HomeMy WebLinkAbout1206 DORSET LN - Building Permits ADDRESS OF BUILDING: . 1206 DORSET LN UNITCITY OF COSTA MESA — BUILDING PERMIT ` y 001-4 `et
OkSLUSK, DAVID E FLOOD : X 46 PERM NO: B 087675
1,lRRNAMEIFN4OWN:ADDRESS:LUSK, KATHERINE A m •
1206 DORSET LN PERMIT NO: B 087675 PLAN CHECK. NO: 01371-98 S GOVT: N SUPP: N
•sr • COSTA MESA, CA 92626
APPL.MAILING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT •
•
ARCNITEC,OR ENGINEER: .uc No.: JOB DESCRIPTION : LEGALIZE CONVERTED RAMPUS & BEDROOM TO SQ FT: . ' 3, 000
ARCH OR ENG.'S ADDRESS: UMT:
I •
CLAIM VALUE: 3, 000 . 00 CALC—VALUE: 3, 000 . 00 GROUP OCC : R-3 /
CONDUCTOR'S NAME
.CONTRACTORStunlo COMMENTS : MASTER BEDROOM.
ADDRESS: UC NO: !EIt*3fi(-*1Ei(-iE*iflF**1fiE1E*lE*1f1E1kifitll-1f1EfE3E*lE1(-lE*3EiEiE1E**iE1EiEIfif3fif*iF3EiE*1f1ElESE*f4SEiE3EdE1E1Edf3f*iE3FlE*ihiFlElE*fFiE
UM: ZONING REQUIREMENTS '
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS '
(commencing with Section 7000)of Division 3 of the Wass and Professions Code,and my license is in full force and effect. -
CITY UC.NO.: 'LIC.CLASS: LW.NO.: EXP: MAIN BUILDING •
ACCESSORY BUILDING
• FRNT : FT IN REAR: FT IN FRNT : FT IN REAR: FT IN
0on1eoY LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ,
Contractor
•
aLDER
DECLARATION:I hereby affirm under penally of perjury That I em exempt from the Contractors License Law for the
h.or reps(Section 7031.5
Business to ns issuance also requireions Coda:s lhecapvicant for or such permit to fibesigned statementnnit to •the improve.
sh.' PARKING REQ: PROV: PARCEL: 14115303 ZNE: R1 REF NO: ,,.,
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commendng with Section 7000)of DNeron 3 of the PLANNING NOTES> INTERIOR ALTERATION TO CONVERT A 3RD BEDROOM AND RUMP.US ROOM
Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any volalon of Section ' > TO A MASTER BEDROOM SUITE INCLUDING CLOSET & BATHROOM'.
7031.5 by any applicant lore permit subjects the applicant roe and penalty dna more than lila hundred dollars 55001). *************************************************************N.of*****5E**********
❑ I,as owner of the properly or my employees with wages as their sole compensation,will do Na work,and the structure is not intended DEVELOPMENTSERVICES R E Q�1 U I R E M E N.iT' S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License law does not apply loan owner of property '
who buids or improves thereon.end who does such work Nest or herself or through he or her own employees,provided that such • •
improvements are not intended or offered for sate-If,however,the building or improvement is sold within one year of completion,the ZONING APPROVED B Yd • \/•-[( DATE,:
owner-builder will have the burden proving he or she did not build or improve for d sa
the purposele). /�
- -
El I,as owner d the properly.am exclusively contracting with licensed contractors to=seed the project(Section 7044,Business and i
Profesdmaode: he CTContractors license Lewesnth doappy loan ow er d property ata builds orimproves thereon end vitro BUILDING APPROVED BY : /'s DATE: - y
IA-
/V1'
tracts ler such projects with a mntrador(s)licensed pursuant to the Contractors License Law). IN
nwersectmn$P7044 B.aiRc., �i.}...n WNE�R/ BUILDER APPLICATION ISSUED BY: DATE: .nei-
/ 10'-27 Owrier. 7// f /(Sack ******************yf**********if**if********1E*************************�E.***********
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :Y
: cattily that!am aware d end understand the regairements d Calfomia Health end Sdey Code Sections 25505.25533.ant
and25534, future ° thant g b )nte` ch °°odes and requirement!!or frshAkamento .Rsithmanoomwioraalationamernfrom a BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/RES GRADING
pro+idem' • - . PERMIT • 74 , 75 . 50
Data: Applicant: SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:Ihereby affirm under penalty of perjury one d the following decimations: ISSU 48 59
ISSPLAN
FEE
❑ CdveadwiFerfirmnc of thewdcorwhicto hinruroiSued. 'compenegon,mprmidedlabySedion3]OOdtMLebar BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the performance d the work for which this permit is Sued.
• ❑ Ihaveandwillmaintanworkers'compensationinsurance.asrequired bySecion3700of the Labor Code,for thepedumahceoftha TOTALS----> 75 . 25 0 , UO 48 . 59 123 . 84 123 . 84 , 00
work for which this permit is issued.My workers'compensation insurance carrier end policy number are:
Carrier: - REVENUE DIVISION TOTALS--> COLLECTED: 123 , 84 OVER/SHORT: . 00 ' q
- .
Policy Number - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed d the permit is for one hundred dollars 151001 or less) . 7 4 . 7 5 . 50 48 . 59
❑ I certify that in the performers of not arsn the work for which this permit is issued,I shell nemploy ry peon any manner so ash, '
become subjed to the workers'compensation taws of California, and agree that N I shouts become subject to the workes' *******************************************************************************
compensation provisions of Section 3700 of the labor Code.I shall forthwith comp with those provisions. • INDIVIDUAL F E E BREAKDOWN
Date: _ Applicant:
Warning:Failure to secure workers comps Baton coverage/s unlawful,and shall sub/act an employer to criminal penalties and TYPE QTY 'DESCRIPTIO N UNIT COST TOTAL COST
civil fines up 10 one hundred thousand dollars(5104000),In addition to the cost of compensation,damages as provided for In
Section x70401 the LaborCods Interest,end attorney's fees.
SFR 3000 •
ALTER BY VALUE RESIDENTIAL NOZONE • 1 . 00 3, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there ls a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097.Civ-C). , ,
LENDER'S NAME
LENDER'S ADDRESS: •
♦,� edify lhal l have read this application and state that the above information is cond.eI agree to comply withal]city end county ordinances
wand stale laws relating to building consmwion and hereby aWarizerepresenlatives d the city to enter upon the atom-mentioned property
for inspection parpuaeI.. ca,_es. •
DAVID LUSK • • a4-1C-13'38/113:13 AN/$123.54
•
(5....
u,r rq••q
S • Porn Norma Date. �/ lO-r9,Q •^• "" PERMIT a 887675
Signature f r gent/AppkcantlContrador - -
fl1.WP) - Whi -Building 8 Safely:Green-Ale;Canary-Applicant;Pink-Revenue Goldenrod-Assessor
-,..CONSTRUCTION AND PLANNING - - - POOL &-SPA y
% '7s/ bate Inspector. 1 Date . Inspector
,,
APPROVALS Permit# t - - APPROVALS Permit# •
1. Temporary1Electrical Service or Pole'- - - , 4 . 52, Pool & Equipment Location '
•
2. Soil•Pipe-Undrgrnd. . . . 53. Steel Reinforcement. -
3. Electrical Conduit Utility-Undrgrnd. . • + 54. Forms. . - • r
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, O Undrgrnd.,Test ,
9. Water Pipe-Undrgrnd. . - 60. Backwash Lines, P-Trap,❑ Updrgrnd.
10. Structural Floor System .- • 61,. APPROVAL TO1DECK •
11. Property Sewer Line & House Connection ' 62- Backwash &`Receptor-Final , ,
12. Sewer Cap63. Heater & Vent-Final •
, 13. Roof Drains ` . - 64: Plumbing System - Final , '
14. Rough Plumbing • : I- • 65. Electrical-Final •
15. Rough Electrical-Conduit . - ,66. Solar-System-Final x
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. Undergrrid.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 ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED 1
33. Final'Electric - Notes:
34. Final Heating & Air Conditioning '
35. Final Gas Pipe-Test ,
36. Hood or Canopy -C
37. Final Factory Fireplace -c
. 1
38. Final Plumbing ', -
39. Water Service-Final
40. Gas Service-Final .
41. Solar Domestic-Final
42. Backflow Preventer -
43. Backflow Irrigation - ' '
!- 44. Landscape Irrigation System . -
45. Sound Attenuation -- '
, 4.
. '46. Handicap Regulations -
" � yQ .
_
' ; 47- FI NAL STRUCTURE& BUILDING y.2Sz,Q5� _
_ RL
:- 48. FINAL PLANNING ! . `i
-- 49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
_
-'
51, CERTIFICATE OF OCCUPANCY .
No Date _ _ - ' r •
T ADDRESS OFBIALVNO:'., 1206 DORSET LN ' • OMT: CITY OF COSTA MESA - BUILDING PERMIT �� OD AL15 W
ayNEBskJlElraemtLUSK, DAVID E FLOOD : X 46 PERM NO: E 087676
•
ADDREssLUSK, KATHERINE A .
1206 DORSET LN PERMIT NO: E 087676 PLAN CHECK NO: N •GOVT: N SUPP : N
• COSTA MESA,CA 92626
VOL. •
MAURO ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ALT ,
•ARCNRECTOR ENGINEER: - UC NO.: . JOB DESCRIPTION : LEGALIZE CONVERTED RAMPUS & BEDROOM TO ' SQ FT:
ARCN.OR MOS ADDRESS: UNIT:
CLAIM VALUE: ' CALC-VALUE: GROUP OCC: R-3 /
CONTRACTORSNAME
CONIRACTOWS MIMIC COMMENTS : MASTER BEDROOM. LEGALIZE ELCTRICAL WORK . ^ 2-74-75-
4-7
ADDRESS: lit NO: *****+t* >E *x-*****************14**;Ex***N-** ***Rt Es****Ssh4*x**** ********>E**SE*x**SSEt
. UMT: ZONING REQUIREMENTS
•
LICENSED CONTRACTORS DECLARATION:I hereby atkm under penalty of perjury That I we licensed under provisions of Chapter 9 • ' SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in full force and effect.
• CRT UC.NO.: • LIC.CLASS: UC.NO.: EXP : • MAIN BUILDING ACCESSORY BUILDING •
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: • FT IN '
Date: Contractor; • LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for Me
following reason(Section 7031.5 Business and Professions Code:Any city d county whist requires a Penn to construct.after,improve. PARKING REQ: PROV: PARCEL: 14115303 Z N E: - REF NO:
+md'sh.or repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she
censed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Otvision 3 of the PLANNING NOTES>
Mess and Professions Code]or that he or she is exerrip therefrom and the basis for the alleged exemption.My violation of Section > t . -
•
41.5 by any applicant for a permitaubjeds the applicant to a evil penahy of not more thanfive hundred dollars[S5001). ************* *********.********************************************************
❑ I.as owner d the property or my empoyees with wages as reek sole Compensation.will do the work,and the sure a nal intended D E V E L O P M E N T S E^R V I C E S R E U I R E M E N T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Lew does not apply to en owners property I , Q .
who Wads or improves thereon,and who does such work Nmself or herself or through his or her own employees,provided that such
improvements are not intended or fibred for sale.ff.however,the building orinprovement is sod within one year of completion.the ZONING APPROVED 'BY -. • DATE:
owner builder will have the burden of proving he or fire did not build or improve for the purpose of sale).
❑ I.as ovmer of the property,am exclutively contracting with licensed contractors to santnxt the project(Section 7044.Business end BUILDING APPROVED BY
Prof anions Code:The Contractors License Law does nor apply m an owner d property who builds or improves thereon and who .• - - DAT E
contracts for such projects with a contrador(s)licensed pursuant to the Contredors License Law).
a es: +u dersednnBP7O44 ,8.8P.C.,My :O NE UI DER APPLICATION ISSUED BY : . • L. DATE: �1 1 (Y
( and
. — /0rC , Owner: (
_ Health e 25505, LEGALIZATION:N F E .•ES S U M M A R Y STRUCTURAL SEGMENT:N
and that I certify at I Mum buildern ewers ing and undeent will rstand/wit not rthe equirements
one)California
to comply wih said ally Codele Sections eat the requirements 5533. for -
apermit for construction or modification from the Ak�GsT�Fy anagemem District RrkenlW wMredion appiratiau are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 9 :00
Date: Y Appipan': ' . 50% SMIP/NON-RES '
WORKER'S COMPENSATION DECLARATION:I herebyPLAN
atfion underpereftva penury onedthe following declarations:
ISSUE FEE , 122 .(00
•
❑ I have and MI maintain a certificate of consent tet sell-insure for workers'compensalffie es provided for by sedion 3700 of the Lahor BUILDING-DIV-> - PERMIT ISSUE • PLAN-CHECK TOTAL PAID ' DUE
Code.for the performance dthe work for which this pem,i is issued. TOTALS----> 9 . 00 • 22 . 00 % if 0 . 00 31 . 00 31 . 00 . 00
❑ I have and Mil maintain worker:compenselion insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.My workers'compensation insurance carrier end policy number are: -
Carrer: REVENUE DIVISION TOTALS--> COLLECTED: 31 . 00 OVER/SHORT: .00
Ploy Number: - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
Us section need not be completed I the permit is for one hundred SFS,($1001 or lase) 31 . 00 '
J •I certify that in the perlomanoe of the work for which this permit is issued,I shall not employ any person in any manner so as to
yecome subject to the workers'compensation laws o California,and agree that D I should become subled to the woken' ********************************aE'A..H.,***********et********:i4******.*********4fi*******
ktrompensation provisions o Section 3700 d the Labor Code,I shall forthwith campy with those provisions.
I N D I V I D U A L. JF E E BREAKDOWN
Deno: Applicant: `k
e
Kerning:Failure to secure worker.'compensation coverage unlawful,and shallatt/ect an employer to criminal penalties and TYPE . QTY DESCRIPTIO S C R I P T I O N- UNIT COST TOTAL COST
K
cAll fines w to one hundred thousand dollar.($100,000),In addition to the cost of compensation,damages as provided for In
• Section 3706 of the Labor Coda Interest and attorneys fees. ELE 3 FIXTURES, LIGHTING '• 1 ST 20 EA, 1 . 00 3 . 00
CONSTRUCTION LENDING AGENCY:I hereby elfimh under penalty d perjury that there is a conn lion lending agency for the ELE 3 RECEP T/OUTLET - 1 ST 20 EA. 1 . 00 3 . 00
p°do,nancedthe wmkforwhich this permnmissued(Section 3097,CW.C). ELE . _ 3 RECEPT/SWITCH /1 ST 20 EA. 1 , 00 3 , 00
LENDER'S NAME: END OF FEES •
LENDER'S ADDRESS: - t - 3
. ..
•
I certify that I have read this application and state that the above information is coned,I agree to complywith all dry county unty ordinance° •
and state laws relating to building construction and hereby authorize representativesproperty I-lhis city to enter upon the above-mentioned proper
for inspecti
`I'°°°eDAVID LUSK n 24-18-1393/23:14 f4 /$31.G8
-
PT9kC :21-F22241
Dat°: •
•
(5151-46WP) White-Building b Safety;Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor • ' ' '.4"‘\'
CONSTRUCTION AND PLANNINGPOOL 'A _ .
Date Inspector /-• - ,^ -t Date Inspector
APPROVALS Permit # - APPROVALS Permit#r'
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location- `
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 541 Forms -
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding : - -
5. Steel Reinforcement - - : -56: Rough Plumbing& Pressure Test i
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,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 Grains64. Plumbing System -.Final
14. Rough Plumbing - 65. Electrical-Final '
15. Rough Electrical-Conduit • 66. Solar System-Final , ,
•
16. Rough Electric Wiring X67- Fencing & Access Approval , ,
17. Rough Wiring Sign - . ,-68. APPROVED FOR PLASTERING _
18. Rough Electrical-T Bar Ceiling69. POOL/SPA SYSTEMS-FINAL : - -
19. Rough Heating & Air Conditioning - - - . • - FIRE 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 PREY. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION •
32. Electrical Power Meter-Final I f 80: FOOD CERTIFICATE ISSUED
33. Final Electric 7�37� LA Notes: q-1 3 �� /� /7
� L)a
34. Final Heating & Air Conditioning ! !/ /
g-20 "q8 e r CGut ft y 0,>°t^lL�a���
35. Final Gas PipeeTest - • - / A
36. Hood or Canopy -
37. Final Factory Fireplace'
38. Final Plumbing .L i
39. Water Service-Final
40. Gas Service-Final""" • .
41. Solar Domestic-Final •
42. Backflow Preventers - i .
43. Backflow 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 0, -_ .• •
51. CERTIFICATE OF OCCUPANCY
No. Date -
C:O
' BN ?Gib—aoil�`2,
ADDRESS OF UN NG: 1206 DORSET LN CITY OF COSTA MESA BUILDING PERMIT
`I OWNER'S NAME IF KNOW LUSK, DAVID E FLOOD: X 96 PERM NO: P 087677
•
ADDRESS: LUSK, KATHERINE A
1206 DORSET LN PERMIT NO: P 087677 PLAN CHECK NO: N GOVT: N SUPP : N
t. COSTA MESA,CA 92626 •
I . APPL.MMUNGADDRESS: CONSTRUCTION TYPE: V—N ' 'PERMIT TYPE: PLU PURPOSE:. ALT
•
ARCNRECT OR ENGINEER: IIC.NO.: JOB DESCRIPTION : LEGALIZE CONVERTED RAMPUS' 6 BEDROOM TO SQ FT: -
ARCH.OR END'S ADDRESS:r UNC: '
•
' CLAIM VALUE: CALC—VALUE: ' GROUP OCC: R-3 /
CONTRACTORSNAME
CONTRACTORS MAILING COMMENTS : MASTER BEDROOM . LEGALIZE ELCTRICAL WORK. REWF :B-87.675
' ADDRESS: DC NO.: 3fdf******7E1EiElEjfiF3E9ElEj(-3(-***lE1f N-i(-3EdE***1f3Eif1E3f SE9l-1E1EjE3E3f3kiFiEjF-)E*3F****7E***IFikiE***lFfEiE9E***1(-jE1(-3fdf***
UHT: ZONING REQUIREMENTS
•
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(oornmendng with Section 7000)of Division 3 of the Business end Professions Code,and my licensee is in full force end effect.
CRY uc.No.: ua CLASS, LIC.No.: EXP : •
MAIN BUILDING ACCESSORY BUILDING
• . FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT • IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perpry that I am exempt from the Contractors License Law for the • '
Tolowitg reason(Section 7031.5 Business and Professions Code:Any CRY or county whist requires a permit to COnStMci.after,improve, PARKING REQ: P ROV: PARCEL : 14115303 Z NE: REF NO:
demolish,or cepek any Wildlife.prior to its issuance,also requires the aPelicent for such permit to file a signed statement that he or she
is licensed pursuant to the provisions d the Contractors License law(Chapter 9(commenting with Section 7000)d Division 3 of the PLANNING NOTES> • .
.unloose end Profn essioCode)or thatthe or she is exempt therefrom and the basis for alleged exemption.Ary violation of Section
031.5 by any applicant for a penile subjects the applicant to a civil penalty of not more than five hundred dollars($5001). ********************** ********************************************************
El I,an owner dthe property or my employees with wages as their Solo compensation.will do the work,and the structure is not intended
- or offered for sale(Section 7044.Business and ProfesssionsCode:TheContractors License Law does not apply toanownerorpmrertY DEVELOPMENT $ E R �. I C E $� R E Q U I R E M E N T S
who builds or improves thereon.end who does such work limsdl or herself or through ha or her own employees,provided that such .... •
improvements ere rot intended or offered for sale.C,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY • ` i DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose Of sale).
❑ I.as owner d the property,em exclusively contractile with licensed contractors to casaud the pops(Seton 7014,Business end
Professions Code:The Contractors License Law does not apply to an owner el property who builds or improves thereon and who • BUILDING APPROVED BY : �y�3 . DATE :
contracts for such projects with a Donneda(s)licensed pursuant t Contractors License Law). 93 42,� t p
9;by
mexemoumersadiorIBP7044 B.wne.,form aaan.OW ERBU APPLICATION ISSUED BY : DATE :I— Owner:•
LEGALIZATION:N F E E S U M M A) R Y STRUCTURAL SEGMENT :N
certify that I am aware d and understand the requiremerae of Cdlomia Health end Safely Code Sections 25505,25533,andI1for stn anyhnerewudinho�npantwiuswatergenn ) eedtocernptywlthaadeese &ees qme aBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
1 fermitWtioner mndiEmtbnhamdha Ai itt I ori Manpameo e)nee Residentel constmctlen
Provision. PERMIT . 2 6 . 2 5
Data:• Applicant: � . 25% SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaretions: PLAN ••
0❑ Ihave and wimantanacenfficonsent See
tion the Labor IFEE 7 22 . SS
ce,formr
the Pedoanceoftne work f« pent*which this permiasued. BUUILE ILDING—DIS-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUECode.
o thave and wlmaintanworkers'compensmldninsurance.asredukedbySeori,n3700ofthe Labor Code.for the performance ofthe TOTALS — —> 26 . 25 22 . 00 0 . 00 48 . 25 98 . 25 . 00
work for which this permit is issued.My workers'compensation insurance carrier and policy number ere: '
Caner: REVENUE DIVISION TOTALS--> '. COLLECTED : 48 . 25 OVER/SHORT: • . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE . SMIP/TOT GRADING PLAN—CHECK
Sis section need not be completed I the pend is for one hundred dellen($1001 or fess.) 48 . 25 '
J I oerldy that in the performance of the work for which this perMit is issuued.I shall net employ any person in any manner so as to '
become subjed le the workers'compensation laws of California. and agree that it I should become subject to the wo&en' *******************************************************************************
compensation provisions of Sedicn 3700 of the Labor Code,I shall forthwith oompy with time provisions.
INDIVIDUAL F E E BREAKDOWN
Date:. Applicant:
•
Warning:Failure to secure wodws'comoensatlon coverage Is un/awful,and sell subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(S100000),in addition to Ms cost of compensation,damages as provided for In '
Section 3706 of the Labor Cods,Interest,and attorney's lora PLU '1 BATHTUB 8 . 75 8 . 75
• CONSTRUCTION LENDING AGENCY:I hereby affirm under pemdy of perjury that there is a construction lending agency for the PLU 1 WASH BASIN 8 . 75 8 . 75
pedormenced the werkfor which this permit eissued(Sedan 3097,cN.c). PLU 1 WATER CLOSET ( TOILET ) 8 . 75 8 . 75
LENDER'S NAME:
•/ LENDER'S ADDRESS: END OF FEES •
ft I certify that l have read this application and date that the above infatuation is coned.I agree to campy with all Uy and county ordinances '
and state a - . .to building construction end hereby authorize representatives of thisabove-mentioned
city to enter upon the property ,
for inspect. purposes.
R D LUSK
64-16-1998/09:14 AN/$48.25
' in—y( TL:Tq:817322242
Dae: / F'ERP1ZTe087677
Sign : . /Agenk/A.. tM.ont:.:
(515148.WP) While-Buildie S Safely;Green-Fle:Canary-Appicent:Pink-Revenue:Goldenrod-Assessor - - - •
fri
- k" v
CONSTRUCTION AND PLANNING - - - fir' - ,; , POOL A - - - ,
Date Inspector . Date Inspector
APPROVALS Permit # 'APPROVALS Permit#
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, 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 Systeni - Final
14. Rough Plumbing - -, 65. Electrical-Final . -
15. Rough Electrical-Conduit - _ - •. 1 ,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
l
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 I 80' FOOD CERTIFICATE ISSUED
r
33. Final Electric - - Notes: •
34. Final Heating & Air Conditioning _ .
35. Final Gas.Pipe-Test -
36. Hood or Canopy -
37. Final Factory Fireplace . t� ,-{_;
38. Final Plumbing - _ / e -�� -
39. Water-Se(vice•Final !!// / . ,
40. Gas Service-Final -
41. Solar Domestic-Final - - 1 • .
42. Backflow Preventer - ' ' - -
43. Backflow Irrigation , - •- -
44. Landscape Irrigation System ..
7,7 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
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. TRACT.NO. LOT NO.
UNIT NO.
CITY OF COSTA MESA CONSTRUCTION PERMIT E A.P.# I Zone
Project Address /010 c/e�, �1029f-, E 4-oI z- .
Y' / E Main Building: Accessory Building: Z
��p/2 _ YF- �N TYPE OF CONSTRUCTION L I NEW H ADD' ye ALTERATION ❑ REPAIR Front Applicant's Mailin Address /i- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - T - O
Owner's Narne' � 9�I.A �� IZ Phone El
DESCRIPTION OF WORK/USE OF BLDG. I B Rear N
Address /zR000 D025E-* A I
•Arch/Eng. License No. TVPE OF PERMIT El GRADING GRADING ❑ FOUNDATION I K Right G
Address ❑ TENANT ELECTRICAL .❑ PLUMBING ❑ MECHANICAL $ • Left
R
Contractor's Name ac.. Phone ❑ 'OTHER Ping. Ref.# Parking Req,/Provided E
PROJECT DESCRIPTION SQ. FT. /7 00 OCCUPANCY S PlanningNotes: • Q
Address(mailing) CON ST RUCTION TYPE VALUATION S /P.�O M
City License No. TZONE GRADING CU,YDS. ACRES
LICENSED CONTRACTOR DECLARATION - S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - '
with section 7000) of Division 3 of the Business and Professions Code, and N
my license is in full force and effect. ELECTRICAL FEES
License Class _License No.
Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORKERS' COMPENSATION DECLARATION - Construction Pole Sub. 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 7 Cooking Unit / Meter ❑up to 100 amps `a
SC
)0, Lab. C.)
olicy No. Company Backflow Irrigation Sewer Cap - Dishwasher Meter Dover 100 amps
11 Certifietl copy is hereby furnished. V Dryers ®Gas (EElectric Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection •
Date Applicant Fan Motors❑0-1 HP ❑1'A-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100)or F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
less). Dishwasher Solar Piping _
I certify that in the performance of the work for which this permit is issued, I Fixtures
shall.not employ any person in any a Per $,o as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Com gsation Lawsof Calif Orgla. .// ,O'/
Date 5-19-137 jSignature ll//4rcY ,GiaWr Device Boxes Pole Li ht
l} Floor Drains Swimming Pool w/Spa 9
NOTICE: If,after making his declaration,you should become subject to the Range Outlets R ¢ -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 9 •
comply with such provisions or this permit shall be deemed revoked. —
CONSTRUCTION LENDING AGENCY Gas Service Outlets . Switches Sign
I hereby affirm that there is a construction lending agency for the performance Water Closet -
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater / Garbage Disposal Standing Sections
Lender's Name -LGenerator 00-5 KW 05-15 KW Trash Compactor
OWNER Bnder's UILDER Address Kitchen Sink Water Service DECLARATION
I hereby affirm that am exempt31.5from the Contractor's License Law for the Lavatories _ Auto-Wash
following e (Section to Businessnand, Professional prove Code: Any cry ar
countyr which priorequires permitac ,construct,alter,improve, t rdemolish or repairmiP-Trap Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit
•
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains '( Ls
the Contractor's License Law (Chapter 9(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt - Reinspection Fee $15 Issue Fee •—•$"3--
serefrom and the basis for the alleged exemption. Any violation of Section .
31.5 by any applicant for a permit subjects the applicant to a civil •
—
nalty of not more than five hundred dollars($500). I 3 DEVELOPMENT SERVICES REQUIREMENTS:
I, as owner of the propertyor my employees with wages as their sole Reinspection Fee 6 $15 Issue Fee $
9 Zoning Approved By •
_Date
compensation, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By c _Data.--��I�
License Law does not apply to an owner of a property who builds or improves CXJ p- `�'�
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ Application Issued By ' 1 _Date
employees, provided that such improvements are not intended or offered foryP
• sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 - - SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground
prove for tt4 purpose of sale). BUILDING PERMIT $ SMIP $
LJ I, as ow er of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK
tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT
• The Contractor's License Law does not apply to an owner of property who Duct- Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING : $ ISSUANCE $
builds or improves thereon, and who contracts for such oroiects with a con- ENERGY P.C. $
tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration PLAN CHECK 25% $ •1
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ 3_,7N GRADING $
❑ lam exempt under Section B. & P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers J MICROFILM $
` -,J PLAN CHECK 50% $ 2
Date 5'-/$-R9 Owner �---=0 `�A Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ �,o
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT - -
information is ect. I agree to comply with all city and county ordinances PLAN CHECK 25% $ ,
and state la rel ting to buildin onstructlon, and hereby authorize repre-
sentatives chi city enc up the above-mentioned property for
inspection urpo es, •
Si nature Date 9- 9,99
Drriivers' License or SS It Reinspection Fee $15 Issue Fee $ 3 01 COW 1°,5-:: 2ie5 TOT :33,5'3
• GATE: uS, 1,, ;:- T E: 12:u:
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor (
•
'CONSTRUCTION AND PLANNING • POOL ?A
APPROVALS Permit# _ Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location a -
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. .Ele!•,vical 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, ❑ 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. Rooff,Drains 64. Plumbing System - Final
14. Rough Plumbing Aa 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
1'87 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 ad. FINAL INSPECTION
32. Electrical Power Meter-Final /Z.-[rs . FOOD CERTIFICATE ISSUED
33. Final Electric 12 Lf� Notes:
34. Final Heating & Air Conditioning i • 1 '��-- _ _ -.i.
•
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final -
42. Backf low Preventer
43. Backflow Irrigation `t.
44. Landscape Irrigation,System 'J
45. Sound Attenuation c. - r
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING •
48. Special Requirements Completed • -
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co • j __ • ,r
i
51. CERTIFICATE OF OCCUPANCY _
No. Date
OWNER COLLEGE-MESA COMPANY DATE 10-11-56
JOB ADDRESS 1206 Dorset Lane BUILDING PERMIT NO. #3840
GENERAL CONTRACTOR The Hale Co. VALUE $ 30960.00
18k BLOCK TRACT 2671 Si ng]e dwelling Watt. ear.
GROUP I & J TYPE V ZONE ji,(j FIRE DISTRICT 3870
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
,c 7 DATE NUMBER
2,-"e4Footing Trench -G.4 ii- i - 7.
Foundation Forms and Grade to Garagee 84 //,4_o'3 6
Rough Framing tt em / "Z J
Plumbing, Rough to Slab p/� 'h&h 9a .apt4-.n2f,2, , /D-3a-S�i 7a 97
Plumbing,Rough Complete hi eS AV3.SZ d
Temporary Pole ��/1�'�� ,p/� C�
Wiring, Rough 411-CA zi ft ,< .�w..-r/ GK ai 11-.- c-s; 31C 1 )--y
Heating,Rough 14403 /#14d-S-46 t
Hating, Final n s $'- • 7 .Itite ,„J /,°-zo -(% 7Ci9 G"
Sewer, House 0A/ Sewer,St. A4,44-5 L 1 �� 1 2 i/-84-64 /_i 17/
�Sentic Tank or Cesspool / �sTI w
ig, Int OutA 1.-F.,4 /2. J/ ,
1-....tering t9.- ---1a ^/T- "7 j i
Plumbing,Final,Fixtures Complete Al/4-5_r.,1q.a'i / c //
Plumbing,Final Gas Test is/ /I, i4.1 f-.26i.$., \ / Ci ,,/Ct //G'_7
Wiring,Final ►,iAy 1 . 1957 VC@ - / I- /
Occupancy 6,'/Ej-E 6 -/y- 7 ,
FORM 210 3M 10.55
Costa Mesa Building Department APPLICATION FOR PERMIT .
P. O. Box 3!7ZQ� BUILDING 1
COSTA MESA, CALIFORNIA .® o
FOR OFFICE USE ONLY
• FOR APPLICANT TO FILL IN Receipt No. Permit No.
Addding ���/C)
Address 1206 Dorset Lane TT
Costa Mesa, California Received by Date Reed. Date
Date Issue
Nearest ./r-LIC) /O —lam -i /(J -//-•S Co
Cross St. Fairview Road Building
Address
Owner College Mesa Company
Mail Costa Mesa, California
Address 1777 W. Lincoln Avenue Nearest
M. Cross St.
City Anaheim No.KEY 3-3161 Zone I No.of Type Gro /1
Architect or Lic. Plans I // Ob[. �/-.
Engineer Davis & Quigley No. C-1790 Approved 6' TY ////
by Date
Address 43 Mabga Cove Plaza, Palos Verdes
City LiuCORRECTIONS
*tractor The Hale Company No. 3422
Address 1777 W. Lincoln Ave. , Anaheim
Legal I Lot I
Description I No. 184 I Block I Tract 2671
(Attach Metes and Bounds) •
Size of Lot 64 x 113 I
No.of Now on
Bldgs,Lot None 0
Ilse of No.of No.of a
Existing Bldg. Families I Rooms if 5
Setback Line from Rear Yard 44
Center of Street 50 Side Yard $ :6 x.
10
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
Repair I I Moving I I Demolish I 8
Building No.of
Size 1270 Rooms 6 Stories 1 0
ulterior Wall I Roof —
vering Stucco Covering Shake APPROVALS
Use of New
Building Single family dwelling with Foundation Location Inspector Date
Forms,Materials,
attached garage. Under-Pinning
Frame: Fire Stops, W
Bracing,Bolts 'Q
I hereby acknowledge that I have read this Application G
and state that the above is correct and agree to comply Lath.Int. o
with all City Ordinances and State Laws regulating A 1
building construction.
Lath.Ext.
Signature of THE CO -
Permittee Plaster,Int -
Authorized Agt. Plaster,Ext e_
Valuation Permit Fee $ 26.00 Masonry Reinforced Os
a.
Plan Check $ 13.00 Bond Beam
$10,960.00 Total - a
Fee $ 39.00 I FINAL ir C
FORM 209 1055 D.P. &S.
•0 I i
t u -
7u
}pn J o
4 0
..[1�...�. .... .., •,
..... .21 . r . .• J.i.l c . . . . .
Street •
•
PLOT PLAN
Show location and distances from
property line and between buildings.
J
o..L.. UO9 J:. .
a
•
W W.75��
G
Cr
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O
kki
W
JJ .
JJ .: 2
`
311 ' i3
OWNER TOLFREE, RUSSELL DATE - AUG 1 1 1964
JOB ADDRESS 1206 Dorset Lane BUILDING PERMIT NO. - 22794.
GENERAL CONTRACTOR C. M. Lumber Co. VALUE $ 3,000.00
AP No.141-153-03 LOT TRACT _ FIRE ZONE 3 DESCRIPTION OF WORKAdd Bdrm.toRes.
F ECTIONS Signature DATE GROUP I TYPE V ZONE El
S PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. 0 / •
Rough Heating (7,/I - _ 1. ,(/ . ° _J...,. j/--.7$-(.,Z -
Rough Plumbing
Miscellaneous
Prop. Swr. Line Cl House Con. 0 St. Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power :0 �J�
Rough Wiring '�I°�`� G�y l ,� -eta- 1, -74u ,:1 3zr-3
Trenches 9' Forms 1- Steel Reinf. ❑, ,,(A 1 /i3 e y
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing $- i7/y
Frame and Flashing n'. ,r , ,
Lathing—In Out Q ,MO s'7-7 67-
P' -`er, brown coat
. 0 Air Con. 0 Final
.ng, Finalr//q�GS'
Plumbing Fixtures, Final ��``
Final Gas Test
Electric Fixtures, Final (�
Building, Final .�/ 4, / ? ,
OCCUPANCY .
Form BU4-5M-3-63-_s-B P 2 7Ok
22794 j FEE RECEIVED.
..- ,COSTA MESA BUILDING-SAFETY DEPARTMENT AUG l 11964
P.O.BOX 517 COSTA MESA,CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely APPLICA�16N 9 RCO�ST I�VIESA .
TYPE 'OR PRINT BUILDING
For Office Use Only
BUILDING t?nQ MaseT - lalJE
ADDRESS T' - - -
RBCEIPTNO. PERMIT NO.
COSTA MESA, CALIFORNIA V-2-7'3FD-/y/
�y lie
7 ��! RECEIC,BY pAT$�� ED ��Tp�i3� -
OWNER StLL..�oLF IieE (/`(/// *7 \ rJ/i�/ ' r
MAIL ' TOWN ( -4:9C eye_S t-�J�{,
ADDRESS L"LOa , OOPS= wI TEL.
/J - FIRE
CITYTQ Mslq NO. _ ZONE '� TYPJ:' GROUP - -.
APPROVED //
ARCHITECT' TEL. BY /IJDATE /I I • '
OR YAWNER
�� a ,I, NING , .Lg►I
A " S •
nn gr
//�8 NO.OF USE OF NE /
CONTRACTOCOCE }�i'� ,� Lu M?�G. "\ ( I PLANS C)7 BUILDING
,
�R _�(''� ASCRIPTION L 0 f In I P� I)07/
ADDRESS 11 in
10 aPC424 ®R Ryer �`/
CITYc4'Y, M p _A.P.NO. _t_/ ` l53 ' 3
STATE s TEL. c a SO •
NOTTO SIDE&RE: NO EAVE EAR P.LEAVES
ANG SHALL BE LESS THAN
LIC.NO. f+/�-'I (o-s5/ NO. v� O I O
SIZE / `/ '/2' 3 �)J NNOW ON tATB ALLOWED
RDS APPROVED (U YARDS APPROVED REQUIREMENT)
OF LOT YI I.
USE OF - MAIN BUILDING ACCESSORY BUILDING
. •
EXISTING BLDG. & '
-- -- (FROM C/L STRE
SETBACK LINE FROM qq I FRONT // FT.
CENTER OF STREET REAR YARO`? '7r - Cr
SIDE YARD I LEFT S I RIGHT 12 R.SIDE ��. FT.
DESCRIPTION OF WORK L.SIDE 5 FT. - Fr.
ALTERATION - ADDITION / L REAR ) 3 FT. 7 FT.
I DISTANCE BET. BET.MAIN Q
MAIN BLOCS. ACCESS.BLDGS. ,
REI-,AIR MOVING • DEMOLISH _
BUILDING r NO.OP VAR.# DATE
SIZE 'D se
ROOMS I STORIES f C.U.P.# APPROVED
EXTERIOR WALLC/ ROOF /� APPROVED - /C{�
COVERING J11;CC.. , OVERING`..,0 (p' BY I���i; + /( 6.
USE OF BUJ,4.DIINOGAAND RXT BE PERFORM'Dt Ii LL .
Lro���j .�'IKS� . M /iYI
• BO.Fr.
. -
I HEREBY ACKNOWLEDGE THAT I.HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT A AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 0
PLY WITH ALL CITY ORDINANCES AND STAT WS REGULATING VALUATION .....--
BUILDING CONSTRUCTIO N
SIGNATURE PERMIT FEE $ � • D
PERM ITTEF drJ ^
$ Ie?� - A B
AUTHORIZED AGENT CO 4
TOTAL FEE $
OWNER DAVID LEICiPPON DATE 4-7-80
JOB ADDRESS 1206 Dorset Lane BUILDING PERMIT NO. 49928
GENERAL CONTRACTOR Owner/Builder DESCRIPTION of WORK Patio Legalization
141-153-03 LOT TRACT FIRE ZONE VALUE $ 2,016.00
:TIONS Signature Dare TYPE V GROUP J-1 ZONE R-1
SI SUBCONTRACTOR PERMITS ISSUED
GAs Date Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. n •
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES 5 FORMS 0 STEEL REINF. ❑ EXP R E D
FLOOR SYSTEM fncom Ie Ins ectlols
BOND BEAM n STEEL REINFORCE n P N
SHEATHING Cel � q
FRAME AND FLASHING Date ‘L It 1 4— Sig h4.
LATHING - IN n OUT 7
PLASTER, BROWN COAT
S TURAL, FINAL Electric _ __
1 ,G. VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL
i t,a2R to/n7/P0 60.50 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVED®V PERMIT
For Applicant to Fill in Completely— Use Ink Only Gt/t A4 q..a'S
BUILDING I OHO ( �� n �.c I L.44
A.P.NO. ' 1 =,_ 153 — 63
ADDRESS tO C/J 1C.J I _ I
BUILDING
OWNER OR `' / s+ ADDRESS 1.20h CE'7 Lar
s1 Thaw l 'D L,.GICI H/TOC UNIT OR• MAILING �-' '
ADDRESS IO 1� 'Repo/NR &r. SPACE NO:- � �
TR.NO. j• LOT ;ALK.
r.�C q.
TEL
CITY W " I F.0� "04c4-1-1 S—. NEW _ADD ALTER I REPAIR MOVING DEMOLISH
CONSTRUCTION-
LENDER '
1/- '
BRANCH
OWNER /IVV If> Lel GHToN
• ADDRESS ATO iCqieattALUE
ARCHITECT . TEL. . USE �.�,q Liz 110 $
' OR ENGINEER NO "• �//� T
ADDRESS • ZONE '\- I TYPE V GROUP V j
� /
APPROVED
WNE� !
CONTRACTOR W I L..,U L, fC BY DATE 7_ 80
•
ADDRESS
• TEL. -
CITY • NO.
(-' STATE CITY APPROVED SETBACKS
LIC. NO. LIC.NO.
W p SIZE ye NO.OF BLDGS. (FROM C/L STREET) •
IY OF LOT l7 I I ,^L I NOW ON LOT FRONT FT.
� USE OF s'Me)LC 1 T7rl �C
EXISTING BLDG. 1—_ q SIDE FT-
CO
FSeparate permits are required for L.SIDE FT. •
G electric,plumbing and heating work: REAR FT.
(W., USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
a
/ierrl Q DATE -
1 r/� y�CCMIe it _ APPROVED
Y. ! I- t� L^_l Pit—I G.� n I I O k) APPROVEDY DATE
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W
P. N.
I hereby acknowledge that I have read this application and state - p
p( that the above Information is correct and agree to comply with
Or all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of E
the State of California.
m
3 I hereby certify that I am properly licensed as a contractor under 5p 4 SQ. FT. I x� r3
the State of California Business and Professions Code, Division 3,,. THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or ITHE PURPOSE OF ESTABLISHING A PERMI FEE ONLY:
am exempt from the provisions of the State of California Business a('-se.
and Professions Code, Divislo '3,Chapter 9. VALUATION PERMIT FEE $ /•.��Ol] en
L
Signature - • i PLAN CHECK $ 1� 00 o
/ 1 2
Permitt,._•
Signature, �•� ,.'G•��{� $ I `--'' TAX $ •.r f
or ! -`r-RC Va U
Authorized Agent Datey _ TOTAL PAID $ •
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