HomeMy WebLinkAbout2448 ELDEN AVE - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626
1ob Address: 2448 ELDEN AV
Suite No
Vicinity:
Parcel Nunmber. 43929104
App�icant: GRODSKI, STEVE
Address: 2737 S CRODDY .
SANTA ANA, CA
Owner: GRUBB, STEVEN J
Address 10272 NIAGRA DR
HUNTINGTON BEACH, CA
PLUMBING PERMIT
Phone: 714-241-1414
Zip: 92704
Phone: 714-968-7442
Zip: 92646
Contractor: COAST ROOTER PLUMING HEATING & AIR CONDITIONING
Address: 2737 S CRODDY STE D '
Arch / Eng :
Address:
SANTA ANA, CA
Phone: (714)241-1414
Zip: 92�04
License: 529127
� ,_ . � . . _-• �. ._
WATER HEATER CHANGE OUT
ISSUE PEE � �
Backflow irrigation �
Backflow Preventer
Bathtub
Clarifer System .
Connect (Ice,Soda,etc)
Dental Units
Dishwa5her
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas EaAhquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
50.00
$0.00
$0.00
S0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
Phone:
Zip: � , �
License:
SCOPE OF PERMIT
FEE SUMMARY
-' AMT �� QTY
laundry Tub / Washer " $0.00 �0
Landscape Irrigation _ � $0.00 0
P-Trap $0.00 0
Pressure Regulator $0.00 0
Process Piping (per 10 ft) $0.00 0
Receptors $0.00 0
SepticTank $0.00 0
Sewer Cap for Demo $0.00 0
Sewer Connect $0.00 0
Sewer Private Line $0.00 0
Shower . , , $0.00 0
Sink, bar $0.00 0
Sink, wmmercia� . $0.00 - 0
Sink, Floor $0.00 0
Sink, kitchen $0.00 0
Sink, service/mop $0.00 0
Spa (private) $0.00 0
Spa (public) $0.00 0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 12/132001
Issued: 12/14/2001
ISSUED BY: /\�C�
'
�
///
�ti.
�'
SumpPump
Swimming Pool
Trap Primer �
Urinal
Vacuum &kr BkOow(7-4)
Vacuum Brkr Bkflow(5+)
Wash Basin �
Wash Basin Set
Waste and Vent System
Water Closet (Toileq
Water Heater / veN
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
50.00
50.00
50.00
50.00
$0.00
50.00
50.00
$0.00
50.00
50.00
$12.30
50.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
$0.00
TOTAL CALCULATED FEES: $35.60
aTY
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
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, § 7, 1241-92)
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 penod 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
requtred inspectlons and itnal 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
zsauas �frm�
WORKERS' COMPENSATION DECLAAAnON:
I hereby aNirtn untler penalty oi perjury one ol the following declarations:
❑ I eve end will malntain a cenificate of consent �o selbinsure for workers' compensation, es provitletl for by section 3700 ot the Lebor Code, tor the peAortnance of Ihe
ork tor which this pertnit Is Issuetl.
I hava antl wlll meimain workers' compensation insurance, es reQuired by section 3700 of the Labor Code, Por the pertortnance oi ihe work for which ihis pertnit is issued.
My workers' compensatlon Insurance cerrler and policy number ere:
Cerrier: Policy Number:
(This section need not be complefed i! the permJt /s velued ef one hundred dollers ($100) or less.)
❑ I certify thet in the pedormence e rk br which this pertni� is issued, I shall not employ any parson in any manner so es to become subjact to ihe workere'
compensation laws ol Galifornl , and re �hat if I hppp��� Id become subiect to ihe workers' compensation provisions of Sectlon 3700m the Lab r Cotle, 1 shall fonhwith
comply with ihese provisions. � I/� �' �� ��
Applicant Signature: . Date: L
WARNINO: FAILURE TO SECURE WORKER CO ENSATION COVEPAGE IS UNLAWFOL AND SMALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIE AND CIVIL FINES UP TOONE HUNDRED
THOUSANDDOLLARE(5100,OW),INAODITI �07HECOSTOFCOMPENSATION,DAMAGESASPROVIDEDf-0RINSECTION3]O60FTHELABORCODE,IMEREST,ANDATTORNEY'SFEES.
LICENSEO CONTRACTORS DECLARATION:
I hereDy ettirm that I am licensetl untlar o sic
force antl eHecL Lic, a
Contractor's SignaNre:
9(commencing with Sectlon 7000) ol Division 3 of Ihe Business and Professlons Code, entl my licensa is in full
CI855 M
Da�e: _ _ ( �
CONSTRUCTION LENDING AGENCY;
❑ I �ereby ettirtn that Ihere is a consWction lending agency for the perfortnance ot the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Neme:
Signawre: _
OWNER•BUILDER DECLARA710NS:
Lentler s Atldress:
Date:
I here6y eNirm �hat under penalry of perlury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Busineu and Professions
Code: Any ciry or counry which requires a permit 10 cons�ruct, elter, improve, tlemolish, or repair any 5trucWre, prior to its issuance, also requires lhe applicant tor such pevmit
to tile a signed stetement that �e or she is Iicensed pureuant to ihe provisions of the Contraaors License Law (Chapter 9(wmmendng with Section 7000) ot Division 3 of the
Business and Pmtessions Code) or that he or she is eaempt therelrom and the basis for the elleged exemption. Any videtion of Section 7031.5 by eny epPlicant for a pertnit
subjects ihe applicant to �a civil penelry o� not more then five hundred tlollars (5500).):
❑ I, as owner of Iha properry; or my employees wlih wages as thelr sole compensation, WILL 00 THE WORK, antl ihe siructure Is not Intendetl or oMeretl for sele (Sec.
7044, Business and Professions Ceda: Tha Conlrac�ors License Ww does not apply �o an owner of properry who builds or improves thereon, antl w�o tices such work
himself or herself or lhrough his o� hei own�employees, pmvided ihat such improvements ere not imentletl or offered for sale. If, however, ihe building or improvemeni is
sold within one year of completion. �he owner�Guilder will have the burden of proving ihat he or she did not build or improve lor purpose o� sale.�. �
❑ I, es owner ot (he DroOetly, em EXCLUSWELY CONTRACTING WITH LICENSED CONTRACTORS to consiruc� �ha project (Sec. 7044, Business antl Professions
Cotle: The contractors License Lew does not epply to en owner of praperty who bullds or Improves ihereon, antl who contracts br such project wit� a contractor(s)
license pursuent to the Contrectors License laws.).
❑ I em axempt untler sec.
SignaWre:
Owner ID varified by dnver's license. ❑ �es ❑ No
Business and Professions Code for this reason:
Venfication of Ownership by (type ol documem, i.e. - property tax �ill or deed):
DIVISION OF INDUSTRIAL SAFETY PEAMIT CERTIFICATON:
Dnvers License No.
Date:
Expires:
❑ I hereby certify ihe� no eacavetion five (5) a more fee� in tlep�h into which e person is required to descand, will be metle in co�nection wiN work eu�horized 6y this
permit, antl that no builtling siructure, scaHolding, falsework, or demolition or dismantting Ihereof, will be more than thirty-slx (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, TUe 8, Calitomla Adminisirati�e Code).
❑ As ownerbuilder, I will not employ enyone to tlo work which would require a permit fmm the Oivision of Industnel Sefery, es notetl ebove, unless such person has e
permit to tlo such work trom ihe tli�ision.
Signature: Date:
Division oi Intlustrial Safety Permit Number:
CERTiFlCATE OF COMPLIANCE AND A�MORIZA710N OF ENTAY: I certiy under penalry of perjury that I have read ihis epplication and state that ihe information given is
correct I agree to comply with all s;ate laws end city ordinances relating to building construciion, entl authodze representetives ol the qry of Coste Mesa to enter upon Ihe
flbove-descnbed properry for inspection purposes. I egree not to occupy or allow occupancy of any building authanzed by this permit until final inspection.
CO�E t. INSPECTIONTYVE
1616 Fixetl System Final Fire Prevenlion
1266 Pool Spe Final
200 Final Re-Rool
201 Final8locWReteining Well
202 Final Fectory Fita Plece
203 Final Sign
203 Final Demolition
� ,�
�: :
Q�jF 7�R�$ y_Qpg( INSPECTIONTVPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Finel Fire Prevention
220 Final Plan�ing Approval
222 Final Site
250 Finel BuildincyOccupancy
PdIE I[�LS
7NOJECT ADOflE55: z Q Q 8 ELD EN AV
OWNEfl'SNAME: DAVIS DALE
noosess: Z q q g �LDEN AVE
UNIT B3
COSTA MESA, CA 92627
714 695-9145
AflCMIENGINEEH:
AOOHESS:
HEC.NO.:
uwT: H 3
UNIT:
PEXMITTEE: NOCK PLUMBING ( 714 ) 895-1246
aooness: 11610 SEABOARD CIR
STANTUN CA 90680
LICENSED CONTBACTOfl OECUIBATION: I �¢re�y aflirm IAai I am li[ensetl unCer O�ovisions o� C�ap�er 9(cOmmencing wilA Section
]000) ol Oivision 3 0l the Business antl Pmlessions CoOe. ana my license is in full torce antl eilecl.
c�rr uc.: 0q 5 3 8 6 STRTE LIC.: S S S 9% S c ss: 6
_� ` SignaWre: _�
� ,BREPS' COmPENSATIUN OECIABpT10N: I nere�y allirm that I have a cehifica�e of consent to sell�insure or a cetlificate o1 workers'
�om0ensation Insi ra c 9,r cj�nif�eQ coOY ihereof (Seclian 9800, Lab. 1
POLICY N�.: S��� 7� L J V EXP. DRTE: j I O I� 9 S
comrnNr: STATE ,q
❑ Cerlilie cop/y ^is herehy Iumi5�e0. L�Y Certilied CODV is liled wit� Ihe ciry Buildin,g/ DiviSion.
. . � _ V � C� I AOVlicani: ����� ✓ (/
E%EMPTION FRUM WOBHEAS' COMPENSATION OECLAflATION: (Thi55eciion nee4 noi be compleleU il �he permi� is brone huntlretl (51W) or less�.
I ceriify that in I�e pedarmance ol Ihe work lar w�ich Ihis permit is issued, I s�all not employ any persan in any manner so as lo become
su�lect lo Ihe Worker5' Comp¢n5aiion Laws ol Calibmia.
Oa�e: Signamre: '
NOTICE: II, aller making Ihis Oeclaration, you s�ould become sublec� b Ue Workers' Compensation provisions o� Ihe Labor
Code, you musi for�hwi�h compty with suc� pmvisions or �his permi� shall �e tleemed revake0.
CONSTNUCTION LENOINC AGENCY: I �ereby al�irm ihai there is a conslmc�ion IenUing agency �or the pedOrmance o� Ihe work �or
whic� I�is pe�mit is issue0 (Section 3097. Civ. C�.
LENOEH:
nooaess:
OWNEB BWlOEB OECLAHRTION: I hereby allirm IAat I am exempt Irom i�e Convamors' State License Law for t�e following reason
(Section 7031.5 Business an0 Prolessional Code'. Any ciry ol coun�y w�ich requires a permi� to consbuct, al�er, imD�o�e. demolish, or
repair any Slruciure. prior Io its issuance, also requires Ihe applicant �or such permii to file a signetl s�a�ement t�a� helshe is licensetl
^�vSuanitolAe Omvisi0n5 O��he COnira[Iors' Slaie LiCense Law�Cha0�er9(commencinB wi�h SeCliOn 7000)o�Division 3 o�lhe Business
Prolessfons Cotle) or t�a� he/she is exempt Ihere�rom an0 I�e Uasis lor ��e alleAeO exemption. Any violation ol Seciion 703L5 by
applicanl lor a permii sublec�5 the applicanl Io a civil penal�y ol not more I�an �ive hundre0 Aollars (5500�.
I, as owner ol ine pmDeny ar my employees wilh wages as iheir sole compensation, will tlo ihe work, antl the
❑ svucture is not intenaea or oiferea for sale (Section 70a4, Business antl Pmiessional Cotle: The Cantractars' State License Law
aoes noi appty to an owner oi a pmDeny wAo huiltls ar impmves ihereon, anE w�o tloes such work himsell/herself or ihrough
�is oi �er own emDloyees, pwvitleE that suc� impmvemems are not intentlea or ollereC lor sale. If, Aowever the OuilOing or
imD�ovement is solA within one year ol comple�ion, ihe owner will �ave I�e burden of proving he/she did not huild or impmve
lor �ne purpose ol salel.
I, as owner ol Ihe o�openy. am exclusiveiy coniractinA'n'i1h licensetl coniractors to consimct tlle pmject (Sectian 7004, Business
❑ and Pmlession5 COOe: T�¢ Cqnlracl0r5' Slaie LitenSe Law tl0e5 nol apPM �o an owner o� pmDeM `�'� �mlAs ar imDmves lhere0n
an0 who convac�s lor suc� pmjects wi�h a comracmr(s)license Dursuan�to the Comractors' State License Law). I am aware
Ihal pmol ol IM1eir Worker'S Compensa�ion insurance ShoulJ be D�ovide0 b me.
� I am cxempi under Sectian: B. 8 P. C.
lar this reason:
Date: Ownec
I ao nereby cenity inat I am aware ol ana unaerslanA Ihe repuiremenls ol Caldomia Health ane Salety Coae Sections 2550.5, 25533, ana
2553d antl Ihal I or any �Wur¢ EuilOing accupanl vnlVvnll not (CirGe One) need to campty wiih SaiA s�a�e codes anE ��e requirements �or a
permil �or conslmclion or mOEilicalion irom I�e Air Oualily Managemenl Distn[I. fleSfGeniial fAnSimction aOP�itatians are exemD� ��om
IA¢SC P�Ovi5i005.
Oa�e: ADOlitanl:
1 �er¢Oy certify Ihal I have reatl I�is ap0licalion an0 s�ale tlwl I�e aUove inloimalion is wrrec�. 1 aA�ee �o comON �'^�h all city ana counry
ordinances anU siale laws relaling Io UuilOmg cons�mdion antl �ereby aWharke reprejjemal 5 0� I�is city to enier upon the above�men�ioned
O�opetly lo inspec�c� pwposes. ��
�r Z� ZS' I� I Signature: �,/
o�i�er's �icense or Socia� secudiy
t6ab<6 Wbite—Builtling; Green—CoOe En�orcemanC Canary—App4canl: Pink—Revenue: Goldenrotl—Assessor
_ CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 09
PERMIT NO: P 051099 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : CHANGE OUT DISH47ASHER SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-1 /
COMMENTS: CHANGE OUT OF DISHWASHER
*��e�**�r��*�*�*�***�*�e***�r***�e�e*+�**x�r*******�rx**�*******�r**x��***�r�*+�*****x x+��+�+e
Z O N I N G R E Q U I R E M E N T S
sErBAcxs
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REO• PROV; PARCEL: 43929104 ZNE: REF NO:
PLANNING N151'ES>
i
if 3f IE iF *�f iE �E if iF �E If �k iE iE iE if 1F 1E �If If If �EiF1E it 1E if IF 1k k if iF if iF k�E iE iF M 1E k If iE 1! ff 1E if iF M k if iE �k If iFiE if iF if 1E Ik �f 1E if k iF 1f iF iE if if iF 3F �E �E if iE iF
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED HY • DATE;
APPLICATION ISSUED BY•���a�� DATE• ,��'��
ikiFifiFifif%ifififiFiFiFiF�MIklfifiFifkiE iF'iF�7F7f�F3F1EiFiFiFiFlEKif�fiE 'iF'�iF1E�F
iEiE1F�lEikiFiFif�fifiElFMifiEjfiFaF1E3EKiFiEiE�E1f1FiEiFiEiF�FiFiEiFlEifif if±E1E1E1fiEiflfiEafi6lEifififlffEiElf1E*iEalifltiF*3fif�E3f)EjFifiFiflF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTAIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 2 00
�152 � ' SMIP/NON—RES
PLAN ,.
ISSUE FEE 3.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2.00 3.00 0.00 5.00 5.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 5,00 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
5.00
if ik k if if �k 1E iF �f iF iE 1f if �E iE If iE iF iF if iE if iF iE k if if 1E if iE 1E �F if 1E 1E iF IF iF if jf if k�E k iF if k�f k!F iF 1E iE 1E If If if 1f IF if 1f iE±E iF iE k iF 1F IE 1F 3f if 1F 1f #E If iF IE �f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 DISHWASHER � 2,OU 2,00
END OF FEES
\1
o� �oas�.�s-cc�tsa�� ti c:-r -...
flATE: �13J1?/91 1_TFiE: 'eo�2y
CONSTRUCTION AND PLAi, .G POOI & SPA ��
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole_�_; 52. Pool & Equipment Location -
2. Soil_Plpe•Undrgrnd. �� ��� 53. Steel Reinforcement
.��3.�•Ele�trical Cond'uiY�l.�ility-l�ndrgrn�. �� 54. Forms
��4; EjectriealCo�duit��OPdrgrnd. 4 55. Elect�ical8o�ding
�' 5-Sieel; ReintorcemB�f ,� 56. Rough Plumbing & Pressure Test
�i 6..�lecirical UFEFi,Grnd. ' 57. APPROVAL TO COVER�GUNITE .
: •r
.,. 7...Footirigs �;S E`_ 58. Electrical Conduit-Undrgrnd. '"
�l 8. Fo ndation � 59. Gas Pipe, O Undrgrnd., Test ,
9. WatOr Pipe�Undrgmd. � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System . w 67. APPROVAL TO DECK
1 i. Property Sewer Lirt2& House Connection 62. Backwash & Receptor-Final
72. Sewer Cap "
c. .. ... 63. Heater & Vent-Final
13. Roof Drains �= 64. Plumbing SYstem � Final
.-. r
74. Rough Plumbirig ` 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. Fough Electric3J-T Bar Ceiling 69. POOI/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- ' ' - C tn. :t1':-' 3'. . "
20�Rough Factory Riieplace ' ��'� y'"` " " "�' � TAPPROVA4$�J�Per7"nit # " '' ~
�, m S T_-x i Sh' �..eL :. � - _'` '• '.. o: ���,-„- �-T
21 _�Ducis, in�Str �ctuF'e : `-. .. ;:,.� e S _ _ k �• �;..�, � i :
N . s :70. Undergroand Hytlro
22. Du�{5, Venti{etirig; � � �,�.�„ T S `t�" `77, product`�pwing O��i�as �Oil
. -'� t i s r �, x S rl;.
:�:>. i `-.. ' . "
23.`;Gas.Pipe�-Rough$��Test , h� ; r; s 'y �. ; _72. UndergroundFlush� • �
24.cRoof Freming � } . . • ' _� - �- �+ �73:�Undergrnd'.Storages.Tank:L7Gas.00il
25. Roof Sheathing ,- �� :,; ' �° `- ;;;. ± ~ � :
74;;�Overhead f-lydro_ `
26._T�Bar Ceiling �Struoturaq &`M000coat _ T � � ._� � •� 75YT.Dry Chemical � -' �
27. �Frame and Flashin e '• .
9, -�,<<x. ;, '� ,. , 76. Dry StandPlRe -�ii� - a � w
� QB.� Lathing & Siding= s r�� :�:C i w �' •• �-y + 77," FIXED SY$TEM�FI�AL' � 't
' 29. Insulatiqn ' .� �� �� .. � '� � h� � 76:;FIRE PREV. FINAL � � . C�'
i, - � - � - � � - -` - -
.T30. Drywall;Nailing'U� a � •HEALTH=DEPTeREQUIREMENT
c r,.�
'�'37. Plaster Brow� Co�dt: � ,,. r j � .'; ; r79"'FIN'AL'flS1SPECTIQN - '
� 32.:Electrical Power.Metet: Final� � � t; ��. :r r$O:rF00D CER71FlCATE ISSUED
33`.�Finaf Elgctric "� .,, � ;. , ' � � � �/ � � ' Notes:� ,. � P� � 1
*l •1 J, a . � " • . , - .>.
••34.-Final Heating;& AirtConditioning � �+ � � , ' i ,. - 5 �
- .r
35�'Final Gas Pipe-Test' _ - _ . _ ,�� ` '
p� � ''�, - �.
„36:�Hood or Canopy '. - , i . '. i ,y. + s; ^ G
- , ,.
37.-Firial Factory Fireplacex � -� � �� �6 '� � '
F � i•
` . •.i: . .. .. ., ,, , y .
-38. Final Plumbing , i �(� � • • ��'
'39. WatCr Service-Final-^ ? � 'i � i , � r ;1 , r ,.
;40. GasService-Final � " � � . "
�� �L�- S 'h � n r , _ �i:
541. Solar pomestic�Final'_ •• _ � R �'� '2 -
'„ :� r �r . .-
+ - N . .� � � � - � .>
•'42:'Backflow Preventer� � �,r - .
43. Backflow Irr�igation° ���-- • �r�' - '�
- U "
, 44. Landsca e Irii ation S stem ''''' . - � -- _ -
P 9 Y .� r�: i ' � :J -
>'45..`Sound Atteouation l!-4 *' � � • • ' '�'' '
��, �nt - ^7
_46.-HandicaP Regulations ' '� ' �� � � � ;. '' � ' - '
. �: i �
��47: FINAL STRUCTURE & BUfLDING ` . � � �?. R . .> > �
� - _.
48:_FINAL PLANNING ' ° `� � ` ' } =
- : . �. .
_.49._ Electric Release to Edison . �. � �' � • %' �i, � •
n ^ -
"50._Gas Release to Souihem California Gas Co ; � I y;I� ;�' ` ;';� p .
: 51. CER7IFICATE OF pCCUPANCY , ; :� � ij ,: . ;� �,
No. Date
YECF PO�BESS: Z 9 4 B ELD EN AV
I,WNEfl'SNAME: WILK, CHET TR
aooeess: 459, LENWOOP CIR
COSTA MES"A,CA
714) 646-2087
pFCH/ENGINEEH: .
aooaess:
92627
NEG.NO.:
u"�T I : . CITY OF COSTA MESA —, HUILDING PERMIT PERM NO; B U6821.i
PERMIT NO: B 068217 PLAN CI-IECK NO; N GOVT: N SUPP: N
uxiT:
rEaMiTTee: FAIRWEATHER ROOFING (719)997-9949
aooness: 3845 E. CASSELLE AVE
ORANGE CA 92669
LICENSEU CONTflACTOB OECLAflATION: I hereby afhrm �hat I am licensetl untler D�ovisions o� Chap�er 9(commencing wi�A Section
7000) ol Urvismn 3 0l i�e 6usiness and Professions Cotle, antl my license is m full torce and ef�ec�.
ciTruc.: Oa78'8 STATELIC.:SISSZS ss: �—,99 EXP; 00/00 .
�ale'. �lZ� � Signature:. �� .
WOBNEBS' COMPENSA710N UECIAHATION: I hereby allirm t�at I have a certiticate oi consent m selbinsure or a cetlificate ol Workers'
ComDensation Insurance, or a certihetl copY �hereof (Section 3800. LaU. C).
POIICV NO.: E%P. OATE:
COMPpNV:
❑ CeNhetl CopY �5 �ereby lurnished. ❑` Ce�ified coOY �s IileA with �he ciry Builtling Division.
.te: ADPlicant
E%EMPTIONFBOMWOHKEPS'COMPENSATIONOECUflATION: RhiSsectionneetlnalbecomple�eUi�Nepermi�isloroneAundr¢d�5100�orless�.
I cetlify t�at in Ihe pedormance oi ihe work for w�ich this permi� is issued I s�all no1 employ any Derson in any manner so as to become
5ubjeci lo Ih orkers Compensalion Laws ol Califomia. ,Q� A
� �ate: ? Z � Signa�ure: �i/U/�/ ���
NOTIC : If. af�er making Ihis Aeclaraiion, you shoulA hecome su�l� ect to ei�orkers' Compensa�ion pmvisions of �he La�or
Coae. you must lort�with comDly wiih such pmvisions or Ihis permif shall be Ueemetl revokeE.
CONSTBOCTION LENOING pGENCV: I hereby affirm that there is a cons�mction lending agency for �he pedarmance of �Ae work lor
v�hich Ihis Dermi� is iuuetl (Section 3097. Civ. C).
LENOEfl:
aooxess:
OWNEX BWLOEfl DECIABBTION: I hereby alfirm Iha� I am exemp� imm the ConVacior5' S�a�e License Law far the following reason
(Seclion 7Q3t.5 Business anA Pmfessional Coae: Any city of county wnich requires a permit to constmct, alter, improve, Oemolish, or
repair any simcture. prior to ils issuance, also requires ine applicant for such permit to lile a signe0 statement that he/she is licensea
pursuam m Ihe pmvisions of Ihe Comraclors' S�a�e License Law (Chapter 9(commencing wi�h Sec�ian 7000) o� Division 3 oi �he Business
antl Pmfessions Catle) or thal he/she is evempt Ihere�mm anA Ihe basis lor �he alleged ecemption. Any viola�ion of Section 7031.5 Uy
any applicant for a permii suUjects t�e applicant �o a civil penalry oi not more than five huntlreG Ootlars (5500�.
I. as owner oi Ihe propetly or my employees with wages a5 �heir sole compensa�ion, will Oo the work, and Ihe
❑ SINCIOf¢IS OOIi0�C04Etl Of�flCfCtl�afShcE�$ECI10lI 7044, BOSIIIC55 df1A Pf0�C5510fIdi�OtlC: Th¢ �OIII(dC�OfS $ld(E LICCtISE LdW
tl0e5 nol apply m an owner of a pmpenV who bui105 Or improves thereon, an0 who d0e5 Suth work himsel�/hef5ell of �hfoug� �
his or her own employees, pmvi0etl that such impmvemenis are not intentled or offere0 for sale, Ii,.however ihe builAing or
impmvemenl is sold wilhin one year of completion, �he awner will have �he GurE¢n of pmving he/she tlid not build or impmve
tor �he Durpose ot sale).
I. as owner o� �he D�opehY. am eKCNsively comracling wit� licensetl comractors lo constmct Ihe pmlect (Section 704a. Business
L� and Professions COAe: T�e Contracmrs' S�ate LiCense Law tloe5 no� apply la an ownef 0� DrOperty w�o hui105 a� imD�m'¢5lhereon
and who comracisior such pmjecis wi�� a coniracroqs�license pursuam m ihe Coniracrors' State License Law). I am aware
�hat Dmol o� Iheir Warker's Compensation insurance shoul0 be D�oviaetl m me.
� I am exempl under Sec�wn: B. 8 P. C.
�or Ihis reason'.
�a�e'. Owner: '
I Oo �ereby cenify Iha� I am aware ol an0 untlerslan0lAe requiremems o� California Heal�h and Sa�ery Cotle Sections 2550.5, 25533, and
25534 antl ihat I or any IWure �uiltling occupan� will/will no� �circle one) need to comply wiih saitl sla�e coEes and IAe requirements �or a
permit tor conslmclion or motltlica�ion imm I�e Fir Quahty Managemen� �i5tricL Residen�ial cons�mc�ion applications are exem0� ��om
Ihese pmvisions. �
�ate: FpphcanP.
I hereby certity Ihal I have reaa this applicaiion an0 stale �hat �Ae above information is mrrect I aA�ee �o campty vn�h all cily and counry
ordinances nnd 51ate laws relaling io builtling constmclion and hereby aNhorize represenlatives oi lhis ciry io enter upon lhe above-men�ionetl
pwpeity br i� pecli n purposes. ��
� ��ale'. � ZG S 1 SignaWre � �
oriverS �icense or Sociai Seamv ,
16aba6 Whne—BoilEing; Green—Code Eniorrement: Canary—ApPliwnl; Pink—Revenue; Goltlenrotl—Assessor
CONSTRUCTION TYPE: 5—N ' PERMIT TYPE: STR PI7RPOSE:�ALT
JOB DESCRIPTION ; REROOF OVER EXIST. "1 LAYER " W/COMP. , SQ FT: � 3,000,
CLAIM VALUE: 3,000.00 CALC—VALUE: 3,000.00, GROUP OCC:,R-3 /M-1
COMMENTS: SMOKE DETECTORS REQUIRED PER 91 UBC, REROOF 3200SF RESID & GARAGE
**;�**�***+��***�*******�r**j:-k�r�+�*�tx�+��r*���***�r**�r�**��+�?���r*��t�t*�t�x��r�c*ar*�r,ru-*i:-�e*��r*x�
Z O N I N GS ERTEB�AUCIKRSE M E N T S -
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING -----,---
FRNT: FT IN REAR: FT IN FRNT: � FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT, IN
PARKING REQ; PROV; PARCEL: 43929104 2NE; REF NO:
PLANNING NOTES>
>
#*����**�+t***�*���**i��t*+t*��;�rx�**i��t#�-�r��Et�-**x**�**�*******ir*******���r*��?r##x*�i�x��x�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N.'T S
ZONING APPROVED BY LATE; :�^
BUILDING AFPROVEP BY ; � DATE: �'-- '
APPLICATION ISSUED BY: ��. DATE: +:.�J26'�7
ificiEiE*jEiF#i(�iE�EikiEiEiEiE�1F�FitiffEif x . +cx� iE3f#iF#iFjfitiElc��iFF�F?iF#1b
iE if if if iE iE iE i( �E iF if iE iE iF ik # 94 3f if it 3f 9f iE IF iE 1F if #�)E k jElF iE iF',E ib iF 3f iE IE 3E �f �)E if �74 iF jF jE if ?E 9f if if iF 1h iF �Flf �lF if iF'1E il� ik i(� �]f dE �IF jF i� iE if i�- if ;K iF iF if M'
LEGALIZATION:N F E E S U M M A R Y � STP,UCTURAL SEGMENT:Y
.�
BLD� PMT PLUMBING ELECTRIC MECHANIC FIRE�;., SMIP/RES GRADING
FERMIT 54.00
S�OK� D �� SMIP/NON—RES
PLAN
ISSUE FEE f7 C rr C T TOTAL �� PASD DUE
BUILDING—D�l'—> PERMIT ISSUE�.��m �, -���j�.E �R �
TOTALS 54 . 50 0.00 �I►�7�Q 54 . SO .,- 54 . 50 .00
REVENUE DIVISION TOTALS--> COLLECTED: °+*"�.OVER/SHORT; � 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO'� GRADING PLAN-CHECK
59 .00 .50`�,
#'� iF iE iE iE iE jE ih ib iE # jf if ?E if iE iF if iE iE it %iE if iE iF it iE iE it ih it iE it i! �F iE iE # iE it it i(� iE iE iE �1E it ## if if if 1E i! iE iE iE � P�iE iE iE it iE �E �It i! if iE iE jE �k 1f i.'- 3t it # iE ib
I N D I V I D 0 A L F E E H R E A K D�O W N '
TYPE QTY D E S C R I P T I O N UNIT::COST TOTAL COST
SFR 3000 REROOF HY VALUE RESIDENTIAL NOZONE 1;00 3,000,00
END OF FEES
.^1
C�I 001347Q3—OC11647�4 T�_lT
OA7E: �7/2619� TItfE: 1I:35
� �1
1
rt
54.50,
,`
� CONSTRUCTION AND PLANNING POOL 4
' APPROVALS Permit # Date Inspector APPROVALS Permit �k Date Inspector
1 '
1. Temporary Electriral Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steei Rziniorcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electricai Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcemenc 56. Rough Plum6ing & Pressura Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundatitln 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,'.-'� Undrgrnd.
70. Structural Ploor SYstem 67. APPROVAI TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Finai
72. Sewer Cap 63. Heater & Vent�Final
73. Roof Drains 64, Piumbing System - Final
74. Rough Plumbing 65. Electrica6Final
1
15. flough Electrical�Conduit 66. Solar System-Final
76. Rough EI¢ctric Wiring 67. Fencing & Access Approvai
17. Rough Wiring Sign 68. APPROVED FOR PLASTcRING
18. RoughElectrical-TBarCeiling 69. POOL;SPASYSTEMSFINAI.
19. Rough Heating & Air Conditioning FIRE DEPT. REQUtREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts,in Struciure 70. Underground Hydro
22. Ducts, Venr.tating 77. Product Piping Q Gas ❑ Oi1
23. Gas Pipe-Rough & Test 72 Underground FWsh
24. Roof Fram�ng 73. Undergrnd. Smraye Tank O Gas ❑ Oil
25. Roof Sheath(ng 74. Overhead Ffydro
26. T�Bar Ceilin9 (Structurall & Monocoat 75. Dry Chernical
27. Frameancl Flashing 76. Dry Standpipe
28. Lathing & Sidinq 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Dryrvall Nailing .� HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. Ftn;:1L INSPECTION
32. Electrical Powzr MeterFinal 80. FOOD CEf:'fIFICATE ISSUED
33. Final Bectric Notes: ��_ � �
34. Final Heating & Air Conditioning �-� :;;
35. F(nal Gas P�Pe�Test - � r1� �,.�•
36. Hood or Canopy �r�^, (j�
37. Final Factory Fireptace l �-"
38. Final P�umbing
39. Water Service-Final ` •
J^ �
40. Gas Service-Final ,
41. Solar pomesticFinai �
42. Backflow P�eventer
43. Backflow Irrigation %LG� G�(�� �� �i.�pm � �
[
44. Landscape Irrigation Syscem (L ��
45. Sound Attenuation
46. Handicap Regutations
47. FINAL S7RUCTURE & BUILDING y.a(,l � W6[
L
48. FINAL P4ANNING - �
49. Electric Release to Edison .
50, Gas Release to Southern Cati4ornia Gas Co �" �
51. CERTIFICATE OF OCCUPANCY ' �
No. Date
PflOJECTp00HE5S: Z4'i$ ELDEN AV uN�T: C 2 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06958
OWNEfl'SNPME: DALE DAVIS
aoonEss: 2448 ELDEN AVENUE PERMIT NO; P 069589 PLAN CFiECK NO: N GOVT; N SUPP; N
UNZT C-2
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
695-9145
AHCH/ENGINEEfl:
flEG.NO.:
RODHESS: UNIT:
PEflMITTEE: PAi 39IW VICTORIAPSTANCE ( 310 ) 329—d476
nooness: GARD ENA CA 9 0 2 9 8
UCENSEO CONTHACTOH UECLAflATION: I here�y affirm I�a� I am licensetl unUer provisions ot ChaD�er 9(commencing wilh Set�ion
70W) o� Division 3 of ihe Business antl Pm�essians Code. antl y license is in tull lorce antl fect.
ciTvuc.: 06o03 1 raTeuc.:362642 cu�ss: C36 P; A9/95
WOFl�ale �—"' � L Signalure: _ _ o���
MPE RTION OECIANATION: I here0y a�hrm t�al l have a te �i te o� conse seli�insure or a cenifica�e ol Workers'
Compensalion Inc�r �caZ� �cuclUie6jtgpy�thereo� (Sec�ion 3800. La�, ��B � O 1/ 9 S
voucvr+o.: GOLDEN�EAGLE EXP.OATE:
COMPANY: ,.,( (�
� Ceridiea capy is hereby fumishetl. t? Certilietl copy is file0 rth e ciry BuilOilg Oivi
a���. .� Z-� ` APDlicam:
E%EMPTION FHO WONNEHS' COMPENSATION OECLAflPTION: (T�is sec�ion neea nai be mplet¢ ' th efmii i5 �or one hunAreA ($7q1) or Ie55�.
I certity Ihat in the petlormance oi the work far which this permit is issued, I s�all nol emplo a erson in any manner so as to became
� sublec� to t�e Workers' ComOensa�ian Laws ol Galilomia.
Date: Signamre:
NOTICE Ii. alter making this declaralion, you stlould become suhlect to the Workers' ComDensation provisions oi the Labor
Cotle. you musl foh�wi�h comply wit� such pmvisions or �his permil s�all be Ceemetl revaked.
CONS7BUCTION LENUING pGENCY: I hereby allirm that ihere is a consimction lentlmg a0ency for ihe De�ormance oi t�e work Por
wAich Ihis permit is issuetl ($eciion 3W7, Ciu. C�.
LENOEF:
aooxess:
OWNEB BUILOEB UECLAflRTION: I here0y aifirm Inat I am exempt imm the Cantracmrs' Siate License �aw tor I�e tollowing reason
(Secnon 7031.5 Business an0 Professional Code: Any ciry o� county which requires a Oe�mi�lo constmci, al�er,improve, tlemolish, or
reDair any s�mcture, prior ro iis issuance. also requires Ihe applicant for such permi� �o �ile a siAned s�atement tha� he/s�e is licensea
pursuant m t0e pmvisions of I�e Contracmrs' State Lirense Law (Chapler 9(commencing wit� Section 7000) of Division 3 of t�e Business
an0 Pmlessions Cotle) or that �elshe is exemp� thereirom anE Ihe 6asi5 lor �he alleged exemption. Any viola�ion o� Seciion 703L5 Cy
any applicant for a permi� 5u01e��5 Ihe applicani Io a civil penaliy at nol more than hve huntlretl tlollars �5500�.
I, as owner ol ihe pmDehY or my employees wit� wages as t�eir sole compensation, will tlo ihe work, antl the
❑ slmcNre is nat intentle0 ar ofiereC lor sa�e (Sec�ion 70G4, Business an0 Professional CoOe: The Contractors' Sta�e License Law
does not apply to an owner of a property who builds or improves ihereon, antl who tloes such work himseltlherself or ihrouAh
his or her own emplayees. pmvide� that such impmvemenis are not intentled or o��ered �or sale. It, however [he builAing or
impmvemeni is soltl within one year o� compleiion. �he owner will have I�e bur0en of pmvinA �e/She tlid not huiltl or improve
lor ihe purpose o� sale).
I, as owner of �he pmperly, am exclusively conVac�inA wi�h licensea conlraciors �o consimct �he proled (Section 7044, Business
❑ and Pmfessions CoOe: The Coniracmrs' State License Law tloes not appty m an owner of propeny wAo 6mI0s or impmves Nereon
antl w�a comrans for such prolens wiih a contracmqs) license Oursuanuo �he Commctors' Slaie License Law). I am aware
�hat pmof of Iheir Worker'S Compensa�ion insurance shoultl be pmvidetl Io me.
� I am exempt untler Sec�ion: B. 8 P C.
for ihis reason:
Oale: Ownec
1 tlo hereby cerlify Iha� I am aware of and unders�and t�e requirements ol Calitornia Health antl Sa�ery Cotle Sections 25505, 25533, an0
2553a antl Ihai I or any �uNre builAing occupani wilVwill no� (circle one) neetl �o comply wilh saitl s�a�e co�es an4 ihe requirements for a
permil for conslmction ar modilica�ion �mm the Air Ouali�y Managemen� �i5lricL Re5i0en�ial constmction applica�ions are exempt irom
I�ese O�avisions.
Date: AppliCanf
I h¢reby certtly thal I have rea0lhis applitali0n antl Siate �hat I�e ab ve
ordinances and Slalelawsrelalingto building cans�mciion and �ere�y uln
pmperly lor mspe i/on pur ses.
11aie: ��YL� Signalure:
oriver�s License or Sacial securiry
t6at�a6 wnne—Buiming: Green—Coee ENorcemem; Canary—ApplicanC
�o comply with all city antl counly
lo enleruponlhea6ove�menli0ne0
Goldenrod—Assessor
JOH DESCRIPTION ; DISHWASHEA C/O SQ FT;
CLAIM VALUE: 75.00 CALC—VALUE: GAOUP OCC; R-1 /
COMMENTS: ONLY FOR THE DISHWASAER C/O
+r+r+�*aie�-�rx�ae�r-�r�r�**�r+r+�x�x�+r�r�rx�-x�*�t+r*��rat+�a�+tx��r**+�+r+r+t+r*+r*+��*�*x�+�*r**+r+r�t*�r�r-�+t**-��e***�**�*
Z O N Z N G R E Q U I R E M E N T S
5 E T B A C K S
------------ MAIN BUILDING ----------
FRNT; FT IN AEAR; FT IN
LEFT; FT IN RGHT; FT IN
--------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN
PARKING REQ; PROV; PARCEL: 43929104 ZNE: REF NO:
PLANNING NOTES>
S
jt it if if iF it if if iF it if if iF iF it if it itr if 1t 1Fif if it it it it if if i! 4 iF iE iE iE af iE it #t if if if f! 1f 1E it it 1e fF ie ft iF it it if if if if 1E it if fE it it it it it it it it it if ik if iF it if it iE
D E V E L O P M E A7 T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE;
HUILDING APPROVEL� B DATE;
APPLICATION ISSUED BY; - ' � DATE: �O—�^91F'
irf�i�*x�*ir�r*�x*x�*��r**�r�t*�r�r**iy�F*i **r�r�r�r+t**�r�* ***�;* �r*i�i�*�-*******�-�rr****��*rt*�r**#*
ififiEififlfikMikjflf7f�)k�lfltltiflEiF1lil34itiFikit11�1FiFihlffflfffiFltil�lfilif�if141f 1f�M1li FlflEikitiFifif#fiflfjFjfififlfifikiEifififiEifififiEiFiE
LEGALIZATION;N F E E S U M M A Y STAUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADING
PERMIT 7.00
25� , SMIP/NON—RES
PLAN '
ISSUE FEE 20,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 7,00 20,00 _'; 0.00 27,00 27,OQ ,OQ
REVENUE DIVISION TOTALS--> COLLECTED; 27,00 OVER/SHOAT; ,OQ
BLDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CFIECK
2 % . Q Q _
jE 1k if ff if if iE iE it iE i! if 1E it if if if if It if 1! iF if ik if k ih if if jf if if jf if i! 1t i! if it if it 1f 1E 1f * if if it 1f jf k ff iF if iE it M:F iE it 1! jE if i! it iE it iE iE 1F if iF aE iE iF ik iE iE if
I N D I V I U U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 DISHWASHER " 7,00 7,00
END OF FEES
t
L�1 �J�7.7032b—�D17+33?b T�7T 27.i�0
�A7E: :�/?7/94 7IMc: 1`:`3
CONSTRUCTIQN AND PLANNWG POO� ,PA �-
APPROVA�S Permit # Date inspector APPROVALS Permit # Date Inspector
7. Ternporary Electrical Service or Pole � 52. Poo1 & Equipment Location
2. Soil Pipe�Undrgrnd. . � • � 53. Steel Reinfo�cement
31��cVicat Conduit Uti{ity-Und*grnd. " / 54. Forms �:�
4. E�ectrical Conduit-Undrgrnd. . r 55. Electrica! Bonding
�5, Steel Reinforcement 56. Rough Plum6ing & Pressure Test
�-6..'Electrieat UFER Grnd_ � �� 57. APPR�VAI,T� COVEft�GUNtTE "
l: Fontings � 58. Electricai Conduit�Undrgrnd. �
8.' Poundation '. .� . 59. Gas Pipe. O Undrgrnd., Tesc •
9. Vi24er Pipe�Und=grnd. 60. 6ar_kwash Linas, RTrap, C Undrgrnd.
10. Structural Floor�Svstem . 61. APPROVAL70 DECK
11, pre.perty Sewer �ine & House Connection $2. Backwash & Recepior�Pina! ��
, r"�
12. Se�.Ner Cap . 63. Heater & Vent-Final --
r
13.. RoOf Drains � -� 64. Plumbiny System � Final
74. Rcugh Piumbing • 65. Electrica6Pinai
15. Roi�gh Electrica6Contiuit .� 66. Solar System-Final
16, Rough Eiectric N+iring 6Z Fencing & Access Approval �
77. RoUgh Wiring Siyn 68. APPROVED FOR PIASTERiNG
18. Rough Electrical-T Bar Celling 69. POOUSPA SYSTERrS FINAL
19. Rcugh Heating & Air Condit�oning FIRE DEPT. REQUIREMENT
, � -
20.,;Raugh Factory Firepiace �� � - _ � � APPROVALS �"' - Permit #
21.' DuCis, iq Sxructure , ' � � . .70. Undeigeound Hy,clro
22. D»cts, Ventilating ' - ' 71. Product Piping �7G8s UOiI
��, .
23. Gas P�Pp�Rq�9h & Ter. �; . .. - '72, Underground Fiu'sh,
24. Ruof Fcaminq . � � �. , ..73:'Undergmd.SmrageTank OGas ❑Oii
25. Roof Sheathino � � � . , ` ' 74. Overhead'FlYdrq J �
26.�T�Sar Ce;ling (Svucturai) & Monocoat ' - 75: Dry Chemical �' '�
27. F:ame aqd Flashing � . T � 76. �Dry Standpipe �� ' . '
,28. �athing.& Sidinc,�'r , . • -', Y 77.. FIXED SYSTEM F.INt1L'
29. Insulation � � ' ' ' -, ' � � 78:,-FlRE PREV. FINAL �
30. Drytvall Nailing r: � � ��q � HEALTH�DEPTc REQUfREMENT
31. P�aster Bi�own Coaf �- J9. FINAL INSPECTIpN '� ' �
,. ,.
32. Electricai Power {tileter-Finai -. ; ., . : SO..�,FOOD CERTIFICATE ISSUED
�33. Findl Elec:ric � ' . � � ' ''Notes: //_�- �
: !1 :
34. Pinai Neating & Air Conditioniny� � ' ' ' , ' . ��l
fy/5 «C.
�35:�final Gas Pipe-Test ' ' � � - '
` - i i>
.36. Hood or Canopy -' . ' . �
37: FinB� Faaory F;replace . i' � • ' � ` .- ' ;
38. fin21 Plum6ing � , �� �� � ... �
1-3 �
39. Water Service-Final� - . . . . . . .
' �•
,40. Gas Service-Finai � . . , � , ; � -� • �
�-0t. Soia� �omestic-Pinai � ' . , '
,
42, $ackflow Preventer� - �; - � . ' _, . . .
43. Backflow Irrigation- � . : �
44. landscape �rrigation System "i ; , . � �. • . .
95. Sound Attenuation ' � � � ' _ � �
46. Handicap Regulations - T� � � - � �
47. �PiNAL STRUCTURE & BUILDING � , � � .
48. FINAL PLANNING. � '� � �
,.
49. Electric Release to Edison `�' � •
I
50. Gas Release to Southern Calitornia Gas Co �' � � � r
51. CERTIfICATE OF�QCCUPANCY " - . -
Np, Date
Ci[Y OF CUSTA MESA
CALIFORNIA 92828 P.O. BOX 1200
FROM THEOFFICE OFTHE FIRE PREVENTION BUREAU
�'� G(.�� �ec,�J�
G�sO� �� � C��y�G.G��.' Go
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CITY OF COSTA MESA
CAUFORNIA 92828 P.O. BOX 1200
FROM THE OFFICE OF TNE DEVELOPMENT SERVICES DEPARTMENT/
BV ILOI NG SAFETV DI V ISION
January 28, 1980
Barry Williams
1401 Ibve Street
Newport Beach, California 92663
RE: 2448 Elden Avenue-Permit �43887
Dry Fire Line
Dear Sir:
This is to advise you that your Dry Standpipe has never
been finaled. The construction company neglected to call for
the tests and inspections necessary, therefore, your system is
considered incomplete.
We are advising you to contact this office within 30 days
to arrange for these tests and appmvals.
Yours truly,
Victor C. Nzwton
Director Building Division
��:�
cc: Fire Marshall
Construction Cim[pany
F�lco Associates
1635 Bluelzrd Canyon Drive
Laguna Beach, California
77 FAIR DRIVE (714) 7545273
• , : , �, , r. ��i ;�.
�.. .s � � � � ;[�_. } 1 I�/ <�. ;�r f }
John Hilliard ❑
August 15, 1977
Consulting Acoustical Engineers ❑
Mr. Barry Williams
901 Dove Street, Suite 115
Newport Beach, California
77/550
Gordon Bricken
Subject: STC Measurements at 2448 Elden, City of
Costa Mesa
Dear Mr. Williams,
At your request we have performed STC measurements at
2498 �lden in the city oP Costa Mesa. Measurements were
performed on three walls between six bathrooms in the
complex. The results are as follows:
Test 1
Test 2
Test 3
STC 51.0
STC 50.5
STC 51.0
All units will meet the minimum field test value of
FSTC = 45. An explanation of the method'employed in
this testing is attached along with the STC charts.
Prepared by:
C�-��
Gordon L. Bricken
Vice President
/vlp
Enclosures
�
Hi'1Tiard, p Sc.
� Y
a�
p� F�Cf.(C1� �(r
\�� VE CA���J�
1971 [ast Fourih SVeet, Suite 18 ❑ Snnta Ana, Califo�nia 92705 ❑ (714) 835-3728
\�
E�-9��L6AR� &z �E�G�&���-
John Hilliard ❑ Consulting Acoustical Engineers ❑ Gordon Bricken
Single �lumber Ratings
.« � ,» ,w " .� �°° „e .� � ,,.. ,.00 °°° , �� ' � .� '°°° ..
e..a c�.r�. �.ro�E+c'v _ �t �
Sound Trnnamission Class (STC)
The Sound Transmission Class is a method of rating
the airborne sound transmission performance of a,
wail or a floor-ceiling structure at different,frequencies i
by means of a single number.
The STC rating method is based on the labora-
tory test procedure specified in the AST1.1 Rocom• �
mended Practice E 90-66 7", in wnich the sound �
transmission loss of a test specimen is measured at �
16 frequencies at 1/ 3-octave intervals covering the I
range irom 125 to 4000 Hz. To determine the STC �
of a given specimen, its measured transmission loss �
values are plotted against irequoncy and compared �
with a reterence frequency curve ISTC contour�, as �
shown in the iliustration at left. The STC rating may i
then be determined by means of transparent over- �
lay on which the STC contour is drawn. The STC !
i
contour is shifted vertically relative to tho test data �
curce to as high a position as possible �vhile (ulfilling ;
the following conditions. �
1. The maximum deviation of the test curve below �
the contour at any single test frequency shall!
not exceed 8 dB.
2. The sum of ihe deviations at all 16 frequencies
of the test curve below lhe contour shall not ;
exceed 32 d8. This is an average deviation of i
2 d8.
When the STC contour is thus adjusied (in integrai
decibels) the STC value is read from the vertical scalel
of the test curve as the TL value corresponding to the�
intersection of the STC contour and the 500-Hz fre-'
quency line. In , the example, Ihe STC valuo is gov-
erned by the 8 dB deviation at 32IQiz, although tho
totai deviation adds up to only 27 d8.
ASTM Desiflnaiion: E 90-66 T, Tontative Recommendotl
Praciice lor L. bo�atory Mcasuremenl o� Airborne $ound Trans�
mission Loss 01 Duilding Partitions. RM 14�2 Proposed
Classilitation lor DctCrminalion ol Sound Transmiisron C�ass.
1971 [ast Fourth S�rcct, Suite 76 ❑ S�mta Ana, California 92705
O (714) f�:t5-3726
1
e-36LL6r`"a6'�� � ���C����9
John Hilliard ❑
November 8, 1976
Consulting Acoustical Engincers ❑ Go�aon ericken
SOBJECTIVE RESPONSE TO S�PARATION ASSEMBLIES
HAVING VARIOOS STC AND IIC RATINGS
Considerable experience in the field testing of party
walls and floor-ceiling assemblies has indicated that
the minimum field STC and IIC ratings of 45 permitted
by the California Noise Insulation Standards is not
sufficient to prevent tenant complaint of intrusive
noise. The following list has been compiled indicating
the subjective responses of a person �vith average
sensitivity to the average noises a neighbor may make
in an adjoining dwelling unit for walls and £loor-
ceiling assemblies of certain STC and/or IIC ranges:
IIC or STC Rating
(field tested)
Less than 35
35 - 94
45 - 49
50 - 54
55 - 58
58+
Subjective Response
to Acoustical Privacy
most unaccentable
unacceptable
tolerable
good
very good
�
excellent
1971 East Fourth Strcet, Suitn 16 ❑ Santa Ana, Caliiomia 'J2705 ❑ (714) II353720
CITY OF ''"`STA MESA
PAR... .�EES
Fee Payment Receipt
N° 255
Project Address ol�'Y 6 � O��M �� Park Area
A. P. No. I I'7 —�%(r/ �— ��
Building Permit No. l-.��.�(,� ��
Owner's Name
// i �r {% ' 1
Mailing Address/7`O� [/D�/P� �_JT. . N " � .
FEE
Single Family • No. of Units
Multiple Family �• No. of U�i[s 7
Planning Department Approval Date
@ $455.20 ��
@ 5321.32 =
Total Fee gi�
i, _ . ,_ i� . .� � '
Applicant's Signamr�
+ Glty OrGlnance 72�44 '
" Clty O�tllnanca 72-45
'•' Clty Resolutian 74124
Wnite- Planning; Canary - Planning; Pink - Finance; GOlqenroU - Applicant
�
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� ' � COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADDRESS
OWNEF �
MAIL
ADORESS
TEL.
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CONSTRUCTION
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CITV NO.
STATE CITY
IIC. NO. LIC. NO.
S I Z E I NO. OF BlOGS.
OF LOT NOW ON LOT
VSE OF
EXIS7lNG BLDG.
Separate permits are required for
electric, plumbing and heating work.
USEOF BUILDING AND WORK TO BEPEREDRMED
Fl.1.. iri} :r A /
.,. 19-77�,:�.00 720 ` 4�.51
APPLICATION FOR STRUCTURAL PERMIT
FECEI DATE f±ECEIVED D E IS UEC
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A.P. NO. I I l� F�l� l��//D PERMIT'NO.
BUILDING �
AD�fiESS
TRACT
FIRE
20NE
APPROVED
ZO NO.OF �
PLANS
VARDS APPROVED
MAIN BUILDING
(FROM GL STREET)
VAR. 9W
C.U.P.q
HOLD FOR
I heraby ecknowletlpa thet I have reatl this oppllcation entl scate
Met tha above (ntormeHon it correct antl aBroe io comply with
ell laws regulatlnB bulltling eonstruetlon, entl I shall not employ
any perwn In vlolatlon of tha workman's companseUOn lawa oi
Me State of Celitomle.
I hereby certify that I am prope�ly Iicensatl es a controctor under SQ. F
i�e State of California Business entl Proteaslons Cotle, Dlvision 3, THE AMOUNT
Chepter 9, �a het such licenses ere in f�l force entl effeet, or I THE PURPOSE C
am exemDt Ma prov sl �+s t Stat of Celifornia Buzineu VALUATION
antl Prof io :oda, Li I i 3 Ch �t r
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Signature o /� DD�
Permittae 5 �
AUMorizetl Agent
USE OF NEW
BUILDING
VAROS APPR
DATE
APPROVED
JN VNDER VALU
ABLISHING A PERI
PERMIT FEE 5
PLP.N CHECK S
TAX S
TOTA�PAID S
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, COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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P IC TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only RE i v DATE RECENED
DATEISUED
BUILDING �% �/ ` �w' / �1 _ _�
ADDRESS Q� � G/a+ J
PERMIT NO.
OWNER . �C.(,.�.� A.P.NO.
MAIL BUILDING � � ( � r7 ��� /� _.,.
ADDRESS ADDRESS �7 •CL IY'�F
TEL. TRACT LOT BLOCK
CITV NO.
CONSiRUCTION W A A P
LENDER
BRANCH
OWNER L�,� S
AODRE55 �
VALUE
ARCHITECT TE�. USE $
OR ENGINEER
FIF2E �/
ADDRESS ZONE TVPE V GROUP �
APPROVED
CONTRACTOR BY DATE
ADDRESS
TE� ZONE . NO.OF VSE OF NEW
CITV NO.
PLAKS BUILDING
STATE CITV �'ARDSAPPROVED VARDSAGPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDC.S. (FROM C/L STREET)
OF LOT NOW ON LOT RONT FT. FT.
USE OF
EXISTING HLDG. 5 F
Separa�e permits are required for L SIDE FT. FT.
electric, plumbing and heating work.
FEAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISfANCE BET. BET. MAIN &
MAIN BLOGS. ACC65. BLDGS.
VAF.�W �ATE
C.U.P.� APPRpVED
APPROVED
I ho�eCy ecknowladBe thet � have raad this opplication antl stata
thet Me ebove Informotion is corract entl apree to eomply wlth
ell lews raqulatinp bullCinp construcNon, ontl I ahall noi omploy
ony pa�wn In viOlaiion of tha wo�kmon't compansetion lawa of
tha Smta of Galifornia.
1 �areby cenify Mat I am properly Iteenmtl es e contractor untler SQ. FT.
Me Stete of Californla Business end Frofaulons COCe, Dlvlsion 3, THE AMOUNT SHOWN UNDER VAlUAT10N IS FOF
C�aptar 9, end Shet suc� licenses era in tull forca and affeet, or I THE PVRPO6E OF ESTABL6NING A PERMff EE NLV:
am exempt from the provisions of She Staie ot Cellfornia Businacs VALUATION PERMIT FEE $
antl Professione Coda, Dlvicion 3, Chapter 9.
� PLAN CHECK S
Signature of
Permlttae 5 TAX S
AuihorizatlAOant TOTALPAID S
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COSTA MESA BUILD�NG-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
vai:
�,,,, � q.7 i��-�:O�J 727 :• ,^�,*;:95.07
APPL[CATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only qECEI DATE RECEIVED
DATE SSUED
BUILDING � �u � �_ _�
ADDRESS (i►�
OWNER �� I A.P. NO. —O PER ILI�IQ I'
�� i
MA � L BUIL�ING
ADORESS ADDRESS n
TEL TFACT O �Nr BLOCK
CITV NO.
CqNSTRUCTION W A A R
LENDER
BRANCH
OWNER % � S
AD�RESS VALVE
ARCHITECT TEL. 5 $
OR ENGINEEF
FIRE
ADDRESS 20NE VPE �� GROUP
APPROVED r1� _�'1
CONTRACTOR ev DATE J L
ADDRESS
TEL. Z NO.OF USE OF N
CITV NO. P�� BUILDIN
STATE CITV �'AfiDSAPPROVED YARDSAPPR VED
UG. NO. IIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BIOGS. (FROM C/ TR�E ) ��
OF LOT NOW ON LOT ROfYT FT � FT.
USE OF � I �
EXISTING BIDG. S O .O FT.
Separate permits are required for L. SIOE FT. FT.
electric, plumbing and heating work.
REAR T. FT.
VSE OF BUILDING AN� RK p B PEfiFORMED DISTANCE BET. BET. MAIN & �
MAIN BLDGS. ACCESS. BLDGS.
N VAR. # � DATE
C.U.P. APPROVED
APPROVE�/ i i. 1 v
V(/L�
HOLD FOR PECI L QUIR M NT
1 hereby ecknowledge that I have reatl this epplication and smte
i�et tha abov0 Informetion is correci antl apree to comply wlth
all laws regulating building cons[rucUon, entl I shell not employ
any perwn in ��oletion oi Ma workmen'z compenution lews of
ffia Smte of Californla.
1 hereby cartify [hai I am properly Iicensetl as a contrector undet $Q. FT.
t�a Stata ot Callfornia Business antl Professions Cotle, Divisian 3, THE AMOVNTSHOWN UNDER VALUATION IS FOR
Chapmr 9, antl thet s�ch Iicenses ara in full forca end effect, or I THE PVfiPOSE OF ESTABLISHING A PERMR FEE ONLV:
am ezampt frOm t provlsl ns t e$t e of Celltornia Buslnass VALUATION PERMIT FEE 5
antl Protassion e, Dlvlsi tar
�/ PLAN CHECK S
SIB�etura o 0
Pe�mittee � 5 BO TAX § , s
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
UILDING a � �" C.DE/U E ��
DDRESS
OWNER
MAIL
ADDRESS
CITV
BRANCH
ARCH
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TEL.
NO.
ADDRESS
CONTRACTOF
ADDRESS
TEL.
CITV NO.
STATE CITV
LIC. NO. LIC. NO.
SI2E I NO. OF BLDCS.
OF LOT NOW ON LOT
USE OF
EXISfING BLDG.
Separate permits are required for
electric, plumbing and hea[ing work.
USE OF BUILDING AND WORK TO BE PERFORMED
I hereby acknowledge thet I have raetl this appllcation antl stata
that tha abova informaHon is corte<t entl egrae to eomply with
oll laws repuletln8 builtling construction, antl I shall not amploy
any Oe�son In v101aSion of Me workmen'g compenutian laws ot
the Staie of California.
I hereby certify ihet I am properly Iicensatl as a contractor untler
tha State of California Business antl Profassions Code, Divtslon 3,
Ghaptar 9, antl that such licanzes ara in full force antl ¢ffect, or 1
em ezempt from ihe provisions ot Ne Smte of Calitornia Business
entl Profassions Coda, Division 3, Chaptar 9.
SIB�ature of
Permlttea
n�<non:aa nea�a
\\�
�,��; -��-�?�:;zJOQ 314 ��::. � 189.00
APPLICATION FOR STRUCTURAL PERMIT
A.P. NO.
BUILDING r
ADDRESS �(
TRACT
OWNEfl
vN
FIRE
ZONE
APPROVED
�i ''T � �
ERMIT NO.
� �i�
ZONE INO.OF I USE OF NEW
PLANS BUILDING
VAROSAPPROVED VARDSAPPI70VED
MAIN BUILDING ACCESSORV BUILDING
DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLD
VAR.# DATE
C.U.P.qW APPROVED
APPROVED
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TNE AMOUNTSHOWN UNDER VALUATION IS FOR m
THE 7UfiPpSE OF ESTABIISHING A PERMIT FEE ONLV'
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VALUATION PERMITFEE 5 �
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PLAN CHECK E o
$ .�� TAX $ LL
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TOTALPAID $
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COSTA MESA BUILDING-SAFETY DEPARTMENT ��
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR STRUCfURAL PERMIT
For Applicant to Fill in Completely — Use Ink nly RECE DATE RECEIVED
DATE IS$ UEO
BUILDING /J � � A /� d. . /A / �. .S / 1 �
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OWNER �
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ADORESS
CITV
CONSTFUCTION
LENDER
BRANCH
ADDRESS
ARCHITECT
OF ENGINEEF
ADOFESS
CONTRACTOR
ADDRESS
CITV
STATE
LI0. NO.
SIZE
OF LOT
TEL.
NO.
TEL.
TEL.
NO.
CITV
UC. NO.
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
elec[ric, plumbing and heating work.
ED
i haraby acknowledBe that I hava reatl this applicaiion antl siate
that tha above Informaiion !s correct antl agree to comply with
all laws reBuleUnB bulltllnp conrtruciion, antl I shall not employ
eny person in violatlon of Ma wotkman's compansation lews of
the State of Californla.
i hereby cartity [hat I em proporly licensetl as a contractor �nder
the Steta of Coli(ornia B�sinezs end Profeuions Code, Divicion 3,
Chapter 9, enE Net such I(censas are in tul torce and eftect, or I
em ezampt from ha Drovicion o e Stat ot Californla Buslness
and Professi tle, �Iv C pt �
c �
S19natura of �
Perminae
Authorizad ABant
BVIIDING
ADDRESS
TRACT
OWNEF
NO. OF
VAFDSAPPROVED
DI5iANCE BET
MAIN BLOGS.
V AR. qW
C.U.P.� �
DATE �J—"�" (
USE OF N
BUILDIN
VARDSAPPR VED
ACCESSORV BUILDING
BET. MAIN &
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPO6E OF ESfABLISHING A PEFMIT FEE ONLY:
VAlVAT10N PERMITFEE $
PLAN CHECK E �
$ 5/, oov TAx $ ,
TOTALPAID $ �Q
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PPIu J
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� COSTA MESA BUILDING-SAFETY DEPARTMENT
o n anx i�nn cnsTn nnFcn r.n� iFnwnun n�F�F
APP IC TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
EL(� � � � DATE RECEIVED DATE ISSUED�
BUILDING
ADDRESS
PERMIT NO.
OWNER //U/C.LIQ-m AP• NO. �7
MAIL qDl RIE S�T L`��n��►t1 �
ADDRESS
TEL. TRACT LOT BLOCK
CITV NO.
CONSTFVCTION N W ADD A P
LENDER
BRANCH
OWNER ILL(
ADDRESS VALUE
ARCHITECT TEL. USE S
OR ENGINEER
FIqE
ADDRESS ZONE TVPE GROUP
APPROVED
GONTRACTOR BY �ATE
AODRESS
TEL. ZONE NO.OF USE OF NEW
FLANS BUILDING
CITV NO.
STATE CITV �'ARDSAPPFOVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT NOW ON LOT RONT FT. FT.
USE OF
EXI5TING BLDG. E T. FT.
Separate permits are required for L. SIDE FT. FT.
electric, plumbing and heating work.
REAR FT. FT.
USE OF BUIIDING AND WOflK TO BE PERFORMED DISTANCE BEf. BET. MAIN &
MAIN BLDGS. ACCE�. BLDGS.
VAR.ak DATE
C.UA.�l'+ APPRpVED
APPflOVED
I hareby acknowletlBe that 1 have reatl th�a applicetion antl staie
that the abave Information Is correct antl agree to comply wlth
all laws reBulatlnB buildinB �onstruction, antl 1 shall noi employ
eny permn in violallon of Me workman'a compensatlon laws of
the State of Celifornle.
I hereby cartify thet I em properly Iicen58G as a conttacior untler SQ. FT.
t�a Stata ot Californle Businass end Profawions Cotle, Oivision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Cheptar 9, entl that such licenses ere in full force antl attect, or I THE PURPOSE OF ESTABLSHING A PERMIT EE ONLV �
am ezampt from the provisions of the Stata af Galifornie 8�siness VALUATION PERMIT FEE S
antl Professionz Cotla, Division 3, Chepter 9.
PLAN CHECK $
Sipnaiure of
Parmittae 5 TAX S
A�thorlxatl ABant TOTAL PAID §
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink O^y
BUILDING � ,AQ U �� � n ' � . _
OWNER
'l��rT'1!^7�;'i!/�r�.�.h.�'
LENDERV V
`�•
BRANCH
ADDRESS r—
ARCHITECT ,BIA�
ADDRESS � / I , �'���
�Y
CONTRACTOR ��
ADDRESS r—
TE��
qTV �.-y NO.
STATE CITV
L10. NO.'�`��� LIF NO�_
SI2E NO.OF BLDGS.�
OF 1.0T � NOW ON LUT �
USE OF ♦ � a
EXISTING BIDG. � /.�]i
� Separate permits are required for
� electric, plumbing and heating work.
USE OF BUILDING ANO�WORI� j0 B� PEFjFORMCyD_ _
I horeby acknow�edBa that 1 have reatl this application antl state
that the above intormetion Is correct antl aprae to comply with
all laws repuletin9 building construction, antl I shall not employ
any persan in violaiion of the workmen's compensation laws of
che Stata of Cali}ornia.
I hereby certlfy that I em prOperly licensetl es a contracior untler
iha Stata of California Businoss entl Professlo Cotle, Division 3,
Chapter 9, anC t such lice ses are In tull fo ce antl etfect, or I
am ezempt fr Provi o e tate of Califor la` usiness
antl Protessi e, D visl .3, ap
Signature ot I
Permittee
Auffiorized ABent
�y.� � PR:u
ii �' � 19-77��;-�0 725'= *��:�tGl.i�L;
APPLICATION FOR STRUCTURAL PERMIT
RECEUCjq DATE RECEIVED nn'rF ISSucr
BUILDING
PoE�RM'yNo.
VALUE �-7�-y-�
s ! u rl I�
FIRE �
ZONE PE �GR UP
�A�PROVED L DATE ��-1 �� /
ROM
i NO.OF USE OF NE
PLANS BUILDING
APPFOVED YARDS
BET.
C URP#�y'-S_ 7� "��l APPROVED %_ / �
p� I ��T� �: ��-
HOLD FOR
N
n
5�'� m
u
SQ. FT. N O
�
.THE AMOUNTSHOWN UNDER VALUATION IS FOR �
THE PURPQSE OF ESTABLISHING A PEflM1T FEE ONLV: �
VALUATION PERMIT FEE $ a
� PLAN CHECK b f � �^ �'
$ � � DOO TAX $ S j �•
TOTALPAID S �Q v'"v
� � - 33 3
� COSTA MESA BUI�DING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
1�,� _��-77�a�,��� 313 c�'itt:;r2�di.(1Cl
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to FiI1 in Completely — Use Ink Only qECEI V ED B V DATE RECEIVED
/��-�/ DATEIS UED
ADORESS L/,/r//V , C l � �� ��
PEflMIT NO.
OWNER ' LU � /a.P. NO.
MAIL BUILDING �4q.g ��o�-v„ F! �I'-
ADORESS ADDRESS
TEL. TRACT �OT BLOCK
CITV NO.
CONSTRUCTION W ADD A R P
LEN�Efl
BfiANCH �I��
OWNER
ADDRESS
'I VALUE
AftCHITECT TEL. SE ✓ 5 �
OR ENGINEER NO
FIRE
ADDRE55 ZONE TVPE GROUP
APPROVED
CONTRACTOR BV DATE
ADDRESS
. TEL. zONE NO.OF USE OF NEW
PLANS BUILDING
CITV NO.
STATE CITV YARDSAPPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUIIDING
SI2E NO.OF BLOGS. (FROM C/L STREET)
OF LOT NOW ON LOT FRONT FT. FT.
USE OF
EXISTING BLDG. SI FT. FT.
Separate permits are required for L. SIDE FT. FT.
electric, plurnbing and hea[ing work. REAR FT. FT.
USE OF BUILDING ANq WpRK TO BE PERFORMED DISTANCE BET, eET. MAIN &
MAIN BLDGS. ACCESS, BLDGS.
VAR. # DATE
� C.U.P. # �'PAOVED
APPROVED
I hereby acknowletlge that I have read ihis application antl rtate �
that tha ebove Information is correci entl agree to comply with m
all laws reguleting builtling consiruction, untl 1 shall not employ
eny Oerson in violaiion bf tha workmen's compensaiion laws of �
the State of Calitornla.
m
I hereby certify ffiat I am properly licensetl as a connactor untler SQ. PT. w
the Stata of California BUsiness antl Profeuions Cotle, Divislon 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOfi m
Chapter 9, entl that such �i�enses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: �
am axempt from the pro�islons ot the Steta of Californla Business ^- a
antl Professions Cotle, Dl�ision 3, Chapier 9. VALUATION PERMIT FEE g o j
m
PLAN CHECK $ ^
Signetura of /'j� �
Permittee S ���� TAX $ �
U
AuthorizetlAgent . TOTALPAID $
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. 43750
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely — Use Ink Only
BUILDING /J /']/�/ ^ `�
ADDFESS r1�f,/r!T {•��vc
OWNER j/�CI��/��/ ���•�//7
F' A /�' 'T�
MA�� q(L//� �/(�'T
ADDRESS
CITV xrjW{�%/_I (%� NOL /_7�
�i'
CAN5TFiVCTION
BRANCH
A�DRESS
TE
ADORESS -
CONTRACTOR O � .R�— p �,
AODRESS
TEL.
CITV NO.
STATE CITY
LIC. NO. IIC. NO.
SIZE NO.OF BLIX'aS.
OF LOT�✓ �4 NOW ON LOT
h
USE OF
EXI5TING BLOG.
Separate permits arc required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
I hereby acknowledBe that I hayo reatl this applicetion entl rtete
that the ebove informailon Is cbrrect and agree to comply with
ell laws regulatlnB buildin8 �onstrucHon, entl I shell not employ
any perwn In vlolatlon Of the Workman's compansation laws of
the Stete ot Celifornia.
I hereby certlfy thot I em prope �y Iicensetl as a contrector under
ihe Stete of ornia Bvzlness tl Profeulons Cotle, Divisian 3,
Chapter 9, tl t at such license era in full force antl eftect, or I
am axam x r th P( ov ion the Stete of California Buziness
and Profo n C . Dl sion 3, � henter 9. ..
AuthoNzatl ABenS
�
FA1�
'PI'l -1'���:��; �n 017C5 ir:: i,� {:ir•^,.J�
APPLICAT�ION FOR STRUCTURAL PERMiT
ECEI DATE RECEIVE6 n o icci mn.
BUILDING
ADDRESS
OWN
� VALUE
FIRE
ZONE
APPROVED
BLOCK
��NO.Of n USE OF NEW . �
PLANS (� BUILDING �
VARDSAPPROVED VARDSAPPROVED
MAIN BUILDING ACCESSORV 8UI D
]hM Ch STRFFTI � . .
DISTANCE BET. / BET.I
MAIN B�OGS. ACCE
VAR. #�' DATE
�
m
i
v
m
SQ. FT. �
THE AMOUNTSHOWN UNDER VALVATION IS FOR m
THE PURPOSE OF ESTABLISHING A PERMIT F ONLY: �
VALVATION a PERMIT FEE $ a
� D N
�� PLAN CHECK E � o
5 gO0 TAX E � LL
/ �
U
TOTALPAID $ Q
- � � 43887
` COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely — Use Ink Only
� BUILDING n.iiiU _�. L.. . . .
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OWNER (�N�—v.`(
MAIL
ADDRESS
CITY Lw Q�
CONSTRUCTION ✓I,.. n',
LENDEF %7����(C �
BRANCH ,S(/{/ �C�
ADORESS �
ARCNITECT ��y�
OR ENGINEER U7�"
ADDRESSss'(J %v�
CONTRACTOR FI/I
AODRES^�3���
CITV �QGAAti_
B_" ___
STATE �•�/�
LIC. NO,/�
S�ZE 6G X'3o�
OF LOT
USE OF _ �
TEL.7
NO. /SL
-�3�
��Z
�r` '
TENOL• `(s
V ]D'
�
TEL.
NO. �
CITV
LIC. NO.
Separa[e permits are required for
electric, plumbing and heating work.
UILDING AND WORK TO BE PERFORMED
�,�q-�,�;.�;o0 609� IP.SC
� � ,�,: � ,:
APPLICATtON FOR STRUCTURAL PERMIT
BUIIDING
ADDRE55
TFACT
OWN
^ NO.OF
OC PLANS
)5 APPROV ED
VAR. ¥
C.V.P.�
APPflOV ED
VARDS APPROV ED
FT
&
1 heraby acknowladpe that I havo reatl ihis applicaHon ¢ntl steta
thet tho ebovo Informetion It eorrect entl agrea to comply with
oll lows repuletlnB builtlinB conettuction, and I shall not amplay
eny Darson in vlolatlon of tha workmon'e eompensailon laws of
the Smte of Calltornia.
1 hereby cartity that i am proparly Iicensetl as a contractor untlar SQ. FT.
MB Stata Ot Californla Business antl Professions Code, Olvlsion 3, THE AMOUNT SHOWN UNDEF VALU
C�apter 9, entl ihat sueh Ilcensea ere In full forca anC eftact, or 1 THE PURPOSE OF ESTABLISHING A PERI
am exempt from Me prOviz'ons of the Stem of Celifornia B�sinesa VALUATION PERMIT FEE
ontl ProfBsc n otle n 3, Choptar 9. 5
� ♦ d PLAN CHECK E
SlBnetura o ��\ / /7� Q`
Permittee g �� TAX S
Aut�oriza pent TOTALPAID E
N .
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m
m
N
IS FOR m
ONLY: �
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' 44;07
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 80X 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use I k Only
BUILDING - i/// �/ j�� �
ADDRESS y T� (�/�
OWNER " � (�IL,(�% �
MAIL /J
ADDRESS % I �
— I) _ _ / TEL. _„ �
G T V �i(V
CONSTRUCiION
LENDER
BRANCH
ADDRESS
ARCHITECT
OR ENGINEER
ADDRESS�CI'
F
TE
R
A.P. NO.
BUILDING
ADDRESS
FIRE
;1i�7-z-77c�t�00 2op* a*�`*1D.5C
FORSTRUCTURALPERM[T
D TERECE ED 7EISSUEO
__ �• � 9„_� .,,
a.ii-���a. •
VALUE
$
—�GROUP ��
"__ � � � .
ADDRESS ��'� �C'(� � �� /�_
/ EL. y�// ZONE NO.OF USE OF NEW
CITV 1�� 1IY � / I/ NO. ">•7/' Z� PLAN$ BUILDING � ✓�.
F STATE � CITY VAR�SAPPROVEO VARDSAPPROVED
LIC. NO. � � �IC. NO. MAIN BUILDING ACCESSORV BUIIDING
� SIZE NO.OF BLDGS. (FROM C/L STREET) � �
,L i
�. OF LOT � �[% NOW ON LOT RONT FT. FT.w
a USE OF �
i.�„ E%ISTING BLDG. T. FT
.N. � r' � ,
� Separate permits are required for L. SIDE FT. FT. v
Q eleclric, plumbing and heating work. REAR FT. 'T.
[.�.i USE OF UILDING AND WOflK TO E PERFORMED DISTANCE BET. BET. MAIN &
Q� MAIN BLDGS. ACCES'u. BL�GS.
VAR.3W DATE
..1 � � C.V.P.qW APPROVED
Q
7 APPROVED
%'
.J
a
{sl
0 1 hereby acknowletlBe thet I have �eatl this application end steta �
p,' th¢t She abova Information is correct antl agrea io comply with m
a all lews reBulating bulltling construction, end I sheli not amploy �
.� any persOn in vloletlon Of the workman's compansaSiOn lawe of
� c�e Stam of CalHomla. -=
x m
3 I hereby certify thei 1 am properly Iicencetl as a contractor untler SQ. FT. �+
J
the Steta of Callfornie Bualness entl Professions Code, Dlvlsion 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR m
Chapior 9, enC thet such Iicensas are i force entl effeci, or 1 THE PURPOSE OF ESTABLISHING A PERMIT EE O V: �
em exempt from Me Orovlsions of t�e tate of Califprnia Buslnecs a
antl Professl nsCotle, Oi s 3, Cha ter 9. VALUATION PERMIT FEE S O � ,�
� �
� PLAN CHECK E o
S{ nemre of
P¢ m(tte � �+ / TAX E � �
U
Authorizatl�Rpont TOTA�PAID $ v� �