HomeMy WebLinkAbout176 DEL MAR AVE - Building Permits ea *.y.,, CITY OF COSTA MESA
4BUILDING DIVISION
h ,' .�( •
DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
O1.1141
PERMIT 06-00018
+ -
-`°Momrce fi"
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 176 DEL MAR AV Status: ISSUED
Suite No B Applied: 01/12/2006
Issued: 01/12/2006
Vicinity:
I
Parcel Number: 43922146
ISSUED BY: Ale
Applicant: PARSONS, GORDON ...r/ •
Address: 2282 ORCHARD DR " ' -
Phone: 949-456-0064 "
NEWPORT BEACH,CA Zip: 92660
Owner: ' BROCKMAN, CARLA2WART TR
Address: =20271'ACACIA ST STE#110 - " '
Phone: •
NEWPORT BEACH;CA Zip: 92660-1731
Contractor ABC HEATING AND AIR CONDITIONING
Address: 2282 ORCHARD DR • . , .
Phone: 949-456-0064
NEWPORT BEACH,CA Zip: : - 92660 . .
License:810481
•
SCOPE•OF PERMIT'
•
y CHANGE-OUT OF A WALL FURNACE TO A 35,000 UNIT FOR UNIT B. '
- ' NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
' Repair/Alt Cooling/Heat $0.00 - 0 Evaporative Cooler $0.00, 0
Inst/Rep.Recess Wall Htr $0.00-0- --_ --- - - . ' Commercial Incinerator . r': $0.00 0
'Refrig Sys<100 k BTU $0.00 0- Domestic Incinerator . , - $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 _3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust \I $0.00 0 15 To 30 hp/1,000 k BTU - $0.00 0
VAV Box ' ' - $0.00 0 _ _ 30 To 50 hp/1,750 k BTU - '$0.00 0
Vent Fan/Single Duct " " • $0.00 0 � - Over 50 hp/Over 1,750 BTU $0.00 0
Appliance $0.00 0 - Boilers
Fire Dampers - $0.00 0 ', . Up to 3 hp-. - $0.00 '0
Smoke Dampers -y -$0.00---_0, - - 3 To 15 hp,_ • - . $0.00 0
Inst or Relocate Appl Vent_ '`:$0.00 - 0- " = 15 to 30 hp ,,$0.00 0
Air Handlers<-10000cfm j:," ' $0.00 ., 0: - - ", 30 to 50 hp .. ' - $0.00 0
Air Handlers> 10000cfm' - $0.00 0, - Over 50 hp : $0.00 0
Floor Furnace ` - $0.00 :0 1 - . Other Mechanical Fee
Floor or Suspend Heater $14.80 1 - ._ . -. . Investigation Fee - $0.00
- - - - • - Plan Check Fee $0.00
Reinspection Fee ' ' $0.00
• TOTAL CALCULATED FEES $38.30
' COMMENTS I SPECIAL CONDITIONS
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(WOO)
DECLARATIONS n --•1
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under penalty of perjury one of the following declarations: '
❑ I h ye and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
ork 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 permit is issued.
My works compensatb insurance carrier and policy number are: t� 7��
Carrier: S1n7-7 PLt-s-i4' Policy Number: / / 5- 3 4/ 9-..-cni
(This section need not be completed i he permit is valued at one hundred dollars($100)or less.) I
❑ 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith
comply with these prov'' ions.
Applicant Signature: -f�/r-i�fi-r /�7 Date: 7 / — I Zea/'
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
TFIOUSAND DOI ARE(s100,00UL IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lich# 4 �i/G ye-/ Class.# G-"'7.-C /
Contractors Signature: .._--4.-.,.,t /'c7h— Date: / -/7-G.N
CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: _ Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commenting with Section 7000)of Division 3 of the
Business and Professions Code)or that he or 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).):
❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work
himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). '
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a 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 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2.Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(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 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes 0 N
(Section 25534 of the Califomia Health and Safety Code provides that the 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes 0 No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
...... this permit
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
B (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Date
And/Or Authonzed Applicant Date �p/��gJ�,,
I'
r CODE# INSPECTION TYPE PATE INTITIALS CODER INSPECTION TYPE �� /� Y ,
1616 Fixed System Final Fire Prevention 206 Final Mechanical of"
1266 Pool Spa Final 208 Final Plumbing
I,
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
204 Final Demolition _ 250 Final Building/Occupancy
•
ADDRESS OF BUILDING: 176 DEL MAR AV UMT: CITY OF COSTA MESA — BUILDING PERMIT
ONNERrnIFIOlodfl: BUNDY, SUSANNE M PERM NO: B 072956
ADDRESS: 176 DEL MAR AVE
COSSTA9MGESA,C823 92626 PERMIT NO: B 072956 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.SWUNGADORES4 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR. PURPOSE : OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF & REROOF W/COMP . SHINGLES SQ FT: • 2, 000
ARC"OR ENG.'S ADDRESS: UMT:
• CLAIM VALUE: 2, 000 . 00 CALC—VALUE: 2, 000 .00 GROUP OCC : R-3 /M-1
CONTRACTORSNAa HUNTER CONSTRUCTION ( 714 ) 892-9276
CONTRACTORSMAILNG 11671 LUZON ST COMMENTS : SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM & HALLWAY
ADDRESS: CYPRESS CA MHO.: 692829 ********************************************Ir**********************a *.*****+arty-**
90630 DMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force end effect.
"a:064394 LIC.CLASS: B LIC.NO.: 692829 EXP : 02 /96 MAIN BUILDING ACCESSORY BUILDING
�'e: //�]� conrea �J �� � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
at °'/7"""� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
NER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law(or the
folewig reason(Section 7031.5 Business and Professions Code:Any city or countywhirh requires a perms to construct.alter.improv. PARKING REQ: PROV: PARCEL : 43922146 ZNE: REF NO:
demolish.or repair any stmcture,prior to as issuance,also requires the applicant for such permit to file a signed statement that he or she
•
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES>.
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section
7031.5 by any applicant 1«a perms subjects the applicant(0acell penalty of not more than the hundred dollars($50131)' *************rt*****************************************************************
❑ I,as owner of the Properly of my employees with wages as their Bole compensation.will do the work.and the structure is not intended D E V E L O P M E NT T SERVICES R E U I R E M E N T S
or offered ler sale(Section 7014.Business and Professions Code:The Contrados license Law does not apply to an owner a M proPeQ
who bulds«improves(hereon,and who does such work himself or hared or through his or her own employees.provided that such
improvements are not intended or offered for sale.I.however,the building or improvement is sold within one year of completion.the ZONING APPROVED' B YDATE:
rd
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I.as owner of the property,en exduseely contradi g with licensed contractors to construct the project(Section 7044.Business and
Profession Code:The Contractors License Law does not appy to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY :_ DATE :
contracts for such projects with a contractors)licensed pummel to the Contractors License Law). '�
❑ I am exempt under Section: B.AP.C..for this reason: APPLICATION ISSUED BY: /'a C DATE:
Dale: Owner: *************dE.dE'*******3F*' - **cox********** "® **
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534,and that I or any future building occupant will/wll not(circle one)need to comply with said state codes end the requirements for
apens f«oorstruction o motheaten from the AiOualdy anegemem Dimdc.Redmie
dedwhdmaopplapplicationsme exempt these ese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 45 . 00 . 50
Date: Applicant: SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedartipns: PLAN
ISSUE FEE
0 I have Code,fndwmeirmancedemcateofcoenttoisperreforsued. compensaton.=provided for bySecton37Doathe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK- TOTAL PAID DUE
cede.f«iMpertomaceathe work t«w hthlspemaenaaed. TOTALS----> 45 . 50 0 . 00 0 . 00 45 . 50 45 . 50 . 00
0 I have and wi1 maintain workers'compensation insurance,as required by Section 3700 of the labor Code.for the performance of the
work for which this panni S Sued.My workers'compensation insurance carrier and policy number are:
Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 45 . 50 OVER/SHORT : . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
is section need not be completed y the pane is for one hundred dollars(stool or Ws) 45 . 00 . 50
RI I certify that in the performance of the work ler which this permit is issued,I shall not employ any person in any manner so as to
become subject to the workers'compensation Man o California,and agree that if I should become subject to the workers' *******************************************************************************
//// pensaton provisions of 37013 of the Labor Code,I shallforthwithforthwith comply with those provisions.0INDIVIDUAL F E E BREAKDOWN
D:Failure to secure orkera'compensation coverage Is unlawful,and shell subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil lines up to one hundred thousand dollars($100,000),In edition to the coat of compensation,damages as provided for In
saatlon3asofthe Labor Code,hntenat,and aromwsfees.
prSFR 2000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 000 . 00
• CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END O�, S
performance of the work forwhich the permitis issued(Section 3097,Civ.C). K
LENDER'S NAME:
LENDER'S ADDRESS: •
y^,� ///+++�����t
I certify that I have read this application and state that the above information is correct.I agree to comply with all city end county ordinances D :EQUIFiE ly�O�
and state laws relating ho building construction end hereby authorize representatives of this city to enter upon the above-mentioned properly �J /C7■
for inspection purposes.
RONALD HUNTER
o Print Name /2/11-0(4.1
Jam• y.✓ Cl 00 134900-00184301. TOT_ 45.50
�� � • Data'_/2/11-�l-CC DALE: 06/27/95 TOE: 08:4)
JJ 77 Sgneture of Owwe gent/ pp roan 9 j,
(5151-45.WP) White-Building&Safely:Green-File:Canary-Apptcant;Pink-Pavane:Goldenrod-Assessor ,
1
CONSTRUCTION AND PLANNING/ - POO- .. SPCA _
APPROVALS Permit # - Date Inspector APPROVALS Permit # •' Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location f ,
.1
' f. Soil Pipe-Undrgrnd. i 53. Steel Reinforcement
.1
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. r-+ 55. Electrical Bonding ". L
. .,
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. -Electrical UFER'Grnd. - 57. APPROVAL TO COVER-GUNITE 5 i-
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation . `
59. Gas Pipe, 0 Undrgrnd., Test 'r_
9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap, 0 Undrgrnd.
f
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 i
13. Roof Drains -' 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit .; 66. Solar System-Final _ l
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 O 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 -
6-2..,5-qS' g..17---74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 76. 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. Elebtrical 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 , - - v,. •• ,'-.
37. Final Factory Fireplace - - - �
38. Final Plumbing ,
39. Water Service-Final r - - '
• 40. Gas Service-Final - .
41. Solar Domestic-Final .;. - '.
42. Backflow Preventer- ' -
43. Backflow Irrigation , - ` .
44. Landscape Irrigation System- '- = ;, - -
. t .
45. Sound Attenuation, _ , _ •
46. Handicap Regulationsr . .
47. FINAL STRUCTURE & BUILDING 6220_gs6w(� ` . I
48. FINAL PLANNING -_ L
49. Electric Release to Edison •
y-• - -
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. 73 (�72 / 3
Property Address / 7 G° h"-/ raid F' ////
Owner n iA ei Oh/
Contractor A"' -S �,A4
•
State Contractor License Number lQ 9_t)-9 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).
II,��furthhe�er certify that I am:
L1YOwner 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,
�rH n7 fir/ ��-7? �S ,r H!t 1 Jam-./
f •
Company or Corporate ame
J,./1/4-77 /'t)A-i et-
Address
Received by Building Division P rr—c l//'_,ez-// fa oz a y/
By: /
.�/Si�gnature ) j Dat
17-7
I Nal to Printed or typed name
0990-46 Wane-Bwiding Div CanaryContractor.Pink-Owner
,'
/
COUNTY OF ORANGE 1 i. l
.3 CP
BUILDING DEPT. Permit NO
636tNo.Broadway
CaliforniaApplication for Building Permit
Santa Ana,Californ
Phone:KI 2-6211 AND FOR A
Certificate of Use and Occupancy
Date MARCH 31l9SZ
1. OWNER'S NAME...9tL 132' 8 I 0. N A- R, T PHONE- No NF_
MAILING ADDRESS....2.2 2 C A B RIC L6 CITY COSTA fY\ ISA
Name.... NONE- Name ...P 1:.KeI?7 Di MA/17
(Architect or Engineer) - • (Contractor)
Address Address
City City
State State
Lic. No.. Phone Lic. No Al a /I I= Phone
PROPOSED USE D w E C L 1 N C-
2. JOB LOCATION 176 DEL- MAR C O 5 TA M i-.5'
(House No.) (Name of Street) (Town or School District)
3. LEGAL DESCRIPTION: Lot A/1414 Y CO it LeT S3 Block Tract.37C
(Metes and Bounds Description—Use reverse side of form) BOolc IC PA GFE 2°l
, 4' CORNER LOT ( ) INTERIOR LOT ( )O THROUGH LOT ( ) SLOPE OF LOT (L Sr L
5. SIZE OF BLDG • /9'Xzcr AREA- Li 751a-24,- SIZE OF LOT- -5....0 1 X /G8 AREA.204®.-o?.-41
r r J
6. HEIGHT OF BLDG • /21 CEILING HEIGHT- 8 t NO. OF STORIES.../
7. NO. FAMILIES / Size of Smallest Bedroom- /0°11//A‘ Size of Kitchen 70/136
8. EXTERIOR WALL CONSTRUCTION- STO CC o INTERIOR WALL COVERING FL ASTC/(
(Frame, Stucco, Etc.) (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Street 45-61
Nearest Side Yard f Rear Yard t; Distance in Feet Between Bldgs. on Same Lot NO 0111C*L? /MOOS.
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For �� rr C N
(a) Footing: Width E� Depth in Ground /2 Width of Wall
Accessory
Bldgs.'and (b) Size of StudsSpacing
Similar 7 X U Sacro /G - -CC Material of Floor Co 1V GRLTL'
Structures:
(c) Size of Floor Joists- N 6 Al Spacing
/a Spacing
(d) Size of Rafters- 2 X ft Spacing 21/ " "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ -3 '0C, 6 O
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 CALIFORfNII APPLICABLE THERETO. t
d
Signe ILL 134441—as
(Owner)
Plans Filed:...-3../ if"�
By. ,
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY - -
'^ -
FEES: H G BY 1,
Bldg. Permit - $ 104. &Q .. GROUP / APPLICATION45e -_HEALTH
/ , 9�1 TYPE v FIRE
Plan Check - $._ ZONING
Total - - - $ /../. ...#15._/../. ...#15DIST. / ' PLANS AND MARSHAL
Recei t No. - MAP G mob
P r- SPEC'S STATE
Paid to - • tit SHEET NO CORRECTIONS ENGINEER
Date ] , { Er.. L. VERIFIED CAL
PERT O tJI-!UE- COINSP TYSTORING
• DATE --3/(VP--- /� fro j/�/
5M-1-5I • 6/////^1A
4
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT I
636 North BroaFORy St. ,D I N G
cl • SANTA ANAA,, CALIFORNIALI -- -
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.'
BUILDING ' S .
ADDRESS 1Y_ in)
ell thy I�ye ‘9ri/ �ys/ ,
SCHOOL DIST. Mesa
OR TOWN Costa_ RECEIVE 'BY DATE RECD. DATE
//,DATE ISSUED
7
NEAREST Ile 71� j9 roe;
� / -g/ 3-I V/ -,i 6, › _
CROSS ST. I/Ip����(yry I (0 f0
OWNER el/at*** /4BADDRESS ' / 7 ( Del
''ffrr Y� Y ADDRESS ' 1 j" �vC
MAIL
ADDRESS e7B �e ay �e
SCHOOL DIST. Cos-74.6.7
TOWN II
TEL.
CITYrn ta ties
NO. NEAREST ®�
CROSS ST. 'Cs'-At cst l 1 ,
ARCHITECT OR LIC. ZO NO. OF E 1 GROUP I
ENGINEER NO. 1 PLANS
ADDRESS -
APPROVED '
LIC. BY .�,,.�. DATE
?! NTRACTOR ow4eY •
NO. +RRECTIONS
ADDRESS
LEGAL
DESCRIPTION I LNOT53 I BLOCK I TRAC37L
(ATTACH METES & BOUNDS) -
SIZE OF LOT 50x 168 I NOW ON LOTNO.OFS / �'
USE OF ■^` _ NO. OF NO. OF
•
EXISTING BLDGTIIU�I n/yy FAMILIESI ROOMS '
SETBACK LINE FROM: ( REAR YARD sB
CENTER OF STREET �S SIDE YARD !G7
DESCRIPTION OF WORK
NEW I ALTERATION I I ADDITION I 4,
D
Z
REPAIR I I MOVING II DEMOLISH I r
SZIEDING27 re` NO. OF ROOMS S STORIES /EXTERIOR
COVERING WALL DI COOVVERINGd94n45
OF NEW � e/'
DING
,n,9, ID
APPROVALS
FOUNDATION: LOCATION ./INSPECTOR'_ DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, r '. A0 ,22 "5)
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING lllr\\'�'I/V{A/r/(J { IF
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS, \ ,3 s•-•/,- -53
BRACING. BOLTS ,J
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH, INT.
SIGNATURE OF LATH, EXT. &./..i d:_o-S_
PERM ITTE
PLASTER, INT.
by 'AUTHORIZED AGT. i PLASTER. EXT.
$ PERMIT FEE $$'# MASONRY REINFORCED
VALUATION ! V J J / cc, PLAN CHECK $ 3FC \
�/ { •) V/ r� �7��yy BOND BEAM 1
Y • \ I1 7 J fl TOTAL-Y SI'/ ""FINAL f/ JC -jrV 'V
FEE Y
5M 9-30-59