HomeMy WebLinkAbout2433 FORDHAM DR - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 2433 FORDHAM DR
Suite:
Viciniry:
Parcel Number: 14143112
Applicant: ROSSEAU,WALTER
Address:
Zoning:
Phone: 714-403-3939
Zip:
Owner. LONGPRE,ROBERT & CHERI SLADEK
Address 2433 FORDHAM DR
, , . Phone: 94&515-4985
COSTA MESA, CA Zip: 92626
Contractor:
Address:
� , Zip:
.4rch :
Address:
Zip:
Phone:
License:
Phone:
License:
Eng:
Address:
� ;� .�. SCOPE OF PERMIT
� 224 SQUARE FOOT ATTCAHED PATIO COVER AT REAR OF-EXISTING RESIDENCE.
FEE SUMMARY
Plan Check: $63.21
Permit: ' $97.25 - -- - - - - -
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection`. . $0.00
Total: � $160.96
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existina: o
NOTES:
Stalus: ISSUED
Applied: 0211 B/2004
Issued: 02/20/2004
ISSUED BV: �-
Calc Valuation:
Claim Valuation:
.,.::'
PLANNING & ZONING
Rear 36- 0 � Left� 26- 0 Right 0- 0
Rear 0- 0 Left 0- 0 Right 0- 0
Re uired: 0 Proposed: 0
Phone:
License:
$3,610.88
$o.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-20, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 7 BO days, or if work is suspended or abandoned
tor a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspeetiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expira�lon of this permit.
FOR INSPECTIONS CALL: (774) 7545626
!aas�ae (�wl
WORKERS' COMP2NSATION DECLARATION: ' ' i
I hereby aHirm undar penalry ot perjury one of the tollowing declarations: � �.�
❑' I heve end will meintein a certificete ot consenc to self-Insure for workers' compensation, es provided for by section 3700 ot ihe Labor Code, for the pertortnence oi the
work tor which Ihis permit is IssueG.
❑ 1 have antl will malntain workers' compensation insurence, as required by section 3700 of Ihe Labor Code, for the peAortnance ot ihe work tor which this pertnit I5 issuetl.
My workers' compertsation Insurance carrier antl policy number are:
Carrier. Policy Number.
(This sectlon neetl not be completed i! fhe permif is velued et one hundred dollare ($ )00J oNess.)
❑ I certity ihat in the pertormence of the work for which this pertnit is iuued, I shall not employ eny person in eny manner so as to become su6ject to the workers'
compensetion laws oi Califomia, and agree that It I should become sub�act to the workers' compensation provisions ol Section 3700 of the Labor Cotle, I s�all forthwlih
comply with these provisions.
ApDliceni Signeiure: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL AND SHALL SlIB1ECT AN EMPLOYER TO CFIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TYIOUSAND OOLLARE (5100,000), IN NDDRIIXJ TO THE COST OF COMPENSATION, DAALIGES AS PROVIDED f-0R IN SECTION 3]W OF THE LABOR fADE, IIJrEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensed undar provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
lorce and ettect. Lic. a Cless x
Coniradors Signature: Da[e:
CONS7RUCTON LENDING AGENCY:
❑ I hereby aXirm Ihat there is a construction lending agency for Ihe performance of �he work for which �his pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lentler's Address:
Signawre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby attirtn that under penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business an0 Professions
Cotle: Any ciry or counry which requires e permit to conswct, alter, improve, demolish, or repeir eny structure, pnor to its issuance, also requires Ihe epplicem tor such pertnit
to file a signed statement ihat he or she Is Iicensetl pursuaN ro the provisions ot the Contractors License Law (Chepter 9(commencing with Section 7000) ot DiWsion 3 ot the
Business and Professions Cotle) or Ihet he or she is exempt therafrom and the basis for ihe alleged exemption. Any violation oi Section 7031.5 by any epplicant for e pertnit
subjects the epplicant to a civil penalry oi not more than five hundred dollars ($500).):
❑ I, as owner ot tha properry, or my employees with wages es Iheir sole compensatian, WILL DO THE WORK, and ihe struciure is nat intendad ar oHered tor sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves theraon, antl who does such work
himself or herself or through his or her own employees, provitletl Ihat such improvemenis are not intended or oHered tor sela. It, however, the building or improvement Is
—"
soltl within one yeer ot completion, ihe owner-builder will have ihe burden ot proving that he or she did not build or improve for purpose oi sele.). '
❑.. I', as owner oi the pr e, EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, BuSinass and Protessions
�Cotle: The c nirac s c se Law tloes not apply to an owner ol property who builds or improves thereon, end who conirac�s for such project with a comrector(s)
�licepse pur�ugnt h ntractors License Laws.).
Business and Professions Code for �hi5 rea5on:
by drivefs license. ❑ V63 ❑ No
Venfiwtian of Ownerehip by (rype of document, i.e. - pmperty tex bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION:
❑ I hereby certify that no excavation tive (5) or more teef in depth into which a person is requlred to descentl, will De metle in connection with work euthorized by this
parmit, end Ihat no builtling siructure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tille B, Calitomia Administrative Coda).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit trom �he Division of Intlustnal Safery. as noted e6ove, unless such person hes e
permit to do suc� work trom �he division.
Signature: Date:
Division ot Industnal Safery Pertnit Number.
CEfiTIFlCATE OF COMPLIANCE AND AUTHORVATION OF EMAY: I certify under penalty of perjury that I have read this application and state t�et the information given is
correct. I egree to compty wlih ell siate laws end ciry ortlinances relating to building cons�ruction, and authonze representatives oi the Ciry of Cwia Mesa to enter upon Ihe
abova-descnbed property lor in�ypec�purpwes. I agree not to occupy or allow occupancy of any building aulhonzed by this permit unlil tinal inspection.
COpEt, INSVECTIONTYPE QZ¢. INIQIAL$
1816 Fixetl System Final Fire Prevention
1268
200
201
202
203
204
Pool Spe Finel
Final Re-Roof
Finel BIocWRetalning Wall
Final Fectory Fire Place
Final Sign
Final Demolition
COOE 1 INSPECTION TYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
��7\I�CYIIILIS�".
2-�j-O ��
,
dECLARATION OF AUTHORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
Street Address:
Bldg. Permit #
This Permit #
AP Number:
1. I(we), �//1 0�l � li y� . r/) ��:��f� . declare that I am the Owner of Title of the above
referenced reai property, and that I(we) hereby authorize:
/e: �� • LL/ /�� %���?'1��Q�d� Te�one Number: 7� 7 / D � � � /� /
n
reet Address:
;ti: �� Y���7� _T�- � C� �9a�y�
to obtain pertnits in my behalf, as owner/builder, for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Workers
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City ot Costa
Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I 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. I declare under the penalty of perjury that the foregoing is true and correcl. .
Executed this � day of �.P �ll� 20 Q,� , at
PrintName: �/L� / /• S/aCY�! \ �
Signature: �,�t OAt_c: ��' /' JC/iC/.l'/.C.C/`�/�
Date: � � � � ��
Note: This autlmrization dces not grant autlrorizatbn to perfortn the work as owner,
it solely pmvides tor limited power of attomey to secure this pertnit in any behaH.
0]]936 (rev.11/00)
California.
;
. Applieant to till in all soaces witnin heavy bortler lines antl sign all aoGropriate Ceclarations.
'CITY OF COSTA MESA �� - PERMIT NO. - TRACT NO. -'LOT NO.� �BLDG. NO: - "-
CONSTRUCTION PERMIT � ,Sl� 27`JO "] �
rro�ect Aatlress � ' -
TVPE OF CONSTRUC710N �
'OWnef- `Phone- _ -pd ❑ NEW ❑ ADD ❑ ALTERATION
Address� a �3 � �❑ REPAIR ❑ CONVERSION ❑DEMOLISH
� Arch/Eng. - License No. �� OTHER
' AddIC55 ' - . . - DESCRIPTION OF WORK
' Cantractor - ' ' ' Phone TYPE OF,PERMIT - � �
' Address " ` � � ' - ' "' ❑ GRADING'- ❑ FOUNDATION Q STRUCTURAI
LICENSED CONTRACTOR� DEGLARATION � � O TENANT ❑ ELECTRICAL'OPLVMBING�OMECH{
I hereby aftirm that I aT IlcenSetl untl¢r O�ovi5ion5 of Chdrt¢r 9(Com- � � '.er�_.._��� �,Z+,_
menUn9 wlth section �000) of . Dlvislan �3 of the Business antl ❑ OTHER � --
Protessions Cotle, antl my Iitense is in full torce antl eitect. pROJECT D SCRIPTION _ . .. ..
License Class License No. . '
Date Signature �- - � ' SO.�FS. , .
4 ���
WORKERS' COMPENSATION DECLARATION � - - - OCCUPANCY�_CpNSTRUC7tON•TY.PE •
I hereby atfirm that 1 have a<ertificate of consent to self-insura or a VALUATION �f� ZONE
�certi(icate of Workers' Compensation Insurance, or a certitietl copy - - - - � - -� �
�reof (Section 3800, Lab. C.). GRADING CU. VDS. ACR»5
ty No. Company ' ' '
CerU(ietl copy is h¢r¢by fumishetl. REMARKS:�i l ... .
❑ Certifietl copy is tiletl with the Clty Builtlin9 DivisiOn. _ _ .
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' '"-" `
(Thls section neetl nat be completetl if the permit.is.for one huntlretl , __ _ .
(E300) or less). � - �� • - " " -
1 tertify that m the performance of_the work for which this.permit Is
iSsueC, I shall not employ any per n I any manner so as to.become PLUMBING ��i' � � PLAN CHECK �— '
Subj¢ct�o th Worker5' Compensa ' � of Califon 75} _ _. � , _ . _ _ _ _ ,
Date rJ � Siqnature BATHTVBS SFIOWERS �
NOTIG : f�ng this tleclara[ion, y shoultl become subject TOILETS., � • URINACS '� �' ' r '
to the Workers' Compensa[ion provisions of ne Labor Cotle,'you must - �
forthwith comply with such provislons or this permit shall be tleemetl LAVATOftIES OOUBL'E LAVS ' �-"
revoketl.. - _ ... . .. __ . . . . _ . _ .
CONSTRUCTION LENDING AGENCV ' �KIT.�SINKS' � DISHWASHERS �
I M1ereby affirm that tM1e�e Is a conStruGtion lentling agency to� the pe�- SERVICE SINKS "' SUMPS ' -�� � "
tormance ot the work for wM1ich this permit Is issuetl (Section 3097
Civ. C.). � " - ' - - ' - - '" ' - - �� FLOOR SINK$ FLOOR DRAINS ' �
Lentler's Name
Lentler'S Atldress � DRINKI}VG FOUNTAINS � � '� "�' "
OWNER BUILOER DECLARATION- " "' - - ' ` '� INTERCEPTORS � CLARIFIERS - -
I hereby affirm tha[ I am exemp[ from.the Con[raCror'S LicenSe Law for .
the-following reason (Section ]031:5 Buslness antl Professions Code: �--SWIMMING POOC �" PTRAP �' ''-
Any city or county whiGh requires a perTit to ConS[ruCt, alter,
2979 8/07/81. � , 17.00 TL
r
ZONING REGULATIONS � �
A.P. if � � � . i
LONE R�' � � PLNG. REF. � �
3U�.,_,,.. _.. _' ZQ.$�IL�ING..��jjClOq'/1 '
REAR VARD (TO P/L) � U, � '
PKG.SPACE REQ. � .PROVIC
;`:� STREET WIDTH� � � ,PARK F
ZONWG APPROVED BV . D
� SPECIAL GONDITIONS: .
ECECTRICAL '- vL.aN GHECK
improve, tlemolish or repair any structure, prior to its Issuance, also re� yyqTER SERV ICE ALTERATION� ' -"
quir¢5 the applicant fo� Such permit to file a Signetl statement tha[ he
is liceosetl pursuant-to the provisions of the Contractor'S Cicense"tLaw "GASSERVICE � � OUTLETS � -
^hapter 9(commencin9 �+iih SettiOn ]OOOp of Division 3 of the
i'y.-•,�oocra�n a.r�rou�oo� r�nai �.�rnar no �. ,.�or rna.oe.�,.� a�n rna .,,..«., � ��,..l�..,-.. ...._. � ,,.._...._ _. . _ _ _ .
'"'� tol [tle allegetl exemp[lon. Any vlolatlon ot SeCLon /031.5 by '
t;"iy�'applican['tor a' permit subjects'the applicant'to a'civil'penalty 'SEWER CONNECTIONS" "'"� '
,'t3'a�' not more than five huntlretl tlollars ($500). �'
µ� I, as owner of the properCy, or�my employees with wages�as ttieir SOLAR TANK `-- COL'CECTORS
stll¢ Compensation, will tlo.the wo�k, antl.the.5t�ucturE i5 not intentletl. _
or offeretl for sale. (Section 7044, Business antl Professions Cotle: TM1e SOLAR PIPING SVS. -
Contracto�'S�License.Law-tloes nol apply.to an owne� of a property _ _._ _.
who bulltls or improves ihereon, antl who tloes such work himself or ISSUE FEE �
through-hibown employee5, provitletl [hat such iTprovements are not
intentletl or otferetl for sale. If, howeveq tbe builtlin9 or improvement MECHANICAL PLAN CHECK
is soltl within one year of completion,.the owner. will have tM1e burtlen
o� proving he tlid not builtl or improve for the purpose of'sale). HEATING SYSTEM 0-100,000 BTU_
❑'I, as owne� ot the property, am exCluSively contracting� with `qND DUCTING' �' ' '- ""' ""
licensetl contractors to construct Ihe project (Sec[lon �044, Busine55 100,OOO+g7V _
antl P�otesslons Cotle: Tne Cont�actor's LiCenSe�Law tlOes not apply to
an owner of property who builtls or improves thereon, antl who con- REFRIGERATION 0-100,000 BTU_
iracts'from'such projet[s with� a contractor(5) licesnetl pursuant to SVSTEM - - -�
the Contractor'S License Law). 300,000 � BTU _
❑ I am ezempCuntl¢r Section � � q &�P. C. for tni5' '
/T' BOILERS BTV
reason�j ' " � • � � • ^ � _
Date ',^-��A��' ^��^_� ����� �0 � SVSTEMREPAIR,ALTERATION
I hereby.ce fythat I have reatl this applicat n antl state that tne above EXHAUST SYSTEM MULTIPLE
intormatio �s mrr ct. I agree to comply with all tlty antl county
ortlinances antl stat laws relatin9 t ponstruction, antl hereby authorize '
representative thi city to ter upon the abo3e mentionetl' ,
p�operty f n p rposes ! _'-(�I
Signature Date � �
Oriv¢rs' License or � � � �i 'ISSUE FEE ' -� � �
CMF 0865-46 White-Builtling; Canary-Appli<ant: Pink-Accounting; Goltlenrotl-Assessor
,� .
5(]. FT ...... . . . . . . . .....�.....� ; _
GENERATOR' -`0-1 KW �_ 1-lO�KW. � �` `
'TRANSFORMER �
'APPLIANCE� 10-50 KW '_50 + KW ' -
MOTORS ' ' "03 HP=1-30 HP '
(INC.SOLAR)� 10-50HP_SO+f{p °i' - .
'FIXTURES '"- OUTCETS SWITCHES �
�GAS'TUBE'SIGNS " ' " ' - -
`POLE LIGHTS ' ' ' - � ' - '
f
!
I
�PANELS ` MAIN ' SVB
' SERVICE ' -' - - • HMP- -
. . . ___ . _ . .. � . . ' _
� - ISSUE FEE ' ' - • -
'APPLICATION APPROV ED BV - � DAT r
� �SjU�M�M�ARV OF F.EES � � � -
'PERMITVG $1 _ KL ., SMIP • ' �$ , D Sa .
r
(PLANCHECK $ •S� PERMIT .� ,
. - . ISSUANCE �S�"�
,PLUMBING $ - � -
PLANCHECK ��S � - ' "GRADING` $''-
ELECTRICAL $ � ' ' ' '-' $ �-
� - . MICROFILM $
PLAN CHECK $ �
� � TOTAL FEE $• - i �
,MECHANICAL-$ � .
' LE55 AD- � '
'PLAN CHECK � $ � VANCE PC� $ _
, FINALFEE $ / ���
CONSTRUCTION AND PLANNING POOC & SPA ' •
APPROVq�S Permit# ' Date Inspector qppROVALS: � Permit# ' � Date -�Inspector -
1. Temporary Electrical $ervice or Pole 43. Pool & Equipment Location � -
� Soil ipe-Undrgrn . 44. Steel Reinforcement -
J_ 3., „Electrical Conduit Utility-Undrgm 45. Forms �
--
4. Electrical Conduit-Undrgrn - ' 46. Electrical Bonding -
�. �. tee �.ein orce . - . 47. Rough Plurribin & Pressure Tesi�
6. Electrical UFER Grn ' "qg. APPROVAL TO COVER-GUNITE
7. Footings ' , 2 49. Electrical Conduit-Undr rn � �
. B. Foundation � � 50.� Gas Pipe,.� Undr rn, Test
„ 9. � Water Pipe-Uridigrn - � 51. Backwazh Lines P-Tra ❑ ndr m -
10. Structural Floor SYstem / . 52. APPROVALTO DECK " � " ' � �' � � �
11,. . Property Sewer Line.& House Connection 53:.': Backwash & Rece tor-Final �•
. 12.. _.Street Sewer Conneciion • 54. Heater & Vent-Final - �
i3. Rough Plumbing, �- - � � - � - - - - - �
14. Rough Electric-Conduit � � - �56. � - Electrical-Final � �
15. Rough Electric-Wi�ing �� ' " � - - - � - -- 57. Solar SYstem-Final .., - ` " ' - '
16. Rough Heating &-Air Conditioning � �- � encing & Access Approval � ��
. 17: Ducts, in Structure. ; ' � APPROVED FOR PLASTERING �� '
16. - DuMs, Ventilating . - � .i . ' '� _ • � '. - , . -
19. Gas pipe-Rough &Test " 60. POOUSPA'SYSTEMS FINAL ' �
20. Roof Framing . ' - ' ' ' � " � � � '
, 21. Roof Sheathin � � _ ' .. _ . � _ � . . � '
22. Frame and Flashing � NOTES: • ` "-
. 23. InsWation � � - � � -� � � " � � � '
' 24: lathing & Siding " -
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 vJ '
� 39. Special Requirements.Completed �' " ' ' �
40. Electric Release to Edison ' ' ' � � � �
' 41. Gas Release to Southern California Gas Co. - � � � �
• 42. CERTIFICATE OF OCCUPANCY ,
� No Date - . -
OWNER Costa Mesa Estates �
JOB ADDRESS 2433 Fordham Drive
GENERALCONTRACTOR Roven-Spiegel �o
L, . %�- BLOCK
GROUP I& J TVPE V
INSPECTIONS I DATE
Foundation Forms and Gra
Rough Framing
Plumbing, Rough to Slab '�
Plumbing, Rough Complet�
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
�wer, House L Se�
SP� ",� Tank or Cesspool
L g, I n O
Final, Fixtures
Wirina. Final
FORM 310 3M 10-•v3
to Garage 6'�' /� � `/ "
� �� `
r W,.�G� /O %'�7
w��S �� i /s�
�i/i� //- /q-Y/
1M l�i S I� l�✓
H1N S v-/c S 7
'�St. irylCs /�-•%-$��
K -� A �� -�
%. _Z% �
�p�ete/7NS y-/G S�
Mli'.s � -/c -s7
MAY 1 1957 VCB
MAY 1 1957 VCB
TRACT 277�
ZONE 1�=
SUBCONTRACTOR
DATE 4�12—C6 ~
BUI�DING PERMIT NO. z6�1
VAwE $ 11�200.00
Single Res w/att gar
FIRE DISTRICT 2693
PERMITSISSUED
DATE I NUMBE
r Mesa Snilding Department APPLrCtITION FOR PERMIT
117 EAST 20th STREET B U. B�L D� N G �
=' � t4.OSTA MESA� CALIFORNIA �
"� ,• FOR APPLICANT TO FII.L IN FOY� OF�ICE USE ONLY
� Receipt No. � Permit No.
Costa Mesa, Ca ' rnia
Nearest
Cross St. G'��G��GC� �`��
Owner �Cl�Y/',-'�' €T✓!�-�`�%�%
Mail .��) E^ l�/, 2l l�� �-
Address �
Tel
c�cY � 5 c�riFz-ES Nopi%e
ArChiteCto� �� G J � LiC.
Enaineer %-. �it � . No: �....
— � • , � ,l c�tY ���..
Contrector�fJd�N` J��C-`l7'�C-> No.7 �/2�
Address J��J(j `.Ui % � Gi�. �os �
Legal I Lot i/ I I.
Description No. � Block I Tr:
t
(Attach Metesand Bounds) �
� �x /�) I No. of Bldgs.
Size of Lot ` Now on Lot
Useof No.of �
Existing Bldg. Familles R
Setback Linefrom / Rear Vard 5
Center of Street �� �— Side Yard .
Addition
Demolish
�• f� i �-i.z-v�i �r-
Building
Addre55
Costa Mesa, California
NearesY
Cross St.
Zone �� I P�ans I Typc� G
APPr'oved
by Date
CO�ZIItECTIONS
uwming ����. /� Rooms � Stories �
C9
CoveringWalS�Ul.�O� I covering � d� APPROVALS
Use of New ��
Building �G� ��7 Foundation Location Inspector
Forms, Materials,
� - ,C Under-PinNng
. r Frame: Fire Stops,
Bracing, Bolts
I hereby aclmowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int
with all City Ordinances .and State Laws regulating - .
building construction. � Lath. Exi.
3ignatureof �/_s�� ��� E��f„��
Permittee ��f� �� � Plaster, Int.
Authorized Agt. �^iiLl/�-- �cC%s� Plaster. Ext
Valuation P mit Fee $ �,� � Masonry Reinforced
� Plan Check $ � ' gond Beam
$ ����'� Total � .
Fee �' `$ —' � �FINAL
aNr zna s-sr zns s-ss . � �
Date
r
��nv�R DUNSCOMB, G. D. vR�� 3-11-74
J08 ADDRESS 2433 Fordham Drive BUILDING PERMIT N0. 38058
ZAL CONTRACTOR Wilson Associates DESCRIPTIONofWORK screPnPd Patso Covar
`. . 141-431-12 LO7 TRACT FIRE ZONE VALUE E 2 -
� INSPECTIONS Si noe�re Date TVPE GROUP ZONE _
� soi� PERMITS I55 ED
�As SUBCONTRACTOR �
3 WATER �ate Number $i nafure
Plumbin
� ROUGH PLUMBING
�1 PROP. SWR. LINE Q HOUSE CON. �
� S�RINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO rIIR CONDITIONING
POWEft
WI
FLOOR SVSTEM
BONO BENM � STEEL REINFORCE
SHEATHING
FRAME ANO iLASHING �
LP' "'G — IN � � f
P 2, BROWN COAT
AL
ELECTRIC, FINAL
BUILOING. FINAL
GPG!'ILI RG/1111fiFMFNTG
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
'�iu''i11�-'14����:�0 32?_�� **i*�Z0.�0
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j APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Complefely
RECEIV�DBV � EjECEIV D DIjTE�%+ED
BUILDING �/ L���� ' e�
ADDRESS, �% � d r {� �' j �j
OWNER .,�- ]G fi( A.P. NO. I� T'� � l2 PER � V Q
l7
ADDRE55 5 C1 Ni e S� / %�DDRIE 5�[�� �Q'�Q �
, U CITY CU� (,t NOL �/ TRACT �!�� LOT C' BLOCK
-Z
� Q CAN5TRUCTION NEW ADD A P
�N LENDER
_ m
� � BRANCH �'` / �
� WNER LT�
ADDRESS � VALUE / LB
m ARCHITECT (� TEL. . S $
� N OR ENGINEER Ii II(( ,i N. .
� Q FIRE
j� ADDRESS ZONE TV E GROUP
W
APPROVED � �/ (
�Q CONTRACTOR �j(% �/S�/Y� C� e�' DATE
l � ADDftESS D� �p p/j' �'
� w TEL. ' 'A ZON NO.OF USE OF NEW�CNCLOSL
�= CITV �"'�(:�ii'�i. NO.S� I DY�/ PLANS � BUILDING I�A. O
'r
�� STATE ' CITY �'AROSAPPROVED VARDSAPPROVED
; O LIC. NO. SS?//G LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT ' NOW ON LOT FRONT FT. FT.
USE OF
EXISTING BLDG. S I FT. FT.
� SIZE OF y NO. OF �
Z NEW BLDG. �/� �� ROOMS STORIES L. SIDE S FT. + ' FT.
EXTERIOR WALL FOOF
L% COVEFING COVERING ' REAF '� FT. FT.
USE OF 8 I N WORK TO BE PERFORMED DISiANCE BET. BET. MAIN &
MAIN BLDGS. ACG65. BLDGS. '
Q VAR. � DATE
O 1 C.U.P.# APPROVED
F � � " APPROVED / _ � � lI �7
� W
z
0
V'I hereby acknowledge that I have read this application antl stateJ � STATE
� that'the ebove intormation is correct antl agree to comply with,µ
� all laws regulating building consvuction, and I shall not employ` ,��
� any person in violation Of ihe workman's compenzation laws ot _
y the State of California.
zI hereby certify that I am properly licensed as a conttactor untler�; SQ. FT. 7{V(
the State of Califomia siness antl Professions Cotle,'�ivisicn 3,� THE AMOUNTSHOWN UNDEfi VAWATION"1S FOR
Chapter 9, and tha uch censes are in full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt fro . :e pro isions of ffie S[ate ot C lifomia Business VALUATION
antl Profession oe vision 3, ha ter 9. D. � OU . PERMIT FEE $
SiB�ature o . A A�1�. �,/ ✓ �
Permittee �" V �I � $ �� j �' PIAN CHECK $
Auihorizetl ABent ' �
TOTAL FEE S