HomeMy WebLinkAbout799 PRESIDIO DR - Building PermitsCITY OF COSTA MESA, CALIFORNIA
NOTARIZED STATEMENT OF RESPONSIBILITY
T0: WHOM IT MAY CONCERN Building Permit No. ��6
This Permit No.
%�% '�i� �s� ���, 11� /5%/ - 3/3 - o�
Street A ress AP Number
I,��� !�%/%E/�,t/Cr o J✓ , as Owner i n Ti tle of the above refer-
ence pr perty, o ereby request permits to be issued as Owner-Builder.
Should any person become an e�loyee engaged in the improvement of the
property, I sha11 immediately provide Workers Compensation Insurance coverage
and Cause a certificate of that coverage to be filed with the Building Division
of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do
not transfer to any other person, canpany, or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or
officers harmless from any claim resulting in damaae or personal injury to
myself or any other parties.
Jos�! � � , i � , /� �.��9�a
rinted Name Date
`► .__�..'% - � .
' ��-' . . _
Notary's Statement:
, ,,, �State of California
County of Orange
� _ . _ _ . ._ .
� Suhsrribed and sworn to befare me tYus 18Yh day of April 1980.. JOSEPH C. MELANCON
whose Divers Liscense No; D1-N-3255273 California e�cpires 11-19-83.
r. � � `� � �1C\��--�c.tu'✓�
,T ET P. McISAAC
Notary Public - - - - - ------�---�-��
my commission expires (�FFi(.'IAL SEAL '?
Feb. 8, 1984
' "" � JULIET P MCISAAC
�=m ^ NOTARY PUBLtC - CALIFURNI4
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5611 4/21/80 5.50 T�
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI ATION FOR STRUCTURAL PERMIT
' P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
REC PERMIT , / D/.
For Applicant to Fill in Completely — Use Ink Only �� Q V
AD'DRESS / / / Q S( ".P. "o. / y ( _ 3 / 3 — O
(f//y BUILDING � '
�R�/OSC �J(� � �/Q�� ADDRESS /QBC)
q UNIT OR
ADDRE55 7/ �/L/y�� �,.� . SPACE NO.
CITV C: R�O�(� �/�/ / TR„[JO�,. ,/ � 'LOT y 9 BLK.
NOLdT�' 7%S S _�
NEW ADD ALTE REPAIR MOVING DEMOLISH
CONSTflUCTION
LENDER
BRANCH
� OWNE � .Q %LlEL F�
ADDRESS VALUE
ARCHITECT / TEL. USE �(rG� O" L%�� �Q,C� $/�O
ORENGWEER � - N
�✓�
ADDRESS ZONE ' T v ROUP
APPROVED � q' q�
CONTRACTOR 'C j�0/�j ,qJ L BV - DATE L QV
ADDRESS g. q.�-p-.r�� �
TEI.
CITV NO.
STATE CITV %�PPROVEDSETBACKS _
LIC. NO. LIC. NO.
SIZE / � r/ � NO.OFBLDCS. (FROMC/LSTREET)
OF LOT �O S� f\ NOW ON LOT RONT FT.
usE oF y �
EXISTING BLDG. �S 7� FTE�Ci O FT.
Separate permits are required for L. SIDE FT. O
electric, plumbing and hea[ing work: D II
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PL.qNNING ACTION O_��
z i�' /
�y{ OATE <-
�Y �/=� C H.�' APPROVED ��— I Y r
APPROVED / . /� / _ p ,l
'�' l Q V
I �ereby acknowledge'that I hava read Nis appllcetion and state � '
ffiai ffie above information is correct antl a8rea to wmply wiffi _ �
all laws reBulatin8 builtlin8 consttuction, entl I shall not employ . � �
any person in violation of the workman's compansation laws of
the State of Cslifornle.
I hereby cerNfy that I em proparly licensed as a contractor under SQ. FT.
the State of Californie Businass antl Professions Cotla, Division 3, THE AMOUNT SNOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licenses ere in full forca antl effect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from the provisions ot the State of Calitornia Business VALUATION PERMIT FEE
and Professions Cotle, D(vision 3, Chapter 9. $ � 0 0
� / PLAN CHECK ' E � �' �
Signature B `{r/ /
Permittae 07 �'�� $ /8� TAX $ Q' �SO
or _. �
Auffiorizetl Ageni ate TOTAL PAID $ s S�
OwNER JOSEPH C.
AP No. 141-313-(19 LOT 47 TRACT 3749 FIRE ZONE
AS
ATER
S�ROP. SWR. LINE U HOUSE CON. U
5 INKLING SVSTEM
MISCELLANEOUS
�ROUGH HEATING AND AIR CONOITi0N1!
�TEMPORARY SERVICE OR POLE
NOERGROUND � POWER �
OUGX WIRING
SRENCNES FORMS STEELI
�LOOR SVSIEM
ON� BEAM � STEEL REINFORCE
HEATMING
AME aN0 FLASHING
LATHING — iN � OUT � -
PLASTER, 9ROWN COAT
STRUCTURAI. FINR�
DATE 4-21-80
SUBCONTRACTOR
� ,� r , 38670
� COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Complete/y
BUILOING �� ' �FS1���O 1='� �
ADDRE55
�
OWNER �.P ,� �, �y��.=�-�,��„�
ADDRESS / � I�I�LESf�+.O �%'�`�
m�7 TEL.
CITV t�6,S�J�j� �! �j /�' NO.��I(.%
CqNSTRUCTION /j/O/✓C
LENDER /
BRANCH N ��!�
ADDRESS SA�JG
ARCHITECT S C=�'S
OR ENGINEER
11DDRESS Si�-{i� �[ %�-S
CONTRACTOR Cl.�/
ADDFESS
CITV
STATE
LIC. NO.
SI2E
OF LOT
USE OF
EXISTING BLDG.
NEW BLDG. 1 �� �v
EXTERIOR WA�L
COVERING S�Ntt
USE 9F BUILqINs• AND
TEL.
NO.
/�Gou r
I
TEL.
NO.
CITY
IIC. NO.
INO. OF BLOGS.
NOW ON LOT
NO.Of
Fi00M5 I STORIE!
ROOF
COVERING �O/+'J IZ
I( TO BE PERFOFMED
PAID .i.a;: ��1.�U
';li 11-Ri'�:�c;�� 90"0': :._ L
.I ATION FOR BUILDING PERMIT
D V DATERECEIVED O E�UI
� � �� i
141_3��_ �o ��"y`�i
BUILDING G
ADDRESS
TRACT 3
W A
OWNER OS
U E �=
FIRE
ZONE
APPROVED . /
VALUE
DATE /�,
ZONE � NO.OF USE OF NEW
I PI.ANS � BUILDING A
VARDSAPPFOVED VARDSAF
MAIN BUILDING ACCESSOF'
VAR. q�
7—
R
BET. MAIN &
ACCESS. BLDi
OATE
APPROVED
I hereby acknowledge that I heve road this application antl steta
that the above information is correct and egree to comply with
atf laws reSulating builtlfng wosauccio4 antl 1 shell not amploy .
any person in violation of the workmen's compansetion lawz of
the State ot Calitornie.
I hereby certify thet I am properly licensed as a contrecm� untlar SQ. FT.
the State ot California Businass end Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER V
Chapter 9, and thst such licenses are in full forca and etfact, or I THE PUflPOSE OF ESTABLISNING A
am exempt from the provisions ot t�e Steie of Cal�fornie Business VALUATION
antl Professions Cotle, Division 3, Chapter 9. �
/ PERMIT FEE
Slg[�dtUfBOf�i / � (?il� L �}��/ ��
Permlttae ,� �-{ /G`'7 � � ' -�' t`-'C¢��'L/ $ `✓ J- PLAN CHECK
Authorized Agant
TOTAL FEE
�
O
S FOR j
ONLV: m
��./� ¢
/ N
�,
m
ti `o
� LL
JOB ADDRESS 799 �'esiUio Dr. BUILDING PERMIT
APNo.t41-311-iu LOT TRACT FIRE
WS
W ATER
ROUGM PLIIMBING
PROP. SWF. LINE [l NOUSE CON. �
SPqINKLING SVSTEM
MISCELLr1NE0U5
ROUGM HEATING AN� RIR CONOITIONING
TEMPORARV SERVICE OR POLE
UNOERGROUNO � GOWEF �
ROUGH WIRING
TRENCHES � FORMS � STEEL RE
FLOOR SVSTEM
BON� BEAM [� STEEL REINFORCE [
SHEATHING
FRAME FNO FLASHING
LATHING - IN OUT �/�7�
PLASTER.BROW COAT
STRUCTIJRAL FINAL
HEATING. VENT., REFRIG. AND A.L, FII
GLUMBING, FINNL ANO GAS TEST n
ELECTRIC, FINAL
BUILOING, FINAL
SUBCONTRACTOR
. �2282
: �,.. : r-
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 CDBTA ME6A, CqLIFORNIA
For Appl(eanf to Fill In Complefely
� TYPE OR PRINT .
COSTA ME5A. CALIFORNIA ,
Mesa Del Mar Devalopment Co.
Suite 1. 3800�E. Coast 81Ah�
Levanas NE`�1Dr 37010
Macco CoXporation
1 OF LOT 65 R 93 I�o, oF e�o6eQ �
NOW ON LOT
��� R����vE�
�� JUN 17 9
FINANCE DEPT.
CITY OF �COSTA MESA ,
APPLICATION FOR PERMIT
.oe � 47 BUILDING
?lan.� 2C
- For Office Use Only
REGEIPT NO. I 6
e�r
RECEIVEO GY pAT6 HELEIVEO DATE 168UEO
�'�J � 6-i�� o ��� -� 5 G h
ADDRE55 799 Prasidio Drive
COSTA MESA. CALIFORNIA
APPROVED
ZONING
ZONE NO.OF lI6E OF NEW
/� � I PLANB BIIILDING
� /
�;°�e,e.,,,., Lot 47 T�e„« dt a
utie Vr YARDS EVES
EXISTING BL'DG. APPROVED ALLC
MeR OP eineeiM �LO REAR YARD 31 ��NTEA L{NC BT.
FRONT FT.
SIDE YARD I LEFT S I RIGHT 5 R. SIDE S FT.
' DESCRIPTION OF WORK __ ,—� _
BUI�DING . NO. OF
&IZE 2 0 ftOOM6
EXTERIOR WALL SCUCO� ROOF
COVERING ICOVERII
USE OF BOILDING AND ORK TO BE
Residence
with attached garage
I XEREBY AGKNOWL6 GE THAT 1 HAVE ReAD THI APPLIWTION
AND BTATE THAT T ABOVE �8 CORREC AND REE TO CON-
PLY WITN ALL CITY RDI Ge9 ANO TE 8 fIHODUTING
BUILDINO CON9TR 10
SIGNATURE OP
PERMITfE �
AUTHORIZED AGHN Pr�ject Manager
REAR �
APPROVED
%�g� `�!
�/ ./„ p �_ :
TXE AMOUNT 6HOWN UN�ER YqLUAT10N IB POR THE
PUIiPOBE OP EBTA�LIBHING ♦ PEflMIT FEE ONLY.
VALUATION 3Z . OO
' PERM17 FEE $
$ 13�515.0� pLAN CHEGK $'16.0�
� TOTAL FEE 48.00