.P. qW Zone
.Pr��lect Address ��� RJ"`"�R�N�� „"� _ � S Main Building: Accessory Building:
P�ppliCant'S Ma� ng dre55 _ TVPE OF CONSTRUCTION NEW AD� LTERATION REPAIR
r
- / / ❑ CONVERSION ❑ DEMOLISH � OTHER �"/eD�G T Front p
Owner'sN�g! u5 �v � hone �z"�w OESCRIPTIONOFWORK/USEOFBLDG. A Rear N
Address• y
Arch/Eng. LicenuNo. TVPEOFPERMIT GRaoiNG FOUNDaTioN S7aVCTVRaL I K Right G
AddrEss ❑ TENANT ❑ ELECT{iICAL ❑ PLUMBING ❑ MECHANICAL ' g� Left
R
❑�OTHER Ping. Ref. # Parking Req./Provided E
Comracmr's Nam Phone
� PROJECT DESCRIPTION 5G1. FT. oCCUPANC!Y��� n
Adtlre551mailingl � �� CONSTRUCTION TVPE VALUATION $�d d 6.OV Planning NoteS: ' M'
T
City License No. �w ZONE GRADING CU. VDS. ACRES S
LICENSED CONTRACTOR DECLARATION
1 hereDy atfl�m tha[ I am Iicensetl untlar provl5iOn5 of Charte� 9(commendng Remarks:
with section ]000) ot Division 3 of the Buslness antl Grofessions Cotle, antl .
my license is in full force antl effect. ELECTRICAL FEES
License Class �icense No. PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
Dale Signature
WORKERS' COMPENSATION DECLARATION ConS[rUCtion PoleSub. � 50+ KW
I hereby affirm that I hdve a certifitate of cons¢nt [o self-insure or a ce�tifiCa[E Ba� $ink ShOwf�S
o/ Workers' Comoensation Insurance, or a certi(ietl copy thereot (Section gackflow Preventer Service5ink Cooking Unit Meter �up to 100amps
3800, lab. C.) �
Poncy rvo. Company Backflow Irrigation Sewer Cap Dishwasher Merer �over 100 amps
8 Certitietl copy is hereby furnishetl. Dry¢rs ❑Gas ❑Electric Sub Panel
Certifietl copy is tilea witn tne city Building Division. Bathtubs Sewer Connection
Date Applicant Fdfl
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION CldriFi¢r5 S018r COII¢CtOrS MOtOri O0.1 HP �1X-B
(This section neetl not Ue completetl if the permit is for one huntlretl (5300) or F,A,U.
iess). Dishwasher Solar Piping Inc.Soiar �9-15 HP �1615+
I certi(y that in the performance of tne work for wnlcn Nis permh Is IssueQ I Fixtures
shall not employ any person In any m ner so as to become subject to the Drinking Fountains . Solar Tank Microwave
Worker£ Gqrr�pey�tion Laws of Calito� /�, � Device Boxes -
Date � LU ZT Signature ��L�! Floor Drains Swimming Pool w/Spa Pole Light
NOTICE: If, after making ihis tleclaration, you shoultl become subject to tha .
Workers' Compen5ation provisions of the Labor Cotle, you must forlhwith FIOOf Si�kS U�indl OUtICtS Range
Comply wilh such provisioni or thi5 permit Shall be deemetl revoketl.
CONSTRUGTION LENOING AGENCV GasServite OUtlets WaterClOs2t SwitChei Sign '
I her¢by afflrm tha[ [M1e�e is a construttion lentling ag¢nty to� tha performance �
Of the wolk fo! wNch thi5 permi[ is Issuetl (5¢cHon 3097 Civ. C.) Int¢!C¢ptOfS WdtCl H¢dt¢f CidIbBJC Di5p0521 St80dinJ $¢CtiOni •�
�enCer's Name
Lentler's Atltlress Kitchen Sink- Water Service Generatrn �0.5 KW 05�15 KW Trash Compacror •
OWNERBUILDER DECLARATION
I hereby aftirm lhat I am exempt ��om Ihe Cont�actor'S License Law tor the LdvdtOfiCS AutO-WeSh
/ollowing reason (Section 7031.5 Buslness and Professional Code: Any ci[y or
counly whlGh reqWres d pCrmil to con5truct, altar, improve, tlemolish or �epai� p—Tf2p LBufldry T�8'yi -
any struc[urq prior to its issuance, also requireSlhe applicant tor such permit
to tile a siqnea statement that he/she Is Ilcensetl pursuant to the provisions oi Roof Drains
the Contractor's License Law (Chapter 9(commencing wilh SecNon 7000) ot
Division 3 of the Business antl Professions Coae) or that ne/5he Is exempt . Reins eetion Fee
theretrom antl the basis lor Ihe allegetl exemption. Any vlolation of Sectlon P $15 Issue Fee $ 3
]031.5 by any applicant for a permit subjects the apppplicant to a civil
�alty ot not more than �ive huntlretl Dollars (5500). O ,^� � $ 3 DEVELOPMENT SERVICES REQUIREMENTS: �
� �j1 1, as owner o1 tM1e properly 9 p� Y 4h� J3 Reinspeetion Pee $15 Issue Fae
E�mpe�l, will tlo lhe work, antl the structure is not intenCetl or offeretl Zoning Approved By Date
ior salc (Section �o4n, Business antl Pro(essional Cotle: The Contrattor's MECHANICAL FEES Building Approved By Date
License Law Coes nOt apply to an Owne� ot a proPerty wM10 builtls or improves
thereon, antl wha tloes such work himselt/herselt or tttrougn his or �er own AppliCdtion laued By Z
employees, provltletl [hat such Improvements a�e not intendetl O/ otferatl to� BOiIE� HOOd O/ TypC I ❑ Det
sale. If, �oweveq the builtling or improvement 15 sola within one year ot com- Cdnopy Type 11 ❑ ' '
Dletlon, lhe owner will have tne buraen of provin9 ne/she tlitl not builtl or im- Duct - Under Ground SUMM�AR/V �OF�.FEES
nrove ror tne purpose ot sale). BUILDING PERMIT $� �'� SMIP ' $ ��D
❑ I, as owner o( the oroperty, am ezclusively contracUng with licensetl con- Duct -Structural Refrigeration System PLAN CHECK
Vactorsto tonstruct the project (Section 7044, Businezs antl Protessions Catle: $ PERMIT .
Tne Contractor's License Law tloes not apply to an owner oi prooerty who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU
builtls or improves thereon. antl wno contracts for such oroiects with a con- PLUMBING $ ISSUANCE $
tractor(s1 license pursuant co me Connactors Liwnse Law). i am aware that Exhaust System ❑ Mul[iple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C.' $
proof o/ tneir Worker'z CompenvHon Insurance shoula be oroviaetl to me. ELECTRICAL $ GRADING , $
� I am exempt untler Section B. G P. C. �or this reason Firepl/Fact. Blt. ICBO dk Fire Dampers
PLAN CHECK 50% $ MICROF,ILM § 7�
n •7n o - Heating System & Ducting Registers MECHANICAL � („/
1 hereby certify that I have reatl this application ana state tnat the above ❑0-100,000 BTU �100,0008T � � $ TOTAL FEE $ 5 •S
Information is correct. I a9ree to comD�Y with all tlty ana county ortlinances PLAN CHECK 25% $
antl Stdte laws �¢la[ing to builtlinq const�uction, antl h¢reby autho�ize rep�e-
Sentdtivez ot thls city t0 ente� upon th¢ above-�nentionetlp property for
Inspection pur ses. /� yl, � — Da[eZ�� �
Signature ����'�'�`�� �_ P S 3 01 ��OI5125-ppD1512o ii
Drivers' License or 55 � Reins ection Fee $15 Issue Fee T T 54.54
rerr. noio�roo rrme. ,...�
0865-46, rev. 5/BB White - BWltling; Canary - Applicant; Vink - AccoUntlnq; Goltlemotl - Assesso�
.�STRUCTION AND PLANNING POOL & SPA
Date Inspector ' Date Inspector
, APPROVALS Permit # _ _ APPROVALS Permit #
e 7. Temporery Electrical Service or Pole 52. Pool & Equipment Loc�tion
2. So1 Pipe�Undrgrnd. -_ 53. Steel Reinforcemen[ � �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4.� Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcem�nt . 56. Rough Plumbing & Pressure Test �
,6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE t I
7. Footings . � 58. Electrical Coniiuit-Undrgrnd. •
8t Ftlundation ,' 59. Gas Pipe. O Undrgrnd'., Test
9.'Water,Pipe-Undrgmd. 60. Backwash Lines, P-Trap, � Undrgmd.
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.�RoughPlumbing 65. Electrical-Final �
15. Rough Electrical�Conduit 66. Solar System�Final
,1& Rough Electric Wiring 67. Fencing & Access Approval
i
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1S� Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace APPROVAIS Permit #
21! Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough &��fest 72. Underground Flush
24. Roof Framing � 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof She�thing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Fra�ne and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV, FINAL
30. Drywall Nailing � • HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final ,..
40. Gas Service-Final . -"'�
41. Solar pomestic-Final
42. Backflow Preventer ��'
43. Backflow Irrigation
44. Landscape Irrigation System , �
45. Sound Attenuation
46. Handicap Regulations �3 � �_G
' 47. FINAL STRUCTURE & BUILDING �- -- a 3 c� g�Y
48. Special Requirements Completed �
49. Electric Release to Edison • •
I i
50. Gas Release to Southern California Gas Co ,�
51. CERTIFICATE OF OCCUPANCY '
No. Date � '
ADDPESSOFBUILpNO: ?9S3 JACARANDA AV '
owr+easwucivaowN: MALEC—BURNSIDE, SUSAN K
� \ess: 2913 JACAAANDA AVE
7�4T662E26�i0A 92626
AVPL. WUlMO �DOXESS:
ANCNRELT OP ENOINEEP:
1pCN, OR EM.'8 AUDNESS:
CONfItACTORf N11�:
aarrm�croxeuuwn
�oonee�
UMT:
ue. wo.:
' ONT:
ua wo.:
uNr:
LICEN9E0 COMNACTONB DECL�PATION: I hmW Nkm unMr p�nMy d qr�ury Ihtl I un Ibmxd uMa proWNon� al Chyur Y
(mmm�ndip wilh B�c�bn 10001 d Dlvhbn 3 0l ih� &ninw uM PMpNon� CoE�. uM mY Ilwnw h In fuil bru ud dhd.
cm uc. No.: uc. cusa: uc. no.: . EXP :
Dela: � Contr�ea: �
• OWNER BUILDEfl OECLRRRTION: I Mnby tlfirtn unGr parutly of pnWry �IW I un uwmq Imm tha ConVetlan Lkaru� lew la IM
Mbwip rwon (�� ]W 1.5 Busirow enC Pmfaeion CoM: Mry ctY p�M' � AVulm � pa�mX to amsuuct•Mw. Mpon.
amd'nh, or rapv eny �IrucWro, prior w il�'sauarKa, abo rpulros Ihs epd�� lor �uch prmll to fils e W irod �btament thet M a�M
n licenrod punuent lo IM prwbiau d tM CaMratlw� Wme Lew �Cheq�r Y(oomm�iWnp witA 9erlion �000) d DNbbn 3 G Ih
BUNnaa eM Aafmidu Codel a Ntl he a Ma h azamq �hrahan eM th� Wa� la �hs �MOb exsmqion. MY violetion d 8W ion
]W1.5 by ury eppllunt la e permn wbjetl� iM apWieani 10 e eMl peWry d ml mm Ihen M� huMred dollen �55W11.
� I.uowr�rdlMpopeMamyempbrwaw'lhwaps�uihsiWsodnqn�qbn.WldoNewk.eMNen'uGuroendimandaE
a dlmed tor We (Saction ]Osl. Bwinea end Vrdmaom CoM: The CaMredon Llo�na� lewdoaa nd WdYm en ownm d wcwb
who buid� a inyww �Mrson, eM Mn doea �uch r.ork lim�stl p Mnd a Woup� he a Mr mm empbyaee, pavkM �hN wch
improvemeM� ue M inieMM or dle'eC br ede. M, Irowawr, �M WiNirp p'vnqwemem is eok wnhin ona ymr d oomplelion, Ne
y owrer-0�itlx MII heva tM burden d pwiip M w eM Eid na Cuik or impv.a tor IM WTae d ede).
AI. ee ohner d Ihe O�M. em utluvnroM �nlredmp wiih licenssd conVecton to cmmrup the prol� (Smun )OIG. Bueinwe eM
Profeuiom COEe: Tha Conlreticn license Law dwe nq apply Io an owror d popeM ��iMe a impovm �Mnon eM M1n
eonlreeb lor vu h Drol�s wilh e meurmor(s) IcenxE Wnuenl lo the ConireGae Liunse Lex�.
� I em eRem uM Setlion: B. d P.C., lor �his rmao
o�<: 9�f�%�9r �<,: � �v✓ �
i do naro�y coniN me� i� e.e�a a e�w u�ae�i�e me �w�emema d camomie Neenn ena smery caee seaions xsws, zssaa, em
z553a, uM �hei I a eny linure WiNiiq ovupent vnll I wll mi (dreb are) neetl lo wmply w�h eaid meie mdea vd tM raquinmann br
e permn Imconewciianer maddvatbn han iM Air�6�l.iaa0ement Dimna. Reeidentiel conslrud'pn eppfceliareeraezempt Irom tM1eae
w�suna.
Deta: AON' ��
W OHKEP'S COMPENSATION DECL�NATION: 1 MreW elfirm uMar peneAy d perjury oro d the bMwiiq Exle�vbm:
❑ I heue eed W meimen e ceWrme a minmt Io satli�uun lor r.arkms' �wnvM�ion. m vrwNed I« W Serbon 3l0o a tM Labar
coa.. i« m< wno�. a me �n ia �n m�. w�u n ro�ad. �
❑ i n..e �d a� meune:�.m�aa• oomw�m:n �.,�,m... �aw.d M s«am a�oo a� iece, com. ro, ma roa«merce a m.
- wark lor xi�idi thie permn n iaued. My worMers mmpenaelion ineurence rarrier aM pdicy number era:
c.m.:
% varv �+omna,: .
�is seaion rreee mt w candaree I �M va'm� b hr arro numred eme.s (Jimi n bv.)
I cenly thm in Ne pMormemn d IM wark la xfich ihi� pemin ia iawed. 1 ehell na emplry eiry penon in e�ry manner » ro to
become wbpu b Ine Mwkne' camDense�ion le� a celtlamie. erM eoree Nm B 1 nhouk bxome wblea io iM Mwkaa•
compenseib O�a'isona oi Sedion 3�a0 d ��e Labor Cotle. I eM1ell fonM1wi�� �^pN �F tho.e p�mieianv.
oa,, q1��9 � A��,,
� aG� iN. �J i �
�
Wem/np: F�Ilun ro�xen woMen'romperueHon rovenp� b unlawNl, en0 �hll �Wl�n an �mploysr ro cAMrul pena/Hes enJ
n.n nrr, w ro on. nunarsd mo�uM aonm is+oo,o001, �n aed�non ro m. cw� or mnwen,.�ron, a.msw u vrov�asa ro. �n
Swtlon J]OS ol M� LNor COM, InMMeaq entl ettomsy'� le�i.
CONSTFUCTION LENUINO �dENCY: I Mreby effrm �rder pendry d per'ryry Ihei theee e e mrwivaion Imdinp eperiey lor Ne
paAamarrm d IM wA Im vfiiM the peim� ia'asued �Setlion 9091. CN. C�.
LENOEN'S NAME:
LENUEN'4 ADOqESS: ,
I cendy Uiei I heve roeE I�u eppicetian end nme thm Ne ebwa iNarmNion u conM. I ep�ee io camply wnh NI fny ud wunry adiw�raa
eM s�ele lewe relelep la WiWvq mnaVutlion eM M1ereby eNMrrte iepraeenlelivaa ot Ihu tlly lo enlm upan IM1e ebo+e-meMioned piopaM
'°"'u°°"'°"""D°'°'' ROBERT W HURNSIDE
�� w� om,: 9� 9 s—
SipneNre d OwnedApenVApplcen4Gomraaor
(5�51-t6 WP) Whne-Buildiq d Sefely: Green-Fle: Ceiury-Appirenl: Pink-Fmenue: GWdenroE-Asaesmr
.�-
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 074120
PERMIT NO: B 074120 PLAN CHECK NO: 03603-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
JOB DESCAIPTION : 60 LIN FT OF 6FT BLOCK WALL SQ FT; 60
CLAIM VALUE; CALC—VALUE: 1,200.00 GROUP OCC: A-3 /
COMMENTS: PARTY WALL AGREEMENT/ 2 ADJACENT PROPERTIES
if if if if iPit iFitit iE 1E iE iF 1F �k9E if iE it it K iF it it iE 7f if ih 3f if iE at if iElFiF it itik iE iF it ltitiF it iF it it 1f iF itit if iP ia iE it1E ft iF �t 1E ef 1t it if 14itit it±� iE 1f� iE ��t iE it
� Z O N I N G R E Q U I R E M E N T S
3 E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HQILDING ---------
FRNT: FT IN AEAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGAT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 13928430 ZNE: R1 REF NO:
PLANNING N6TES> 60 LINEAR FEET OF 6' HIGH BLOCK WALL ALONG REAR PL TO
> MATCH EXISTING
iF 1F iE �f IE 1E IE iE 1ElE 1liE 16 iF1k1E iF if 1F 1@ 1Fii 1F1F 1E 1E if 1E 1E 1E1F1F iE1E�F iE'N'�(' 1E 1E1E 1E # if iE 1f If if It 1f iE 1f iF iE 1E 1FlE iE df IE iF if �)F �lE 1f 1EiE'k �E iF 9f # 1E IE iF1i 1f 1F iE
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 T S
ZONING APPROVED BY �(/� DATE: `T—`D'7i
HUILDING APPROVED BY :_�1_� DATE: `I' Ti'`7S�
APPLICATION ISSUED BY: � DATE: 9' B�7�
,������*�����,���#,���+«,�,� � � *�*���«*»**� *,�
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 29.00 50
PLAN 18.85 SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSIJE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 29.50 0.00 18.85 48.35 , 48.35 .00
REVENUE.DIVISION TOTALS=—> COLLECTED: 48.35 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECRANIC FIRE SMIP/TOT GRADING PLAN—CHECK
' 29.00 .50 18.85
11� 1E iF if iE 1F iF iE 1f 1f iE 1flF 1f if # ik 1FiF iF1E 1f if if 1E'IF iE 1F 1f 1f 1F1E 1k 1E 1E iE'lE 1E'If 1E 1! 7F if 1f 1f M iE 1E 1E 1f iE 1f iF1F iE 1E if iEiFiE 1E if if iE If iE iE 1f 1f iE 1F # iF i! 1k 7f # 1f 1E
I N D� V I D U A L F E E H 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 60 RES—CONCRETE BLOCR WALL / FT. 20.00 1,200.00
END OF FEES
' 01 �]OlE9E17—OUlE9E19 T��" 48.35
DATE: U9/D8/95 TItIE: 08:30
owrrEx IsoY, rfELVIx
AP. No.u}-o�}-}v LOT T1tACT
INSPECTIONS I DATE
SUBCONTRACTOR
OCCUPANCY
DATE q_21_(�p
BUILDING PERMIT N0.
Form 210—SM—it-59 5-B P . ZZHH9
�� 12889
C�3TA MESA BUILDING•SAFETY DEPARTMENT
P. O. BO% 9f7 C06TA MEBA. CALIFORNIA
For Applicani fo Fill In Complefely
TYPE OR PRINT
BUILDING ,..._ _ _ . _ . � ...._ . . ��..
COSTA MESA. CALIFORNIA
SHLIIPJ
■ ARCHITECT
■ SIZE
� SEiHl�CK 1.IN8 FHON
TEL.
NO.
TEL.
FEE RECEIVED
�,�'SEP 211960
FlNANCE DEPT.
APPLICATiQj��� �MESA
BUILDING
For Offiee Use Only
RECEIPT NO. I PERMIT NO. �
�
2913 J9CAR14NDA A
COSTA MESA. CALIFORNIA
RIRE
ZONE
Y POOLS APPROVED
BY
STONE
Z
TEL. �,gaw�
NO. oeecntrit
/ INo. OF BlDGB.
NOW ON�LOT p, p, NO.
H��l �RES YAfiO6
APPROVED
iunrca une
DESCRIPTION OF WORK
NEW I II ALTERATION I II ADDITIO
HEPAIR I IIMOVING I IIDEMOLIF
SIZEDING/l: ��,.., � ROOMS STOS
J
EXTERIOR WALL IROOF
COVERING COVERING
USE OF BUILDING AND WORKTO B� PERFORMED
I HBRHBY ACKNOWLEDGE TXAT 1 XAVE RCAD TH18 MPLIWTION
AND BTATC TNAT TH8 ABOVE IB COMECT AND A6REE TO CON-
PLY WITH ALL ROINMICEB AND W6 RBGULATINO
BUILDINO C B�U �ON.A �� /
// /
� AUTHORIZED AGENT
`f��1//� �•
NO. OP „� I U88 OP N6W/� fV
PLAN3 BYILGINO
� C�S 'f-�: 1 1 %'
�i�- 6d3 -3�
�
EVES
THe AMOUNT BHOWN UND6R VALUATION �8 POP TXC
PUIiP09E OF E6TABL19HIN6 • pERMIT FEE ONLY.
VALUATION
PERMIT FEE $ /D
/"�_
g �+SOO�OO pLANCNECK $ J
TOTAL FEE $ /� �
r�
; i .' �����
t
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31] COSTA MESA. CALIFORNIA
fOR APPL/CANT TO f/LL /N COMPLETfIY
TYPE OR PRINT
eu��o�N� ,�y13 Jacaraz7da Avenue
ADDRE55
COSTA MESA. CALIFORNIA
OWNER A�s Acres, Inc.
MAIL 1 l(3 �'. l�.th S`t.
A�DRE55 y'1'
arr Costa Mesa TNo: LISll59
ARCHITECT Carlson & LIC.
OR ENGINEER NO.
AO�RFSS Garden Grove
IEGAL
DESCNIM
A.P. NO.
NuG 7 1959
i=iVtRI�CE OEPI.
�,��„ �� �nc'sa nytc��
APPLICATION FOR PERMIT
BUILDING
fo,e officF usE oNa
STATE 167293 , ovPROVED
IC. NO.
63 x 113 I N�w��N ;°,:'
USE OF
EXISTING 9LOG.
SETBACK LINE iPOM CO� l.l.�
CENTER OF STREET J� REAR YARD W�-F
SIDE YARO I LEFT I�49' I RIGHT "t
DESCRIPTION OF WORK "
NFW I A II ALTERATION I II A�DITION I
5 ZIE DING 1560 ROOMS 7 STORIES �
EXTERIOR WALL ROOF
COVERING C'�[,L1rCn ICOVERING shingle
US QF UILDING A O WORK TO BE PERFORMED
�ing�e £ami�y residence with
a tac ed garage,
I HEFE9Y ACKNOWLEDGE THAT I HAVE REAO THIS FPPLICATION
ANO STATE THAT THE ABOVE IS CORNECT AND AGREE TO COM�
PLY WITH ALL CITY ORDINNNCES AND STATE LqWS FEGULFTING
9UILOING CONSTRU�O� �� _ /
SIGNATURE OF ,f (
� AUTHORIZED AGENT D�CC.'
V�
E RECEIVEO
i �i
COSTA MESA. CALIFORNIA
ZONING
ZONE I NO.OF �I USE OF NEW
/ PLANS BUILUING
APPROVED �J
BY .�(/ DATE
YARDS EVES
REqUIRED ALLOWED
(LENTER LINE ST.)�J)
FRONT J [/ Ff.
R. SIDE S FT.
L. SIDE � FT.
THE AMOIINT SHOWN UNOER VALIIqTION IS FOR THE
PUNPOSE OF ESTP9L16HING A PERMIT FEE ONLY.
VALUATION
PERMIT FEE s 35�00
s 15,571 PLAN CHECK $ 17�5Q
TOTAL FEE $ S2�S�