HomeMy WebLinkAbout1741 PITCAIRN DR - Building Permits - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT P cgilV0�rj ,9 TRACT NO. LOT NO. • UNIT NO, • • I
Project Address 17�I Pitea_ Ir a4"- IF/� •
11 "/1 ' may / ,2087 2/1'0/87 5.00 TL
Applicant's Mailin. Address • •. Id A.1 II-L' \ . n TYPE OF CONSTRUCTION •❑ NEW LJ ADD U-ALTERATION LJ REPAIR
.�� _ Phone ,�� 9 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER_ qp #
Owner's Name DESCRIPTION OF WORK/USE OF BLDG.
Address co-�.1S Main Building: Accessory Building:
TYPE OF'PERMIT ❑ GRADING ❑-r OUNDATION ❑ STRUCTURAL E Front O
Z
Arch/Eng., License No. T
Address (' : ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL• B Rear • N
Contractor's Name - 'V �1 Vt Phone Rrganr�S ,❑ OTHER _ -. - A _ I
Iy� PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) •7 -p K •
G
i�+� I CONSTRUCTION TYPE VALUATION S Left I • R
City License No. ,/ ZONE' !GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under:provisions of Charter 9 (commencing Remarks: .. - Planning Notes: •
Q
with section 7000) of Division 3 of the Business and Professions Code, and - :FEES
L {`('y Mmy licenl i5 in fulJ�fwzc-,and effect. 11,x' r�(J(y • RLC�IVI,D �r 1'1 � T•
•
License C a s L-'�� / �r c> se 411S"l(�J(s1/ a S.
_ gg�� `� PLUMBINGDate �Y Signature ���,L.L-�_WORKERS'COMPENSATION COMPENSATION DECLARATION Bar Sink - Showers -
ereby affirm that I have a certificate of consent to self-insure or a certificate MEM. ELECTRICAL .FEES
Workers' Compensation Insurance, or a certified copy thereof (Section .t ,
0800, Lab. C
Backflow,Preventer -Service Sink Automatic Washer Transformer ❑ 15-50 KW
Policy No. —/j9�` y—{— Company 1,y .Qn� Backflow_Irrigation. Sewer Ca ❑ 50+KW • • '
:yawned copy is hereby furnished. • p Construction Pole Sub.• .
yCeer •iii c D Is filetl with the city Idin n , Bathtubs Sewer Connection -
Da ft 1 y� ¢�} y�ljpjjo [' /�, Cooking Unit Meter 0 u to 100 amps
Date / lJ Applicant COMPENSATION DECLARATION Clarifiers• • Solar CollectorsDishwasher Meter Dover 100 amps , lt
(This section need not be completed if the permit is for one hundred ($100) or - --. i
j 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 • - •• _
' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank , ' - • Fan •
Workers' Compensation Laws of California. - . Motors 00.1 HP ❑1''i -8
Date Signature Floor Drains ' Swimming Pool W/Spa , — F.A.U: • .
NOTICE: If,after making this-declaration,you should become subject to the .. _ __ _ Inc.Solar 09-15 HP 016-15+ -_
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal -
comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING'AGENCY ,
Gas Service Outlets Water Closetr 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 I Water Heater
Lender's Name •
Outlets - Range
•
Lender's Address- - - - - Kitchen Sink Water Service . ' - - Switches' Sign - •• - .
I
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories t• Auto-Wash -
• following reason (Section 7031.5 Business and Professional Code, Any city or Garbage Disposal Standing Sections ,
county which requires a permit to construct,alter,improve,demolish or repair P—Trap • Laundry Trays - Generator ❑0.5'KW ❑5-15 KW
any structure, prior;to its issuance, also requires the applicant for such permit Trash Compactor ,
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
II t.e Contractor's License Lew (Chapter 9 (commencing with Section 7000)of - - _ - - `
'sion- 3 of-the Business and Professions Code) or that he/she is exempt
afrom.and the basis for the alleged exemption. Any violation of Section • I
j1.5-by any applicant for a permit subjects the applicant to a civil _
. 'penalty of-not more than five hundred dollars•($500). I ' •
-
` Ii I,'as owner of the 'property or my employees with wages as their sole Reinspection Fee Y' $15 Issue Fee, $ 3 -
•
I compensation, will do the work,and the structure is not intended or offered ' • - Reinspection Fee I $15' Issue Fee $ 3
• ' for. sale (Section 7044', Business and Professional Code: The Contractor's MECHANICAL I— FEES I
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 • , DEVELOPMENT SERVICES REQUIREMENTS: • -
employees, provided that such improvements are not intended or offered for Boiler - • Hood or Type I 0 n A
sale. If, however, the building or improvement is sold within one year of com- Canopy ,Type 11 ElZoni9 pp roved By Date a
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved BY Date •
rove for the purpose of sale). / /(�
U'I, as owner of _ 1 the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System . Application Issued By ,s Date i/ ?/ !
tractors to construct the protect (Section 7044,Business and Professions Code: - /
The Contractor's License Law does not apply to an.owner-of property.who Duct-Ventilating - ❑0-100,000 BTU?❑100,000 BTU • -. - SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con- -
.tractor($) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration - " BUILDING PERMIT $,. 3MIP , $
proof of their worker's Compensation insurance should-be provided to me., _ _ - -
I - PLAN CHECK $ - -PERMIT -
❑ I am exempt under Section B. & P.C.for this reason Eirepl/Fact,Bit. ICBG# Fire Dampers ,+�t� ISSUANCE - $
-- PLUMBING - $ C:0
,Date - - - Owner - ' -• Heating System& Ducting Registers . ' . - ' ' ENERGY P.C. $ -
PLAN CHECK 25% • $ -
I hereby certify that I.have read this application and state that the above ❑0-100,000 BTU ❑100,000 BTU, • ' 'GRADING $
information is correct. I agree to comply with all city and county ordinances - - ELECTRICAL . $,' -
and state laws relating to building construction, and hereby authorize repre- - • PLAN CHECK 50% $ - MICROFILM $inspection
of tsis' y to e er upon. the above-mentioned property for _ - - _ ��J
inspection pun..e / J,O� CM MECHANICAL $ TOTAL FEE $ `-� o'
Signature �.�
-
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor /
CONSTRUCTION AND PLANNING
APPROVALS Permit#
Date
Inspector
POOL & SPA
APPROVALS Permit #,
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd,
53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, ❑ 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
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping El Gas El Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas ❑ 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 '
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
,
33. Final Electric
Notes: (0.Z$.Q7 L,(.WCgeD 4.avwD
34. Final Heating & Air Conditioning
1-2-T-05 C 44-L� As Pa 1468 UPC. L.Eb
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
- 41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
s
MECT ADDRESS: 1741 PITCAIRN DR UNIFY: 0
OWNER'S NAME: OKAB AYAS H I
ADDRESS: SAME AS ABOVE
714/250-2500X2646
ARCN/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMGl CAL -PAC ROOFING (714)583-0884
ADDRESS: 9272 JERONIMO 120
IRVINE CA 92718
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect.
CITY u/fr�r,:�0 Q 2 3 4� STATE L1C.:512 8 0 . DMSS: n n Fl
Date: (�/� _2— Signature:, (.J�X�'
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a�c(ertificate of consent to sell Insure or a certificate of Workers'
xY NO.: tgryrylgf a ygnl(¢6 V, thereof (Section
00 Lab.
6)4/01/91
.JMPANY; SUPERIOR NAT.
❑ Certified copy Is hereby furnished. [N Certified copy is d vnth the ci0' Building Division.
Date: / b /p-lbyL 6 Applicant: I ), H
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed 0 the permit is for one hundred (5100) or hiss).
I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner m as to become
subject to the Workers Compensation Laws of Cxlifomu.
Date: Signature:
NOTICE: It, alter making Ads decimation. you should become subject to tie Workers' Compensation provisions of the Labor
Coda, you must forthwith mmpry With such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit Is issued (Section 3097, Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Prolessional Code: Any city of county which requires a permit to construct, atter, improve, demolish, or
repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/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 live 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 (Section 7044, Business and Professional Code: The Contractors' State 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 employees, provided that such improvements are not intended or offered for sale. If, however the building or
improvement is mid within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
Eland Professions Code: The Contractors' State License Law does not appy to an owner of propel who builds or improves thereon
and who contracts for such projects s4th a contractors) license pursuant to the Contractors State License Law). I am aware
that proof of their Worker's Cumpens0on Insurance should be provided to me.
❑ I am exempt under Section: B. A P. C.
for this reason:
nm.
I do hereby certify that I am aware of
a
25and that I or any future building
permit for construction or inoddicatio
these provisions.
Owner:
534
rad understand the requirements of California Health and Safety Code Sections 25505, 25533, and
occupant wi ilmll not (circle one) need to campy, with mid state codes and the requirements for a
n from the Air Ouality Management District. Residential construction applications are exempt from
I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county
ordinances and state Laws relating to building construction and here out rue repmic ii es of this in to en or upon the above-mentioned
property for inspection purposes.
Date: A l a- /-) 6 Signatur : V
Driver's License or Social Security
164146 Whim—Building; Green—Code Enforcement; GenWy_Applimnl;.P1\k—Revenue: Goldenrod—Aseefeer
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 049266
PERMIT NO: B 049266 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION REROOF W/DECRA TILE OVER SHAKE SQ FT: 8,500
CLAIM VALUE: 8,500.00 CALC-VALUE: 8,500.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED
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 BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN
PARKING RE8: PROV: PARCEL: 13933323 ZNE; REF NO:
PLANNING N TES>
Mki4 iE*k*k4k#141fk**k*kk*ef***14 i4 i4**of i4 kif i4*i4kiE*i4*if MiFitri4*44 iE i4**kif it 14ki414*ef 1434 iE****1E iE iEit if*at i4k
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N_T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE:
APPLICATION ISSUED BY: DATE:
k*if 144kif*N34 iN 9f ki4 ik*ikkikMkiF iE 44 eF 1E 4Ek14 if 44)4 *e4
#*Mi4*ki4*♦fkke4*M*iF*iE4E*1F*1F i4MiE iEki4M if*iF i4Mkkif ki4 i4 if ik 14k**1Ek*1E 1F i41Ei41414*if***i4 )414 it34*141 1E*it 1F*343414*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108.00 ,60
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 108.60 0,00 0.00 108.60 108.60 ,00
REVENUE DIVISION TOTALS--> COLLECTED:
108,60 OVER/SHORT:
,00
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN -CHECK
108,00
,60
iF iE iE***i4*i4**14k4if*if Mif kif i4lF if*if*♦f♦E**kk*****i4kkif*♦E 1ER1f*kiF*iFk1Fk*1E
i4k 141t if%k MiE eE*1E 3E iE %3E aE iE*iE 1414
I N D I V I D U A L F E E
B R E A K D O W N
TYPE QTY
D E S C R I P T I O N
UNIT COST
TOTAL COST
SFR 8500
REROOF BY VALUE RESIDENIAL
NOZONE 1,00
8,500.00
END OF FEES
\\
DATE: 10/02."T TIDE: 1 -1 -JO /
x
CONSTRUCTION AND PLANNII.
)L & SPA
` APPROVALS Permit # - '
Date
Inspector
APPROVALS Permit #
Date
Inspector
1, Temporary Electrical Service or Pole r,
52. Pool & Equipment Location
2_LSoil Pipe-Undrgrnd.. _ 3C•,
53. Steel Reinforcement
3LElectrical Cond-u'it-Utility-Undrgrnd;
54. Forms
,-
'!.,Electrical ConduiF=Undrgrnd.
55. Electrical Bonding
Steel Reinforcement c,a;x
56. Rough Plumbing & Pressure Test
. OElectrical UFER:Grnd.
57. APPROVAL TO COVER-GUNITE
-_. 7�Footings z c
58. Electrical Conduit-Undrgrnd.-
.� 8. Foundation •"
59. Gas Pipe, O Undrgrnd., Test
`
9. Water •Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
10. Structural Floor System a
61. APPROVAL TO DECK
11. Property Sewer Line•& House Connection
62. Backwash & Receptor -Final
12. Sewer. Cap
63. Heater & Vent -Final
L�
13. Roof Drains -, -=,
64. Plumbing System - Final
14. Rough Plumbing -
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
15. Rough Electric -Wiring
67. Fencing & Access Approval
17. Rough Wiring Strjn,
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19, Flough Heating &-Air Conditionying
REQUIREMENT p�
r„v
> rn
C <x
h,FIRE_P_ff_T.
VA•7LmS�Dx�0Per�m-t[# x� ^
-APPROVALS,
20.'�rjR0uh Fiicto_yFira lace
a^
ti �-, i• i•
c «� n.�!' r.�: to
21. Dubts, in"Structure,X70,
Undergrourt,~d, Hy�gro
r
x
22.<Du t ,Ventilating
0 F +
`•71. Product -Piping O Gas Oil
23.'Gas'Pipe-Rough &,Test tr1S
* "+ '=
0* *
72. Under ror Flush
tr`"
�x .�• tr tr CKO
*
tS Sx c
D 9 -0�
24.'Ro6fFraming =,; t*!
*
x .�,:x
••73nUndergrnd.Storag(FTank'OGas ❑Oil
_
... _
r
25. Roof Sheathing-'* '2 `�
' �' t7
> ^j r.
�-' G 4,
74:'Overhead HYdro�
G y
.,
m D;; *
,J, x
26.;1 --Bat Ceiling (Structural) &'Monacoat
,; p
_ 0 i
75:_Ory Chemical
27. Frame and Flas hirigs xi
rT
>'?�
76. Dry Standpipe
'�,n tr
28. Lathin & S din _ < _
9� g,, vit-, O
x E
* '
-•'
1 .x
c' s'� fi
77.-' FIXED &YSTEM.F-INAL*-t� _
Insulation S
y
*
78 CFIRE PREY. FINAL > `
X29. ux
M30. Orywall,Naiing
�.
j HEA LTHbEPT-REQUIREMENT
^<*
f� I
~
•=31. Plaster Brown";Coat'' =- "t-
M
yy
T79. -FINAL 1 ^ SECTIO i'
Meter -Final
I
y,
80.' -'FOOD CERTIFI:OATE ISSUED.+
�32Zelectricai,Power
,;
1
_
33=Final Electnc
t
_
t" ,
Heating;& Air;Contlitioning
x ,
<
,34.GPinat c
^ R7
35.cPinal Gas,Pipe-Testi Di ••
- 1
°•20
'
L��; .r. --�!^
Fti
R' x _ G
`"36.SHood =Canopy
,37. Finai•Factory Fireplace 4F
e • •
�-
538. Final; Pl umbing rte
- ax
-
`39. Water Service,Finaly
-`40. Gas Service -Final x 07
;41. Solar Domestic -Final -' ;�
is
j i� '
7C) a,
42. Backflow Preventer*
43. Backflow Irrigation•- i
x t,
'r
-' -' n '
Irrigation System: r�L'.,.
,"44. �Landscape
E st x
p < G 0 1
'40. ound A_tten_uatiom: _ ••
s t•?
- -
t_ _ f.
X46. Handica Re ulatiohs
_
-47."FINAL STRUCTURE &BUILDING
S�Zr�
w
-" I'
(Or
4^ F7 Q
48.`F,INALPLANNING' `"`"
;
,
49. �Iecilric R_ elease to Edison
• 50. 'Gas;Release to Southern California Gas Cox
'
•A:15
p _
#'
i
51. CERTIFICATE OF OCCUPANCY
No. Date
DAVIS, D.
GENERAL CONTRACTOR Modern Const. VALUE$ 290.00
1 AP No. 139-333-23 LOT TRACT FIRE ZONE3 DESCRIPTION OF WORK Coma. Block Wall
INSPECTIONS I Si¢nalure I DATE I GROUP .I TYPE III ZONE RI
S SUBCONTRACTOR
PERMITS ISSUED
DATE NUMBER
Water
hough Com. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line ❑ House Con. ❑ St. Swr. ❑
Sprinkling System
Construction Pole
Underground ❑ Power ❑
Rough Wiring
Trenches ♦?i, Forms % Steel Reinf. V_ 3
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In ❑ Out 0
Plaster, brown coat
Ref rig. ❑ Air Con. ❑ Final
F ,g Final
P..._..bing Fixtures, Final
Final Gas Test
Electric Fixtures, F'
_
Buildin Final
OCCUPANCY
roan bu4 m�o8 -B P ot)770
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 917 COSTA MESA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING / / _�%'
ADDRESS /✓l.
C*=aldk�� �_l
COSTA MESA. CALIFORNIA
1
TEL.
NO.
FEE RECEIVED
OCT 7 1863
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
7 For Office Use Only
R[CEIPT No. I PI
' ZONING
11Z0
N NO. OF -USE OF NEW
Y PLANS BU ILDINO
ADDRESS U - �Aj,+NOTE:
RION i✓D j/ I V_
vL
O.
CITY
NO EAV E OVERHANG SHALL BE LESS THAN
STATE TEL. ^6c SIDE @REAR P. L. Lp-.-.�LIG. NO. J NOT SIZE _ No.OF EAVES
EDREQUIREMENT]
OF LOT NOWONDS APPROVED YARDSAPPROVED
USEOF IN BUILDING I ACCESSORY BUILDING
SETBACK LINE FROM
CENTER OF STREET - REAR YARD
SIDEYARD LEFT RIGHT
DESCRIPTION OF WORK
DISTANCE BET. BET. MAIN B
MAIN BLDG'. ACCESS. BLDG'.
VAR.# DATE
USE OF
G '
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THAT THE ABOVE IS CORRECT AND AGREE TO COM.
ALL CITY ORDINANCES AND STATE LAWS REGULATINGI
E OFA%yPERMITFEE
(�ZED
rAUTHORTZED
THE AMOUNT SHOWN UNDER VALUATION IB FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.O
VALUATIONONSTRUCTION.
$���
$
m
CHECK
AGENT l / JrGI-�� 4
ADDRESS 1"(41 Pi
A^ No139-333-23 LOT TRACT FIRE ZONE VALUE $1,425.00
1 ECTI-ONS Si nature
Dore
TYPE V GROUP
j ZONE RI
SOIL
SUBCONTRACTOR
PERMITS ISS ED
GAS
Date Number Si nature
WATER
Plumbin
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
-
ROUGH WIRING
Heatima and Vent.
TRENCHES ❑ FORMS [-] STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PLASTER, BROWN COAT
'ICTURAL, FINAL
Electric
IING, VENT., REFRIG. AND A.C., FINAL
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iEP?_6740117PAI 01087 ****23.00
3902b
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
P I TION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RE I
DATE RECEIVED D
BUILDING
��� ( ADDRESSOWNER
RMAIL
E p
A.P. NO.P
BUILDING
ADDRESS
DDRESS114/)//�5�,,�TEL.
CIT V a -C rl•%�NO.CONSTRUCTION
TRACT TQV
LOT�
W
ADD I REPAIR
JED
MOVINGLENDER
BRANCH'rogr-
i-.OWNERADDRESS
VALUEARCHITECT
S $OR
��ss TEL.
ENGINEERI:t(-.
FIRE
ADDRESS zZONE
TYPE GROU
APPROVE
CONTRACTOR
BV DA 4- (/
ADDRESS A-txX a47,
nn TEL
ZO
NO. OF
USE OF NEW CNC
CITY A'KbA NO.q%35�
PLANS Z
BUILDING. C
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. �1 .. Z� t LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NOWBLDGS.
(FROM C/L STREET)
OF LOT
NOW ON LOT
FRONT FT.
FT.
USE OF CC
EXISTING BLDG. J I F• DW 157(.(.") N
FT.
FT
SIZE OF NO. OF
NEW BLDG. ROOMS STORIES
L. SIDE f, FT.
FT.
EXTERIOR WALL
ROOF
�j�—
COVERING
COVERING
REAR , FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN&
MAIN BLDGS.
ACCESS. BLDGS.
/
3 PAT -ii
VAR. #E
DATE
1-2 o V ILEI°
C.U.P. #e
APPROVED
tol& s ( 1 // Q `>
{I�� 1� .L�� L
APPROVEDDFr
_ _
3J O
I hereby acknowledge that 1 have read this application and state
Sl
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
s
j
the State of California.
I hereby certify that I am properly licensed as a contractor und,
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such lice ses are in Lull force and affect, or I
THE PURPOSE OF ESTABLISHING A PERMR FEE ONLY:
VALUATION
xempt from th8 prov151 S Of the State Ot alliOrnl BVSIl1e55
e Professions Code, Divis 3, Chapter 9.
An;
PERMIT FEE $ r
tU
ign tura of
Permittee
/,//•r�
$ /'y"
PLAN CHECK $
f /
Authorized Agent
TOTAL FEE $
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 3I7 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT n/
—ITIE
ADD BUILDRE% /Y
COSTA MESA. CALIFORNIA
F E RECEIVED
JUL 311961
rr''TT
FINANCE DEPT.
APPLIKfIA WIPEMM
BUILDING
For Office Use Only
WNER Pacesetter Jt. Venture
RECEIPT NO. PERMIT NO,
'I r,��
AIL 1653 Minorca Drive
RECEIV BY D RECEIVED/ /I bATEf0dbab
DDRESS
'�p7
ITY Costa Mesa No: -0395
[AR
BUILDING
ADDRESS
' LCT TEL'
R .INEER NO.
COSTA MESA. CALIFORNIA
FIRE
DDRESS
ZONE TYPE GROUP �.
APPROVED
Mesa Verde Builders, Inc.
CONTRACTOR
BY DATE
ZONING
ADDRESS 1653 Minorca Drive
ZONE NO.OF UBE OF NEW a/ l ,
Costa Mesa
CITY
PLANS z BUILDING
I
STATE 181269 TEL. Ki 9-0395
LEGAL / ys— T'f yom 8
LIC. NO. NO.
DESCRIPTION
SIZE7500 S NO. OF BLDGS. 0
OF LOT I q' NOW ON LOT
A. P. NO,
USE OF
YARDS EVES
EXISTING BLDG.
APPROVED ALLOWED
GC`iTSACK LINE FROM / 5 30.02
CENTER OF STREET REAR YARD
(CENTER LINE ST.)
FRONT '/ FT. IN.
SIDE YARD I LEFT
RIGHT 5
R. SIDE s FT. IN.
DESCRIPTION OF WORKL.
3!— —
_
GIDE FT. IN.
NL I Y II ALTERATION I IIADDITION I
REAR 3�' O Z FT. IN.
APPROVED //N DATE %/t///aj
REPAIR II MOVING (DEMOLISH I
1800 Sq Ft.NO. OF 7
SIZE ROOMS STORIEStj
Q/
,.
EXTERIOR WALLStUC O ROOF Shake Shingle
COVERING I COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
in le family residence and garage.
yh'f
Standard Plan No. 800 D
Attached garage 450 Swq. Ft.
I HEREBY ACKN
ANO STATE TH
LEDG THAT I HAVE
HE OVE 19 R
READ IB A LIGATION
CT ANO AGR TO COM•
THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE
PLY WITH ALL 1
O INANCEB NO
TATE W GULATING
PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY.
VALUATION
BUILDING cON
SIGNATURE O0
PERMIT FEE S •�
!!ff LL Q
/
PERMITTEE—
$
l
AUTHORIZED AGENT
�� �/ L,0
PLAN CHECK $ 51 J
TOTAL FEE S/1 I