The URL can be used to link to this page

Home My WebLink About157 DEL MAR AVE - Building Permits CITY OF COSTA MESA -- --------- --� we*"Mes BUILDING DIVISION FAy"'�',Wait I ES 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us k. d FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER: BC10-00205 PERMIT TYPE: B_COMBO STATUS: ISSUED • Sub Type: RES_ALT DATE ISSUED: 05/13/2010 ^.1- ISSUED BY: CAC JOB ADDRESS: 157 DEL MAR AV CM - 'Suite/Unit: • APN: 43916122 -Zoning: , , - `- : Vicinity: . Primary Occ: : Const Type: V-B ,. SQ..FT: .. 0 - Valuation:• $2,000.00 .-,__-__._, _ SCOPE OF WORK: CONVERTE-528SF STORAGE AREA TO A GAME ROOM WITH BATHROOM AND EXPAND BEDROOM-AREA 1 BY ADDING A BATHROOM AND A CLOSET. 2 TOILETS 2 WASH BASINS 12 SHOWERS 2<1 HP FOR BATHROOM FANS ' 11 LIGHTS 8 OUTLETS 8 SWITCHES 2 VENT FANS 1 ALT DUCT SYSTEM. :. GAME ROOM IS HAETED BY-THE EXTENSION OF THE EXISTING DUCT SYSTEM OWNER: HARGROVE H M Address: 157 DEL MAR ' • - .. Unit: Phone: 714-296-2177 . • - City/State/Zip: COSTA MESA,CA - ' ' '10-`_)`l;jl./t; APPLICANT: HARGROVE H M . •Address:- 157 DEL-MAR - • ' Unit: '.,'I'' .. Phone: 714.296.2177 _ -, City/State/zZip: COSTA MESA,CA - - - - CONTRACTOR: License No. . Phone: Address: Unit: . • '" Cell: City/State: • .,ZipCode . , ARCHITECT: - License No. . PHONE: ENGINEER: - License No. - - PHONE: - � COMBINATION PERMIT FEE SUMMARY -• - • Building Plan Check: -$45.01 ::,d?/-)Cki-Ab.FP. I Building Fees: - $69.25 - - . Electrical Fees: - $62.70 . Mechanical Fees: $51.70 Plumbing Fees: - $58.80 . SMIP Residential: $0.50 . ' _ SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: • $288.96 •-+ ;a.-ritT2. ,} "Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 : • ' ' ' ' ' Monday thru Friday-7:0o am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: •- New Years Day,Memorial Day,Independence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related 'regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: 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 with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expirationof this permit. LOGE N. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE GATE"`"" INPTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - - - — ----- 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval • • 203 Final Sign 222 Final Site ' ' .f': :.;n5 204 Final Demolition 250 Final Building/Occupancy ._-. .130a7S., e:aa, hol:•:zys: , WORKERS'COMPENSATION DECLARATION: Owner I vent-. .y drive iicce[nsseYes ❑ No I hereby affirm under penalty of perjury one of the following declarations: � - �'o. :� �/ E ves El I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax sill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. El I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsew ork,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed dtho permit is valued at one hundred dollars($1OO)orless) 2.Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's signature Date the Labor Code.I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicants Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect, a registration form for acutely hazardous materials? ❑Yes ❑ No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? CIYes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the ) Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8 (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property,am E LUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to constmfthe project(Sec.7044, Business and _ Professions Code: The contractors Lic"se Law does not apply to an owner of Signature Date property who builds or improves Cher-,.n,and who contracts for such project with CERTIFICATE OF COMPLIANC r/AND AUTHORIZATION OF ENTRY: I a-Acontractor(s)license pursuant tot Contractors License Laws.). certify under penalty of perjury the I have read this application and state that �L I am exempt under.- � the information given is correct) agree to comply with all state laws and city w ordinances relating to building onstruction, and authorize representatives of Business and Professions .de for this r ason: the City of Costa Mesa to 4nter upon the above-described property for inspection purposes. I agre: • to occupy or allow occupancy of any building authorized by this permit al inspection. Z 2y �6 � ,r Z°/-7/s' Yam`6 .ure or - er �te lj 3057-4613/07 V`- C Dl And/or Authonzed Applicant Date Lay of Costa Uviesa (ding Dims' ion • Costa Ntesa 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit# -/O ' C6/ZOS Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. i/l. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 121 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. (a 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ei 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. dJl 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. ei/6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. W 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 - . tif 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 0% 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the in ormation I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsib for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, other verification acceptable to the agency is required to be presented when the permit is issu o verify the property owner's signature. Signature of property owner Date: /rat"/a Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 p • ^ • CITY OFCOSTA MESA •, , - 0 t""' �9 - • ' BUILDING DIVISION hiq` 'a • 'l) 77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. FOR INSPECTIONS CALL: (714)754-5626 h ""o� PERMIT NUMBER: BC09-00149 • PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 05/12/2009 ISSUED BY: CAC JOB ADDRESS: 157 DEL MAR AV CM. .. - ' ' -Suite/Unit: APN: 43916122 - Zoning: - - Vicinity: - ,Primary Occ: R3 Const Type: V-B - SQ. FT, 0 .Valuation: $20,000.00 SCOPE OF WORK: REPLACE ALL WINDOWS WITH SAME SIZE AND LOCATION.ACCEPT:ATTHE BEDROOMS WINDOWS WILL BE LOWERED T OCOMPY WITH EGRESS REQUIREMENTS.AND DECREASE THE SIZEOF THE:WINDOW IN THE LIVING ROOM. NEW FAU IN THE ATTIC.WITH ATTICACCESS _. - , - CREATE A NEW BATHROOM. - - - ,, FAU <100K BTU 3 BATHROOM VENT 1 KITCHEN HOOD 18 LIGHTS 35 OUTLETS20 SWITCHES 3 BATHROOM VENTS< 1 HP. r^ .b .s-t-r x, 1 DISHWASHER 1 SHOWER 1 KITCHEN SINK 1 TANKLESS WATER HEATER. 1 WASH BASIN AND 1 TOILET:T WATERIPIPIM€ 1 SHOWER OWNER: MICHAEL HARGROVE ',Address:' 157•DEL-MAR- ' . - Unit: Phone: 714-296-2177 - City/State/Zip: COSTA MESA,CA . . ' APPLICANT: MICHAEL HARGROVE Address: 157 DEL MARUnit: : • Phone: 714-296-2177 City/State/zZip: COSTA MESA,CA CONTRACTOR: OWNER-BUILDER License No. 000000 - ' Phone: . . Address: Unit: - Cell: City/State: _ -.ZipCode • ARCHITECT: - -License No., - PHONE: ENGINEER: -License No. PHONE: _ Is vim M.'.CiWS mu. 1 HE LUViNG COMBINATION PERMIT FEE SUMMARY Building Plan Check: $0.00 Building Fees: $321:25, . ._ Electrical Fees: $112.50 • Mechanical Fees: $70.45r;,- In ,rn Plumbing Fees: $92.10 = 1 -b',rtrl'EF?'f'IPkF SMIP Residential: $2.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $599.30 "Refer to fee receipts for all fees paid for project ,if' f,: : NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: 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 with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. 60DE S. INSPECTION TYPE DATE INTITIALS CODE* INSPECTION TYPE DATE .IO ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical JJ it '�bt[--.10 ( 71!... 1266 Pool Spa Final 208 Final Plumbing �I*i`u' 200 , Final Re-Roof _ 210 Final Electrical df(1i 201 Final Block/Retaining Wall 212 Final Fire Prevention r2:1:1 Final Final factory Fire Place 220 Final Planning Approval r 20 Final Sign222 Final Site 7•`-1" �d.'a 204 Final Demolition 250 Final Building/Occupancy 1t1 } /// A WORKERS'COMPENSATION DECLAt TION . • - ,^ •.. e - - . rive?_ .censf@, • x.i . ,. - ❑ I have and will maintain a certificate of consent to self-Insure for workers' - • - •. o Ownership by(type of document,i.e.-property taxbill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by • section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm (Thisseaon need not be completed;Ithe pennis valued at one hundred dollars($100)or less) 2 Art 2Sec.341.Title B,Califomia Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicants Signature Date Division of Industrial Safety Permit Number: Applicants Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractors Signature Dale hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes CINo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑ No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested That he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). Ai I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other co pensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for control sale. If, however, the building or improvement is sold within one year of officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. property, ❑ I, as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty • perjury that I have read this application and state that ❑ am exempt under s the information given s correct. I agree to comply with all state laws and city ordinances relating r• building construction, and authorize representatives of Business and Professi s Code for this reason: the City of Cost. Mesa to enter upon the above-described property for inspection purp,•'r s. I agree not to occupy or allow occupancy of any building authorized by i - permit until final inspection. 49 i• ature of Legal Owner(s) ate ignature 3057-46(3/07) , And/or Authonzed Applicant Dale City of Costa fllesa Budding Division Costa77 Fair Drive, Costa Mesa, CA 92626 Mesa 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit# 16O9 - oto l°b Disclosures & Forms for Owner- Builders Applying for Construction Permits . IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at /.s9- DEL MAXA/E2✓uE We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 62)1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand.that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 12_4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. t5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 49 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. dej 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 • • r ��. 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held-Ruble for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. (/y 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for more information about� licensed contractors. al 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: Ii - '7jcl.MARA✓£ t11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. V 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issue , this form must be completed and signed by the property owner and returned to the agency respon ble for issuing the permit. Note: A copy of the property owner's driver's license, form notarization/or other verification acceptable to the agency is required to be presented when the permit is iss d to verify the property owner's signature. Signature of property owner Date: /Z MAY Qs? • Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 111110 CITY OF COSTA MESA ' 9p BUILDING DIVISION i':'. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us tt Sr* FOR INSPECTIONS CALL: (714)754-5626 44ofi PERMIT NUMBER: E09-00113 PERMIT TYPE ELEC STATUS: ISSUED APN: 43916122 DATE ISSUED: 05/2912009 .ISSUED BY: RMD JOB ADDRESS: 157 DEL MAR AV CM Suite/Unit: Vicinity: _ SCOPE OF WORK: ELECTRICAL PERMIT TO UPGRADE SERVICE PANEL TO 200A,.SAME LOCATION(SIDE OF GARAGE)FOR SFD. • OWNER: HARGROVE H M Address: 157 DEL MAR',,,Unit: PHONE: 714-296-2177 City/State/Zip: COSTA MESA,.CA APPLICANT: HARGROVE, HARRY - - Address: 157 DEL MAR Unit: - PHONE: 714-296-2177 City/State/zZip: COSTA MESA,,CA - CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit - - PHONE: - . City/State: _ ZipCode: : • - _ • CELL: • ELECTRICAL PERMIT FEES • Electrical Plan Check Fee: $0.00 Electrical Permit Fee: . $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00 • • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28, §1, 12-21-92) EXPIRATION: 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 with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE It. INSPECTION TYPE DATE WEALS CODE It INSPECTON TYPE DATE INTTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /} 200 Final Re-Roof 210 Final Electrical _I /j79 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATIO• Owner ID verified byyddrs license: Yes ID No I hereby affirm under penalty of perjury one of the following declarations: Driver'sLicense N& Expires:„ O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seann need not be completed dShe permit is valued al one hundred dollars(Sr00)or less) 2.Art 2Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder. I will not employ anyone to do work which would (❑. I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not emplo any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' comps ation laws of California. and agree that if I should become subject to th workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I sh forthwith comply with these provisions. 1044U Division of Industrial Safety Permit Number: Applicant's Signature ; 'Otte HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractors Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec. 3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 17Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits), License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.), information given above is correct. I agree to comply with all state laws and ❑—I,-as owner of the property,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMP IANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of pe'ury that I have read this application and state that ❑ I am exempt under sec. - the information given is ..rrect. I agree to comply with all state laws and city ordinances relating to . ilding construction, and authorize representatives of Business and Professions ode for this reason: the City of Costa M sa to enter upon the above-described property for inspection purposes agree not to occupy or allow occupancy of any building u� W�/1 cc�� authorized by this !,-)i it until final inspection. ��09 ''//414 d�J "Signal -of Legal Owner(s) `-"'' - Date !Signature ' Date`/ 3057<6(3I07) And/Or Autnonzed Applicant Dale - 7 ( y of Costa Uviesa But, ig Division . . 77 Fair Drive, Costa Mesa, CA 92626 0 �a Mesa77 / Fax 714-754-4856 • OWNER BUILDER VERIFICATION Permit # f1 — WO Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been itt n ruforne listing yourself as the builder of the • property improvements specified at �j/� / -c O . We are providing you with an Owner-Builder c n wle gment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. ( Thf 1. bunderstand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. r $-2. I understand building permits are not required to be signed by property owners unless they are Fesponsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. A. . '4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. -1 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be/considered an "employer" under state and federal law. y� 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �g [•t' 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family 'residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. (-t8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 1 of 2 i, . . . . Co -9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California • Contractors' State License Board (CSLB) at 1-B00-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. ...t 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand 'that I am the party legally and financially responsible for proposed construction activity at the following address: 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abi e by all applicable laws and requirements that govern Owner-Builders as well as employers. /-12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the i orrnation I have provided on this form. Licensed contractors are regulated by laws.designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' t compensation insurance coverage. t 1 I Before a building permit can be issue , this form must be completed and signed by the property owner and returned to the agency respons le for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, r other verification acceptable to the agency is required to be presented when the permit is issue to verify the property owner's signature. Signature of property owner .' C Date: a7�0//A`/ 09 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. • Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: . Date: _ . 2of2 ADDRESS a BUILMNO: 157 DEL MAR AV UHT: CITY OF COSTA MESA — BUILDING PERMIT G#NErcsie'EIElwaIHMC ALARY, JAMES J PERM NO: B 073105 Apms P 0 BOX 10116 COSTA MESA, CA 92627 PERMIT NO: B 073105 PLAN CHECK NO: N GOVT: N SUPP : N APPI.MARINO ADDRESS: 646-2678 CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: OTH •ARCHITECT OR SMOKE DETECTORUC. NO JOB DESCRIPTION : T/OFF 6 REROOF SQ FT: 1 , 100 ADDRESS: ARCH OR ENG'S UNIT: N ^0 C.!t CONTRACTOR'S NAME: REQUIRED CLAIM VALUE: 1 , 100 . 00 CALC—NACU • : 1 , 100 . 00 GROUP OCC: R-3 /M-1 CONf11ACTOWS MA111NG _ COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 HALLWAY ADDRESS: UC.NO.: ******************************************************************************* UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under;with of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full lace and effect. CITY LIC.NO.: LIC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Date: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 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 the ollowI1g reason(Section 7031.5 Business and Professions Code:Arty city a county which requires a permit to construct.alter.improve. /� PROV: PARCEL: 43916122 ZNE: REF NO: demolish,a repair any structure,prior to its issuance.abo requires the applicant for such permit to file a signed statement that he or she PARKING REQ: is licensed pursuant to the provisions of the Contractors License Law[Chapter S(commendag with Section 7000)of Division 3 of the PLANNING NOTES>" Business and Professions Coder or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >i 7031.5 by any applicant lore permit subjects the applicant los civil penally dnotmore then fee hundred dollars iFfEifik IfiflElEiEIE1E3EIFlkiEiEiElE1f1E1EIf IEdEiE1ElE3Ei(-iEiEl(tF1E1ltE#tEiElftE#jE1EiE****1EiESEfElE1E1EiEfEtEiEikt(-iP3flEiFlEtf-iEifiEiE*3(**if** ❑ I,as owner of the property or my employees with wages as that sole compensation,will do the work,and the structure is not intended or offered ler sale(Section 7044,Business and Professions Code:The Contractors License Law does not applyto an owner of property D EV EL OPMENT SERVICES REQUIREMENTS who builds or improves thereon,and veto does such work Iimselt or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.B,however,the building or inprovernent is sold within one year of completion,the will have the burden of proving he or she did not build or improve for the purpose of sale). ZONING APPROVED BY DATE: ❑ I.as owner of the property,ern exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE: • contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). . Ia�mJexemptunderSedionBp7044 B.BP.II,f«misreeson:OJ NER—BU LDER APPLICATION ISSUED BY: ( DATE: Date..7QLY L, (q9 - owner -....a,. / V/. . **'***************************3E******3E*** jE iFx-iE1E3Fl ***lf#iFtEiFtt4FjF***4* o hereby certify that I ern aware of and understand a cements of CaBomlth Health and Safety C.OF..ions 25505.25533.and LEGALIZATION: N F E E SUMMARY STRUCTURAL S GM N T: Y 25534.and that I or any future building occupant will/ ' • (circle one)n..• o comply with said state:•:es and the requirements for a permit forconstruction or modification from thAl Quaiy Management District.Residential mMngioneppirations ere exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 27 . 00 . 50 Date: Applicant: SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: PLAN ❑ I have and wit mainuan a certificate of consent to see-insure for workers' Labor m compensation,as provided for by Section 3700 of the ISSUE FEE Code.forthepedoanceaftheworkforwhichthispemitisissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ I haws end will mental,workers'compensation insurance.as required by Section 37C0 of the Labia Code,for the performance of the TOTALS----> 27 . 50 0 . 00 0 . 00 27 . 50 27 . 50 . 00 work for which this permit is issued.My workers'compensation insurance carrier and policy number are: Carrier REVENUE DIVISION TOTALS--> COLLECTED : 27 . 50 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed i'the permit is for one hundred dollars[$100]of less.) 27 . 00 . 50 ❑ I certdy that in the perfomurnce of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'compensation laws d CaN«nia,and agree mal i become I should bece subject to the waken' ******************************iE*****!E***1E******************************i(-***'lE*** compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Date: Applicant: INDIVIDUAL F E E BREAKDOWN Warning:FallURI to secure workers'compensation coverage is unlawful,and shall subject an employer to criminal penalties end TY P E QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($104000),In addition to the cost of compensation damag es as Provided for in Section 3706oyme aborCods,Interest,andammey'slees. SF 0 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 100 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that then is a construction lending agency for the $` /my�{/•�� ` 'a' END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). V 1 Y i s.,J v K LENDER'S NAME: LENDER'S ADDRESS: REQUIRED I certify that I have read this application and state that the above information is coma.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above•mentoned property for inspection purposes. JAMES MCALARY Print Ne �rr Date�/b(-YLA /9954 01 03185.47i1-0011:6495 'T n 27.50 dun4Ag 1 I/Contractor DATE: 07/06/93 TIME: 08:43 (5151-45.WP) White-Building 8 Safely:Green-Rle;Carry-Appicam;Pink-Revenue:Goldenrod-Assessor -4 - P. . & SPA CONSTRUCTION AND PLANNING ' " APPROVALS Permit# Date Inspector:.( APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.• 53. Steel Reinforcement 3. ElectricaLConduit Utility•Undrgrnd. ' 54. Forms - s� 4. Electrical.F nduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinfafp.cement 56. Rough Plumbing & Pressure Test . 6. ElectricallAERThrnd. 57. APPROVAL TO COVER.GUNITE 7. Footings :"-f �= 58: Electrical Conduit-Undrgrnd. 8. FoundatitA I - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water PipetUndigsnd. _ 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structura4,FloorTSystem 1 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cagy_ 63. Heater &Vent-Final 13. Roof Drains _ 64. Plumbing System . Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace -, APPROVALS : Permit # 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts,Ventilating 71. Product Piping OGas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing Ir 73. Undergrnd.Storage Tank 0 Gas 0 Oil =' 25. Roof Sheathing 7-z7-J7q 6c0074. Overhead Hydro 26. T-Bar Ceiling (Structural) & Moriocoat 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 lI 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 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation 44. Landscape Irrigation System' • • - 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 3-g- 1 wte 48. FINAL PLANNING 49. Electric Release to Edison r ' 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY - No Date • CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Permit No. /3) 0 Property Address /S 2 !)L. L Al 412 ff✓e, Owner rTA'Va s c7 M (Ai 4/2Y Contractor Occ, -4) uZ State Contractor License Number Classification I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ® I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. T ss IAJc-19i2Y /S 7 v ec- M412 Cos-n9 Ade i in Address Received by Building Division By Signa ure Date .<72Initia" I ?Mr Printed or typed name • 0990-46 White-Building Div:Canary-Contractor.Pink-Owner • - _._ . . - . - . .. Applicant to fill in all spaces except those-within heavy border lines and sign all appropriate declarations. •- - - - - - - - - . .�. .- _ . _ .. - _ - CITY OF COSTA MESA •CONSTRUCTION PERMIT . T PE MIT N • - TRACT NO. LOT NO. UNIT NO.- . • ' �y • Project Address IS? Dal- / 219i2 - L ' ��9 - \ 7243 .6/11 /86 . - ; 50.00 ' TL c ^ -I r' - - TYPE OF CONSTRUCTION LI NEW LJ ADD LJ ALTERATION LJ-REPAIR - ' - - ApF�IcznCs Mailing Address _ s� • Owner's Name c MCS Q1 Alt AGFJ/Z e65'b-2678 ❑ CONVERSION'S ❑ DEMOLISH ❑ OTHER A.P:e _ ` • , _ I Zone Y • 'Phon _ • .DESCR I• HUN O�NQR1C/ S : OG. ; `r'�i /`�'� Address /S2 Occre/4/Z' . , • - K�XJ �, $ Main Building: . , - Accessory Building: „ ' Arch/Erig.- License No. • . ' TYPE OF PERMIT ' N GRADING •.FOUNDATION sL STRUCTURAL' T Front` -- . I et I - - - ) O' Address -- - - ❑ TENANT' ❑ ELECTRICAL -❑ PLUMBING ❑ MECHANICAL f • 'B Rear - . - I - "N' I Contractor's Name - . • - ' ^-Phone i .❑ -OTHERi : s - ' ' . 'A - ' ' I _ t' C Right . ' - Address(mailing) «'VNC/Z /.av/L-7 ,trfl PROJECT DESCRIPTION Sq. FT - CO OCCUPA Y K'—� K • • - _ - G' x c • - CONSTRUCTION"TYPE - .VALUATION$ �OOD $ Left y City License No. . - R ' ZONE GRADING CU.'/DS. ' ' ACRES ' 'Ping. Ref.# Parkin LICENSED CONTRACTOR DECLARATION - - � 9 g Req./Provided, • hereby affirm that''I am licensed under provisions of.Charter 9 (commencing Remarks:D ' F��U'� Planning Notes: • - Q with section•7000) of Division 3 of the Business and Professions Code,and : /C C n�c 6. rep_Afir DAM�GcD RA ND . - M my license is in full force and effect. t I T License Class ' ' License No. _ R/fJ TrJ2 DAi.�,/GED hG yid co D. oor,f.weez%/e6 . : ' i ' Date ' " 'Signature• • ' , PLUMBING , I I I 'FEES - . • - , 1RKERS'COMPENSATION DECLARATION ' . 1 ' - Bar Sink i Showers 1 - I ELECTRICAL areby affirm that I have a certificate of consent to self-insure Or a certificate t 4 - I FEES 3800, kers' Com ensation-Insurance', or _ - revert --- " - - _-'-- -- -' - - -- - - �" -- "- p -a-certified-copy thereof,(Section- ' Backflow l reverter -'Ser,..- Sink Automatic Washer ' Transformer 0 15.50;KW 3800, Lab. C.) I • I Policy No. Company - , Backflow Irrigation I Sewer:Cap j Construction Pole Sub. ' i 0 56-(KWCertified copy Is hereby furnished. i : rt 7 - - Certified copy Is filed with the city Building Division. ' Bathtubs ! I ' 1Sewer•Connection ' , t - Cooking Unit t , Meter Oup to 100 amps Date Applicant ' - ' ' • - - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION -- . Clarifiers . , - j. .. t , -Soltr Collectors-• - -- , - - - - --- Dishwasher •-•-- -- -Meter Oover:100 amps( -{ ^ (This section need not be completed if the permitis for one-hundred ($100)or I , _ less). 1 ' - Dishwasher I ;Solar;Piping. I Dryers ❑Gas DElectric ', I Sub Panel _ � I I certify.that in the performance of the work for-which this permit is.issued, I - - - shall not e Ioy any person In any anner so,as . become sub'ect to'the • Drinking Fountains Solar 1 i I • - Fan' ' a Workers',C�Smoeds tun Laws of Cali �rn ia. / _ I - i Motors 00-1 HP -1'4-8 . Dale 00( /( /dle8• Signatur- fc-ri... I// Com -- t Floor Drains - Swimming Pool w/S a . - - ' • 'NOTICE:'(f,of r making this de la Ion,you -lard become sub]-. • the — 1 -at . 9 P F,A.U. Inc.Solar ❑915 HP 016-15+ Workers! Compensation provision of'the Labor ode, you must GP hwith , ' Floor Sinks ... - Urinal _ Fixtures I 'Microwave I 1 comply with such-,provisions or this permit; shall be deemed revoked: ' - - - - - - . - - 1 - - - CONSTRUCTION LENDING AGENCY _ j ' I. — - Gas Service , .Outlets. Water Closet' . ''-{ ' ' r Device Boxes , i ' Pole Light I hereby affirm that there is a construction lending agency for the performance _ - 9 , of the work for which. this permit-is Issued '(Section 3097 Civ. C.) • Interceptors ' ' , 'Wat r Heater • - Outlets ' - Lender's Name. ,0 1Q�� s - I , _ . Range Lender's Address ,�R - Kitchen Sink r - -Mt Service. • I OWNER BUILDER DECLARATION I - - - - .' Switches. Sign I hereby affirm that I am exempt from the Contractor's License Law for the I Lavatories I _ .A,utoWash i Garbo a Disposal •' ' following reason (Section 7031.5 Business and Professional Code: Any city or I - ' ' - - - •• g P : Standing�Secti0f 5 county which requires a permit to construct,alter,Improve,demolish or repair _ P—Trap Laun y Trays- r', _ Generator �0-5 KW 05-15 KW any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor , . •n file a signed statement thathe/she Is licensed pursuant to the provisions of i ROOF Drai•ns + • 1 '� -- - - I - - ' Contractor's-License Law (Chapter 9"(commencing with Section 7000yof . 1 , vision 3 of the Business and Professions Code) or that he/she is exempt , - ' erefrom and the basis for the alleged exemption. Any violation of Section , ' + . f ' '- • ' t I I I - 7031.5 •by any applicant for- a permit subjects the applicant-to a civil • _ - ' -- . - - - ' ' penalty of not more than-five hundredtlollars ($500).' ^ti' - t f - - LJ i, as owner of the property vi y Il y -y^ *^a• Reirispe Mion Fee 1 $15 Issue Fee $♦3 • .,ee s_t:ei, will do the work,and the'structure isnot intended or offered I - Reinspection Fee •I $15 ;Issue Fee' , $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ; 'MECHANICAL _ FEES ' License Law does not apply to an owner'of a property who builds or improves . thereon, and'who does such work himselfherself or through his or'her own - I I DEVELOPMENT SERVICES REQUIREMENTS:_ employees, provided that such improvements are not;intended or offered for Boiler • Hood or Type 1 0 1 , sale. If,'howevcr, the building or improvement is sold within one year of com- : Canopy Type II, 0 • I ¢ 1 I Zoning Approved By 1 Date • - proven, r the purpose se o havele the burden of proving he/she did not build or im- Duct- Under Ground . Building Approved By . - • I Date • prove for[he purpose of sale). • '' 1.. ❑ I,'rs.owner of'the property, am exclusively contracting with licensed con- Duct-Structural , Refrigeration System ' Application Issued By ' ' I ' • Ddt tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License-Law does not apply to such er.of.property.who Duct-Ventilating I - - ' 00.100,000 BTU-0100,000 BTU — -- - I SUMMARY OF FEES ' builds or improves thereon, and who contracts for such projects with a con- O•s•�O tractors) license pursuant to the,Contractor's License Law). I am aware that ' Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 30.co: SMTP • $ - J proof of their Worker's Compensation insurance should be provided to me.1 _ I I - , 0 lam exempt under Section B. & P. C.for this reason . Firepl/Fact.Blt. ICBO# Fire Dampers I I I PLAN CHECK , $ /f r S7) PERMIT QQQ 'o' - - PLUMBING , $ ISSUANCE $ • Date - Owner' Heating System& Ducting Registers PLAN CHECK '25%� $ ENERGY P.C. $ I hereby certify that"I have a this apps' n and state t the above 00-100,000 BTU 0100,000BTL - - GRADING $ information Is correct. I agree complywit all cityand-co ty ordinances - ' - ELECTRICAL , $ I and state la s relating!to building construction,and hereby authorize repre- i • - - ' • ' PLAN CHECK 'S0% MICROFILM $ sentatives •-1 this,city, • enter upon the above-mentioned ,propppprty 'for - 1 $ ' inspection rposes. 1 . � //R� ( ' I 5' Cir MECHANICAL I • $ TOTAL FEE $ J�•D'p Signatu - L ... . ►�� Date Driviarnse or, 57 � � Reinspection Fee _ $15 Issue Fee $ 3 PLAN CHECK i25% $ I , I e CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 1/1 • CONSTRUCTION AND PLANNING I PC x SPA 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 . i. 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, 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 System - Final - 14. Rough Plumbing 65. Electrical-Final • • 15. Rough Electrical-Conduit 66. Solar System-Final I// 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 - r. • 70. Underground Hydro 22. Ducts, Ventilating' 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test. - - .-.-/ 72. Underground Flush - . ' • ' 24. Roof Framing ' , G.' 1c �.' ad _7 3. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing '•/ `//�g 74. Overhead Hydro - 26. T-Bar Ceiling (Structural) & Monocoat L- • 75. Dr Chemical 27. Frame anis Flashing 76. Dry Standpipe - • 28. Lathing & Siding � �7.FIXED SYSTEM FINAL - .29. Insulation, 78. FIRE PREV. FINAL ' 30. Drywall Nailing - - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTfSlN . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ; , •- 35. Final Gas Pipe:Test - 36. Hood or Canopy _ 37. Final Factory Fireplace - - 38. Final Plumbing - , ' 39. Water Service-Final 40. Gas Service-Final . , 41. Solar Domestic-Final • - 42. Backflow Preventer 43.1)Backflow Irrigation 4..-Landscape Irrigation System - 4 • . 45.,,Sound Attenuation . 46.7.Handicap Regulations ��,yyy 47_�FINALSTRUCTURE & BUILDING p,( ,� - 48. Special Requirements Completed . 49. Electric Release to Edison - - '.--- 50.'Gas Release to Southern California Gas Co • , 51. CERTIFICATE OF OCCUPANCY - . _ _ ' No. - Date • • ROO- COVERING CERTIFII . PION • • Permit No. - Z y//9 . • Property address /57 DEG- /Win • • Owner •�4E S o7 /4 C qL.Al7 / Contractor State Contractor License Number Classification I hereby certify that I have installed, or caused to be installed,a minimum Class C roof covering at the above address in conformance with Chapter 32,and Section 1704 of the 1979 Uniform Building Code, as amended in Section 5-17 Title 5 Costa-Mesa Municipal Code, and the installation instructions of the manufacturer. 1$'I I further certify that I am the owner of the property. (Owner-Builder permittee only): ❑ I'further certify that I am: ❑ . Owner of sole proprietorship company ❑ Full partner of the company - ❑ Limited partner of the company ❑ Officer of the corporation • I certify that as an authorized officer or agent of the company or corporation, I am empowered to • make this certification, which shall be binding on all successors or assigns of the company or corporation: I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. • • • Company or Corporate Name • Address • • Re -ived by Building Division bye' • - si• ature , • Date YOV yr N c A/ 9/, Y • Initial D e Printed or Typed Name Space for Notarial Statement for authorized officer or agent • n • • • • • • • • CMF 0990-46 White-Building Oiv.;Canary-Contractor;Pink-Owner 4•' - - - , - _ _ Applicant to fill in all.spaces except those within heavy border lines and.sign all appropriate declarations. . . , . - . ____ _ -_ - . 4784 5/C35/�F , PERMIT NO. ,TRACT NO. LOT-NO:, I UNIT.NO. t� •- - -01: CITY•QF COSTA MESA CONSTRUCTION PERMIT - , - I - - , , +L � �3(08`� . • Pro)eet'Address 'IS Dec /44/7 - - - -t I r _ - - TYPE OF CONSTRUCTION- ' )U NEW•LJ ADD ❑ALTERATION H'REPAIR' • Applicant's Mailing Address �s.57 DC=L/N fl%G _ �. .L Y6_2. Q8. ❑ CONVERSION;.❑ DEMOLISH El OTHER _ ,q.p.# _ - - - - Zone, . ci• Owner's Name 079M(=J :ter ia'IC. 44/2"( •Phone DESCRIPTION OF WORK/USE OF BLDG. r • • Address /3) Dec coign - Cairn MFJ.V 1242? - , ' . - ' • S Main Building: - - 'AccessoryiBuildirig: - ' - • - • E - _ ,. . 1 -, 2 • Arch/Frig. License No, - ' TYPE OF PERMITS - 'RADING ❑ FOUNDATION :❑ STRUCTURAL T Front _ • Address ' ' - ❑ TENANT L(A"E LECTRICAL"❑ PLUMBING ❑ MECHANICAL - • ❑ !OTHER ' r; i I �. • B , Rear ,. • 'r- N 1 Contractor's Name ' - -Phone - - C Right _ . . - ' N PROJECT DESCRIPTION 54. FT. 'OCCUPANCY - - , G Address(mailing/ '�W' ±Ycn/7 /(�v/eOG/1. .K Left - • I .-- • CONSTRUCTION TYPE ' • 'VALUATION$ - -a , City,License No - ZONE GRADING du.YDS. i ACRES - E • LICENSED CONTRACTOR DECLARATION ' - t Ping. Ref.4 • Parking Req./Provid¢dj _ E CI Phereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • P,lann ng NO es: - • ._ M, with section 7000) of Division 3 of the Business and Professions Code, and , - ' . - - ! T my license is in full force and effect. ' - i 1 ' I ' t -s I - _ 1 i.... _ 'is A" _ ,.i _..._/A. S, License class' License No. - - Ui� Date Signature - r r PLUMBING - r i FEES ' - )RKERS'COMPENSATION DECLARATION' ' Bar Sink • Showers ' t • ereby affirm that I have a certificate of consent to self-insure or a certificate - wers I ELECTRICAL { j FEES ' _r Workers' Compensation-Insurance, or a certified copy thereof:;(Section — -' - n ---' - - -- -- ±`� - — - - - - 3800, Lab. CJ '.S Backflow Preventer Service'Sink Automatic Washer Transformer ❑ 15-50 KW I , Policy No. • •• "- " ' -_Company - Backflow Irrigation _- ' -* 0 50+KW R Certified copy is hereby(urn fished.'.;' I g Sewer Cap , p Construction Pole Sub. , •_ ! Certified copy is filed with the-city_B uiltlin9 Division. Bathtubs I Sewer Connection ' Cooking Unit' / Meter.74rp•to 100 amps Date : - *Applicant- - I . — • - - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION -- - Clarifiers _. • . Solar.Collectors .• _ ..t .. . . . Dishwasher ._ .. ... I. Meter Dover 100 amps__ _ , - .• • (This section heed not be completed if the permit ($100) or i is for one'hundred less). - Dishwasher • Solar Piping - - • Dryers ❑Gas ❑Electric Sub Panel I certify,that,in the performance of,',the work hich this permit Is issued, I • . • shall not employ any person in an 'manner so' to become subject to te Drinking Fountains • Solar Tank - Fan ' Worker Cosnisteat ion Laws of Cal)o nia. forZ , Motors❑0-1HP ❑1R-8 • . Date !O OO6 Signa Floor Drains 1 Swimming Pool w/Spa F.A.U. 'NOTICE: If,after making this d tion,yo s uld become j ct to the _ _ Inc.Solar ❑9-15 HP ❑16-15+ i 'Workers; Compensation"provisio of)the-Lab Code, you t'forthwith ' . . Floor Sinks - ' - Urinal . - . ' - Fixtures 1 comply with such.provisions or• this permit. shall be deemed revoked. • - , Microwave , ' CONSTRUCTION LENDING AGENCY' Gas Service ,Outletst •Water Closet _ I Device Boxes i I hereby affirm that there is a construction lending agency for the performance - - - • -- ' Pole Light y , ' •of the work .for which this permit is• issued,' (Section- 3097 Civ. •C.) -' , Interceptors - - • ' Water Heater - Outlets i Lender's Name - - - - _ - - , Range Lender's Address • '' - ' - - , Kitchen Sink - Water Service, - Switches • OWNER BUILDER DECLARATION i - _ _ Sign , I hereby affirm that I am exempt from the Contractor's License Law for the , Lavatories , 'Auto-Wash - � ( Garbage Disposal following reason (Section'7031.5 Business and Professional Code: Any'city or . - - 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair PTrap • , ' ( Laundry Trays ' Generator ❑0-5 KW ❑5-15 KW ' ' any structure, prior to it5.isauance, also requires the applicant for such permit , Trash Compactor ..,to file a signed state La athe/she is licensed pursuant to the provisions of - 7 , { - - _ _ ?,''.,e Contractor's License Lawn hapter.9(commencing With Section 7000)of - • ROOF Drains .n i ,j;`),„.vislon 3 of the Business and Professions Code) or that he/she is exempt . ., - ' �7:crefrom and the basis for the alleged exemption. Any violicant of Sectioni ,. ,, 7031.5 by any applicant for a permit subjects the applicant to a civil • ' I - - _ - - - 0 •penalty'of not more than five hundred dollars ($500). • _ • i - • - - - -c..03 I,I, as owner of the property '^ 'Reinspection'Fee $15 _ Issue Fee ' S.3 ' • �...,, oncatien will do the work,and the structure is not intended or offered - Y .._..e _ _. - _ _. - i for sale Section:7044. Business and Professional Code: The Contractor's ' - Reinspection Fee .I $16 Issue Fee $ 3 ( 1 MECHANICAL • ., FEES r License Law does not apply to an owner of a property who builds or improves thereon', and who does such work himself/herseltOr through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not intended or offered for . Boiler T I • Hood or Type I' ❑ ', • sate, If.'however, the building or improvement is sold within one year of corn- Canopy' Type II 0 Zoning Approved By Date pietion, the owner will have the burden of proving he/she did not build or,im- Du¢t-Under Ground • , Building Approved By DateLir-2-570,,,, LIrove for the purpose of sale). p I, as owner of(the property, am exclusively contracting with licensed con- ; ; Duct-Structural , , Refrigeration System Application Issued By • 0 Date '5---..2 7 tractors'to construct the project (Section 7044, Business and Professions Code: - ' ' _ The-Contractor's License Law does not apply to an owner ot;property who.. Duct-Ventilating -- - ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES ' builds or improves thereon,and who contracts.for such projects with aeon- - - - - • i , tractor(s) license pursuant • to the Contractor's License Law). I am aware that - r BUILDING PERMIT • $ ' ' 'SMTP $ ' proof of their Worker's Compensation insurance should'be provided to me.' Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK ' $ • PERMIT • ❑d am'exempt under Section B.& P. C. for this reason Fire I/Fact'Bit. ICBG# Fire Dampers ' 1 spm —_ 1 p 1 PLUMBING i $ ISSUANCE $ Date SJ,�/ Ow .+ (X20 <a� Heating System& Ducting Registers PLAN CHECK 25%' $ ENERGY P.C. $ - I hereby certify that I have ea this applic n and state t a tie above - . ❑0.100,000 BTU ❑100,000BTL - i ' /j GRADING $ ' information is correct. agree comply with all city and coun ordinances l ELECTRICAL . $ c( CO 1 I and.state laws relating'to building construction;and hereby authorize repre- - , - i MICROFILM ' $ ' sentatives 0 this city • enter upon the above-mentioned ,property,for ' I l t I PLAN CHE- 50%. $ pp� ^^•T7, , inspection p�poses. I c�7/ S/8�86 • - MECHANICAL , $ ' TOTAL FEE ' $ ' OWL/ Dgners4atur Sii� w r:,Mr • Date Reins Reinspection Fee $15 Issue Fee - $ 3 - PLAN CHECK ,25% i • Drivers�nse or SS �' p $ - CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor • CONSTRUCTION AND PLANNING PO r SPA �' APPROVALS Permit# Date Inspector APPROVALS Permit# _ Date Inspector • 1. Temporary Electrical Service or Pole 52: Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. ,S e v 54. Forms 4. Electrical Conduit-Undrgrnd. V� j elj 55. Electrical Bonding • 5. Steel Reinforcement ZZ+�� 56. Rough Plumbing & Pressure Test 6. Electrical'UFER Grnd. j / �G . 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 System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • • 16.-Rough Electric Wiring 67. Fencing & Access Approval 17..Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. `Product Piping 0 Gas . 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas n oil • • 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation . 78.,FIRE PREY. FINAL • 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 4/ gv 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 . 41. Solar Domestic-Final - 42. Backflow Preventer - - • 43. Backflow Irrigation • 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 149. Electric Release to Edison - - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date COSTA MESA BUILDING DEPARTMENT EE RECEIVED I P. 7301 O. BOX X 317 COSTA MESA CALIFORNIA `5_91/5 INANG DI=PT. ` FOR APPLICANT TO I IN C.L. OF STREET----- CIIY OF G STii MESA (/ BUILDING A�,.:, SS �n 7/1:2s ...,_---PROP LINE Owner '^7�`� caageV' ' i 10 FT. FOR 60 FT. STREET rr12 FT. 61t t-21- I \ I Mail Ad. -s • /i/ ! �i j r`50 FT. STREET I City Ph. No. Contract I / ro I Address * ifraIsl� 50FTIIF FRON City Lic. No. C,'U State Lic. No.' 7074,'3 IOF PROP. 1. _/I 150 FT. Ala cc Size of Lot Q O X ( Y . AP No. // 9- 0 720_ ��Z-'- /�[,� t- I wl \ 1- Setbacks: C/L Street TY , Rear I W I t Z �' cc I JI t.. Side Yard - Right I Left to r----Th -- CI V Type of enc ti / 0 - 6 " S:5 I a ALLEY QR P"OP. LINE o G. a-I F---•` x -� I I hereby acknowledge that I have read this application and state I J m �_ ;! that the above is correct and agree to comply with all City Ord- V j Ell L - i I inances and Stat a'vs regulating building construction. U •'J I I--- y Fay I Signature C, ;y J O 10 I I of Permittee -i. i-G - g} 4 U o R. FTI Agent !L� da-c �� 37 6 IN. 9I FOR OFFICE USE ONLY FT. w - ° m i I 40 _ Z t V y a FT T• I Permit No. o. m I I I X30 / IX 60 FT ST. Received by Date Received Date Issued ,� 50 FT. ST. It P.I. . F �� / ? /' / tPROP LINEt` _ I VALUATION - -1�-=-- __ -- - - - — - - - / Permit Fee $ - '& 0 $ / 7k Plan Check $ C.L. OF STRF,FT� I TOTAL FEE $`Q" MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS OWNER MC ALARY, JACK DATE 2-23-60 JOB ADDRESS 157 Del Mar BUILDING PERMIT NO. 171t 92 GENERAL CONTRACTOR Custom Craft Mas. VALUE $ 250.00 AP.No. 119-070-54 LOT 35 TRACT 376_ FIRE ZONE DESCRIPTION OF WORK blockwall I ECTIONS DATE I GROUP TYPE ZONE R14 1 -ground Soil U.G. Water PERMITS ISSUED Underground Gas — — SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole _ Underground Power Rough Wirin Trenches Forms Steel )_ -I.¢- go Floor System Steel Reinforce Chimney Re-Rod Bond Beam .9` 'fig and Flashing vg, In Out Plaster, brown coat Plumbing Fixtures, Final Electric Fixtures, Final Building, Final OCCUPANCY 1 PP 9 ,nom„�L CC446C (21 Form 410-5M-11-59 S-B F V' • 11492 .. _ 11492 SEE . RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT [ 7 `Leto P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEI 1. FOR APPLICANT TO FILL IN COMPLETELY - APPLICAT 4 Vock ERMIT TYPE OR PRINT SA _ BUILDING BUILDING ADDRESS /67 ' DEL /9H2 COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY �)9CK' //'C pt921 I RECEIPT NO. I �PP,I1M,4 J2 OWNER /"! L i A`-� MAIL OSY DATE RECEIVE DATE ISSUE ADDRESS /S7 Del ATA,e • TEL. BUILDING ....- CITY ndc p hGSa NO. _ ADDRESS /�/ 7 ciVee: 2-CG,,/ • ENE LIC. !NEER NO. COSTA MESA, CALIFORNIA ��// ADDRESS FIRE C-6,/eLQQ/ //nn// . (n' �/�y," - ZONE TYPE OUP CONTRACTOIWSTOII`RAFT /IAS_ LIC.NO.1C,b3 APPROVED ,,'' BY DATE ADDRESS `-4 I MOLSp 1 NlELOPnn ACM ZONING LEGAL LOT 3'9' ZONE / NO.OF USE OF NEW DESCRIPTION I NO. Q' S I BLOOCK I TRACT /'Li (U p IPL(...VO ANE 1� BUILDING j A.P.NO. II y _aJ q 0 �.J / APBYP`RLOV ED I.✓ V(/ DATE a --�IJ 'GSIZEO OF LOT (� o ' . to, .Y I NOW ON LOT REQUNO.OF SLOGS. IRED A/LLLOOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT 4_9 FT. CIL- IN. SETBACK LINE FROM - CENTER OF STREET REAR YARD R.SIDE FT. / IN. SIDE YARD LEFT (RIGHT L.SIDE —.- IN. DESCRIPTTION REAR N.OF WORK • ALTERATION ADDITION I - REPAIR I II MOVING 1 II DEMOLISH I BUILDING NO.OF SIZE ROOMS STORIES EXTERIOR WALL 'ROOF ' COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED twit ell eowei'rrE 5(oci.e 3/AIC. — 33'x4 y4' LTA- 124 41 .6' 41h I HEREBY ACKNO GE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE TH ABOVE IS CORRECT AND AGREE TO COM- 1 PLY WITH AL ORDINANCES NO STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CO TIO //A�/ VALUATION SIGNATUREO SAF . ///�Owi.-.- . / PERMIT FEE $ a. PERMITTEE /T/`/7 iT 'y✓ c ! - (�t $ 2 J G• OO PLAN CHECK $ AUTHORIZED AGENT TOTAL FEE $ 07. V WNrat MC ALARy , JAMES LA'I'ri 10-13-b5 JOB ADDRESS 157 Del Mar Street BUILDING PERMIT NO. 24797 _GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Garage Extension TQ 119-070-54 LOT TRACT FIRE ZONE VALUE $ 1,4'32.00 ._ .:ECTIONS Signature Date GROUP j TYPE V ZONE R-1 Soil I PERMITS ISSUED Gas - SUBCONTRACTOR Date I Number I Signature e gr Plumbing J Rough. Plumbing Prop. Swr. Line 0 House Con.0 t tr- Sprinkling System Miscellaneous _ - Rough Heating and Air Conditioning Temporary,Service or-Pole Underground 0 Power 0 Rough Wiring 2-13- -_- Healing and Vent. Trenches U—forms 0 Steel Rein'. 0 —.TNI • ' — Floor System Bond Beam 0 Steel Reinforce 0 Sheathing 48 is-6-GI Frame and Flashing /0, ' .,,,/,,,AT�,AT Lathing— In 0 Out @lylUO2/i94S -ter, Brown Coat /r'iP (2-23-(s chiral, Final Electric Heating, Vent., Ref rig. and A.C., Final 61/A711/2, -v4' 2f Jc.24-(,5 42 6 ,) Plumbing, Final and Gas Test 0 Electric, Final RJ? /2-43-(_g'_ _ Building, Final /'8 023-6A • I 2477 . I COSTArM�SA BUILDING SAFETY DEPARTMENT ' CITY OF COSTA MESA P.O.BOX 317 COSTA MESA,CALIFORNIA • OCT 13 1965 For Applicant to Fill In Completely APPLICATION FOR PE IT TYPE OR PRINT ��ppI?o,B{ L G BUILDING 7�ff�-� /�/j1 (j f {'E��7-iYee Onl ADDRESS IS 7 GL IT'` J - - RECEIPTNO. _ PE249 7 . COSTA MESA. CALIFORNIA `RECVBY // /J1J/ DATE BU p /� �/�'/S OWNERT /Q ec J /LIC' AL/ �y BUILDING ' ARESS An b a L- A/4 R.. Sr. ADDRESS /1 74 Aldry/p_Oct_ CITY InQS /'!ES NEOIJ TO ZONE TYPE / GROUP APPROVED �f' �CZs�C AP^H ITECT TEL. • BY l///` TE ' t',_(/'.J IGINEER NO. Z a L • • ADDRESS JA ZON/J�� NO.OF/ USE OF NEW 'L�f+f,./.�J/'�f�// CONTRACTOR�ftt M es !T 'N/c,4t/R/2y �L / PLANS �Z BUILDINOCLII' -".\//Ik ADDRESS ISS Dal- /Y SrEGAL / /_1�O� _h 4 ix- 37.e7 f �/ A (J r DEeCRIITION �/ �J CITYeOSinI iaAA//" ' A.P.NO. / l9 ` (J _ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE - TEL. SO'TO SIDE @ REAR P.L. , LIC.NO. NO. EAVES OF LOT Z 0 SC /Q OI NO.OF SLOGS. / NOW ON LOT ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF 77�� 1 MAIN BUILDING ACCESSORY BUILDING _EXISTING BLDG.?4d&LU/VG n'vP GAL/TG4 (FROM C`/��BUILDIN SETBACK LINE FROM 1 FRONT`*�•K�FT. FT, CENTER OF STREET .$'O REAR YARDS9 I. SIDE YARDI LEFT S/ I RIGHT" I R.SIDE FT. FT. DESCRIPTION OF -WORK L.SI al• t -4.j2.-.74. ? 3�/ FT. �/:3 // ALTERATION ADDITION REAR ,..39 FT. _ FT. DISTANCE SET. BET.MAIN& REPAIR - MOVING DEMOLISH MAIN BLDGS. ACCESS.QLDGS. BUILDING y NO OF VAR.# DATE SIZE X / ROOMS � STORIES / C.U.P.# ,I n APPROVED/!� / EXTERIOR WALLi Ism cGOI,COVERING ?QCK' B PROVED V/ t. I, ATE /6 !..5/1pL)/ COVERING JJ ..VV 7777 . .4,444L-D USE OF BUILDING AND WORK TO SE PERFORMED . , CA-Z14G E 4_'-ATe'A[I!o41 N ' - SQ.FT. . c I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE.AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE T 'T THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH AL 1 ITT ORDINANCES T,ND STATE LAWS REGULATING VALUATION m BUILDING CON q RUCTION. - 1 �J� N SIGNATURE 0dt_• PERMIT FEE $ / j PE(RM I$TFF / C r�) f� F Al) e16 `HORIZ • AGENT $ /y E _!77 '7lT� 0 TOTAL FEE $ / `- OWNER McALARY, James DATE 1-21-58 _ JOB ADDRESS 157 Del Mar Ave. BUILDING PERMIT NO. 6324 GENERAj. CONTRACTOR Armitage Builders VALUE $ 8,584,00 112-0 .54 LOT 35 TRACT 376 FIRE ZONE DESCRIPTION OF WORK Residence w/att gar. _ iUP I & J TYPE V ZONE R PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches fj j!'orms Steel 215EIFIA - Floor Systc. Steel Reinforce Chimney Re-Rod - ` ' Bond Beam �j Win_ �n Frame and Flashing _,..tril ;[raSAINIMI� Lathing, In: OufJ\ arrAIIIrME'_ Plaster, brown coat = - Underground soil,q//.5 W/G Pipe TestM , i,-s' - Top Out /•S SIIIIIMPIr Furnace v S 7 7 Gas Vents IIIMIEMISMIANSMINE_ Rough Plumbing A77-/-.9 , --/--4/1 '' c-' S. 4 7 7 Cesspool Septic Tank ' I Prop. Swr. Line ouse Con. L"--St. Swar ,./- 3 7 r lraSMMMMMlj 3 1C ¢ C / Sprinkling System 11E1111 .....11111111Mird, ingFinal shin. Fixtures, Final Arga e, -6-7 1.11.1111111MMINIF�l Final Gas Test 'y M/fs (� _y-. _4-V 1 Construction 'ole -_ i Underground Power a I/ Rough Wiring f�j/ 71 a IY Fixtures, Final sauss1 -OCCUPANCY "Yr -Pt• I • Form 210-5hf-1-5732 • 6324 COSTA MESA BUILDING DEPARTMENT JAN 21 .58171fla tOSTp Miff. ****33.00 P.O. BOX 317 COSTA MESA. CALIFORNIA FORy4PPLICANT TO FILL IN APPLICATION FOR PERMIT BU ADDRESS /NG / a1(7 D-elrnrX�- /!^�'"� BUILDING AD COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY / /' / RECEIPT NO. PE'MIT (NQ OWNER II `,C/ _ 0 25 MAIL /�� b [��J/ RECEIVED BY DATE RECEIVED 'ATE 'ATE/IS' ESS ADDRE'. # / ' V 77��I.4 �J✓ ^� i ( 7_ /mil) / Z�jf///5,�.� BUILDING CITY , / . , / TN (✓ 7S / / ADDRESS l V / / �� /l.K/', C TECT LIC. C .INEER . COSTA MESA. CALIFORNIA • NT FIRE ADDRESS ///� ZONE CONTRALTO/f1 , ' jjI/T NO. �]///(U y/ YONE�— NPo.OF� TYPE, / GROUP . • _ADDRESS 1/•l�U //� O/• • NL� /°L /T/r/ !/ BPPR�✓.jDV Y ��ATE /� / 5r� . LEGAL LOT /j 7 CORRECTIONS f/ � DESCRIPTION NO. 35 BLOCK TRAC3 6 A.P.NO. /lq._„ 20— c 1 SIZE / �I n NOF BLT OF LOT/jf0 /I 102 NOWW F LOT Q 111JU Yy USE OF EXISTING BLDG. CITY OF 'TA MESA SETBACK LINE FROM / �/ C-i,.3..NN: 4 DEPT. CENTER OF STREET 5o REAR YARD�/{ / SUP SECT TQ f1 IlFPT RFC; SIDE YARD RIGHT a LEFT J DESCRIPTION OF WORK _ By_A/• a DATE 1.._-?� Q^ PLAN TLCInv/ O N ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDIN A NO.OF / SIZE Q ROOMS `f' STORIES sy EXTERI R WA • / ROOF COVERING CO�V/ERIN,G/ USE OF NEW V/ + `. BUILDING / //q 1/49D y 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 5J ATE LAWS pREGULATING BUILDING CONSTRUC• TION. /' �/, / VALUATION SIGNATURE OF///. / _ . PERMIT FEE $ 0.702-- PERMITTEE ✓(.�[N�-� n S-851.... y PLAN CHECK $ //- $ U } AUTHORIZED AGENT TOTAL FEE $ 33,_, NBMF • OWNER MC ALARY, JAMES J. OCT 2 8 1958 DATE 8_19-58 JOB ADDRESS 157 flet Mnr Streat. BUILDING PERMIT NO. 7301 �GENpE'7RAL CONTRACTOR Custom Craft Masonry VALUE $ 178.00 1g . N'o0-54 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Block Fence /UP TYPE ZONE PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED . DATE NUMBER Trenches )( Forms JI Steel &toS 8 '2O--5X" Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing Lathing, In Out • Plaster, brown coat Underground soil WIG Pipe Test Top Out Furnace Gas Vents Rough Plumbing t Cesspool Septic Tank Prop. Swr. Line House Con, St. Swr. Sprinkling System 'ng Final thing Fixtures, Final Final Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final / t OCCUPANCY f 3//j4 Form 210-5M-1-57 V 7301