HomeMy WebLinkAbout2752 DESOTO AVE - Building PermitsCITY OF COSTA MESA
BI/ILDING DIVISION
F` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
•�� ��
PERMIT NUMBER: P08-00246
. , ..
PERMIT TYPE PLUM
APN: 14164104
JOB ADpRESS: 2752 DESOTO AV CM
Vicinity:
STATUS:
DATE ISSUED:
ISSUED BY:
SuitelUnit:
ISSUED
11/1312008
YH
a
SCOPE OF WORK: PERMIT TO LEGALIZE INSTALLATION OF GAS WATER HEATER INSTALLED W/OUT PERMITS.
OWNER: KRANEISS, CHRISTOPH Address:
PHONE: City/State/Zip:
APPLICANi; BRIDGES, ELIZABETH Address:
PHONE: 323 552-0178 CitylState/zZip:
CONTRACTOR: HOME DEPOT USA INC
Address: 12774 E FLORENCE AV
City/State: SANTA FE SPRINGS, CA 2ipCode: 90670
ARCHITECT; ' . License No.
ENGINEER: License No.
2752 DE SOTO AVE
COSTA MESA, CA
: ��r
License No. 602331 . �i i0
PHONE: 562-981-1600 ': _ . ,
CELL: , ,
PHONE:
PHONE:
�
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
�
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requiremenls under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12•21-92)
EXPIRATION: PERMIT EXPIRES 1B0 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must comply with all applicable codes, and all
required inspactions and final approval must be obtained. Failure to oblain inspections and final approval will result in the expiretion of this permit.
COpEt, INSPEC�pNTYPE p� NI7171RL5 COUEt INSPEC710NTYPE QRTg IN11ML5
1678 Fiaed System Final Fire Prevention 208 Final Mechanical
12fi6 Pool 5pa Final . 208 Final Plumbing )-13 - 09 �pL
200 Final Re-Roof 210 Final Elecincal
201 Final Block/ReWining Wall 212 Final Fire Prevention
202 Final Facmry Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Sile �
20a Fir�al Dertrolifan r 250 Final Builtling/Occupanty
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penal[y of peryury one of the (ollowing declarations:�
❑ I have antl will maintain a certificate of consent to sel(-Insure for vrorkers'
compensation, as provided for by section 3700 of Ihe Labor Code, tor the
peAormance of the vrork for which this permit is issued.
� I have antl will maintain v.orkers' compensation insurance, as required by
section 3700 of Ihe Labor Code, fw Ihe pertortnance of the v.ork (or which this
pertnit is issued. My workers' wmpensation Insurance cartier and policy
number are:
Camer:������_���t�0. ��(L1.w ,
(TNs seCqn neeC nol Ee tpr�etetl /pNe pcmN 6 vah2V ef are nimbetl A�Wrs (S10J) abss )
Polity Number: �q �. a � S �
❑ I certify that in the peAormance of the work for which Ihis permil is
issued, I ehall not employ any person in any manner so as to become subject
to lhe workere' compensaUon laws of California, antl agree that if I should
become subject to Ihe vrorkers' compensation provisions o! Section 3700 of
th abor Code, I shall forthwith comply with Ihese provisions.
�'� 3 S�i,..c� �SP ��—� 3- u�
Appiran�'s SB�a�ure Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SFW�L SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLP,RS
($100,000�, W ADOITION TO 7HE COST OF CAMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensetl under provisions of Chapter 9(commencinq
with Section 7000) of Division 3 of tha Business and Professions Code. and
my license is in full force and eflect. �j
Lic. tt �,p � �, 3 '� Class # `�
`�s�'.,, � � C9A \ \ - �3 - o�
T3igndWre Date
;._
CONSTRUCTION LENDIN6 AGENCY:
❑ I hereby affum that lhere is �a��construclion lending agency (or the
peAortnance of the v.ork for which tNs permit'rs issued. (Sec. 3097, Civil Code).
LenCer'S Name: . .
Lender's Atldress:
SiB�amre "' Da�e
OW NER•BUILDER DECLARATIONS:
I hereby aKrm that under penalty of peryury that I am EXEMPT FROM THE
CONTRACTORS LICENSE U+W �or the following reason (Sec. 7031.5,
Business and Prolessions Code: Any ciry or counry which requires a permii to
construct. alter, improve, demolish, or repair any structure, prior to its
issuance, also requires Ihe app�icant for such permit lo file a signed statemenl
lhat he or she i5 licen5ed purSuanl to lhe provisions of lhe COntractors
License Law (Chapter 9(commencing witn Sec�ion 7000) of Division 3 0l the
Business and Prolessions Code) or that he or she is exempt therefrom and
�he basis for the alleged exemption. Any violation of Section 7031.5 by any
applicam for a permit subjects the applicaN to a civil penalty ot not more than
five huntlred tlollars ($500�.�;
❑ I, as owner of the property, or my employees vnth wages as their sole
compensation, WILL DO TME WORK, antl the sWcture is not intendetl or
oflered for sale (Sec. 7044, 6usiness and Prolessions Code: The Contractors
License law does not apP�Y �o an ovmer of property who builds or improves
lhereon, and who doe5 Such work him5ell or herself or through hi5 or her own
�employees. provided thausuch improvements are rw� intentled or oBered for
sale. II, hovrever, t�e build�ng or improvement is sold wi[hin one year of
completion, the ovmer-builtl2r will have the burden of provinq that he or she
did not builtl or improve for purpose ol sale.). '
❑ I, as ovmer of t�e property. am EXCLUSIVELY CONTRACTING WI7H
LICENSED CONTRACTORS to construct the project �Sec. 7044, Business and
Professions Code: The contractors License Law dces not apply to an owner of
property who builtls or improves thereon, and who coni2cts for such project with
a cont2cta(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
SignaWre ��e
]O5�<6�Y0]�
Ovmer ID venfied by driver's lice ❑ Yes ❑ No
Oriver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby ceAify that no excavation ('rve (5) or mae feet in deplh into wfiich a
person is required to Oescend, will be made in conneclion with woAc authonzed
by this permit, antl that no 6uilding structure, scaffdding, (alse�wrk, a demolition
or dismantling thereof, will be more than thiny-si� (36) feet hig�. (Chap. 3.2, Grp
2. M 2. Sec. 341, Title 8, Califomia Administraiive Cotle).
❑ As owner-builtler, I will not employ anyone lo do work which vroultl
require a permit from the Division ot Intlustrial Safety, as noted above, unless
such person has a permit to tlo such work (rom the division.
Aoollcanl's SipnaWre Wte
Division of Industrial Safety Permit Number:
MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
cehily a Business Plan for emergency response to release or threatenetl
release of a hazardous material? ❑ Yes ❑ No
(Sectioa 25505 ot the Cali(omia Heallh and Satety Cocie requires, wilh some
ezceptions, that a Business Plan be filetl with Ne Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantiry of hazartlous materials equal ro or greater �han a weig�t of
500 pounds, or a volume oi 55 gallons. or 200 cubic teet of wmpressed gas
at standartl temperaWre antl pressure).
2. Does or will the applicant or present or fuWre building occupant neetl to file
a registration form for acutey hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Cali(omia Health and Safety Code, with some
exceplions, requires registralion with ihe Costa Mesa Fire Department by
each business which at any one time �as on hand a quantiry of acutely
hazardous matenals equal to or greater than a weight of 500 pounds. or a
volume of 55 gallons, or 200 cubic feet o( compressed gas at stantlard
temperature and pressure).
3. Does or will the apDliwnt or present or tuWre 6udtling occupant need ro
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materialsj? ❑ Ves � No
(Section 25534 of the California Heallh and Safety Code provides lhat the
Costa Mesa Fire Depanment may require the preparation, certification antl
filing with the Fire Department of an RMPP by businesses which are required
to register awtely hazartlous materials with the Fire DepaAment.
4. If an RMPP is p�esently required, has Seclion 25534 of the Califomia
Health antl Safety Code been (ully complied wilh? ❑ Ves ❑ No
5. Does or will the applicanl or presenl or future building occupant require for
the work which is the subject ot this application a permit br such conSWction
or modilcation (rom ihe Soulh Coast Air Qualily Managemenl District or Irom
any other air pollution control districl or agency? ❑ Yes ❑ No
(Section 658502 0l the Califomia Govemment Cotle requires lhat tlie requesteC
infortnalion be fumishetl on applications fa ran-resitlential Duiltling permits).
6. Will any part o! Ihe faciliry to be consWctetl under �his permit �e vrithin
1000 feet from the outer bountlanes of a school? ❑ Yes ❑ No
pf yes", the facility must meel lhe requiremeN of Sections 25534 antl 42303
o! the Califomia Health and Safery Code).
7. I( a permit from the South Coast Air Ouality Management District or other
air polWtion control district or agency is requiretl for the vrork which is ihe
subject of this applicalion, have all ol the disclosures prescribed by Califomia
Health and Salety Code Seclion 42303 been made? ❑ Yes � No
8. (II'yes", atfach certificate of compliance from the appropriate air polWGon
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty,ol perjury lhe
infortnation given above is wrrecL I agree to wmpy with all state laws and
city ortlinances regarding Hazardous Materials and Emissions. .
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
ceAify under penalry of perjury that I have read this application and state that
me information given is correct I agree to comply vnth all state laws and city
ordinances relating to builtling consWction, and authorize representatives ot
the City of Costa Mesa to enter upon the above-descnbetl pmperty for
inspeclion purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit until final inspection.
SignaWr alOvmeqs� Pate
�h S�\rQ C _S.r� �� - \3- 04.
uNIX�zMAOPIiUn1 `_ Wie
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(714) 754-5273 • Fflx (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Jab Address: 2752 DESOTO AV
Suile:
Vicinily: ROOF
Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: 14164104 Zoning: R1
npplicant: FERGUSON, LEW
Address: 4091 E LA PALMA
SUITE D
ANAHEIM,CA
Owner: KRANEISS, CHRISTOPH
Address 2752 DE SOTO AVE
COSTA MESA, CA
Contrector. MC CORMACK ROOFING
Address: 4091 E LA PALMA
SUITE D
ANAHEIM, CA
Zip: 92607
Arch :
Address:
Phone:
Phone: (714)630-5543
Zip: 92807
Phone:
Zip: 92626
Phone: (714)630-5543
License: 643700
En9:
Address:
Status: ISSUED
Applied: 03/10/2005
Issued: 03/10/2005
ISSUED BY: i l �
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING SHAKES, FILL IN SPACED SHEATHING, INSTA� 1 LAYER OF 30# FELT UNDERLAYMENT, AND REROOF WITH 30 YEAR
COMP SHINGLES (24 SQ).
Plan Check: $0.00
Permit: $125.25
SMIP Res: $0.52
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.77
SETBACKS
ACCESSORY
PARKING
Front 0- 0
Front 0- 0
Existin : 0
Rear 0- 0
Rear 0. 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
Ss,2oo.00
55,200.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis 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 780 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
raqulred Inepeetione and final approvel must be obtained. Failure to obtain Inspectlons and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
taaaae (eroo)
WORKERS' COMPENSATION DECLARATION:
I hereby effirm untler penelty of peryury one of the tollowing tledaretions:
❑ I have end will maintein e certificete of consent to sell-Insure lor workers' compensation, es provided for by section 3700 of ihe Labor Code, lor the pertormence ot the
w ot w�ich lhis pertnil is issuetl.
have and will maintain workers' compensetion in urance, as required by section 3700 ot t�e Labor Code, tor the pedortnance ol the work for whlch [his permll Is Issued.
My wo rs' compensa�lon Insurence car a p011cy number ere:
Carrier: ����✓L�NwCZ � �C� PolicyNumber: L�C�iO/O�-/O�-��I
(This sectlon need not be campleted il the permif is valued et one hundred dollars ($100) or less.)
❑ I certity t�at in t�e peAormance of the work for which this pertnit is issued, I s�ell not employ eny person in eny manner so es to become sub�ect b the workers'
compensation laws ol Celifomie end egree that if I shoultl become subject �o the workers' compensation provislons ot Section 3700 ot the Lebor CoOe, I shall toMwlth
comply with these provis ons / /
Applicant Signeture: .��>-� �� Date: � 3�O / � 5
—vy— �—�— y
WARNING: FAILUFE TO SECURE WORKERS' COMPENSATION COV IS UEM6E NUWFUL AND SHALL SUBIECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO dJE HUNDRE�
T/%)USANO DIX.URE (5100,000�. IN ADDfiION TO THE COST OF COMPENSATION, DAM4GES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CO�E, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am Ilcensed under provisions of Chepter 9(commencing with Sectlon 7000) oi Divislon 3 of ihe Business and Professions Cotle, antl my license Is In lull
force and eHact. Lic. a Class M
Contractors Signature: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm that there is a construc�ion lending egency for ihe peAormance ol ihe work for w�ich Ihis permil Is Issued. (Sec. 3097, Civil Code).
Lenders Name: lentler's Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I here6y eMirtn ihat under penalry of perjury t�at I am EXEMPT FROM THE CONTHACTORS LILENSE LAW for the following reeson (Sec. 7031.5, Busineu end Professions
Code: Any ciry or county which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires tha epplicant for such permit
b file a signad statement Ihet he or she Is licensed pursuent to the provisions of the Conlrectors License Lew (Chapler 9(commencing wil� Secllon 7000) ot Divislon 3 0l Ihe
Business end Prafessions Code) or Ihet he or she is exempi therefrom end the 6asis for Ihe allegetl e:emption. Any violetion of Sectlon 7031.5 by eny applicanl.tor e pertnit
subjects ihe eppliwnt to e civil penalry oi not more then flve hundred dollers (5500).):
❑ I, as owner of ihe property, or my employees with weges as their sola compensatlon, WILI DO THE WORK, antl the siructure Is not intenCetl or oflered lor sele (Sec.
7040, Business antl Professions Code: The Contracbrs License Law dces not apply to an owner oi properry who builds or Improves theraon, entl who does such work
himself ar herselt or Ihmugh his or �er own emplayees, provided that such improvements ere not imentled or oNered lor sele. If, howaver, the building or improvement is
sold within one year of completion, the owner-builder will heve ihe burden of proving ihat he or she did not Cuild or improve for purposa of sale.). �
❑ I, as owner oi the property, am EXCLUSIVEIY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Professions
Code: The cantractars License Lew tloes not appy to en owner ot pmperty who bulltls or Improves t�ereon, entl who conirects lar such prolect with a contrector(s)
license pursuant to the Contractors License Lews.�.
❑ I em ezempt under sec. Business end Prolessions Code lor this reason:
Signature: Date:
Owner ID verilied by drivers license. ❑ Yes ❑ No DnvefS LltenSe No. Expires:
Verifiwtion of Ownership by (rype of tlocumeni, i.e. - propeny tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION:
❑ I hereby certify that no excavatlon five (5) or more leet in depth inm which e person Is required to descend, will be made in connection with work euthonzetl by this
permit, and that no huilding siructure, scattolding, lelsework, or demolition or tlismantling ihereof, will ba more ihan thirty-siz (36) feet �igh. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomia Atlministrative Code).
❑ As owner-builder, I will not employ enyone to do work which would require a permit irom the Division of Industrial Safety, as noted ebave, unless such person hes e
permit to do such work trom the division.
SignaWre: Date:
Division of Industrial Safery Permit Number:
COOE �, INSPECTIONTYGE
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Finel Re-Roof
201 FInaI B1ocWRetalning Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
PAIE ItII�ALfl
y !O -a5��
COUE 1 INSPECTION TYVE
206 Final Mechanicel
20B
210
212
220
Finel Plumbing
Finel ElecMcal
Finel Fire Prevenifon
Flnel Planning Approval
222 Final Site
250 Final Builaing/Occupency
f��CYInL14.
�..
r
Hr. Nelse K. Shepard �
2751 De Sota Avenua '
Costa Mesa, Califoraia 92626
November 1, 1972
�
Dear Sirs
A building pe it has been iesued Irvine Poole to eonatruet
a private swimming�ool on your propnst .
In oider that your�p 1 will be a sefe one and for the purpose
of advising you of your rea sibility reEarding tha requirements
� of the Costa t�leaa,Muniotoal C � we refer you to Seetlon 8107, a
� copy of Which� is ��tac�. i
i ' i ''
Thia leLtar dir�ected to you in order that yo�i will be aware
of ouz ordiaaace��n make a complete safety check oF your pool
area. - ., - �
RHscb
Sincerely yodre�
1
RICNARD HANHART
Building Safeey Director
� ��2� '''1`pF
v.=�� �°2
TESTING
Laboratories �f : s�t��f=�= c'�l��faZ,=«i, �,Z�.
P.O. BO% V. 3310 nIRPORi wnY . LONG B[�CH, C�LIF. 90001 . �1i7� +t6�3355 . �t17� e36�27Bb . �71a) 878�6�32
pAnNC� O�qCES.
isi. o ue,m H.�o., s•,.., r+., o.n..n... r.,.,.y
5.,�.n.eC.'io....o]�a) �%a'••��'•, n55o.do,den..roeo..�
11��) AL106 � j � �'q' �a^q ��e�e, Cs41, v4801 �10� EJA�SIBe
+�.. � �f P
Novembar 29, 197Z
�
Examination: SC72-7$14
COMPRESSION TESTS ON GUNITE CYIINDERS
L. E. Sprague
1411 Windemere Lane
Tusttn, Callfornla 92680
PROJECT S��fmnfng Pool for NELS SHEPPARD
ADORE55 2752 De Soto, Costa Mesa
SAMP�p FIiOM �� Bond Beam: U2 Shallow End: d3 Deep End
ARCMIflCT
ENOINEEN
MIX
DATE CAST
DATE 7ESTED
CYIINDER NO.
COMPRESSION
TOTAL LOAD, 185.
POUNqS PER SQ. IN.
SIZE:
COMPIIANCE
Gunite
i1-21-72
II-28-72
CONTN�CTOM
Irvine Pools
SUlCONTN.4CTOR
SPECIFIED
STRENGTN
SLUMP
11-28-72
1 2
7-Day 7-Day
94,500 87,500
3,208 3,228
6-1/8" x 12-1/2" 5-7/8" x 12-I/4"
7-day [est complfes with spectffcations.
Permit �35621
2,000 p5i
11-28-72
lA "HOLD"
3 2A "HOLD"
3A "HOLD"
7-Day
77,000
2,725
6" x 12-1/4"
�M er DEIIVfRED !Y IECEIVFD ON
CYIINqERs L.E.Spragua LES 11-21-72
DIfT0.1�YT�ON:
��<r� �.sa BLdg. Dept. BUILDING SAFETY DEPT.
L. E. Sprague - 4
NOV 3 01912
`�'.-�-�-� ! -- �.
�LL PCPONTS �RE SU9MITTED �5 1NE COvfIDCNTI�I pPOVERlv O[ CLIEMiS. �UTMOa�2��lON iOP PUBLIC�TION O� OIIN aEPOPTS. CONCLVSIONS. OP EY.
TF�RS inOM On wCWwO�rvG iMEH IS AESIMVED vENO�MG Ouw WertTEN �PIROV�I �5 � MUTU�L vROT[CnOv TO CUENT9. TNE FUGIIC �NO OURSELVES
330��2 �,
�OWNER J���Axo,-rranK DAIt �->-��
JOB ADDRESS 2752 De Sota Avenue BUILDING PERMIT N0. 43632
GFNFRAI C(1NTRACTOR t.i; l �..,, e��n..; �re� nESLRIPTION ei WORK Patio Cover
�,11 �CTIONS
y s�. .
� c�s
M'ATER
�p�UGN PLUMBING
PROP. SWR. LINE HOUSE CON.
SPqINNLING SYSTEM
MISCELLAHEOUS
pOUGM HE�TING ANO AIR CONDITI
� TfMPOR4RY $ERVICf OR POLE
UNDERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS 5T!
F�OOR SYSTEM
BOND BERM [� �STEEL REINfI
SNEATHING
FqqME ANO FLFSMING
IqTNING - IN � OUT n
PLRSTER,BROWN COAT
`�RUCTURAL, FINFL
TING, VENT., REFRIG. ANO �.
PLUMBIHG, FIN4L �N� WS TEST
E�ECTRIC, FINAL
BUILOING.FINAL
�e«�ei pcnllleFMCNTS
SUBCONTRACTOR
� � 43632
� COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
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For Applicant to Fill in Completely — Use Ink Only
BUILDING > /
AD�FESS i. i S Y II e Si_'/ � _
OWNER
MAIL
GTY ( AS/I /YV.OA NOL�IC�%
�i/�O �'�
BFANCH
ADDRESS
ARCHITECT � � . ... M� ! TEL.
CONTRACTOR rj�I � ISi:'� � SfG��A�J�o
ADDRESS �� �dO.Se /�'OT��' ^�V�
� U%✓�R�^ ��% NOL�3��
CITV
l C NO. �� S Z�G �ILVNO.
S12E a FX q3 NOW ON LO�T
OF LOT ��> > /
VSE OF �7
EXISTING BLDG. /L /
Separate permics are required Eoc
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERPORMED
I ha�eby acknOwl�dps thet I heva �aeC thia epplleeNon entl stnte
mec me ebova Informetlon Is eorract and apree io comply wiM
ell lewa rpuletin0 bulldlnp conrtructlon, entl I�hall not employ
eny penon in vlolatlon of the workman's eompanaetion laws oi
Me Steta of Cellfornia.
I �eraby cartify thet I em provarly Ilcan�etl os a contrector untlar
Me Smts of Celifornle Bu�lneu entl P�ofacsione Cotle, Divl�lon 3,
Chaptar 9, entl thet �ueh Iiean�e� ere in tult fareo ontl affoet, or 1
em axempt from ty�ovlslon� of the Stete of Californle eu�lnau
entl Profau� n� G6de vl�lon 3, f a ter 9.
SlpnMura of/ � ��G�.
PBfT�tSN ��
Authorizatl ABent
PAib :::tirb
'��R -�-77�M�.0� 55?� 17.00
APPLICATION FOR STRUCfURAL PERM[T
RE{.��yqD BV DPTEBECEIVED �TF�aciior
A.P. NO. �YI ^� S�I l �/ I�✓!O V 1
BUILDING p �7 7 � ,D�liJ /l�._
ADDRESS �— /y � /J
TRACT��B�� LOTS BLOCK
i"r f}sc/� k v
. . J / VALUE
FIRE
20NE
APPROVED
BV
20 F� NO.OF Z
��r PLANS—
VAROS APPROVED
MAIN BUILDING
(PROM GL STREET)
DI5TANCE BET
APPROVED
DATE � Ny ��
/�1 i.. c.�.w � i;. w+ �
JSE OF NEW /tT0
3UILDING� �{/'/�%/A'G
VAR�SAPPROVED
ACCESSORV BUILDING
FT. I
r
FT
G !r( F..e:�
� e�K
FT. �
BET. MAIN &
ACC65. BLDGS.
DATE
APPROVED
---- 3 -9_7 i
THE AMOUNTSHOWN UNDER VAIUATION
TNE PURPOSE OF ESTABLISNINO A PERMIT FEE
VALUATION PERMIT FEE 5 � �
�� PLAN CMECK S
s /01 � ` TAX S
TOTALPAID §
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� OWNER . c
1JOB ADDRESS
GENERAL C0�
� No. i4i—E
?ECTIONS
Pool Location
Forms
Main Drain _
Steel Rsinforce
Elec. Bond
.�
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines ahd Recep.
Electrical Final _
Heater and Vent Final _
ter System Final
Backwash and Recep. Final
�1:7[�II
DATE 1
BUILDING
FIRE ZONE VA�UE
GROUP TYPE
SUBCONTRACTOR
E lectr ic
�
%L Plumbing
7Z �ti�.N
Fencing Final �� 7Jr�T�
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' 35621
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFOHNIA 92626
For Applicant to Fill in Completely
BUILDING ��C� ^^�Y ��
AODRESS �J ( x'� �C,J( (�
OWNEP �}El�� � - SI ����
AOORESS G /��� ���,/� tJ �
CITY ���""�A �T.Cf4 NOL�f'T.�
BRANCH
ADDRESS L},�)L
CONTRACTOR �Q
ADORESS �O `
��T� �.�Pn�
STATE
LIC. NO. p�.��
SIZE
OF LOT
USE OF ,/��
EXISTING BLDG. �j_j
SIZE OF
NEW BLDG.
EXTERIOR WALL
COVEFING
USE OF BUIIDING AN
NO.OF
ROOMS
ROOF
( NO�SS( JOC
CITY a358
IIC. NO
INO.OF L8�
NOW ON LOT
I hereby ecknowletlBe that I have reatl this application antl state
Shet tha above info�mat�on is co��ect antl apree to comply with
ell laws reguleting builCinB construction, untl I shall not employ
any petson in violation of tha wOrkman's compansatiOn laws of
the Stata of Calilomia.
I hereCy certlfy Mat I arn p�oparly licensetl as a connector untler
the State ol California 8usiness antl Proteszions Cotle, Divisicn 3,
C�apter 9, antl thet such licenses are in full forca antl effaet, or I
om euempt from the prOvisions ol the State oi California Business
antl Profazsions Code, Divislon 3, Chepter 9.
�
Sipnature af
Permittee � _ Ll�n�`�
AuthorixedAOent ��v1�� ����
or,r 3p-�2�M;°OOi2soR��***34.68
APPLICATION FOR BUILDING PERMIT
:EIVJDBV DAT�REC�IVED nnTFissui
BVILDING
ADDRESS
BLOCK
t�yELSE 5-��'t�A'�D
_ . _ . c�.. _. VALUE ..� �.c
N NO.OF USE OK NEW ((J/�!
PLANS .�.� BUILDING .p �
VARDSAPPROVED VARDSAPPROVED
MAINBUILDING ACCESSORVBUILDI
DSTANCEBET
MAIN BLDCS.
VAR. #
C.U.P.qW
APPROV ED I ,
BET. MAIN &
ACCE�. BLO
�ATE
THE AMOUNTSHOWN UNDER VA
THE PVRP�E OF ESiABLISNING A P
VALVATION
PERMIT FEE :
$ Z�� _PLAN CHECK 9
:i�
il� e
O
lI�N FOR '
t ONLV: ¢
'�,�.�'-v r
�
// � E
� . v�tJ "
, � � r 1885
C�STA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA M�A. CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
BUILDING _—__ .. �. . .
� MAIL
� ARCXITECf
� STATE
COSTA MESA CALIFORNIA
aM1 _ � COS4A1 N *$*���'2.SQ
' A -fi ( P�ivv�� 64=
�.cosr� .. .. ..._._
APPLICATION FOR PERMIT
BUI6DING
For Offiee Use Only
rtacelrr No. r@R
R6CeIVE BY CASB PE IV! DATH �64IIED
E Cda t Hwv � ,�'-�-�3 , f9 ;
TEL. BUILDING
NO.OR I qODRE65
.. R,...lkir (`.� TmEn'(1R 1L99n COSTA MESA. CALIFORNIA
NO. OF
98TBACK LINB PROM '1
CeNi6q oP BTIieLT SO � REAR YARD 31 �
SIDE YARD LEFf l� IRIGHT 6�
DESCRIPTION OF WORK
1 _(�II en�nuc
PERFORMED
ZONING
ZONB NO. OP q U8H OF N
�" `PLAN9 / BUIIDINO
f•'
LEOAL � . � � _ i
(C8M8R LINB 6T.1
APPROVED
S
I N8P6BY ACNNOWL¢DGE iHAT 1 HAVE REAO TN18 APPLJGTION THE AMOUM BXOWN UNUEP VALUATION 18 FOR THE
AND BTATB TNAT TX8 ABOVE IB COqR¢Ci AND AGREE TO COM- pUqPOBE OP C6T�BL19HIN0 A PERMIT FEE ONLY.
PLY WITX ALL CIiY ORDINANG¢9 ANV BTATE UWe ftEQULATINO
BUIlDINO CON6TRUCTION. VALl1AT10N �J
81GNATURE OF PERMIT FEE 8 /`� �� Q
PERMI7TC Mesa Del Mar Development Co. -
B •^- / �� �/ /�/ 8�Z3�9Z5.QO PLAN CHECK $� J�i,s�
AUTNORIZED AGE i•.f`�. .. !N �'/�/J .. w.... i� i L'Y
0