HomeMy WebLinkAbout2053 FLAMINGO DR - Building Permits(714) 754-5273 • Fax (714) 754-4656 • www.cl.costa-mesa.19MLDING PERMIT
Job Address: 2053 FLAMINGODR
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
77 FAIR DRIVE, COSTA MESA, CA 92626
Parcel Number: 13954306 Zoning: R1 R1
Applicant: SIGGINS, RICHARD ISSUED BY:
Address: 1239 ALMOND
Phone: 704-402-4673
ORANGE, CA Zip: 92868
Owner: CONNOLLY, DAVID T
Address 2053 FLAMINGO OR
Phone:
COSTA MESA, CA Zip: 92626
Contractor:
Address:
Phone:
Zip: License:
Arch : Eng:
Address: Address:
Status:
ISSUED
Applied:
12/31/2003
Issued:
12/31/2003
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF, INSTALL SHEATHING AND COVER WITH EAGLE LITE TILE, ICBO 4660. REPAIRIREPLACE FACSIA AS NEEDED.
Plan Check:
$0.00
Permit:
$209.25
SMIP Res:
$1.15
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $210.40
SETBACKS
MAIN STRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existing: 0
NOTES:
FEE SUMMARY
PLANNING & ZONING
Rear 0-0 Left 0-0
Rear 0-0 Left 0-0
Required: 0 Proposed: 0
Calc Valuation: $11,500.00
Claim Valuation: $11,500.00
Right 0-0
Right 0 -0 -
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. 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 180 days.
INSPECTIONS: in order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and afi
required inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aae46 (6=)
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following deciara8ons:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is Issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this pemdt Is Lswed.
My workers' compensation Insurance carder and polity number are:
Carder: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars ($100,1 or less.) A
❑ 1 certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OOVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (SI 00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full
force and effect. Lic. M Class e
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a coaslruction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) 01 Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).):
❑ I, as owner of the property, or my employees with wag" as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Ptolesslons
Code: The contractors License Law does not appty to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, Ls. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, California Administrative Code).
❑ As owner-builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and cemy, a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reponed year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
.or 200 cubic feet of compressed gas at standard temperature and pressure).
............... ...... .......__._............................._._—..-_.._-_.....__..._............. _......................... _...... _................................................ _.... __._.__......... _................_.._.__.�
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ o
(Section 25533 of the California Health and Safety Code, With some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely handout; materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feat of
compressed gas at standard temperature and pressure).
................._...,............................... __.............................. ........ _._................................ __....................... __........................ _......................................................................................... _..... _._...... __.......... _..... __...... _""'-
3 Does or will the a plicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ o
(Section 25534 of the California Health and Salary Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
........._..._._..................._......._.—_..._........._...._._..__.__.-._.__.._........._._..........__....._.........._...._...................._._................................. ..._..._.... ..........
4 If
an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No
5 Does or will the applicant or present or future building Occupant a require for the work which is the subject of ? a p Yes
oggermii for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency! � Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
................._........... ........... _...................... _____...__.........................__.................................___....................................................................._...__._...___...
6 Will any pan of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑ Yes ❑ No
(11 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
....................__._............__.....................__—_.__..__....................... _....................................... ................................ _...................................
_._._._.—__�—
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
........................................................................... ____._... ... _......................_....................... _.... ........................... _................................................................... ............................................................................ _................. __.................... _.__
6 (If' yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by thispermit until final inspection.
SatI ry�,Of Leel Owner(s)
Antl/O nzed Applicant
CODE, INSPECTION TYPE gag, INTITAL5 CODEr INSPECTION TYPE PAR INTmlL9
1616 Flxod System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 206 Final Plumbing
200 Final Re-RoofH-BK 210 Final Electrical
201 Final BIOcWRetaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
DECLARATION OF AUTHORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
Bldg. Permit # 9cr3 XZn
This Permit #
Street Address: -?�o gz r knkn V^ -Q 6 ��" "'�- AP Number:
1. I (we), CA, W N Lo Vl Vt C, � 1 V declare that I am the Owner of Title of the above
referenced real property, and that I (we) hereby authorize:
\ 1VNQ4A S 1 \VLS '1 1 t-1— S;7 Lt O JC -
Name:
Name: n 1 Telephone Number: I �— �Z'�( "� 1014
Street Address:
City: State:
to obtain permits in my behalf, as owner/builder, for N k u v-
at
at the above referenced property.
Zip: --
2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa, as required by State of California laws.
3. As owner/builder in fact, 1 understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. 1 agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. 1 declare under the penalty of perjury that the foregoin1g_ is true and correct. /' j 1� ,,
Executed this day of Q..G e Wl YJW 20 O 3, at ( _—L- �T4 V V 1.L5 ct , California.
0]]946 (rev. 11/00)
Print Name
Signature:
Date: 1 r-'1 ' t l u
Note: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attorney to secure this permit in any behalf.
{ k 1
t
f
OWNER -BUILDER
VERIFICATIO
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner -builder verification.
Attention Property Owner:
An 'owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
I. 1 personally plan to provide the major labor and materials for construction of the proposed
property improvement. ❑ Yes ❑ No
\ . 1 (have/have not) Ark t,9. signed an application for a building permit for
he proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name 'T N'T & 5 �D` u- C. S I
Address V1S Mt�`tI,� ST �i c City AV%QNEiVn (.
Phone niq) X02' 4613 Contractor's Lic. No. q 1 k 4"1 Cl
4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address u " Phone Type of Work
:MT 02 Keo I-N�)MJLe4 ��7 7t4 -4o2 x/673 R
1U2 -a6 (REV. 9MB)
]�y0. C �l
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 2053 `Ia A.114 �.NLaO DR
ADDRESS: ME-S'iYANEr� JOSEPH E JR TR
2053 FLAM,_tiG0 DR
�C
COS -,'A MESA,CA 92626
ARCHIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: ACTJOL r!RS': ROOF CARP_ (714)841-7663
ADDRESS:
18352 GO'ifiARD ST
FICRLICENSED CONTRALTORATTTI hOVy VI H censed undeCpo9mfUuDPe
t 9 (commencing with Section
70001 0l DmSlon 3 0l the Business and Prot Code, and my home o in fol lane and effect.
CITY LIC.: STATE LLL.: CLASS:
��45135 5029 C-39
Date: -2_j �%� Signature:_'Ge3"7'� �.� .
WORKERS' COMPENSATION OECLARATIO : I hereby affirm that I have a cenilKate a(wnsent toself-insure or a certificate of Workers'
Compensation Insuranceor a certified copy thereol (Section 3800. Lab. C).
POLICY NO.' 1042000-90 EXP. DATE: 09/01/91
COMPANY: STAT E FUNI!
❑ Caroledcopyris �nereoy furnished. 4( Ce ed copy is filed with the city Building Division.
.ate. rO • L a • 9 Applicant: �i-� F'} �Y _..N7� V/• �.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be com0letetl if the iii a for one hundred ($190) or less).
I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: II, after making this declaration, you should become subject to the Workers' Cumpeosation provisions of the Labor
Code. you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the Performance of the work for
which this permit is issued (Section 3097. Cry. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7931.5 Business and Professional Code: Any oily of county wWon requires a permit to construct, alter, improve. demolish, or
repair any structure, prior to Its issuance, also requires the applicant for such permil to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7090) of Division 3 of the Business
and Professions Code) or that Ire/she is exempt therefrom and the basis lot the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($599).
h as owner of the property or my emplyees owith wages as their sole compensation, will do the work, and the
El structure is not intended or ollered for sale (Section 7044. Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves (hereon• and no does such work himsell/netsell or through
his or her pain employees. provided that such improvements are not intended or offered for Sale. 11, however the building or
improvement is sold within One year at completion. the puppet wild have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the pmperly, am exclusive contracting with lamed contractors to construct the project (Section 7044. Business
C1 and Professions Code: The Contractors' Slate License Law Opens riot apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s) license pursuant to the Contractors' Slate License Law). I am aware
that proof of their Worker's Compensation insurance should be prodded to me.
❑ I am exempt under Section: B. d P. C.
for this reason: _
Date: Owner
I do hereby certify that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply win said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from
these provismns.
Date. Ap licant:
I hereby certify that I have read this applicatio no state that the above information is correct. Iagree to comply with all city and co411y ordinances antl state laws relating to building a slruCtion and hereby authorize remesentativesof this city to enter upon the above -menti
properly for inspection purposes.
Dale: �' ZI'9 I Signature: "•a��'�'
Driver's License or Social Security e:
1641.46 White—Building: Green—Cade Enforcement: Canary—Applicano Pink—Revenue: Goldenrod—Assessor
CITY Of' COSTA MESA - BUILDING PERM . -T PERM. NO: 3053598
PERMIT NO: B 053598 FLAN CHECK NO: N GOVT: N SUPP: u
CONSTRUCT -ON TYPE: V -N PERMIT :YPE: STR PURPOSE: Al."
JOB DESCR'PTLON REROOF 1300SF SOUTH SIDE OF RESOD W/SHAK SQ FT: 3,800
CLAIM VAL.JE: 3,800,00 CA:.C-VALUE: 3,800,00 GROUP OCC: R-3 /
COMMENTS: REROOF SOU -H SIDE OF RESID ONLYrrYY OR
-i:#NiE###Yc:E#%##########}#########'#::<###%##�####liii#};%##IFM K##1r####7r.R#IE YGY tO' E�f`lrf.•#%#Y
Z O N I N GS ERLEBQAUCIKRSE M E N T S S'poK�QV����
____.__ ____—____ ^ V
------------ MAIN BUILDING ---- ACCESSORY SUILIC-NG
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT YN
PARKING REO• PROV: PARCEL: 13945515 7.NE: REF NO:
iGILANNING N TES>
#
D E V .E L 0 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:
BUILDING APPROVED BY DATE.
T'
APPLICATION ISSUED BY: DATE: F ��
###-####%IE+A#if%####3f#iE##ir±F'irh�n'?F3f7r r3r irTr rciv7r#irTlTr iFir'#TF,rirFiriir,?-TriFx####3r#Ti### n. tx r:t#
#####{.ii*#####ef##########'1F####IE##ie###########if###If########%iE'f.-it##ii•#iE 3i#+F##!£#r######
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMEA1;Y
BLDG PICT PLUMBING ELECTR_TC MECHANX FIRE SMIP/RES GRAD NG
PERMIT 63.00 .50
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TO'- AL PA -D DUE
TOTALS ---- > 63.50 0.00 0,00 63,50 63,t)0 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHOR-; ,00
BLDG PMT
PLUMBING ELEC7RIC. MECHANIC FIRE SMIP./70T GRAD -NG PLAN-CH_
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
SFR 3800 REROOF BY VALUE RESIDENTIAL. NOZONE 1,00 3,800.00
END OF FEES
0? 00055::2 /-0^7953s":,
DATE: 03/27/91 i'il:: !^:'•
CONIATRU�rION AND PLANNING
APPKOVALS Permit # Date
Inspector
POOL A
APPROVALS 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. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, ❑ Undrgrnd., Test..
9. Water Pipe-Undrgrnd. „
-
60. Backwash Lines, P -Trap, ❑ Undrgrnd.
-
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line &,House-Tonnection
;,
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing 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
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas O Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24, Roof Framing
25. Roof Sheathing
C%(U��l
VV
�j�i'
73. Undergrnd. Storage Tank ❑ Gas ❑ Oil
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
I
I
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
33. Final Electric
34. Final Heating & Air Conditioning
80. FOOD CERTIFnICA�T/�/ SSUED
Notes:
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 Domestic -Final
42, Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation!,Xem
45. Sound Attenuation 1..
46. Handicap RegulatioQ�-. `4
47. FINAL STRUCTURta&4UILDING
48. FINAL PLANNINGI
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
B AC
NER
JOB
.LlNL;. vM 1 L
DING PERMIT N
T39-543-06 LOT 3q TRACT 5492 FIRE ZONE VALUE $3,000.00
INSPEC
TIONS Signature Date JIGROUP I TYPE V ZONE R-1
sr PERMITS ISS ED
SUBCONTRACTOR
Date NumberI Signature
WATER Plum bin
ROUGH PLUMBINGX-42
- 6
PROP. SWR. LINE HOUSE --C0.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING "
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING 1- Hea ino and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ O ,�� L
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME ANO FLASHING /
LATHING — IN OUT F I�1 �/-
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL `
t GING, FINAL AND GAS TEST
:TRIC, FINAL 7.
BUILDING, FINAL z -2G -la
SPECIAL REOUIREM EN TS
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
Ts=*5492 TYPE OR PRINT P1. 66—BR
BUILDINO
ADDRESS 20
COSTA MESA. CALIFORNIA
OWNER Mesa Verde Builders
Ao IL 2850 Mesa Verde Drive
USE OF
JJW'12°6 00 458* ***158.25
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO.
��� ��Q���R280CIy9�l�EgqEp6��..
YY /DATE —, R� — 17 0�1��T�'S"UNY®6�1�.T�1`SJYLD�NY®
APPROVED
R Kaltenbach NEL-5478046 BY
1823 E. 17th St. S.A. ZONING
ZONE NO. OR UBE
PLANS � BUII
OR Mesmzii
ers
6 SQ. FT. V
v, —/?/~
461111
28Drive
I HEREBY ACKNOWLEDGE THAT I
AND STATE T E ABOVE 18
PLY WITH A CITY DINANEES
BUILDING C NST U JON.
IGNTUR
PERMIT
LEGAL
DE6CRIFlIOCosfornia
OUNT 8H N UNDER VALUATION 18
E OF ABLISHING A PERMIT
FOR THE F
FEE ONLY. O
N
"'
NVV I"
A. P. NO.18126995
SOT TO SIIDE 6 REARE: NO EAVE RIEAVES
PLANCHECK $
AUTHORIZED AGENT
X 1()n
LL
�1 �`
BLDOS.
LOT
ALLOWED4
ypRDB APPROVED
MAIN BUILDING
., .,,.
SETBACK LINE FROM
CENTER OF STREET 48 I REAR YARD 28 '
SIDEYARDI LEFT 5' I RIGHT 6'
DESCRIPTION OF WORK
1751 sq'
6 STORIE
ANG Wood
PERFORMED
2 ' VAR.#
SHALL BE LESS THAN
(U. B. C. REQUIREMENT
YARDSAPPROVED
ACCESSORY BUILDING
DATE
•
6 SQ. FT. V
v, —/?/~
461111
O
I HEREBY ACKNOWLEDGE THAT I
AND STATE T E ABOVE 18
PLY WITH A CITY DINANEES
BUILDING C NST U JON.
IGNTUR
PERMIT
HAVE READ THIS APPLICATION
CORRECT AND AGREE TO COM.
e C:'iY'�Jn/T_A
AND STATE LAWS REGULATING17-
OUNT 8H N UNDER VALUATION 18
E OF ABLISHING A PERMIT
FOR THE F
FEE ONLY. O
N
"'
NVV I"
PERMIT FEE $
�(�' m
/o / 0
PLANCHECK $
AUTHORIZED AGENT
TOTAL FEE
LL
�1 �`
OWNER PEARCH, H C DATE 4-23-69
JOB ADDRESS 2051 Flaminao Drive BUILDING PERMIT NO. 30155
AN No. 139-543-06 LOT 34 TRACT 5492 FIRE ZONE VALUE $ 17 .00
"SP ECTI ON5
Signature Data
GROUP J TYPE
III ZONE H-1
L
SUBCONTRACTOR
PERMITS ISSUED
Date Number Signature
OAS
WATER
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING
Heating and Vent.
TRENCHES FORMS 0 STEEL REINF.FLOOR
SYSTEM
SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
Electric
4EATING, VENT., REFRIG. AND A.C., FINAL
'LUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
-I.
I
Z .
a U
ZZ
Z_ <
O M
am
J �
-:I LU
C3 J
J m
Q
ZW N
ZM
aw
w Z
JO
mZ
J 2
W w
Z_ H
WO
Ir
70
H
Z
a
U
r,
:XO 155
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APR 23-69PMSQ001270 d*****5.00
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RE/CyV/E��DY/BVD/ATE
_
REJCEIVED
Y—�J'�
DATE ISSUED
l�_a 3"�
ABUILDING
DDRESS
j�
OWNER /YJ r, C Pe ^ 4
/ PERMIT NO. �
A.P. NO.
MAIL
BUILDING
ADDRESS
ADDRESS
TEL.
./� �^
CITY GO NO.
/ o Y4 C_
TRACT
LOT BLOCK
CONSTRUCTION
I�LenC
W
ADD
LENDER
BRANCH
OWNER
ADDRESS
pp��ALUE Q1lI�
USE t%4/Wysv S
ARCHITECT TEL.
OR ENGINEER N .
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED
CONTRACTOR j CrePler
BY DATE
ADDRESS O Aj Qn '! �'
TEL.
Z0
NO. OF /
USE OF NEW
1�
CITY "/ a ///L' NO. S�O YS.3B
q_(
PLANS Y
BUILDING LPl
STATE CITY
YARDS APPROVED
VAROS APPROVED
LIC. NO. �l L -L� LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
S1ZE
NO. OF SLOGS.
(FROM CIL STREET)
OF LOT
NOW ON LOT
FRONT FT.
USE OF
EXISTING BLDG.
R. SIDE FT.
SIZE OF NO. OF
NEW BLDG. ROOMS STORIES
L. SIDE FT.
FT.
EXTERIOR WALL
ROOF
COVERING
COVERING
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
IN BLDGS.
ACCESS. BLOCS.
L^
VAR.+
DATE
a
C.U.P.*
APPROVED
APPROVED
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and tnat such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
and Professions Code, D 3, Chapter 9.
VALUATION
�-
'ion
PERMIT FEE S
Signature of
Permittee
S
PLAN CHECK S
Authorized Ag//_
TOTAL FEE $
1 29366
' COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA, CALIFORNIA
34 For Applicant to Fill In Completely
Tr 5492 TYPE OR PRINT, P1. 66-B
BUILDING O
ADDRESS —
COSTA MESA. CALIFORNIA
NOV 19-68PA1cRG.00 902* ****
18.OG
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. O.
is 2850 Mesa Verde Drive
ADDRESS
FIRE
I,
V
Costa Mesa
No1549-039
ZONE
TMP
ECT
(NEER Kaltenbach
No'547804
APPROVED
Br
ZONING
;S 1823 E. 17th
St. S.A.
ZON[tp
I NO
PLAO. NEP -'),I
USE
BUII
ADDRESS 2850 Mesa Verde Drive
CITY Costa Mesa
LIC..TNO. 6 0' 549-0395
SIZENO. OF
OF LOT SJV' I. 1 O ' NOW ON LOTS 1
USE OF
EXIST'NGBLDG. Single Fa.m'1 Res.
SETBACK LINE FROM
CENTER OF STREET 48 I REAR YARD 29
SIDEYARDI LEFT 5 I RIGHT 51
DESCRIPTION OF WORK
51Sq 1 ROOMS 6 STORIES 2
BU
Sinele Family Residence
Comoletion of Bonus Room
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANDSTATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM-
PLY WITHALL CITY ORDINANCES AND STFE LAWS -REGULATING
BUILDIN G CONSTRUCTION]. iJ / F
■ AUTHORIZED AGENT
'RIFT' ON)p. I ^ • s y/
•. NO. / 3 r - , OCD
'E: NO EAVE OVERHANG SHALL BE LESS THAN
TO SIDE a REAR P. L.
ES
.OWED (U. B. C. REQUIREMENT)
YA! APPROVED YARDSAPPROVED
MAIN BUILDING ACCESSORY BUILDING
DISTANCE BET. I BET. MAIN R
MAIN BLDGS. ACCESS. BLDGS.
VAR.# DATE
-6
N
SQ. Fr.
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. p
VALUATION
dd PERMIT FEE $CHECK S
t: v X
J [