HomeMy WebLinkAbout422 PRINCETON DR - Building Permits� ;
�� w
,
, ;
CITY OF COSTA MESA
` 0'rtp MF q BlIILDING DIVISION
F�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
° � FOR INSPECTIONS CALL: (714) 754-5626
��'°"°"°� PERMIT NUMBER: 609-00283
PERMIT TYPE B_ROOF2
APN: 14137109
JOB ADDRESS: 422 PRINCETON DR CM
Vicinity: RESIDFNCE AND ATTACHED GARAGE
Squares: 2500
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
1 1/1 6120 09
BJK
$5,000.00
SCOPE OF WORK: REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED,
1 LAYER 30# FELT, qppLY 30-YEAR MALARKEY COM SHINGLES. 25 SQUARES PITCH 5:12
OWNER: TRACY, KENNETH L
PHONE:
APPLICANT: TORRES, CUSTODIA
PHONE: 949d98-2274
CONTRACTOR: J L RAY COMPANY INC
Address: 103 W E5CALONESUnit:
Ciry/State/Zip: SAN CLEMENTE, CA 92672
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
$0.00
$111.25
$0.00
$1.00
5112.25
Address: 422 PRINCETON DR
City/Stale/Zip: COSTA MESA, CA
Address: 103 W ESCALONES
City/State/Zip: SAN CLEMENTE, CA
SUITE A
License No.
License No.
License No. 567238
PHONE: 949-098-2274
CELL:
PHONE:
PHONE:
UniL
Unit: :SUITE A
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes antl related
regulations. (Ord. No, g2-28, § 1. 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result rn the ezpiratron o( this permit.
CO�E R INSPELTIONTYPE DRTE IN1171r1L5 CO�E/ INSPELPONTYPE �ATE INTI71RL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 PoolSpa Final '1 ��{{ �� 208 Final Plumbing
200 Final Re-Roof j}�_�y.�%��+� 210 Final Eleclriwl
201 Final Block/Retdining Wall 212 Final Fire Prevention
202 Final Factory Fire place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Finai DerrNlitioq 250 F'mal Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aflrm un0er penalry of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compenSalion, a5 prOvidea (or by Section 3700 0( lhe Labor Code, lor Ihe
perfo e of Ihe work for which Ihis permit is issued.
(� I have and will maintain �wrkers' canpensatbn insu2nce. as requiretl by
section 3700 of the Labor Cotle, for the perfwmance o( lhe v.ork fa vfiich this
pertnit is issuetl. My wnrkers' ompensation I urance carrier and policy
number are:
���: ��� A �
Tlrissectmne rwl� /d�� e��Pe�4u' IuaCalonahuntlretltldlars(S1L1�)wleu)
Polic Num er: /% �% �'g�
❑ I cenily Ihal in Ihe peAormance of the work lor which this permit is
issuetl, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Califomia, and agree that if I should
become su 'ect to the vrorkers' compensation provisions of Se ion 3700 of
iha Lab � ode, I 5 II (orthwith comply with Ihese provisions. q
/ �p � /
ppinncll
WARNING: FAILURE TO SECURE WORKERS' COMPENSA ION COVERP.GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100.000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE. IMEREST, AND
AITORNEY'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 antl Pro(essions Code. and
my license is in full force and eflect.
ic^i � C ss
� / c
.> /
Convact �oeSsiooat'Re
l/
CONSTRUCTION LENDING AGENCY:
❑ I hereby affrtn ihat Ihere is a consWctbn lentling agency (or the
pedormance of the wurk for which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lentlers Address:
Da�e
OWNER•BUILDER DECLARATIONS:
I hereby affrm that under penalty o! perjury thal I am EXEMPT FROM 7HE
CONTRACTORS LICENSE LAW for lhe (ollawing rea5on (SeC. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
conslruct, alter, improve. demolish, or repair any struclure, prior to its
issuance, also requires the applicantlor such permit to fle a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 ot the
Business and Professions Code) or that he or she is exempt therefrom and
the basis !or lhe alleged exemption. Any vi0lation of Section 7037.5 by any
applicant for a permil subjects the applicant ro a civil penalry of not more than
fve hunOretl dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, anC the slnicture is not intended or
offeretl lor sale (Sec. 7044, Business antl Professions Code: The Contractore
License Law dces not apply to an ov+ner ol property who builds or improves
Ihereon, and who Coes such v.ork himself or hersell or through his or her ovm
employees. provided that such improvements are not intended or oftered for
sale. I(, however, Ihe building or improvemenl is sold within one year of
completion, the owner-6uilder will �ave the burden of pmving t�at he or sha
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am El(CLUSIVEIY CONTRACTING WI7H
LICENSED CONTRACTORS to consWct the project (Sec. 7044, Business antl
Professbns Code: The contractors license Law dces not apply to an owner of
property who Duilds or improves thereon, and who contracts for such project with
a cont2cta(s) license pursuaN ro the Cont2ctors License Laws.).
❑ I am exempt under sec.
Business antl Professions Code forthis reason:
Ovmer ID verilied by tlrive� a iicense. ❑ Ves ❑ No
Driver's License No. Expires:
Verification of Ownership by Qype of documenC i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certify that no extavation frve (5) or more feet in tlepth into wfiich a
person is required to descend, will be made in connection vrith v.ark authorizetl
by t�is permit, and thal no building sWcture, scaffdding, falsework, «tlemolition
or dismantling thereof, will be more than thirty-sx (36) feel high. (Chap. 32, Grp
2, M 2, Sec. 341, Title B, Calilomia Atlministrawe Code).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit Imm the Division o! Industrial Safery, as noted above, unless
such person has a permit to do such vrork from the division.
Apoliwnfs SignaWre
Division of InduSlnal Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
t. Will the applicant or presem or fuWre building occupaN need to file and
cenily a Business Plan for emergency response lo release or threatenetl
release ol a hazartlous material? ❑ Yes ❑ No
(Section 25505 of Ihe Calilornia Health antl Safety CoCe requires, with sOme
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Oepartment by every business which has at any one time during a reported
year a quantity of hazartlous materials equal lo or greater than a weight of
500 pounds, or a volume of 55 qallons, or 200 cubic feet of compressetl gas
at standard temperature and pressure).
2. Does or will the applicant or presem or fWure builtlinq occupaN need to file
a registration form for acutey hazartlous materials? ❑ Yes ❑ No
�Section 25533 of the California Health antl Safety Code, with some
exceptions, requires regis[ration with the Cosla Mesa Fire Department by
each business which at any one time has on hand a quanlity of awtely
hazartlous materials equal to or greater than a wei9ht of 500 pounds. or a
volume ot 55 gallons, or 200 cubic teet of compressed gas at stantlard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Pmgram for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Satety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
(ling wilh the Fire Department of an RMPP by businesses which are required
to register aw�ely hazardous materials with Ihe Fire Departmenl.
4. If an RMPP is presently required, has Section 25534 0l the Calilomia
Health and Safety Code been fully wmplied with? ❑ Yes ❑ No
5. Does or will the appliwnt or present or tuture building occupaN require for
the work which is the subject of Ihis applicalion a permit for such wnstruclion
or motlification from the South Coast Air Oualiry Management Distnct or from
any other air pollWion conlrol �istnct or agency? ❑ Yes ❑ No
(Secl'an 658502 of Ihe Calilomia Government Code requires that the requestetl
infortnation be furnished on applitations lar non-residential building permits�.
6. Will any part of Ihe lacility to be constructed under Ihis permit De wilhin
1000 feel Irom Ihe oUter boundarie5 OI a SChool4 ❑ Ye5 ❑ No
Qf "yes", the lacility must meet the requirement o( Sections 25534 and 42303
o( Ihe Calilomia Health and Safery Code).
7. If a permit fmm the South Coasl Air Ouality Management District or other
air p011uti0n control tlistriCl or a9enty i5 requireC for Ihe wvrk vfiich is the
subject ol this application, have all of the discbsures prescnbed by Califomia
Health antl Satety Code Section 42303 been made? ❑ Yes ❑ No
8. pf'yes", allach certificate o! compliance trom the appropriate air pollution
control oKcer). '
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
inlormation given above is cortecl. I agree to comply with all state laws and
city ortlinances regarding Hazardous Matenals and Emissions.
Slgnawre Da�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state Ihat
the information given is correct. I agree to comply with all state laws and city
ordinances relating lo builtling wnstruction, antl 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
authonzetl by this pertnit until fnal inspection.
Signa e o( Legal Owner(s� �e
Slgnature Da�e � �` // s
]OSP46�101� AntlbrAum '"
--�
�nonEssaem�wxo: 422 PRIA]CETOF] DR
pWNEN8IUYEIFRlOWN: TRACY, xEr�riFrx L TR
♦ �ow+ess 422 PRINCETOPI DR
� COSTA MESA,CA 92626
�vr�.uuiaa �ooxess:
AIICHRECt OR FHdNFFA:
qCX.OX FHQ'S 1NONE55:
wxm�crars�•�.
carm�croxs�uiwo
�no�ss
uMr:
uc. xo:
uNr:
uc. xo.:
uxr:
LICENSED COMflACTOflS DECIARATION: 1 �ereby � m uiMer panely d perjury Mn I em IcaneeE uMs povbiaw d Cheqer 8
(commenarq �mh Section ]000) d Oirie'pn 9 d iM Buainme vM Pmineiona Code. vd mY licame b in lull tace eM eHed.
CITY LIC. NO.: LIG ClASS: IJC. NO.: E}f F1 �
Ome: ConVatla:
OWNEN BUILOEF OECLAN�TON: 1 Mnby elfirtn u'Mm pandy d perjuy �hel I am wmq Irpn �he Comratlan Liceime Lew fa Iha
IdbwnG �emon (Sedpn )W 1.5 Bueiroft eM Prdasaiona Cods: MY JY a oduaY wfi� n9�tim e OamG �o wmbuct, e�a.'vnPova.
demdeR a rspv arry muctura, p'n b m eeueMe. e6o repu've� IM epplimN la wch penrvl to fiM e eproC nmema�u Nei M a�M
n uosb.e wwwara m ine aovi�o�• a m. comrm«s um�.a �ew Icnaq.r s 1�+�*��o wan seao� �aool a o�,ean s a �ro
B�a'vwa erd Rdmsuna Codal a thu M a ena u uemq thaahan eM tM Eem tp Ur elbpaE uamqion. My videtion d SeCion
)0]1.5 by erry eppliranl la e petml wbpCs IM epd� �o e d�+l penelly d �ql maro Ihen /we huMred ddlen �5500�).
Q I, av owror d �ha D�WanY a my empbyeee wil� wepea m Ihei �de compenWian, xill do Ihe work, vd tha si�ucture c �rot imeMeE
w dtereC la mb (Sec�ian ]006. Bueineae end Prolecaions CON: The Comretlae Licwua lew Eom not epplyb en owrier M popeM
wno wb. a mw� �n�..�a ww eoes.�rn � �:m»x « n«+w «m,own ne «ner �.mc�w«•. w�ae inm a��n
impovemems era nd'uNenEetl a diwad lor eele. tl, lwwewr, l�e WiNiiq a inpaanam w wtl wiihN ons yeer d camplMbn. IM
owMr-0uiMx xiq hm the Eurden d pwirp M« sM did � buiM or impow lor IM purpo�s d ubl.
❑ �. m m.�.. d ms o�wm. am kdu.iwM em�rea�o wnn �icanesa cowenas ro mmne m. aa� Iswun rou. ani�wss vd
a�aeemo�. coee: rne cwu�.ao� ucenu �.. eoas �a .cdv a.� w�e. a ww�r .no ww. « wwo+a ��, .�a .no
ooniracb la a#i pojaa� wilh e mu�aeor(e) fcerned punueM to �he Cad�erJaa Liwns lew).
❑ i.m �/^�y� ��a s��: e. a a.c.. wf/w�. ,...o�: r //(� ,M.,/�, •�.y/ �
Daza: S/ ��� � Owner: /i� .1 iYLIL�N 1/� �Ll/ � �
1 Ea MnEy cMiry Ila� I em eware d en0 uMeniend the repuirameM� W CelAomie Meellh eM Sefety Cads Saqiwu , 2551'f. enE
25S1a, end ihm I ar eny INun Wildiip ampeni will / wdl nw (arcb one) neeE to canpy wYh eek tlete oodm end �M repuimmems la
epeimnlacwnvunionamotlifiWionhantheAi e�iy anepamaniDiatna.ReaMmiial�mnrwionepplrmioroeieexemqiramlhme
Dele: AVq��
WOPKER'S COYVENSATION DECLAX�TION: I hreEy eff udr pruAy d prµry oro d Ne to0owirp Eedutliom:
� IhevaeMWmeinteneemNiWotlmmMlo�etlaw�alorwekrs'eompav+tion.mpmiJedlorbySauion�100dIMleCw
COEe, ln tM perlarmerca d tM xdk la wlich ihu prmu u uvued.
❑ � nm. ena w meimen �w�wa.• w�c«�on �wre�ce.., �ec���.a M s«aian smo w m. leno, coe.. ror me o�«menm a ine
wak la Miidi IM1u pe'mil b u�ued. My wvFen' compen5a�ion ineure�ws � ie� eM poliry �wmbm us:
c�a,:
vdKyN�me�:
(Thi .Wiun nead not 6e rompbred / tM pmmt's br are hundred Ed/en �YI001 a bv.J
1 oenN � in Xr peAamerce d Ilr wark lar v.hch the pem�4 b bauM. I MM nd amploy uy ps�on m vry memer n m Io
bqec�ame�e p�ieyd t }�qh�eayxaLM1Bxeda' com�ethe labor CaEe, aNe. ��� Nm 4 1 wbia to tM wlmn'
Dele: J j� r[ J Appl.
Wemlip: F�Nun ro�xuro wo�keri rompru�Hon cavenp l� un4wh�l, �ndLu/l ub/�c! en �nrylayw lo cAMrol p ms
dHl fln�� ,q ro om hunJrs! tMvuM Co/Nn (SI00,000/� In Md/tlon ro tln cw! o/ romveru�tbM1 earrupu u qo r In
Sxtlon J]O6 0l Ms Lebor Code, Infxuq enAettomey i/wa.
CON4TqUCTON LENOINO PGENCY: I MreEy �im under penalry W perjury �lat �here o e mnmiwfbn bnC'up apency la Ne
perlormenoe d iM nork la xAiM Ih's pemiY ia esueE (Sedion 3091. CM. C�.
LENOEfl'S NMIE:
LENDEH'S �OONE55:
I cMiM1/ Rai I hew meE Mo epp�ce�m end aeia lhe� IM aEwe "udammion e cmm.l epne to canpy wM1h e0 ary md advuyad'vivar
end eteie lews nW iq w buYdiq omvruaim and harabY eWrvi=e repraeenleti+ee d iNs cly ro emm upon tM ebo.smentiarod poperly
iw inspetlbn Wr
f�E ' � �
N�'ry/ n /�� �
���n /•f/lY ( v 'Q "�if-- De1e: � / �
Sgrawn d OanMhpenVAppkranvContrep
\ (5t5�J6.WP)
Whue-Bwldnp d Selery; Gnen-Fb: Geneiy-Appfunl: Pink-pewiue; OONervaFMae�ear
CITY OF COSTA MESA - BUILDIP7G PERP9ZT
PERM NO; B 072190
PERMIT A70: B 072190 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR FURPOSE: OTH
JOB DESCP.IPTION : LEGALZZE REROOFING W/COMP SHINGLES SQ FT: 2,000
CLAIM VALUE: 2,OOO.Q4 CALC-C'ALUE; 2,000.00 GROUP OCC; R-3 /
COMMENTS; LEGALI2E DOOR OPENZNG BET GARAGE S DINING ROOM
�tx�ihiF�F�)fit�ifaFjf±tr�f.F*iFiF*r*iF1F*if*�c�lRitrit�f*ic+taEificY.�EaFjtita:{Fa�s1�#*xacacicrk�ac�Fracx�cit�i�aF+c.r+�-++.�w�,c+r�iF,F�raciF
Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN P.EAR: FT IA7
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REO• PAOV; PARCEL: 19137109 ZNE: REF NO:
PLANNZNG NdTE5>
i
iE ifi4 IE if if�IF # iE i�'i� 1f iFiM-Y 3F Y-1EJf if�lf if�M-Mi�-1f'N�if �fif if')f iE iF if ifiF�)f YY-Ak dM.1.�1L ii ii if-1F1E M iF Y if iFif i' df {: �F iF ici4 i� Y i: iF a� �f �f iF�Y'7E iE 14 M"M'IE�iE i(�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONZNG APFAOVED BY .
BUILDING APPRO�TED HY :
LATE:
DATE:
APPLICATION ISSUED BY: �-�4- DATE; ��7
iEitiaiE�-<ii�Eifiaiti�ifx�caEia*ic�rticiFiF�iF��iF7FiiiZSt�i�if�lEic�r�F�iFi:i`7��aZ��������z�c*,�.�.+ar..r.w.acaF a(. �.ic -,F *x�c*
LEGALIZATION:Y F E E 5 U M M A P, Y STRUCTURAL SEGMPNT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADIAlG
PERMIT 90,00 .50
SMIP/NON-�ES
PLAr�
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECIC TOTAL PAID DUE
TOTALS----> 90.50 0.00 0.00 90,50 90.50 .00
REVENUE DIl'ISIOr] TOTALS--> COLLECTED: 90,50 OL'ER/SI?ORT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP;TOT GRADING PLAN-CHECK
90.00 .50
if !F ?F af M iF�1R M if iM1 if 1f 11�!! fi fi �t tt latf if iF i{ if�)f if iE jf iF if iR if Y-iFifiFif it s iF ?h if if �1-Y if iF1F�4 tfiL�ki�-�h iF 1f Y lfif iE Y-1�-9F aR Mx M Y i4 iF aR 1F iF if iF if if iF At
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R 2 P T I O T� UNIT COST TOTAL COST
SFR 400 ALTER bY VALUE RESIDENTIAL NOZONE 1.00 400,00
SFR 16U0 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,600.00
END OF FEES
. � ,
i
� i ' /A+�
�• I
01 0625l422-901$142o T�Gn�" �p.5p
GA7E: �JS�qg�y;, t,Tli�: 15:L9
�C�STRUCTION AND PIANNWG VOO. . SPA
APPROVALS Perinii # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Elec[rical Service or Pole � 52. Pool & Equipment Location '
2. Soil Pipe�Undrgrnd. ' 53. Steel Reinforcement � 1
3. Electrical Conduit Utility-Undrgrnd. , 54. Forms
4. Electrical Conduii-Undrgrnd. 55. E�ectrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAI TO COVER�GUNITE
7. Footings 58. Electrical Cqnduit-Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd„ Test
9. Water Pipe-Undrgmd. ; 60. Backwash Lines, RTrap, � Uiidrgrnd. .
10. Structural Floor Svstem ! 61. APPROVALTO DECK .
i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final , •
13. Roof Drains 64. Plumbin9 System - Final
14. Rough Plumbing 65. Electrital-Final
15. Rough Electrical�Conduit 66. Solar System-Final �
16. Rough Electric Wiring � 67. Pencing & Access Approval �
77. Rough Wiring Sign 66. APPROVED FOR PLqSTEqING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Oucts, in Structure 70. Underground Hydro .'�
22. Dutts, Ventilating 71. Product Piping OGas i.70i1 !ii„ `'
23. Gas Pipe-Rough & Test 72. Underground Flush ' !
24. Roof Framing 73. Undergmd. Storage Tank �7 Gas ❑ Oil %• 9 i
25. Roof Sheathing 74. Overhead Hydro i�''� ��
26. T�Bar Ceiling IStructurai) $ Monocoat 75. Dry Chemical �
27. Frame and Flashing . 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINA�
29. Insulation 78. FIRE PREV. FINA�
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 f o ��� c� Q� �
35. Final Gas Pipe-Test /
36. Hood or Canopy
37. Final Factory Fireplace
38. Finat Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to $outhern California Gas Co
51. CERTIFICATE OF OCCUPANCY
N0. Date
y
� �
FDOPFSSOiBNLOPIO: 422 PRINCETON DR
avrhxsruueiva�a+++: TRACY, KENNETfi L TR
moxess 422 PRINCETOPJ DR
COSTA MESA,CA 92626
�vri. y,vima.00xem
�xcxrtECT on ��+:
ANCH ON FlA'S �WflE53:
CONIHACipfSN�K.
CONiN1CTOR4YNW10
1DURE55:
UNT:
uc ra.:
uNr:
IlF NO.:
uNr:
LICENSEU COMflACTONS DECLAFAiION: I Mraby Nim unEm penetly d pajury iM� I am Ikeneetl uMer pwiaiona d Chapter B
(oomme�rp wiih Section ]000) d Gviaion � d Ne &vimae eM GMeaeions COEe, erd my lioenes o in lull brce vM eHeM.
cm uc. no.: uc. cuss: uc. No.; EX P:
OWNEfl BUILUEN OECUNRTION: I heeaby elfirm inMer pa�Wy N per�ury iMt I am uemp ham IM Conlrtlaa Liwua law lor Ne
idbxiq ieswn (Sedion )W 1.5 Bw'vime vM Praleuian CaEa: Airy cYy a oouMy wlurh nqu'vea e pemin io cantrucY. eMr.'vnprwe.
bmdeh, or repei mry s�Nclum, pior io'ta uauarv.e. eLw �uiim Iln epplimM la ach perme to fJe e egiwE s�e�emenl tlW ha a eM
� IieneeE Wn�� �o ihe porivane d iM Cmtretlora littn�e Lew �Cheqm B(cammmaiq wnh Saaion'lWO) d Oi+uion 3 W iha
Busrosa vd hdeae'wu Codal n �Mt he a ehs u uemq therahan enE �he buu Iw Ne elk0� memqion. Mn volmun d Seeion
)OJ1.5 6/ eiry eppkO�tl Ia e psmil auhptlf IM eppl'ceM �o e dW psnelly d nol mas Ihanlna hwd�ad ddlen �5500�.
�i] I.mownsrMlMVwaMamYemvM�+wi�weO�ro�IwWowmromeYon.wJldoNewak.eed�hemunureunol'vqeMeE
a ollmed be We (SMion)OM. Bue'uwm eM Prdme'vu Cods: Tha Cwrrfae liomae Law Eroe nol nYC�YIo en ox+wd pW�Y
wla Wide a inpowe �haean. end who doea euN �wk IimeA a MnN a N�aph he a Mr orm emGbib+. P�� IMt ach
improremeM� ere mi imended a dlemd la eeb, tl. hoWewr. iM bWCi�q a mpwwnam is wld M'nkn ane Y� d mmpblion. tlro
owror-0uiUx xill heve �M burden d D�'��B he a eM did nd bwk a im Va+la �he WT�e d abl.
❑ �... owiw a �ne aweM. em udmiMr mmreeno M'qn �imuee comranas ro cmmw me w4� (seaun �ow. Bus'v�ms am
Pmfwum CoCa: The Comreuors L'cenaa faw Eme nol W W lo en ow�wr d qweM x1a b lda n impw'm �lw�ean end Ma
mnVeele br exA pqerls wM e mmietlw(a) fcemad punueni �o �he CorueaGan limue lawl.
� I em aum u on: B. 8 P.C., br Nia
o�,: ��5�� �.,:.��-i.� �.�/1 a �"
I Eo henby cMM �� v^ ewere M vM uManimM IM �uiremenq d CelEomia HeeAh end 6dey COAe Sed'nm 2 , 2%33. eM
usa�. ene met � ar env nnw. waaire acwoem �+n � ra� na Idicr msl neee �o canoH wm eeid .im. weae end �nn reauiram«us mr
epermnlorowntiuelionartaEifiaiionhomtheAi ue3TnyT.—eropememDietMf.RsudoniidmnmiutlioneppY�bnsaeee�mmq/mmMna
woviaione.
Dma: AGP���
WONNEP'S COMPFHS�TION DECLAN�TION: 1 hereW elfi�m uMx penMy d pe�jury ane W Ns Idbxinp Cederetum:
� IhmaadWmeintenecenAicmodmreemloeetlinumlurxakes'wmqnWion,npovidedlabySatlian3l00dtMleEa
cod.. �« �ne wn«mence d me wh �n wNcn Nro varmn b muea.
❑ � n.ve w.;� meinien wM1a.• canw�+m ��. m�.m�u.e M s.ulon alao d m. l.bo. cros. rn �ne ro�«menm a in.
wak la xfii�li ihis pemu u usueA. My wlmrs' mmpemmion irourvKa wnr end paGry number ara:
c.m«:
PofcY Number.
�nu�ep, nese m' w cm�p.ron r me o�� u w. a,. n�red ddr.�. R+ool n b...�
��1 canN � in tM pMmiwice d Ihe wak br r.fich ihu perma b e�uaA. I Nel nol emplv/ vry pveon m emy mermer �o n to
Eecome wbjw !o iM wFsY mmpenedian lexe d Cefd'om'u'y uk pres Ntl)� I WW4 aEjetl lo tM xv�lmn'
wmPo�pn pwiaian d Sqv�3'!00 d iM labor Gods. �puy IUM1wnh cq�pJ/ hlh �I�vp q�u.�. _�
Weminp: FeNun ro�un woikri ronqarustlon cavenp� l� un/eMul, �MW/I �uE/�cf �n r�plqw ro MMrcI psnaltlss eM
c/vll fln�� �p ro on� huidrsd IhouuM EWkn (f10[{000), In erld/tlon b N� cwt ol rompwvetbn, tlemge� u povltlsA br In
Sxtlon J10�4 0l !h� Lebor COM, /ntsn�l, end ettomsy'� /w�.
CONSTflUCT10N LENDINO AOENCY: I hereby �rm wMer panehy d perjury Ihet Ihan ie e contlruaim bMi�q epancy br iM
o,no�d,� d�n�.w� i« wnKn ma v�� n m�a lsaeoo aw�. cw. cl.
I.ENDER'S NUIE:
LENOEIi'S A�OHESS:
I ceniM �hm I hew reeE Nb eod'emian vM ame thm iM eEwe in1«mmion o cortsa. I ap�se �o camvM wan M dIY eM cam�v ad'vivrm
end siele levn relmip lo buiMiq cmlrWion eM M1xeby eNlwr'¢e �aqeunietnm W Iks tlty b mter upon �he ebv.e�memioneE piapery
�a /�E i � �� ,^ 'i%1` '�L� �.-/T ,'t iAC � ,/
�(���Pi/`��Ll[�.L � Dme: `J S �'
srowured ✓npmunoo�u�com
(S15t<O.WP) WNIe-Buldiq 8 SeMy: areen-�Fb: Genmy-Appirent: Mk-Rvrowe: Cmldenmd�Asemsar
CITY OF COSTA MES� — BUILDING PERMIT
�PERM P10: P 07218E
PERMIT A10; P 072188 PLAN CHECX DIO: N GO�!T: N SUPP: N
CONSTP.UCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTIOTI , REPLACE GAS PIPIAIG 6 IP]STALL IRRIG. VALV SQ FT;
CLAIM VALUE: CALC—CTALUE: GROUP OCC; R-3 ;
COMMEP7TS: X
ti i Y Y�Y iL if iF iF 1E ifiF iE i(-jF If iF iF 1f 1!�'If 1f a('if +f-if 1�--Y�iF iF if iEif if-1 iE if'Ik if M'lF iF iF ii��1F iLifAG iE if1� i� YY'1F if � iE i4 1f if iFjf i�"N�iF i4 Jf �h if iF +i 1�-+f f it iti: i{
Z O N I N G R E Q U I R E M E N T S
S E T B A C R S
------------ P9AIN BUILDING ---------- --------- ACCESSOP.Y BUILDING --------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT Ihl
LEFT: FT IN AGHT: FT IN LEFT; FT IN P.CHT; FT IN
PARKING REQ: PROV: PARCEL: 19137109 ZP1E: - REF NO:
PLANNID]G NOTES>
i
sac*r*«*+�+�**�r***a�*s.*r��t-*r�x-****+r*�v-***�c�r*�r+�...r****x�*�c*�c�*<*-�*.�-*+ta�x.��rx+.�ca�x**s**�r-*
D E V£ L O P M E N T 5 E R V I C E S R E Q L I••R E M E N T S
ZONING APPP,OC'ED BY �' DATE:
BUILDING APPROVED BY : DATE;
APPLICATIOA7 ISSUED HY: S�fA.. '�� DATE: �5��
***r****�-+t�r-«�ar+cr�-r+rsa�*iF�;F�.3F�i:�itiF�.iFSF+TiFi�*�3t�c3F'gif i['Yi't'�.F�i3F.-rF'�.�*ria��:r�c+rx . . � ., raF
LEGALIZATION:N F E E S U M M A A Y STRUCTURAL SEGMENT:N
BLDG PMT PLUAIHING ELECTRZC MECHANIC FZRE SA".IF!RES GRADIA]G
PERMIT 12.00 •
25R � .� SMIP/NON—RES
Pr.,Arr
ISSUE FEE 20.00 �
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DOE
TOTALS----> 12,00 20.00 0.00 32.00 32.00 .(?0
REVENUE DIVISION TOTALS--> COLLECTED: 32.OQ OC�ER!S??ORT; .00
BLDG FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
32.00 .
!f 1E -II' 1F iF lI' Y if iF M i1' %j('tf j!'Y 1F!f if M if 1f'M"M' if It k V 1f 1h'N"If'IF if M' 1�"N-'fi.'M if M�F'if M"If'M' -)f N"II' �f 1�' Y 114 M' iI' iF iF'F M")f'M"K aM1 4'If M Jf �/' il"Y 1F'If iF M' iL'N' AF 1f
I N D I�' I D U A v'� F E E B P. E A K D O Y7 N
TY�E �,iTY U E S C R I P T I O N. UNIT CUST TOTAL COST
i
PLU 1 GAS PIPID]G SYS OF . 1 TO 4 OUTLETS 5,00 5.00
PLU i HACKFLOW IRAIGATION;,,' 7.00 7,00
fiNDi�OF FEES
�
U1 DC�1314Z§—.7p181i24 Tl�T ?Z,pp
4Nic": �75;'v;i4� iI�iE: 15:Qi
CONSTHUCTtON ANDPLANNING POG SPA I
APPROVALS Permit �," Date Inspector APPROVALS Permit�# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location : 1
2. Soil PiDe�Undrgrnd. 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �' '� '
R. Electricai Co�duit�Undrgmd. 55. Electrical Bonding � .
5. Steel Rzinforcement 56. Rough Plumbing & Pressure Test ,
6. Electricai UFER Grnd. 57. APPROVAL 70 COVER�GUNITE �
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Pousulatio� 59. Gas Pipe, Q Undcgrod., Test ' �
9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P�Trap, Cl Undrgrnd. � '
10. Structural Floor System � 61. APPROVAI. TO DECK `
71. PropertY Sewer Line & House Connection � 62. Backwash & Receptor�Final � �
12. Sewer Cap 63. Heater & Vent�Final � .
13. Roof Drains 64. Plumbing Sys[em � Final �
tA. Rough Plumbing � 65. Electrical-Final . �
15. Rough Eiectrical�Conduit 66. Solar System�Finai . �
16. Rough Elettric W{ring �; 67. Fencing & Access ApProvat ' �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERiNG '
1$. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS PINAL
79. 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 Pipin9 O Gas ❑ Oil
23. Gas Pipe-Rouqh & Test 72. Underground Flush
24. Roof �raming 73. Undergrnd.5tora9eTank OGas ❑Oil
25� Roof Sheathing 74. Overhead Hydro
26. T-8ar Ceiting (Scructural) & Monocoat 75. Dry Chemicat
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding ' " 77. FIXED SYSTEA4 FINAL
29. Insulation 76. FIRE PREV. FINAL
30� Drywali Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
31. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: S� [^ 1 � • �
�a'-L- 7.}s_ fr P�ri -r.�t�,L
34. Final Heating & Air Conditioning r
'17-r�i YcT�": �C�v-.�l�
35. Final Gas Pipe�Test
36� Hood or Canopy
37. Final FactorY Fireptace �
3$. Finai Plumbing
3g. Water Service�Final
40. Gas Service�Final
41. �Solar �omesticFinal
42. Backtiow Preve�ter
43. Backtlow Irrigation �'-� �P
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulat�ons
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
OWNER College Park Co � � �� oare 4-23-56
JOBADDRESS IyPZ Pt1riC8tOII D2'. -� BUILDINGPERMIT NO. ZJOS
GENERALCONTRACTOR Harbor i�.ORSt. CO VALUE S 12�f��0 Q�
LOT �J BLOCK TRACT 2�2% Sin�le Res W�Btt �2T'
GROUP I& J TVPE V ZONE �l FIRE D�STRICT 2932
PERMITSISSUED
INSPECTION3 DATE SUBCONTRACTOR DATE I NUMBER
Footina Trehch 5 ��
Forms and Grade to
Rough Frami�g �. /� �'
Plumbing, Ruugh to Sla �yf/({/�L ! JU ,� ,
Plumbina.RaughComplete !' %.r�'� %� / � ._. � _l� i � _ 3 S� sL7 CL/ �
Wiring, Rough �LCl/� •� U4� f1�i�' �i /.1: :: � ��—.S�i .-� �^ � �
Heating�Rou9h � ...• i. �..'� 711��: 1-rn�n. 7'9� <'/ c �</L �
Heating, Final r
Sewe[, HousC ,r 5�
—�-r—
Septic Tank or Cesspool
Lathing,ln �
Plastering
Plumbing, Fi�al, Fixtures
Plumbing, Fi�al GasTest
Wiring; Final
Occupancy
FOFM 210 3M �Q�+�
St. `� �%'n -S'y � i��../�. Cn x�. �-.�, w. �. S- 3:S'i � lC )'/ /—
3i' �
Psa w c ng epar men
'111 EAST 20th STREET
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
�9
ss 1J�.Z PRINCETON DR.
Costa, Mesa, California
Owner COL�E6E f ARK CO..
Mail
Address �1�i $�. �A1N $T,
Tel.
Cfty SANTA ANA, Cp��F, No}
Arohitect oY Lic.
Enqlneer '— No.
ContracMr�ARBOR CONST.CO
Address SAh1E
Legal I Lot
Descriotion No. 9 I Block
Use of
Repafr �
Bullding
Size � F2�
Exterlor Wa��
Covering
Use oT New
Bulldinn R
No.
G
�
�tion � � Addition
9 I I Demolish
No. of
Rooms Stories
IRoof
Covering
JCE Ec ATTACHED
Av
:'�
I hereby acknowledge that I have read this Application
and state that the above is rnrrect and agree to comply
with all City Ordinances and State Iaws regulating
bullding construction.
Si9natureof HARBOR CONSTf�UCTI' N C0.
Permittee
Authorized A9t. !7�A '
t
Valuation Permit Fee $� ✓
'. Plan Check $ � �
$ �2�4��• Total i
Fee $ � �
FOEtM 204 5-BP 2M 8-55
APPLICATIDN FOR Y�nivul
Bui�D�NG �
FOR O�'ICE USE ONLY
I � Receipt No. I Permi,t�N�
,s�
cJ� v
�eived�y Date Rec'd. Date Issued
;'/ s�-�.� S-6 y a3-s�
ing
55
Costa Mesa, California
CORRECTIONS
/
APPROVALS
�.ion � InsPecta
e: Fire Stops,
cing, Bolts
Int
Masonry Reinforced
Bond Beam
PLO� PI..4N
6how _ locatlon and dietances from
property lina and between buildinga
COST!'
�,"i Z3i5�ME5a 7�Ei te': A;ni�S !'0
. i.
OWNER p�E�Y �, R. M
�JOB ADDRESS 1�,22 Princeton
,�GENERAL CONTRACTOR Santa A�
� AP No. 1�F1-371-09 LOT q
�INSPECTIONS
soi�
� GAS
�W ATER
OUGH PLUMBING
PftOP. SWR. LINE � HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONOITIONING
TEMPORARV SERVICE OR POLE
rUN�ERGROUN� � POWER ❑
ROUGN WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BONO BEAM ❑ STEEL REINFORCE ❑
SHEATMING
FftPME AND FLASHING
LATHING - IN n OIIT n
STRUCTURAL, FINNL
HEATING, VENT., REFRIG. �
PLUMBING, FINAL ANO GAS
ELECTRIC, FINAL
fiWLOING. FINGL
DATE
SUBCONTRACTOR
1�r ~ 28%%�
�COSTA MESA BUILDINCrSAFE'TY DEPARTMEM
P.O. BOX 720D COSTA MESA� CALIFORNIA 9262D
.,�:p�p� $+r�,t�3.Q0...