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HomeMy WebLinkAbout159 GEORGEANNE PL - Building Permits • • :; CITY OF COSTA MESA BUILDING DIVISION Fy a.All 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us �• FOR INSPECTIONS CALL: (714)754-5626 a`D+ m<r• • PERMIT NUMBER: v BX07-00110 PERMIT TYPE B_MISC STATUS: ISSUED APN: 43926208 DATE ISSUED: 09/06/2007 Zoning: , ISSUED BY: RMD JOB ADDRESS: 159 GEORGEANNE PL;CM; ,: --S'uite/Unit: Vicinity: THROUGH OUT , -Primary Occ:.; Const Type :?? SQ. FT: 0 Valuation-,; $7 000 OOr/. SCOPE OF WORK: WINDOWS AND 1 SLIDING GLASS DOOR CHANGE,OUT,THROUGH OUT HOUSE LIKE FOR LIKE, NO CHANGE-INHEADER: WINDOWS SHALL MEET1997 UBC`EGRESS REQUIREMENTS. UPGRADE SERVICE TO 200A. OWNER: PEARSON,JEFFRY.K, Address:: 159 GEORGEANNE PL Unit City/State: COSTA MESA,,.CA "" Zip Code:. -92627 - Phone: 949-200-955.0 APPLICANT: PEARSON,JEFFRY K, - Address: 159 GEORGEANNEPL Unit City/State: COSTA MESA,CA Zip Code: 92627 - - Phone: 949-200-9550 CONTRACTOR: OWNER-BUILDER - - • - s License No. 000000 Address: Unit: - - • City/State: - - Zip Code: ` Phone ARCHITECT: - License No . - Phone ENGINEER: License No. . Phone FEE SUMMARY ' 3P Building Plan.Check: - $0. Building Permit:.;. . Electrical Permit: $85:65 SMIP Residential SMIP Commercial ';2.$0:00 $0.00TOTAL FEES • $224.90 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I. INSPECTION TYPE DATE INTI ALS CODES INSPECTION TYPE DATE INTIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 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 //13/04H PP a 'Y ' WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive se. es 0 No r I hereby affirm under penalty of perjury one of the following declarations: Driver's•License.No. , E`pires: /7 7213 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):, compensation, as provided for by section 3700 of the Labor Code, for the performance of the work 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Corner: • or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2.Grp (Tho seriion need not be completed dthe pent is valued at one hundred dollars(51 00)or less.) 2,Art 2,Sec.341.Ttle 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would cg-'certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless Issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the work ' compensation provisions of Section 3700 of Applicant's Signature Date the Labor C de I hall fort h comply with these provisions itfrt `/ //� G`/, /y'7 Division of Industrial Safety Permit Number: (� ppl nt5 gma ureg r/ b e/v HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No (3100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is ininfull force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No `c:#— A.- Class# (Section 25533 of the California Health and Safety Code, with some V exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No . I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). 1-as-owner,of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other CCompensatiori-WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). , Completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply'with all state laws and property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. ❑ I. as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date . property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agr not to occupy or allow occupancy of any building authorized ,t i pepit til final inspection. e � D 9 Date -7_ /��ir- % /Q'�` f . Z _/_-.,.. _ C -'=!"eo e�al Owner(s) 'r Date _s gnature�=-- e'—�— - — 0051-46(3/0 And/or Authorized Applicant Date 1 ii 1 ci 'e:n OWNER-BUILDER eli VERIFICATION Address: Permit#: 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 verifcati. is received. 1. I personally plan to prov e the major labor and materials for construction of the proposed property improvement. J Yes ❑ No 2. I(have/have not) 4Ygve- signed an application for a building permit for the proposed work. 3. I have contracted with the following person(tine) to provide the proposed construction: Name Address City_ Phone ( ) Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work • 1042.46 (Rev.1110.4) i CITY OF COSTA MESA .;�p BUILDING DIVISION FI ,. 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 111.4 FOR INSPECTIONS CALL: (714)754-5626 41/41"100.Ro PERMIT NUMBER M07-00474 PERMIT TYPE MECH STATUS: ISSUED DATE ISSUED: 09/06/2007 :ISSUED BY: RMD JOB ADDRESS: 159 GEORGEANNE PL CM + Suite/Unit '`,.: Vicinity: ATTIC AND REAR YARD ' - SO. FT: 0 SCOPE OF WORK: INSTALLATION OF A NEV/FAU < 100 K BTU IN THE ATTIC AND,1;COMPRESSOR TO 100K AT REAR YARD. OWNER: PEARSON,'JEFFRY K ` Address: 159 GEORGEANNE PL- Unit:'. PHONE: 949-200-9550 City/State/Zip:- ` .COSTA MESA,CA , ,. APPLICANT: PEARSON,,JEFFRY K' Address: 159 GEORGEANNE PL Unit:. PHONE: 949-200-9550 - ' City/State/zZip: COSTA MESA,CA`- . CONTRACTOR: OWNER-BUILDER • - License No.- 000000 Address: Unit: , - PHONE: - - - City/State: MECHANICAL PERMIT FEESUMMARY MECH ITEM FEE: PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0:00,REINSPECTION FEE: TOTAL FEES: $53.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. '�/�'��� CODES. INSPECTION TYPE DATE INTnlALs CODES INSPECTION TYPE �]'����f/// DA INTIMAL V 1616 Fixed System Final Fire Prevention 206 Final Mechanical/ ��{4.7j eJ jx 11/> os rQ�'"(� 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive se. es ❑ No r I hereby affirm under penalty of perjury one of the following declarations: , Driver's /26/ Ddver's'Liceds`e,No: EFpires: 07 3 ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work 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 DIVISION'OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: - 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be compeetedd the permit Is valued al one hundred dollars(5100)w less.) 2,Amt Sec.341,Title 8,California Administrative Code). Polis Number: ❑ As owner-builder, I will not employ anyone to do work which would „I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless tssUed-l'shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. 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 C e, Applicant's Signature Date 1 shall fo th comply with these provisions. �'//.._( e �„�il � ��J Division of Industrial Safety Permit Number: • - Pph nes Signature,_Signature,_ ( Date .. .,'�t- S �-"''`''"• HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ElNo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: . - 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). t.-.• 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). �+ I,.as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other Compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for control officer 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 CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. ❑ 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 Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that CI I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: . the City of Costa Mesa to enter upon the above-described property for inspection pur ses. I agree to occupy or allow occupancy.of y building `�/� / // �/ 9 / �j authorized by his mit un,al inspection. r d t /o4a4 ont //(1�O / Sig re Legal Owner(s) _� Da y {`/�/ Signature (i lei r "' z...s 3057-x6(3/0 ) C_______... ....—••• Andior Authorized Applicant Date • CITY OF COSTA MESA, .. - tt BUILDING DIVISION Ft`' ''' , 77 FAIR DRIVE,COSTA MESA, CA 92626 • (71: r% .273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us `? FOR INSP_:";0.`.t : (714)754-5626 . • " • PERMIT NUMBER: P07-00513 PERMIT TYPE PLUM . ,`v�i• STATUS: ISSUED • EXPIRED nPDA /2007. " r ISSUED BY: RMD DATE ID•dI OI �L-h-)-,:,2•:,` ` " " 4 ail JOB ADDRESS: 159 GEORGEANNE PLCM 'Surte/Unit' / " Vicinity: REAR YARD jr ; . ' SCOPE OF WORK: REVISED41/15/07 REPLACE KITCHEN SINK, 3 WASH BASINS 2BATHTUBS AND 1 SHOWER. WATER HEATER CHANGE OUT'AT REAR`OF HOUSE. ry / OWNER: PEARSON,'JEFFRY K ` ! Address '1 159 GEORGEANNE PL PHONE: 949-200-906 %f " City/State/Zip. COSTA'MESA CA APPLICANT: PEARSON,'JEFFRY K+`: Address: 159 GEORGEANNE PL-t' z i - PHONE: 949-200-9550 ' � I .. . .-- -.City/State/zZip: -. COSTA MESA CA? CONTRACTOR. OWNER BUILDER '— _- License No.<. 000000 Address: City/State: - ZipCode -` '' - CELL: �,j - PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0 00 • PERMIT FEE: $143 60 `" TOTAL FEES: $143.60 . P w 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE S. INSPECnON TYPE DATE INnTIALS CODES INSPECTION TYPE DATE INPTIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's,. ,. ❑Yes ❑ No—r„x, I hereby affirm under penalty of perjury one of the following declarations: •D'hver's Licens'e No: tEa es ,3 El have and will maintain a certificate of consent to self-Insure for workers' -Verification of Ownership by(type of document,i.e.-property tax ill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work 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 .,DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - permit is issued. My workers' compensation Insurance carrier and policy •0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized • by this'permit,and that no building structure,scaffolding,falsework,cr demolition Carrier: or dismantlingthereof,will be more than thirty-six (This section need not be completed fl the perm9 is valued at one hundred dolars(5100)or less.) rty-su(36)feet high. (Chap.3.2,Grp 2,Art 2,Sea 341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.# Class# (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 Contractors Signature Date 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 CONSTRUCTION LENDING AGENCY: ' temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? CIYes ElNo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). 11951 as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other mpensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for • sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and El I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that iam exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of - Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection p pos s. I agr not to occupy or allow occupancy of any building authorized y t i peri it final inspection. 5J�}.� vew, e S / iii _/ 47 C J 1 A .LeoalOwner(sltmxa" Datew.'-aa•+.: 1‘46.3717) And/or Authonzed Applicant Date ^ft(Oct _ . 4,.. 483 i�, • COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only �Y� /' p r Aft p� r RECEIVED BY DATE RECEIVED DATE I UE DDRESS // ! uCz'f®AI�.e FF�Ej�1�1�i/�P N/'G ��• I ' R� 7 OWNER EE LV /I 128026- A.P.NO.//9-0 - VJQ{7 p /1 BUILDING ADDRESS ISI G [[��o IfCC6E 4IriRE /ntL , ADDRESS / •-or� ee i - r �, OF TEL.CITY CDSTA_ ' ` Es Q NO. 4T V'4�4 TRACT 4/lilir- LOTS BLOCK CONSTRUCTION NEW ADD AL,TE(i REPAIR MOVING OFMOI ISH , LENDER BRANCH E. 2L/� //O� OWNE Ao ADDRESS (//1_� ,,y/I��/� ARCHITECT NEL. USE -/_�v� C-�.V ��' je OR ENGINEER NO. FIRE • ADDRESS ZONE TYPE GROU�Pritr • APPROVED 'fele/dr ✓/ / ..,7 CONTRACTOR ' BY ATE (J✓ //�`��j//� • ADDRESS • • TEL. LCJ ' p�OF GINEER NSE OL�%��==. CITY NO. FSTATE CITY YARDS APPROVED YARDS APPROVED �y+ C LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZE . I NO.OF BLDGS. (FROM C/L STREET) A. OF LOT NOW ON LOT FRONT FT. ' T. Q USE OF V) EXISTING BLDG. R.SIDE °J FT. _ VJ 1,-. Separate permits are required for - L.SIDE , ' FT. FT. C electric,plumbing and heating work. _REAR . F FT. fa7 USE OF BUILDING AND WORK ORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QQ ,/��' J �/ /t IN MAIN BLDGS. ACCESS.SLOGS. X 1 nsr / LrNG Ir-LJ ' I Dy r, CURP.# . DATE APPROVED > APPROVED( 2)f€ ATEVE�7 .7 ELY ..l O. I hereby acknowledge that I have read this application and state 'Si N ed that the above information is correct and agree to comply with m L all laws regulating building construction, and I shall not employ t , Z any person in violation of the workman's compensation laws of the State of California. • m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N Cha State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e • am exempt'from the provisions of the State of California Business and Professions Code, Division 3,Cha r 9. VALUATION PERMIT FEE $ 1 o-� ro Die •PLAN CHECK $ G Signatu of /\� �,/,�(n A ,t V- • 0 Permittee \� y :11-0-1..> 5 �/sV/'/ �- TAX $ U. r si 2 1 CCC���''s' V V Authorized Agent TOTAL PAID $ OWNER LUNDBORG E. E. DATE 7_7_77 JOB ADDRESS 159 Geargeanne Place BUILDING PERMIT NO. 43483 GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Tnsral1 Window An No. 119-052-33 LOT TRACT FIRE ZONE VALUE $300.00 'ECTIONS Signoture Date TYPE V GROUP I ZONE R-1 sUIL SUBCONTRACTOR PERMITS ISSUED GAS Date I Number I Signature WATER Plumbing ROUGH PLUMBING 4PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE - UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. . - • TRENCHES U FORMS U STEEL REINF. 0 FLOOR SYSTEM • BOND BEAM STEEL REINFORCE FT SHEATHING • FRAME AND FLASHING LATHING — IN ri OUT n - PLASTER, BROWN COAT S -TURAL, FINAL Electric NG. VENT., REFRIG. AND A,C., FINAL ' PLUMBING. FINAL AND GAS TEST n. ELECTRIC, FINAL /J �)2'/r 77 ♦,` BUILDING, FINAL R/Jty� 24989 1 • �+ y r __ -p COSTA MESA BUILDING-SAFETY DEPARTMENT �+IT9 OF OS AIr.JI1 P.O. BOX 1299 COSTA MESA, CALIFORNIA 92020 0E0101965 For Applicant to FM In Completely • APPLICATION FOR PERMIT TYPE OR PRINT HuaDINa p P4 , IPA���} ADDRESS/�/ ',A',A.?Lp�.rljA9/• .`— RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA /1 24989 RECEIVED BY DAT RECE ED DA ISSUED Cd /1 1/v 6s, i 2//o/6,4 OWNER IAA", /La. P// ADDRESS _ 4a •sa ADDRESS JS9 F�IPC ES /Q L/hI MAIL. fis BUILDING //�� Q (FIRE4,1 .4 CITY C�, NoorX-iiv, ZONE GROUP—/ //ARCHITECT TEL BYPROVEDDATE / ,�//O/ 4OR ENGINEER NO. 777NING ADDRESS ZON 1 NO.OI W[OFNEW .l ��/ I PLAN[ Z I BUILDING CONTRACTOR g♦ rr�, ,�j�yi..�` /^ /l LEGAL 4OY d3 rl/L /- 6 S K ADDRESSS/S 3 f 3 9'' (Y-L 70117! {.e�L.a DESCRIP ION /� ( ) 3 CITY / ATE ^ b fr NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIG.NOa?3C p 9 Nq e4KC../C�'y4 SO'TO SIDE ft REAR F.L. EAVES SIZE I NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON IAT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. o". (FROM C/L_STRCnt C SETBACK LINE FROM FRONT g O FP, 4.-V FT. CENTER OP STREET REAR YARD ,_ 'I SIDE YARD I LEFT I RIGHT R.SIDE / PT. _ . FT. DESCRIPTION OF WORK L SIDE // FT. PT. I REAR © FT. PT. NEW ALTERATION ADDITION DISTANCE BET. BET.MAIN B REPAIR MOVING - DEMOLISH MAIN BLDaH. ACCESS.SLOGS. BUILDING NO.OF VAR.# DATE SIZE ROOMS STORIES , C.U.P.# APPROVED COVERING ....-..— EXTERIOR WALL I COVERING STROOF FR �LAA/l/'(/' DATE /� 70 �J USE OF BUILDING AND WORK TO BE PERFORM'? /�� UF�WVJ��� {��/� - IL IFS `I /— 41 a ran./PI ..4 ..e.~.al (.M�.f:Fll r W i, 1 yn /6 1L 14 %. "Oz.ma/ en-i SQ.PT. I HEREBY ACKNOWLEDGE THrAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM.. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH AU.CITY ORDINANCES AND RATE REGULATING VALUATION �6 D BUILDING CONSTRURT191/� 01 IGNA�B�OF JJ�[ �� PERMIT FEE f C�� E f 5 D 0 PLAN CHECK S /�y� w ZED AGENT ' !, CO ._. .. ._... _. TOTAL FEE ; V uwNrn burHiurai, DALPAM .10-1U-0) JOB ADDRESS 159 Georgeann Street BUILDING PERMIT NO. 214-9$9 GENERAL CONTRACTOR Kephart & Potts DESCRIPTION OF WORK 6' Block Wall AP No. 119-052–t3 LOT TRACT FIRE ZONE VALUE $ 500.00 •( 'PECTIONS Signature _ Date GROUP ,7 TYPE III ZONE R-1 PERMITS ISSUED I SUBCONTRACTOR Gas pDate Number Signature ,^ Water Plumbing v Rough Plumbing Prop. Swr. Line O House Con. 0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning Tl Temporary Service or Pole Underground 0 Power p RoughenWiring/ / /I5 f.4?7 Heating and Vent. Trenches � Forms C/Steel Reinf. fid ((///��' Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing —In ❑ Out ❑ Plaster, Brown Coat S*--^lural, Final Electric ng, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final ,/� Building, Final p�•Yn v R I, 19299 FE F"�'EIV3ED .. COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE 2 o i P.O.BOX 817 COSTA MESA,CALIFORNIA - CITY OF COSTA MMEFSA For Applicant to Fill In Completely APPLICATION FOR PERlvlff TYPE OR PRINT BUILDING For Office Use Only BUILDING ADDRESS j.5 7 cae Lc sn.0Nar PL_ • RECEIPT NO.• �PEgpET"p0" COSTA MESA, CALIFORNIA Y J]]T'((JJ.�.''(LJJ.((�t77J] • ,/ /� /J' RE E 11,7 773 DATE ISSUEt OWNER KO L..C_o C-0,--,S C� YY//////!!//IYY// .4.1.D JIL /�L_V� _ BUILDING MAIL ADDRESS ' ADDRESS n3 L� 17-Tff - ' - FIRE TEL. ZONE TYPE GROUP cm, Co 0-61 It-i E5 - NO. ,�//���� /�77 ARCHITECT ( - TEL. l ,). BYPROVED .. ,ATE 3p2- e OR ENGINEER S" NO. ,_J// M ONING -GAJ ADDRESS ZON'� NO.OF �.'T USE OF NE - n '' .I PLAN: .2.... ..I BUILDING CONTRACTOR _ 'c: c 2 .co - 5 O LEGAL -air � 2 DESCRIPTION'' ADDRESS X71> 3 g,,,-/ ✓� pT LJI� L✓`17 • CITY ' J GFA- Q 0 5.7,4 — A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATELIC.NO. NO. 6`"IO 3 ./ 3O' TO SIDE @REAR P.L EAVES • SIZE I NO.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT • YARDS APPROVED YARDS APPROVED • USE OF I MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. '-`J. (FROM C/L STRE ) EN • I •� RK LINE FROM FRONT C FT. � CENTER OF STREET REAR YARD SIDE YARDI LEFT - I RIGHT - R.SIDE !/ FT. FT. DESCRIPTION OF WORK L.SIDEj' FT. • NEW ALTERATION _ ADDITION REAR ,✓/ Fr. DISTANCE BET. BET.MAIN Be REPAIR J�,{/1 MOVING • DEMOLISH MAIN BLDGS. ACCESS.BLDGS. 1 VAR.# DATE BUILDING NO.OF SIZE ROOMS STORIES ' C.U.P. #p yam// • APPROVED EXTERIOR WALL I COVERING ROOF BYPRQ(/lJ • : O� DATE 3 a"94 COVERING USE OF BUILDING AND1'WORK TO BE PERFORMED I/ 17/ I I4F1T1 ALi. '�E“--) . i z ..,KiPicrTI c#3 ff . • t2kJ Ilei a1.17 f3c--p G— N - SQ.FT. B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IB FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION.• [J 0 d C. � L G LIQ,,, PERMIT FEE $ D SIGNATURE B PERMITTEE C. Z / DD" 'LAN C EC. e+5-0 B AUTHORIZED AGENT /�� r TOTAL FEE - .7 OWNER KOLCO CONST. CO. DATE 4-1-63 JOB ADDRESS 159 Georgfanne Pl. BUILDING PERMIT NO. 19229 'ERAL CONTRACTOR " Chas. C. Warren & Sons VALUE $ 1,500.00 A.. No. LOT 3 TRACT 469E FIRE ZONE DESCRIPTION OF WORK Found.undderr eel INSPECTIONS Signature DATE GROUP J TYPE 1/ ZONE Rl g. s3 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water 1l Gn,/ -P „o $L Rough Corn. Refrig. ❑ Air Cond. 0 7, ; 44.elle° l j .4 „ ,10 7 ' Rough Heating a., / n n i 1 Rough Plumbing effidiscellaneous .,_,(hckfioGJ i.' ry( -2dt yo _7-30-,C.3 375[2.2. Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power r..] _ Rough Wiring '/ -e J Trenches 0 Forms 0 Steerrtelnf. 0 ---q-X1 3 -1`s, It' Floor System _,-, rr Bond Beam 0 Steel Reinforce 0 i I J 1 IP • S'--athing - ' FI !' iY e and Flashin / ,/���� Ok ' nh;a ..mg m Out PY f r en a' --LL " 103 n , . /1 ' „Q'v Plaster, brown coat - ti I ' J' Ref rig. 0 Air Cond. 0 Final -_n ,it'.3 Heating, Final n.7,i b I Plumbing Fixtures, Final s//aci 'f 3,f 27 6�-yid . /0 -i,%- ' 3.fix/0,,✓ 7/' t o ' Final Gas Test Electric Fixtures, Final _ Building, Final TX.e, 047)-C3 OCCUPANCY FORM 13L14-5M — 7.61 19229 • 175 #h, FEE RECEI . .LD COSTA MESA BUILDING-SAFETY DEPARTMENT JUL 161932 P. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT. Far Applicant to Fill In Completely • gPik TION'FOR"PERMI0 U' � j TYPE/�jORPRINT , BUILDING ADDRESS /J/'/ 4-e- fr lS Q G„X• .9-1 . COSTA MESA. CALIFORNIA�/� For Office Use Only / I Z_ / RECEIPT NO. P1RM/ . mping OWNER , lMJ`1(�1 • RECEIVED BY I DA _ - P�REC EO-ci D - 186 D • ter•`4, BUILDING ADDRESS ENGINEEROR ARCHITECT a • FIREAC�'OSTAtESA. CALIFORNIA D //�� • ZONE gp/v.V Jg TYPE GROUP CONTRACTOR ,I lam{]' APPROVE 01 S�j DATE ADDRESS CCwyw\ BY ��I 1 ZONING _ ZON ) -MOANS USE OP NE'12424 CITY _L/ PLANB� IBUILDINO , STATE rI A Q 7 4�EL. LEGAL �� ' 2 , I - r/ LIC.ND. (/(i• / •-� NO. ` DESCRIPTION I-V SIZE /I”K PS,.4 y X39.8Y (NO. OF BLOCS. / OF LOT its/ a 6 X s0AA. E I NOWON LOT ' A.P.NO. --------- USE OFS , YARDS EVES EXISTING BLOG..� I Q. cf _ ' APPROVED ALL D SETBACK LINE FROM (CENTER LING ST.) ``J /,L-(M8 CENTER OF STREET REAR YARD FRONT / FT. IN. SIDE YARD I LEFT I RIGHT R.SIDE 6 FT. R IN. DESCRIPTION OF WORK L.SIDE 3 FT. IN. NEW (I ALTERATION ( I(AD TION I . REAR D FT. ''] / IN./' REPAIR II MOVING DEMOLISH ( / APPROVED DATE L l ^('J Z SIZE DING .24' ROOMS / '-STORIES // . EXTERIOR WALI,,�- 77 ROOF �/ ` COVERING 5/ece VI COVERING 5-41/4 /`J ` '. S USE OF BUILDING AND WORK TO BE PERFORMED t di �C��'�-(.t..�0 lam.✓\' / I c nac / /VAgyJ- �l • / , p I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ROMANCES ,ND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING cowBTRu ICN. /. �l n VALUATION SIGNATURE OF n // /IL/A'//.ltU�{jn�"f•/•,-✓I` w^ PERMIT FEE $ PERMITTEF /7d(� CV VirI S 'a--• PLAN CHECK $ AUTHORIZED AGENT TOTAL FEE . 9 ----'I I OWNER K0LCO CONSTR. CO. DATE 7-16-62 I JOB ADDRESS 159 Georgeanne P1. BUILDING PERMIT Na 17563 yt 'IERAL CONTRACTOR Koko Const. Co. VALUE 300.00 ;) AY No. LOT 3 TRACT 169H FIRE ZONE DESCRIPTION OF WORK Reloc.det. r gg rt INSPECTIONS Signature DATE GROUP S TYPE v_ ZONE R-2 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. ❑ Rough Heating Rough Plumbing ? a,-�-J�w.�� a ,'/•n �, t/ i_ ,y r-, p C� 7 Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. ❑ Sprinkling System Construction Pole . I • Underground 0 Power ❑ l.: Rough Wiring Trenches U Forms U Steel f. 0 �/7 -- ( ]/ i\ ja ./ Floor System V'. Bond Beam 0 Steel Reinforce ❑ _ ,r A •1�` 1 y o,_.,athing a1'-!a ` t s . .. v7 Ah ne and Flashingj� (� I ° 11 N Lathing — In 0 Out �'j O 7'1 /Z + - 6._2-' 1 I,,/ i Plaster, brown coat The 12 -- -IC .1 6 Y . a" "V �'Y ,t; Refrig. 0 Air Cond. 0 Final '/ ALP N . ! Heating, Final 7 " \' Plumbing Fixtures, Final ` r,r 0 \1 Final Gas Test l Electric Fixtures, Final Building, Final '71;15 (p yo•C. _ A`\ OCCUPANCY FORM 8U4-5M - 7.61 1(56j 17736 . FEE REGE. _ cD ' - AUG 3 0 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE OEP1.CITY OF OA ``A ``11� For Applicant to Fill In Completely APPLICATION FORE PERM PERMIT TYPE OR PRINT ;BUILDING BADDUILRESS DING 151 //.fitq Z_-_ r, Pi • COSTA MESA.'CALIFORNIA For Office Use Only T JJ RECEIPT NO. PERMIT,_NO.. OWNER fj(I/y �. • / 77���/ MAIL y/� / ECEIVEO/BVAJRECEIVED ATE 1990�j_D ADDRESS C.. / 7 ( �10� ✓(�X�' I o./.cry er 7n. TrT,I4 ,P0 4Z - BUILDING /i-(J �// ADDRESS/�J % �.ARCH ITECT TEL. CY�/ OR ENG I NEER NO. COSTA MESA. C-.IFORNIA ADDRESS ZO E /- - TYPE V GROUP �/ // / ZONE {J� q CONTRACTOR / • �• BYPROVE. / /DATE G/�(J 6' 2— ADDRESS S ZONING ///y CITY 7 /���-/I�{�,/�i - L /./� 1, ZONE_- Z II/�PLLAAJ(NSP 4 BUILDINGDEW�f{ LLI TC TNO.E 2 ✓ ." /2(1 NO/` I SiO / 6 tri, DESCCRRIPTION k • 3 7K J �d .fy._ _"t SIZE �� 3h PbI NO. OF BLOCS. d OF LOT IJ Y 1 ( k Per NOW ON LOT A.P.NO. USE OF A, \ „Q_ 2 " l''lyp YARDS EVES EXISTING BLDG. 'JA/)t-jYl APPROVED ALLOWED ' SETBACK LINE FROM f ( ci I4 (CENTER LINE ST.) (-_ CENTER OF STREET l%OH�Lw Z REAR YARD / +( FRONT �0 FT. IN. SIDE YARD I LEFT////c' '' I RIGHT Cle R.SIDE /74 FT. �� IN. DESCRIPTION OF+ WORK L.BIDE // J� s� FT. N. F� NEW I ALTERATION f\ ADDITION I 'I. REAR /T it k-d *F/ Tt/ IN. REPAIR / I MOVING (DEMOLISH I BYjoin PROVED � DATE COQ/�L•'f BUILDING 12.X.)10. / D� NO. OF A' STORIES / ' EXTERIOR WALL. - / I ROOF II, .g COVERING O_M_ fAI COVERING U al- USE OF BUILDING AND WORK TO BE PERFORMED 7 Y/4 IO LEW DG¢ THAT I HAVE READ THIS APPLICATION ' HEREBY ACKN THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRU oN. VALUATION SIGNATUR OF A / fin PERMIT FEE S 7 44-.-"C" PERMITTEF '(��� !!l ��_"`���Iyn v �/ �J S �[ _O IZa ye / S / / V. PLAN CHECK S 7 ' '- ,AUTHORED AGENT I V / Jy—Q TOTAL FEE - a „ ,r z f. 17r •,S- /r -4L9 4. /7s 6 a-Gz. OWNER KOLCO CONST. CO. / PS' �� y DATE S-30-62 1 JOB ADDRESS159 Geon e P1, BUILDING PERMIT NO17736 TERAL CONTRACTOR Kolco Const;. CVALUE $ 1912.00 He No. LOT 3 TRACT FIRE ZONE DESCRIPTION OF WORK COnV.Cpt to INSPECTIONS ' Signature DATE 1 GROUP I TYPE V ZONE$-2 1F''� Soil PERMITS ISSUED Gas SUBCONTRAC'1'OIL DATE NUMBER Water Rough Com. Ref rig. 0 Air Cond. ❑ Rough Heating 7a ct _ /-3/-1p3 /a 9.6_ ikRough PlumbingMiscellaneous l rOi7=63 3 9S 7Prop.Swr.Line ❑-House Con. fd-St.Swr. L7' a t /•O�f fjC �- ��-�-i.--Y- ec.c.✓S' et/ L(l( Z f LI rt- Ili^7 Sprinkling System Cm. Pole 1..1 Underground 0 Power 0 s Rough Wiring /C� .d f-” 2Yr 3 .94-0- -['it�����-,f�X�IL�O /-go-43 ' / W. Trenches ❑ Forms 10 Steel Rend. ❑ � -_ y —.S y 1 Floor System .t-. .,, ,r/ 1 Bond Beam 0 Steel Reinforce 0 9,f ,ff tiatt.FiL gi... 1st—e. ii n vthing • !: .e and Flashing G X- i!' / ._.ring — In 0 Out to - A'd 4-1 � b j_2-A 6 24 , , Y i I Plaster, brown coat I � . 1 ,j- if 1 q tieing. 0 Air Cond. 0 Final 4) ,f , v't f C Heating, Final �V 71-'4.3ff47 It' /6' Plumbing Fixtures, Final /-/7/ 0•/k^l i , I l OSf` Final Gas Test 14- //�� Di 6/c"J2-/.7 V) r1 Electric Fixtures, Final //�f7/� /(',r. .3 I/ If Building, Finales /trio"C-3 OCCUPANCY_.-0-\_-----1—' ' / -- FORMRM BU4-5M -- 7.61 ✓ " _ - ' S 1 1 J�+ COSTA MESA BUILDING—S .TY DEPARTMENT , P. O. BOX 1200 4036 8/27/61 7.00 TL • Costa Mesa, California PERMIT NO. PLUMBING .PERMIT'APPLICATION TRACT NO, RECD. BY YeL 73¢ CONTRACTOR TµE CRRL5 aumbI -knC- LOT NO. DATE ISSUED BUILDING USE o d� d�fi/ Address 1;33 W . LlMWI-PI A City R N n Fly I rnZip Code q0,8 a Building 1 S9 L-EUKG C Ft) 0C Address //��� State License No. (21-7 (es/ Class. c-3(, Owner LUN b .BU Q l7 • Lu City License No. S9 3 Tel.No. 7')d-397D Mail 50 (,r�o Rc,t 14tJN( l— Address < NUMBER TYPE OF FIXTURE OR ITEM FEE 1- CD�IfMe.54,11-c k)p Tel.Noi9G -AD.(2 0 - Bathtub City J Laundry Tub or Tray I hereby acknowledge, that Ihave read this application and Q state that the above is confect and agree to comply with all -Automatic Washing Machine City Ordinances arid'State Laws regulating plumbing. Shower I certiNtliat Ihpossess the above valid State of California classi- Sink, Bar ficalioh orV am the legal owner of the residential property de- cc i Sink, Kitchen scribedobove. W Wash Basin(Lavatory) �(� I certify that I have obtained a permit from the State Division of C. - 1 Industrial Safety for excavations,other than swimming pools,five • Water Closet(Toilet) O _ feet deep or deeper and into which a person is rquired terdescend. CC Drinking Fountains Art, \r IV'p_ Signafu/e of. p^ '/ V C -Floor Drains .,i ,s It Permittee Permittee Int?- f1.�.S- num i 1')ij' 1 1ci ci Z Interceptors '4y ,'„,i" C/ _ -Receptors ,. t/ `, t INSPECTION RECORD Sinks,Commercial orfriddstrial .Sinks, Floor ..in t ,_v _Sinks,Serviep g -- )I SwimminePcoi" CC WUrinals) ' C ''1l Dishwasher CC p•• Garage Disposal ' 7 _Water Softener n I _Water Heater and Vent y 00 Gas System.. .Outlets... to -Roof Drains APPROVALS CO _Water Piping Alteration INSPECTOR DATE I _Backflow Preventer U/G Soil I I— Lawn Sprinklers(Res or Non-Res) • U/G Water I Property Sewer.. . Feet Services—Water 0 Gas 0 I Solar Piping _ Rough Plumbing _Cesspool,Septic Tank Sprinkler System Sewer Cap Gas Miscellaneous Property Sewer Pool Rececle ptor Filter System • l x Sub-Total Pool Heater 1 Reinspection Fee Miscellaneous .. O Processing Fee 3 op -' Final Gas ��� TOTAL FEE I ,7I 00 Plumbing Final , Utility Co. Notified rlr t -- 9 CMF 0450-46 BLDG. PERMIT NO. Al/e-----1 le • NE./0 /VA co& Dirio.0/4)6 /00 COrN PRF 550 kleTt, Hi- in/a . ZS y N tri . tOitiDeW S eLeCrr/G 7.7,-A-)eL - c 2 'iv CealQ6- cgsSum pub f�aoi2 b . �/+STfC l3fni10a�+1 . GARS GE /FRoiuT tom CITY OF C;. STA MESA PL;NNiNG DIVISION SUBJECT TO BLDG. DEPT. REG. NOTE: ADDITIONS, DELETIONS, 51' _ OR CORRECTIONS SI-FALL PE - ` PE APPROVED BY THE PLANNING DIV. BY: -71E: lq - � (-4 At @ ch_ /C9 GEleg_eE.a_Niti., __. P-1-- - --.- - ry • • •