HomeMy WebLinkAbout1863 PITCAIRN DR - Building Permits .
aCITY OF COSTA MESA
:41�F4, BUILDING DIVISION
F r ,i.„„...:...:.,;.; 'i DEVELOPMENT SERVICES DEPARTMENT
PERMIT /
PERMIT NUMBER P99-00535
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
-lob Address: 1863 PITCAIRN DR Status: ISSUED
Suite No Applied: 09/15/1999
• Issued: 09/15/1999
Vicinity: GARAGE AREA
Parcel Nunmber: 13938328 ISSUED BY: z-/ r /
Applicant LORIE GLOVER .. ' ' - • •• • "
/
Address: - -
Phone: /
Zip:
/
- _
Owner: GIBBS, BILLY L
Address '1863 PITCAIRN DR. -
Phone:
COSTA MESA,CA Zip: 92626
Contractor COAST ROOTER PLUMBING HEATING &AIR COND
Address: 2737 S.CRODDY . - -
SUITE D ' ,- Phone: (714)241-1414 -
-SANTA ANA CA , - ' - - , Zip:_ 92704 -
License: 529127
Archl Eng:
Address:.
• Phone: '
Zip:
License:
' ' SCOPE OF PERMIT , '
WATER HEATER CHANGE OUT. _ / / - '
FEE SUMMARY_.' -
AMT QTY AMT -QTY r AMT ' QTY
ISSUE FEE $23.50Laundry Tub/Washer . $0.00 0 Sump Pump $0.00 0
Backflow irrigation .$0.00 0 ' Landscape Irrigation , $0.00 0 Swimming.Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 - Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 ' 0 Urinal • $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank • $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line - ' $0.00 0 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 ,�
Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0. OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATEDFEES: $35.80
SHO
COMMENTS/SPECIAL CONDITIONS
DATE 1 1 u :t': 6s
i r1y `
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
•
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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 wodcers'c mp nation Insurance carder and policy number are:
Carder: r' k/1� Polity Number: HO LOS 8Xvg
(This secti need not be completed if he permit Is valued at one hundred dollars($100)or less.) t
❑ 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 provisions. QQ
Applicant Signature: /
�---��r- Date: 9--/P-7
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,0001,IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS FRONDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS 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.Lic.# S a 91 Class# C—SG
Contractor's Signature: Date: 9•-ir S
CONSTRUCTION LENDING AGENCY:
O 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).
Lenders Name: Lenders 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 properly,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 end Professions Code:The Contractors License Law does not apply to an owner of properly 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 drivers 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,Art 2,Sec.
341,Title 8,California Administrative Code).
O 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:
1 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,ora 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.
4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this pli
a cation appermil for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 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).
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 0 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 end 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 informatlomgiven 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 torent�'upon the
above-described property tor.inspectlon purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
S e Of L'egaliOwner(s) Date
A •
nd/Or Authorized Applicant Date
CODE I INSPECTION TYPE PAIS INTTNALS CODE. INSPECTION TYPE p INTmALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical ((II (�
1266 Pool Spa Final 208 Final Plumbing "7 '�-, —Oct IJt4
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall _ 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2448-46
PROJECT ADDRESS: UNIT:
O��IER•s NAME: 1663 PITCAIRN DR CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 064420
ADDRESS: GIBBS BILLY L
,Cr 1863 PITCAIRN DR PERMIT NO: B 064420 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; OTH
ARCM/ENGINEER: 546-4825 REG.NO.:
JOB DESCRIPTION : T/O REROOF PART.W/COMP SHING, 6 WOOD SHIN SQ UNIT: Q FT: 7, 800
PERMITTEE: CLAIM VALUE: 7, 800 . 00 CALC—VALUE: 7, 800. 00 GROUP OCC: B-2 /
ADDRESS: LEE ROOFING ( 714 ) 642-7223
1653 SUPERIOR COMMENTS : REROOF PART W/WOOD SHINGLES AND OTHER SPART W/WOOD SHAKES
COSTA MESA CA 926,?7 ***************************�L*+t*�e**ir�riEiE****year*****3r -�kyE*�t***ryE�E�r�E****srx-+E*********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of apter 9(commencing with Section
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect, Z O N I N SERRT EBQAUC I KRS EMENT S
..........—.. CITY LIC.f: 028751 STATE LID" 349686 cuss: 3/�
Date:(.O /�— signature:— _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: 111Xreby affirm that I have a certib a of consent to set sure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy ther f(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICYNO.: 1300948-93 EXP.DATE: 06/30/94
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL : 41217403 ZNE: REF NO:
Ell Certified copy is hereby f-uurrnnishetl I_X Certified copy is filed the city Bui Division. PLANNING NOTES> /—
1 Applicant > ,
—` EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be co ted if the permit is for one hundred WOO)or less). -DEVELOPMENT S E R V I C E SR E Q U I R E M E N" T S
I certify that in the performance of the work for which this permit is issued,I shall not ploy any person in any manner so as to become
subject to the Workers'Compensation Laws of California. r'
ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: '
Code.you must forthwith comply 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 APPLICATION ISSUED B Y: DATE: V ��
which this permit is issued(Section 3097,Civ.C). ,**,****,*,***,***-,***,*****,***,*,**,***,**** *, ****,*,**,*,***-,********,********** **
ENDER: ********************************************************************i(-**********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRESMIP/RES; GRADING
(Section 7031,5 Business and Professional Code: Any city of 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/she is licensed PERMIT 99 . 00 . 78.
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9lcommencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(3500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation. win do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 99 . 78 0 . 00 0 . 00 99 . 78 99 . 78 . 00
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. II.however the building or ve
it improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 99 . 78 OVER/SHORT: . 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 99 . 00 . 78 /"r
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contraclorfs)license pursuant to theContractors'State License Law).l am aware ***.*.*-****.*-**************,**********.*********************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.a P.C. INDIVIDUAL F E E BREAKDOWN .
for reason: •TYPE QTY DESCRIPTIO N UNIT COST ',TOTAL COST
Date: Owner:
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 7800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 800 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a END OF FEES ,�
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from
these provisions. Xi
Date: Applicant: 7
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county S i�OSCE ®ETECTOF? !!
ordinances and state laws relating to building construction and hereby prize representatives of this city to enter upon the above-mentioned
property for inspection purposes. !�/� !/ ^p .
_� Date:/0 —/9-9 3 Signature: flu' 01 00148739-00148740 TCET 99.73
Drivers License on Social Security 4: , ` -u+ CATE7 10]/139%93 TInE: 16:33
1641,46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
I .
CONSTRUCTION AND PLANNING POL .(i SPA
'APPROVALS Permit# Date Inspector 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
i
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
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 1
12. Sewer Cap 63. Heater & Vent-Final II
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final I
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring67. Fencing & Access Approval
1 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
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 /p_I?--43 (tuff- 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical , r t
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 - 1 Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test ..
36. Hood or Canopy
37. Final Factory Fireplace r -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
111 42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING fi_Y.,_qiZ 6144i- 5..catrez_c ogrIi pip_4,2j49--
I48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date
•
adnnee7 •((]]� o L A B O Rr
rs- X90• fe;tiny and. ,,spec[ion CJni nears
COMPRESSION TEST REPORT
Test made for Automation Pools. , 8372 Garden Grove Blvd. , Garden Grove
Job Identification 1863 PITCAIRN DR. , Costa Mesa (Gibbs )
Location in Structure •
•
GUNITE_
LABORATORY DATA
•
Laboratory Number 82397 82398 83298A
Mark 1 2 3
Date moulded 5/7/63 5/7 5/7
Date tested 5/14/63 . 5/22 6/4
Age,days 7 15 28
Weight per cu.ft.,lbs.
Dimensions, (inches) 6. 2x11,3 6.4x12. 1 6.3x11.3
Area,sq.in. • 30. 19 32. 16 31. 17
• Compressive Strength
Total Load lbs. 44 ,000 39, 500 46, 500
Lba.per sq.in. 1 ,457 1, 228 1,491
• FIELD DATA
•
•
MIX: 1: 4 .5
Cement • • Specified Strength @ 28 days 2000#
Sand . Slump
No. 4 Admixture
No. 3 Ready Mix Plant
No. 2 Cyls. made by Dick Von Deist
Water Date cyls. delivered
11•
12
• Cement: Colton II (Low Alk . .
. �•R 1953
1- Automation PooBldgs P Respectfully lOs`aktysa pect _N
Costa Mesa Bldg. Dept. submitted,
1- Wm. S. Miller RAYMOND G. OSBORNE LAS A�T1o11ES, Inc �w
401 E. 68 St. . Inglewood 2
1= Robert H. Parlee ♦j. Ea
CF-4 By•
%.. . �'�J
235 WEST TWENTY-SEVENTH STREET • LOS ANGELES 7. CALIFORNIA • RI1cHMONo 9.3111
��8�� F E RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT SEP 1 91962
P. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely TION APPLICA461N�TINESA
21-- 14-7211 TYPE OR PRINT BUILDING
BUILDING i 9'&-a / /�
ADDRESS
(ion
pi re. C' I A � • p
COSTA MESA. CALIFORNIA�/� For Office Use Only d 02
OWNER APA-44 4 h r //. f RECEIPT NO. T'P
MAIL /^� An ���j=ice RECEIVED BY DAATT/E RECEIVED E)1ESUED5T
ADDRESS //l1,�7 'J ,AJ/���I-ybuzv G -/ '/7'ai tr ld V (h�•V_
CITY i /41 G� / IL i" dr1 BUILDING /4/i � '/4�rJ /y
ADDRE86 OO(4 GC/
A TELT [IAGr J,&4 7 tEL. COSTA MESA. CALIFORNIA
O. .GINEER f--f'Y�(`A��//�t1//-� /�(�NO. '// J/n n
ADDRESS //44�!/ EMA I_���I1// 4 FIRE
ZONE TYPE I GROUP�..1' Y/�
CONTRACTOR 4'.4 14,c immi1 1 APPROVED (�J/
A- A�y} �) BY DATE
ADDRESS /6 /7 3 !.l /nnlP' 7T- ZONING �p
_^ .14/��� ZONE NO.OF USE OF NEW s1-'f T z_, CS
CITY �//��e AI+I r`" `� \ 2 - I et-
I BUILDING W/a ' 1 or
1 C1 ' go c LEGAL LO( rer
LIC.TNO. ` ` S 3 Q NO. , 34 J DESCRIPTION z I 17(.3 lIJ
SIZE
OF LOT /�7/ IP-26/ I NO. OF BLOCS.
NOW ON LOT A.PNO. 39 — 383 -- `8
,
USE OF YARDS EVES
EXISTING DLO . mai-i.-iiiiit""e- APPROVED ALLOWED
CENTERSETBACK LINE FROM /-D REAR YARD FRONT LINE ST.)
FT. IN.
OF STREET ?
SIDE YARD I LEFT g I RIGHT -7 R.SIDE , 7 -
FT. IN.
DESCRIPTION OF WORK
L.SIDE __CIT FT. IN.
NE. I X II ALTERATION I II ADDITION I • REAR a g FT. - --- IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED /^ DATE /7/V
BUILDING NO. OF �/ ,�A Si D.�
SIZE 7/74--10 ROOMS ( STORIES v
EXTERIOR WAi.....).,^ ROOF /
COVERING ULGO COVERING 4. / A •,...r
USE OF =U14DINOhI'1D WORK TO BE Ic4.1MEP ,p
I HEREBY ACKNOWLEDGE TN I HAVE READ THIS APPL. TION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOV IS ORRECT AL REE CO - PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINN•_ . A•'T ' �1',.
BUILDING CONSTRU , a, %K2, ar • ♦ VALUATION
/SIGNATUR 4 Orel �/ / PERMIT FEE $ �� N
0
///(/� � PLAN CHECK $ 37 -0
AUTHORIZED AGEN-112a C /02, 6 Q
TOTAL FEE y
OWNER GIBBS: B. L. DATE 4-18-63
JOB ADDRESS 12563 Pitcairn Dr. BUILDING PERMIT NO. 19310
GENERAL CONTRACTOR Pools by Automation VALUE $ 3,000.00
AP No.139-333-28 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt.Swim Pool
INSPECTIONS Signature DATE GROUP J TYPE III ZONE R-1
I- SUBCONTRACTOR PERMITS ISSUED
�y� `s DATE NUMBER
Water afi -
Rough Corn. Ref rig. 0 Air Cond. 0
Rough Heating �/.7 Q' " �" n ,� /� �/
Rough Plumbing?inefr,,'} 4 -` �.ZI-M-w @M ,, #{-/S=413__Mar —
Miscellaneous U
Prop.Swr.Line ❑ House Con. 0 St.Swr. 0
Sprinkling System
Construction Pole
Underground Power ❑ le ' 6e/-‘3 , /{_,,per __ q _
Rough Wiring /LJ-cL(o t�t�CGCLGIYX- 70-7!J ittigr:—y3..'�' /77e5A —
Trenches Forms 0 Steel Reinf. cU I-' lfl it -
Bloorond eam f_..- //s:3.. )
� -Bond Beam tr Steel Reinforce � /�-/{- 1
Sheathing
Frame and Flashing �1
Lathing — In 0 Out 0
. Plaster, brown coat (' -
P-prig. 0 Air Cond. 0 Final b
ing, Final CS
Plumbing Fixtures, Final ,y 1 "F
Final Gas Test /cc- N - ?
.....-
Electric Fixtures, Final 1 H n2& /Y N
Building, Final �j •f,�
OCCUPANCY
FORM R04•5M — 7.61 unr.n FY114 C• CT.T. • '11 • 'r .1 . ____
FEE RECEIVED
19310• 4PO 1 g INN.COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEFT.
P.O.BOX Sl, COSTA MESA.CALIFORNIA
CITY OF cer.crA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR —RINT BUILDING
411, For Office Use Only
BUILDING / / i i - /�
ADDRE69 A (9 _ moi, �.�
RECEIPT NO. I)73;45,
COSTA MESA, CALIFORNIA gy[J6 J3/{/)(}(�E/p/ �J
OWNER (Dr
R IV • / /r/• /'7� /! LJ
MAIL �_{' �_-n
BUILDING ! g / 5 ._ %_-/ J
ADDRESS / r�J ADDRESS (a .tiL�w-'�.L�'L
_ FIRE
TEL. ZONE PE' GR•UP J
CITY ECT �e _i NO 0.1 � �
APPROVED f /
I '1 IGINEER �' TE / BY—
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ZONING
ADDRESS ' I � -- .G _ _-
/ Z N NO.OF USE OF NEW Ir.
I PLANS UILDING '/ ,
CONTRACTOR �� �. 1 111111 /
7,../. ....46,4_„4.0_14-2-,
y +� �"/�� �� LEGAL / V /� •
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ADDRESS
/�/� 3 / r`C .46A 4aJh/Jr.fiJ
DESCRIPTION (i I (,'1( // R. J
clrr
4O ? L�� / NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
LIC.TNO.! ! 7 D p 7 TiE L/4 5-4(Y 90'TO SIDE a REAR P.L.
EAVES
SIZE /� y / (�/ No.OFBLDGS. ALLOWED (U.B.C.REQUIREMENT/
OF LOT / p ` n I Now OH LOT YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. 1_}
(FROM C/L STREET) L/-
SETBACK LINE FROM /II FRONT FT. ',/ FT.
CENTER OF STREET REAR YARD / C
SIDE YARD I LEFT c,p / I RIGHT /0 /� ,/ R.SIDE FT. ".19 FT.
o
DESCRIPTION OF WORK L.SIDE FT. )- - FT. A
N. `ALTERATION _ ADDITION REAR FT. '• I Ff.
DISTANCE BET. BET.MAIN S
MAIN BLDGS. ACCESS.SLOGS.
REPAIR _MOVING DEMOLISH
VAR.# DATE
SIZ a A X `[i-e ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL I ROOF APPROVED(LIP �I% /�
COVERING COVERING BY �,� E 7 1(1
USE BUILDING AND WORK TO BE PERFORMED L!-/�
-
, ?V..'1* / m— HOLD FOR SPECIAI REQUIREMENTS
Cl
_ SO.FT. B
I HEREBY ACKNOWLEDGE{ THAT I NAVE READ T IS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
O
AND STATE THAT THE •• I COjjjjjjttttttRECTA AGREE TO OM- O
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY AN •RD STA [GU ING VALUATION B'a co
BUILDING CONBTRU N
SIGNATURE OP 0.0
PERMIT FEE $/� CO o
PERMITTEE _ L
743aoo PLAN CHECK $ V 0
AUTHORIZED AGENT . E
TOTAL FEE $ /
OWNER GIBBS, B. L. DATE 5-3-63
JOB ADDRESS 1863 Pitcairn Dr. BUILDING PERMIT NO. 19400
GENERAL CONTRACTOR Modern Construction Co. VALUE $ 1t37.00
AP No. LOT 21 TRACT 4311 FIRE ZONE DESCRIPTION OF WORK PYt.Elkdjall
IL�'��. N:CTIONS Signature DATE GROUP J TYPE III ZONE R-1
PERMITS ISSUED
G.i5 SUBCONTRACTOR DATE NUMBER
Water
Rough Com. Refrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line 0 House Con. St. Swr. 0
Sprinkling System
Construction Pole
'Underground 0 Power 0
Rough Wiring
Trenches 0 Forms 0 Steel Reinf. 0 E 1,-21-'t,
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing — In 0 Out 0
Plaster, brown coat
P 'q. 0 Air Con. ❑ Final
1. .ng, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final RA4 r-11-C
OCCUPANCY •
Form 13U4-5M-3-63—S-B P ,��,M
19400 FEE RECEIVED
.COSTA MESA BUILDING-SAFETY DEPARTMENT MAY 4 In$
P.O.BOX 917 COSTA MESA.CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely APPLICATION FCHk1PERMTTLOSTA MESA
TYPE OR PRINT BUILDING
///. , For Office Use Only
BUILDING I�b //�� / Z
ADDRESS ( i it%��/:.lii�
'RHC[IFT NO. P�jTt
Till 0
COSTA MESA. CALIFORNIA /
.// ��� R[C[I1IED BY DATE----RECEIVED DATE ISSUED
OWNER .• I A�'ZZ ` -
,JI BUILDING X13 , 6
MAIL / ,+/,� ( ,,{/JL.-
------",,ADDRESS
f
ADDRESS (� O I /[__.P/ .,--,
/ /L�!_ /J FIRS ' 22 ROUP
CITY C' �(;Q- /1L� L No' ZONE ' TYPE
APPROVED / i
i^^HJIGI BY DATE 0/6/5.(5.
ZONING
,--------
ADDRESS
ZONE HO.OF U9[OF N[W 0/"4-
/ ��, / C,?E-�fJ �— PLANE BUILDING w n/
CONTRACTORr .17763//'/`.rZl/%i�Y� C - ( e° / ( �( �j ,
` U !�!� h� V r ' _ LEGAL LG/' L T/� Q3 /I
ADDRESS �J']�q/ ,n{ DESCRIPTION
CITY /Y-*T/✓L-li{.( i `✓7�U A.P.NO.
STATE '7 / (� TEL I NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.NO.2.06 975-
/ ( % NO. 57,7 f /CJCI 30'TO SIDE B REAR P.L.
EAVES
SIZE /^� �r �/ / O I I NO.OF NOW ON LOTS ' ALLOWED (U.B.C.REQUIREMENT)
OF LOT C / �_V/T�(VJ InIO
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. -40
MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBACK LINK FROM u---- FRONT FT. rTT:---..„___
•
CENTER OF STREET REAR YARD
I �� R.SIDE FT. 0 FT.
SIDE YARD LEFT I RIGHT r
DESCRIPTION OF WORK L.SIDE FT. UP Fr. J
N I±I ALTERATION ADDITION REAR tFT.
ILh DISTANCE BET. BET.MAIN Q
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLOQS,
BUILDING NO.OF VAR. Y DATE
SIZE ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL I ROOF ` APPROVED '0Q6O /
COVERING COVERING BY 46'djADATE `5/�/4.J..,
USE OF BUILDING AND WORK TO BE PERFORMED
/2-9-..-/ 14#1:A. 4(/
/r / N
e -- 6Q.Fr. T
I HEREBY ACKNOWLEDGE T 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Y
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. J H
SIGNATURE OF rat ..//
./ /��t�(��^� -ERM IT FEE
PERMITTEW _
�" s �L3 7 K
0
u.
AUTHORIZED AGENT TOTAL FEE $