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Home My WebLink About925 JASMINE CIR - Building Permits�, H. V. LAWAfiASTER ��0.� ��C• 73CM5-973A-002 7940 MAIN STREET — STANTON, CALIFORNIA 828•8040 XXX Field Data on Test Specimens Core Concrete Gunite Gro�t/Mortar Project � - Harald Michael Pool Permit No. 35996 Project Location 925 JasmiR:Circle, Costa Mesa Coniractor Blue Haven Pools Arthifect Location in Structura Deep end Walls Engineer R�III {il��i; CA�FN ISF�� Date Moulded 3/19/73 No of Spetimens 6 �-f,� q., �n�� • � �. •v � y Sl�mp - Specimens Marked Specified Strength at 29 - days �nnn p,S.l. Mix Desionation Age to be tested 7 days 28 days days days READY MIX PLANT AGGREGATE SOURCE Weaiher Condition �arm 1 Yd. _Yd. Batch Cement Monolith Type I/II Cement, Ibs. 182 bags Admix Sand 4fi tons Specimens made .by Century Gunite #�4 Data by �wen Cromwcll #3 Delivered by Oscar Sanderson #2 Date Delivered 3/20/73 # REMARKS: 73-487 6ottom of sample crumbled 73-488 diagonal break Lab. No. 7 Date of ?est Specimen Dimensions Aree Ultimate Load Lbs. per sq. in. H/D Corrected Foxq M�015 73-486 Test 6.05 X 12.25 20.75 93,500 • 3.252 Water, Gals. 73-487 7 Day Test 3/26 6.D5 X 12.25 28.75 61,00� 2,122 Y 73-488 73-489 � Day Test 3/26 6.09 X 12.375 � 29.13 No fu 73,500 2,523 73-490 73-491 Test tests necessary February 1, 1973 Mr. Harold Michael � �' 925 Jasmine Circle ' Coata Mesa, California 92626 Dtar Sirs � � A Du3lding permjt has been iesued to Blue Haven Pools to construct a private swimming pool on your proper[y. In order that your;+pool 11 be a safe one and for the purpose of advising you of your respons3b ty regarding the requiremen[s of [he Costa Mesa Municipal Code, we refer you to Section 8197, a copy of vhieh is attached. �� •� -�•� This letter is rected to you in order that you will be aware of our ordinences and ea ake a complete eafety check of your pool area. Sincerely yoars, RICtURD HANHART Building Safety Directoz RNtcb r CZTY OF COSTA MESA REQUEST FOR QCCUPANCY TRACT N0. �'li�i DATE � �� l� TAT N0. �'� ADDRESS `•t �S �(}-s�v-r� �n�A_ The developer of the above entitled tract desires to sell the above set forth 1ot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they). (was or were) ��,�Q � advised that this tract has not been given fina ' inspection nor has it been accepted by the City of Costa Mesa as having canplied with the conditions of approvai which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agzees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. RECEIVED C�iV 0� CDSTA M�SA PLaNNiNG DEPT. JAN 2� 1�73. ��8�9��ll��3i4i5 6 � ^ �JJ/ �� X'r BY �� Purchaser BY G2�i,i�p I�'_ �— . Developer and/or authorized representative BY�C.t�G(G-- C�'� Lender AVP��ant to fill in all spaces within h CITY OF COSTA MESA � � ae IT NO - '- CONSI`FiUCTIONPERMIT � — �%SZ D�.�:nn� C �uee /I� i� 1 A f:AA�f�.l �� T�i� i.C. � Addrea � . . 5:�;� Arch/Eng. ' ' ' Address -' � � � � License��No: - - � Eortler lines antl sign all appropriate Oeclaration! '� A� i�`fQ• - LOT NO. BL�G. NO.- � � ri Z TYPE OF CON CTION '� � O NEW ADD ❑ ALTERATION .� REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESLi21PTION OF WORK Contrac[or � � � � r� - rnone 3�Cr- TVPE OF PERMIT � . �; - , 1 AtJdress' �` � - ' � , ' �/ ._ ' ❑ GRADING O FOUNDATION ' STRUCTURAL' LICENSED CONT0.ACTOR-DECLARATION ❑ TENANT ❑ ELECTRICAL OPLUMBING ❑MEGHANIi �I he�eby at(I�m Ih:.t I am lic¢nSBtl untle� p�ovisions of Chdrte� 9(coiT- � � menclnq 'with -5ectiom 'lD00) of � Dlvislon 3 of �fhe Business entl � Q OTHEF - Professlons Cotle, jantl my Iicenze is in fuu force antl eftect. , pROJECTD� SCRIPTION , ' License lass ` LicenSeNo-��VSO� ' /�/� '- I�" Dzie ��T-5lgnature � " -' • � SQ..FT.��. _ 'WORKERS'COMPENSATION�ECLARATION . -. . . ' OCCVPANCV !/„�j�C,oNSTRUCTIONTYPE,T_ �1 hereby aftirm that 1 have a certlFlcate of consent to self-insure or a VALUASIOIV_}r�tZ20NE �certififzte-of Workers' Compensafion -Inzurance; ow-a certifietl <opY - - - thereof (Section 3800, Lab. CJ. . GRADING CU. VDS. ACRES Pblicy No:" - - Company' ' - " ' - ' ' � Certlfietl-copY �s �h¢raby fumishetl. . .._ . � REMARKS: - ' . ' �l_ _ _ _..._ . _ . __ � ❑ Certifletl cOpy Is (iletl wi[h [hC clty Builtlinq �ivi5ion. E%EMPTION�FROM WORKERS' COMPENSATION'DECLARATION - ' ' ' � ' 1 ' (This_sectlon.need noLbe completCtl if th¢ permi[ Is_tOr_ one huntlretl � . • _ _ _ , _. _ _ 1 (5300) or less�. ' ' . � � � ' �- � ' "� I. cerlify that in the;performance of the work tor which lhis permit Is IssueA, I shall not em0loy any porson in any manner so as to become PLUMBING�, . � PLAN CHECK ' Sub'¢C[ o th Wo�ke�s' Compenzall� L"awS of. Caf r 1Datet�5lgnature.{�c�+^� �� BATHTUBS -� VSHOWE0.5 - �� NOTIf�E: I aHer making [his tlecTaration, you shoultl Oecome subject TOILETS� . URINALS- to tha Workers' Compensation provisions of t�e Labor Cotle, you mus[ LAVATORIES� DOVBI'E LAVS'-'- ' to�thwltn comply wilh suth prov751on5 or Ihis perTit shall be aeemetl revoketl. __ .__l . _ .., _ . . _. , . _ .CONSTRUCTIONLENDINGAGENCV KIT.SINKS ''" 'DISHWASHERS ' ' I bereby affirm lhat Ihere is a cons[ructlon lentling a9ency for the per� SERVICE SINKS . 'SVMPS '� --' -'" - tormdntG Of Ih0 work lor wnlch [his Oermit is issuetl (S¢ction 309] -� Gv. C:). -' -' -'- ' -' ' - ' _'y "' ' ' "FLOOR.SINKS "' " FLOOR DRAINS � ' � ,' " LenGer'S Name Lentler's Atltlress � DRINKING FOUNTAINS - - ' '- �' f. OWNER BVILDER'DECLARFTION ' - ' - "" '" " jIVTERCEPTORS CLARIFIERS 1 hereby attitm lhat I am exempl from th¢ Contrattor's License Law for [he-followinq'reason (SecHon ]031:5•Business antl-Profe55ions Coee: _SWIMMING POOG. 'PTRAP "- ' � Any Gty or ,county„whith, repuir¢T�a permit [o�,mn5truct,_ alter, - - Improve,"tlemollsn or'repalr any structure; priorto itsissuance, also re- � yyqTER SERV ICE -. �' ALTERATION "' .' quirez the'Sp�, IlrvnC /oc such permit_ [o-4ile a signetl statement,tnat he ' � � - � Is"licensetl pursuant to'tbe provisions ot the Contra<tor's�License�l.aw� -GAS SERVICE ��OUTLETS'� � -- �" (Chapter 9(commencing with Sectlon 7000) dt Division 3 of [he Business antl-Prdessions Cotle) or tnaYhe is'exempt iherefrom antl�the �yyqTER HEATERS- " BTU'OUTPUT'� ' -�" basis lor tne allegetl exemption. Any violation of Section �031.5 by any appliwnt �fora-permit-subjectr�the aOP��cant to a-tivil-penalty -'SEWER CONNECTIONS '"- l` - of nol more titan live nuntlretl tlollars ($500). ❑ I. $s�owner of ('he orooerN: or-mJemploveei witli�wages as roeir --SOGARTANK-' ' -' COLLECTORS - or �r of work isso�tl w�mm one year ot compieuon, tne owner ww nave me ouroen of proving ne tlitl nol buib or improve for the pu�pose of zale): ��1,-as owner-of-lhe•properly,��am�exclusively-conVacting-with licensetl contracmrs to construct tne proiect (Section 1044, eusiness antl'ProfG55ionsCotle:.The�Contractor's-Lic¢ns¢ Law�tloes�not aOP�Y �o an owner ot D�operly w�o builtls o� Improves the�eon, antl who COn- bactrtrom sutn projects with a coniractm�s�-Ucesnea�pursuant co Ue Conlra<tor's License Law). ❑'I"am exempt untler'Sectidn - -'B.-&' P: C. for this reason - -- - - - Dace Owner e reatl inis apPlication antl 5[ate that Ihe abpve I a9ree lo comply with-all'city antl wunty relating lo const�uction dnd hereby authotiie cily to enter upon the above mentionetl aG�uq%%f'w'� _ _'e Iq f�Z SOLAR PIPING SVS. � - - - - "- ISSUE FEE � � � � MECHANICAL PLAN CHECK � HEATING SVSTEM 0-300�000 BTV � AND DVCTING'" " 100,000'> gTU REFRIGERATION 0-300,000 BTU SVSTEM - ' � 100,000 ! BTU - S BOILERS BTU SVSTEM REVAI R, HLTERATION EXHAVSTSVSTEM MULTIPLE Slgnature /�..�k-- � �_ Date � . I. ISSUEFEE Drivers' Licensc or 55 � CMF 0865-i6 White-Builtlin9: ��ary-Applicant: Pink-Accounting; Goltlenrotl-Assessor 0 FEB 181982 REAR VARD ( PKG.SPACE R � �. ,. REGULATIONS . . PLNGp. gRUEF. � _ . �ROPE�RT�4 iET WIDTFi � � � NG APPROVED BV"�x IAL CONDITIONS: �� PROV PARK _ _ _ ' ' _ . _. . . _ ' ' � J ELECTRICAL �- � � P�arv�CHECK ' -GENERATOR '0-1KW-_1-IOKW - ' ' � ;TRANSFORMER • � � �AV7LIANCE - 30-SOKW�_50+�KW- ^ - - - MOTOR$'� - 0-1 HP=1"-10 HP "- ' "' � �,�IN0.50LAR).- 10-SO�HP=50�+HP-�� FIXTURES "" OUTLETS"'- SWITCHES -'- ' -- ' - - GAS TUBE SIGNS '•- -- --' ' - - •' � ' ' " ' _ ' 1 iPOLELIGHTS -' -'� " '�- ' ' - � � I 'POLES METERED "�.SUB . � iPANELS'- -MAIN-'_---$VB-' - ' ' -:SERVICE ' ' ' - ' . ' " AMP " ' ' j .� . - . .... .. '_ ' '__' "" " ' 'J._. ' .. '. , � .; . ..__ " _ ' _ " '- . i . . . • . '. ' . � _. .�- .. _ " " ' " " .... . .-_ __ _. . _ . I � "' ISSUEFEE' -' "' " " -' APPLICATION APPROV ED BV - � OAT Z SUMMARV OF FEES ., � �i BUILOING �PERMIT y / _SO:C, �SMIP.•, � S. 1 •�O PLAN CHECK b � PERMIT' 1 - � - ISSUHNCE\ t � �PIUMBING� S _ __ _"GRADING�' E. '� � ` �PLAN CHECK b � .• }ELECTRICAI -S. .. "' "'- . ' 1;-' �s ' � } - �' ��MICROFIhN'S' ��' � PLAN'CHECK"E' ' - - -- . � MECHANICAL E = TOTAL FEE S��-�� PLAN2HECK� S' •. �' � • • VANCE PC I . S_ . .�. � FINAL FEE 5=� , 4 CONSTRUCTION AND P AN�11 45,`+� kF� �.,, POOL & SPA' ` - . �� "'�pat0 �nspector - � Date Ins ector APPROVALS Pgr t# � APPROVALS Permit #� �' 1. Temporary Electrical Serv;l�e�Or Pole'�� " � "-� �t� � 43. Pool & Equipment Cocation' ' - ' - - ' - - - Soil _ipe:Undrgrn_ � ..._ ' J 44. Steel Reinforcement� - � 3. Electrical Conduit Utility-Und. �ry.i�; �.� �j �ji� y`��!) 45. Forms - . 4. . Electrical Conduit-Undrgrn_ ' 46. . Electrical.Bonding � - - - - - - - - � tee em orce - 47. Rough Plumbin & Pressure Test - - . 6. Electrical UFER Grn �' 48. APPROVALTO COVER-GUNITE - � --- -- - � • - � 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation � 50. Gas Pipe, ❑ Undr m; Test " ' �' ...9. . Water P.ipe-Undrgrn ~. 51 . Backw sh Lines P-Tra ❑� � nd?-�m -' ' 10. Structural Floor System ' ' 52. APPROVALTO DECK � " ' �" - '" - ' -� - ' " " 11.._.P.roperty Sewer Line & House �qnnection � 53.�Backwash & Rece to�-Final � . 12. .._Street Sewer.Connection _ - - ' - - - 54. Heater & Vent-Final � 13. Rough.Plumbing ' ' ' � - 14. Rough Electric-Conduit - - -- � �56. Electrical-Final ' � 15. Rough Electric-Wiring - � - - 57. Solar System-Final � ' ' - 16. - Rough Heating & Air�Conditibning- -" - - . - � encing & Access Approval . - 17. Ducts,�in Structure '' ' � APPROVED FOR PLASTERING 18. Ducts, Ventilating - . . ' . ' ._ , , , _ . � 19. Gas Pipe-Rough &Test - ' '. . - 60. POOL/SPA SYSTEMS FINAL , ' ' � ' � 20. Roof Framing - = - ' � ' � ' '� - 21: Roof�Sheathin - � - -�� ' � � �� - ' - • � , 22. Frameand Flashin - �� ,a}- .,Z NOTES:� � ` ' ' . . ' ' . , 23. Insulation- �- ' - ' . �,, " �..C�oe 24. Lathing�& Siding . ! � - - � - �, 22 . 2 25. Drywall Nailing . _ . . �• - ' - � ' 26. �Plaster Brown Coat - - 27. Electrical Power Meter-Final � . ' 28. Final Electric - � � - � ' 29. Final Heating & Air Conditioning � • � - � - 30. Final Gas Pipe-Test ' - � � - 31. Final Plumbing ' � � �- � ' •32�- - Water Service-Final � ' ' � ' '' � � ' ' 33. • Gas Service-Final� � " ' 34. Solar pomesticFinal� �' � ' �- � �� 35. ' landsca e S rinklin S stem � � � � -� ' ; 36. Sound Attenuation - � � � � �' � - - � �� 37. Handicap Regulations - �� - � � ^ � � . 38. FINALSTRUCTURE&BUILDING 3�s '� �� ' � 39. Special Requirements Completed � �' � ' � � � � � ' � � 40. Electric Release to Edison � � " � - � - -- " - 47. Gas Release to Southern California Gas Co. � 42. CERTIFICATE OF OCCUPANCY - ' No" � ' Date _ . CITY OF COSTA MESA ' ° BUILDING DIYISION > � � � DEVELOPMENT SERVICES DEPARTMENT / v � PERMIT PERMIT NUMBER / �� dP 898-0� R.r,1 (714) 754-5273 • Fau (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Jobnddress: 925 JASMINECI Suite: Viciniry: Parcel Nunmber: 41218309 Zoning: R1 R1 App�icant: KENNEDY, TIMOTHY Address: 925 JASMINE CIR Phone: COSTA MESA,CA , . Zip: 92626 � Owner: KENNEDY, TIMOTHY 8 SUSAN Address 925 JASMINE CIR . � � Phone: 714-754-6963 � COSTA'MESA,CA , Zip: 92626 � Contractor. Address: Arch / Eng : Address: Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: Phone: Zip:, � � License:' � � Phone: � Zip: License: SCOPE OF PERMIT TEAR OFF RESHEATH WITH CDX & REROOF WITH 40 YR COMP. SHINGLES: $0.00 $74.75 $0.50 $0.00 $0.00 $0.00 $75.25 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING existinq: o NOTES: Rear 0- 0 Rear 0- 0 Reauired: 0 FEE SUMMARY � � - � � �` i PLANNING 8 ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Status: ISSUED Applied: 70/13/1998 Issued: 10/13/7998 Calc Valuation: Claim Valuation: Right 0- 0 Right 0-0 $3,000.00 $3,000.00 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 ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALI: (774) 7545626 WORKERS' COMPENSA710N DECLARATII ' I hereby aHirtn under penalry of perjury one ot ihe tollowing tleclaretions: ❑ I heve end will melntein e certificate of cansent to self-Insure for workers' compensetlon, es provitletl for by section 3700 of tha Labor Code, tar ihe pertortnence of the work for which ihis pertnil is issue0. ❑ I have end will maintein workers' compensatlon insurance, as requlred by section 3700 of the Lebor Cotle, for t�e pedormance of ihe work for which Ihis pertnit is issuetl. My workers' compensation Insurence carrier end policy number are: Carrier: Policy Number: (Th/s section need nof be camp/etetl il the peimit is velued et one huntlretl tlollars ($700) or less.) ❑ I cartity that in the pertormance oi Ihe work for which this pertnit is issued, I shall not employ any person in any manner so es to become sub�ect to the workers' compensation lews of Celitomie, and agree ihat if I shoultl become subjed to the workers' compensetion pmvisions ot Section 3700 of the Lebor Code, I shall torthwith comply with Ihesa provisions. Applicant SignaWre: Date: WARNING FAILURE TO SECURE WOflKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN�RED THOUSAND OOLLARE (E100.000). IN ADDITION TO THE CQST OF COMPENSATION, DAMAGES AS PROVIDED f-0R IN SECrIIXJ 3i06 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eflirtn thet I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the eusiness and Professions Code, end my license is In Full force end eHecl Lic. p Class # Contractors Signature: � Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that there is a consWction lentling agency tor Ihe pedortnance ot the work for which this permit is issuetl. (Sec. 3097, Civil Code). Lentlefs Name: Lentler's Adtlress: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHlrtn ihet under penalry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor Ihe following reasan (Sec. 7031.5, Business entl Protessions CoAe: Any ciry or counry which requires e pertnit to construct, alter, improva, tlemolish, or repair any sirucWre, pnor ro its issuance, elso requires the applicant ior such permit ro tile e signad stetement that he or she Is Ilcensed pursuant to the provisions ot the Camreqors License Lew (Chaptar 9(commencing wlth SecNon 7000) of Division 3 of ihe Business end Professions Code) or thet he or she is exempt iherefrom entl the basis for �he elleged exemption. Any violation of Section 7031.5 6y any epplicant tor a permi� s�ub/jecis �he aDP�icant to a civll penelry of not more ihan five hundred dollars �$500).): I4 I, es owner of ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe strudure is not intendetl or oHered tor sale (Sec. 7044, Business end Profeuions Code: The Contractors License Lew does not epply to an owner of praperty who builtls or improves iheraon, entl who does suc� work himself or herseli or ihrough his or her own employees, provitletl that such Improvements ere not intendetl or oHered for sale. If, however, Ihe bullding or Improvement is sold within one year oi completion, the owner-builder will have ihe burden of proving ihet he or she did not 6uiltl or improve for purpose of sale.). ❑ I, es owner ot ihe pmperty, am ERCLUSIVELV CONTRACTING WITH LICENSED CONTRACTOBS to construct Ihe prqect (Sec. 7044, Business and Pmfessions Cotle: The contractors Llcense Law does not apply to an owner ot proparty who bWltls or Improves thereon, antl who contrects for such project wit� e contrector(s) Ilcense pursuant to ihe Coniraciors License Laws.). ❑ lem Signeture: Owner ID sec. by driver's license. �Ves ❑ No Business antl Professions Code for this reason' Verificetion of Ownership by (rype of document, i.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: �/ Date: /YJ^/�—�iP' . Drivar's License No. � Ezpires: _ S- �D ❑ I hereby ceNty ihet no e:cavetion five (5) or mora teet in deplh into which a person is required to descend, will be made in connectlon with work euthorizad by this permit, an0 ihat no building siructure, scefroldinq, falsework, or demolition or dismantling t�ereof, will be more ihen thirty-siz (36) feet high. (Chep. 32, Gry 2, An 2, Sec. 347, Title 8, Calitomla Atlminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which would raquire e pertnit trom the Division of Indusinal Sefety, es noted above, unless such person has a pertnit to do such wark trom the division. Signature: Date: Division of Indusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENfTiY: I certity under penelty of perjury ihet I have read this application and state �het Ihe Informetion given is correct. I egree to comply with ell state laws end city ordinences relating to building construction, and authorize representatives of the City of Cosla Mesa to enter upon the above-describetl property for inspection purposes. I agree not to occupy or allow occupancy of eny building euthonzed by this permit until final inspection. l� -/1 f` SigneNre Of Le I Owner(s) Date And/Or Authonzed Applicant Date CODE I. INSPE[TION TYVE 1616 Fixad System Final Fira PreveMion 726fi Pool SDe Final 200 Final Re-Rool 201 Finel Blxk/Reteining Well 202 203 204 2a&I6 Final Fectory Fire Place Final Sign Finel Demolition �A7E U�ALS LQyE2 INSPECl10N TYPE 206 Finel Mechanicel 20B Final Plumbing 270 Final Electricel 212 Final Fire Prevention 220 Finel Planning Approvel 222 Final Sita 250 FinelBuilding/Occupancy �ff U�lLS ��10WNER M y JOB ADDRESS �GENERAL C01 _�5 AP No. �i\ INSPECTIONS ` Pool Location Forms Main Drain _ Steel Reinforce Elec. Bond _ Approval to Cover Underground Electric _ Gas Piping Test Filtering System Lines _ Backwash Lines and Recep. Electrical Final Heater and Vent Final Filter System Final _ Backwash and Recep. Fencing Final � DATE BUILO DESCRIPTION of WORK p� $ FIRE ZONE VALUI Date GROUP TYPE ' �'73 SUBCONTRACTOR Electric "%'7.� Lt��i. is �z7-73 Plumbing ��- o,.� z7-7� a.%8�-I � � - 35996 COSTA MESq BUILDING-SAFETY DEPARTMENT P.O.BOX12pp COSTAMESA,CALIFORNIA92626 For Applican Fill in Completely BVILDING ADDRESS � OWNER � �j��Q MAIL �� Z ADDRESS W w yY�� TEL. a U CITv �/� NO. Z2 Q CONSiRVCTION ON LEN�ER /�� _ am J � BRANCH J � m J ADDRESS J m ARCHITECT TEL. a OR ENGINEER N U N Q W 2 ADDRESS a w I, J O CONTRA R (j ,�—�,� m Z / J ¢ ADDRES$/ '��-- w w � TEL. Z F CITV NO. w � STATE �; CITY y� LIC. NO. �Y�' LIC. NO. � � SIZE � NO.OF BLDCS. OF LOT NOW ON LOT USE OF EXISTING BLDG. F� S12E OF NO. OF Z NEWBLDG. ROOMS STORIES U EXTERIOR_,WALL ROOF GOVERING COV.EAING J USE�OF BUILD N ANO WOR O BE PEfiF RMED a a a � f N 2 O U1 hereby acknowletlga ffiat I have read this application antl stn[e � that the above information is correct and aprae to comply with � a11 laws regulatinp buildin8 �onstrucNon, antl I shall not omploy F any permn in violation ot Me workmen's compensallon laws of y tha Staro ot Califqmla. ZI hereby ceriity [hat 1 am properly licensetl as e cOnt/actor untlar the State of Califq�nia Business antl Professions Code, Divisicn 3, Chepter 9, antl tha[ su<h licanses are in tull force en t, or 1 am ezampx fro the provisions of Ne Stat¢ of Cal' rnia usiness antl Profe55io Co , Division 3, Chapter 9. Sipnature of � . . �% Pe�m a �L�B�� q/J Authorized Apent %k.'��/ � ::u� Z%-�?PAIOOO 9�5�� •* `�35 G0 �,- APPLICATION FOR BUILDING PERMIT �EIy,�D BV DATE RECEIVED nerc �ccimn A.P.NO. NON� YY�'� I rer � BUILDING /�� S JA-S�u� �uc ADDRESS %o�- �l GHA-c,—�c � // v. FIRE ZONE APPROV 2 r / L— ZONE n^ NO.OF VSE OF NEW r-,'�,(J/M I�I PLAfS 2— BUILDING 6` VARDSqPPqOVED VARDSAPPROVED MAIN BUIL�ING ACCESSORV BUILDING (FROM C/L STREET) Q �/�/� M FT. V FT. ��1'� � � FT. 1 CIf1F T `� FT VAR. # C. V.P. al� APPROVED BET. MAIN $ ACCESS. BLDGS. DATE ' � APPROVED I —.�yqT_ '� - 2z '7 3 S7ATE m � SQ. FT. TAX d THE AMOUNTSHOWN UNDER VALUATION IS FOR j THE PURPp$E OF ESTABLISHING A PERM�7 FEE ONLV: m ¢ VALUATION � � � PERMIT FEE $ �" � $ �y/'� �y m //DQ� PtAN CHECK $ F 0 TOTAL FEE $ �3 s= " � 35116 COSTA MESA BUILDING-SAFETY DEPARTMENT �+OLAP�O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fi!l in Completely BUILDING G!]f]RFSS � Jasmine Circle Z . av F- Z Z � � N am J � J N Q W m J m J Q U N 2� aw wz J � m Z J � W W 0 ZH w� N � 70 H z Q U J a a Q � H N z � � U � � F N Z OWNERLarwin Southern Calif., Inc MAIL nooaEss16255 Ventura Slvd_ CITV Encino, Calif. 0,0�986-88 CANSTRVCTION LENOER Larwin Southern Calif. _ BRANCH 16255 Ventura BZVC1. ARCHITECT ADORE55 9100 Wilshire, Beverly Hil CONTRACTOR Larwin Southern Calif nooaess 16255 Ventura Blvd. c�rv Encino, Ca].if. NoJ86-8890 LIC. No. 191311 LICVNOB_1 SI2E NO.OF BLDGS. OF LOT SH X 9O NOW ON LOT Q USE OF EXISTING BLDG. NEWBLDG.17S�} ROOMS STORIES 1 COVEERINGALLStUCCO COV�EfiINGWCI. S�i11IICJ12 VSE OF 6UILDING AND WORK TO BE PERFORMED 5 I h¢raby ecknowletlpe Mat I have reatl [his application antl state Ihat [ha abOve info�mation is correct antl agree to comply with nll laws reBulatlnp buildinp eonstruction, antl I shall not employ nny person in viOletlOn Of the workman's compensation laws of tho State of Celitornio. I hereby certify chat I am proparly IicensaC as e contractor under �ho Smm of California B�siness antl Protauions Cotla, Divisicn 3, Chapter 9, entl thoc such licenses ere In (uli torce antl attaci, or I em exampt trom IhB prOvisiOns Of Ne S[ete of Calitornia BusinBaS antl Profossiona Code, Dlvizion 3, Chaptar 9. Signatura of � �) —'A D. Dp�anS Permkteo ��'i/1� AuthoNxatl ABont PA1D nuc is-iz�%SFOOioUi# ��*142.R8 TION FOR BUILDING PERMIT T�OL %%Qf'� �� A.P. NO. BUILDING ADDRESS FIFE ZONE NO.OF � �� a�+r�s VARDS APPqOVED VAR. �'+ C.U.P.�W APPROVED FOR SPGC:AL M/NE L% /� LOT� BIOCK �G, �U G VALUE � $ GROUP DATE �i7� � � VSE OF NEW��N(.�� BUILDING �/�� VARDSAPPROVE DATE APPqOVED & � m � SQ. FT. C THE AMOUNTSHOWN UNDER VALUATION IS FOR � THE PURFOSE OF E5TABLISHING A PERMIT FEE ONIV: o ¢ VALUATION � PERMIT FEE S � j 3 a/ �y+ m (Q � PLAN CMECK § r� E /� LL TOTAL FEE S (i L