HomeMy WebLinkAbout1614 PONDEROSA ST - Building Permits ' CITY OF COSTA MESA
04, E
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
I. 1 `rw_• or 1
ry*le PERMITSbarftlemst B06-01250
ii
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.EWILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1614 PONDEROSA ST Status: ISSUED
Suite: Applied: 07/26/2006
Vicinity: ROOF _ Issued: 07/26/2006
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: 13931106 Zoning: R1
Applicant: CURTIS, JIM
Address: 27282 LAS NIEVAS
Phone: 949-206-9963 ISSUED BY:
MISSION VIEJO,CA _ - - - Zip:. _92.691
Owner: GOUD, RAMESH1_,92' , , - " 1 r - - - -
Address P O BOX 4088%7'r.; # , I ii / 1-- -s ���
,� /,%� � Phone ` i `` ```.
COSTA MESA,CA, A--- \ - _ Zip 9628 // C.---.)
- _
Contractor/CURTIS ROOFING- /N )\ 'A
Address:- '„27282 LAS NIEVAS - ��Q �� `�� A j A\. A
V -. ,77„,-<''.- Phone: 949-206-9963 -',..N. 7,/./� i �� A
;',-./ MISSION VIEJO;CA' NV y`7/ c �� ,, Avg.
Zip 92691 4%,,,/,,,;_i/ License: 647204 \\N\i / 7.
Arch': %,' /'i/7 -' Eng: w A� / ”\
Address:. '', /' '' �'' Address: ‘ ,-,\.\\ , �' ��:.
�;
Phone: , __ \ :Phone: \ ,
i �''--.0 ti;.‘,:' - ,
N
Lcense: License:
' _ <., ., _ SCOPE OF-PERMIT, . -V ' ' < -
TEAR OFF EXISTING ROOF.INSTALL 1 LAYER OF 30#FELT,30 YEAR,ELK,COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS
NEEDED.24 SQUARES,INCLUDES ATTACHED GARAGE. - \ '
' ,i i -> C 7 A'�
FEE SUMMARY_ - _ -v �
�
Plan Check: $0.00 i 1
n 7 /r, _ "�" / '77L-27"1"-',/ `;Yn,c7 Calc Valuation: S§,900.00
Permit: $139.25 - • `- '2'- - .4 IL e"- `'• 1ClaimValuation. " ,_ $6soo00'
SMIP Res: $0.69 N -- ` i
� i
SMIP Com: ' $0.00 y, „ �-
. ' Other:;, $0.00 - - ,� ; ' , ..y;/ , //, ; `_-J i ,I
Inspection: $0.00 _
l
Total $139.94 ( J/ - \
4/
PLANNING &ZONING (26 _
SETBACKS � _,;-,,,,....7";;!-- , '%/ �� , /' 1 ,/
MAIN STRUCTURE Front -\0-0 Rear --.u.:0' : Left -- 0: 0 Right o-0�%/ �,%7.X • -
ACCESSORY '' Front 00.� ,�('` 'Rear 0-0 Left 0-0 '�.` "� Right /,0/0 ) 7 i //
yvv 7,72 i
PARKING Exisbn 0 Required: 0 -Proposed: - 0 ,,-\\-7, `
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)754-5826
2446-46 WOO)
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
th/Work for which this permit is issued.
—theve 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.
2:;;;_:;.--My workers'compensation Insurance canier and policy number are: Y.. _
Cr- ary ----- -1- 1-E- tt JN .,P 6.2y:Number:-ZQ-J -00 -2273
_Wilts-ffiction 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 f• ich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Celifomia,and agggroe If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with.these provisio /1
„April pent Signature:_ t 1 `-Daje4 7. (0//2�-i,
0,FiMrTG:FAILURE TO SE RE W KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER��PENALTJES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($1 ,000),I ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affien.thal-l.am-licensed under provisions of Chapt• commencing with Section 7000)of Division-3roti11a'Businesss''andProfessions Code,and my license is in full
fort,antl-`e}1ecl.Llc.k !-_ AZO 'iT, • �las's:tl___ &.Z.
Cotltretlor's;$ignnCejaaseture: i/I/I� Date: - Z& 24.-6
CONSTRUCTION LENDING Are
❑ I hereby affirm that there is. Structien lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's 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 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 drivers 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,end 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,Califomia 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:
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,or a volume of 55 gallons,
or 200 cubic feet o1 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 0N
(Section 25534 of the Califomia 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 a plication akEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? application
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? ❑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 end 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 cos 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 • poses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
-;�� R�af Legal Owners) -7_ 7
Data
`1 _ I 6/ 6
Or-•uthonzed Applicant -.,_ Dated„
.. I., s. ..=....._-
- . .. .
QomiNTITIAI4 CODES INSPECTION TYPE DAIS 1NTMA1,$
1616 'd System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof tic &t 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
PROJECT ADDRESS: 1614 PONDEROSA ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 052530
OWNER'S NAME: GOYD, 'RAMESH
ADDRESS: GOUD RANJAN' PERMIT NO: P 052530 PLAN CHECK NO: N GOVT: N SUPP : N
'� P O BOX 4088
COSTA MESA, CA 92628 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
968-8653
ARCN/ENGINEER: REG.NO.: JOB DESCRIPTION : REPIPE GAS BBQ 6 INSTALL SPRINKLERS SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
PERMITTEE: RAMESH GOUD ( 71.4 ) 968-8653
ADDRESS: P.O. BOX 4088 COMMENTS : SMOKE DETECTOR REQUIRED IN THE HOME
COSTA MESA CA 92628 *****.*.***** *********x ****,e*** ****roc-x****x*x-****>F *fE*N•*>E ****x),:**+tyi•******+ *** •
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIR EMENTS
7000)of Division 3 of the Business and Professions Code,and my license is N tug force and effect. SETBACKS
CITY LIC.: STATE UC.: CUSS:
Date: Sgnature: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C).
LICY NO.: EXP.DATE:
oMPaxr: I PARKING REO: PROV: PARCEL: 13931106 ZNE: REF NO:
❑ Certified copy is hereby fumis ed. ❑ Certified copy is filed with the city Building Division. PLANNING NO'TES>
>
Date: Applicant: ********************************************* *
**9E********** * MiE***** ** *******
EXEMPTION FROM WONKEIIS'COMPS TION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S F. R V I C E S- R 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 employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED • B Y ,i. ' . DATE:
Date: Signature: BUILDING APPROVED BY : DATE:
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. 210 -a/./�
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction tending agency for the performance of the work for APPLICATION ISSUED B Y: L.�, DATE: �^
which this permit is Rsued(Section 3097,Civ.C). *****A'****************tri R.*.*#r.r74******. **x—.y.k..****.**h Roc****Z********A'*7t-* K*M'•*
LENDER: *********************i(**************1n-r-**jt*if**Y.*k**ii*N**************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 6 0 0 ..
repair any stmcture,prior to its issuance.alto requires the applicant for such permit to file a signed statement that he/she Is licensed 25% SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business P 7.AN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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). ISSUE FEE 3 . 00
I, as owner of the property or my employees WO wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 6 . 00 3 , 00 0 . 00 9 . 00 9 . 00 . 0U
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 REVENUE DIVISION TOTALS--> COLLECTED: 9 .00 OVER/SHORT: 00
Improvement emldwl)nin one year of completion,the owner will have the burden of proving he/she did not build or improve
fororthe 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 9 . 00
❑ 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 projecswith acontractor(s)license pursuant to theContractors'State License Law),I am aware ***'N'ii'i.'i'**'**?i'**iF************n'**'********'******4!**k'X'*******1F***'X'it*****'?('*****-1('*****
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B P 7 0 44 B.S P.C.
for this reason: ALL// WORK BY OWNER r`,,, , TYPE QTY DESCRIPTIO N UNIT COST • TOTAL COST
Date: C( 9N6 f I_ Owner: WW �y � PLU 1 GAS RE—PIPE 2 . 00 ' 2 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 1 LAWN S P RN K L ER SYSTEM ON 1 METER 2 . 00 - 2 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the Irements for a p L U 1 VACUUM BR F'R/B ACK F'L OW PRO T. 1 TO 4 2 . 00 2 . 0U
permit for construction or modification from the AirAlr Duality Managet District.Residential onstructi pplications are tempt from , END OF FEES
Cthese provisions. I
//Date: 12�' 1 1 Applicant' /
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 hereby autho' representatives of this city to enter upon �above-mentio
property torinspection purposes. �0// ✓ -
yeTa' I I Signature:
F/Driver's License or Social Security is
1641-46 White—Building;Green—Code enforcement;Canary—ApplicanC Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING ' - & 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
5? Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7..Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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
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 1 79. FINAL INSPECTION
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning -
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 77n/w Gep
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation -tf c.(Q( £4 t2
44. Landscape Irrigation System 1/44{ (_A&
45. Sound Attenuation '
46. Handicap Regulations
471. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. .
CITY OF COSTA /M $ CONSTRUCTION PFWMIT PERMIT NO. �� TRACT NO. LOT NO. UNIT NO. A'P'#
Project Address /p/hi 41Q?)
PONOtAos/} CogrIMV sq 8 Ste- (39 - 311 - 0(0 , Q7 Zone R,t
1 S Main Building: Accessory Building: J
"'. 7S1" TYPE OF CONSTRUCTIOrI H NEW pg ADD ALTERATION H REPAIR
Applicant's Mail' g Address 6 E / Z
re-- ^dt /'>� 9 e• 7 ❑ CONVERSION DEMOLISH ❑ OTH ,y�,� T Front 0
Owner's Name "F1 r'1�5�� WU Phong .J3 `i DES RIPZIO�N OF 4YOR OF g1-gG. PO/"/� 1______ ' B Rear (x� N
Address /6/`]/ f'oNE'IZOS� CO$'r�}M'7L�$,�q,e. F NC-E 4a V4- U L�LOa( t-stcL l. . A 1 I
IArch/Eng. License No. Sae_ (p$ TYPE OF PERMIT ❑ GRADING L7 FOUNDATION El STRUCTURAL K,.Right bn p"C� - l'!`� �2-{7ty1 G
Address T l— ��� ��• �n ID TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL (`r S Left 'fit_ a f r0��'es R
Contractor's Name — ' ^
7l�SEPH m4 Phone�.,Z l ' ❑ OTHER 4G.M 11 Foo 1Np -�71(buy I Ping. Ref.# Parking Req./Pro ded ' E
Address(mailing) PROJECT DESCRIPTION SQ. FT. 23 OCCUPANCY 0 1 h �t r� f.7S.A.J-+! Q
/� N,u L-/ r PlanningNotes: /,., r
, ( �', CONSTRUCTION TYPE r GRADINGR•"�1 (. LU9TION$ ��I IG `v p�f. ce-e, nQ �u� M
City License No. LL1 ZONE CU.YDS.--� ACRES Q S�Cs�� /`YS.V''-4'/1'/ �.L PfOW's V ISS S.
LICENSED CONTRACTOR DECLARATION -7 3 L� c �•T . 1
I hereby affirm 7 that) I am licensedion under provisions ns Charter Remarks: f ^•/ S. �,r _�, tr/No_cli section �--i-
myhis n full of Division 3 of the Business and Profess �tle a 3 Wt �E�
ge
my license is in full tome a -vifect. • ELECTRICAL FEES
License la l... I - se No. 4"---"mine
fSr -'rte
pate PLUMBING ' FEES Automatic Washer Transformer 0 15-50 KW '
_ Signature �/a%:r�, !• ����
7ORKERS'COMPENSATION D/
" LA RATION Construction Pole Sub. •
0 50+ KW
-, Bar Sink Showers
dereby affirm that I have a certificate of consent to self-insure or a certificate
`df Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
3800, Lab. C.) Dishwasher Meter Dover 100 amps
Policy No. Company' Backflow Irrigation Sewer Cap
8 Certified copy is hereby furnished. —
Dryers ❑Gas ❑Electric Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant - - Fan Motors❑0-1HP ❑1'f.-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(Thislessection need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. Inc.Solar 09-75 HP 016-15+
I certify that in the performance of the work for which this per it is issued, I Fixtures '
shall not employ any person in any manner as to b om s 'ect to the Drinking Fountains Solar Tank Microwave
W kers'z�o pen�9 n Laws of C lifornia. ,
Oaat 'Qom—Signature Floor Drains Swimming Pool w/Spa Device Boxes • Pole Light
NOTICE:If,after making this declaration, pu shout become Subject to the -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range ,
.
comply with such provisions or this permit shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
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. C.) Interceptors Water Heater - Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water ServiceGenerator 00-5 KW 05-15 KW Trash Compactor
•
OWNER BUILDER DECLARATION .
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash --
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 Laundry Trays
,any structure, prior to its issuance, also requires the applicant for such permit
1 file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
e Contractor's License Law (Chapter 9 (commencing with Section 7000)of .
,vision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
.nerefrom and the basis for the alleged exemption. Any violation of Section -
703L5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars($500). II DEVELOPMENT SERVICES REQU REMENTS: //
• I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3 S/a/8 U
,yam/
compensation, will do the work, and the structure is not intended or-offered 1 Zoning Approved By !v`AA` Date !
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
CiCA-Law does not apply to an owner of a property who builds or improves p'� /J
thereon, and who does such work himself/herself or through his or her own Hood or Type ❑ • Application Issued By Dateir;
employees, provided that such improvements are not intended or offered for Boiler
sale- If, however,the building or improvement is sold within one year of com- Canopy Type 11 ❑ SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground /\Pa
prove for the purpose of sale). - BUILDING PERMIT $ ' c - SMIP $ 1.1
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - PLAN CHECK $ 222c PERMIT
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 ' 0o-100,000 BTU'❑100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon- and who contracts for such oroiects with a con- -
tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration I PLAN,CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers
MICROFILM $ r
PLAN CHECK 50% $ 1
�to — Owner Heating System&Ducting Registers _ MECHANICAL $ $ �j82
reby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTI, • TOTAL FEE
•PO mation is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
andlrstate laws relating'to building construction, and hereby authorize repre- -
•
•
sentatives of.this city to e'ter upon the above-mentioned property for
Inspection pun•sec. ,(]_�8t?
Signature e1: L♦ !/
— ; Reinspection Fee $15- I e Fee $ 3 ' 01 00011070-00011072 TOT C-l" 8,25
DATE: 08/02/88 TIME: 15:05 C/
0865-46,rev.5/88 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor
I/
ill
COIt�STRUCTION AND PLANNING F -& SPA
AF6PROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole_ ',''-" 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. '1 53. Steel Reinforcement
r
3.1 Electrical Conduit Utility-Undrgrnd. 54. Forms -
4. Electrical Conduit-Undrgrnd. 1 55. Electrical Bonding •
5. Steel'Reinforcgment 56. Rough Plumbing & Pressure Test ,•
6. Electiic1l UF ER Grnd.• 57. APPROVAL TO COVER-GUNITE ' 1
7. Footing"s ; t 58. Electrical Conduit-Undrgrnd.
i 1t
8. Foundation ' 1 - 1 Ogg G, N[ 59. Gas Pipe, 0 Undrgrnd.,Test ,
9.'Water Pipe-Undrgrnd. i,1 • 60. Backwash Lines,P-Trap, 0 Undrgrnd.
1
10. Structural Floor System . I ,l^ 61. APPROVAL TO DECK
11. Property Stjwer Line & House Connection 62. Backwash & Receptor-Final
1
12.' Sewer;Cap,1 ',i 11' j1 63. Heater & Vent-Final
.1 i
13. Roof;Drains tL -'< '•i' 64. Plumbing System - Final I
14.'Rough Plumhing; . - 65. Electrical-Final
15. Rough Electrical-Conduit • -.i r - - i • :66:SolarSystem-Final,
16. Rough Electric Wiring 11 ' - 67. Fencing & Access Approval
17. Rough,Wiring Sign i: • _
- ' 68! APPROVEQ.EOR PLASTERING
18. Rough Electrical-T Bar Ceiling ., 11 : 1 1 69. POOL/SPA SYSTEMS FINAL _
19. Rough Heating & Air Conditionirj'g I •FIRE DEPT. REQUIREMENT ' I - ' -
20. Rough Factory Fireplace _I .. : - APPROVALS Permit#
i .1 1
21. Ducts, in Strucftjre I 70. Underground Hydro
22. Ducts, Ventilatin t
t9 c .� 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test I
_f 72: Underground Flush
24. Roof Framing _. 73. Undergrnd.Storage Tank 0 Gas 0 Oil •
25.--Roof Sheathing" I I 74. Overhead Hydro
26. T-Bar Ceiling (Siructural) & Monocoat I 75. Dry Chemical
27. Frarne and Flashing i 76. Dry Standpipe
28: Lathing & Siding 1 L 77. FIXED SYSTEM FINAL
29. Insulation r . 78. FIRE PREV. FINAL
•1
30. Drywall Nailing -; .HEALTH DEPT. REQUIREMENT
Si. Plaster Brown Coat r; ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD`CERTIFICATE ISSUED
33.Final'Electric l= •^%% 1 Notes: $' ( i 1 I t6 dot Iv a�_8JC . tJ
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test I
36. Hood or Canopy ( I
L.
37. Final Factory Fireplace '
1
38. Final Pl1mbing
I .
39. Water'Servi�ce-Final ' I
40. Gas Service-Final 1. - •
.
41. Solar Domestic-Final. . - •
42. Backflow 9reventer ' ' -
- I
43. Backflow I(rigation j • _ ,j I
i
44. Landscapeilrrigation5ystem I
45. Sound Attlenuation
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING 71/G(// ^-/• •
48. Special Requirements Completed d�' �
49. Electric Release to Edison
'50.�Gas Release to Southern California Gas Co 1 I
•51. CERTIFICATE OF OCCUPANCY
No. Date • - 1 I
4 f
PARTYWALL AGREEMENTc+�
THIS AGREEMENT, made and entered into this a "2'- (U8 day of
, 1988, by and between 12 4-ME S \-F M - 0-E3 v-
hereinafter referred to as "LAND OWNER", and Tu WE O IJ lc Cp Cot)
hereinafter referred to as *ADJACENT PROPERTY O]NER".
It is hereby agreed that a party wall will be constructed on the
property line between 16, 10 PO M D E ce4- f} .517-
(Address
T(Address of Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map
recorded in Book , Page of Miscellaneous Maps, in the office of the
County Recorder of said County. The party wall shall be permitted to encroach
IN WITNESS YIIERREOF, the parties have entered into this Agreement the
day and year first above written.
LAND OANER ADJACENT PROPERTY G NER
(Signature) (Signature)
R6cr. ESH- M4- CT° S� u7P/co 4(/eAso, )
Name (Typed or Printed) Name (Typed or Printed)
1it Pondetc3ti Sr— /4/0 coSfa mrc Gv 4-26z4
(Address) C ��C C +� c ZG 24 (Address)
(NOTE: Please see reverse side for notary's statement)
• vim i(o ,Of(aIy �0�, �05 _
( re`s' - n K I I �v
•
Mr•a- wav tnu.. ••
�AFP5RO D
••
City of Costa Mesa Building Dept. CRY OF tosri,°W •
c A .,c w�tc oar 7 3 1I
AaCt
' : BY Pte- DATE 8-249 iO ram Ob'E• w
'HESEOCH CHANGES
WITH L.J PR JOB P O iL OF MAK:
NO Cr'i �GES WIT..I�UT PRIOR APPROVAL OF DEPT. gt
• 13 '34r13`s o.aRASO*•
a
i i HEI i59JAr•:CE OP tir:,Fi;;N.) OF A PERMIT OR AFFEOVAI OF
.. PLANS A—D SPECT ''A-fi,•:S ,.IAl. NOT SE CONSTRUED TO BE A
FE m T: FOK. G& :IT 'IT Pi:n.'•. ('1:. AN, IOLATION OF ANY OF
THE PRE:v.$IGN' T)C:r ` ' fl PERMIT P.€ uMING TO GIVE
1 AUThOFO _.> < THE PROVISIONS OF THIS •
• 2 SH BE o .:C, ET c: I: EAR AS THE WORK OR USE
i WHICH iS AUTHORIZES iS u.'.tFi:L.
1 THE ISSUANCE OF A PERMIT 53„SL9 C.'ON PLANS AND
3 SPECIFICATIONS SHALL NOT P,: `V,..tr 'WE Bl rING OFFICIAL .
T FROM THEREAFTER REOUI^ING It::: :VRR_CH•;)N ::F ERRORS IN
SAID PLANS AND SPECIFICATIONS,] Fftit,,\•:'!°VENTING
ILD
UUING]OPE I`!d5 SER G CA:?RI •I•LI U$DF'WHEN
IN VIOI/51ASED4 THIS CODE OP(OT ANY OTHER ORD: ANCE OF
, THE CO. 70 .70
1I .
'
.b 9 t .
lb
RESIDENCE RESIDENCE r' RESIDENCEIA RESIDENCE
W . ,JJ <jrw
•W
(n, F6/ /‘ F*4/6 04, 1610 h
ams
_ ST_REET S
'FON) g.05ft
•
•
} TYPICAL 61
1
CONCRETE BLOCK FENCE -
Cement Coping Optional I-1 ���— GENERAL— NOTES
Channel Block With 1.3/8 ill
Horizontal Top of all •
Fences • J MORTAR: One part Plastic Cement, and
E� GROUT: Three Parts Sand
For Fences 5'or Less 70 One Part Cement Three and
Vert.Bars 3/8"f at 4' -0"O.C. :CI o : �_- . ,� J`� • One Half Parts Stand
cr _ — COPING: One Part Cement, Three
• Parts Sand
For Fences Higher t Than"5' •,� ' -� CONCRETE: Well Mixed 11:2-1/2:3-1/2
Vert.Bars 3/8".9 at 32" O.C. Y m - - - - -
11 > = , ' Max. of 7 I/2 Gollons eof
nFill Cells Solid With Grout > z Wafer Per Sdck of Cement
Where Steel Occurs > -Reinforcing Steel Shall1f 'DGROUT MAY BE POURED FROM THE TOP
• �,irmi
� OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A-15-39 to 6 OCCURS.
A.S.T.M. iIN _ 1- I ' I . CELLSANDAREASOFHORIZONTALREIN-
All Steel to be Lapped 4 pi r - FORCEMENT SHALL BE CLEAR,CLEAN&
Ipe I I --r / FREE OF ALL MORTAR DEBRIS,ETC.
24"or to Code (H I(
NATURAL GRADE ' -
/vim\ .($% ndA ';
TWO3/8"OBARS a " . t• ' r e .• • .
CONTINUOUS TOP 1.-•-
•
- - -
& BOTTOM ` "� F-.-WIDTH TO 16' O.C. MAX. s
SEE CHART . °_
.HOQIZ.STEEL MUST BE TIED IN BELOW , DEPTH OF EARTHTCOTH
PLACE AT TIME OF TRENCH ---I - . ll
1/3 THE HEIGTH OF FENCE
INSPECTION. L . ---BLOW -BOTTOM OF FOOTING.
o-� l0' -
, „ 2"bAL- ` ' .. 'SCALE: 1/2" : I
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6 ' 5' i 4' I 3'
WIDTH 14" 14" i 12" . . 12"•
THICKNESS 10" 10" • 8 " 8 "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . . . . .20" . . . . . . . . . 16" 12"
SPACING OF EARTHTOOTH. . 12' 14' 16' • 16'
OWNERS NAME:
City of Costa Mesa, California PERMIT OERMADDNUMBER
• Building Department SIGNATURE: •
VY-'6D Nov.82 ••£E
PROJECT ADDRESS: 1614 PONDEROSA ST 174, UNIT: �,F6D CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 067597
. OWNER'S NAME: GOUD, RAMESH f
ADDRESS: GOUD, RANJANPrk- �L PERMIT NO: P 067597 PLAN CHECK NO: N GOVT: N SUPP : N
I P 0 BOX 4088
COSTA MESA, CA 92628 CONSTRUCTION TYPE; VN PERMIT TYPE: PLU PURPOSE: NEW
F'9 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL NEW WATER HEATER SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
PERMITTEE: RAMESH M GOUD ( 714 ) 968-8653
ADDRESS: 9442 SHADWELL DR COMMENTS : NO OTHER WORK AUTHORIZED
HUNTINGTON BEACH CA 92646 ***************************************************************r***************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S ETB A C K .C.,'
CITY LIC.: STATE LIC.: CLASS: EXP :
Dale: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
MP : EXP.DATE:
COMPANY: PARKING REQ; PROV: PARCEL : 13931106 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
Date: Applicant: **********************************************?E********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
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. 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: _I__
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. '_ L
CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY•3F3F"----ill . DATE ; __
which this permit is issued(Section 3097,Civ.C). ********************** m TWIX**************************************ifi.7l •I. 47**
LENDER; ************************** -**********************************************.F*****
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason PERMIT BLDG PMT PLUMBING ELECTRIC , MECHANIC FIRE SMIP/RES GRADING
(Section 7831.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or ,
repair any structure.prim to its issuance.also requires the applicant for such permit to file a signed statement that he/she Is licensed 25% SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
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 five hundred dollars(S500). ISSUE FEE 20 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
7 structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 7 . 00 20 , 00 0 . 00 27. 00 27 . 00 . 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.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 27 . 00 OVER/SHORT: 00
orimprovementMe
issolds le). one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for Inc purpose of sale(.
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business
X27 . 00
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 contractor(s)license pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F; E E BR EAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: �L .) TYPE QTY D E S C R I P T I O N , UNIT COST TOTAL COSTy
61 1044 L�L\ _
Date: Owner
PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END.'OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Dale: Applicant:
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 stale laws relating to building construction and hereby oute representatives of this city to enter upon the above-mentioned
properly for inspection purposes. b
(y �" � 1 01 00162264-00162264 TS7T 27.00
^Gate:_ `—( signature: � DATE: 06/14/94 TIME: 11:41
Driver's License or Social Security.:
1641-46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor •
e
CONSTRUCTION AND PLANNING • _ & 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
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. l 57. APPROVAL TO COVER-GUNITE II
7. Footings 58. Electrical Conduit-Undrgrnd.
8, Foundation 59. Gas Pipe, D Undrgrrd.,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
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
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping r7 Gas D Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas n 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 PREY. 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:
34. Final Heating & Air Conditioning 6_j .G',/1 a-itra tyaif
_ 7
,
35. Final Gas Pipe-Test / -az v f �! ,
-IA'
-
36. Hood or Canopy l� eta-4-'
37. Final Factory Fireplace
38. Final Plumbing ` l�
9.49
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backf low Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co _
51. CERTIFICATE OF OCCUPANCY
No. Date
10735
COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED
P.O.BOX 317 COSTA MESA. CALIFORNIA GG/iee���I ,-/- ‘,/- 0I fOR APPLICANT TO f/LL /N COMPLETED' APPLIOAEIN UK PERMIT
/,1
TYPE
EEY}OR PRINT an rib uQer SA
DREIS
ADS 1614 Poi; rosy Street �`�YLJI1
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
OWNER Maylene, Inc. RECEIPT NO. I JeIT NO.r
MAIL RECEIVED BY DATE RECEIVED 1(D,ATE IBuU i�cC
ADDRESS 419 E. 17th Street n I //— - I . uv .1
[Tv
ICosta Mesa, Calif. TNO.I� 81159 BUIADLDING RCHITECT Carlson & LIC. COSTA MESA, CALIFORNIA
R ENGINEER :,:iddlebtuuk NO. FIREnnDDRESS 'I� Garden Grove ZONE TYPE I GROUPONTRACT Rke & 01egrove, Ino• LC?NO. 167293 APPROVED
6Y DATE
DDRESS 419 E. 17th .St., Costa Mesa ZONING
f� 3'�'7'��lr9 ZON NO.OF UBE OF NEW
ESCRIPTION I NOT 5" I BLOCK I TRACT ( �/ I PLANE 1 �I"BUILDING Q
A.P.NO. APPROVED / ,/ i ir/- � r57
BY �/j //�I �DATE 'J
OF LOT 701 X 1001 SIZE I NOW OF BLOT YARDS IEftWED�
NOW ON LOT None REQUIRED L OWED
USE OF None (CENTER LINE ST.) i/
EXISTING BLDG. FRONT 3 2-....1-T. IN.
SETBACK LINE FROM ry}
CENTER OF STREET 521 REAR YARD 23 R.SIDE FT. IN.
SIDE YARD I LEFT 51 I RIGHT 51 L.SIDE /�ZZFT. IN.
DESCRIPTION OF WORK REAR D,----3 FT. IN.
NEW I X II ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
BUILDINGNO.OF
S ZE 1647 ROOMS 7 STORIES 1
EXTERIOR WALL ROOF
COVERING Stucco 'COVERINGBRock n�'r/A
US OF BUILDING AND WORK TO BE PERFORMED `� 7
Ingle family residence with
attached garage
Plan 7t0 A
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. VALUATION
SIGNATURE OF PERMIT FEE S 36.00
PERMITTEE ) 7t7,0 /.41,-----
S 16,562. PLAN CHECK $ 18.00
AUTHORIZED AGENT Dike 6 Co igrove, Inc. TOTAL FEE $ 54.00
a