HomeMy WebLinkAbout969 GOVERNOR ST - Building Permits(714) 754-5273 • Fau (714) 754-4856 • www.d.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 969 GOVERNOR ST
Suite:
Vicinity: ROOF
Parcel Number: 42242404
Applicant: ALLEN, MIKE
Address: 537 NEWPORT�CENTER DR
NEWPORT BEACH, CA
Owner: BOWLES; KATHY VARLEY
Atldress 2438 MOUNTAIN VIEW DR
ESCONDIDO, CA
Contractor. ABOVE IT ALL ROOFING
Address: 537�NEWPORT CENTER DR
NEWPORTBEACH,CA
Zip: 92660
Arch :
Address:
Zoning:
Phone: (949)673-9222
Zip: 92660
Phane:
Zip: 92027-4929
Phone: (949)673-9222
License: 765842
, Eng:
Address:
A
Status: ISSUED
Applied: 11/19/2002
Issued: 11/19/2002
ISSUED BY: / �
� � Phane: � � - Phone: �
Zip: License: License:
-. SCOPE OF PERMIT-
REMOVE EXISTING ROOF. INSTALL 30#.FELT ASTM, CERTENTEED, 30 YEAR; COMPOSITION SHINGLES. 2,400 S.F. INCLUDES ATTACHED
GARAGE. � �- � � � - ,
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$11125
$0.50
$0.00
$0.00
$0.00
$111.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existina: o
FEE SUMMARY
— Calc Valuation:
Claim Valuation:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Lek 0- 0
Left 0- 0
, , Praoosed: 0
Right 0- 0
Righl 0- 0
$a,soo.00
Sa,80o.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: 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 inspactlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
a�r.ae 1�'oa)
WORKERS'COMPENSATION DECLARAnON:
I hereby aHirtn unde! penalry of perjury one oi ihe following tleclarations:
❑ I have and will maintain e cetli}icate ot consent to self-Insure for workers' compensetlon, as provided for by section 3700 oi the Labor Code, for the peAormence of the
Lwork for which ihis permit is issued.
,IN l I heve and will maintain workers' compensation insurance, as required 6y section 3700 oi ihe Labor Cotle, tor the pertormance of the wodc for which this pertnil Is issuetl.
fMy workar ' comR nsa' n Insu% �n e� carri� ntl policy number ere:
Cemer:. �� ��`—I ��j 1�[_J N I/ policy N� be ����
�(7iris section need nnt be campieted ii fhe permit is velued at one hundred doilers ($100) or less.) ---�� �
❑ I certify ihat in Iha pedormence oi the work Por which this permit is issuetl, I shall not employ eny person in any manner so es to 6ecome subject to tha workers'
compensatlon laws oi Celi o ia d ree thet Ii I shoultl bacome subJect to t�e workers' compensation provislons of Sac' n 3700 ol ihe Labor Code, I shall torthwith
e Comply wiih th�se p vi ' � ��/�/�
�Appliwnt'Signature: ? Date:�1 C_��
WARNINO:�FAILUFE TO SECURE WORKERS' CAMPENSATION CAVERApE IS UNLAWFUL AND SHALL SUBIECT AN EMPIDYER TO GFIMIN PENALTIES AND CIVIL FlNES UP TO ONE HUNDFED
TFK)USPND OOLLARE (5100,000), IN ADDITION TO THE COST OF C,OMPENSATION, DAMAGES AS PqOVIDED FOR IN SECTION 3]O60P THE LABOR CODE. INrEREST, AND ATTORNEV'S FEES.
LICENSEDCONTRACTORS DECLARATION:
I �are6y affirm ihat I am licensetl under rovisions of Chapter 9(commencing with Section 7000) of Division 3
,force'end effect. Lia � ���y� _ �
� �recmrs Signeture_��` _ �
Class #
Cotle, and my license is in full
CONSTRUCTION LENDING AGENCY:
❑ I hereby aMirm Ihat there is a construction lending egency br the pedormance ot Ihe work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender'S Address:
Signatura:
OWNER•BUILOEN OECLApATIONS:
Date:
I hereby aflirtn Ihat under penalry of perjury ihat I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for ihe tollowing reason (SecJ037.5, Business end Professions
Code: Any ciry or coUnry which requires e permit to construct, elter, improva, tlemolish, or rapair any strucWre, prior ro its issuance, also requires Ihe applicant for such pertnit
to file a signed statement ihat he or she is Iicensed pursuent m the pmvisions of the Con(rectors License Lew (Cheprer 9(commencing with Section 7000) ot Division 3 0l tha
Business antl Profesb�ons Cotle) or thet he or she is ezempt ihe�efrom and ihe basis for the alleged exemption. Any violation o� Sectlon 7031.5 by eny applicant for e permit
subjects the applican� m a civil penalry of not more ihen fiva hundred dollars ($500).):
❑ I, as owner of tne pmpeny, or my employaes with wages as iheir sole compensation, WILL DO THE WORK, and ihe sWCWre is noi Inlended or oHered for sale (Sec.
7044, Business end Professions Code: The Contractors License Law does not apply to an owner of properry who builtls or improves ihereon, and who does such work
himself or hers�lf or through his or her own employees, provided that such improvements are not Intentletl or oHered for sele. If, however, Ihe building or improvement is
sold within ona year of completion, ihe owner-builder will have ihe burtlen of proving that he or she did not build or improve for purpose of sale.). �
❑ I, es owner oi the property, am EXCLUSIVE�V CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The wnvactors License Law tloes not epplY �o an owner ol property who builds or Improves ihereon, and who contracts for such project wlih a comractor(s)
licensa pursuaa< <o lhe Contraclors Liceosa Laws.).
❑ I am exempt untler sec. Business and Professions Code for ihis reason:
Signature: Date:
Ownar ID verified by d��ers licensa. ❑ Ves ❑ No Dnver's license No.
Verification of OwnerShip by (type ot tlxumenL i.e. - property tax bill or deetl):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity �hat no excavation five (5) or more feet in depih into which a person is requiretl to descend, wlll be made in connection with work euthonzed by this
permit, and ihat no building structure, scaflolding, talsework, or demolition or tlismantling thereof, wiil De mora �hen ihirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
341, Ttle B, California Adminisirative Cotle).
❑ As owner-builtl��. I will not employ enyone to do work which would require a pertnit irom the Division oi Industnal Setety, as noted e6ove, unless such parson has e
permit to do suCh work irom Ihe division.
Signature: Date:
Division oi Intlusirial 5afery Pertnit Numbar.
CERTFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTHV: I certity under penalry of perjury that I have reatl this epplication antl state that the inFormation given is
correct I agree to comp�y with all state laws entl ci�y ordinances relating to bullding consiruction, end authonze representatives ot ihe Gty of Costa Mesa to enler upon iha
ebove-described pmperty for inspection puryoses. I egree not to occupy or allow wcupancy of any building authorized by this permit until tinal inspection.
CQUE !, INSPECTIONttPi
1616 Fixed Systert� Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roa�
201 Final Block/qetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final DemoliC�on
INjRJO� QQpg1 INSPECTONTYPE
206 Final Mechanical
f1/ "� �
208 Final Plumbing
210 Final Elecirical
212 Final Fire Preventi0n
220 Final Planning Approval
222 Pinal Site
250 FinalBuiltling/Occupancy
Qdff 1HIDeL$
1
�
PflOJECT AOOFESS: 9( 9 GOVERNOR ST
OWNEN'SNRME: CORBIN KATHY R
aooeess: 658 JOANN ST
COSTA HESA,CA
631-5187
pptH/ENGINEEN:
FOOPESS:
UNIT:
. w,
92627
HEG.NO.:
UNIT:
PEPMITTFE: AKS ELECTRIC ( 714 ) 641-3550
nooeess: 1315 EAST ST, ANDREHS PLACE C
SANTA ANA CA 92705
LICENSED CONTflALTOH �ECtAMT10N: I �ereUy allirm Ifut I am IicenS¢E un0er 0«b^5 0l Chapier 9(camrtrenting vrith Seclian
7000� at Drvision 3 0l Ine Busineu antl Pmiessions CaOe. anC my license is in lull �orce an0 eliecl.
CIiY LIC.: Q IJ�� �TRTE LIL.: 4 8O Z z Q -('� CLASS: 1�
/ 'l7
� 9 s�9�aw�e: _e� —
W08NEP5'COMPENSATIONOECIABpTION: I�ertUyaHirmttull�aveacenilicatealconsenitoseli-insureoraceR Workers'
Compensalion Insurance, or a cenilie0 coOY �h¢reo� (Seciion 3800. LaO. C�.
roucvxo.: WP80540504 E%P.ORTE: IO/OL�9Z
comvaxv: FIREMANS FUND
�I Cenifiee copy' Aereby fumis�ea. � CenifieA copY is IiIM xit� t�e cit BuilEing Division.
. %/ Applicant: "
E%EMPTION Fp M WOPKEflS' COMPENSATION OECLAMTION: (ThiS uction neM mi be compkltd iI Ne permit is iw one hu � tlq) o less).
I cetlify Inai in Ih¢ perlormante ol �he wOrk �or w�ich ��is permi� i5 i55ue0, I Shall no� employ any p¢rson in amr ner 5o as ecome I
subieci �o ihe Workers' Compensa�ion laws ol Calitomia. �
Da�e: Sipnalure:
NOTICE: II, ali¢r making I�iS tletlaration. you Shou10 Uecame 5u0i¢CI lo IAe Wofkefs' Compensatian pmvisions of �Ae LaOor '�,
CoOe. yau must lon�wi�h comply wit� suc� O�ovisions ar tNs Dermii slwll Oe OeemeO rewked. '
CONSTflUCTION LENOINC RGENCY: I �ereby ailirm Ihat I�ere is a wnSirucli0n lentlinq aAenty br ��e pedormance oi the work �Or
whicn Ihis permil is issuea (Seclion 3097. Civ. C�.
lENOEN:
RODflE55: �
OWNEfl BUILOEN DECIAflRTION: 1 �erz0y a�lum I�ai I am e�empi �mm t�e Contratmrs' Slaie License Law br t�e lallovnng reason
�Seciion 7091.5 Business anC Prolessionai COGe: Any city of wunry wAic� repuires a permii to wnstmci, alier. imprme, tlemolish, or
re0ai� any 9mclure. prior lo ils iuuance, alw RQuires ihe apWiGnt lor suU permit lo lile a siqneU slatemenl ihat �elshe is licensed
pursuam �o ��e provisions of Ihe Canira[Iori Slaie License Law (CIuO�er 9(cammencinp wit� Section 7000) ol 0ivision 3 of the Business
ane Pmiessions Co0e) oi ilut nGsne a e.empt Inemlmm aM ine Oasis tor tne allepeC exemption. Any doWtion ol Section 7031.5 by
I any aDPlicanl lor a permit suEjecis ��e appliUnt lo a civil ce�ally ot nol mote tAdn fMe �unUr¢O tlallars (SSOfI).
I. as ownei oi me o�ooeny a� my employees vnt� wapes as l�eii sole compensatim, will tlo �he vrork, antl the
❑ strucmre is no1 imeneea or anereG lor sale 15e�uon 70a<, Busineu an0 Pml¢ssional Cade: The Conirac�ars' Siate License Law
aoes not aDoly lo an owner ot a o�openy wM euilas or imOroveS Itrcr¢on, an0 wl�o GO¢5 suctl wOrk IlimSelUherself or throupn
hi5 or her awn emDloyees, o«dea IIWI sutli imprwemen6 aee not intaM¢0 or ollereE far Sale. If, however lhe Ouiltlir.q ot
impmvemenl is 5a10 wi�hin one year oi completion. I�¢ owner wiA have I�e OurOen o� provinq ANshe O�A nol builtl ar improve
lor ine purD�e ol salel.
I. as owner at �ne D�openy, am eecWSiveN camrac�inp vnt� IicerneE comracmrs �o mrrsimcl ttre prqeci (Section 70a4, Business
❑ and Pmfessims CaOe: T�e Coniractors' State Lice�e Uw Oces noi aDdY �o an o-xnu of D�ceM � OmIOs onmproves t�ereon
aM w�o tonlracls lar suc� pwje[ls wiN a Conlracio��s�license Dursuant to tlk fAntrapors' Sia�e License Law�.l am aware
��al Omol ol I�eir Worker 5 CAmp¢iRdiqn i�Ruranca s�0u10 be prOvq¢0 10 m¢.
� I am exempt unEer Secuon: B. 8 P. C.
lor Illis rea5on:
Daie' Owner.
1 ao nere�y cenily tha� I am awdte ol anG unOersldn0 ine reauiremenu ol Cdlifornia Hedlth an0 $alery CoEe Sections 25505, 25533. and
2553d antl I�a11 or any iWure OUAUinq occupani vnlUvnll nol (Lircle one) nK0 lo LOmDN m�h sai0 slaie C00l5 anA Ihe reQuiremenis lor a
permi� �or consimclion or rtroUilicalion from Ille Aif�l dlliy Ma0d0emenl USVKi. fl¢Si0¢niNl fAnSiru[tion appliWiiqis are exempi from
��ese prOvisions.
o��e: aovi��a��:
I hereby cetltly Inal I nave reaa inrs apolicalion ane slate inat ihe aeove information is torrecL I agree lo como�Y `M�� all city and county
or�inanteiandS�aleldvrsyrelatinglOOmlEmg[an5irutlionanQlrerety`�\au�lpr¢ecepre5enlativ¢So�itisdrytoenterpu.p_o.niheabov¢�mentionetl
prooerl�I%SO�Y/ �/�ses c�,.�,��..e. C /✓ 71+--1'C( ✓\ //..Gri(�
�river's License or Social Securiiy p: �
I6aL46 W�i�e—Butleing: Green—CODe Enb¢emenl: Canary—ApO���ani: Pink—Revenue
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05497
PERMIT NO; E 054973 PLAN CHECK NO; N GOVT; Y SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE; OTH
JOB DESCRIPTION ; SERVICE CHANGE 6 CONNECTION SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: *�* CITY PROJECT NO. 91-07 *�*
*�t*�t***�r*x��t*+r�r*�r+e�r�t�t�r�t�r*�r***�r�t�r*�t*�r�rr*�rx***�t�t�t**+t**x���t**�t�e�rx**�t�r�t*x*�r**�t**�t�r*x�x�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT ' IN
PARKING REQ• PROV: PARCEL; 42242404 ZNE; REF NO;
PLANNING NOTES>
)
kMififiFMfFlfkiFifMkikkiFiFiFitMkikkiFkiFiFMiFiflfk�FlFlflFitiEifMifMiFkikifiFkMifkifMkififMkMiFkiFlfiEiFiFifiFifklfifiFiFiFifiEiEif
D E V E L O P M E N T S:`En R V I C E S R E(a U I R E M E N T S
ZONING APPROVED BY " DATE:
BUILDING APPROVED BY : �' n DATE; _
MMMikifikkiFff�fiklfififlfltMMMiENifMMilMKifikikifiFiFiFMfFMM�i'�I�M�FMkififiFkifikklfikiFMk�fMMlEifkMiEkifM�fitiFkMlfkit
LEGALIZATION;N F.''fi E� S U M M A R Y STRUCTURAL SEGMENT;N
� BLDG PMT PLUMBING ELECTRIC NECHANIC FIRE SMIP/RES GRADING
PERMIT 18 SO
SOi SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 0.00 0,00 0,00 0.00 ,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: ,00 OVEA/SHORT: ,00
BLDG PMT PLUNBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CNECK
iFMkiFifiFkiFiFiFkifiFkkifkkkiFlfltikihkMitkifitkitiFifkififiFififiFkifiFifiFkMifM!!IllfiFiFilMkMkiFMiFififMif�fif�F�flf�F�flEkMkiF
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP - 18,50.: - 18,50
END OF FEES ' ': ,
' EYEfiPTIC�J !�c'RiF1ED.��_
, ��
CONSTRUCTION AND PLANWING p��� "PA
APPROVALS Permit # Date Inspector APp�OVALS Permi* # Date Inspector
1. Temporary Electrical ServrF"'ee or Pol,e�,,, 52. Pool & Equipment Locatmn
2. Soil Pipe-Und�grnd. x� 53. S[eel Reinforcement
T
��"yf�ctrt�l Con�iF���ty�Cndrgrnd�� 54. Forms '
�' �,�4..E�tricol Condai��etdrgrnd. vt+: 55. Electrical Bonding
C 5���e1 �eintorC2�',,�t� � � Jx 56. Rough Plumbing & Pressure Test �-
�
lT� ctrical UFE�., rnd. x „ 57. APPROVAL TO COVER•GUNITE '
i
S�FF tings �'� �' 58. Electrical Conduit•Undrgrnd. ��
� Foundation � 4 59. Gas Pipe, O Undrgrnd., Test ;t'
0
=9. Water Pipe•Undrg'Pnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. �✓
10. Structural Floor .S�'ystem o 67. APPROVAL TO DECK
11. Pcoperty Sewer liin�& Hqnse Conrection 62. Backwash & Receptor•Final
��
12. 5L'wer CaP J' c i
.y y 63. Heater & Vent-Final
13. Root Drains ^v 64. Plumbing SYstem - Final
14. fiough Plumbi� •- 65. Electrical-Final
1S� Rough Electri •Conduit 66. $olar System-Final
16. Rough EleCtrirWiring 67. Fencing & Access Approval
17. Reugh Wiring i�n . 68. APPROVED FOR PLASTERING
78. Rough Electri oAT Bar Ceiling 69. POOL/SPA SYSTEh1S FINAL
19. Rough Heating & Air Conditioning ' FIRE bEPT. REQUIREMENT
----�-f '_ .. - d-M .. 7 ^ lT H iL f-' G: :F H tT7 .
20a*Ro�h F�ctocY FGieplace i Ktn <L- y� O� a.w. ��pppRt�VA'CN�CPer�it #! �"'-
't i 7: x 5 '-1 7:1. t. � U; -
..i . r I ��G+ %. '�: 1-� y, .�, ciF' [` � � 'n
21�u�t,iniStf�ct .k � • i-,S � S v Fl"� � 70. �dergCn�v'H4�ro ;�
22� Ou¢c, `OdntRatin'��r � C:.S i �� S 1� +. �77. Produc `F�3iing [71�s C70i1
c � n .! -itv� .'1 (� L. ♦
23�Ga�"Pipi�toi�h&7,est � � �..+ � ���..x �72. Under Po �i� Flcr # c�
i p75 tTl T d.7* a� 9 t'" d 1+?i,. .� ;-.
24,:Roa: F�.nir.3 *; i FF-� >> v^ a� k� 73�Undergrn� Stor6g�'f kna �t7 Gas O Qr1
'! E N s K �7 O Na' � �7 �-+F t�
25. Ro�$I�thiOg .. � y.,� C�,,��.* 74r;OverheadXlYdrq� _�,
26vT- Ceilin (St�uaural) &�iwiecoat �� cD ` Mx .r S�r
�f 9 � 75Q'Dry Chemical - x�- p N
H^
27°fr e Flash' a ' .� � .�: � ' �± OS * S m'z
.� � � �� ..^.t�cK � 7 > n:� r� 76' �Dry Stan`tCt."*.e Fcr � �+
� a .. . �_���_L`
�..�8. La in Sidin� � i y��x cX a 3: ••.t .v. 770� FIXED 9Y9fEN:S1NAlt !�
=,:_. . . �
�� � _ . .. � ». [q � X � Y� {U
�'29. Insulatiy'n �;* r� .. q� � � 78s+...FIRE PflEV. FIIjJFr� a� r�
cV*'30. Drywall Nailing r K �� ? �� �-+ �EQA�TFhDEPTF R�QyIR6MENT
-r
�'31. Plaster ^ow��Cciatw S � ��� * , � 7^�FINAL If�P.�CTI�N *" � �
K
E,32trElectri Pmqerd7qtgr.;Finali ` E���/ � t,Ot�1FO0DC TIFkC['i,T�E IS6'ED ro
� r
n�� ' -' i
i r. � "' t/ -� n c,� �-; � r. o
3�i' Elgft� o;r m rL x���/ „'�i; tir-, w�7 :T�
�n','�34� fi H�siin�& ir, �dition�� ,1 y + i� .tv `.5 (�x x S U
�
� 35«Firtat G^ Pi�-Txst� ^o `± � H : , t�cu c�o C+S � �`' ;�tr
�36Tlioyd o��:anOPY . r [r'-7 � '� !'1 r � s_ iio ..` . i. •�, ;;r
,'� 7!=Firi'al FSCtory Fire�a'GE� ; FF y Y�
�-38. Firt2j Pfumbin9 # p� �•.•• � � w
::39. Wat2r Service-Fina * 5, 4 a #`t
�;fi0. Gas Service�Final ;. Y, ��rtr .s w t*.
FA7. Solar pomesticFinalS C� � •• �K �
r.
`'�42''Backflow Preventey: ` f�',',�. y; �
.43. Backflow Irt;[gation� V '�SS »�
,. a z
��4. Landsc�pe F�r�sipatioF SYsterr+� �� „� � �n
t---
>�75�Sound Atten'Latior* ^�CE- �'' Y >
rr � - :r
�46'�-landic�p Re¢ulati6�jis �� w ''
47>FlfytAL STR�CTUfiE & BUf,LDING �"
c T
48�IN�ALPI.A1dNINGx � :r�r
� �.., Y a !t�
o4�cfle�tric Release to�Edison i x
�
:`„50:SGa Fielease to Sou�hern Cali�e�t�ua Gas Co ;
:�51. CEA IFICA7E0 zOCCUPq,NCY ,.
No. Da[e
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I' OWNER BUNCH� JOHN DATE 5-zo-55
JOBADDRESS 969 Governor $'t. BUILDINGPERMITNO. 132�
��GENERALCONTRACTOR Gentosi BT'O8, VALUE S 850.00
i • 33
� GROUP I
IINSPECTIONS
Plum6ing, Rough to Slab
Plumbing, Rough Comple�
Temporary Pole
Wiring, Rough
Heating, Rough
� Heating, Final
�3ewer, House S�
Septic Tank or Cesspool
Latti'n9,ln I
�I ing
Plumbing, Final, Fixtures
Plumbing, Final Gas Test
Wiring, Final
Occupancy
N'nrm 'L10 l;-H � 5001-5:
TRACT 1872
V ZONE R1
DATE I SUBCONTRACTOR
i1CT !i»�
PERMITSISSUED
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Costa Mesa Building Department APPLICATION F]OR /P►ERMIT
--� •�� 1t7 EA3T.20th STREET �8 g U i� L D^4 � V �
- , - . COSTA MESA, CALIFORNIA
FOR APPLICANT TO FII.L IN FOR OF'FICE USE ONLY
/'1 Receipt No. Permit No.
Address L7C0 � NQ %a ✓ � �a �
Costa Mesa, Ci'dl1i01111SL Rec ed by Date Rec'd. Dato Issued
Nearest G ,Q.�- �//('iT�� / � 's o�0 -S ��� �-1
Cross St. ) Buildi / �j _ ��
Address (O .k$��N�P
Owner ' osta Mesa, Cie,IlfOPi118�
Mail /' /7 /� p
Addrcss (O C�G U'G �"1 � ��. Nearest �
Tel. Cross St.
City No. ZoneA � I No. of I Type I Group
n.r�.��o.,.�..� Lir._ � Plans � �
Address
City
No. of Bldgs. �
Nnwnn I n�
r
No. of
� �ri
;ri
Addition
Buildfn U ° f�, Fountlatlon Lxation Inspecto� ' Date
9 ,�+ " '"r� �"�� Forms, Materlals, i�
il / 1' .. er1 ..��P_O Under-Pinning '�
/ �- Frame: Fire Stops, j
/
Bracing, Bolta
�
Lath.lnt. �
I hereby acknowledge that I have read this Application � �
and state that the above is correM'and agree to comply ^ o
with all Clty Ordinances and State Iaws regulating Lath. Ext. v�
building constructlon. ��
Signatureoi ' � /� Plaster,tnt, r
Permittee ��if�+� ✓'=y � NR
/� ���i� / �_ Plaster, Ext
Authorized Agt. '�/ /�T"�'.rs� �'� :}
Mawnry Reinforoed U
Valu,ation Fermit Fee $ `. � O �
��..% Plan Check $ e Bond Beam i
$ � Total ^-� a
� Fee $ �, � � FINAL a � Q _��`�
Fa0.M 204 G•H 2M 9-34 �
PIAT PLAN
Show locatlon and distancea Trom
property line and between buildings.
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ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT �
. �/i
636 North Broudway . � � � p �' �-�"—'-
� � SANTA ANA, CALIFORNIA `
FOR APPLICANT TO FILL IN FOR OFPICE USE ONLY �
RECEIPT NO. PF.RMIT.NO.�
aoo E'S5 969 Governor St. ' r/j�j 5�+����•
,: ,
SCHOOL DIST. !� REC IVEO-BY DATEREC'D. DATEI6B4lD
OR TOWN yOBtA MBBH �
�Ros55s . 3tat e St . � j �Y 5 ��gq �y � �g
OWNER Blackfoot Homes If1C. nooRe�ss �'7��� �N"Ai�/_P/)�.AZ�•
nooaess 9363 W118h11`B BlVd. scxoo� oisr. �
OR'TOWN 1 ��
cirv Beverly H1118 No`eR 5w36i NEAREST : �
CRO55 ST.� f
ARCHITECT R IC ZONE NO.OF TYPE GROUP
ENGINEER �ain-Mc%errache�s0. � � , I PLAi15 �
ADORE552110 E.Walnut-Paaadena qppROVEDI ! �
�TRACTOR palb�a Vi$ta N0�43231 BV : D.STE •
� CORRECTIONS �
..00REsS � 9363 Wilehire—Beverly Hil e ' ! '
DESCRIPTION NOT �� BLOCK I TRACTIS(2 �---
fATTACH METES 8 BOUNDS�
SIZE OF LOT / O R ZO r I NOW ON LOT O
i
USE OF I NO.OF I NO.OF �� ' �
E%ISTING BLDG. Feqiues ROOMS H�Z r . o
CENTERNOP STREETM� �L Pt. SEDE YARD p�l ' " ' ' ' " ' ' - ` ' ' '
DESCRIPTION OF WORK °
�, y
�
NEW I I ALTERATION I I qDOITION I �'3•: ".� .`."�J iu. _,� V,'�f��. Z
D
REPAIRljJ 1, I I MO♦VING I[ I OEMOLISH I � � "� r
5 ZfE D j,� 'i B . P 4.ROOMS J STORIES 1
EXTERIOR WALl.,a. ROOF Qm
COVEfiING '.SYUCCO COVERING � ij� Q��.
'. OF NEW
�DING Residence-Att.Caroort
i HEREBV ACKNOWLEDGE THAT I HAVE READ THIS FI
APPLICATION AND STATE THAT THE ABOVE IS CORRECT U
AND AGREE TO COMPLV WITH ALL GOUNTY ORDINANCES FRAMF
BI
AND STATE lAWS REGULATING BUILOING CONSTRUCTION.
IATN.
SIGNATURE OF Ba1b a OlEta CO � �/TM.
PERMITTE
PLAST
AUTHORIZED AG � � �
PLAST
1' PHHn�i F!E S ��%% MA50!
VALUI�TION � S y�3 QQ »
� PL1N CNECK S �'S
BOND
FEEA� �G FINAL
I(1M ].fll.\9
INSPECTOR I _ DATE _ I
,� ! ,�
STREET
PLOT PLAN
Show tocotion and dstonces from
' 'propeYty line and between buildings.
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os a Mesa Building Department-
_ � �• 1t��E:�GT20th STREET �
� COSTA MESA, CALIFORNIA �
FOR APPI.ICANT TO P'dY.L IN
Building /+ c-F
Address � �� (J O U e IZ �0 I'� J r
Costa Mesa, California
Nearest St�T � � ,A � �
Cross St. t
pwner �� (` .�, �3 U I� C N.
Address 7 b / Go v � r Na E" .St
n Tel.
City (-OL� A K��S� No. /YO/y�
Architector �� lic.
Engineer No.
Address �_,,,_.��'/
O w � � � City Lic.
rtractor No.
�`�(�o�e�ivor-
Lot �7
No. J� � Block Tract
APPLICATION FOR PERNdIT
�103 - - -.- � l9: I'L_D 9, N G__. _ _ _':
FOR OFFICE USE ONLY �
� � Receipt No. Permit°No. ;
i ' �' /� �^� �
Rece�ve�by, 'Date Rec'd. Date Issued �
,
— i��ii ' 3-3a-_a_
Buililing �
ada�>« � '
�-I ��o. �� omgs. /
of Lot ! � x�� � Now on Lot �
of No.of No.of
ting Bidg. �IA/ 2���N`� I F,amilies I Rooms �
�ack Line from `z i Rear Vard �
:er o1 Stree} J �{�p yard _ �Gr i�
j Costa Mesa, California
Nearest
Cross St. � ' � '
Zone� � �� No. of � Type ,/ � GroUp �
Plans (/ 7 �j
Appro�ed �
., , ..,. . �.
NGw ' I AI[efa:i0❑ I Atltlltl0n iv
Repair 1 I Moving � I Demolish I ' " - • - "• -Y . ... -
Bu��ding q No. oi �.�
Siie ✓ �% 3�� Roams �� Stories Oly¢-
' '<rior Wall Roat C
.rina QIRS��r I Covering , r APPROVALS
liae of New Foundation Location Ins ecto
RVilAing ^�� 1 4- _ � P
—�j— Forms, Materials,
\�trs�^�— Under-Pinning
-----� Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is wrrect and agree to comply Lath. Ext.
with all City Ordinances and State Iaws regulating
bUildine constr`uc 'jV '- -' _ ^ �
Signature of � 1�7� l� Plaster, Int.
pgrmittee ' .J��~"�
Valu,ation PGflI
�. Plan
S � /d � rota
Fee
O O F
g ��'
t� �
�'p....-,- - vx
r- � '
PLOT PLAN
Show location and distances from
propeMy line and between huildings.
] '. �—'1 \.1 ►��
4ShR 30 �5��cosra � �„��,�� 1 .00
wFsa 434a
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