HomeMy WebLinkAbout1582 PONDEROSA ST - Building Permits 3Y 9 CITY OF COSTA MESA :' ;
4 BUILDING DIVISION •
j? �� PERMIT NUMBER
F t wrier r DEVELOPMENT SERVICES DEPARTMENT
• PERMIT
do 601-01253
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1582 PONDEROSA ST Status: ISSUED
Suite: Applied: 08/13/2001
Vicinity: HOUSE&ATTACHED GARAGE Issued: 08/13/2001
Parcel Number: 13931114 Zoning: R1 R1
Applicant: ATKINS, BRIAN ISSUED BY:
Address: 23511 WHITE DOVE DR
Phone: (949)597-0192
LAKE FOREST,CA Zip: 92630
Owner: REDDING, WILLIAM C
Address 1582 PONDEROSA ST
Phone:
COSTA MESA,CA Zip: 92626
Contractor: SOUTH COUNTY ROOFING
Address: 23511 WHITE DOVE DR
Phone: (949)597-0192
LAKE FOREST,CA
Zip: 92630 • License: 737515
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(17 SQ).TEAR OFF EXISTING WOOD SHAKES&
RESHEATH WITH 7/16"OSB. INSTALL 15#ASTM FELT UNDERLAYMENT&REROOF WITH 25 YEAR ELK COMPOSITION
SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,800.00
Permit: $125.25 Claim Valuation: $5,800.00
SMIP Res: $0.58
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.83
•
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 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
2446-46(8/00)
a }- •
J
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.
,trihave and will maintain workers'compensation i urance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My works ',comppriatloalBSyrance carder a poky number are:lair ������� _OD
(Thissection
_ �7` Policy Number: •
(This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) L ---
❑ 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 Mamie,and agree that If I sh Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with Ih ons. r _
Applicant Signature:,
Signature: A�� �i� /'�"�J C Date: O-/3- d /
WARNING:'FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000).IN ADDmON 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 licensed undesions of Chapter 9(commencing with Section 7000)of Division 3 of theBusinessand Professions Code,and my license Is In full
force and effect.tdc.-R-' r3'7 , ((-Class-4.21g?
Contractors Slgriature:- - (Date: f
I
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).
Lenders 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 end Professions Code)or that ha 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 penally 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.).
O 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 Drivers 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 greeter 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 buil0ing occupant need to file a registration form for acutely hazardous materials? ❑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 appliwnl 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 aEEermlt for such construction or modification
from the South Coast Air Ouelity 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).
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 Ira 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 t0 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.
Si re t a4Owner(s)
Ditto
And/Or Authorized Applicant - - - 1Date _
CODE# INSPECTION TYPE PATE MBA CODE( tNSPECTIONTYPF. PAZE 1NUllAS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final (� 206 Final Plumbing
11/
200 Final Re-Roof A 210 Final Electrical
201 Final Block/Retaining Well 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
• t CITY OF COSTA MESA
0 a. BUILDING DIVISION
>4:lb. 1 ,,;,, i, DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
I.\ arra PERMIT 07-00261
4thePwamo°4.
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa5LECTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1582 PONDEROSA ST Status: ISSUED
Suite No Applied: 03/29/2007
Vicinity: Issued: 03/29/2007
Parcel Nunmber: 13931114
Applicant: HENSON, TIM
Address: 25035 CRYSTAL CIRCLE
Phone: 949-496-0983 ISSUED Y:
LAKE FOREST,CA Zip 92630
Owner: AGNEW, REBECCA C
Address 1513 ANTIGUA WAY
Phone: 949-646-5218
NEWPORT BEACH,CA Zip: .
Contractor: UNITQUE LIGHTING INC
Address: 25035 CRYSTAL CIRCLE
Phone: 949-496-0983
LAKE FOREST,CA Zip: 92630
License:624715 , -
SCOPE OF PERMIT
ELECTRICAL PERMIT TO UPGRADE SERVICE PANEL TO 200A FOR SFD.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 _ up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 over 100 kva/kw $0.00 0
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 .
Service to 200a $30.50 1 Misc.Conduit $0.00 0
Service to 1000a $0.00 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 Christmas Tree Stand' $0.00 0
Motors to 50hp $0.00 .-0 Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 -, 0 /y ,
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 - 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee
Sign Circuits $0.00 0
Temp Pwr Pole -$0.00 0 TOTAL CALCULATED FEES $54.00
Intermed Pole $0.00 0
COMMENTS I SPECIAL CONDITIONS
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
2446-46(6/00)
DECLARATIONS
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.
❑--1 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 Ls issued.
T.-- My workers' n tion Insurance carne�av policy number are:
Carrier: I rIS /Frolic;Number: 0 61 "4-G//0 JgUIUl
-(This section need be completed if the permit is valued at one hundred dollars($100)or less.)
[3' I cavity 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 pravisiona.
Applicant Signature: /', Date: 34 Q/�o 7
[WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RIVES UP TO ONE HUNDRED
THOUSAND DOU.ARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3700 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 theBusiness and Professions Code,end my license is in full
force andeffect'Lic.N �7cr'7/S — C/6 Cla Class ) /C--)
Contractor's
Contractor's Signature: Date:
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).
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,altar,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 DWision 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 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.). •
O I,as owner of the properly,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.).
O I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers 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 end 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 end 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 et 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 end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification end filing with the Fire
Department of en 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 application aEEermit 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 Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility tribe 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).
he__.._._ _ ._
7 If a permit from the South Coast res QualitycedManagement al or-Other air-pollution cton control district3be or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by Californiaia 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.
— / / „`Signature Of Legal Owner(s) ?/947 /I]aln-,
/ •
_Ariid/Or Authorized Applicant GDete---
ODE 1 INSPECTION TYPE DISE IIflaldLE CODE# INSPECTION TYPE DAIS MALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final 208 Final Plumbing G'
200 Final Re-Roof 210 Final Electrical /V2^0-7
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
OWNER VAN AMERONGEN, GERALD DATE 9_14-78
JOB ADDRESS 1582 Ponderoc cvenue °"'LDING PERMIT NO. 116726
GENERAL CONTRACTOR PRmi R f ;trurtinn DESCRIPTION of WOR.
Pi IN Pama� O. it
AP No. ],�q_ _14 LOT 66 TRACT X187 FIRE ZONE VALUE S�5 non
INSPECTIONS Signman DPN TYPE tr GROUP I ZONE R-1
SOIL PE�MITS IS54(ED
GAS SUBCONTRACTOR
Dote Number I Signature
WATER Plumbing
ROUGH PLUMBING all.1.111111111111 -7.., I 7g4.2•7-.:l'
11 PROP. SWR. LINE 7 HOUSE CON. 0 ` O/� a,3_79_VA000 g- V'/
SPRINKLING SYSTEM
MISCELLANEOUS /
ROUGH HEATING AND AIR CONDITIONING /
TEMPORARY SERVICE OR POLE /
UNDERGROUND Li POWER 0 ,,p 7,C /
ROUGH WIRING lq C/ � 'Heating and Vent.
TRENCHES 0 FORMS LI STEEL REINF. LJ c/fl / 9ez7-'- ,\i6,.37L ---"..-
FLOOR
FLOOR SYSTEM
BOND BEAM i1 STEEL REINFORCE n
SHEATHING L
FRAME AND FLASHING�y10
LATHING - IN WI OUT / 4�,.b
PLASTER, BROWN COAT ��77 . _
STRUCTURAL,ING, RE p�y'J1.ANDIlia
/ -FleFhi[HEATING, VENT., REFRIG. AND A.CN., FINALOl 8 /D-Y-79 <icis& —'
PLUMBING, FINAL AND GAS TEST InfJ ELECTRIC, FINAL 1 o-iBUILDING, FINAL /,74-tei
•
• -q 43 7 2/6 49.3.1 9/ 14/7p1 109.05 ' TL
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - -
APP A, ON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely -Use Ink Only ;
"EC=/�.E.: DATE RECEIVED DAAA���TE 15S ED/
BUILDING (y^ 7475/$.0.0", %/�/` 9— / /W
ADDR ESSG i,. IS rn O "A(//rt'GN{/ •/Q/yam
OWNER Geg.....4�L'L7 /.oi.&I gecdie A.P. NO. /.39-3Ii'- I� j�0
MAIL
ADDRESS/] (71 Pa �pe' 654
BUILDING /AI.'
� (j^ p0AIDand /,
,s,� ADDRESS yA .X /
CITY os, / /(//(i54, 2'Y NOLGj7572� TRACT 5V?7 LOT t0,6 BLOCK
CONSTRUCTION a �=-� NEW ADD ALTER R PAIR MOVING DEMOLISH
LENDER �/ -/ 1 ,,•' 1
BRANCH OWNERL9tIZ.ALO iA /I.0JQLN/TJ/�A/ ;
ADDRESS 7_ ✓
ARCHITECT TEL. USE Pit. _OAn,46t G$ 1.5 poo
OR ENGINEER NO.
FIRE �p�/y
ADDRESS ZONE YPE-'1`—' GROq.." -:_ 7(
U/U�P�� /./
-
APPROVED / .. [L_ (
CONTRACTOR DAM O�
/S TQ(Xe� (1,4:2t.„.../GJ BY DATE -/ / 7
7 /
ADDRESS 359 a £oiy BPx4L 81.4) .
/ ZONE //�� NO.OF USE OF NEW
CITY L,OAI(,° Se.t TEL.NOSIAX / PLANS O BUILDING Ad pa-Adv. -
#. �l CITY ```"`^^^^^^'"VVVV�� YARDS APPROVED YARDS APPROVEDI/
q LIC.STATE ati 39 LIC.NO. MAIN BUILDING ACCESSORY BUILDING
i SIZE I NO.OF BLDGS. (FROM C/L STREET)
0. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
fir EXISTING BLDG. bei fight Y.NJ R.SIDQI g� FT. ^•
/ FT.
VI
Off
F.P . Separate permits are required for L.S1 FT.
LO
electric,plumbing and heating work.Cc REAR FT. _ FT.
I.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
MAIN BLDGS. ACCESS.BLDGS.
t VAR.# DATE
Q, (A�Js''� ��/rn Q,i,(�Q / il �-///�_ �/�p/pQy�� / C.U.P.9 APPROVED
/J7
>" ( / � p[:7/G�JUI QX/'�1. wAPPROVED nl.J l] ( DATE •! /V/ ii
C Zat,.� It/1".Coy...a v / r' 1 C N
w
0. I hereby acknowledge that I have read this application and state n
X that the above information is correct and agree to comply with a
6: all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of m
the State of California.
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: "
am exempt from the provisions of the State of California Business y/� d6 vt
VALUATION PERMIT FEE $ /_/ ✓ P
and Professions Code,Division 3,Chapter 9. �y, / [�� •
m
{,]V PLAN CHECK $ '' 1
Signature of /�)�r�t� _. (Q c
Permittee ` j� (fUU TAX $ U
Authorized Agent ,yi r - f� �y„ry jy.,,/ TOTAL PAID $/O 05-
• ' ��� 3 FEE RECEIVED
•
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA.CALIFORNIA �� //-(7,./- ' 2
FINANCE ���� /
fOR APPLICANT TO TILL IN COMPLETELY APPLICAp rC�1 ]?1JMIIT
TYPE OR PRINT BUILDING
M
ESA
BUILDING
ADDRESS 1582 Potli rosa Street FOR p
COSTA MESA. CALIFORNIA OFFICE USE ONLY
OWNER /Knightwell Land Company RECEIPT NO. hrgJLT r{.
AMAILDDRESS 419 E. 17th Street RECEIVED BY I i/TE yE1VE '' 'ov ISSUED
IVED B .l`(y NOV 6 1950
CITY Costa Mesa, Calif. TNoo.LI 81159 ADD EISS
ARCHITECT Carlson & LIC. COSTA MESA, CALIFORNIA
OR ENGINEER NO.
Middlebrook
ADDRESS Garden Grove FIRE 1 / �//�
_ ZONE TYPE I/ ail il
Dike & Uolegrove, Inc. STATE APPROVED
CONTRACTOR LIC.NO. 167293 BY DATE
ADDRESS 419 E. 17th Street, Costa Mesa ZONING
LEGAL I LOT 66 - 13487 / NO.OF USE OF NEW //////11 ^
DESCRIPTION NO. BLOCK TRACT it I PLANS 7 ( BUILDING /Y
A.P.NO. BY DATE
/�` ///� /�/ DATE 1i/O j J )
SIZEOF LOT 701 X 1001 I NO.OF BLDGS 0n$ YARDS // //SES V
Now oN Loi Y REQUIRED LI ALLOWED
USE OF None (CENTER LINE ST.)
EXISTING BLDG. FRONT g-S/.
FT. IN.
SETBACK LINE FROM2r,
CENTER OF STREET 551 REAR YARD lI 1 R.SIDE FT. IN.
SIDE YARD I LEFT 51 I RIGHT 51 L.SIDE . FT. IN.
DESCRIPTION OF WORK 7 Fr. IN.
NEW I X II ALTERATION I II ADDITION
•
REPAIR I II MOVING I DEMOLISH I
S ZBUIE LDING 1601
COVERING ROOVVEMSRI6 STORIES 1
EXTERIOR WALLStUCCOICONG Shake
USE OF BUILDING AND WORK TO BE PERFORMED REAR
Single family residence with q r a
attach garage / / 4/
- Plan X750 ER i 7
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
j} �T /' VALUATION
SIGNATURE OF�v Jam(,_/.,(' PERMIT FEE $ 36.00
PERMITTEE �I ""`
$ 16,424 PLAN CHECK $ 18.00
AUTHORIZED AGENT Dike & Col prove, Inc. S TOTAL FEE $ 54.00