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HomeMy WebLinkAbout1857 PARKGLEN CIR - Building Permits 4 CITY OF COSTA MESA • BUILDING DIVISION 0-e n1 DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER p4 PERMIT %wo oee B04-02034 (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1857 PARKGLEN CI Status: ISSUED Suite: Applied: 12/02/2004 Vicinity: LIVING ROOM Issued: 12/02/2004 Parcel Number: 42431121 Zoning: Applicant: JIM TREECE ISSUED BY: �- i Address: 2220 E ORANGEWOOD Phone: 714-385-1202 ANAHEIM,CA Zip: 92806 Owner MERLINO, ROBERT A Address 1857 PARKGLEN CIR Phone: COSTA MESA,CA Zip: 92627-4506 Contractor WIN-DOR INC Address: 2220 E ORANGEWOOD Phone: 714-385-1202 ANAHEIM,CA Zip: 92806 License: 545553 Arch : Eng: Address: - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CHANGE OUT SLIDING GLASS DOOR AND REPLACE WITH DUAL PANE,VINYL, FRENCH DOOR LOCATED IN LIVING ROOM.HEADER WILL REMAIN THE SAME. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,600.00 Permit: $63.15 Claim Valuation: $1,800.00 SMIP Res: $0.50 SMIP Corn: $0.00 • Other: $0.00 Inspection: $0.00 Total: $63.65 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rea 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1,12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 �'-- • 2448413(WOO) WORKERS'COMPENSATION DECLARATION: . • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the �,,// work for which this permit is issued. Jr'J'"S have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. S " "My work rs'compensaAp Insuranceciarrier and policy number are: _ Cartier._ p/9ot (' (iHGe'crr, �"C/S :NOfObar -00000-�S 7 7 teenier:- dead not be completed if the permit is valued at one hundred dollars(8100)or less.) ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 p1 the Labor Code,I shall forthwith comply with these provi ' ns, `}t Applicant•Signatum:�.( - ir�,GC� — Date;_ I.2 O I ,WARNING,FAILURETO SE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FiNES UP TO ONE HUNDRED THOUSAND DOLLARE(St , ),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensO un•er provisions• Chapter 9(commencing with Section 7000)of Division 3 of the Businesa.and��Pj'r fessions Code,and my license is in full -' fordo a i effect-uc'a-- 5. rcTa r7C—L / 7 _. ;Contractor's Signature: -z' - c2-_,--- Dater,- i...? 2`O y CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No, Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,An 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). q 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of + compressed gas at standard temperature end pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes Al No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. i e Of Legal Owner(s) D to rAnNOr ulFodzed Applicant � rDme SORE t INSPECTION TYPF �— QA¢•---1 RITOIALS cQINJ INSPECTION TYPE ------PATE ME48 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/Occupancyge I'ea it 4 �9, CITY OF COSTA MESA >�IPIORW ! BUILDING DIVISION rI i .' PE TNUMBER : DEVELOPMENT SERVICES DEPARTMENT iRi PERMIT 00-00795 M1CO4?ORaitO\q4• (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1857 PARKGLEN CI Status: ISSUED Suite: Applied: 06/01/2000 Vicinity: HOUSE&GARAGE Issued: - 06/01/2000 Parcel Number: 42431121 Zoning: - Applicant: MIGUEL ENRIQUEZ ISSUED BY: Address: 1420 E. EDINGER AV#111 Phone: 714-542-5222 SANTA ANA,CA Zip: 92705 Owner: DEPT OF VETS AFFAIRS OF Address CAL 1857 PARKGLEN CIRCLE Phone: %ABRAHAMSON,ERROL M Zip: 92627 Contractor: BEST VALUE ROOFING Address: 1420 E. EDINGER AV#111 Phone: 714-542-5222 SANTA ANA,CA Zip: 92705 License: 715903 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: • SCOPE OF PERMIT REROOF-PO, INSTALL 7/16"OSB BOARD, INSTALL 1 LAYER OF 15#FELT AND INSTALL GRAND CANYON GAF LIFETIME COMPOSITION SHINGLE ROOF AND NEW TORCH DOWN BUILT UP ROOF OVER FLAT AREA. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,000.00 Permit: $125.25 Claim Valuation: $6,000.00 SMIP Res: $0.60 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $125.85 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • 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 1801days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS • i I ' WORKERS'COMPENSATION DECLARATION: -I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the 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 permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisiofr Applicant Signature: Date: j WARNING:FAILURE TO SE E WORKERS' PENS N COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($1 ,000),IN ADDITI TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisionsoniof Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# 1 (,S Q 7-1/ Class It �/� Contractor's Signature: %I Date: (D — ( — O 0 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: _ Date: • Owner ID verified by driver's license. 0 yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. an......._......__..r—.ny...r.__._.__,.hsSecion'--_ _ _ _. ---- _ 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5or will applicant ppcaru --_ t - 5 Does e the oast irt or present or future building occupant at y other for the work which is the or this a pliestion e0p Nnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .._ a'.. part of ...to ...cted e-o _. c ... 6 Will anyfacility _..._..... ..._ part of the to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7...... from South _r' al Management district agency f.__ which is h subject 7 application,If a tiothan the hCoastlosAir prescribedrri iDistrict Health or otherd air pollutionoecontroln42303 been agency is required for the work the subject of this have all of the disclosures by California and Safety Code Section made? ❑Ves 0 No .. ...... a iate efr ...ro.__ __,._. .............. ............ ____..__ B (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • Sign re Of L al wner(s) Date n Or Authod Ap Date CODE I. INSPECTION TYPE 1Ja>g INTITIALS CODE I INSPECTION TYPE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re-Roof fy,/ —W�0�1 aerfr 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 2446-46 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Clry a OF COSTA MES CO STR CTION PER IIT PER NO TRACT NO. LOT NO. UNIT NO. _ 5260 1c/I 7/83 5,00T.. Project Address anti mart Eft e l'A r • a� o a Applicant's Mailin ddres !.- ea 444 A • - — TYPE OF CONSTRUCTION LI NEW Li-ADD H ALTERATION LT REPAIR /� / 1' /1 ❑ CONVERSION CI DEMOLISH ❑ OTHER_ A.P.# Zone Owner's Name Phone(nC1.2G7t�1/ DESCRIPTION OF WORK/USE OF BLDG. tAV Address /LN! e.' S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF,PERMIT ❑ GRADING r❑/SOUNDAT I ON ❑ STRUCTURAL T Front O Address p ❑ TENANT ❑ ELECTRICAL R44LUMBING ❑ MECHANICAL B Rear N 1! l I f D OOr ❑ OTHER A I Contractor's Nam Phon f(J�, C Right N Address(mailing)_ /'_ 1 / I I ' PROJECT DESCRIPTION. SQ. FT. OCCUPANCY K Left � < CONSTRUCTION TYPE VALUATION$ S G City License No. ZONE GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref.# C Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: , Planning Notes: RECEIVED t ES 1 7 3988 M • with section 7000) of Division 3 of the Business and Professions Code, and my license is in ful once .nd effect. ` t 7 S Ucen e - Date — A *k • eNo. Signature M�gI ' Aa4 —' • PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES Ac. 'hereby affirm that I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 300, Lab. C II a.( C�/ �1/� Automatic Washer Transformer 0 15-50 KW Policy No. -P/ ,014- ! Company . 1 9/411 N- Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW if-Certified copy is hereby furnished. ' Certifi opci filed with the city a ddm9 Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date I T Applicant ttttttWWWWWWdddd ion /r/ EXEMPTION FROM WORKERS'COMTION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred ($100) or ` less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I snail not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. — Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance / Pole Light of the work for which this permit is Issued (Section 3097. Civ. C.) Interceptors / Water Heater Outlets Range Lender's Name / ..Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays any structure, prior to its issuance, also requires the applicant for'such permit Generator ❑0-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the-provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000)of fivision 3 of the Business and Professions Code) or that he/she is exempt 'refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil ,malty of not more than five hundred dollars($500). $ 3 ' II] I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure is not intended or offered - Reinspection Fee ! $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _ ------- = thereon, and who does such work himself/herself or through his or her own Boiler Hood Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: or employees, provided that such improvements are not intended or offered for yP sale. If, however, the building or improvement is sold within one year of com- Canopy Type 11 ❑ Zoning Approved By Date p , the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date prove for the purpose of sale). - 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a can- tractor(s) license pursuant to the Contractor's License Law). I am aware that• Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ S, 0 a ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU ❑100,000 BT - " ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building .nstruction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $ sentatives of this city to e ter fon the above-mentioned Pro erty for inspection pur.. es.441 4 ' / eye p - — - MECHANICAL $ TOTAL FEE $ O Signature N as ..• Date / . -La ( ---- -- Drivers' License or SS# - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ a CMF 0865.46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION ANDrPLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector ' 1.,Temporary Electrical.,Service or Pole 52. Pool & Equipment Location 4 • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ii• . 3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms J9 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure T1)est 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GU„N,ITE 7. Footings ' ‘ (;- ; 58. Electrical Conduit-Undrgrnd1.1I 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Tesrj nt 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67, Fencing & Access Approval 17. Rough Wiring Sign j 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling :.) 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# - - - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - • • 74. Overhead Hydro . • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • • 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION �A' 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED / 33. Final Electric Notes:2•23_8$ L,CPT Ceszta. L.€4) ,1 34. Final Heating & Air Conditioning "• 35. Final Gas Pipe-Test 36. Hood or Canopy 4' 37'Final Factory Fireplace r • _ ,, 38. Final Plumbing 2/ r ‘-co - ✓ ,, .:i 39. Water Service-Final - - :', - 40. Gas Service-Final r ' T -.41. Solar Domestic-Final � 42. Backflow Preventer '' " - • 43. Backflow Irrigation ` ' 44. Landscape Irrigation System , • i 45. Sound Attenuation _k. '- ' 46:Handicap Regulations 47. FINAL STRUCTURE & BUILDING • • , 48. Special Requirements Completed - r • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - • ' 51. CERTIFICATE OF OCCUPANCY No. -_ Date _ 1 1 ` • June 18, 1973- ‘44> Mr. Frank Buday 1857 Parkglen Circle Costa Mesa, California 92627 Dear Sir: A building permit has been issued to Irvine Pools to construct a private swimming pool on r property. In order that your pool will b .a safe one and for the purpose of advising you of your responsibility regarding the requirements of the Costa Mesa Municipal Code, we refer you to Section 8107, a copy of which is ached. This letter is direct to you in order that you will be aware of our ordinances and can make a complete safety check of your pool area. Sincerely yours, RICHARD HANHART Building Safety Director • RH:cb ko �� 2s �4�� ,dII0114 Twining Laboratories Of GJOEEtl2£472 dag077:(cl, 12.C. P.O. BOX 47 . 3310 AIRPORT WAY . LONG BEACH. CALIF. 90801 . )213) 426J3S5 . (213) 636-2386 . (714) 828.6432 BRANC4 OGRCESI TESTING .I S'..D No tH'o p.,s• r t Nee oe,•.e..,lenLR Se•e A'- C, fo,e 92203 ry° � "' 295E Redonda A.e..R O Bo.47 OW 53,2045 ?d r 1 -a _ ecb.Cel 9 90501 92'31 ele-230o July 20, 1973 . • Examination: SC73-4761 COMPRESSION- TESTS O . GUNITE CYLINDERS Mr. Errol F. Heesch 12921 Aspenwood Lane Garden Grove , California 92648 PROJECT Swimming Pool for FRANK BUDAY 3aid ADDRESS 1857 Parkgien Cir . Costa Mesa • SAMPLE FROM Gunite Swimming Pool ARCHITECT CONTRACTOR Irvine Pools ENGINEER SUBCONTRACTOR Grove Gunite Co. SPECIFIED MIX 4-1/2 to 1 STRENGTH 2,000 pol DATE CAST 7-13-73 CYLINDER SIZE DATE TESTED 7-20-73 7-20-73 7-20-73 IV"HOLD" CYLINDER NO. I 11 Ili V"HOLD" VI"HOLD" COMPRESSION 7-Day 7-Day 7-Day TOTAL LOAD, LBS. 128,500 106,000 120,000 rvM.. POUNDS PER SO. IN. 4,555 3 ,750 4 ,255 CYLINDER SIZE: 6-I/4"x12-I/8" 6-1/4" x 12-1/2" 6-1/8" x 12-1/4" COMPLIANCE 7-Day test complies with specifications. MADE BY DELIVERED BY RECEIVED ON CYLINDERS - - - Heesch 7-14-73 DlsrRleunoN 7 E. F. Heesch - 2 fix 7-zK 7-3 (t to Mesa Building Dept . • • s . 9. . . ..� (.• i u p, Jw•S CO•.t . 5.0'.5 , u ! �• -5 ev .. .. vl :.iv .... ..Ir .. u. . r . u 1 OWNER RT1T)AV FRANK DATE 5-26-78 JOB ADDRESS 1857 Parkglen Circle BUILDING PERMIT NO. 46114 • GENERAL CONTRACTOR Spiro 7afirov DESCRIPTION of WORK Add Family ROOM. isAp APNo.11Fi_011=P0 LOT TRACT FIRE ZONE VALUE $ 10.000. N"SCTIONSSignature Dore TYPE V GROUPTZONE R-1 t. PERMITS ISSUED SUBCONTRACTOR Dole 1 Number I Si WATER an afore ,(���� Plumbing V ROUGH PLUMBING ✓ Ililt- b-12-X6 1'10, PROP. SWR. LINE I__1 HOUSE CON. EIr� 4)-7-712, J SPRINKLING SYSTEM , P MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICEr-� OR POLE LJ UNDERGROUND POWER ❑ ROUGH WIRING • C.S.-` 6/11-11. Heating and Vent. TRENCHES I`/FORMS STEEL REINF. 1' v (_ ?_; FLOOR SYSTEM BOND BEAM t STE, t NFORCE • SHEATHING '..i2,..„LN,4r1W21r4 i 9-)4•• FRAME AND FLASHING k '/ 6°1'90' LATHING — INKS our frj .d47-J_ . PLASTER. BROWN COAT cN,IP/ 2.41->r STRUCTURAL, FINAL Electric HE NG, VENT., REFRIG. AND A.C., FINAL S.AJ.A 7 •e0 5-, .b`) Y3923 P INC. FINAL AND GAS TEST n V ELECTRIC, FINAL BUILDING, FINAL =61 ' '. 1670 6%26778 78.70 it MESA BUILDING-SAFETY DEPARTMENT ' "' - ' P.O.130X 1200 COSTA MESA,CALIFORNIA 92626 a A'P A ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only QQ.� �j p / �+ , I RE - s s DATE RECEIVED DATE Si EDBUILDING _ ADDRESS I/J"�15� )7 P#LKg4L CN) `cc. Cr .i. vitt. . L IV J� • i • �/7/ OWNER Fe4N Il IJU D /t J ..p.NO.J� - 01/� PERMIT NO. MAIL tBSIQReKGLFJ C . C. N. Cr?C ADIDRIES fSF7 PR-e e6CE ✓ CC. CI?' ADDRESS �M-r CITY costea~ rl 8 SQ NOL TRACT-7093 LOT (• ( BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI ISH LENDER 7' BRANCH /s too*OWNER fi2�UD G oom s"/ ADDRESS VALUE/As,' ARCHITECT TEL. $C��r� OR ENGINEER NO. FIRE ADDRESS AJC �J ZONE TY GROUP ��(..�(, SP�eJ Zfr'I l /vO ✓ BYAPPROVED � DATE 4 2G �'((J CONTRACTORQ 7� (� �+ ,t ' lll��� ADDRESS 1923 P Or- E.4y 4V. p COS F-11.- Hai-A- NOL c4S gird ZONE PLANS 2 BUILDING USE OF NEW A CITY /vyJ( 4� i STATE z,j 7 !- 2 '� CITY YARDS APPROVED YARDS APPROVED LIC.NO. ,f't V� I(J LIC.NOW MAIN BUILDING CESSORV BUILDING Is7 SIZE NO.OF BL (FROM C/L STR ELT) B. OF LOT NOW ON LOT FRONT FT. a USE OF � V) EXISTING BLDG. ,__El.SIDE a ET.U$//�`OM P FT. rA ESeparate permits are required for L.SIDE 7 FT. FT. electric,plumbing and heating work. REAR 27 FT. FT. GM I.—, USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& O MAIN BLOCS. ACCESS. BLOCS. TO OU/C ^ `, / 4,dp VAR.# DATE Q OQ „co /�,/`/'tl1Roo /.� yv� T� ��1✓ C.U.P. /� APPROVED 7 / 7' „CQF /e mod' /y &men: APPROVEDaudeP'✓ D$ -2C. ')e S4 W O I hereby acknowledge that I have read this application and state n CL that the apove Information is correct and agree to comply with m B. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u the State of California. � I hereby certify that I am properly licensed as a contractor under SQ.FT. w the 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 em exempt from the provisions of the State of California Business �l7 a and Professions Code,Division 3,Chapte 9. VALUATION PERMIT FEE $ ` m Signature of PLAN CHECK $ a� 2 Permittee 6 / /� 17) _ (./N./ $ /D 0-f15 TAX $ .70 Cit U Authorized Agent .. TOTAL PAID $ 78 70 ,OWNER BUDAY Rrank DATE o%JOR ADDRESS 1857 Parkglen Circle BUILDING PERMIT NO. IERAL CONTRACTOR 3n� 808 1� Trvi enl�nol s DESCRIPTION of WORK private swimming ng enool1 o. 115-011-20 LOT 4q TRACT 7 41 FIRE ZONE VALUE $ 13nn nn INSPECTIONS Signature Date GROUP J TYPE in ZONE Bl. Pool Location � /'H01-7) , SUBCONTRACTOR PERMITS ISSUED /1 FOlms 1 ! ) Date I Number I Signature Main Drain • ` I/` c) Steel Reinforce \\ Elec. Bond Electric Approval to Cover no /Ho 73 S .t(.At(///) /;-A-/,y3 Skis/.i� Underground Electric rI 7�� I Gas Piping Test ��/2 <.2 3 Plll m�bing� //�J/)�/ System Lines `�"L(l7//1-('tet 7/s-Cd !O 15--23��JJ73 . -- Filtering Backwash Lines and Recep. i / Electrical Final ' 'er and Vent Final F,..er System Final Backwash and Recep. Final L WY ©r' C6St /1 • 36F 3 COSOTA.BOXESA 200 BUILDING-SAFETY A MESA,CARNIA 9 626 T JUN 151973 • For Applicant r ill in Com.letely S7I0N FOR BUIL R Vt?fl REIVED DlT T6(iEF nn 6/tb�pJ� _ BUILDINGDDRE ® -/J a? �n -t/ Ll, [/O_ / /_( [- /J ADDRESS /3 j OC eC , ��J /1� ✓ �/ OWNER �/Iai..,4 t GZ. A.P. NO kg/I."... -/^) PWAITAO MAIL BUILDING /FS7j /'— / , Z . ADDRESS ADDRESS(/ / ///G� P.(r� 2 U TEL. CITY NO. TRA 040 LO BLOCK Z CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISHO< LENDER a m / J BRANCH �/y) - N OWNER ✓�Q a 03 W ARCHES �� / E ^��� fD J f_ VALUE 3 'm ARCHITE TEL. USE J Q OR ENGINE .44 yli NO, - Z c( r FIRE �' Z 2 ADDRE * ZONE Litt TYPE 131-GROUP a w APPROVE WZ COW -�tr. . 015"----J..- BY �-- DATE(// "15.13 J p / mZ Y'3 / ci /j J ADDRESS ° W W ZON NO.OF.... USE OF NE Wr�k Z r I T PLANS BUILDING '^ CITY ,/va/ W O STATE CITY YARDS APPROVED YARDS APPROVED tn O LIC.NO. /S7 LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE • OS (FROM C/L STREET) ��jjJJ�� OF LOT I NNOOW. ONF LOTBLDG . FRONT FT. $ ' FT(p USE OF EXISTING BLDG. g,SIDE FT. FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. ‘70/69 FT. UEXTERIOR WALL ROOF �f _ COVERING COVERING REAR FT. [}' FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a d MAIN BLDGS. ACCESS.BLOCS. QC______J) VAR. B DATE 0 /F- (JQ�� C.U.P.# APPROVED 6.". C/) / �yROVE/� DATE`� /�/S Z 0 UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with NJ CC all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of U) the State of California. - co ZI hereby certify that I am properly licensed as a contractor under SQ. FT. 0 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: v am exempt from t• provisions of the State of California Business C and Professions C cie ivmion 3,Cha r VALUATION / OM CO PERMIT FEE S of-Cq N 7 Signet": ace ?�� /.3 t.�{.� m Fermi \ �� $ r? PLAN CHECK $ v E !� o Authorized Agent Q TOTAL FEE $ I , / a UWNtI< BUDAY, Frank DATE 3-28-73 JOB ADDRESS 1857 Parkglen Circle BUILDING PERMIT NO. 36305 GENERAL CONTRACTOR Owner-builder DESCRIPTION of WORK Block Wall p 1,.,-•:.Y_. 116-011-20 LOT 49 TRACT 7043 FIRE ZONE VALUE $ 80.00 • 1.9,CCTIONS Signature Date GROUP J TYPE 111 ZONE• Rl Sdk SUBCONTRACTOR PERMITS ISS ED \ GAS Dote Number Signature .▪ WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER LI ROUGH WIRING Heating and Vent. F� TRENCHES ❑ FORMS [� STEEL REINF. L .'IKYM 6 aL -7-73 FLOOR SYSTEM^Y BONO BEAM STEEL REINFORCE ❑ SHEATHING FRAME AND FLASHING LATHING — IN n OUT Il PLASTER, BROWN COAT STS -TURAL, FINAL Electric NE a, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST Il ELECTRIC, FINAL BUILDING, FINAL �jtlg` 4 7i • �r PAIu 3E^ '3 t ?9-73cr=.00? 116':- ::,•:o-.%*5.50 • . COSTA MESA BUILDING-SAFETY DEPARTMENT PP.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVE BY DgTE F3E,C�VE DATE ISS ED BUILDING ,p 1/^7i///OI r.%S O/f//O/ .7 3 a�_73 ADDRESS /�'�7 P�X_kC3/e.� CAP, en, D� �/ / �t PERMIT N^ OWNER A-RA 2/,,,7µ�/ A.P.NO.//(�''/�/ �L Snr. MAIL /`(/L, !!�� /^// r� BUILDING ---I /J Z . y" � ADDRESS �q / 2 ,AR/r G,4✓c;A ADDRESS // j [F 6, s 0__ U TEL TEL. TRACT 7047_3 LOT / BLOCK F Z CITY AA //>G•SR No.loY�-Y7'.�1� 2 < CONSTRUCTION ^'/GN� NEW........., ASO ALTER (REPAIR (MOVING DEMOLISH —I- LENDER L am J D BRANCH ter. -J in OWNER ��V✓�_. segOD M J ADDRESS G VALUE nJQ ARCHITECT TEL. USE /•/Loe=,'c- l��L2-- $ N OR ENGINEER NO U Q FIRE W T ADDRESS ZONE TYPE J ROUP d41BYPROV ED W �/yy � 3 Z CONTRACTOR � ¢ BY DATE / J O to Z J ix ADDRESS 4..Rve!c2-- W w TEL. ZONE / NO.OF USE OF NEW/, -40-/L Z= CITY NO. , PLANS CTI� BUILDING /vim/ v Cr 6 T,� �o s� -5"9-ns� w-0 STATE CITY YARDS APPROVED YARDS APPROVED V)FC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING _0 SIZE iNO.OF BLDGS. (FROM C/L STREET) /7 OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. B.SIDE FT. // h 4-FT. I-'• SIZE OF NO.OF 2NEW BLDG. ROOMS STORIES L.SIDE FT. 0 FT. sil C.1 EXTERIOR WALL ROOF COVERING COVERING REAR FT. r FT. _ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a. a MAIN BLDGS. ACCESS.BLOCS. IFC � I VAR.+ DATE O �/(A/Y/� S Tl.LC e GC/A 7/ C U.P..# APPROVED 9 //!! / APPROVE / J_ CA // ivg. ri/ /- ��/. !/ i r)ATF J -?c) O �/ Sr** UI hereby acknowledge that I have read this application and state , D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of / YA the State of California. OD v?I hereby certify that I am properly licensed as a contractor under SO. FT, ti the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: c cc am exempt from tl a provisions of the State of California Business and Professions Cone,Division 3.Chapter 9. VALUATION 1 S2. rp 'n PERMIT FEE $ j Signature of p/.'�� �f' O"� m Permittee �y/��.�+�/i Ir11�I� $ 9 / PLAN CHECKS E CCC ��• (l `o Authorized Agent a TOTAL FEE $ -)o � ?6-71CR$AOO 705* ***133.50 '• COSTA MESA BUILDING-SAFETY DEPARTMENT —•.Q.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT lot-kg or Applicant to Fill in Completely 4-B-Mod RE EIV D BY D TER CEIVED DATE ISSUED BUILDING <A4 - *--.2,5---7/ ADDRESS i • a a - PERMIVNOt K1 p OWNER Imperial Savings; & Loan. A.P.NO. • -....2-1S BUILDIN ADDRESS 3366 Via Lido MAIL ADDRESS 1857 Parkgl en Circle Z til Ui 0.0 CITY Newport Beach NO.673- 1.30. TRACT 7043 LOT4g BLOCK Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI SFI O— N LENDER same---- X am J D BRANCH J c0 OWNER Imperial Savings & Loan m JLij ADDRESS ll..,� /C�•0•• _ /JALV3 „ -CO ARCHITECT TE J Q OR ENGINEER R. Lavei,n n NO 67 3-701�SE •/'s//~/' i U N FIRE .�� WCC ADDRESS 3432 Via-Oporto,Newport-Bch. ZONE TYPE�^(I • /`V GROUP d W APPROVED c /� _3 '7 JO CONTRACTOR Calah Construction Corp. - BY V• ///�/�� DATL�� %/ CO Z J Ir ADDRESS 4501 Birch St. W w TEL. ZONE NO.OF USE OF NEW Sgl .Fam. 0 r CITY NO. RI PLANS 2 BUILDINGRes/Att.Gar. zI Newport-Awgrh_ 540-8833. STATE CITY YARDS APPROVED YARDS APPROVED V Cr LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING DOSIZE rNO.OF BLDGS. (FROM C/L STREET)Q OF LOT 50 X i no NOW ON LOT 0 _ FRONT ad FT. T JV FT. USE OF J /6 I yT EXISTING BLDG. R SIDE FT. FT. Z NEW BLOG1620 sq. , ROOMS 7 STORIES 2 L.SIDE 8IFT.1 FT. U EXTERIOR WALL 1 e ROOF _ COVERING StUCCO COVERING shnk _rntnrt_ Vp BEAR FT. FT. �/I —I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 1 MAIN BLDGS. ACCESS.BLDGS. • 0 //T � VAR.# DATE 0 residence-- HN�o���lll��� C.U.P.# APPROVED I- —BAPPPROVED WLD:am DATE 3-24-71 Z 0 UI hereby acknowledge that I have read this application and state O that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of z the Sate of California. co FT 46- o I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT S N UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ABLSHING A PERMIT FEE ONLY: _ CC am exempt from •- • •visions of the State of tifornia Business VALUATION �{���/�" co and Professi•• ode,Di sion 3•Chapter PERMIT FEE $ / N O Signatur: •f /J /� m Permittee $„/ / J/Z,/} — PLAN CHECK $ 4. (J E �V V v o LL Author -gent �, TOTAL FEE $