HomeMy WebLinkAbout170 DEL MAR AVE - Building Permits •
PROJECT,AOgRESS: 170 DEL MAR AV UNIT: 0 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 049443
DW. 'n5t COPLEY/COLONY CATV -
SAME AS ABOVE PERMIT NO: E 049443 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
ARCH/ENGINEER: • REG.NO.: i JOB DESCRIPTION ; SCE U/G PWR TO 'COPLEY•/COLONY CATV BOX • SQ FT; -
ADDRESS: i UNIT: - •
PERnITTFF. • CLAIM VALUE: CALC-VALUE:; GROUP OCC: - /
llEKORTE ELECTRIC ( 714 ) 361-8406 '•
ADDRESS: 2725 VIA• CASA LOMA COMMENTS: NO STRUCTURAL WORK BEING DONE •
SAN CLEMENTE CA 92672 ***************�6+E**I�O6 �6*�6*******Or�E06�6�8* **x�6�6*O6*>t*�H*�E*�E*OE**xrt0606****x�EOE**>FOc**x�H**
LICENSED CONTRACTOR DECLARATION: I hereby al firm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS
•
CITY LAC.:051602 STATE LIC.:5 5 9 3 0 4 CLASS: C—i
Date: /V--((..-- It o Signature:_/ MAIN BUILDING •
•
ACCESSORY BUILDING
7WORKERS'COMPENSATION DECLARATION: thereby affirm that I have a certificate of consen to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR :. FT IN .
Compensation Insurance.or a certified copy thereof(Section 3800.Lab. C). LEFT: i FT IN RGHT: i FT IN LEFT: FT IN RGHT: FT IN- '
'\, OOLICY NO.: EXP.DATE: -
OMPANY: PARKING REQ: PROV: . PARCEL : 43922104 ZNE: REF NO:
J Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
Date' Applicant: *******************************lE.*******************************************•****
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). ' D E V E L OP MEN T S• E 'R V ICES R E 'Q U I R E M E N T S
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become • .
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE:
Date'._/a -( Q
(- ! o Signature: ��C -
NOTICE:If.after making this declaration,you should become subject to the Workers'Compe tion provisions of the Labor BUILDING APPROVED BY . DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ' r : / . '
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ' ). (/V/ DATE: •
le /
which this permit is issued(Section 3097, Civ.C1. ****************************************** 1e'**********************' * **
LENDER: •
*******************************************************************************
ADDRESS: LEGALIZATION:N F E /E r SUMMARY STRUCTURAL SEGMENT:N
DINNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031 5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 1 9 , 25
repair any structure.prior to its.issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5(34; SMIP/NON—RES '
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business -
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 1 '
any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($500). ISSUE FEE 15 . 00
•
I. as owner of the property or my employees with wages as their sole compensation, will do the work,'and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK • TOTAL r PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 19 , 25 15 . 0 0 0 . 00 34 . 25 34 . 25 . • . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. If,however the building or improvement
sale).withinBLDGPMT PLUMBING ELECTRICMECHANICFIRE /TOT
one year ofcompletion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION __ OD4 SMIP/TOT
HORT: . 00
lortheGRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 34 , 2 5 '
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • '
.and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Stale License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. • INDIVIDUAL F E E BREAKDOWN
❑ I sin exempt under Section. B.&P. C. •
•
for this reason: TYPE QTY D E S C R • I- P T I O N UNIT COST TOTAL COST
Date: OwnerELE 1 • RECEPT/OUTLET 1 ST 20 EA. - , 75 . 75
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and ELE 1 SERVICES BELOW 600 V S BELOW 201 AMP 18 . 50 18 . 50
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Openly Management District.Residential construction applications are exempt from
these provisions. '
Date: Applicant:
I hereby certify that I have read this application and stale that the above information is correct.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-mentioned -properly for for inspection purposes.
Q, / 01 000718846-00071886 TOT 34.25
+ nate: e' ��� e b Signature:/ ee DATE: 10/11190 TINE: 13:24
' Driver's License or Social Security ,
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
'r { r
CONSTRUCTION AND PLANNING. . - PO I SPA
PPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
Temporary Electrical Service or Pole 1 52. Pool & Equipment Location
Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement __
3:.Electrical Conduit'-.Utility-Undrgrnd. 54. Forms ,,
'4" Electrical Conduit-Undrgrnd. I 55. Electrical Bonding
15:, Steel Reinforcement,! 56. Rough Plumbing & Pressure Test
6:0 Electrical UFER:Grnd. 57. APPROVAL TO COVER-GUNITE
- .7:'•Footings •. j' - 58. Electrical Conduit-Undrgrnd. ;+
..8: Foundation59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. • ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. -
10. Structural Floor System r - - 61. APPROVAL TO DECK _1
11. Property Sewer Line & House Connection __ 62. Backwash & Receptor-Final •+
i ,
12. Sewer Cap : + 63. Heater & Vent-Final
13. Roof Drains _ T _ I 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 Sign68. APPROVED FOR PLASTERING,
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
_ .. _ .. ,. , ,- , ,, .. . r • r. ....rt w . ;T±:
20. Rough Factory Fireplace ' 7'1: v;,-^ t: = 7 t'.:' l• APPROVALS-1r'Perrimit# 1
.]. , L^.... is ""V 1 t. i,
't
21.-"Ducts, in Structure ; • - r S I - . '70. Undergrourid1Hydro 1
22. Ducts, Ventilating' > t ?S r. c " ,c '.' �-
1 •s. • t ! -.. _ ;-, r :_i. .t X71. Producing Q''Gas O,OiI
1 •c r
23. Gas'Pipe-Rough &Test i • • ,. ITV - r r 1-72. Underground Flush] r
24. Roof:Framing- F- ' ",F ,'•t, c r; _r: :. =73'ttJndergrnd'Stor4gdTank p Gas 0 Oil '
25. Roof,Sheathing ' ." .* 1 r...' ' ;yt -74..OverheadHydro°_•_
26.-T-Bar, Ceiling (Structural) & Monocoat t =t -111- r 75 :Dry Chemical J7 ' ' - o'."
-. k 1 •. "t 1: ., - L-
Y.L'
i .3 ri: A rn'-1 c': _ Ti t 1
27. Frame and Flashing, _)u- , t: t-• >. • ± e 76. Dry Standpipe I..C; 1. 11 • •
.28. Lathing& Siding; .- ., J`•= � 77.'"FIXED SYSTEMtEINAL'
VN
29. Insulation •• r I t: t 78r:FIRE PR EV. FINAL •r. D
30. Drywall Nailinga:I -! H'
HEALTDEPTkREQUIREMENT
r .T!.'..1
31. Plaster Brown,Coat ; I •ntr. vi, i' . 9."FINAL INSPECTION: ii - - '
32.• Ele• ctrical,Power Meter-Final . Jf/�// r 0 FOOD CERTIFICATE ISSUED
.33.�Final,Electric, ' - ` _ i �.- � / _ No1H •, ..,t� �nt .i ^ - 't
• 34.rFinat Heating& Air Conditioning:: •'1 t r •v r', r S •'.2
35J:Final Gas Pipe:Test r 1--4 FP :I- x, a1 + +.
136..Hood or'Canopy 1 tr. I t ii t- • - .I. .: C;o ` . : +o'
37. Final.Factory Fireplace . 'r7.1, C I. .I 1��� : ; .. :-r "'L
f:
-
38. FinaFinal.Plumbing - - i. �' t. Li" - -
39. Watet Service-Final'• `• h' e n "t'"• :e ":
'40. Gas Service-Final 1 .. Le. r•rr• S i. r, • I i !, Com_ ....
_11.1 'r r
:41. Solar Domestic-Final 1 ' Th. 1 F. '
'42.'Backflow'Preventer' ,4t ± I I, :k .;.: .k• •+ .
y
43. Backflow Irrigation'• - r :I-+ 1 -
s •
, i .o - ;
.1;' ' I
� q, f v na-
.444. A
LandscaeIrrigation SYstem, -, 't. to - :'st .t: :: v - r ' c?
•45. .Sound Attenuation• .IV ' 1 ;4- ' '` 1 . I r..•L i
46.'Handicap';Regulations ;. "i rr ' r7w r
47. FINAL STRUCTURE & BUI-LDING 1 i,
48. FINALPLANNING' .t: •-_ r1 t1f 44
.49.1 Electric Release to Edison l.t: If. -
I .1 I /4 ' 'r . , 1
50. Gas Release to Southern California Gas Co n '�(Ii: i. ,• .I _ . "_•"1 .i, 1,,
51. CERTIFICATE OFtOCCUPANCY - - - t; .
No. pate
V l
PROJECT ADDRESS: 170�{,TJEL MAR AV UNIT: 1 /2CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 048806
OWNER'S NAME: COPLEY COLONY CABLE • '
. ADDRESS: SAME AS ABOVE - PERMIT NO; E 048806 PLAN CHECK NO: N GOVT: Y SUPP : N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
• '72-30.40
ARCN/ENO..c REG.NO.: • JOB DESCRIPTION : PEDESTAL METER FOR COPLEY COLONY CABLE SQ FT: •
gODRESS: .' UNIT: '
CLAIM VALUE: CALL VALUE: GROUP OCC: • /
. PERMITTEE: AMBURGEY ' S ELECTRIC (714 ) 979-2311
ADDRESS: 945 COLORADO ST COMMENTS : ***
COSTA MESA CA 92626 *************************************************x*****************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS '
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S .
cITYuc.c.:023�866 gSTAATIEuc.:39519 fa C-1 .
Date:_!1 �' L r/ Signature: WCMAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION; I hereby affirm thatm
haves certificate of consents in urs oracertificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : - FT IN '
Compensation sr c of cental¢d copy thereof(Section 3800,Lab.q. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: p 0 5 2 /—8 y EXP.DATE: 12 /01 /90 •
MPANY: STATE FUND PARKING REQ: PROV: PARCEL : 42229110 ZNE: ,REF NO:
Certified copy is herebyrefurnished., VI Certified copy is f lith • ilding DDii�yy5)�on. PLANNING NOTES>
Date: a-C ! 0 Applicant: ********************************if**jE*******************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if t mit Is O area(5100)or less). D E V E L O P M E N T SI ;E;R' V I C E S REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any rson in. ner so as to become '
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY /..,-1 DATE:
Date: Signature: • BUILDING APPROVED BY : /; 'DATE:
Cy:If,after makingwthis declaration,you should become subject the Workers' empensatipn provisions of the Labor ))) I.
Code,you must foNAG comply I withsuch rprovisions this permit shall be deemed revoked.cy • 4 • ^ / �
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance at the work for APPLICATION ISSUED B Y : A ! DATE: OY/ 1, D
which this permit is issued(Section 3097,Civ.C). iF**
LENDER: ********************************"***:je*******************************************
• ADDRESS: - • LEGALIZATION:N F/EJE , . S U M M A R Y STRUCTURAL SEGMENT:N
/
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT , ' 18 . 50
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed • tin$ SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN i
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00
I,' as owner of the property army employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> \ PERMIT ISSUE PLAN—CHECK TOTAL ' PAID DUE
O tructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 0 , 00 0 , 00 0 . 00 0 . 00 . 00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through '
'his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : . 00 OVER/SHORT • 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
• for thepurpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business •
O and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects Lyth a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BREAKDOWN ,
9 l am exempt under Section: B.8 P.C.
for this reason: TYPE QTY. DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and . END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a '
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from •
these provisions. , ,
Date:• Applicant: •
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and her•..uDmrize representatives of this city to enter upon the above-mentioned - i
property for inspection purposes.
al-7 0 / 0100068663-00068563 TOT .00
Date: signature: I DATE: 03/29/90 TIME: 15:35
Driver's License or Social Security x: '
I 1641:46 While—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
k
CONSTRUCTION AND.PLANNING PC & SPA
Date Inspector , Date Inspector
APPROVA,S Permit# - _ APPROVALS Permit #
• 1. Temp ry Electrical Service or Pole • ' 52. Pool & Equipment Location
2-. - _ e-Undrgrnd. - - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. \ 54. Forms
,., 4. Electrical Conduit-Undrgrrid l - 55. Electrical Bonding
• 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings -I . 58. Electrical Conduit-Undrgrnd. 7 r
8. Foundation 7 / . 59. Gas Pipe, 0 Undrgrnd.,Test
•
9. Water Pipe-Undrgrnd. /; •�. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . -
10. Structural Floor System / 4/ / "Ii • 61. APPROVAL TO DECK 7
11. Property Sewer Line &.House Connection - 62. Backwash & Receptor-Final 1 n
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 1 '�1
16. Rough Electric Wiring 67. Fencing & Access Approval . . _ '
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - •
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating -71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat fir, FINAL INSPECTION
32. Electrical Power Meter-Final rat9 �� .OD CERTIFICATE ISSUED
33. Final Electric �' -
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
J
47. FINAL STRUCTURE & BUILDING -�.
48. FINAL PLANNING
49. Electric Release to Edison ~='
i
50. Gas Release to Southern California Gas Co !f
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 170 DEL MAR AV - UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: EP 062327
DOWNER'S NAME: CITY OF COSTA A MESA
• ADDRESS: P 0 BOX 1200 PERMIT NO: BP 062327 PLAN CHECK NO; N GOVT: Y SUPP; N
d. COSTA MESA, CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLO STR PURPOSE: DEM
7545273
ARCH/ENGINEER: REG.NO.: • JOE DESCRIPTION DEMO SFD SQ `T•
ADDRESS: UNIT: '
CLAIM VALUE : CALC—VALUE: ! , 000 .00 GROUP OCC: R-3 /M-1
PERMITTEE: BARSOTTIS INC . ( 310) 944-0078
ADDRESS: 11936 ALTAMAR PL COMMENTS: DEMO SFD
SANTA FE SPRINGS CA 90670 ****-*:********#*>E*,Par+ #******mkF*x*** x#3**xa!>E** -x*** ?xx****8F,tx*#3t**4(******x#sw***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E 1 B ,A C K S
LIC.: STATE LIC.:4 31 901 CLASS:B
. Date: Signature'. _ MAIN BUILDING ACCESSORY BUILDIN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' t RNT : FT IN REAR: FT IN FRNT : FT IN REAR : T I N
Compensation Insurance.or a certified copy thereof(Section 3800. Lab.Cf LEFT : FT IN RG H T : FT IN LEFT; FT IN RGH T: T IN
POLICY NO.:RMWC 12 3 6 9 3 6 EXP.DATE: 10/01 /93
COMPANY:NATL UNION FIRE PARKING REO: PROV: PARCEL : 43922104 ZNE: REF NO: fl
) Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
PLANNING NOT_S>
/ Date: Applicant: *?c**'(4*** *******#**?P**#x***!E*##**aPie **jcriP*#?P#*##7r#ic#****ki(-if********#*' c#�****it*
•
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for'one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R F M F N 'Tom•S
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become ..---
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - DATE: k
Date'. Signature: - _ `
NOTICE:If.after making This declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : r _ 4 _Q is 464c44 DATE: •G• r
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. Tr/
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED By. 1=00, MN7x;x**#x-#DATE• p' Z-S-1 3
$1
which this permit is issued(Section 3097, Civ.C) ***x.***4E? .*
{ ********,, ,,n.xA} x x
'r:**x .r it ie ***#*AC xxx .-pt*If**
LENDER: / **#********?E*********if LE******?E+' f***?E****1 *3P#*#*****#*******is lP***',E**# 4/:)01-******
ADDRESS: LEGALIZATION:N r E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUME I1.G ELECTRIC MECHANIC FIRE SM I P/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or P ERM;T 25 , 00 7, 0
repair any structure.prior to its issuance,also requires the applicant for such permit to fife a signed statement that he/she is licensed2 5 SM I P/NON—RES
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031 5 by PLAN ,, . 50
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE `E 20 . 00
t%•
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTAL::1 AL S > 0 . 00 0 . 0 0 '1,- `:---. 0 . 00 0 . 00 , 00 , 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through r
his or her own employees, provided that such improvements are not intended or offered for sale.If, however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> C SOL ECTED: . 00 OVER/SHORT: ,00
for the purpose of sale). PMT PLAN—CHECK
M PLUMBING ELECTRIC , �FiANIC FIRE SMTP/TDI GRADING LAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts ter such projects with a contractor(s)license pursuant to the Contractors'State License Law). l am aware **R4******************************** SiP*********************************##Y.-*****aP
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. I N D I V I D U A' i, FEE BREAKDOWN
for this reason'. ;
TYPE QTY U E -. C R I P T I fl4kg. UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and PLO 1 SEWER CAP / DEMOLITION
_ _E_ EACH 7 . 00 7 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a EDND OF t ES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. i,
Date: Applicant:
I hereby certify that I have read this application and state That the above information is correct.I agree In comply with all city and county
ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned r
operty for inspection purposes. _ e
/�G _ F OT I .00
v/ Date'. Signature: DATED ( P d
Driver's License or Social Security
1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
Z
/' PO u SPA
CONSTRUCTION AND PLANNING ii.
APPROVALS Permit r- 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. 54. Forms 1
4. Electrical Conduit.Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56. Rough Plumbing& Pressure Test ' `
6. Electrical UFER Grnd. 57. APPROVAL TO CdVER-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
4/7'/13 iS 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 ❑Gas ❑Oil f
25. Roof Sheathing 74. Overhead Hydra
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing i 76. Dry Standpipe • •
28. Lathing& Siding !:. ' i 77. FIXED SYSTEM FINAL
29. Insulation • . • s 78. FIRE PREV. FINAL
30. Drywall Nailing :,...;iii HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat II ;; /9. FINAL INSPECTION
32. Electrical Power Meter-Final lilt, •` 80. FOOD CERTIFICATE ISSUED
Hl
33. Final Electric f„ 1• Notes: .. e (12. g2.... ovitAr_
34. Final Heating & Air Conditioning Cir 11.J1 -
(may_
,35. Final Gas Pipe-Test ���//
I
•,,
36. Hood or Canopy G
37. Final Factory Fireplace '
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
cs
-. c: .c
42. Backflow Preventerinrei
43. Backflow Irrigation cJ
44. Landscape Irrigation System li
45. Sound Attenuation
46. Handicap Regulations .. 1
47. FINAL STRUCTURE 8 .Qet yNG a f, frj - . .
48. FINAL PLANNING 7[6iif if ! '!ter,
tr
49. Electric Release to Edison . ' "
50. Gas Release to Southern California Gas Co :.<1 . !_
.
51. CERTIFICATE OF OCCUPANCY •
-
No. Date J
_ 1
. CITY OF COTTA MESA PE T 01.21L62- .
' DEPARTMENT OF P IC SERVICES
`m'-''iiz-s4APPLICATION AND PERMIT FOR WORK DESCRIBED BELOW NO.
.,4VENDOR.NO.
:1 I3-0 4ZIZ Del Pin,,,,Pin,,,, Ave, who( caa I-4rwmt�'IUh S/
r.A' Address or Location of Work 1 Date 7i0(9 3
:Type•of Work to be Done T'€N`O tt 4-,tfh_ - ' - -
r
Start Date Or\cW 2 -I�q3 Permit Not Valid After TAW I t/93 (Expiration Date) Plan No. •
•
Contractor's Name -//Arne rl C..2-r. Li recKir..i th (fug aaAITC ddress ZOO/ Ty ler Air %2�
Telephone No. (Day) O ( t- 4 j--fa(4Night) / ` City & State A ,, m.n A. .•
State License No./Class__ I O'r� .____..--_ City Business License No. a 6-1 4-4, .___
Applicant's Name BAR-CO i Ttl S -tor . (G en1etz c (OulRperce)ddress i i 936 ArCTA-MAA Pf.4Cr SAnITA pc sole::.
Telephone No. 310 - 9 Lig–Corn Developer's Name Telephone No. CA 10167(
Name of Insurance Co. J( t ."
C -c4 ley – i L IE.' we; Insurance Cert. No.(s) 5J 5t/75
24-Hour Emergency Contact. • Telephone No.
FEES PERMIT APPROVED FOR CITY ENGINEER
Bond $ I . -' 48 HOURS MINIMUM REQUIRED
Cash Deposit $V` IJ,
FOR PROCESSING PERMIT By C' '\QV
Issuance $ -. ' L. 'Date S 1 S)'\� I
Inspection $ Account # I 1 1
TOTAL $ t ` 'h Underground Service Alert ID No. i
Permittee shall contact the City Inspector's office(754-5025)at least 24 hours prior to commencing any work.Failure to Obtain proper inspections prior to commencement of work
may be cause for its rejection.THIS PERMIT WITH APPROVED PLANS MUST BE ON THE JOB AND AVAILABLE TO CITY REPRESENTATIVES AT ALL TIMES.You are guided
by Municipal Code Sections 1-33. 15-25, 15-27, 15-27.1, 15-39, and 15-48.
THE UNDERSIGNED PERMITTEE HEREBY CERTIFIES:
1. That all work shall be performed in accordance with the Standard Specifications for Public Works Construction(latest edition);Standard Drawings of the City
of Costa Mesa; special agency provisions; and all applicable laws and ordinances.
2. Control of traffic shall cohform to the Work Area Traffic Control Handbook(W.A.T.C.H.)(Latest edition). The permittee shall furnish and/or install all signs, lights,
barricades,traffic control or warning devices,flagmen and flashing arrow board.The permittee shall obtain approval of the Transportation Services Engineer for all
street closures,detours,turn restrictions,parking prohibitions and methods of accommodating traffic.The permittee shall notify Emergency,Fire and Police services
an°residents or businesses twenty-four(24)hours in advance of any access limitation or traffic restrictions.
3. That a maximum of• tenets)may be closed if necessary to perform work within the public right of way during the hours of 8:30 a.m.-3:30 p.m. Monday
•
through Friday as I es traffic can be maintained in each direction with flagmen unless otherwise approved by the Transportation Services Engineer.
4. That throughout all phasgs of construction the work site shall be kept clean and free of rubbish,debris and dust and drainage shall be maintained.
SUBJECT TO THE NOTES BELOW;
1. City will provide inspection between 7:30 a.m.and 3:00 p.m., Monday-Friday(except on City observed holidays)
2. .Prior to placing Portland Cement Concrete or Asphalt Concrete (A.C.), the following will have been inspected and approved; native 0 and imported 0
subgrades and forms J. Flyash is not allowed as a cement substitute.
' 3. Curb and gutter shall not be removed on the day prior to a weekend or a City observed holiday.
4. Fill in areas left by curb and gutter removal flush with the adjacent pavement on the same day that removal occurs.
5. Sore under all streets,curbs and gutters,sidewalks, cross-gutters and driveway approaches. Tunneling is not allowed.
6. Open excavations must be backfilleo org(fated with spikes and A.C. tacked around edges during non-working hours.
7. Sidewalk shall be constructed per City&Costa Mesa Standard Drawing No. .
8. Driveway approach shall be constructed per City of Costa Mesa Standard Drawing No.
9. No traffic allowed on concrete for minimum of seven days for curing. See traffic control above.
10. Trench compaction and resurfacing shall conform to City of Costa Mesa Standard Drawing No. 813.
II. Trenches exceeding five(5)feet in depth require a permit from the Division of Industrial Safety, State of California.
12. Permittee shall pay for all S.E., compaction and matertals tests deemed necessary by the City.
13. Alt trenches shall be permanently patched within ten(101 days of completion of work below subgrade.
14. Permittee shall provide the City with record drawings of permitted work before final inspection by the City.
15. Permittee understands and agrees to the hold-harmless agreement required by CMMC Section 15-27 and printed on the reverse of this application.
16. Other:
NOTICE: Contractor must notify the following Utility Companies two working days before starting work:
Costa Mesa Sanitary District Mesa Consolidated Water District UNDERGROUND SERVICE ALERT
(714)631-1731 ` (714) 631-1200 Toll Free- 1-800-422-4133; After Hours&Holidays-(714)739-3031: (213)621-3111
INSPECTION RECORD I Inspector of Records CERTIFICATE OF INSPECTION
Date ' Remarks I hereby certify that the street work
allowed by this permit has been con-
• structed according to the plans and
specifications and I hereby accept the
work in this manner.
By:
I Inspector
r I Dale
0183.62,rev. t50 I ce ify I have read-old undersand all of the above and that all statements made are correct and complete.
White-Inspectors: / n '"/1/) 1 C
Canary-Engineering:
LL.' • p�-�,-' —���
Pink-Finance; - - - A • cant's Signature Date
Goloenroo-Applicant I .
•
3 COPIES OF SKETCHES OR PLANS ARE REQUIRED PRIOR TO PERMIT ISSUANCE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED AND VALIDATED
PROJECT ADDRESS: 170 DEL MAR AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062326
OWNER'S NAME: CITY OF COSTA MESA
AODRESS: P 0 BOX 1200 PERMIT NO: 3 062326 PLAN CHECK NO: N GOVT : Y SUPP : N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: DEM
ARCH/ENGINEER: 754 7 2 7 3 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : DEMO POOL SQ FT:
PERMITTEE: CLAIM VALUE: CALC—VALUE: 1 , 000 . 00 GROUP OCC: R-3 /M-1
ADDRESS: BARSOTTIS INC . ( 310 ) 944-0078
11936 ALTAMAR PL COMMENTS: DEMO POOL Q—E- F 6 P 6L3Z`1
SANTA FE SPRINGS CA 90670 *********************x-:Fx1xrt******aE*tE#3t*******.:ESE*:Fs**:6*x#***xm**:E*x xa-X**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
70gD)of Division 3 of the Business and Professions Code.and my license is in lull force and effect S E T B A C K S
Y//e(rr tic.: _NATE uc.:4 319 01 cuss: 3
Dale. �� Signature: / r ♦� MAIN BUILDING ACCESSORY BUILDING
' WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or ac•iifiestaofWorkers' tRNI : FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT : FT IN RGHT : FT IN LEFT: FT IN RGH T: FT IN
POLICY NO.:RMWC1236936 EXP,DATE: 10/01 /93
COMPANY:NATL UNION FIRE PARKING REQ: PROV; PARCEL : 43922104 ZNE : REF NO:
11 Certified copy is hereby furnished. ❑ Certified copy is file with the city Build Division. , PLANNING N6 T ES
ate: �-2 / J Applicant: t/L•llf1/ / I�AX !
*************?0.** ESE***********M*****Ie*********************?*********? **********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for unfired(5700)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any ner so as to become
subject to the Workers'Compensation Laws'of California.
ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:It.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for AP PL T CATION 'S S UED BY.;_
LY
which this permit is issued(section 3097.Civ. C). *******u***9*****u*.***'- 7s.r.tr +:x*x#x at**nrift7t it�xnrz.r xrx**********�,*.n)(-*x d?*3E
LENDER: ***************************ix**Y.4*************************3E*****************3i•**44
Roofless: LEGALIZATION:N 7 E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'State License Law for the following reason BLDG_PMT PLUMB I.N', ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 J . 0 0
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SNIP/NON rR ES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN . 50
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation. 'will do the work, and the BUILDING-DIV-D PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contactors'State License Law TOTALS S--——> 0 , 0 0 0 , 0 0 0 , 0 0 0 , 00 , 0 0 , 0 0
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If.however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED- . 00 OVER/SHORT : :00
Iorlhe purpose of sale), BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ,***4;*****,****.k.k.,M.**,*!x****u******,***.);*********;t*.),E.1F1i,******************************
that proof of their Worker's Compensation insurance should be provided to me. _
am exempt under Section, B.s P.C. N D I V I D U A L _—
E E B R E A K D O W N
.(for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: Owner: se
I do hereby certify that I am aware of and understand the requirements of California Health and Solely Code Sections 25505,25533,and NO FEES ,'✓FERE SELECTED FOR THIS PERMIT
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a s,
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions E X P I R E
Inco p
Date: Applicant: — '�:ink;le jc.
aiotg
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county s� 11
o nances and slate laws relating to budding construction and hereby authorize representatives f this city to enter upon the above-mentioned
Dente
1 141-4. 01 00139757-001Z27.57-a-T-----��.�` 0
rforeclien�pn�� � � � .Sf / /.., DATE: 0517 �q�- h
Date: Signature; (' 1
X5-,-,Jul,EquIftin
_..--
Driver's
Driver's License or Social Security a: . I . -- -
1641-46 Wnne-Bmldmg',Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor �jt
A
r
From the Desk of . . .
PLANNING DEPARTMENT
Mr. Watcher's married son has muscular dystrophy
and will be living in this guest house with his
wife so that he will be near for the family to take
care of him.
This is an Rl zone and in order to even apply for
pother unit, he would have b have two two car garages,
rich is impossible on this lot.
This is a hardship case and the feeling of Mr. Dunn's
was that they could have it with a guest house designation.
By: Anne Morris
, .
• ' .i
•.
COUNTY OF ORANGE •
Pr
• BUILDING DEPT. Permit No 3
636 No. Broadway Application for Building Permit
Santa Ana, California
Phone: KI 2-6211 AND FOR A
Certificate of Use and Occupancy
Date c-Wee'tfr' 1 — /(7 CO
c....)
\ .04- e (. -neSt(- • • at.e.,0-.^-,
I. OWNER'S NAME PHONE-------
MAILING ADDRESS<7C 7° J-(21 2Zet<7_2.1a CITY eCat 7967-0a.,
-----_-
Name -----)iika.1-2---- Name 6191._•ana,-,1 01;18-c41--E6-411 6:71L-4°1
(Architect or Engineer) - (Contractor)
. Address Address_.2241_______________
City City
.
State State
Lic. No. Phone Lic. No. ' Phone
PROPOSED USE: ________...a-sz .,e_._ iiiz.,Y-- (• 9 --)) . ,1-
bait,
2. JOB LOCATION 17° 4d 7/1/14 a --
(House No - te,te./ (Name of Street) (Town or School District)
3. LEGAL DESCRIPTION: Lot.. a7L.k a al'e a.-- Block Tract
(Metes and Bounds Description—Use reser side of form)
4. CORNER LOT ( ) INTERIOR LOT ( V) THROUGH LOT ( ) SLOPE OF LOT ( )2.e.VeL
d" 35-6 :-. ?Cal7 ' /p0,.,L3,3 y/
5. SIZE OF BLDG.: 2- -2 i #2-G AREA• 6.7 2-',.eige,SIZE OF LOT. 13 - c -- AREA•Y3-ci cc)
0 f fie
6. HEIGHT OF BLDG - • '5...4 e. CEILING HEIGHT- 47; '-d, " NO. OF STORIES 1:--'l
7. NO. FAMILIES
/ / .w
Size of Smallest Bedroom: /0XIV Size of Kitchen: /0
8: EXTERIOR WALL CONSTRUCTION• 676-11-44:An INTERIOR WALL COVERING (ffecet-¢4,t_.
(Frame, Stucco, Etc.) -....t4e ,k,, (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard from Center Line-of( Street 13-4,-7'4
/iS /
Nearest Side Yard ,, Rear Yard - 41-Distance in Feet Between Bldgs. on Same Lot.#9 ./2<"1-1<0 •111—
6
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
iit l : r... ,..,
11: For (a) Footing: Width / b Depth in Ground /7 Width of Wall 0
Accessory .„..0a4-evz..-•61-z-rtAak-
,11
Bldgs. and
(b) Size of Studs: .1•••" Kifi Spacing /6 't "CC Material of Floor Cif tai,4-te a
Similar
Structures: > A.//v "7/a /a "
(c) Size of Floor Joists: / Spacing "CC
ti
(d) Size of Rafters: i2-" X-4" Spacing .2-1' 'cc - -
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring., heating, fire sprinklers, paint-
ing and sewage disposal $
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK .WILL CONFORM TO ALL
LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Plans Filed- WilSigned:- . 1\--aceo--j-'irs_a_TT\ A caE-----
r° (Owner)
\
By:
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
CHECKING BY
FEES: ..,
Az
Bldg. Permit - $ / .3-- se., ej GROUP -. ". _______.__.. APPLICATION_QITHEALTH
Plan Check - $ 74' - TYPE
t -=: ZONING iftte FIRE
Total - - - • $ ,1 4.-/ ---'' DIST. C —. re-4- MARSHAL
PLANS AND
Receipt No. - - ___04'fr3 9 MAP
SPECS V STATE
Paid to - - /2."_3_,?1-.- SHEET NO ..5—..
CORRECTIONS ENGINEER
Date___________________________/./--::4_75.:70 ______._ VERIFIED CAL
---/-- - ill—o PERMTCaNen•4Vilr
COUNTY
BU:LDING4,
iINSi , TOR
- -- - - ------- )1DATE ii ,
10/
i , PtrTY
Jr5M-7.50 -/' i i • /0, re, 2cm
COUNTY OF ORANGE 3 Sµ2/7
'BUILDING DEPT. - - Permit No
636 No. Broadway
Santa Ana,na,CaliforniaC
Application for Building Permit
• Phone:Kl 2-6211 AND FOR A
Certificate of Use and Occupancy(� DateI/S5/57/
i � //,/1. OWNER'S NAME �01 -"A Q .. PHONE '�" -19 I9,
MAILING ADDRESS / 71 ;, " ' �v CITY a 7 " -'eP--
Name Name
(Architect o eer) (Contractor) •
Address Address
City .-. - City
N. , r
State State
e
Lic. No Phone Lic. No • Phone
PROPOSED USE. /lYzo lea a74 411,4-416V5/�,tJ 6
2. JOB LOCATION -/7I nt-eg-r � �- -42-4--)7(...a.1--4.-et �•t/ x/�
(House No.) (Name of Street) (Town or School District)
�3' LEGAL DESCRIPTION: Lot It : 7 Block Tract 2 4
(Metes and Bounds Description-Use reverse side of form)
�4. CORNER LOT ( .) INTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT ( )
/ t7
/i. SIZE OF BLDG.IX2d9 �" RtA •/G� SIZE OF LOT- AREA
i I
r" 6. HEIGHT OF BLDG • J T CEILING HEIGHT g NO. OF STORIES
7. NO. FAMILIES C-R-' Size of Smallest Bedroom. Size of Kitchen
EXTERIOR WALL CONSTRUCTIONA041 c:SAILINTERIOR WALL COVERING \
(Frame, Stucco, Etc.) V( (Plaster-Drywall, Etc.)
SETBACKS: Front Yard From Center Line of Street L- 0
Nearest Side Yard b Rear Yard ,` I b Distance in Feet Between Bldgs. on Same Lot / d ed
.10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width XA?� Depth in Ground /
/ Width of Wall
Accessory / Q
Bldgs. and ✓ , �' `' /� " "CC Material of Floor b / a"4-•
Similar (b) Size of Studs Spacing
Structures: --- / ^'
•(c) Size of Floor 5oists• Spacing/ li "CC
r
(d) Size of Rafters:C. :-..7-1- C •••",/6 Spacin ,' "CC
12. VALUATION OF P��SED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ D L
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE .INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERET1O.
Signed �., � 1
(Owner)
Plans Filed--------- ---- --A .-�.. , kr-
���sss
73)/7t (Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY
Bldg. Permit $ �t' Cr° GROUP � APPLICATIO - _ II�EALTH
Plan Check • $ , � TYPE -ham-r ZONING... .. .. 1-1 `-�JMARSHAL
Total - • {U a_ DIST. /y1l PLANS AND
Receipt No. MAP �— SPEC'S STATE
Paid to • - — SHEET NO CORRECTIONS ENGINEER
Date � � VERIFIED CAL
�//� ( MIG TI ISJ.�JED_B� .
DATE v �f� /
5M-2.5t
/7/Y97
/ .
U�
- b,
TRUCTURAL APPROVAL ONLY
E PERMITS ARE
? c
n
FOR ELECTRICAL, REQUIRED g \l, 1 ,e m -
eD-
HEATING, VENTILATING
Z. i 0Q.it s Q 0 N-�
AND o z �M�'j m
REFRIGERATION WORK �� oP®� z �, p�'
Petite
THIS NU;;3.1;- -z
oi ACCOMPANY �, r '� p
ALL INSPECTION RE�UESTS v O O-
e
rA CD
CD
ratr
FOR BUIL1/1:GS :,liz E P .;S S ARE TO
BE EMPLOYED, WE S c,;EST THAT THE
STATE OF C LIFO,,;,q C ,,;
INDUSTRIAL SnFETY iSION OF
ADDITIONAL REQUIREMENTS.t FOR I (t
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•
MAIN OFFICE BRANCH OFFICE
1535 WEST GAYLORD ST..-P.O. BOX 9065 • 1514.0 NORTH HARPER ST,
SANTA ANA.CALIFORNIA
LONG BEACH 10, CALIFORNIA
HEMLOCK 5)493 JEFFERSON 12045
SPRUCE 520131 • JEFFERSON 12046
lawman. . Laboratories of soutKetn Cat f otnfa, Jnc.
Inspection and'Testing Engineers T • Soil Foundation.,Analysis. .• • - ChemicalAnalysis •
GUNITE
REPORT OF ;'ItidetwM:c EST CYLINDER
Examination No. SC61-3078
Project For - Blue Haven Pools
1221 N. Palm, Anaheim, Calif.
Sample from L. PRATT RESIDENCE - 170 Del Mar, Costa Mesa
Gunite Swim Pool
Architect
Contractor Blue Haven Pools/4-Star Gunite, Inc.
Mix
Water, gal./ski cement
Size 5-3/4 x 12-3/8
Date cast 5-17-61
Date tested 5-24-61 6-14-61
Cylinder No, 3-A 3-B 3-C "Hold"
COMPRESSION TEST 7 Days 28 Days , D v is r v
Total load to destruction, lbs. 30,500 1441//c�
Ur /Ow jR5
Pounds per square inch 1,175 ' 'Fr VI '
i!
Cylinder made by Gunite Crew //P
key RCFVi
/
Cylinder delivered by Brad i / ' �EO AIt 198
hia
Cylinder received on 5-18-61 ' Bg g
���n D peg
`
cc: L. Pratt `4
Blue Haven Pools
Costa Mesa Bldg. Dept.
SA Lab
•
ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AUTHORIZATION R PUBLICATION>��EPORi CONCLUSIONS. OR EX.
TRACTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES.
OWNER PRATT, L. DATE }-1-b1
JOB ADDRESS 170 Del Afar BUILDING PERMIT NO. 114338
GENERAL CONTRACTOR Blue Haven Pools _ VALUE § 2,600.00•
AP. No. 119-080-03 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt. Swim Pool
' ECTIONS DATE I GROUP TYPE ZONE Rat
u ,rground Soil U.G. Water T f §- i Ir-LPERMITS ISSUED _
SUBCONTRACTOR
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating uitc ,,,r.
Rough Plumbing '` ,, iar. 5--int/ �+?, 41-2°41 °29 8/ 177"
Miscellaneous -- _'f „
Prop. Swr. Line House Con. St. Swr.
Sprinkling System _ --
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Lf Power ,
Rough Wiring I I”%LI Elet-Fri s. L-6 -61 lrc+ R'1✓
Trenches Forms Steel 1 it ,j /}4I
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
1,PS' thing
Q• ' _ and Flashing
¶Q• La..ang, In Out
Plaster, brown coat /
11' I
Plumbing Fixtures, Final 4f `r fit e-z/-(�-..
Electric Fixtures, Final
Building, Final -- I
UWNLN COUNTY OF ORANGE. (THE SHELTER) DATE 1-27-76
4 JOB ADDRESS 170 De I Mar Avenue BUILDING PERMIT NO. 41 136
JGENERALCONTRACTOR Owner/Bldr. DESCRIPTION of WORK Stu&�WaII
FY,"g 119-080-03 LOT TRACT FIRE ZONE VALUEEZ00.00
>;CTIONS Signature Dote TYPE V GROUP I ZONE R-2
%�... SUBCONTRACTOR PEpMITS ISSUED
GAS Date I Number I Signature
,WATER ■ Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. •
SPRINKLING SYSTEM -III- IIIIIIIIIIIIIIIII_IIIIIIIIIIIIIIIIIIIIIIIIIII.
,M ISC EL LAN E OUS
OUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER n
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. 0
FLOOR SYSTEM ^
BOND BEAM n STEEL REINFORCE L I
SHEATHING ,
FRAME AND FLASHING1
r
LATHING - IN I I OUT in
PLASTER. BROWN COAT .
S� -TUBAL, FINAL . '
3, VENT., REFRIG. AND A,C„ FINAL
P. MNG, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING. FINAL
'4 I 136 PAI➢ :. *,.:�r*A
JAN z7-10ER:�00 981 5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . - •
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to.Fill in Completely— Use Ink Only
Ray?DBV DATE RECE ipD' i- =
BUILDING yyII,�II 61/J7 W,
ADDRESS/'/ 70 04 Mgr eilie.
OWNER l el Q/1- �1 of ordgc (TIIP c/Ia.i) A.P. •
NO. I�� �v�O /D 5 P I �I
MAIL / BUILDING
7 ) (r'�y�) ,�rJ/f/lL ei
ADDRESS /44! Si ye nor 44Ve ADDRESS / (� f///f�u/ low
TEL.. vV 3B
CITY N�f, NO. 64,E-9a4o TRACT37L . LOT 37 BLOCK
4 .
//y�`�t•RG N
CONSTRUCTIO0/"I'
N - NEW ADD 'LTER REPAIR MOVING DEMOLISH
LENDER "X /�s� / /yam/ /t, }/J
BRANCH OWNER CITY(.:Yz.. (ir7 (//
•
ADDRESS //t/Ltis/�- BLUE ,�/s�I-9
led
ARCHITECT TEL. US § Row
OR ENGINEER NO.
FIREfir
ADDRESS ZONE TYPE GROUP seri.7 ��JJ
APPROVED
CONTRACTOR 0( /u" 2
�n(J/- BY DATE
•
ADDRESS •
TEL. • ZONE NO.OF '//7 USE OF NEW
CITY NO. Z PLANS L. BUILDING
Sy STATE - CITY YARDS APPROVED YARDS APPROV
gi LIC. NO. LIC.NO. MAIN BUILDINGii Bti
SIZE ' NO.OF BLDGS. (FROM C/L STREET) (V.
6..z..._.4 OF LOT NOW ON LOT FRONT FT.
Q USE OF
CA EXISTING BLDG. R.SIDEPt
FT.
in
FSeparate permits are required for L.SIDE `\ FT.
electric,plumbing and heating work. IV
7 - REAR ' FT. - FT.
USE OF BUILDING AND WORK.TO BE PERFORMED DISTANCE BET. - BET. MAIN&
G / / MAIN BLDGS. �/r -ACCESS.BLOCS.
Q ! 7 z r/(/ �`� C.U.P.31sleg )L/ APPROVED
APPROVEDCW� 7
a _By flATF/���
a
W
B.
I hereby acknowledge that I have read this application and state n
g that the.above information is correct and agree to comply with m
gl all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of u
5W the State of California.
3 I hereby certify that I am properly licensed as a contractor under . SQ. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
La
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ e
and Professions Code, Division 3,Chapter 9. en
�.Q n
j, /' �7 PLAN CHECK $ �'- n
. Srof u /l/_ - / - fI V4141r -4fret $ // O '— o
Permittee /lam/r�'r' �5, O. TAX $
.5-0 U
Authorized Agent . TOTAL PAID $ ace, Co
I
ELF
.✓* 1.4.338.. tAPR24ISM
COSTA MESA BUILDING-SAFETY DEPARTMENT ` FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
• TYPE OR^ / l.[L/P/IRIIN� •
PRINT BUILDING
RE
ADDSS / /�'7 0 / �
S ESA. CALIFORNIA For Office Use Only
�/$.�'�f��^f�O�/�
if I RECEIPT NO. ,/ 3 /
OWNER `\/ '/(`'j _(j
MAIL
RECEi/p
ms 1 DATE
, Ve // !pe
UED
MADRE "C1/21---7-r--2----
ci` ciy'`"'/ 9'-"2C (/% -/ 6/
Y —7TEL. BUILDING
CITYir-pi
NO. ADDRESS
AR( SE Ti . COSTA MESA. CALIFORNIA
OR zad
ALDRESS VD T r-JL`/JJ�iC FIRE
R `q J/n ZON TYPE GROU
APCONTRACfO 13•&c(..6 'T [ / j/'4-2 BY P DATE ( �r I F/ .
ADDRESS w2--2-7
2-f/�/ f"/ FIA-1--4-1- ZONING l'7)"0/
�I'/,,��J�(✓I��,y�ry .fi
CITY C `'i [I'—y"�"-� ` ZONF�• PLANE Z 8111E-1NO EW • 1. 1'
LIC.TNO. i J / 3 TNO. J i O 5/ LEGAL -4 7-,36169 tR 3 '2!,
DESCRIPTION �/ )
SIZE
OF LOT c / , NOW ON OTNO. OF B 11 / '-o b(/— 0 3
USE OP �A�-O YARDS EVES
i 7
EXISTING BLDG. • 1 �J� APPROVED ALLOWED •
SETBACK LINE FROM • (/// (CENTER LINE ST.) /
CENTER OF STREET REAR YARD FRONT �3 FT. /!C/.la-1.
dIN.
SIDE YARD I LEFT I RIGHT R.SIDE /15 FT. JJ!. 1y. IN.
DESCRIPTION OF WORK L.SIDE 4 FT. .' ✓ N.
NE ALTERATION I II ADDITION I REAR ./t5-0/ FT. f- / ,^ IN./
REPAIR . II MOVING I II DEMOLISH BYPROVED LA ` //1 DATE I2-t -i /
BUILDING JQ � 3 /NO. OF AO
�/ I
SIZE / Q /l J ROOMS STORIES
EXTERIOR WALLROOF
COVERING I COVERING
(USE/'OOF BUILDING AND WORK TO E",.P/E$/)FORMED
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORREC AND A TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND TE LAMS RE UUT O
BUILDING C-- • r. .CTION. VALUATION /�
SIGNATURE OF / CtC PERMIT FEE $ /L,
PERMITTEE ///% / _n
� y// `�� / $, �� " PLAN CHECK $ './ �'
AUTHORIZED AGENT '-�f V_V v_". C
TOTAL FEE $ �'5 y
Y