HomeMy WebLinkAbout2977 JACARANDA AVE - Building PermitsAOVlicant to fill in all spaces exce0� t�ose wit�in �eavy EorEer Iiney ana sign ail avvraoriata tleclantions.
�F coS7A MESA CONSTRUCTION PERMIT
ProjectRkidress 1 97 7 TC4 (A4 ANQ A-
F•".�"^�1's Mailing Address � 0. %%o k' G.S�S S��✓i.� /�%NQ TLi<�
G er's Name r0 w/-7-RLE'N K.l A� Phone
nddress '2-9 7 7 7'/?--a.c A..iDq
�
ArcM/Eng. License No.
Address
Contractor's Nama�A-�T'� ��"R %t� ^�^'� �'� Phone �"'+"-3 70 7
Addresslmailingl�n.�'u,{GS.�` Sia,.r.o-/�Ir�A 9L?'O�
CityLicenseNo. C7'i.S?O�
LICENSED CONTRACTOF DECLARATION
I hereby a(firm tha[ I am Iicansetl untl¢r prov7510n5 oi Chartm 9(commendng
wi[h section 7000) of DIvi510n 3 ot [ne Business antl Prat¢S5iOn5 Cotle, antl
my license is in full torce antl eifect.
License Class /'- Y 9 Licenso No. yG �S9G
Date Si9nature
WORKEpS' COMPENSATION DECLARATION
1 hereby affirm tba[ 1 have a certiiicate ot consen[ to seH-Insure or a certiflcate
ot Wbrkers' Compensation Insurante, or a certi(Ietl COpy th¢reof ($ectlon
3800, Lab. C.)
Goiicy No.� �✓��T �S'J Comaany S!4 %� F�'�p
�CertitieC coOY is flletlbwHhrthenC�tY Itli ivision.
Date '� -�T --FY APPlicant �� �/�^M �(-��—
E%EMPTION FPOM WORKERS' COMGENSA�CLARA IOT N
(Thi55eclion n¢etl mt be com0letetl it the permil Is tor one huntlretl ($100) or
less).
1 certify Ihat in the Pertormance of tha wOrk tOt whic� Inls pe�mR is ISSu¢tl, 1
Shall not employ any Oe�son in any manner so as to become Subje<t to the
Workers' Compensation Lnws Ot Califomia.
Date 99�ature
NOTICE: It, after makin9 this aeclaratlon, you shoultl becamo sub�ect to tne
Wo�kers' COmpensatiOn provlsions oi the Labor Cotle, you mus[ fortbwi[h
comply with such O�ovl5ion5 Or tbis pCtmit shall be tleomotl rnvoketl.
CONSTRUGTION LENDING AGENCV
1 herety aftitm lhat ther¢ IT a Constructlon lentling a9enCy for th¢ portormance
of Ihe work Por which thls perml[ IS iisu¢tl (Sectlon 3097 Civ. C.)
Lentler'S Name
Lan08r's Atltlre55
OWNER BUILDER CiECLARATION
I hereDy affl�m that I am ¢xempt from lhe Cont�aclo�'s LICanSo Law /or tho
following r¢ason (Sectlon ]031.5 Bu51ne55 antl ProteS5londl Cotlo: Any city or
county whlch requiras a pe�mlt lo ConSlruct, alte�, imprave, Oemolish or �apalr
any structure, prbr to its isSuanCC, also reqWreSlhe appllcanl for sucM1 parml[
f0 file a signetl statement lhdl ho/sne it Iitrnsetl pursuan� to lh0 P/ovlSionS Ot
tM1e Contracror'S LfCenSe Law (Chapt¢r 9(commencing witn Sectlon 7000) Of
Divlsion 3 of tne BuSinuss antl Prol¢sslons Cotle) or that ho/sha is axompt
Iherc/rom and th¢ basis br the allegetl ezemptlOn. FnY vialatiOn ol $ectlon
7031.5 by any applicant fOr a Permil Subjects tha applitant to a<Ivil
�enalty of not more than fivu huntlretl tlollars (y500).
I, a5 owner ol Ihe propmly Or my am0�oyoe5 witn wage5 as th0i� solo
compensatiOn, wlll tlo tho work, an0 the 5[ru<tw0 I5 not IntOntlatl o� otter¢tl
lor sale ($ection ]094, BuSiness antl Protessional Cotlo: The Conlractor's
Licanse l.aw tloes not dpPIY to an Owne� ot a prOOerty wh0 builtls or ImprOVCi
ther¢On, antl who Co¢5 such work M1lmself/I�orselt or througM1 his or her own
empioYees, orovitletl tnat such improvements are not Intentlntl or ofroretl for
sale. It, nowever, tna bulltlin9 or Improvement is soltl wit�in one year of com-
pletion, the owncr wlll Itave the burtlen Oi proving ho/Shc di0 nol builtl or im-
ptove tor th¢ pu�paie ot Sal¢).
❑ I, as owner ol lhe property, am exclusively contracUng with Ilcensetl Wn-
tractors to construct the Oroject (5lCHO� 7044� BO51�055 d00 P�078SSIOOS COUB:
The Con[racloYs Licensc Law doe5 not appty t0 an owner ot property wh0
builCs or improves tnereon, antl who cOntrac[S to� Suc� Profecli wilh a con-
l�actor(51 bcense putsuanl to tlte Cont�actor's Lit¢nse Law). I am aware lhdt
prOa/ o( their Work¢r'S Compensation insuranca ShoulG be provltletl to me.
❑ I am exempt unaer Settion B. S P. C. tor this reason
TVPE OF CONSTRUCTION LJ NE\
❑ CONVERSION ❑ DEMOLISM
DESCRIPTION OF WORK/USE OF_8
�O -cC� a
TYPE OF PERMIT GaADING
❑ TENANT ❑ EIECTRICAL C
❑ OTHER
J ADD LJ ALTERATION LJ REPAIR
OTHER
JFOVNDATION U STRUCTURAL
PLUMBING ❑ MECHANICAL
PRQIECT DESCRIPTION 5c]. FT. �/ ' oCCUaAraCv
CONSTRUCTION TVPE VALUATION S� ZS'�' u0
ZONE ORADINGGU.`/D5. ACRES
Remarks:
Sink
Preventer
Irrigation
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service OuUets
Interceptors
Kitchen Sink
floof Drains
ReinspaMion Fae � $15
Duct- UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Date owner Heating System & Ducting
I hereby certity inat I have reatl Mis apv���ation antl stata that Ne above ❑610U,OOOBTU �100,000BT1
�� information is correct. I agree to comoly with all city ana county ortlinantes
antl state laws relating to bwltlmg wnstruction, anG �ereby autnorize repre-
Senlatives of t i5 tlly [o <n[er upOn Ihe abOve-menUonatl prOperty fOr
IOSpECIl00 OU[ 52
Si9nature � /i � � ��i:�� Data L-/7�.�r
• �� ��c «' Reinspection Fee
ev. 30/84 Whi[¢ - Builtling; Cana�y - Appliwnt; Pink - AC<ounling; GOltlenr00 - AsSesso�
$15
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collec[ors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
WacerService
AutO-WeSh
Laundry Trays
Isue Feu
Hood or Typel ❑
Canopy Type il ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Iswe Fea
EES
A.P. yp
S Main Building:
E
T Front
A Hear
C Right
K
g Left
Plnq. Ret. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Ouclets
Switches
Garbage Disposal
Generaeor OO-5 KW �5�15
50B7 2/IG/0'1
Zona
Accessory Building:
Parking Req./Provided
ELECTRICAL �
Transformer ❑ 15-50 KW
O 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors �0-1 HP � 1'h - 8
Inc.Solar �9-15 HP 016�15+
Microwave
Pole Light
Range
Standing Set[ions
Trash Compactor
72o5i� �
FEES
Z
O
N
I
N
G
R
E
�
M
T
$
5 3 �
�. Reinspection Fee S75 Issue Fee § 3
FEES
DEVELOPMEN7 SERVICES REQUIREMENTS:
2oninp ApprOvad By Data
Building Approved By Onte y
Appliption luued By Dat 1.� �.v
�—
SUMMARV OF FEES ^ ,�.
BUILDING PERMIT $ �Z — SM�P 5 `�
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. 5
ELECTRICAL § GRADING 5
PLAN CHECK 50% S MICROFILM S�
MECHANICAL 3 TOTALFEE $ �
$ 3 PLAN CHECK 25% $
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Perm'it # Date Inspector qppROVALS Permit # Date Inspector
. �
1.. Temporary Electrical �Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd.' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Elec[rical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings � � 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-UnB�grnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Piumbing System � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas O Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT '
31. Plaster Brown Coat 79. FINAL INSPECTION •
32. Electriral Power Meter-Final 80. FOOD CERTtFICA SUED ��
33. Final Electric Notes: ( -- � D�,
34. Final Heating & Air Conditioning .,_
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing � .
39. Wa[er Service-Final � ' -
40. Gas Service-Final
41. Sotar pomestic-Final
42. Backflow Preventer ,
43. Backflow Irriga[ion '
i
� 44. Landscape Irrigation System �
45. Sound Attenuation . ,
46. liandicap Regulations � .
47.FINALSTRUCTURE&BUILDING �//i3 �- .
48. Special Requirements Completed ' -
49. Electric Release to Edison • .
50. Gas Release to Southern California Gas Co , �
'7. CERTIFICATE OF OCCUPANCY
' Date '
CITY OF COSTA MESA
CALIFORNIA P. O. BOX 317
FROM THE OFFICE OF THE DIRECTOR OF PLANNING
January jl� 1966
d•fr. Edi•rard Krau�
� Jaceresida
Costa I��sa, Cnlifornl¢
Dear Pool Qwner:
The Coeta Mesa Plannin� Department has been notiPied of the completion
of your swimming pool.
So that your poo2 will be a eaPe one and Por the purpose of advising
you oY your responsibility regarding the requirements oP the Costa Mesa
Municipal Code, we quote Section 929$•9:
1. No swinmming pool shall be constructed closer than Yive (5�
feet to any property lines, measured Prom water line oY pool.
2. No swirmming pool shall be constructed under any electric power
lines or on any electric power easement.
3. No swi�i.ng pool ahall be constructed unless the yard
surrounding such pool is completely enclosed by a Yence
six (6) Yeet in height and have a selY-closing and
locking type gate or gates.
This courtesy letter is directed to you so that you will be aware oP
our ordinances and can make a complete safety check oi your pool area.
Sincerely yours,
�i'��iCG�.YK'
William L. Dunn
Mrector oP Planning
M�IH OFFICE '
1!J! WEBT GAYLOND BT., - P.O. BO% YOl3
LON6 OE�CH 10. WLIiORHIw
NEMLOGK �.>�Y!
SPRUCE 0�0524
JACR60N )�3681
Twinina
Laborato�ies
oE cSouE�Zezn
October 11, 1965
GUNITE
REPORT OF CQ4FP�E TEST CYLINDER
BRANCH OFiICE
1l1�-O NORTH H�RPEF ST.
•ANTA �N�. C�IIFOFNIA
JEFFERSON 1406]
JEFFERSON ��20<6
¢nia, �nc.
Examination No. SC65-4572
For - Jos. M. Henley, 1973 Newport Blvd., Costa Mesa
Project EDWIN hRAUS SIdI?�f POOL
2977 Jacaranda, Costa Mesa
Sample from
Architect
Contractor
Gunite Contr�
Mix
Specified Strength, psi
�iS�3Fif3C S iz e
Date cast
Dace tested
Cylinder No.
COMPRESSIOI�' TEST
Total load to destruction, Ibs.
Pounds per square inch
Cylinder made by
Cylinder delivered by
Gunite Swim Pool.
Tibor Gyimesi
llluc Ilaven Pools, 12222 Harbor, Garden
Four Star Gunile, 11937 Vose St., No. H
4i - 1
2,000 psi
6 �"x12"
10-1-65
10-8-65
1
7-Day
100,000
3,015
Jos. M. Henley
Jos. IL Aenley
6'�"x1Z"
10-8-65
?
7-Day
100,000
3,015
�ECE�IVEO
OCT 13 1g6$
City ot Costa Mesa
eB��iding Dept.
6-'z"x12"
10-8-65
3
7-Day
104,000
3,134
4 - 5 - 6 "HOLD"
Cylinder received on 10-1-65
cc: Blue Haven Pools
Four Star Gunite Co. POTE: 7-day tests comply with specificatinns.
Jos. M. Henley '_ E/
�ta Mesa Bldg. Dept. � (p�
�� �
�-�� � �...�.-
���
ALL NLpRTO �I1[ lUOMITTCO A� TH( CONFIDCNTIAL �ROP[NTY Of CLI6HTB, hIITNORI2ATION F�R �UGLIC.�TION OP OU0. RF�OFTB. CONCLUlIONl. Ofl !%•
T11ACT� /qOM OR RCO.�HOING TMCM �/ R[86RV[D PCNDINO 011q WRITTCN 6��POV�L AO � MVTWL �ROTECT1011 TO CLI[NT6, THE PUBLIC /�NO OUR06LV[6.
�wNr;x Ug pgll llATP: -1 -b
JOB ADDRESS 297'T JaCST821d.8 BUILDING PF,RMIT NO. 2'700
GENERAL CONTRACTOR BluB Haven Pools DESCRIPTION OF WOAK private S�im Pool
AP No. l ZO_'�l l_JJ LOT TRACT FIRE ZONE VALUE S 7 7rn nn
SUBCONTRACTOR
� � - �d,nn
COSTA MESA BUILDINCrSAFETY DEPARTMEPIT
P.O. BOX 1200 - COSTA MESA, CALIFORNIA Y2626
� For Appltcan� ro Ftll In Complefa�y
TYPE OR.PRINT
COSTA MESA, CALIFORNIA
� ! i
BTATH
LIC. NI
s¢e
i ccrewcK uHa
�i xeaeor �
AHD BTATG
PLY WITH /
EUILOINO C
yI
.Q/
T!L
NO.
T!L
DESCRIPTION OF WORK
WALL
� AVTHOIIIZiDAO[NT
�
C�
CI�Y Qr CvStA MESA
SEP 15 1965�
��,
BUILDING
fOr Oiflce Use Only
BUILDIND
ZONIN�i
SON[ MO.O� UYiOIN[W
/ �un� yL su��o�na
DUC111TON //. �YGib� � I�C,
�. P. No. j 3 9- �2/i -a. �.
NOTQ: NOiAV60V[RHAN08HALLE8LE88THAN
YARO! MPROVED
MAIN BUILOINO
VAR. �C
YARDBAPPROVfiD
�ACGEC60RY BUILDI—N6
. � � C/�—�
PI'.
� / �.
� � /
DATB
HOLD FOR SPECTA�, REQUIRFMPn�T� I w
/ / . . _ • .f ' . A
MAV[ 11GD TXIp A TIO T1[ AYOIIMT 9MOWN UHD6R VALU�TION IB IOR TX[
CORR[R�I1N0 • [ T CO . �UHPO![ OP UTI�GLIONINO h P6qMIT Pl[ ONLY.
AND RAT[ Lw R[ T� o yALUATION �j
/ PERMIT FEB oG � �
_� , � ,. .
s 2�0 — d °9 w
•" -,� . 1�� �"� . . i'�� ��i��,i�g'�L��
'� AU� 7 1959 .
COSTA MESA.BUILDINGSAFETY DEPARTMENT I. ni;,r��
� P.O. BOX 31] COSTA MESA. CALIFORNIA `�t1f:i\UE �����,
�i� `r .��..�r. :..}_�,� .
FOR APPL/CANT TO f/L[ /N COMP[ETELY. � aPP��cwr�or, FOR PERMIT
. � TYPE OR PRINT ' BUILDING
ADDRE'S5 2977 Jacaranda Ave. � � � � �
COSTA MESA„CALIFORNIA � rV�{ OFFICE USE dNCY �
RECEIPT NO. �I�q plT�f�p.a� '
OWNER � AC�B.IIIS Acres Inc. ' � I � I ��'-, ,�, a
MAIL ' RECEI ED BY DA E flECEIfV—ED 11D�PTE IBSI{�(�
AOORE55 E. 1{',]7 S}.• ' I �SJ �AV�] 1 u ia.+�
cirv Costa M253 TNo: LI81159 AooRe�ss � q ' C�itrt'
AftCHITECT Carlson & uc. �.� ' COSTA SA. CALIFORNIA
OR ENGINEER NO. �
Garden Grove ' F�RE •�'
AODRESS ZONE
i e o egrove� i1C. STATE 167293 APPftOVED
CONTRAGTOR LIC.NO. gy DATE
ADDRE55 �+7-9 E. 17th St:� Costa Tiesa � ZONING ' '
LEGAL � I LOT I . I ZONE I NO.OF �I lISE OF NEW �}�/�
OESCRIPTION NO. ��� BLOCK TRAGT P�-ANS BUILOING ir U.�
�1/�
A.P.NO. APPROVED � y / (-G
BV �ATE o � J �
5'ZE . 60 X 113 I�o. or e�ocs � �
OF LOT rvow oH �oT hone YARDS EVES
REpUIRED ALLOWEO
USE OF ' � ' (CENTER LfNE STJ/' ��"� '
EXISTING BLDG. FRONT ti V Ff. 'IN.
SETBACK LINE FROM
ceHrea ov sirs[[i O� REAR YARD � R. SIOE �FT. IN.
SIDE YARD I LEFT � I RIGHT t� � L. SIDE FT. IN. '
DESCRIPTION OF WORK : � � "
REAR Ff. / IN.
NEW .I X'� II ALTEkATION I II AODITION ' I � '
REPAIR I IIMOVING I� IIDEMOLISH I "
S ZIE DING 1 6O \• ROOMS ! STORIES 1 �
EXTERIOR WA�LLUCCO ROOF �
COVERING _ V ICOVERING Rock .
USE OF BUILDING ANO WORK TO BE PERFORMED �
Sin 1e famil re.;idence with .
attached �arage. , � _
I HENEBY ALKNOWLEDGE THAT I HAVE NEAD THIS APPLICATION THE AMOUNT SHOWN UNOER VALUATION 19 FOR THE
ANO STATE THAT THE A90V@ IS CORRECT NNO RGREE TO COM� �
PLY WITH hLL CITY OFUINANCES ANOy"TiTE UWS FEGULqTIN PUPPOSE OF ESTPBLISNING A PEflMIT FEE ONLY.
6VILOING CONSTliOCTI N. / .
vn�unrioN
SIGNATURE OF �. � PERMIT FEE s 35�00
PERMIITEE . r/
. ' ' __ $ 1�J��J�Jl PLANCHECK $ 1(.5�
T (
AUTHORIZEDAGENT Dike'& Colegrove, ynC� -. TOTAI_ FEE_$ 52�50 �
vi ' �• - -