HomeMy WebLinkAbout3257 MICHIGAN AVE - Building Permitsannnessorau�wa: �Z57 MZCIiIGAN AV r;
owNE�sN,u,E,F�,: WHITED, EARL J TR • FLOO�: X 37
. �ooacss:3257 MICHIGAN AVE
COSTA MESA CA 92626
714) 545-4�i17
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LICENSE� COMHACTOfl3 DECLAPATION: 1 hmeby Mim uMv parielly d pajwy Nn I em licemed under paieions ol Chaqar 9
(mmmaMiiq wiih Sxtian ]000) d piwion 3 M Me Buznen eM Pmlmdoru COEe. aM mY lioenes e in hA beea xk elled.
cm uc. No.: uc. cuss: uc. No.: EXP :
Oele: Canratlar.
OWNEN BUILDEfl DECI�NATION: I Mmb� NNm under pmNy d pmjwy �MI I em uemq fmm Ihe CoMmfa+ lioarroe lew lor tM
lollowin9 re%� I�mn ]C01.5 Buaneae eM Prdevioro Code: Airy cry a mumY �� �Ouiiee a paimn �o mroMN.M. ellm. improve.
demdah, ar repa"r arry sltuclurt, pv b ia iwvre, aLw �epu'u» IM eppliran Itt wN petm! lo fib e agroE datemeM thet M or eM
m r���a w���,� �o ma w��� w ub c�vma. wa�,.e �w Icn.ae, s loomm��a wnn seao�, �aao1 a owo�, s a ma
eu��� �e ara�o�. c�eel ��mm �e « a» A wma �n>d�om d,a �ne e�. ror me v�d �emqo�. nm •wm� a saao�
o3t.5 by eny epplirent lar a permil wbpqe iM appl'rant to a riHl peraliy d ewi mwe ihan IHe huMieE doAen �5500��.
�] �.dow,e.w�newownv«mremaw.e....n�mub:aw.00moe�ia+..aeoub..w..�au.nruMn:�ainia,aed
or ollered br aeb (Setlion )OM. Budroa eed Pminz'vn COEe: TM Contrmm Lie«ue Lew does rM app�yloen ovmer d propeMy
� wu. a mv� �n�o�..�a.ro ma..w� ��.n a naw «ww� w,, ne. �.mo�m+�. a�«i mr.�n
impeovamema ara na iniended «otlueE lor eeb. p.lwwe+er. �he buikiiq w inpwemom u vald wnhin arY� d mmplaun. the
x mmxau�ux �.w n.� m. euree� a aw+�e na w ene ed �a dau « imaa+�u �,e o�w�a a miel.
❑ �. d o.,wr a ine aororo. ���v �wioi.+�u .w e�n..a w�v,aa. w conm,b m. qqen (swa, �ou. a,.inm. ena
PrWesabn9 Code: Tha Comreeon Liceroe lew dwa iw eGdY b an onar d PW�Y x1a dnlas or "unG�'p IMrem uM who
mnVene Iw ewi� pqea� w4h a mmreeor(a) IicemeE pusueM to iM ConirerJon lioenae Lew).
I em eaemq uMer Seciion: B. 8 P.C., br Nu ie��eaon: ��JJ //��
/ete: '�� Y Ownor. �� ���
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4 o Mrtby cerliN Ihat I em ewere d eM vdenieN tM nQuiiemeim G Cellanie fi6Mh eM Selay CaEe Sadiom 25505. 2553J. eM
em
255�, e�M ihet I a ury h0.un buildirp oovryant xill / wil rwi (a�cb aro) med �a camply xih eaN ems ooEm erd tM nQuiromenb br
epermnlawmvuctionamoEifraiianhwniMAi3ii yeTl�wpemsnlDiYntl.RmiCe�MWmMrudionappire�iwuenwmqiromthasa
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WOPKEN'S COYPFNSATIOH DKLIN�TON: I Mreby elfum urder psiWly W parjury one d Ns Idbwiip Estleralione:
� I heve aM vril mein�en a cenMicma d oonseni io eetlimuro br v.oMere' canpaneetion, m praiCeE lor Ey Seaion �]00 d IM LeEor
COEe. la �M ps�lmmence d Us rork la whirJi Nu permtl u 6eueE.
❑ � new ene wio meim.:� v,on�.� oomo�o� imure�ce.., �.a���ed M s.am 3�0o d m. �.mr coe.. �« mo ro�rormeMe a m.
work i« xhid� ihu prtnn ie mueG. My wviwe' campemelion'vuuronc� urt'w eM pd'ry mimber vs:
� c�.,:
�' Pdiry NumEr:
� -n;,..n;o,��.e�orw�o,�d.�.erwo�rqro�o�en�wedam.�.R�oola�.l
I ceMYy Nel in ihs p«IameMa d �M wark la xfiFJi thle pmne h muM, I 4WI m� ampby ury paeon in eny menner eo u lo
� becoma euEjw �o iM waM1wre' m�aneeiion brn W Cefdmm. uM q�na rtW E I Wuk becaiw rbjad io tM r.akers'
compenxiim prwuions M Sedion �1W d iM lebor Coda. I ehell lathvmh mmpy wiN Nws D���.
Dele: ApplicaM:
WeminO� Fellun ro ucun wo�ker�'rompwvetlon rov�rep� Is unNwNl, intl �NII �WJ�et en �mploysr fo erlMnl peneltl�� enC
c/vll flnw'q ro m� h,ndrM fhouaW Od4n (11Pq000A b��n b fM evt o/ romoxwWM1 demep�� u provWM br In
SwHon 9RI6 a/ M� L�Gor Code, InMup mtl ertomql Iws.
CONSiqUCTON IENUINO AOENC�: I Mnby elf�m uMs penelry d perjury ihm iMm u e connrvqion bMiiq epenry fm tM
perloemerce d iM xak lor v.f�id� thv O�i b ewod (Smion �. CM. CI.
LENDEF'S NAME:
LENDEN'S ADONESS:
1 ce�ity ihet 1 heva neE Nb apqiWion ud state Ihm Na ebwe vJamelion c cane.l eprae to arnpy wilh M my end oouMy adinenma
end eime kxa relelvp ta buildvq mintruclion ud MreEy e�nhorae iepeaenie�ivea d Ihe dry to emw upon tha ebova-memonad pmperly
�«"'P°°�""°°'°` EARL WHITED
Dme. ���_
(5151<B.WPI Nmne-BuiW'vp 8 Sefey: oreaMFle: Cenery-/�vP��: Rnk-Revenue: Goldenio6-qnyeyam
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: H 072684 PLAN CHECK NO: 02135-95 L
'CONSTRUCTZON TYPE: V-N PERMIT TYPE: STR
IJOB DESCRIPTION : CONST. 54'X 6' HIGH BLOCK WALL
PERM NO: B 072684
GOVT: N SUPP: N
PURPOSE: CON
SQ FT: SS
CLAIM VALUE: 1,500.00 CALC-VALUE: 1,160.00 GROUP OCC: R-3 /M-1
COMMENTS: CONST. 6' HIGH BLOCK WALL ON 3257 MICHIGAN SIDE ONLY
it****�e**�eit*�it�et�t�r�r*�itrit�r��**�rit�r**�it�****�r******�*ft�x�x��r�r�r�e*�****it��*�ritie*it�ritititieat�r
Z O N I N G R E Q U I R E M E N 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 IN
PARKING REQ: PROV: PARCEL: 13907406 ZNE: R1 REF NO:
PLANNING NOTES> CONSTRUCT 58' LONG, MAX. 6' HIGH BLOCK WALL ALONG SIDE P/L.
>
if iF 1F 1f iE 1E 1E i! 1k 1E iE iE if iE 1F 1E ik f!'k iE 1E k iE 1k iE 1E 1E iE iF 1E iF 1F 14 i(� ik ik'lF 1k iE iF 1F if iElk ik ik if 3F k �E iE iE iE iE 1E iE �f iE iF if iE If IE iE �f 1F If iE IE 1E ik 1E 1E if' �f �IE �f 1f 1E
D E V E L O P M E N T S E A V /I�C E S R E Q U I R E M E N�-T•
ZONING APPROVED BY (..-L DATE: /
BUILDING APPROVED HY : �ifa-C DATE: 7
APPLICATION ISSUED BY: � DATE:
iFKiFitiElf�if�iEitikitikikififiliEkiEikitiE3fiF'if7FiFTf7F'iFiF�F3F�"{F'�"if"{F"iF7F SF�iFTFifif7FiFiF'iF7FiFiFTF��kifiliEffiEiEiEibiE ifK
LEGALIZATION:N F E E S U M M A R Y STRUCTURA SEGMENT:Y
HLDG PMT PLUMHZNG ELECTRIC MECAANIC FIRE SMIP/RES' GRADING
PERMIT 29.00 .50
SMIP/NON-RES
PLAN 18.85
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE 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
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
29.00 .SO 18.85
iFifilifltlEikltiEifiEkkkllilillEiEkiEiEiliFilikiEkkkikiFillfkikfFi61F%iE�fiFffikillEifiEiFitki61kiF1EikitrlEkiEklEiFkikiEiEkiEitiPikififiFiEkif
I N D I V I D U A L F E E B R E A K D O W N
TYPE {JTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 58 RES-CONCRETE BLOCK WALL / FT. 20.00 1,160.00
END OF FEES
)1 �02°3497-OOlE;4°9 T�]�' 4E.35
DA�E: �6105195 TT11E: 13:38
� CQNSTRUCTION AND PLANNING POOL 8 .
°APPROVA�S Permit,i-`_- __ Date Inspector APPROVALS Permit# Date Inspector
1. Temporery Electrical Service or Poie ; 52. Pool & Equipment Location '
2. Soil Pipe•Undrgrnd. . 53. Steel Reinforcement
^ 3._Etectrical Conduit Utility�Undrgrnd. � 54. Forms ''
., h:, �'4 �:E�ectrical Conduii-Undrgmd. 55. Electrical Bonding �
��
•.S::Steel Reinforcement 56. Rough Plumbing & Pressure Test - '
: '.-'r' �
_� 6:rE,lectrical UFEFi Grnd. 57. APPF6VAL TO COVEfl�GUNVTE i
[�%//�� �
;�.ffaotings ���!�"" 58. Electrical ConduiFUndrgrnd. .
�=' $. Poundation 59. Gas Pipe, O Undrgrnd., Test
-'6. Water Pipe-Undrgrnd. � 60. Backwash Lines,P-Trap, O Undrgrnd.
10. Structural Floor System � 61. APPROVAL TO DECK
11 'Property Sewer Line & House Connection %62. Backwash & Recepror�Pinal
12.._Sewer Cap 63. Heater & Vent•Pinal
�
13. Roof Drains ! 64. Plumbing System - Final
�'14. Rough Plumbing '� 0 65. Electrical�Final ,
.
=15, flough Electricat�Conduit "; 66. Solar SYstem-Flnai •
�;16. Rough Electric Wiring 67. Fencing & Access Approval .
17. Rough Wiring Sign 66. APPftOVEO FOR PLASTERING �
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEfv1S FINAL
19. Rough Heating &_Air Conditioning _ .� c ,,,w ..: r. F,J,RE�I�EPT...REQUI�iEMEJVT .
" r
(^ ' ' � � = �: \'] r ..; C x r - �1 r i K
20.CRou�h FactoSy Fi�Gpiace -- ,-,r � y CM �� APR�OVACS�� " Petmit #�� -
21!Dutts,inStrSctuik� '� " �'- * �-� ;�w "? 70�`UndergHund F`.�ydro �.
22.-0uct's, �l¢ntiiating: � � `�; i� �_`x � 71. Produc[ Piping CJ_Gas L70i1
23. �6av-F'ipe-Rough & Fesi � "r t`":.- "' - '� ^� � 7Q, Underground Flush � `^
24�Roof Fr`aming ' � ' . .�� � ,�.�,: c "' � _•
7.3. Undergind.Stora:g�Tank OGas ❑Dil
25. Roof Sheathing r�� 4 � w' .. 7 74. Overhead Hydro_ '
r • �n
26.�T�8arCeilin (StrLcturall &�Monocoatt�' ; - '� � �"'� -� "'-' -�
9 � _ ,. �, r-. 7•5,-Dry-Chemical_,-= ,,-
wy .., ... ... - r-� �, ..,. . i _ .. .
27.-prame and F.lashing u �. c >� 'r � 76. Dry Sta�dpip�+�tt .
'' 28. Lael�ing.& Siding`'�'- " .; :i' ,.:��'. � = ' ' "; j7�. FIXEO-SYSTE�N,Y�FINAL_ '•
29. Insulation ��. .. ' .. .. . t 7$. PIRE PREV. FI(9Al '" T .
C
` 30. Drywal�,Nailing ��� �, � .� ' c �� ' ;'HEALTH DEPT. REQUIREMENT
�- 37. Plaster Bcown Coat� _ ' [^n' � ' + �- 79. FINAL:INSPECTsION � � �
32: Electric51 Power Me�te�,Final' �,� �� � , r�� •` 84. FOOD CERTIFICATE.�SSUEO -
33� Final Electri� . �z. ,,: . � Nates: ��
s1c- Gro-
34 � Fin'al Heatin§ & Ajr�Condition��g= '��, � ,� 1 r N � '� =� �'�
t H• '
`� 35.�Fin�'dl'Gas Pipe-Test; �.�" .: x r-: , i � 4 - � ;.;,i,, � ' ' . -
�
36. Hood or_CanoPY . ^ _ � � T` '". • _ �= J=' 'r
�.,. f `. ' ;,� ,r Y;
'�� 37.�.Fina[FactoryPireplace-- � ..z �� �� r .�
' 38.�Pinat'Plbmbin9 � � � - •. . �� = ;7 �` - �
� �... ' l T f�` F� 1•
f
39.�PJat€r Servfce;Finai: � ��r„ ',. x , ) ` • G •_, �
! 40. Gas Service-Finai5 � z� +tr• ; :.� G= x
- t
.� � 41.�Solar pomesuo-F�nal =- ,,:^ ' * - , ,�`" ,r . .
42. Backflow Preventer+ � f+ -+�C ■ - . * r • •�
r • �-+ ,� -� �n -
�
43. Backflow Irrigati't�;. �"' �; r. ,, cru- � u �.
,7 � �1 .4 ^ � ' " _., � • a. n: P, : n - - .-i
h44. �andscape irrigatioh System- _ "
� . � � �, r � + �-r o• ,. r� U:
�45.:Sound Qttemiation( -�. . '` -' rJ -' �' `� ' � �
� � �-� � �r c . � .
�. � . .
�46. �Mandicap�Regulations .� -'o' " * R Tn,� - � -' ,
47. FIN�1L STRUCTURE & BUILDING ""-' � _ ;
�,; 6� / � - �_
48.�INAL PLANNWG rt "" +"= I . y. � �i � � `'
d
49.CEleetiic Felease to Edison ' �� �� � ;' " �
, � .� �
• 50.;6as;fielease to Southern Califomia Gas Co - ' < i- �, � n + '
+ �- -
51. CERTIFICATE OP OCCUPANCY � � � - �.� � '-
Np Date
, � ���� �a����
� ���.��� �
� CITY OF COSTA MESA �
� P:A��IN4� CEPT. 1:
RIBJ£CT TO BLDCi. DEPT. �
1' ��DATE_�?��yJ 1�
ar. __ ..,.�
ouxTa a �o
a
��I ��0 � rnccX- �j�
,�'o t� L wa �I �
Permit # G � r
THIS NUnnBER MUS? ACCOMPAN ���•�— �p �}Gi I I
ALL INSNE�TION REQUESTS �X •
:5 g' -I-��
DIVISION OF BLTILDING SAFETY
CITY OF COSTA MESA
APPROVED �
�/1�-�- 6 � s>>
� �
rnis set oi olans an0 sD����twr�s MUST be kepl on Ws Iob ai �e!
an0 i� t5 unia�nw w niann a�r �
permission trom Ihe Division at
The stamping ol this plan antl
or to be an apOroval ot lhe vii
The e Gs� z'+� Dermit s ali ex i��
the uilCNg or xork is not �omn e
(d) iUun t 80 days ot issi e.
11[!ID[MCL
3��
N
I
_ M �`c�u ��t�/. �-F
ig and Safery, C�1y ot Co
caqons SHALL NOT Oe l
ot any provisions uf anY
AmOation ard b
and maintained
11[610[MC[
3�53
r.3
i��'"�-�`�
Cement Coping Ootional �
Channel Block With 1�3l8�
Horizo�tal Top oi all
Fences
For Fences 5' or Less
Vert. Bars 3/8"¢ at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"t� at 32" O.C.
fill Cells Solid With Grout
Where Steel Occurs
Reinforcing St6e� Shall
Conform to SeC�A-15-39
A.S.T.M.
AllSteelto be Lapped
24" or to Code
NATURALGRADE
TWO 3f8"Q BARS �
CONTINUOUSTOP
& 80TTOM
HOR7iSTEEI MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION. �
TYPICAL 6�� CONCRETE BLOCK FENCE
ING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR; pne Part Plastic Cement, and
Three Parts Sand
GROUT: One Port Cement Thr¢e ana
One Half Parts S�and
COPING: One Port Cement, Three
ParfS Sand
CONCRETE: Well Mixed C2-I/2:3-I/2
Mar. of 7-I/2 Gol;ens ot
• Waler Per Satk of Cement
GROUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE S7EEL
OCCURS.
CELLS AND AREASOF HORIZON7AL REIN�
FORCEMENT SHALL eE CLEAR, CLEAN �
FREE OF ALl MOF7AR OE9RIS, ETC.
DEa7H GF E4RTHTCOTH
i/? THE HEIGTH OF FENCE
�IOW BOTTOM OF POGTMG
WIDTH i4" . . 14�� . . . 12��. .
THICKNESS . . 10�� . . 10�� 8'�
DEPTH OF EARTHTOOTH . 24" 20" .. , 16". ..
SPACING OF EARTHT00T 12' 14� ..... 16�. .
City of Costa Mesa, Caiifornia
Building Department
!�Q -'1S6D Nov. B2
SCALE: I/2��= I'
4
(714) 754•5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.Bl11LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 3257 MICHIGANAV
Suite:
Vicinity: RESIDENCE & ATTACHED GARAGE
Parcel Number: 13907406
Applicant CRANK, JIM
Atldress' 126 COMMERCIAL WY
COSTA MESA,CA
Owner: WHITED, EARL J TR
Address 3257 MICHIGAN AVE
Zoning:
Phone: (949)548-5569
Zip: 92627
Phone:
COSTA MESA. CA Zip: 92626
Contractor. CRANK BROTHERS ROOFING CO
Address: 726 COMMERCIAL WY
Phone: (949)548-5569
COSTA MESA , CA
Zip: 92627 License: 408677
Arch :
Address:
Eng:
Adtlress:
ISSUED BY:
Status: ISSUED
Applied: 04116/2007
Issued: 04/76/2001
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF: T/O, REPAIR SHTG AS NEEDED, 2 LAYERS 15# FELT, APPLY 30-YEAR COMP SHINGLES.
2800 SQ FT
Plan Check: 50.00
Permit: $125.25
SMIP Res: 50.53
SMIP Com: �0.00
Other: $0.00
inspection: $0.00
Total: $125.78
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Reouired: 0
FEE SUMMARY
PLANNING 8 ZONING
Lek 0- 0
Lek 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0. 0
$5,333.00
$5,333.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
� INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
� required Inapectlona and Iinal epproval must be obtained. FaiWre to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
>ms-ae la-vo1
WORKERS' COMPENSAnON DEG�NAnON:
I heraby eHirtn unaer ponalry ol perj�ry ono oi tho following tlaGere�ions:
❑ I heve end wlll melntein e ceNficete ol wnsent to self-Insure lor workers' campensatlon, as providetl lor by sectlon 3700 of tha Labor Code, br lhe peAormenco ol ihe
?,��work for whiCh thl9 pormit i91s5uetl.
1u� I have arW wlll maintein workerb' compensetlon Insurance, as repuired by sectlon 3700 of the Labor Code, for the pertormance of t�o work lor which lhis permlt Is issuetl.
�My workers' compensatlon Insurance carrier end policy number ere:
Carrier.
(This section need nof 6e
hundred dollers
Policy Num6er:
❑ I cenity t at In tha edormanc9 0l the work t�a�hlU Wis�rtnit Is IssueQ I shall noi emplq any person In eny menner so es to become sublect ta the workers'
compan 'on lew of Celifomle, antl a eFSlhet If I r become suD�ect to the workers' compansatlon proNsions ol SecUon 3700 ot Ihe Labor Cotlg I shell forthwith
comply with h se rovi5ions. �' /� _ Q /�
Applicant SIBnaNre: Date: �— L !
WARNINO: F E CURE WORKEAS' CLNAFENSATIIXJ COVERAGE IS UNLAWFUL AND SWU.L SUBIECT AN EMPLOVER TO CM�AINAL PENALTIES AND CML FlNES UP TOONE HUNDRED
DOLLARE 00,000�, IN A�DIT�ON TO T11E WST OF COMPENSATION, DMNGES AS PROVIDED FOR IN SECTION 3i080F iHE IABOR CODE, INfERE$T, AND ATTORNEI^S FEES.
LICENSED CON ORS DECL�1A710N:
I �ere�y aNirm Ihe em li nsad un0er provislo
torce and ettect. Lic. a
Conlreciofs Signat .
with Section 7000) ot Division 3 of the Buslneu and Prolessions Code, anA my license Is in full
Class p �,� �___ .
Date: /i7 �
CONST9{lST10ALENDING AGENCY:
❑ 1 hereCy aNirm ihat ihere Is a c�structlon Ien0ing egenty for the peAortnance ot t�e work for which this permit is iuuetl. (Sec. 3097, Civil Cotle).
Lenders Name: — _.. Lenders Addreu:
Signatura:
OWNER•BUILOER OECLARA710NS:
Date:
I hereby eHirtn that untler penelry ot per�ury thet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the lollowing reasOn (Sec. 7031.5, Business end Pratesslons
Cotle: Any ciry or counry which requires e pormit lo conswct, elter, improve, demolish, or repair any sirucwre, prior to its Issuenco, also requires the epplicent for such permit
to flle e signed sletement thet he or ahe is Ilcensetl pureuent to Ihe proWsions oi ihe Contrectars Llcense Law (C�epter 9(commencing wlih SeUlon 7000j ot DlNslon 3 0l Ne
Business enA Prolessions Cotle) or thet he or sho Is e:empt therelrom end tha Easis for the elleged ezemptlon. Any videtion o1 Sectlon 7031.5 by eny eppllcant tor e permit
subjecLs the epplicant to e civil panelry ol not more then five hundretl dollars ($500).):
❑ I, as owner ot Ihe proparry, ar my employees with wages es their sole compensatlon, WILL DO THE WORK, antl the swcture Is not Imentle0 or oReretl lor sele (Sec.
7044, Business end Professions Cotle: The Contracbrs License Law does not apply to an owner of property who builds or Improves theraon, end who does such work
himself or hersell or through hi5 or har own employees, provided Ihet such improvements are not In[entletl or oRered lor sele. It, �owever, the building or improvement Is
soltl wit�in ona year of completion, the owner�6uilder will �ave ihe burden ol proving ihat he or she did not build or improve for purpose of selaJ.
❑ I, es owner ol the properry, am E%CLUSIVEIV CONTRACTING WITM LICENSED CONTRACTORS to construci the prolect (Sec. 7046, Business antl Professions
Code: The contrectore License Lew tloes not epply to en awner ot property who builds or improves thereon, and wha wntracts �or suc� pmjoct with e contractor(s)
license pursuant to ihe CanlreC�a�s License Laws.).
❑ I em exomp� under sec. Business entl Prolessions Cotle for this reason:
SignaWro: Dato:
Owner ID veritled by drlvers Iicense. ❑ Yas ❑ No Driver's License No.
Verifitetion 01 Ownership by (rype ot documani, i.e. - property te�c Giil or tleed):
Expires:
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certlty thet no e:cavetion fHa (5) or more feet in Aept� into which a person is required to descend, will ba made in connection with work euthorized Oy ihis
permit, entl thet no DuIlCing stNnure, scatlolding, lalsev.ork, or demolition or tlismantling thereol, will be more �han thirty-six (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tltle B, Cellfomia Atlministretive Cotle).
❑ As owner��ullder, I wlll not em0�%' enyone to tlo work whlch wauld require e Oermlt from Ihe DiWsion oi Intlustriel Sefety, es noted ebove, unloss such person �as e
permit to do suU work Irom t�0 divislon.
Signature: Date:
Divislon ol Industrial Safery Permit NNmber:
CERi1FlGA7E OF COMPLIANCE AND AIITHORWTON OF EMRY: I cenity under penalry of perjury that I have read thls epplication and state t�at Ne Information given is
conea. I a9ree to compy with ell sta�e laws end city ortlinances relatlng to building construdion, and euthoriza representatNes of the Ciry of Costa Mesa to enter upon the
ebovadgscdbed properry tor inspection purpase;. I egree not to oaupy or allow occupancy of eny builtling authorized by ihis pertnit umil tinal inspection.
K.a-�.
CObE �. INSPECTONTYPE
1616 Fixed System Final Fire Prevemion
1266 Pool Spa Final
200 Finel Ra-Ro01
201 FIna181ock/Retaining Well
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demolition
�7.11 CIIIII.14
� �
/ l / Date `
l�f '�Q
Date
SOUE� INSPECTIONTYVE
206 Final Mechanical
208 Final Plumbing
210 Flnal Electrical
272 Finel Fire Preventlon
220 Finel Planning Approval
222 FInelSi�e
250 Final BuildinyOccupancy
QLg I[�ELS
OWNER y7�i�;
JOB ADDRESS '
GENERAL CONT
AP "+ 39-074�
I� CT�ONS
SOIL
-� GPS
�S WnTER
� ROUGN PLUMBING
PROP. SWR. LINE
SPRINKLING SYST
MISCELL�N�OUS
� ROUGN nE4TiNG �
EARL J.
UR CONOITIONING
OR POLE
POWEF rl
ROUGH w�RING
iRENCHES FORMS STEEL P
FLDOF SYSTEM
BONO BEeM ❑ STEEL AEINPORCE
SHEPTMING
F0.RME dN0 FLASMING
LdTMING � IN n OUi n
PL�STER. BAOWN CO�T
Si •UR�L, FIN�I
H! .G. VENT., NEFR10. ANO �.C., F
PLIIMBING. FIN4L �NO WS TEST n
pvenue
TR
DATE
��id:l
SUBCONTRACTOR
NG PERMIT N0.
'-� ,,���: ; ;
� t4�27 2/23/79
s
7.50 TL
COSTA ME5A BUILDING-SAFETY DEPARTMENT . ��4+Wr/ �'/2.7/ /7 7.50CAT0
P.O.BOX1200 COSTAMESA,CAIIFORNIA92626 ���k0'�% Op00447555 -IA �
APPLICATl01�'pR±STRUCTURAL PERMIT
For Applicant to EiII in Completely — Use Ink Only
R V �AT�gECELL( qqTE ISSUED
BUILDING �d �/
ADDRESS �{ /
OWNER
A.P. NO. � V��-��p PERMIT NO.
MA�� BUILDING �S� r�„A'
ADDRESS ADORESS �//
TEL. TRACT 2 LOT BLOCK
CITY NO.
CAN5TRVCTION W /aD A R P
LENOER
BPANCH �
OWNER �
ADDFESS ��/ �//..��./ ��� VALUE � ►
ARCHITEC7 TEL. S W(J' S
OR ENGINEER
FIRE
ADORESS ZONE TVPE GROUP
APPROVED
CONTRACTOq BY DATE
AODRESS [ � �
TE �ONE NO.OF q USE OF NEW �
CITV NO.s �I P�� �/ BUI�DING
STATE CITY �'ARDSAPPqOVED VAqDSAPPROVED
LIC. NO. ,2 I D LIC. NO. MA BUI D G ACCESSOPV BUIIDING
S12E NO.OF BIOGS. ET)
OF LOT NOW ON LOT F FT
USE OF �
EXISTING BLDG. 5 FT. FT
Separate permits are required for �. si T.
electric, plumbing and heating work.
REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED OISTANCE BET. BET. M IN &
MAIN BLOGS. ACCFSS, BLDGS.
� VAR.� DATE ^
C.U.P.# qPPqOVED
��i
; ,�Ro��� —a2 - � �
I horeby acknowletlpe that I hava reatl Mis apPlicallon antl stete �^
n
that the a6ova Information is correct antl aB�ee to comply wim
m
all laws re8ulatln8 building construecion, antl I sha�l not employ
i
eny person in vi0�etlon of Ma workmen's compensetion laws oi m
the Stata ot Celifornie.
I hereby cartify t�at I am properly Iicensad as a contrector untler SQ. FT. N
the State oi Cellfornia Business and Profeulons Cotle, Division 3, THE AMOUNT SHOWN UNDEfl VALUATION IS FOR m
Chepier 9, antl tMet such lieanses ere in tull torce antl effect, or I THE PURPOSE OF ESTABLISHING A PERM�T FEE ONLV:
em exempt irom the pravislons of the Scete of Cellfornia Busln¢ss y
VALUATION PERMIT FEE E N
nnd Protessians Cotlo, Dlvlsion 3, Chepier 9. ,e . A m
Sipnatura ot n / `���((( %� � P�AN CMECK E �� o
Petmlttee �//i'��� ��rM� S/� %�U TAX S LL
� � U
AuthorizadABa^y 6 TOTALPAID E
Lor�1� TR 372
: ���_��
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 GOBTA MEBA. CALIPORNIA
For Applicanf fo Fill In Comple+ely
TYPE OR,PRINT
BUILDING �� � Q/��
ADDRES6 3257-��+� ^VENUE
COSTA MESA. CALIFORNIA
65xtoo
�
NO. OP
LINB FftOM �
ip BiPeeT �� REAR YAR[
6� p�
RD LEFT RIGHT /
DESCRIPTION OF WORK
p NO. OF /
� �5U55F ROOMS �
WALL IROOF ROCK
$TUCCO rnvwwin�n
.Z BUILDING
ADORE55
FIRE
ZONE
� APPROVED
BY
ZONE
R-
L80AL
DEBCRIPT101.
� _ ___
FEE RECEIVED
�� �'fFR 24"`i1
FIfdANCE DEPT.
CITY OF COSTA ME$A
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
n¢ceirr No. Bconu K9C7
BY � DAiB RECENED .I DATE
COSTA MESA. CALIFORNIA
ZONING
rvo. on I uee oF xew
PLANB /� BUILDINO���
�YARDS EVE9
APPROVEO ALLC
ZO � (�MQR LINH BTJ �/1
Y //
ATTACHED GARAGE �
PLAN No. 3-B
1 H¢PEDY ACKNOWLEDGE TMAT I HAVE RlAD TXIB APPLIGTION THE AMOUNT BXOWN UNOBR VALUATION 19 POR TH8
�ND BTATE THAT THC ABOVH �8 CORRECT AND AOR88 TO COM- pUIiPOBE OF, 88TABLI8HIN6 F PEIiMIT FEE ONLY.
.PLY WITH ALL CITY OfiDINANC89 ANO HTATe 8 Ii80UlATNO
BUItnINn coNBrnUrnoN VALUATION pERMIi FEE $ J Y�
SIGNATURE OF ' ��� -
�I PERMI'RE /j� /Q
$ / V/� � �/ PLAN CHECK $ ( O �
�F
O
n
I� AUTNORIZED AGENT