HomeMy WebLinkAbout2035 FLAMINGO DR - Building Permits CITY OF COSTA MESA
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► • BUILDING DIVISION •
>N �) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t; Pit1 PERMIT
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_eF /1301-01439
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2035 FLAMINGO DR Status: ISSUED
Suite: Applied: 09/14/2001
Vicinity: RESIDENCE&ATTACHED GARAGE Issued: 09/14/2001
Parcel Number: 13954309 Zoning: R1 R1
Applicant: FUNKE, KENNETH ISSUED BY: .
Address: 18567 PLUMOSA ST.
Phone: (714)964-7171
FOUNTAIN VALLEY,CA Zip: 92708
Owner: JUENGEL, EUGENE THOMAS TR
Address 2035 FLAMINGO DR
Phone:
COSTA MESA,CA Zip: 92626
Contractor: K& R CONSTRUCTION
Address: 18567 PLUMOSA ST.
Phone: (714)964-7171
FOUNTAIN VALLEY, CA
Zip: 92708 License: 348877
Arch : Eng:
•
Address: Address: •
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF:T/O EXISTING SHAKE, 1/2"CDX PLYWOOD, 1 LAYER 30#FELT,APPLY 40-YEAR COMP SHINGLES.2400
SOFT
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $8,600.00
Permit: $167.25 Claim Valuation: $8,600.00
SMIP Res: $0.86
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $168.11
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 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 all
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)754-5626
2446-46(6/00)
DECLAA'ATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O I 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
Pwork for which this permit is issued.
I 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 permit is issued.
/ My workers'`compensation u�
Insnce carder and policy number are:
Carrier: 1, ft-) b Policy Number:
(This section need not be completed iY the permit is valued at one hundred dollars($100)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 workers'
compensation laws o alifomia,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 pr v stens. ',�p/� ,(— 7,
Applicant Signature: 1 `^"t� Date: �— "1--- 20�
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S 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 It
Contractor's Signature: 1:;)•"r(----- Date: C( — it-2-00
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.(Sec.3097,Civil Code).
Lenders 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)of 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 paint.
subjects the applicant to a civil penalty of not more than live hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages 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(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 contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I 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,Ttle 6,California Administrative Code).
O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person hes a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 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 reported 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? 0 Yes 0 No
(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 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).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety 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? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this implication a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (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 COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end 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 this permit until final inspection.
Si at Or ars) - !• I Date yap p
And/Or Authorized Ap liccant Date
COPE# DisascTIONTYPE PATE INTmAL$ OWES INSPECTION TYPE PdIE KITUALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final / 208 Final Plumbing
200 Final Re-Roof q�Z7 et 210 Final Electrical
201 Final Block/Retaining Wall 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
PP.-
.
PROJECT ADDRESS: 2035 FLAMINGO DR UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 054036
OWNER'S NAME, JUENGEL EUGENE THOMAS TR
ADDRESS: 2035 FLAMINGO DRPERMIT NO: P 054036 PLAN CHECK. NO: N GOVT: N SUPP: N
• COSTA MESA, CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
540-6946
ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : CHANGE OUT WATER HEATER SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
PERMITTEE: GEORGE BRAZIL ( 714 ) 535-7905
ADDRESS: 3022 N. HESPERIAN WY 101 COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME
�E
SANTA ANA CA 92706 ******* *�E�¢*�E�E**NAL* iE***�E* ¢************ ¢y6**iF****+¢a¢NiE* ¢ **********************
• LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of,the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 09919 STATE LIC.: 443064 CLASS: 36
la '3d L►_lt.A 49.11.4" JaMAIN BUILDING ACCESSORY BUILDING
MPENSATION DECLARATION: erey affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance or3,cgrtdie%copy Meier':(Section 3800.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: QR 049 18 9 EXP.DATE: 01 /01 /92
COMPANY: UNITED PACIFIC PARKING REQ• PROV: PARCEL: 13954309 ZNE: REF NO:
❑ Certified copy is:herebbyaG
y,furnished. EX Certified copy is�rl 007witith the city Building Division. 1 PLANNING NOTES>
iftwir I-36'-,✓ � ,c //.Y &Lee-17c /"/ >
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1001 or less). DEVELOPMENT S E R V I C E 5. REQUIREMENTS
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 Workers'Compensation Laws of California. ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:II.after making this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : •
•- DATE
Code.you must lonhwilh 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 APPLICATION ISSUED BY: - a DATE- -30'-
which this permit isissued(Section 3097.Civ.Cl. ************************* ** **. •'* * **************************** ******1EJf 1F**
LENDER: • ************************************* ' ***************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
i;
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 2 00 •
repair any structure.prior-to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 5t SMI P/NON-RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt Iheretrom 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($500). ISSUE FEE 3,00
I. as owner of the property or my employees with wages as (Heir sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTAL S----> 2 .00 3, 00 0 . 00 5, 00 5 . 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED• 5. 00 OVER/SHORT• 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve
for the purpose al sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5. 00
❑ and Professions-Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts tor such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that pmol of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I dm exempt dndei Section. B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Dale: .,: . Owner- PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00
I oo hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit ler construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Dale: i.Ajcr Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county 'i! 3C09E,it)-.r!''4.J4a'i _C'- : An
ordinances and state lava relating to building construction and hereby authorizerepresentatives'.this city to enter upon theabove-mentioned PATE: 59111E. '.1. Talc .... ,_
property for nspectioR purposes - U//
ate: 0
�� '9/ a,,;r*luw�-� .`/ / ro�
Driver's License-or Social'Secudly a:
,
-k--_
r 1641.46 White-Building:Green-Cade Enlorcemenf.Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
V .
., ,
CONSTRUCTION AND PLANNING l POOL SPA
APPROVALS Permit# • Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical ServicePole -
'dr52. Pool & Equipment Location
+2. Soil Pipe-Undrgrnd. .,~ 53. Steel Reinforcement
�.?.--Electrical Condbit,U4ility•Undrgrnd4.: 54. Forms
,-
-4.'1 . Electrical Condoi•t-Undrgrnd. ..a...-..- 55. Electrical Bonding
' 5. ,Sigel Reinforcement"... 56. Rough Plumbing & Pressure Test
j,O. Electrical UFEQ Grhd. t:- 57. APPROVAL TO COVER-GUNITE •
.7.CCFootings > 58. Electrical Conduit-Undrgrnd.
' B.-Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
_
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
t
10. Structural Floor System 61. APPROVAL TO DECK
11i. Pioperty Sewer Line& Hottse Connection 62. Backwash & Receptor-Final '
._ r
12. SeWer Cap 63. Heater & Vent-Final
.
' 13. Roof Drains _ 64. Plumbing System - Final
14. Rough Plumbing "c 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
20.,Rough Factory Fireplace r - -; z •APPROVALS `.Permit # `a •
.. c i . .: _ ,' •.z -. -
21. Ducts,in Strjictuce; • - • > .. c 1 _•• . _70. Underground Hydro
22. Ducts, Ventilating + + 2t • :71. ProducrPiping 0 Gas 000
r
23 Gas Pipe'-Rqugh &'Test y 72. Underground Flush_ r
24. Rodi Framing J ' > - >73.i.Undergrnd•.Storage-Tank 0 Gas 0 Oil
•25. Roof Sheathing ,, -' 1•" - `• s •'74. Overhead'Hydro-•
r.26. T-Bar Ceiling (Structural) &"Monocoat s. . - t- _ 75. Dry Chemical
27.=Frame and Flashing ' ' , • ; 76. Dry Standpipe . �1 •
`•
�28.`'Lathing,& Siding - - c >' . •. 77. FIXED SYSTEM,FINAL-
19. Insulation ' • r '. 78,.FIRE PREV. FINAL - ,
730. Drywall Nailing I + - HEALTH.DEPT. REQUIREMENT
.31. Plaster Brown Coat' a 79. PINEAL INSPECTION -
--32.,Electrical Power Mete(-Final ` ..L r80.. FOOD CE`R'TIFICATE ISSUED _
_ 33'Final Electric ' t --,` ''Notes: _ J :
.34. Final Heating& Air;Conditioning .t .. s -'
35.:Final Gas Pipe-Tat' - - '.. -4
36. Hood or Canopy - - --
37i..Findt Factory Fiteplacer ' '•"' t a - - . - ,,
38. Final Plumbing ik;,; 1:411q c- •
- - , ;
r39. Water Service-Final ti it
_ r 3' v: + r ,•
„40. Gas Service-Final , Is
•
>.41. Solar Domestic-Final - _ t--
:,, - ., -
42.`Backflow Preventer • `' y
43. Backflow Irrigation •
'44. Landscape Irrigatio',n System.,
; ' .t. ` I r ; s --
>45._Sound Attenuation . - �'
';46. Handicap Regulations , - _ - -
•
47.- FINAL STRUCTURE & BUILDING / - - - : c -
48.: n•
FINAL PLANNING ' •• & - _
r49. Electric Release to Edison I .. - ,
•
,50. Gas.-Release to Southern California Gas Co ' t- ± „.
- `', ,, -
.51. CERTIFICATE OF OCCUPANCY _
No. Date
28043JAN `, n
COSTA MESA BUILDING-SAFETY DEPARTMENT 12 p 455* ***154.50
P.O.BOK 317 COSTA MESA.CALIFORNIA
la For Applicant to Fill In Completely APPLICATION FOR PERMIT
7/ 5492 TYPE OR PRINT P1 . 68-A BUILDING
For Office Use Only
BUILDING
ADDRESS 2035 Flamingo Drive RECEIPT NO. ry�JQQ
COSTA MESA. CALIFORNIA r{3
RS�C@�{{Vg O�BY DATE RECEIVED DATE ISSUED
OWNER Mesa Verde Builders G l<< ,t �.MN 1 619
MAIL 2850 Mesa Verde Drive ADDRESS ~ Jvr
ADDRESS
FIRE
CITY Costa Mesa No '
TE.5490395 L ZONE TYPE .� GROUP
•
AP
ARCHITECT Kaltenbach . TEL5478046 BYPROV ED DATE •
OR ENGINEER NO.
ADDRESS 1823 E. 17th St . , S.A. ZONING
ZONE NO.OF USEOFNEW 9iug1 Film.
Mesa Verde Builders R.1. I PIANS 2 I BUILDING w/ att gar.
DESCRIPTION Lot
LEGAL
ADDRESS 2850 Mesa Verde Drive 31, Tract 5492
CITY Costa Mesa A.P.NO. none
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.STATE 181269 ms.... 549-0395 90"TO SIDE 3 REAR P.L.
NSIZE 68 x 104 I NO.OF BLOCS. 0 ALVES
LOWED (U.B.C.REQUIREMENT/
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C//LAT(iEET)
SETBACK LINE FROM FRONT 7 FT. FT.
CENTER OP STREET 52 , REAR YARD 30 '
SIDE YARD LEFT 5.751 I RIGHT 5 ' R.SIDE (FT FT.
DESCRIPTION OF WORK L.SIDE (..6"-n175r-r. Fr.
NEW X ALTERATION _ ADDITION REAR i�(/'FT. FT.
DISTANCE BET. BET.MAIN&
MAIN BLDGS. ACCESS.BLDGS.
REPAIR MOVING DEMOLISH _
BUILDING I NO.OP VAR.# DATE
SIZE 2612 sq ROOMS 9 STQRIES 2 C.U.P.# APPROVED
EXTERIOR WALLWood I ROOF Built up APPROVED
COVERING Stucc(1 COVERING Wood BY W T. 1) I J�ATE 1-3-68
USE OF BUILDING AND WORK TO BE PERFORMED 1n/"/✓/)
Single Family Residence
tLsQ.F s/7a 61-ia7°
I HEREBY ACK OSI+ DO8 THATi 1 AHATION THE AMOUNT SH N UNDER VALUATION IS FOR THE Z
ANO STATS AT TH ABOVE B CORRECTHAVBREANOD TAGREE ISAPPLICTO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 0
PLY WITH LL CITY DINANCEY AND ST TE LAWS REGULATING VALUATION
BUILDING ONSTRU ON. I V/Y•'_ }7 �9T G
SIGNATOR PJi�/• PERMIT FEE $/US, o j
PERMITTEE I S/I E�-O K
S1// -D 0 PLAN CHECK $ J 00
AUTHORIZED AGENT IJ `/ /CI' ` 4
TOTAL FEE $/s A/'I'+i
• ur+nt TIIRNMa MR DAIE 4-23-69
IOJOB ADDRESS 2035 Flamingo Drive BUILDING PERMIT NO. 30152
GENERAL CONTRACTOR J. Crevier DESCRIPTION of WORK p ... & Comm'. Block Wall
-v AP No. 139-543-09 LOT 31 TRACT 5492 FIRE ZONE . VALUE $ 125.00
INSPECTIONS Signature Date GROUP J TYPE III ZONE R-1
j SOIL SUBCONTRACTOR PERMITS ISSUED
▪ GAS Date Number Signature
.`WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. U
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER fl
ROUGH WIRING p Heating and Vent.
TRENCHES Q FORMS fl STEEL REINF. ® vv.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT In
PLASTER, BROWN COAT
STRUCTURAL. FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL /VW y-/i fob'
`' 30152 PAID -/kkk kir
l ' APR 23-69chsa001267 v 5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
R ECEI yt;b �V� D 013 V/EG� DAT ISSJID�
BUILDING JOSr P/ t//�' /f� y `�
ADDRESS J< 4rJ am/n(J /l
J� �/ a�
�'. JU en A.P.NO. II % —� �l) ~oy
OWNER / solo
MAIL BUILDING a
Z .
ADDRESS SanrC ADDRESS pfO3S" —
W W TEL.
6 U CITY Co sta Ines a NO. TRACT cidY LOT 3 BLOCK
I—Z
Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH
O y LENDER f N0 11 e.
am
_JD BRANCH '
J to OWNER AAP 7
Q W ADDRESS
03 m ARCHITECT TEL. USE t/ VALUE /2 S —
J Q OR ENGINEER NO.
U Q FIRE "/�/�
w CC ADDRESS ZONE TYPE GROUP
A LL APPROVED
W Z CONTRACTOR J. Crevice' BY DATE
-JO k^—
mZ ^
J� ADDRESS 2061 S (�erl ,'Jr
W W TEL
ZOy{F NO.OF USE OF NEW rue
z_ }. yL `, y 1111/�Jx� PLANS f/ BUILDING
ZI— CITY Cos to Mes a NO. 5-go �O ie.,
W U STATE Ia ./�J�Y '7 CITY /! YARDS APPROVED YARDS APPROVED
7 O LIC.NO. GO YC o ( LIC. NO. L� MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLOCS. (FROM C/L STREET)
OF LOT I NOW ON LOT FRONT FT. —F l.
USE OF
EXISTING BLDG. R SIDE FT, OFT.
I— SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. ei FT.
Q EXTERIOR WALL I ROOF i lj
_o COVERING COVERING REAR FT. FT.
J USE OF BUILDINp AND WORK TOE PERFORM€ID DISTANCE BET. BET.MAIN&
Cl-
0-
foIllierP[( b5tFCUJf
�"C- 4-C W'Ain MAIN BLOCS. ACCESS. BLDGS.
a lyd Je4-1 / VAR.qB DATE
Q
0 C.U.P.qW APPROVEDz �YROVEDerpATEO l
V I hereby acknowledge that I have read this application and state
✓ that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I"' any person In violation of the workman's compensation laws of
rA the State of California. co
ZI hereby certify that I am properly licensed as a contractor under SQ. FT. O
the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are In full force and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business LC
VALUATION
and Professions Code, Division 3,Chapter 9. n
PERMIT FEE $ D
Signature of m
Permittee I_,QS�"'—'�.e 5 `�� PLAN CHECK $ E
// o
Authorized Agent . / LL
TOTAL FEE $