HomeMy WebLinkAbout1207 DORSET LN - Building PermitsMSS OFBeILUNG: 1207 DORSET LN
aIAMElFMIOWN: DE PERIO, FELICIANO D
ADDRESS. 8932 ERNEST FULSON DR
GARDEN GROVE,CA 92641
638-4158
APPL. "UNG ADDRESS:
A IIIPECT OR ENINEER:
UC. NO.:
OMT: CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 075021 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
UNIT.
CONTRACTOR'SNful ROY CHAFEY ROOFING (714)636-1747
CONIRACTOWSNMIING 9692 LUD ERS AV
AWRE55: GARDEN GROVE CA uc.No.: 556624
92644 UNIT:
UCENS ED CONTRACTORS DECLARATION: I hereby apsm under penalty d perjury than I sen licensed under provisions of Chapter 9
(mmmem in, with Section 7000) of Division 3 of the Business and Pmiss9iona Ce end my license is in full fan le affect.
CITY LCN/O..:0255615 uc.CLASS: C_39 Uc.No. 566 07/96
Date: /Y / _ J Contractor:
OWNER BUILDER DECLARATION: I hereby affirm under penaly of penury that I am exempt Irem IM Lumsoce, Licerme Lew far the
efollowing reason (Session 7031.5 Business and Psmanions Coda: Any city or county aduch requires a permit to construct, alar, improve,
ish, or repair
to is issumce. also
nit to file a
"�fi oelnsed nu aunt i the provisions a the Contractors License law applicant [Chapter (commemin, arch Section 7000) d DH'sion ed easement Ifuld a of the
or sh
,''h" 1 staged wemplan. Any violation of Section
1;.031.5 by
professions a Code mi tsu he she o exempt a Ong m and the or mo lar the
7031.5 by any applicant Ian a permit eubpcb IM applicant to a evil pe^atY d rapt man than We hundred dollen j$500)).
❑ 1, as owner Of the property or my employees wlth wages asthis sae compmaanon, will do the walk. end the structure b era intended
or o fend far eels (Section 7oed, Business and Praessvn Cab: The Contractors License Lew does tat so* to
an
bwmra Property
who bulda or noovea thereon, and who does such work himset or heneR Or through h6 or her own employees, provided that each
improwmsnte we nn inlended or opened for sele. R, however, the building Or impovement is sold within me year of completion, the
owner -builder will have the burden of proving he or she did rat build Or improve for the purpose of eats).
❑ I, as Omer of the property, ann extlualaety cantraesq wlth licensed connaclon to cans pees the projects (Seton Toed, Basim ee end
Professions Code: The Contraalore License Law does Iwt apply, to an owner of popery, who Willa Or improves thermn sed eche
contracts for each projects with a contractor(s) licensed punumt to the Contractors Ucense Lew).
❑ 1 am a amp under Senor: B. 6 P.C., or this reran:
Dane: Owner:
I do hereby certify that I am swan of and understand the mouinmanre of California Neath and Set" Code Section 25505, 25533, and
25530, and than I w any Mum building occupied will / wil not (cimb me) need to coolly with aaid small mans and Ihe re0am
nents far
e permit formnstmctlon or modification hope the AtruualRyMmagemend Dario. Residential mnslrugbn eppassiimswa examp from these
provisions.
Dane: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby affirm under malty Of pwjury aro a the fauharp detlaretiona:
❑ I have and oil maintain a oertdcna mn
e emt to set insurefar w Slee s mmpe ea on, ss porided tar by Emom 37M a the labor
Code, far the pedormmce 0 the weak for which this permit is issued.
❑ I have and oil maintain workere' mmpensaton insurance, as required by Segbn 37M of the Labor Code, for the pedormanoe of the
wok for which this permit Is issued. My workers compers lion inwanoe carrier and policy number aro:
Carder: STATE FUND EXPIRES
Policy Number: 01/01/96
.is section need per be mmpleled if she perm[ b for one hundred dollars I$IWI Or bar.)
❑ I oen/y that in the pedamama OF the work for which this penmh is issued, I shall not employ any person in sorry manner an we to
become subject to the workers' compensation lawv Of CalifOmia, and eqr a then H 1 e I soca eabjed the workers
committed n provoons a Seton 3700 a the Labor Coda 1 ah ondhn' 1 �pmpfy pr i
Dane: Appicaw
Wam/ng: Failure M imical"amothass, parwtlon cawrsge /s unh w i sat shell sub)eef an son,1 r hr adrNro perMMes area
civil pros W w on. handrail thuussrat Callan (Slog pop), In eddltlan to Me rosy of compm,,mn, clumages ss provltled Air In
Section 3705 of Me Labor Cob, Interest, and attorney's /us.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there b a cannmtlom bndin, span,, fn de
performwnm of the weak for, chid, this pamlt is waidl (Seaton 3087, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I codify Him I hew read this applicwian and cone that the spore information is appeal. I prey to comply with all city and county ordinances
and state laws mowing to building construction what hereby authorize representaives of this day to enter upon the above-mentioned property
for Imprint. pmpa9ea.
ROY CHAFEY
Dec.; HIS
(5151-06.WP) Whte-Buildvq B Seery: GmmFite; Canary-AppleanC Pink-Rswnue; Gadencd-Awleamr
PERM NO: B 075021
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION T/OFF REROOF WITH FIBERGLASS SHINGLES SQ FT; 3,150
CLAIM VALUE: 3,150.00 CALL—VALUE: 3,150.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS REQUIRED PER 91 UBC
RE iE if * 9i Rf RE iE RI-iF RE 1f iE 3E BE RE fE RE iE iE iF �E iE iE Rf RF iE BF if iE lE * * RE BE iF * * RE RE IE lE 1E 1E RE lE 1E lE 3E BE 1F lE dE BE iE iE Rf RE RF iF RE iF Rf iE iE Rf RE 3E BF iE 1E lE iE dE dE dE iE Io- 1E
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 S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14115402 ZNE: REF NO:
PLANNING NOTES>�
3F dE dE iE 9E 3E iE 1E fE fE RE fE RE lE RE iE if RE iE lF lE Ric 1E lE lE RE fE lE iE dE iE * if * it if RF iF * ♦E * iE * iE iE BE * BE fE iE iERE RE * * 1E lE IE 3E if fE 9E lE iE fF dE 1E 1f fE fE lE Rf ik it Rf if Bf 1E RE
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 •T1 " S
( /�,.
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: ** DATE: g
BElElE BE iE ik lF 1E****1E*BE 1E**RE 3ElE RETF;I'7F7FTf3F7f�FiF3f�3f��3f���f���Sf� �TF���f *if BE BE Bf RE Rf RE RE RE dE RE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63.00 50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 63.50 0.00 0.00 63.50 63.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 63,50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63,00 .50
I N D I V I D U A L F E E•, B R E A K D O W N
TYPE QTY D E S C R I P T I O N ` UNIT COST TOTAL COST
SFR 3150 REROOF BY VALUE RESIDENTIAL' NOZONE 1.00 3,150.00
END OF FEES
01 0U143b7c—OGl9ib?S '1'9SU-
014TE! 11/03/15 TirF! 11;0F.
:3.50
POO• ;PA
CONSTRUCTION AND PLANNING
Date
Inspector
Date
Inspector
APPROVALS Permit#
APPROVALS Permit #
1. Temporary Electrical Service orl'Me
l'
52. Pool & Equipment Locatiori�
2. Soil Pipe-Undrgrnd.
'53. Steel Reinforcement
-.:3. Electrical Condui.Utility-Undrgrnd.
54. Forms
_
X
4. -Electrical Conduit-Undrgrnd.
•
55. Electrical Bonding
• L5. Steel ReinforcernRnt"'
56. Rough Plumbing & Pressure Test
s 1�
6" ElectricalUFER_Gnd.
57. APPROVAL TO COVER-GUNITE
it -
,7.Footings ��'� '.
58. Electrical Conduit:Undrgrnd.
' �8. Foundation 4 •,�, �- -
59. Gas Pipe, O Urndrprnd., Test
„•!,
9:t Water Pipe-Undrgrnd. '.
60. Backwash Lines, Trap, ❑ Undrgrnd.
�tO,Structural Floor System
61. APPROVAL T¢ p'ECK
11:' Property Sewer Line & House.Corinection
62. Backwash & Receptor -Final ,! -
12. Sewer Cap
63. Heater & Vent -Final !'
13. Roof Drains .�!�`/
64. Plumbing System Final`.",'
14, Rough Plumbing f, 4,
65. Electrical -Final -J
15. Rough Electrical -Conduit •'-)
66. Solar System -Final,
76. Rough Electric Wiring
67. Fencing & Access -Approvals-'
v'
17. Rough Wiring Sign
68. APPROVED FdWPLASTERING -
18. Rough ElectricarT Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
- .,,
FIRE DEPT
,
-,REQUIREMENT
APPFjOVpLS��, Permit # -
^r" -
20. Rough Factory. Fireplace ;.- r�
:�•
.t• F.
21. Duc&,, in StruiturF •- -
x,i.}.
�
.
70. Ylndergrau4d Hydro "
�
„
22. Ducts, VeritilaTing y4
71. Product.Piping`OGas Coil
x 4
23. Gas Pipe -Rough & - _
'•^
�'� �-.
-'t d
72. Undergro
_Test
y
24, koof-Framing' - `•�
_
:73. Undergrnd.Storage3ank-l7Gas 06il
,_•,
25. Roof Sheathing i -•.j 1 f.�1i
`
6441&
74.; Overhead Hydro,_- _-
26. T;BaTCeiling SStruciural{ & MdRdcoat
a
.t m
75: ,DryCherpicaf
27. -Frame and, Flashing - rc
=,
76. Dry Star dpipe
_
u
�-FINAL
-_ 28. Lathing Si in,9
••�
'• '•'.'
--• T
FIXED5Y8TN'
!. _
29. Insulation_ -•
_
7$; FIRE PREV. FIJd'AL
30. Drywall Naili ,,�'.
t �;
'- ;NEALTfjDEPTIAEQUIR ME NT
31. Plaster Brown -Coat- - -r• *
4
l t'
79, FINAL INSPECTION =%
IF
F- R:
32. Electrical._Power Meter- -Final
l
"80'. FOOD CERTIFICATE ISSUED., -
ta=r
33. PinatrEleciric_• a
8
Notes '" i t--
_a _
_
34. FinaryHeating4& AiT Conditioning -•
r ['>
i
35. Final Gas -Pipe -Test -. �•
c ,�
E-
- _ _
36. Hood or Canopy
_
- 37. F.inal.Factpry FirePlace
z
' 38. Final'Plumbing• " _
1 +
-j FVC
39. WateFService,Final -
-
;.,' ••,
r 40. Gas Service -Final _
�
T
41, Solar DomestK-Final -' ''
- -
':
;,�• -
-
r.
_
42. Backflow Preventer '
•X ��
43. Backflow Irrig'tion a -'-
,-
t ."
sv
_
44. Landscape Iritgation°System i -' !•
;•; r-
_ ,-x
45. Sound Atten'Va'von . ...
* r,
t'." LT) :; p
r•• _J r;
" -
a
. 46. Handicap Regulations
-
tyr,r
47. FINAL STRUCTURE & BUILDING
/
>"
48. FINAL PLANNING
49. electric Release to Edison
r
50. Gas Release to Southern California Gas Co
-
'-
• r Z, -I '� '
r
r
51. CERTIFICATE OF OCCUPANCY
No Date
I
PROJECT ADDRESS: 1 2 0 7 DORSET LN UNIT:
OWNER'S NAME: DE PERIO FELICIANO D
ADDRESS: 1207 DOR§ET LN
COSTA MESA,CA 92626
6.62-1611
ARCH/ENGINEER: flEG.NO.:
ADDRESS: UNIT:
PERMITTEE: GENERAL INSTALLATION (714)753-2541
ADDRESS: 6558 WEST BLVD,
LOS ANGELES CA 90043
LICENSED CONTRACTOR. DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code and my license is in full force and effect.
CITY LIC.: 0 0 15 3 STATE LIC.: 1518 3 9 Alcenificate
Dale:15? Signature: WORKERS'C mPPuE5NSSATIOpNkDDEECLARATIIO�NN::� I heerreby affirm that have cont Ito self -insure on certificate of Workers'
POLICY NO. Compensation �i 'T WctV V �t7 V V 41Settiq1 3800, EXP. OATEab. 8 4/ 0 1! 9 2
COMPANY: NMI C �Ar U
❑ Certified copy 'S hereby furnished. )LJ Cataloged copy is filed with the city /pulldi g0'rision.
e: LApplicanC t—�
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed' a permit is for one hundred (S1W) or less).
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 WorkersCompensation Laws of California.
Date, Signature:
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.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION:.I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure, prior to its issuance, also requires theapplicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business
and Professions Cade) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for permit subjects the applicant to a civil penalty of not more than live 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 (Section 7044. Business and Professional Code: The Contractors' State License Law
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
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
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). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Serum R. & P. C.
for this reason:
Date: Owner
I do hereby corny that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need 10 comply with said state codes and the requirements for a
permit ler construction or modification from the Air Duality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant'.
I hereby certify that I have read this application and state that the abev information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby a on re lett city to enter upon the abovementioned
property for mspectm purposes.
Date: Signature:
Driver's License or Social Security <:
164146 While—Building: Green—Code Enforcement; Canary—Applicant; Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NU: 1 7H/ I
PERMIT NO: P 054775 PLAN CHECK NO: N v is N _auk,p: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE; OTH
JOB DESCRIPTION REPLACE WATER HEATER SQ FT:
CLAIM VALUE: CALL—VALUE: GROUP OCC; R-3 /
COMMENTS: MAIL IN PERMIT
######If#lE##}F•lElf###%###N#############lf#########9f######ic###};}##4F####-######iE #lf##•%#%
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
------------ MAIN BUILDING
—°-------
---------
ACCESSORY
BUILDING ---------
PANT: FT IN
REAR:
FT IN
FRNT:
FT IN
REAR; FT IN
LEFT; FT IN
RGHT:
FT IN
LEFT:
FT IN
RGHT; FT IN
PARKING REQ -
PROV:
PARCEL;
14115402
ZNE:
REF NO;
PLANNING Nt3TES>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
>
3,00 0,00
5,00 5,00
,00
#'lE#lFif-########it-########if##########-%#############•If#iF#lf#kiF###iP##if##iF#iE##iF
#ir 3f#3E lF #!f#
D E V E L O
P N, E N
T S E R V I
C E S,=,'
R E Q U -I R
E M E N T S
ELECTRIC MECHANIC
E SMIP/TOT GRADING
PLAN—CHECK
5,00
ZONING APPROVED BY
DATE;
BUILDING APPROVED BY DATE: _
APPLICATION ISSUED BY: DATE;
�F#########%###########RiFiF><,F 3rss� ���T���}��•�F��rTE��Te�T#####%##%# x e ##
LEGALIZATION;N F E E S TJ M M A R Y STRUCTURAL SEGMENT;N
BLDG
PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES
GRADING
PERMIT
2,00
25%
SMIP/NON—RES
PLAN
ISSUE FEE
3,00
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
2,00
3,00 0,00
5,00 5,00
,00
REVENUE DIVISION
TOTALS--> COLLECTED:
_5-0 OVER/SHORT;
g_::
00
BLDG PMT PLUMBING
ELECTRIC MECHANIC
E SMIP/TOT GRADING
PLAN—CHECK
5,00
I N D I V I D U A L F E E B R E K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 2,00 2.00
END OF FEES
c,�nC?KE DETEiQITjO16-00101415 TO$ `.00
J1 r-•'_ 11/04l9i Tii1E: 13',t4
REQUIRED
0
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
_ POOL &
APPROVALS Permo
Date
Inspector
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-Undigrnd.
-
55. Electrical Bonding
5. Steel Reinforcement _
56. Rough Plumbing & Pressure Test
6. Electrical UFER 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, ❑ 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. POOL7SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Eactory Fireplace
_
-
'21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating _
-
- 71. Product Piping OGas ❑Oil
23. Gas Pipe -Rough & Test
i
72. Underground Flush
24. Roof Framing ..
73. Undergrnd. Storage Tank 0 Gas ❑'Oil
25. Roof Sheathing '•
- 74. Overhead Hydro '
26. T -Bar Ceiling (Structurall & Monocoat
- -
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe ,
28. Lathing & Siding :
77. FIXED SYSTEM FINAL
-29. Insulation -
t
78. FIRE PREY. FINAL.
30. Drywall Nailing
'-"
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
- `
79. FINAL II.NSPECTION
32. Electrical Power Meter -Final
J
I
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
�!��
39. Water Service -Final
�• .- .
40. Gas Service -Final.
, F
41. Solar Domestic -Final
--
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
-
- -•'i'
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
i
e
48'. FINAL PLANNING
�' 1
49. Electric Release to Edison.',
-
50. Gas Release to Southern California Gas Co
'
51. CERTIFICATE OF OCCUPANCY
No. I Date
M - - Applicant to fill in all spaces a - within heavy border lines and sign all appropriate declarations.
rCITY OF COSTA MESA,as
_ _ -. _ _ _ _. ,
I PERMIT NO. it RACT NO. LOT O.,_ BLD
CONSTRUCTION PERMIT I ;• 545 3/10/83: 31:85 Tl
6� 3' '. ..,7/
_ •:
Apphcenf�Mei ling Address _ T�%f TYPE OF CONSTRUCTION - I NEW ADDS• ALTERATION. REPAIR _ j y 1 Y f ,
Project Address,- , s ^" • ❑ CONVERSION ❑ DEMOLISH ❑OTHER - { - _ _ i
Owners Name 17i7�Mi2BsrA-Cdf'� 'Phoria �.�jT T1/T I DESCRIPTION; OP WO K '/3�-O L'/G. Lt//fL L, - ,9 "7 'ZONING E U TINS - •* '
Address �O(L S ZrL .�, /79
_ TYPE OF PERMIT' GRA NG OUNDATION STRUCTURAL -A.P.# '�� �OZ•ZONE
Arch/Eng ' License No.l ' ' ❑TENANT ❑ELECTRICAL ,PLUMBING 0-MECHANICAL, ? "BUILDING -
i.._ •PLNG. REF. # . '
Address I ❑, OTHER , -' i _ ., -%+ TO BUILDINGc ' ,•
-'' c - Lsy 211Y 50j' = , :� ; - PROPERTY LINE REAR YARD (TO P/U
Contractor.'s Nam hone 1 ,'PROJECT DESCRIPTION : FT. OCCUPANCY' -
Acidress (rrra l nl ��_ ' ) CONSTRUCTION TYPE ! ' l VALUATION $' <LEFT SIDE YARD RIGHT SIDE YARD
License No
)3Bf,�ys l ZONF G RAIDING CU. YDS., 'ACR S P.KG. SPACE;REQ. �1 PROVIDED
� 5r i i I 1
LICENSED CONTRACTOR DECLARATION Remarks: s: ' • } - STREET WIDTH ` , PARK FEE $ ' r
1 hereby-affirm that I am licensed under provisions of Charter 9 (commencing
With section 7000) of Division 3 of the Business and Professions Code, and ; ; it I ! , SPECIAL CONDITIONS:
my. license is In full fo a and effect.
LJcna Class • �- Q U 'n 7No. I
ps33� PLUMBING ' } i 1
Date 11111151
,t 5' Signature
WORKERS' CO PENSATION D CLARATION r t Bar Sink. Sewer Cap 1 ( ELECTRICAL I!, ereby:affirm that.l have a.cerNfiw[e of consent.to seifdnsure or.a certificate_.' ..._ _ _AutomatiLWasher, :Meter_0 over100 amps
i- Backflow Preventer - - '-Sewer Connection' - -- ?•-�- -- -•- Workers' Compensation Insurance,; or a certified copy thereof (Section - )0, Lab. C.) I - Construction Pole ' SubPanel!1'i i Backflow Irrigation Solar CollectorsPot NO. I i Company rs.(�.1nZ[/f JCA14. " -' - g 'Sub Pole '. : ° 1 ! !
�tifled copy is hereby furnlstied. ' Bathtubs " t Solar Piping ! ) ; Cookie Unit S i
111111 YYYYYCerOtiatl copy Is filed with the cit�iltling Dlvlslo i - , , Dishwasher 'Motors 00-1 HP ❑ 1 %i-8
-Date Applicant ' i } Clarifiers t__-.,_ _/ _.i. Solar Tank .. I,__ i i i I 1 }
EXEMPTION�P OMWORKERS',C PENSATION DECLARATION r ; .� ti - Dryers ❑Ga$i ❑Electric ��� - _ hnC.Solari09-15 HP��16-15+ ,r,�' 1
(This action need not be completed the permit I5 for one hundretl ($100) or Dishwasher } I }. Swimming Pool w/Spa , ..
less)' { i Microwave
I certify that In the performance of the work for which this permit is Issued, i S Drinking Fountains i 1 Urinal } } i 1 f
shall not employ any person In any manner so 'as to become subject to the 1 - - - ' }
Workers' Com Denatlon'Laws of California., I FIOOr Drains' i , 1 F.A.U. i I ) i Pole Light >
Water Closet,
Date' 1 ci gnature ' 1
-NOTICEi-If; after makingthis declaration:-you-should, become subject to the Fluor Sinks -^j-----t-^-. — -Water Heatef-- '--• —'-- _. C.-_ Fi_xtures_�_, ; 1 __ 'Range
: Workers', Compensation provisions-of the Labor, Cotle,.ypu,must-forthwith 1 ° r - g
comply ,with( such ,provisions-or �this6permit )shah be deemed revoked• F . y Gas Service' 'Outlets : �Wate4SarJice T ! ! Device Boxes i I i' } Sign;
CONSTRUCTION. LENDING . AGENCY_ - - ' 1
I hereby affirm that there Is aconstru<tiomlentling agency Aor tnalpperformance - ''`• - Outlets } } !Standin Sections
of .the work for,which this permit -is ! Issued (Section X3097 Civ. C.);Interceptors 9 i I
Lender's` Name' ' - i Kitchen,Sink _ ; T t - Switches I 1 (' ITrash Compactor I ,
'Len Uer'S Address - ~ ' • '
Lavatories ra
, .. Garbage
i-OWNER,BUILDER DECLARATION, i
-} t -' ' ar9 Dis oP ,
I hereby, affirm that I a'm'exempU Trom the Contractor's, License Law for the , f Generator. ❑0-5 KW ❑5-15 KW
following reason (Sectlon'7031.5 Business and Professlonal'Code: Any city or i' F-Trapl - .T1 r < j ' i. J i 9 1#1$1,5
county which requires a permit' to' construct, alter Improve' demolish or, repair--Transformer X15-50 KWany structure; prior to Its Issuance, also requires the applicantfor such permit' ! Roof Drams 1 T:' 1 -to file a signed statement that he/she is licensetl pursuant to the provisions of'Contractor's License. Law;(Chapter 9 (commencing with Sectlon:7000) of�5U + KW I ReinspeMion Fea
slon'_3 of the!Business and Professions Code)'orl that! ha/she'Is,exempt Showers C = .� j ty RemspeCtion•Fee { $15
,I_from•and the)basis for the alleged exemption.- Any, violation of,Sectlon _ i " ' _ " ' - Meter ❑pp to 100 amps 1 'Issue Fee: ( i $ 3.
,, `•5 by; any applicant for-a, permit-Subjects the applicant to a- civil-
"alty of not more than five hundred dollars ($500) .`. i, ; _ , Service Sink -1 5 e Issue Fee
: i t -- Zoning Approved By ;Date i
L'J I;'as owner of the:proparty or my employees-with wages as their sola ?
compensation will1do the work, and the structure Is not Intended or offered - t r. ' ; '. i -) MECHANICAL' ; { I Applicatilin Approved By ' ate' 3//
d�J P
for ale .(Sec ion 7044, Businessland Professional Cotle: The i Contractor's t _ - ) p
I License Law does not apply to an owner Of a property who builds or Improves
Boiler ' i .. .- i Refrigeration System i , j
thereon, and who doesisuch work himself/herself or through his or her own : i ' ( Application Issued By 'nate
employees, provided that such-improvements areinot Intended or offered for - - r ❑0.100,000BTU ❑100,000BTU 1"
sale. If; however, the buildingor Improvement is sold within one ear:of com- t Duct -Under Ground i i ; 1 i y I.
p y i i ! S MARY OF FEES I f +
plane n, the ownerlwillo have the burden of proving he/she did not build or 1 1
_for the purpose orale):' -+, r (.?i i Duct-Structural System Repair/Alteration ; )BUILDING PERMIT $' i. SMIP I , $'
LLJJ I, az owner of the property, am exclusively contracting with;licensed con - i I i
-tractore.to construct the project Section 7044, Business antl. Professions, Code:
..1_ Duct -Ventilating _ .�_ _- _ -.. _ _ } ;PLAN CHECK } $'' _'/ a 8pERM1T !
.The Contractor's License Law does not apply to an owner of property who -) r- i ' t I !
I'builds or Improves thereon, and who contracts for such projects with a con- - , ' I ( ISSUANCE $ ' �•
i Exhaust System ❑ Multiple❑ 1 PLUMBING $ : :.
'tractor(s) license pursuant to the Contractor's License Law)., I i ' - I !' I �.
;, ' ;PLAN CHECK. {' $' ! - GRADING ) $
0 I:am exempt antler Section ` 1 l' B. & P. C. for this reason. +' 1 Firepl/Fact. Bit. ICBG # ' } ` - i '
Date 1 1' 1, Owner" ! i i ' ' ' I is Heating�System&Ducting ' 1. 1ELECTRICAL! $ I• �' l' } $ i- f
iry , r t I' } i } 1 -PLAN CHECK i I. i' 4 MICROFILM $ I i I
P•hereby-certlfy thaYl.have read this application -and -state -that the above"{ ❑0-100;000 BTU'B100;000BT -- , - : - T— $ i 1 }, i
Information is re<t. I agree co pry with all Uty'and county ortlinances + r i i I ; -- I '�1 { �MECHANICAI I $ i }' f TOTAL;FEE $ ' 1 1
and state la elating.to but in nstruction,;a ntlhereby authorize repre- , ++
: Inspectio Is citytto to r on the above-mentlonetl property for I Hood or TypeI ,- Reinspection Fee $15 j ! $i �' LESS t I
Inspection poses: , I Cann i .T a II ❑ 1 i PLAN CHECK: ) tI
{ ADVANCED PC $ r
`Signature 1 T. `�: 1 1: Dace?—/ti-Y� i i t. j f j I' I. i
Drivers' cense or'SS'lf,- ' Registers 1 i; Issue Foci (- i $3 ; _ ! FINAL FEE i $ t
CMF 086546 rev. 12/82 - White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
T ryCONSTRUCTIONAND?PLANNING -
%`_L+-'
],�
+ t r 0�•-3` `Datlnspector-"'
Date -
'Inspector
>-SAPPROVALS�Permit#
-
�APP.ROVALS--`Peimit.#
^
rr 7 Temporary Electrical Service or Pole � �
�' 3 �
�' `'t �
�: 52 Pool & Location
_Equipment
2i ;Soil Pipe Undrgrnd: ^• - ; g
-
I
'.X53` Steel Reinforcement
��
�;
3? Elect lira) Conduit Utiliiv-Undrgrnd:
:
�rZ
54: Forms
-
r�,
,
.
4: Ele'etrical Conduit Undrgrnd' s ` ! `
`"o {
�'55 Electrical Bonding •r. `:"c'
- _o r
:-„''
•m,
c
E.
5: Steel!Remforcem14 1 I o
;56 Rough Plumbing & Pressure;Test`
�:
6.' iElectiicaI LIFER Grnd., e
-
r
57 APPROVAL TO COVER-GONITE
`
I I 11 , G
l_ ,
7. Footings' ' I I ~ g" i
3
3�f%�'„
:58' Electrical Conduit-Undrornij o -
i
B. Foundation i {
tiS ,
59. Gas'Pipe; O Uridrg'rnd:; Test"
c
9. Water Pipe-Undrgrnd. o- t
--_
=
6_p. Backwash_ Lin *as,' Undrgrnd.
10. Structural Floor System z` a_
`,
? i
;;61. APPROVAL'TO.OECK
i�
11. Property Sewer Line &'House`Connection,
-'-
- !
i,62. Backwash &:Receptor -Final'_'--
12. Sewer Cap �� i
c,^ _5 j
;'63. Heater,&Vent-Final -
t
13. Roof'Drains
Plumbing System;
,Final
:Iy
14. Rough Plumbing i I
!
Y-
'65. ElectricaGFinal =
P 157 Rough Electrical -Conduit "T
' j i- ' -
� _F`1'
-66.� Solar System -Final- "
--16.;IRough_Ele(4ric;Wi r� g, .� i '7
• r I w'
r
-'67'j Fencing &1Access Approval �• ;"IT
•"�-j- * -i
I, =�'-•�
'}
ug
17: iRosWlnng Slgnr ;j c
j '
I ; j f ;;
,68 APPROVED EOR'PLASTERING
ij
, ;_ , l
•
18. Rough.Eleetrical;T-Bar Ceiling
-
:'
. 69.j 066USP.A SYSTEMS FINAL
+
( , ,
i 19.'RoughSHeating &IAir�Conditioning B I
l
l =' 1
i l FIRE DEPT. REQUIREMENT
`i
'Permit #
l
-)
4''20. !Rough;Factory FireplacesAPPROVALS
J .
''
21,. Ducfs'in Structure' i { }
! j !
i
{ i i
t70. Underground Hydro I
i
_ L II
!Ducts, Ventilating r. j
I i
i
7L: Product Piping O Gas D Oil i
RRt22.
•:. -: . .
l
e[23; hGas Pipe -Rough & Test
72.1 Underground Flush i I
`24; Roof Foam ngj r ! i ; = o+
_�
j.y ! • { I:
173. Undergr d. Storage Tank -0 Gas .O.OiI;
,
25. rRo If'Sheatliin' - ' `•
E
j Overhead Hydro r ' {-
j
f7q
'� 26. -Bar Ceilin`_g (StructuraQl& Monocoat i
` i` f y j `
�± t ''°'I.
75.1 Drjy Chemical ?
1T
s
'.Z7. !Frame and Flashing' tI !' i, I
1 I
1 ,, I I `'
;76.1 Dry Standpipe
28.Lathing &Sldmg i . i
!�°� }
,77.1 FIXED SYSTEWFINAL.
_
29_ll16sulation s�78.�
FIRE PREV. FINAL
30.'Dryvvall Nailing- I, q
! I
I i
l
r
i t
;Notes:
'31. Plaster Brown Coat -
1 l l
I (-
t --� -- 1 j i - + - - -- ---, --• 1 -- r -
IElectrical'Power
,
1�32. Meter -Final ' {
_1
A_-,
�![33._Final Electric j.-
I i--�
1.'t,.
1 '
_
• f
34. Final Heating &iIAii Conditioning
35. Final Gas; 666 T1est'
`rl
, . !::1_1., ,•
,
L
36. Hood or Canopy_`,_! ' { e i
t'
V is 51 •rof �'��^ -1 n!
!_ �I'-
+ii� I",.•I olr' �u -
j.l ITT
37. Final Factory Fiieplac17-
e I a i 5� i�
lJ ; -- I 1,
I ' i
s r•'i _ r.
I •
;;� rf
38. Final P.lu'mbing� 1•.''r'� �j 'l I`
�� !?I
,
l'l -, t1'
1
i I
{ ,
-
39. Water Seit rvice-Final;6�p E.
1l
I
,`,
40. Gas Service -Final k :' i,
1 1• j
I i
I I •- I r I. l i f
a l
!
41. Solar Domestic-Final'F i
42. BackflowiPreventeri"� i'
Iry.-
_-_-
_ -,.
_ • _4__
43. Backflow; Irrigationxt i I•
Via;'; Io'
�,I`!.5;
l�j•i «'-1 1 - '
I ,,.�
-'gationSystem
44. Land sca<le �lr'r
q
45. Sound' Attenuation T -Io - 1 - •�
o
_o' i
! •! i i ;;� •.
V;
46. Handicap) Regulations`i'
''
I I I l "C,_ '! '� _ rr rr 'I
I
•
, ' t f r•
47. FINAL STRUCTURE & BUILDING
Special Requiremnts Completed
I48. [
,
i ,
49. Electric Releaselto Edison)' ' " I_
-I'-t•-�-
-I
. '
- '_�
I _ �, 1 yrt� � �.
- _ i
u 1 1 1 1 1 a
i
_ r- �� i i •
50. Gas Release to Southern California Gas Co
' ii
i I `
' 4 ! 1 i •I� -) ' 1 ' !
,•1 .:,i
}; I
51. CERTIFICATE FF OCCUPANCY
l
1 ! a
Date
I ` I Cement Coping Optional --
Channel Block With 1-3/856
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8" Oat 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8-0 at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15-39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURAL GRADE
TWO 3/8"0 BARS
CONTINUOUS TOP
& BOTTOM
.H007—STEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 6 I CONCRETE BLOCK FENCE
[� W'IDTH
D' SEE CH;
BELOW
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR:
One Part Plastic Cement, and
12 . .
Three Parts Sand
GROUT:
One Part Cement Three and
. . g".
One Half Parts Stand
COPING:
One Part Cement, Three
16". .
Parts Sand
CONCRETE:
Well Mixed 1:2-1/2:3-1/2
16'.
Max. of 7-1/2 Gallons of
City of Costa Mesa? California
Water Per Sack of Cement
GROUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
'H OF EARTHTCOTH
I/3 THE HEIGTH OF FENCE
BELOW BOTTOM OF FOOTING.
SCALE: 1/2'I= II
WIDTH . . . . . . . 14.. . . . . . . . .
.14
12 . .
12°
THICKNESS 10.
.10, . . . . .
. . g".
8..
DEPTH OF EARTHTOOTH . . 24
20 . .
16". .
12
SPACING OF EARTHTOOTH. 12' . . . . .
. .14
16'.
16'
City of Costa Mesa? California
OWNERS NAME. _
JOB ADDRESS
_ _ _ _ _
_ _ _
PERMIT NUMBER:_
_
Building Department
SIGNATURE.
ln7.1 .. ,.-,,_,_... (LEvMSr) Nov. 82.
VPRO
CITY GAF CMA Aye w4t
PIANNNG D®'L
SUBM0 To am mRl v am
BY._0�%-A iDATE.�Q ;00'/e3
DIRECTOR Of PLANNING
RESIDENCE
City of Costa Mesa Building Dept.
_.._..,DATE 19—
THESE PLANS MUST BE ON JOB AT ALL TIMES
MAKE NO CHANGES WITHOUT PRIOR APPROVAL
OF DEPT.
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
OF PLAOS AND SPECIFICATIONS CH'LL NOT BE CONSTRUED
TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION
OF ANY OF THE PROV131ONS OF 1.413 CODE. NO PERMIT PRE-
SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF THIS CODE SHALL BE VALID, ECCEPT IN SO
FAR AS THE WORN OR USE WHICH IT AUTHORIZES IS LAWFUL.
THE ISSUANCE OF A PERMIT BASED UPON PLANS AND
SPECIFICATION§ SHALL. NOT PREVENT THE BUILDING OFFICIAL
FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS
IN SAID PLANS AND SPECIFICATIONS OR FROM PREVEN7E4G
EUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
IN VIOLATION OF THIS CODE CA OF ANY OTHER OROINANCE+
OF THE CITY.
a\
0
w
_
n
y
A
RESIDENCE
LA
�
GN'
RESIDENCE
STREET LE
SEPARATE VEMAIT'S ARE REQUIRED
FOR ELECTRICAL, PLUPABING,
H -EATING, VENTILATING AND
REFRIGERATION WORK
1 U.,, I�I'all 4,X
�THIS NUMBER MUST ACCOMPANY
, ALL INSPECTION REQUESTS
8L'1L01'�3S�'tHEi,E�ER342:T ��>i�3
BE '•.t.1PL,OY:Ii' t:: EIUvGa 4T .s T i�r
'ATE 0
�I
RESIDENCE
OWNER SEDLACK, James DATE 10/16/72
JOB ADDRESS 1207 Dorset Lane BUILDING PERMIT NO.
GENERAL CONTRACTOR Forcier Const. Co. DESCRIPTION of WORK Interior Alto
No. 14L-_154-02 LOT TRACT FIRE ZONE VALUE$ 4000.00
..iPECTIONS
Si nature Date
GROUP I
TYPE V
ZONE
R-1
GAIL
SUBCONTRACTOR
PERMITS ISSUED
GAS
Date Number
Si no}u re
WATER
Plum
bi
ROUGH PLUMBING
-
6
PROP. SWR. LINE [:] HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ED POWER E]
ROUGH WIRING
HeaflnQ
and
Vent.
TRENCHES ❑ FORMS C STEEL REINF.
FLOOR SYSTEM
8 ANO BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
-TER, BROWN COAT
TURAL, FINAL
I
}r'
. ING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
-�'%3
// i-r.tpq.
MiQ
�/
u.✓..�i /
{.�A rl. b-73
Pnle
6r.T 17-nr—x,,00 678* u=*::34.71
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
AWLIAtION FOR BUILDING PERMIT
For to Fill in Completely
RE IV TE gECEIVED �-E ISSUED'
G
BUILDING y+Applicant
d�ORs�fG
U•f
(O/ !/
ADDRESS iOCYi'
OWNER Ae. J99N6 S Sig OL AG' /-
A.P. NO.BUILDIS �Do2 P IT
MAIL
/Lc�? //O�.i�ii Lq-.v�
ADDRESS IZO 7 'r"'�""�•
Z
ADDRESS
dU
CITY L=B�TN" 1"jMS3- NOUJIW
��J/,J
TRACT / LOT/60;;'
BLOCK
Z
Z Q
.
CONSTRUCTION r lf-
VING
ON
LENDER /T� '
M go
J D
BRANCH
J rn
-
OWNER iWfKF�
m J
m
ADDRESS
VALUEI
C- �-XA-
J Q
ARCHITECT TEL.
l� $:�6/C/O
U
OR ENGINEER N
-
Q
FIRE
W D:
ADDRESS-
ZONE T PE RO
d W•
W Z
r
COR/.if Gam-
APPROVED .1,
BV DATE (/
CONTRACTOR�(,s
roO
Z
Jam.
ADDRESS Q �C SL)- e'e"j "e' a-��
W W
O=
(4. NO. t �ILI
ZON NO.OF , USE OF NE
— PIA / BUILDING
Z I-
CITY 9.v 9 .v ¢ -J
O
in
STATE CITY
%y,i
YARDS APPROVED YARDS APPROVED
MAIN BUILDING ACCESSORY BUILDING
IM
LIC. NO. .27O LIC. NO.
7 O
SIZE NO. OF BLDGS.
(FROM C/L STREET)
OF LOT NOW ON LOT
NT FT. F
USE OF
'FT.
EXISTING BLDG.
H
SIZE OF - NO. OF
Z
NEW BLDG. ROOMS STORIES
L SDE
FT.
VEXTERIOR
WALL -
ROOF
Yl
_
COVERING
COVERING
AR FT.
FT.
J
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
CL 1
MAIN SLOGS.
ACCESS. BLGGS.
Q
O
e,
/V/E MO DC
VAR.*
C.U.P. aI
DATE
APPROVED
NAPPROV
�
/{
(/
Z
O
t~.1
I hereby acknowledge that 1 have read this application and state
Q
0
that the above information is correct and agree to comply with
T
all laws regulating building construction, and I shall not employ
F
any person in violation of the workman's compensation laws of
y
the State of California.
?
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
o
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
antl Professions Code, Division 3, Chapter 9.
VALUATION
I -� �-C•'
"�
07—
PERMIT FEE $�
Signature of
q A
✓
Permittee 46V �Z
$ o'y H )r'
PLAN CHECK $
E
o
Authorized Agent
TOTAL FEE $ �] O
OWNER • ul, •ul'•tl "10-11-56
JOB ADDRESS
Dorset
BUILDING PERMIT
GENERAL CONTRACTOR The Hale Co, VALUE $ 10,880,00
T . 187— BLOCK TRACT 2671 Single dwelling w/att. gar
GROUP I & J TYPE 4 7nNP RL Flew nlcTpfcr vA7z
INSPECTIONS
_
DATE
SUBCONTRACTOR
PERMITS ISSUED
DATE
NUMBER
Footing Trench
Foundation Forms and Grade to Garagek
Rough Framingtr
Plumbing, Rough to� � ®",-,. e 7
1'
L
t.-wa,�
/63 n ^_�ti
.3D0—
7500—
Plumbing,
Plumbing, Rough Complete kne-
Temporary Pole
Wiring, Rough
Heating,Rough
?• •157
Heating, Final
_%G -
r7 f .Z ✓
ewer, House Sewer, St.
Tank or Cesspool
I Ig, InK Out X,d,
Plastering
Plumbing, Final, Fixtures Complete
Plumbing, Final Gas Test/S_ MffS
*4'
Wiring, Final MAYI
_6_��
nnnmanev Y/Y/L_
��
FORM 210 3M 10-55
-Costa Mesh Badding Deiiartm� e t APPLICATION FOR PERMIT
', >Q.o:Box 3n�g'�' BUILDING
-OSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
FOR OFFICE USE ONLY
- - -
Receipt No. '
Permit No.
p!!�
O T
Building
Address 1207 Dorset Lane
Costa Mesa, California
Received by Date Recd.
•'-X4->F0 D "/0
Date Issued /
Nearest -
Cross St. Fairview Road
Building
Address
Owner College Mesa Company
Costa Mesa, California
Mail
Address 1777 W. Lincoln Avenue
Nearest
Cross St.
Tel.
City Anaheim No.KEY 3-3161
Zone
No. of
Plans
Type'/ Group
Al V
Architect or LIC.
Engineer Davis & Quigley No. C-1790
Approved
by Date
Address 43 Malaga -Cove Plaza, Palos Verdes
CORRECTIONS
Contractor The Hale Company No. L10 3422
Address 1777 W. Lincoln Ave., Anaheim
Legal
Description I
Lot
No. 187-. I
I
Block I Tract 2671
(Attach Metes and Bounds)
No. of Bldgs
Size of Lot 63 x 117 Now on Lot None
D
Use of No.of
Existing Bldg. Familles
No. of
I Rooms
A
Setback Line from Rear Yard IZ
Center of Street SO Side Yard 6
D
DESCRIPTION OF WORK
New I X I Alteration
I
I Addition I
Repair I I Moving
I Demolish I
Building No. of
Size 1260 Rooms 6 Stories 1
Exterior Wall
Covering Stucco
Roof
I Covering Rock
APPROVALS j
Use of New
Building Single family dwelling with
Foundation Location
Forms, Materials,
Under -Pinning
Inspector
Date
attached garage.
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply
with all City Ordinances and State Laws regulating
building construction.
Signature of
Permittee 4THE HALE CO
Authorized Agt.
Lath. Int.
_
Lath. Ext.
Plaster, Int
Plaster, Ext.
CIO
Valuation
$ 10,880.00
Permit Fee 91` 6.00
Plan Check $ 13. 00
Masonry Reinforced
Bond Beam
Total 39.00
Fee $
FINAL
FORM 204 1055 O. P. & S.
PLOT PLAN
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PLOT PLAN
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